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de Miranda DAP, Gomes SVC, Filgueiras PS, Corsini CA, Almeida NBF, Silva RA, Medeiros MIVARC, Vilela RVR, Fernandes GR, Grenfell RFQ. Long COVID-19 syndrome: a 14-months longitudinal study during the two first epidemic peaks in Southeast Brazil. Trans R Soc Trop Med Hyg 2022; 116:1007-1014. [PMID: 35514142 DOI: 10.1093/trstmh/trac030] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/11/2022] [Accepted: 03/21/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND A growing number of long COVID cases after infection have been reported. By definition, long COVID is the condition whereby affected individuals do not recover for several weeks or months following the onset of symptoms suggestive of COVID-19, the profile and timeline of which remains uncertain. METHODS In this work, in-home, outpatient and hospitalized COVID-19 positive patients were monitored for up to 14 mo to establish the prevalence of long COVID symptoms and their correlation with age, pre-existing comorbidities and course of acute infection. The longitudinal study included 646 positive patients who were monitored once a month. RESULTS From the whole population, 50.2% presented with long COVID syndrome. Twenty-three different symptoms were reported. Most frequent were fatigue (35.6%), persistent cough (34.0%), dyspnea (26.5%), loss of smell/taste (20.1%) and frequent headaches (17.3%). Mental disorders (20.7%), change in blood pressure (7.4%) and thrombosis (6.2%) were also reported. Most patients presented with 2-3 symptoms at the same time. Long COVID started after mild, moderate and severe infection in 60, 13 and 27% of cases, respectively, and it was not restricted to specific age groups. CONCLUSIONS Older patients tended to have more severe symptoms, leading to a longer post-COVID-19 period. The presence of seven comorbidities was correlated with the severity of infection, and severity itself was the main factor that determined the duration of symptoms in long COVID cases.
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Affiliation(s)
- Daniel A P de Miranda
- Diagnosis and Therapy of Infectious Diseases and Cancer, Oswaldo Cruz Foundation (Fiocruz), 1715 Augusto de Lima Avenue, Belo Horizonte, Minas Gerais 30190-002, Brazil
| | - Sarah V C Gomes
- Diagnosis and Therapy of Infectious Diseases and Cancer, Oswaldo Cruz Foundation (Fiocruz), 1715 Augusto de Lima Avenue, Belo Horizonte, Minas Gerais 30190-002, Brazil
| | - Priscilla S Filgueiras
- Diagnosis and Therapy of Infectious Diseases and Cancer, Oswaldo Cruz Foundation (Fiocruz), 1715 Augusto de Lima Avenue, Belo Horizonte, Minas Gerais 30190-002, Brazil.,Institute of Biological Sciences, Federal University of Minas Gerais, 6627 Presidente Antônio Carlos Avenue, Belo Horizonte, Minas Gerais 31270-901, Brazil
| | - Camila A Corsini
- Diagnosis and Therapy of Infectious Diseases and Cancer, Oswaldo Cruz Foundation (Fiocruz), 1715 Augusto de Lima Avenue, Belo Horizonte, Minas Gerais 30190-002, Brazil
| | - Nathalie B F Almeida
- Diagnosis and Therapy of Infectious Diseases and Cancer, Oswaldo Cruz Foundation (Fiocruz), 1715 Augusto de Lima Avenue, Belo Horizonte, Minas Gerais 30190-002, Brazil.,Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, 501 D. W. Brooks Drive, Athens, Georgia 30602-7387, USA
| | - Raphael A Silva
- Hospital da Baleia, Benjamin Guimarães Foundation. 1464 Juramento Street, Belo Horizonte, Minas Gerais 30285-408, Brazil
| | | | - Raquel V R Vilela
- Hospital da Baleia, Benjamin Guimarães Foundation. 1464 Juramento Street, Belo Horizonte, Minas Gerais 30285-408, Brazil
| | - Gabriel R Fernandes
- Biosyst ems Informatics, Oswaldo Cruz Foundation (Fiocruz), 1715 Augusto de Lima Avenue, Belo Horizonte, Minas Gerais 30190-002, Brazil
| | - Rafaella F Q Grenfell
- Diagnosis and Therapy of Infectious Diseases and Cancer, Oswaldo Cruz Foundation (Fiocruz), 1715 Augusto de Lima Avenue, Belo Horizonte, Minas Gerais 30190-002, Brazil.,Institute of Biological Sciences, Federal University of Minas Gerais, 6627 Presidente Antônio Carlos Avenue, Belo Horizonte, Minas Gerais 31270-901, Brazil.,Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, 501 D. W. Brooks Drive, Athens, Georgia 30602-7387, USA
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COVID-19 Severity and Mortality in Two Pandemic Waves in Poland and Predictors of Poor Outcomes of SARS-CoV-2 Infection in Hospitalized Young Adults. Viruses 2022; 14:v14081700. [PMID: 36016322 PMCID: PMC9413321 DOI: 10.3390/v14081700] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 02/08/2023] Open
Abstract
SARS-CoV-2 variants pose a significant threat to global public health. However, their influence on disease severity, especially among young adults who may exhibit different clinical characteristics, is debatable. In this retrospective study of 229 young adults hospitalized with COVID-19, we investigated the differences between Poland's second and third waves of the pandemic. To identify potential predictors of severe COVID-19 in young adults, we analyzed patient characteristics and laboratory findings between survivors and non-survivors and we performed logistic regression to assess the risk of death, mechanical ventilation, and intensive care unit treatment. We found no increase in COVID-19 severity comparing the third and second waves of the pandemic, indicating that the alpha variant had no influence on disease severity. In addition, we found that factors, such as obesity, comorbidities, lung involvement, leukocytosis, neutrophilia, lymphopenia, higher IG count, the neutrophil-to-lymphocyte ratio, C-reactive protein, procalcitonin, interleukin-6, D-Dimer, lactate dehydrogenase, high-sensitive troponin I, creatine kinase-myocardial band, myoglobin, N-terminal-pro-B-type natriuretic peptide, creatinine, urea and gamma-glutamyl transferase, lower estimated glomerular filtration rate, albumin, calcium and vitamin D3, possibly a decrease in red blood cell counts, hemoglobin and hematocrit, and an increase in creatine kinase during hospitalization may be associated with poor outcomes of COVID-19.
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Arayici ME, Kipcak N, Kayacik U, Kelbat C, Keskin D, Kilicarslan ME, Kilinc AV, Kirgoz S, Kirilmaz A, Kizilkaya MA, Kizmaz IG, Kocak EB, Kochan E, Kocpinar B, Kordon F, Kurt B, Ellidokuz H. Effects of SARS-CoV-2 infections in patients with cancer on mortality, ICU admission and incidence: a systematic review with meta-analysis involving 709,908 participants and 31,732 cancer patients. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04191-y. [PMID: 35831763 PMCID: PMC9281353 DOI: 10.1007/s00432-022-04191-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/06/2022] [Indexed: 12/24/2022]
Abstract
Background Cancer patients constitute one of the highest-risk patient groups during the COVID-19 pandemic. In this study, it was aimed to perform a systematic review and meta-analysis to determine both the incidence and ICU (Intensive Care Unit) admission rates and mortality in SARS-CoV-2 infected cancer patients. Methods The PRISMA guidelines were closely followed during the design, analