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Merkin AG, Akinfieva SS, Martyushev-Poklad AV, Beloskurskaya OP, Dinov EN, Ostrovsky SL, Komarov AN, Zakharova OY, Kazhin VA, Nikiforov IA, Glover M. Anxiety: phenomenology, epidemiology, and risk factors during the novel coronavirus SARS-CoV-2 (COVID-19) pandemic. NEUROLOGY, NEUROPSYCHIATRY, PSYCHOSOMATICS 2021. [DOI: 10.14412/2074-2711-2021-1-107-112] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The COVID-19 coronavirus pandemic in 2020 led to significant negative social consequences associated inter alia with adverse effects on mental health. One of the most common mental illness is anxiety disorders, the rise in which is characteristic of social upheaval periods. This paper analyzes the problem of anxiety, reviews information on the epidemiology of anxiety, on the factors and mechanisms of its development. It unveils the association of anxiety with addictive disorders, lifestyle factors, and traumatic childhood experience and highlights the problem of increased anxiety in the context of the novel coronavirus COVID-19 pandemics in Russia.
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Affiliation(s)
- A. G. Merkin
- Federal Research and Clinical Center of Specialized Types of Medical Care and Medical Technologies, Federal Biomedical Agency of Russia; Centre for Precise Psychiatry and Neurosciences
| | - S. S. Akinfieva
- Doverie (Trust) National Center for Social Support and Rehabilitation Technologies
| | | | | | - E. N. Dinov
- Peoples' Friendship University of Russia (RUDN University)
| | | | - A. N. Komarov
- Doverie (Trust) National Center for Social Support and Rehabilitation Technologies
| | - O. Yu. Zakharova
- Russian Presidential Academy of National Economy and Public Administration
| | | | - I. A. Nikiforov
- Federal Research and Clinical Center of Specialized Types of Medical Care and Medical Technologies, Federal Biomedical Agency of Russia
| | - M. Glover
- Centre of Research Excellence: Indigenous Sovereignty & Smoking
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202
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Haryalchi K, Heidarzadeh A, Abedinzade M, Olangian-Tehrani S, Ghazanfar Tehran S. The Importance of Happy Hypoxemia in COVID-19. Anesth Pain Med 2021; 11:e111872. [PMID: 34221943 PMCID: PMC8239260 DOI: 10.5812/aapm.111872] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/14/2021] [Accepted: 01/15/2021] [Indexed: 12/20/2022] Open
Abstract
Background Nowadays, the new coronavirus (SARS-CoV-2) and its complications are one of the main concerns of the world. One of the most severe complications of COVID-19 is hypoxemia. Objectives This study aimed to assess the importance of happy hypoxemia in COVID-19. Methods We systematically searched web of science, PubMed, and Google scholar databases to find articles related to COVID-19 and happy hypoxemia. Results COVID-19 causes a type of hypoxemia named silent (happy) hypoxemia, which has an atypical clinical presentation. This type of hypoxemia has not been noted before in viral pneumonia, and there is no specific treatment for this serious complication. Patients with silent hypoxemia may develop severe hypoxemia without dyspnea and with near-normal lung compliance. These patients are awake, calm, and responsive. Although their lungs are not oxygenated efficiently, they are alert and cooperative. Their condition may be deteriorated rapidly without warning and causes death. Conclusions According to the findings, paying attention to happy hypoxemia is important for improving the health status of COVID-19 patients.
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Affiliation(s)
- Katayoun Haryalchi
- Anesthesiology Research Center, Department of Anesthesiology, Alzahra Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Abtin Heidarzadeh
- Department of Community Medicine, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Mahmood Abedinzade
- Department of Operating Room, Langroud School of Allied Medical Sciences, Guilan University of Medical Sciences, Rasht, Iran
| | - Sepehr Olangian-Tehrani
- Student Research committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Samaneh Ghazanfar Tehran
- Anesthesiology Research Center, Department of Anesthesiology, Alzahra Hospital, Guilan University of Medical Sciences, Rasht, Iran
- Corresponding Author: Anesthesiology Research Center, Department of Anesthesiology, Alzahra Hospital, Guilan University of Medical Sciences, Rasht, Iran.
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203
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Horwitz LI, Jones SA, Cerfolio RJ, Francois F, Greco J, Rudy B, Petrilli CM. Trends in COVID-19 Risk-Adjusted Mortality Rates. J Hosp Med 2021; 16:90-92. [PMID: 33147129 DOI: 10.12788/jhm.3552] [Citation(s) in RCA: 149] [Impact Index Per Article: 49.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 10/21/2020] [Indexed: 12/18/2022]
Abstract
Early reports showed high mortality from coronavirus disease 2019 (COVID-19). Mortality rates have recently been lower, raising hope that treatments have improved. However, patients are also now younger, with fewer comorbidities. We explored whether hospital mortality was associated with changing demographics at a 3-hospital academic health system in New York. We examined in-hospital mortality or discharge to hospice from March through August 2020, adjusted for demographic and clinical factors, including comorbidities, admission vital signs, and laboratory results. Among 5,121 hospitalizations, adjusted mortality dropped from 25.6% (95% CI, 23.2-28.1) in March to 7.6% (95% CI, 2.5-17.8) in August. The standardized mortality ratio dropped from 1.26 (95% CI, 1.15-1.39) in March to 0.38 (95% CI, 0.12-0.88) in August, at which time the average probability of death (average marginal effect) was 18.2 percentage points lower than in March. Data from one health system suggest that mortality from COVID-19 is decreasing even after accounting for patient characteristics.
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Affiliation(s)
- Leora I Horwitz
- Center for Healthcare Innovation and Delivery Science, NYU Langone Health, New York, New York
- Department of Population Health, NYU Grossman School of Medicine, New York, New York
- Department of Medicine, NYU Grossman School of Medicine, New York, New York
| | - Simon A Jones
- Center for Healthcare Innovation and Delivery Science, NYU Langone Health, New York, New York
- Department of Population Health, NYU Grossman School of Medicine, New York, New York
| | - Robert J Cerfolio
- Department of Surgery, NYU Grossman School of Medicine, New York, New York
| | - Fritz Francois
- Department of Medicine, NYU Grossman School of Medicine, New York, New York
| | | | - Bret Rudy
- Department of Pediatrics, NYU Grossman School of Medicine, New York, New York
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204
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Rabbani G, Shariful Islam SM, Rahman MA, Amin N, Marzan B, Robin RC, Alif SM. Pre-existing COPD is associated with an increased risk of mortality and severity in COVID-19: a rapid systematic review and meta-analysis. Expert Rev Respir Med 2021; 15:705-716. [DOI: 10.1080/17476348.2021.1866547] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Golam Rabbani
- Bangladesh Betar (Radio), Ministry of Information, Dhaka, Bangladesh
| | | | - Muhammad Aziz Rahman
- School of Health, Federation University Australia, Berwick, Australia
- Australian Institute of Primary Care and Ageing, La Trobe University, Melbourne, Australia
| | - Nuhu Amin
- Infectious Diseases Division, International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Bushra Marzan
- School of Public Health, Guangxi Medical University, Nanning, China
| | | | - Sheikh M. Alif
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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205
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Gómez Antúnez M, Muiño Míguez A, Bendala Estrada AD, Maestro de la Calle G, Monge Monge D, Boixeda R, Ena J, Mella Pérez C, Anton Santos JM, Lumbreras Bermejo C. Clinical Characteristics and Prognosis of COPD Patients Hospitalized with SARS-CoV-2. Int J Chron Obstruct Pulmon Dis 2021; 15:3433-3445. [PMID: 33447021 PMCID: PMC7801905 DOI: 10.2147/copd.s276692] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 10/26/2020] [Indexed: 01/08/2023] Open
Abstract
Objective To describe the characteristics and prognosis of patients with COPD admitted to the hospital due to SARS-CoV-2 infection. Methods The SEMI-COVID registry is an ongoing retrospective cohort comprising consecutive COVID-19 patients hospitalized in Spain since the beginning of the pandemic in March 2020. Data on demographics, clinical characteristics, comorbidities, laboratory tests, radiology, treatment, and progress are collected. Patients with COPD were selected and compared to patients without COPD. Factors associated with a poor prognosis were analyzed. Results Of the 10,420 patients included in the SEMI-COVID registry as of May 21, 2020, 746 (7.16%) had a diagnosis of COPD. Patients with COPD are older than those without COPD (77 years vs 68 years) and more frequently male. They have more comorbidities (hypertension, hyperlipidemia, diabetes mellitus, atrial fibrillation, heart failure, ischemic heart disease, peripheral vascular disease, kidney failure) and a higher Charlson Comorbidity Index (2 vs 1, p<0.001). The mortality rate in COPD patients was 38.3% compared to 19.2% in patients without COPD (p<0.001). Male sex, a history of hypertension, heart failure, moderate-severe chronic kidney disease, presence of cerebrovascular disease with sequelae, degenerative neurological disease, dementia, functional dependence, and a higher Charlson Comorbidity Index have been associated with increased mortality due to COVID-19 in COPD patients. Survival was higher among patients with COPD who were treated with hydroxychloroquine (87.1% vs 74.9%, p<0.001) and with macrolides (57.9% vs 50%, p<0.037). Neither prone positioning nor non-invasive mechanical ventilation, high-flow nasal cannula, or invasive mechanical ventilation were associated with a better prognosis. Conclusion COPD patients admitted to the hospital with SARS-CoV-2 infection have more severe disease and a worse prognosis than non-COPD patients.
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Affiliation(s)
- María Gómez Antúnez
- Internal Medicine Department, Gregorio Marañón University Hospital, Madrid, Spain
| | - Antonio Muiño Míguez
- Internal Medicine Department, Gregorio Marañón University Hospital, Madrid, Spain
| | | | | | | | - Ramón Boixeda
- Internal Medicine Department, Mataró Hospital, Mataró, Barcelona, Spain
| | - Javier Ena
- Internal Medicine Department, Marina Baixa Hospital, Villajoyosa, Alicante, Spain
| | - Carmen Mella Pérez
- Internal Medicine Department, Ferrol University Hospital Complex, Ferrol, A Coruña, Spain
| | | | | | - On behalf of the SEMI-COVID-19 Network
- Internal Medicine Department, Gregorio Marañón University Hospital, Madrid, Spain
- Internal Medicine Department, 12 de Octubre University Hospital, Madrid, Spain
- Internal Medicine Department, Segovia Hospital Complex, Segovia, Spain
- Internal Medicine Department, Mataró Hospital, Mataró, Barcelona, Spain
- Internal Medicine Department, Marina Baixa Hospital, Villajoyosa, Alicante, Spain
- Internal Medicine Department, Ferrol University Hospital Complex, Ferrol, A Coruña, Spain
- Internal Medicine Department, Infanta Cristina University Hospital, Parla, Madrid, Spain
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206
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Dementia is a predictor for mortality outcome from coronavirus disease 2019 (COVID-19) infection. Eur Arch Psychiatry Clin Neurosci 2021; 271:393-395. [PMID: 33104903 PMCID: PMC7586198 DOI: 10.1007/s00406-020-01205-z] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 10/14/2020] [Indexed: 01/08/2023]
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207
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Individual and community-level risk for COVID-19 mortality in the United States. Nat Med 2020; 27:264-269. [PMID: 33311702 DOI: 10.1038/s41591-020-01191-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 11/24/2020] [Indexed: 02/08/2023]
Abstract
Reducing COVID-19 burden for populations will require equitable and effective risk-based allocations of scarce preventive resources, including vaccinations1. To aid in this effort, we developed a general population risk calculator for COVID-19 mortality based on various sociodemographic factors and pre-existing conditions for the US population, combining information from the UK-based OpenSAFELY study with mortality rates by age and ethnicity across US states. We tailored the tool to produce absolute risk estimates in future time frames by incorporating information on pandemic dynamics at the community level. We applied the model to data on risk factor distribution from a variety of sources to project risk for the general adult population across 477 US cities and for the Medicare population aged 65 years and older across 3,113 US counties, respectively. Validation analyses using 54,444 deaths from 7 June to 1 October 2020 show that the model is well calibrated for the US population. Projections show that the model can identify relatively small fractions of the population (for example 4.3%) that might experience a disproportionately large number of deaths (for example 48.7%), but there is wide variation in risk across communities. We provide a web-based risk calculator and interactive maps for viewing community-level risks.
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208
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Zhang P. Comment on the review entitled "Risk factors for mortality in patients with Coronavirus disease 2019 (COVID-19) infection: a systematic review and meta-analysis of observational studies". Aging Male 2020; 23:1527. [PMID: 33016165 DOI: 10.1080/13685538.2020.1825667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Peng Zhang
- Department of Urology, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan, China
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209
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Mary A, Hénaut L, Macq PY, Badoux L, Cappe A, Porée T, Eckes M, Dupont H, Brazier M. Rationale for COVID-19 Treatment by Nebulized Interferon-β-1b-Literature Review and Personal Preliminary Experience. Front Pharmacol 2020; 11:592543. [PMID: 33329000 PMCID: PMC7734101 DOI: 10.3389/fphar.2020.592543] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 10/19/2020] [Indexed: 12/15/2022] Open
Abstract
The inflammatory response to COVID-19 is specifically associated with an impaired type I interferon (IFN) response and complete blockade of IFN-β secretion. Clinically, nebulization of IFN-α-2b has been historically used in China to treat viral pneumonia associated with SARS-CoV. Very recent data show that the use of inhaled type I IFN is associated with decreased mortality in Chinese COVID-19 patients. However, IFN nebulization is currently not standard in Europe and the United States. Therefore, our group has set up a project aimed to evaluate the possibility to nebulize IFN-β-1b (a drug currently used in Europe to treat multiple sclerosis via subcutaneous injections) and to assess the safety of this new mode of administration in SARS-CoV-2 infected patients. We present here literature data that allowed us to build our hypothesis and to develop collaboration between clinical pharmacists, intensivists and nebulization engineers in order to gain first pre-clinical and clinical experience of IFN-β-1b nebulization. After validation of the nebulization method and verification of droplet size compatible with nebulization, the method has been applied to four intensive care patients treated at our university hospital, for whom none of the COVID-19 therapies initially used in France led to significant clinical improvement. All patients exhibited negative viral carriage and experienced clinical improvement 7-16 days after having initiated nebulized IFN-β-1b inhalation therapy. No side effects were observed. All patients were alive within a 90-days follow-up. Although it is not possible to draw firm conclusions on treatment efficacy based on this case report, our study shows that pulmonary IFN-β-1b administration is feasible, with a good safety profile. This procedure, which presents the advantage of directly targeting the lungs and reducing the risks of systemic side effects, may represent a promising therapeutic strategy for the care of patients with severe COVID-19. However, our preliminary observation requires confirmation by randomized controlled trials.
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Affiliation(s)
- Aurélien Mary
- Clinical Critical Care Pharmacy Department, Amiens-Picardie University Hospital, Amiens, France
- UR UPJV 7517, MP3CV, CURS, University of Picardie Jules Verne, Amiens, France
| | - Lucie Hénaut
- UR UPJV 7517, MP3CV, CURS, University of Picardie Jules Verne, Amiens, France
| | - Pierre Yves Macq
- Surgical Critical Care Department, Amiens-Picardie University Hospital, Amiens, France
| | - Louise Badoux
- Surgical Critical Care Department, Amiens-Picardie University Hospital, Amiens, France
| | - Arnaud Cappe
- Clinical Critical Care Pharmacy Department, Amiens-Picardie University Hospital, Amiens, France
| | | | | | - Hervé Dupont
- UR UPJV 7517, MP3CV, CURS, University of Picardie Jules Verne, Amiens, France
- Surgical Critical Care Department, Amiens-Picardie University Hospital, Amiens, France
| | - Michel Brazier
- UR UPJV 7517, MP3CV, CURS, University of Picardie Jules Verne, Amiens, France
- Department of Biochemistry, Amiens-Picardie University Hospital, Amiens, France
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210
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Lee SG, Park GU, Moon YR, Sung K. Clinical Characteristics and Risk Factors for Fatality and Severity in Patients with Coronavirus Disease in Korea: A Nationwide Population-Based Retrospective Study Using the Korean Health Insurance Review and Assessment Service (HIRA) Database. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228559. [PMID: 33218161 PMCID: PMC7698934 DOI: 10.3390/ijerph17228559] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/13/2020] [Accepted: 11/14/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND We aimed to investigate the clinical characteristics and risk factors for fatality and severity in these patients. METHODS In this nationwide population-based retrospective study, we investigated the data of 7339 laboratory-confirmed COVID-19 patients, aged ≥ 18 years, using the Korean Health Insurance Review and Assessment Service (HIRA) database. Comorbidities and medications used were identified using HIRA codes, and severe COVID-19 was defined as that requiring oxygen therapy, mechanical ventilator, cardiopulmonary resuscitation, or extracorporeal membrane oxygenation. The outcomes were death due to COVID-19 and COVID-19 severity. RESULTS Mean patient age was 47.1 years; 2970 (40.1%) patients were male. Lopinavir/ritonavir, hydroxychloroquine, antibiotics, ribavirin, oseltamivir, and interferon were administered to 35.8%, 28.4%, 38.1%, 0.1%, 0.3%, and 0.9% of patients, respectively. After adjusting for confounding factors, diabetes mellitus, chronic kidney disease, previous history of pneumonia, aging, and male were significantly associated with increased risk of death and severe disease. No medication was associated with a reduced risk of fatality and disease severity. CONCLUSIONS We found several risk factors for fatality and severity in COVID-19 patients. As the drugs currently used for COVID-19 treatment have not shown significant efficacy, all efforts should be made to develop effective therapeutic modalities for COVID-19.
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Affiliation(s)
- Seung-Geun Lee
- Division of Rheumatology, Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Hospital, Busan 49241, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Korea
- Correspondence:
| | - Geun U. Park
- LINEWALKS Inc., Seoul 06235, Korea; (G.U.P.); (Y.R.M.); (K.S.)
| | - Yeo Rae Moon
- LINEWALKS Inc., Seoul 06235, Korea; (G.U.P.); (Y.R.M.); (K.S.)
| | - Kihoon Sung
- LINEWALKS Inc., Seoul 06235, Korea; (G.U.P.); (Y.R.M.); (K.S.)
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Abstract
OBJECTIVES The main aim of this study was to find the prevalence of mortality among hospitalized COVID-19 infected patients and associated risk factors for death. METHODS Three electronic databases including PubMed, Science Direct and Google Scholar were searched to identify relevant cohort studies of COVID-19 disease from January 1, 2020, to August 11, 2020. A random-effects model was used to calculate pooled prevalence rate (PR), risk ratio (RR) and 95% confidence interval (CI) for both effect measures. Cochrane chi-square test statistic Q, [Formula: see text], and [Formula: see text] tests were used to measure the presence of heterogeneity. Publication bias and sensitivity of the included studies were also tested. RESULTS In this meta-analysis, a total of 58 studies with 122,191 patients were analyzed. The pooled prevalence rate of mortality among the hospitalized COVID-19 patients was 18.88%, 95% CI (16.46-21.30), p < 0.001. Highest mortality was found in Europe [PR 26.85%, 95% CI (19.41-34.29), p < 0.001] followed by North America [PR 21.47%, 95% CI (16.27-26.68), p < 0.001] and Asia [PR 14.83%, 95% CI (12.46- 17.21), p < 0.001]. An significant association were found between mortality among COVID-19 infected patients and older age (> 65 years vs. < 65 years) [RR 3.59, 95% CI (1.87-6.90), p < 0.001], gender (male vs. female) [RR 1.63, 95% CI (1.43-1.87), p < 0.001], ICU admitted patients [RR 3.72, 95% CI (2.70-5.13), p < 0.001], obesity [RR 2.18, 95% CI (1.10-4.34), p < 0.05], hypertension [RR 2.08,95% CI (1.79-2.43) p < 0.001], diabetes [RR 1.87, 95% CI (1.23-2.84), p < 0.001], cardiovascular disease [RR 2.51, 95% CI (1.20-5.26), p < 0.05], and cancer [RR 2.31, 95% CI (1.80-2.97), p < 0.001]. In addition, significant association for high risk of mortality were also found for cerebrovascular disease, COPD, coronary heart disease, chronic renal disease, chronic liver disease, chronic lung disease and chronic kidney disease. CONCLUSION This meta-analysis revealed that the mortality rate among COVID-19 patients was highest in the European region and older age, gender, ICU patients, patients with comorbidity had a high risk for case fatality. Those findings would help the health care providers to reduce the mortality rate and combat this pandemic to save lives using limited resources.
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Alnajashi H, Jabbad R. Behavioral practices of patients with multiple sclerosis during Covid-19 pandemic. PLoS One 2020; 15:e0241103. [PMID: 33091088 PMCID: PMC7580932 DOI: 10.1371/journal.pone.0241103] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/08/2020] [Indexed: 12/22/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China, in late 2019 and Covid-19, a disease caused by SARS-CoV-2 became a pandemic in March 2020. As the pandemic still unfolds, uncertainty circles around the impact of SARS-CoV-2 infection on patients with chronic diseases, including autoimmune diseases such as multiple sclerosis (MS). To diminish the risk of SARS-CoV-2 infection and lessen the impact of the Covid-19 pandemic on the healthcare of MS patients, it is essential to understand knowledge, attitudes, and various behavioral practices related to Covid-19 among MS patients. Therefore, this study aimed to look at the behavioral practices related to Covid-19 among patients with MS. A total of 176 MS patients diagnosed at least one year before the survey were conveniently sampled online in Saudi Arabia and their data collected using a structured interview questionnaire in electronic Google form. We determined the reliability of the questionnaire by measuring its internal consistency in a pilot sample of 30 participants. Overall, more than 80% of participants had good knowledge and attitudes towards Covid-19. However, this did not correlate well with the impact on healthcare (r = 0.06). Our study revealed that 46% of participants were anxious about taking their medication, and 32% of participants missed their hospital appointments. Furthermore, 15% of the participants had a relapse but did not go to the hospital because of the pandemic, 15.9% stopped their DMTs, and 35.2% missed drug infusions or refills. Our study revealed overall good knowledge and attitudes related to Covid-19 among MS patients. However, the healthcare impact was considerable, as 32% of the participants missed their hospital appointments, and another 15% had a relapse. This highlights the significance of the impact of the Covid-19 pandemic on the healthcare of patients with MS. Measures to mitigate the effect of the pandemic on healthcare service delivery to patients with MS, such as telemedicine, should be strongly encouraged.
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Affiliation(s)
- Hind Alnajashi
- Neurology Division, Department of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Razan Jabbad
- Neurology Division, Department of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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213
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Goodall JW, Reed TAN, Ardissino M, Bassett P, Whittington AM, Cohen DL, Vaid N. Risk factors for severe disease in patients admitted with COVID-19 to a hospital in London, England: a retrospective cohort study. Epidemiol Infect 2020; 148:e251. [PMID: 33046155 PMCID: PMC7591271 DOI: 10.1017/s0950268820002472] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/25/2020] [Accepted: 10/02/2020] [Indexed: 12/14/2022] Open
Abstract
COVID-19 has caused a major global pandemic and necessitated unprecedented public health restrictions in almost every country. Understanding risk factors for severe disease in hospitalised patients is critical as the pandemic progresses. This observational cohort study aimed to characterise the independent associations between the clinical outcomes of hospitalised patients and their demographics, comorbidities, blood tests and bedside observations. All patients admitted to Northwick Park Hospital, London, UK between 12 March and 15 April 2020 with COVID-19 were retrospectively identified. The primary outcome was death. Associations were explored using Cox proportional hazards modelling. The study included 981 patients. The mortality rate was 36.0%. Age (adjusted hazard ratio (aHR) 1.53), respiratory disease (aHR 1.37), immunosuppression (aHR 2.23), respiratory rate (aHR 1.28), hypoxia (aHR 1.36), Glasgow Coma Scale <15 (aHR 1.92), urea (aHR 2.67), alkaline phosphatase (aHR 2.53), C-reactive protein (aHR 1.15), lactate (aHR 2.67), platelet count (aHR 0.77) and infiltrates on chest radiograph (aHR 1.89) were all associated with mortality. These important data will aid clinical risk stratification and provide direction for further research.
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Affiliation(s)
- J. W. Goodall
- Department of Infection, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK
| | - T. A. N. Reed
- Department of Acute Medicine, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK
| | - M. Ardissino
- Department of Infection, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK
| | | | - A. M. Whittington
- Department of Infection, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK
| | - D. L. Cohen
- Department of Acute Medicine, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK
| | - N. Vaid
- Department of Acute Medicine, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK
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Laosa O, Pedraza L, Álvarez-Bustos A, Carnicero JA, Rodriguez-Artalejo F, Rodriguez-Mañas L. Rapid Assessment at Hospital Admission of Mortality Risk From COVID-19: The Role of Functional Status. J Am Med Dir Assoc 2020; 21:1798-1802.e2. [PMID: 33160872 PMCID: PMC7543696 DOI: 10.1016/j.jamda.2020.10.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/29/2020] [Accepted: 10/04/2020] [Indexed: 12/15/2022]
Abstract
Objective To evaluate the role of functional status along with other used clinical factors on the occurrence of death in patients hospitalized with COVID-19. Design Prospective cohort study. Setting Public university hospital (Madrid). Participants and Methods A total of 375 consecutive patients with COVID-19 infection, admitted to a Public University Hospital (Madrid) between March 1 and March 31, 2020, were included in the Prospective Cohort study. Death was the main outcome. The main variable was disability in activities of daily living (ADL) assessed with the Barthel Index. Covariates included sex, age, severity index (Quick Sequential Organ Failure Assessment, qSOFA), polypharmacy (≥5 drugs in the month before admission), and comorbidity (≥3 diseases). Multivariable logistic regression was used to identify risk factors for adverse outcomes. Estimated model coefficients served to calculate the expected probability of death for a selected combination of 5 variables: Barthel Index, sex, age, comorbidities, and severity index (qSOFA). Results Mean age was 66 years (standard deviation 15.33), and there were 207 (55%) men. Seventy-four patients died (19.8%). Mortality was associated with low Barthel Index (odds ratio per 5-point decrease 1.11, 95% confidence interval 1.03-1.20), male sex (0.23, 0.11-0.47), age (1.07, 1.03-1.10), and comorbidity (2.15, 1.08-4.30) but not with qSOFA (1.29, 0.87-1.93) or polypharmacy (1.54, 0.77-3.08). Calculated mortality risk ranged from 0 to 0.78. Conclusions and Implications Functional status predicts death in hospitalized patients with COVID-19. Combination of 5 variables allows to predict individual probability of death. These findings provide useful information for the decision-making process and management of patients.
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Affiliation(s)
- Olga Laosa
- Centre of Network Biomedical Research on Frailty and Healthy Ageing (CIBERFES), Institute of Health Carlos III, Madrid, Spain; Institute of Biomedical Research, University Hospital of Getafe, Getafe, Madrid, Spain
| | - Laura Pedraza
- Institute of Biomedical Research, University Hospital of Getafe, Getafe, Madrid, Spain
| | | | - Jose A Carnicero
- Centre of Network Biomedical Research on Frailty and Healthy Ageing (CIBERFES), Institute of Health Carlos III, Madrid, Spain; Institute of Biomedical Research, University Hospital of Getafe, Getafe, Madrid, Spain
| | - Fernando Rodriguez-Artalejo
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain; IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Leocadio Rodriguez-Mañas
- Centre of Network Biomedical Research on Frailty and Healthy Ageing (CIBERFES), Institute of Health Carlos III, Madrid, Spain; Geriatrics Department, University Hospital of Getafe, Getafe, Madrid, Spain.
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Jani BD, Pell JP, McGagh D, Liyanage H, Kelly D, de Lusignan S, Weatherburn CJ, Burns R, Sullivan FM, Mair FS. Recording COVID-19 consultations: review of symptoms, risk factors, and proposed SNOMED CT terms. BJGP Open 2020; 4:bjgpopen20X101125. [PMID: 32843331 PMCID: PMC7606148 DOI: 10.3399/bjgpopen20x101125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 07/10/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND There is an urgent need for epidemiological research in primary care to develop risk assessment processes for patients presenting with COVID-19, but lack of a standardised approach to data collection is a significant barrier to implementation. AIM To collate a list of relevant symptoms, assessment items, demographics, and lifestyle and health conditions associated with COVID-19, and match these data items with corresponding SNOMED CT clinical terms to support the development and implementation of consultation templates. DESIGN & SETTING Published and preprint literature for systematic reviews, meta-analyses, and clinical guidelines describing the symptoms, assessment items, demographics, and/or lifestyle and health conditions associated with COVID-19 and its complications were reviewed. Corresponding clinical concepts from SNOMED CT, a widely used structured clinical vocabulary for electronic primary care health records, were identified. METHOD Guidelines and published and unpublished reviews (N = 61) were utilised to collate a list of relevant data items for COVID-19 consultations. The NHS Digital SNOMED CT Browser was used to identify concept and descriptive identifiers. Key implementation challenges were conceptualised through a Normalisation Process Theory (NPT) lens. RESULTS In total, 32 symptoms, eight demographic and lifestyle features, 25 health conditions, and 20 assessment items relevant to COVID-19 were identified, with proposed corresponding SNOMED CT concepts. These data items can be adapted into a consultation template for COVID-19. Key implementation challenges include: 1) engaging with key stakeholders to achieve 'buy in'; and 2) ensuring any template is usable within practice settings. CONCLUSION Consultation templates for COVID-19 are needed to standardise data collection, facilitate research and learning, and potentially improve quality of care for COVID-19.
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Affiliation(s)
- Bhautesh Dinesh Jani
- Clinical Senior Lecturer in General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Jill P Pell
- Henry Mechan Professor of Public Health, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Dylan McGagh
- Medical Sciences Divison, University of Oxford, Oxford, UK
| | - Harshana Liyanage
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Dave Kelly
- Albasoft Limited, Centre for Health Science, Inverness, UK
| | - Simon de Lusignan
- Professor of Primary Care and Clinical Informatics, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Ronnie Burns
- McKenzie Burns Practice, Parkhead Health Centre, Glasgow, UK
| | - Frank M Sullivan
- Professor of Primary Care Medicine, Medical School, University of St Andrews, St Andrews, UK
| | - Frances S Mair
- Norie Miller Professor of General Practice, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Bone AE, Finucane AM, Leniz J, Higginson IJ, Sleeman KE. Changing patterns of mortality during the COVID-19 pandemic: Population-based modelling to understand palliative care implications. Palliat Med 2020; 34:1193-1201. [PMID: 32706299 PMCID: PMC7385436 DOI: 10.1177/0269216320944810] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND COVID-19 has directly and indirectly caused high mortality worldwide. AIM To explore patterns of mortality during the COVID-19 pandemic and implications for palliative care, service planning and research. DESIGN Descriptive analysis and population-based modelling of routine data. PARTICIPANTS AND SETTING All deaths registered in England and Wales between 7 March and 15 May 2020. We described the following mortality categories by age, gender and place of death: (1) baseline deaths (deaths that would typically occur in a given period); (2) COVID-19 deaths and (3) additional deaths not directly attributed to COVID-19. We estimated the proportion of people who died from COVID-19 who might have been in their last year of life in the absence of the pandemic using simple modelling with explicit assumptions. RESULTS During the first 10 weeks of the pandemic, there were 101,614 baseline deaths, 41,105 COVID-19 deaths and 14,520 additional deaths. Deaths in care homes increased by 220%, while home and hospital deaths increased by 77% and 90%, respectively. Hospice deaths fell by 20%. Additional deaths were among older people (86% aged ⩾ 75 years), and most occurred in care homes (56%) and at home (43%). We estimate that 22% (13%-31%) of COVID-19 deaths occurred among people who might have been in their last year of life in the absence of the pandemic. CONCLUSION The COVID-19 pandemic has led to a surge in palliative care needs. Health and social care systems must ensure availability of palliative care to support people with severe COVID-19, particularly in care homes.
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Affiliation(s)
- Anna E Bone
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King’s College London, London, UK
| | - Anne M Finucane
- Marie Curie Hospice, Edinburgh, UK
- Usher Institute, Old Medical School, The University of Edinburgh, Edinburgh, UK
| | - Javiera Leniz
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King’s College London, London, UK
| | - Irene J Higginson
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King’s College London, London, UK
| | - Katherine E Sleeman
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King’s College London, London, UK
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Torres-Macho J, Ryan P, Valencia J, Pérez-Butragueño M, Jiménez E, Fontán-Vela M, Izquierdo-García E, Fernandez-Jimenez I, Álvaro-Alonso E, Lazaro A, Alvarado M, Notario H, Resino S, Velez-Serrano D, Meca A. The PANDEMYC Score. An Easily Applicable and Interpretable Model for Predicting Mortality Associated With COVID-19. J Clin Med 2020; 9:E3066. [PMID: 32977606 PMCID: PMC7598151 DOI: 10.3390/jcm9103066] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/09/2020] [Accepted: 09/17/2020] [Indexed: 11/24/2022] Open
Abstract
This study aimed to build an easily applicable prognostic model based on routine clinical, radiological, and laboratory data available at admission, to predict mortality in coronavirus 19 disease (COVID-19) hospitalized patients. METHODS We retrospectively collected clinical information from 1968 patients admitted to a hospital. We built a predictive score based on a logistic regression model in which explicative variables were discretized using classification trees that facilitated the identification of the optimal sections in order to predict inpatient mortality in patients admitted with COVID-19. These sections were translated into a score indicating the probability of a patient's death, thus making the results easy to interpret. RESULTS Median age was 67 years, 1104 patients (56.4%) were male, and 325 (16.5%) died during hospitalization. Our final model identified nine key features: age, oxygen saturation, smoking, serum creatinine, lymphocytes, hemoglobin, platelets, C-reactive protein, and sodium at admission. The discrimination of the model was excellent in the training, validation, and test samples (AUC: 0.865, 0.808, and 0.883, respectively). We constructed a prognostic scale to determine the probability of death associated with each score. CONCLUSIONS We designed an easily applicable predictive model for early identification of patients at high risk of death due to COVID-19 during hospitalization.
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Affiliation(s)
- Juan Torres-Macho
- University Hospital Infanta Leonor, 28031 Madrid, Spain; (J.T.-M.); (J.V.); (M.P.-B.); (E.J.); (M.F.-V.); (E.I.-G.); (I.F.-J.); (E.Á.-A.); (A.L.); (M.A.); (H.N.)
- Department of Mathematics, Complutense de Madrid University (UCM), 28040 Madrid, Spain;
| | - Pablo Ryan
- University Hospital Infanta Leonor, 28031 Madrid, Spain; (J.T.-M.); (J.V.); (M.P.-B.); (E.J.); (M.F.-V.); (E.I.-G.); (I.F.-J.); (E.Á.-A.); (A.L.); (M.A.); (H.N.)
- Department of Mathematics, Complutense de Madrid University (UCM), 28040 Madrid, Spain;
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), 28007 Madrid, Spain
| | - Jorge Valencia
- University Hospital Infanta Leonor, 28031 Madrid, Spain; (J.T.-M.); (J.V.); (M.P.-B.); (E.J.); (M.F.-V.); (E.I.-G.); (I.F.-J.); (E.Á.-A.); (A.L.); (M.A.); (H.N.)
| | - Mario Pérez-Butragueño
- University Hospital Infanta Leonor, 28031 Madrid, Spain; (J.T.-M.); (J.V.); (M.P.-B.); (E.J.); (M.F.-V.); (E.I.-G.); (I.F.-J.); (E.Á.-A.); (A.L.); (M.A.); (H.N.)
| | - Eva Jiménez
- University Hospital Infanta Leonor, 28031 Madrid, Spain; (J.T.-M.); (J.V.); (M.P.-B.); (E.J.); (M.F.-V.); (E.I.-G.); (I.F.-J.); (E.Á.-A.); (A.L.); (M.A.); (H.N.)
| | - Mario Fontán-Vela
- University Hospital Infanta Leonor, 28031 Madrid, Spain; (J.T.-M.); (J.V.); (M.P.-B.); (E.J.); (M.F.-V.); (E.I.-G.); (I.F.-J.); (E.Á.-A.); (A.L.); (M.A.); (H.N.)
| | - Elsa Izquierdo-García
- University Hospital Infanta Leonor, 28031 Madrid, Spain; (J.T.-M.); (J.V.); (M.P.-B.); (E.J.); (M.F.-V.); (E.I.-G.); (I.F.-J.); (E.Á.-A.); (A.L.); (M.A.); (H.N.)
| | - Inés Fernandez-Jimenez
- University Hospital Infanta Leonor, 28031 Madrid, Spain; (J.T.-M.); (J.V.); (M.P.-B.); (E.J.); (M.F.-V.); (E.I.-G.); (I.F.-J.); (E.Á.-A.); (A.L.); (M.A.); (H.N.)
| | - Elena Álvaro-Alonso
- University Hospital Infanta Leonor, 28031 Madrid, Spain; (J.T.-M.); (J.V.); (M.P.-B.); (E.J.); (M.F.-V.); (E.I.-G.); (I.F.-J.); (E.Á.-A.); (A.L.); (M.A.); (H.N.)
| | - Andrea Lazaro
- University Hospital Infanta Leonor, 28031 Madrid, Spain; (J.T.-M.); (J.V.); (M.P.-B.); (E.J.); (M.F.-V.); (E.I.-G.); (I.F.-J.); (E.Á.-A.); (A.L.); (M.A.); (H.N.)
| | - Marta Alvarado
- University Hospital Infanta Leonor, 28031 Madrid, Spain; (J.T.-M.); (J.V.); (M.P.-B.); (E.J.); (M.F.-V.); (E.I.-G.); (I.F.-J.); (E.Á.-A.); (A.L.); (M.A.); (H.N.)
| | - Helena Notario
- University Hospital Infanta Leonor, 28031 Madrid, Spain; (J.T.-M.); (J.V.); (M.P.-B.); (E.J.); (M.F.-V.); (E.I.-G.); (I.F.-J.); (E.Á.-A.); (A.L.); (M.A.); (H.N.)
| | - Salvador Resino
- Unidad de Infección Viral e Inmunidad, Instituto de Salud Carlos III, 28007 Madrid, Spain;
| | - Daniel Velez-Serrano
- Department of Mathematics, Complutense de Madrid University (UCM), 28040 Madrid, Spain;
| | - Alejandro Meca
- Department of Preventive Medicine & Public Health, Rey Juan Carlos University, 28933 Madrid, Spain;
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García-Villasante E, Baca-Carrasco V, Gutierrez-Ortiz C, Pinedo-Torres I. Diabetes care during COVID 19: Experience in telemedicine from a developing country. Diabetes Metab Syndr 2020; 14:1519. [PMID: 32795744 PMCID: PMC7399660 DOI: 10.1016/j.dsx.2020.07.046] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 07/27/2020] [Accepted: 07/28/2020] [Indexed: 11/16/2022]
Affiliation(s)
| | - Víctor Baca-Carrasco
- Universidad Nacional Mayor de San Marcos Facultad de Medicina de San Fernando Lima, Lima, Peru.
| | - Claudia Gutierrez-Ortiz
- Universidad Nacional Mayor de San Marcos Facultad de Medicina de San Fernando Lima, Lima, Peru.
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Korte W, Buljan M, Rösslein M, Wick P, Golubov V, Jentsch J, Reut M, Peier K, Nohynek B, Fischer A, Stolz R, Cettuzzi M, Nolte O. SARS-CoV-2 IgG and IgA antibody response is gender dependent; and IgG antibodies rapidly decline early on. J Infect 2020; 82:e11-e14. [PMID: 32853597 PMCID: PMC7445467 DOI: 10.1016/j.jinf.2020.08.032] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 08/22/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Wolfgang Korte
- Center for Laboratory Medicine, Frohbergstrasse 3, St. Gallen CH - 9000, Switzerland; Cantonal Corona Study Group, St. Gallen, Switzerland.
| | - Marija Buljan
- Empa - Swiss Federal Laboratories for Materials Science and Technology, St. Gallen, Switzerland; Cantonal Corona Study Group, St. Gallen, Switzerland
| | - Matthias Rösslein
- Empa - Swiss Federal Laboratories for Materials Science and Technology, St. Gallen, Switzerland; Cantonal Corona Study Group, St. Gallen, Switzerland
| | - Peter Wick
- Empa - Swiss Federal Laboratories for Materials Science and Technology, St. Gallen, Switzerland; Cantonal Corona Study Group, St. Gallen, Switzerland
| | - Valentina Golubov
- Center for Laboratory Medicine, Frohbergstrasse 3, St. Gallen CH - 9000, Switzerland
| | - Jana Jentsch
- Center for Laboratory Medicine, Frohbergstrasse 3, St. Gallen CH - 9000, Switzerland
| | - Michael Reut
- Center for Laboratory Medicine, Frohbergstrasse 3, St. Gallen CH - 9000, Switzerland
| | - Karen Peier
- Cantonal Corona Study Group, St. Gallen, Switzerland; Public Health Department, St. Gallen, Switzerland
| | | | - Aldo Fischer
- Cantonal Corona Study Group, St. Gallen, Switzerland
| | - Raphael Stolz
- Cantonal Corona Study Group, St. Gallen, Switzerland
| | | | - Oliver Nolte
- Center for Laboratory Medicine, Frohbergstrasse 3, St. Gallen CH - 9000, Switzerland; Cantonal Corona Study Group, St. Gallen, Switzerland
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Palma G, Pasqua T, Silvestri G, Rocca C, Gualtieri P, Barbieri A, De Bartolo A, De Lorenzo A, Angelone T, Avolio E, Botti G. PI3Kδ Inhibition as a Potential Therapeutic Target in COVID-19. Front Immunol 2020; 11:2094. [PMID: 32973818 PMCID: PMC7472874 DOI: 10.3389/fimmu.2020.02094] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 08/03/2020] [Indexed: 01/08/2023] Open
Abstract
The spread of the novel human respiratory coronavirus (SARS-CoV-2) is a global public health emergency. There is no known successful treatment as of this time, and there is a need for medical options to mitigate this current epidemic. SARS-CoV-2 uses the angiotensin-converting enzyme 2 (ACE2) receptor and is primarily trophic for the lower and upper respiratory tract. A number of current studies on COVID-19 have demonstrated the substantial increase in pro-inflammatory factors in the lungs during infection. The virus is also documented in the central nervous system and, particularly in the brainstem, which plays a key role in respiratory and cardiovascular function. Currently, there are few antiviral approaches, and several alternative drugs are under investigation. Two of these are Idelalisib and Ebastine, already proposed as preventive strategies in airways and allergic diseases. The interesting and evolving potential of phosphoinositide 3-kinase δ (PI3Kδ) inhibitors, together with Ebastine, lies in their ability to suppress the release of pro-inflammatory cytokines, such as IL-1β, IL-8, IL-6, and TNF-α, by T cells. This may represent an optional therapeutic choice for COVID-19 to reduce inflammatory reactions and mortality, enabling patients to recover faster. This concise communication aims to provide new potential therapeutic targets capable of mitigating and alleviating SARS-CoV-2 pandemic infection.
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Affiliation(s)
- Giuseppe Palma
- SSD Sperimentazione Animale, Istituto Nazionale Tumori Fondazione G. Pascale – IRCSS, Naples, Italy
| | - Teresa Pasqua
- Laboratory of Cellular and Molecular Cardiovascular Patho-Physiology, Department of Biology, Ecology and Earth Science, University of Calabria, Rende, Italy
| | - Giovannino Silvestri
- Institute of Human Virology, Division of Infectious Agents and Cancer, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Carmine Rocca
- Laboratory of Cellular and Molecular Cardiovascular Patho-Physiology, Department of Biology, Ecology and Earth Science, University of Calabria, Rende, Italy
| | - Paola Gualtieri
- School of Specialization in Food Science, University of Rome “Tor Vergata”, Rome, Italy
| | - Antonio Barbieri
- SSD Sperimentazione Animale, Istituto Nazionale Tumori Fondazione G. Pascale – IRCSS, Naples, Italy
| | - Anna De Bartolo
- Laboratory of Cellular and Molecular Cardiovascular Patho-Physiology, Department of Biology, Ecology and Earth Science, University of Calabria, Rende, Italy
| | - Antonino De Lorenzo
- Section of Clinical Nutrition and Nutrigenomics, Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy
| | - Tommaso Angelone
- Laboratory of Cellular and Molecular Cardiovascular Patho-Physiology, Department of Biology, Ecology and Earth Science, University of Calabria, Rende, Italy
- National Institute for Cardiovascular Research (INRC), Bologna, Italy
| | - Ennio Avolio
- School of Specialization in Food Science, University of Rome “Tor Vergata”, Rome, Italy
- Section of Clinical Nutrition and Nutrigenomics, Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy
| | - Gerardo Botti
- Scientific Director, Istituto Nazionale Tumori Fondazione G. Pascale – IRCSS, Naples, Italy
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Woolcott OO, Bergman RN. Mortality Attributed to COVID-19 in High-Altitude Populations. High Alt Med Biol 2020; 21:409-416. [PMID: 32815745 DOI: 10.1089/ham.2020.0098] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Woolcott, Orison O., and Richard N. Bergman. Mortality attributed to COVID-19 in high-altitude populations. High Alt Med Biol. 21:409-416, 2020. Background: Since partial oxygen pressure decreases as altitude increases, environmental hypoxia could worsen Coronavirus Disease 2019 (COVID-19) patient's hypoxemia. We compared COVID-19 mortality at different altitudes. Methods: Retrospective analysis of population-level data on COVID-19 deaths was conducted in the United States (1,016 counties) and Mexico (567 municipalities). Mixed-model Poisson regression analysis of the association between altitude and COVID-19 mortality was conducted using individual-level data from 40,168 Mexican subjects with COVID-19, adjusting for multiple covariates. Results: Between January 20 and April 13, 2020, mortality rates were higher in U.S. counties located at ≥2,000 m elevation versus those located <1,500 m (12.3 vs. 3.2 per 100,000; p < 0.001). In Mexico, between March 13 and May 13, 2020, mortality rates were higher in municipalities located at ≥2,000 m versus those located <1,500 m (5.3 vs. 3.9 per 100,000; p < 0.001). Among Mexican subjects younger than 65 years, the risk of death was 36% higher in those living at ≥2,000 m versus those living at <1,500 m (adjusted incidence rate ratio [IRR]: 1.36; confidence interval [95% CI], 1.05-1.78; p = 0.022). Among Mexican men, the risk of death was 31% higher at ≥2,000 m versus that at <1,500 m (adjusted IRR: 1.31; 95% CI, 1.03-1.66; p = 0.025). No association between altitude and COVID-19 mortality was found among Mexican women or among Mexican subjects 65 years of age and older. Conclusions: Altitude is associated with COVID-19 mortality in men younger than 65 years.
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Affiliation(s)
- Orison O Woolcott
- Sports Spectacular Diabetes and Obesity Wellness and Research Center, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Richard N Bergman
- Sports Spectacular Diabetes and Obesity Wellness and Research Center, Cedars-Sinai Medical Center, Los Angeles, California, USA
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Shi L, Wang Y, Liang X, Xiao W, Duan G, Yang H, Wang Y. Is neutrophilia associated with mortality in COVID-19 patients? A meta-analysis and meta-regression. Int J Lab Hematol 2020; 42:e244-e247. [PMID: 32779881 PMCID: PMC7405099 DOI: 10.1111/ijlh.13298] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 06/30/2020] [Accepted: 07/05/2020] [Indexed: 12/29/2022]
Affiliation(s)
- Li Shi
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Ying Wang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xuan Liang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Wenwei Xiao
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Guangcai Duan
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Haiyan Yang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yadong Wang
- Department of Toxicology, Henan Center for Disease Control and Prevention, Zhengzhou, China
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Salomaa S, Bouffler SD, Atkinson MJ, Cardis E, Hamada N. Is there any supportive evidence for low dose radiotherapy for COVID-19 pneumonia? Int J Radiat Biol 2020; 96:1228-1235. [DOI: 10.1080/09553002.2020.1786609] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Sisko Salomaa
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
- STUK-Radiation and Nuclear Safety Authority, Helsinki, Finland
| | - Simon D. Bouffler
- Public Health England Centre for Radiation, Chemical and Environmental Hazards, Didcot, UK
| | - Michael J. Atkinson
- Institute of Radiation Biology, Helmholtz-Center Munich, National Research Centre for Health and Environment, Neuherberg, Germany
| | - Elisabeth Cardis
- Campus Mar, Barcelona Biomedical Research Park (PRBB), Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- University Pompeu Fabra, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Madrid, Spain
| | - Nobuyuki Hamada
- Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), Komae, Japan
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Alsufyani HA, Docherty JR. The renin angiotensin aldosterone system and COVID-19. Saudi Pharm J 2020; 28:977-984. [PMID: 32788834 PMCID: PMC7332203 DOI: 10.1016/j.jsps.2020.06.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 06/26/2020] [Indexed: 12/12/2022] Open
Abstract
The ongoing pandemic has stimulated study of the Renin Angiotensin Aldosterone System (RAAS), and how it can be manipulated to treat COVID-19. Studies are examining whether drugs that act on the RAAS system might be useful to treat COVID-19. COVID-19 and the RAAS are closely linked both in infection and in possible post-infection inflammatory cascades. We detail the Physiology and Pharmacology of the RAAS including the effects of aldosterone and atrial natriuretic peptide. It is appropriate that the theoretical benefits of modulation of the RAAS should be considered based on available knowledge of the complexity of the system. In this short review we have tried to explain the actions of the angiotensin family of peptides and produce a relatively simple model and diagrammatic summary of the RAAS and the possible sites of intervention.
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Affiliation(s)
- Hadeel A Alsufyani
- Department of Physiology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - James R Docherty
- Department of Physiology, Royal College of Surgeons in Ireland, 123, St. Stephen's Green, Dublin 2, Ireland
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Baldacchino A, Radfar SR, De Jong C, Rafei P, Yunesian M, Gerra G, Brady K, Ebrahimi M, Vahidi M, Khojasteh Zonoozi A, Mohaddes Ardabili H, Busse A, Saenz E, Campello G, Niaz K, Ekhtiari H, Farhoudian A. COVID-19 and Substance Use Disorder: Study Protocol for the International Society of Addiction Medicine Practice and Policy Interest Group Global Survey. Basic Clin Neurosci 2020; 11:155-162. [PMID: 32855774 PMCID: PMC7368101 DOI: 10.32598/bcn.11.covid19.2545.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 04/06/2020] [Accepted: 04/09/2020] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION As one of the major health problems in the present century, the COVID-19 pandemic affected all parts of the global communities and the health of substance users are potentially at a greater risk of harm. This global study has been designed and conducted by the International Society of Addiction Medicine Practice and Policy Interest Group (ISAM-PPIG) to understand better the health related issues of people with Substance Use Disorders (SUD) as well as responses of the relevant health care systems during the pandemic. METHODS This is a cross-sectional study using convenient sampling. The data gathering was carried out with two follow-up stages each two months apart through an online conducted survey prepared using Google platform. The survey started by emergence of COVID-19 as a pandemic in March 2020 and respondents were followed till September 2020 when most of the initial lockdowns by most countries are supposed to be reopened. ETHICS AND DISSEMINATION The study was approved by the ethics committee of University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. The results will be published in relevant peer reviewing journals and communicated with different international stakeholders.
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Affiliation(s)
- Alexander Baldacchino
- Division of Population and Behavioral Sciences, St Andrews University Medical School, University of St Andrews, UK
| | - Seyed Ramin Radfar
- Integrated Substance Abuse Programs, University of California, Los Angeles, CA, USA
| | - Cornelis De Jong
- Behavioral Science Institute, Radboud University, The Netherlands
| | - Parnian Rafei
- Faculty of Psychology and Education, University of Tehran, Tehran, Iran
| | - Masud Yunesian
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical sciences, Tehran, Iran
| | - Gilberto Gerra
- Drug Prevention and Health Branch, Division for Operations, United Nations Office on Drugs and Crime, Vienna, Austria
| | - Kathleen Brady
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, USA
| | - Mohsen Ebrahimi
- Department of Semiconductors, Materials and Energy Research Center (MERC), Tehran, Iran
| | - Mehrnoosh Vahidi
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Khojasteh Zonoozi
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Mohaddes Ardabili
- Psychiatry and Behavioral Sciences Research Center, Ibn-e-Sina Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Anja Busse
- Prevention, Treatment and Rehabilitation Section; Drug Prevention and Health Branch, Division for Operations, United Nations Office on Drugs and Crime, Vienna, Austria
| | - Elizabeth Saenz
- Prevention, Treatment and Rehabilitation Section; Drug Prevention and Health Branch, Division for Operations, United Nations Office on Drugs and Crime, Vienna, Austria
| | - Giovanna Campello
- Prevention, Treatment and Rehabilitation Section; Drug Prevention and Health Branch, Division for Operations, United Nations Office on Drugs and Crime, Vienna, Austria
| | - Kamran Niaz
- Research and Trend Analysis Branch, Division for Policy Affairs, United Nations Office on Drugs and Crime, Vienna, Austria
| | - Hamed Ekhtiari
- Laureate Institute for Brain Research, Tulsa, Oklahoma, USA
| | - Ali Farhoudian
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran; Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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de Moura DTH, Proença IM, McCarty TR, Sagae VMT, Ribeiro IB, de Oliveira GHP, de Souza GMV, Hirsch BS, Scatimburgo MVCV, Thompson CC, Carrilho FJ, Cecconello I, de Moura EGH. Gastrointestinal Manifestations and Associated Health Outcomes of COVID-19: A Brazilian Experience From the Largest South American Public Hospital. Clinics (Sao Paulo) 2020; 75:e2271. [PMID: 33146362 PMCID: PMC7561063 DOI: 10.6061/clinics/2020/e2271] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 08/26/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Brazil has rapidly developed the second-highest number of COVID-19 cases in the world. As such, proper symptom identification, including gastrointestinal manifestations, and relationship to health outcomes remains key. We aimed to assess the prevalence and impact of gastrointestinal symptoms associated with COVID-19 in a large quaternary referral center in South America. METHODS This was a single-center cohort study in a COVID-19 specific hospital in São Paulo, Brazil. Consecutive adult patients with laboratory confirmed SARS-CoV-2 were included. Baseline patient history, presenting symptoms, laboratory results, and clinically relevant outcomes were recorded. Regression analyses were performed to determine significant predictors of the gastrointestinal manifestations of COVID-19 and hospitalization outcomes. RESULTS Four-hundred patients with COVID-19 were included. Of these, 33.25% of patients reported ≥1 gastrointestinal symptom. Diarrhea was the most common gastrointestinal symptom (17.25%). Patients with gastrointestinal symptoms had higher rates of concomitant constitutional symptoms, notably fatigue and myalgia (p<0.05). Gastrointestinal symptoms were also more prevalent among patients on chronic immunosuppressants, ACE/ARB medications, and patient with chronic kidney disease (p<0.05). Laboratory results, length of hospitalization, ICU admission, ICU length of stay, need for mechanical ventilation, vasopressor support, and in-hospital mortality did not differ based upon gastrointestinal symptoms (p>0.05). Regression analyses showed older age [OR 1.04 (95% CI, 1.02-1.06)], male gender [OR 1.94 (95% CI, 1.12-3.36)], and immunosuppression [OR 2.60 (95% CI, 1.20-5.63)], were associated with increased mortality. CONCLUSION Based upon this Brazilian study, gastrointestinal manifestations of COVID-19 are common but do not appear to impact clinically relevant hospitalization outcomes including the need for ICU admission, mechanical ventilation, or mortality.
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Affiliation(s)
- Diogo Turiani Hourneaux de Moura
- Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil
- Brigham and Women’s Hospital - Harvard Medical School, Boston 02115, MA, United States
| | - Igor Mendonça Proença
- Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil
| | - Thomas R. McCarty
- Brigham and Women’s Hospital - Harvard Medical School, Boston 02115, MA, United States
| | | | - Igor Braga Ribeiro
- Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil
- *Corresponding author. E-mail: /
| | | | | | - Bruno Salomão Hirsch
- Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil
| | | | | | - Flair José Carrilho
- Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil
| | - Ivan Cecconello
- Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil
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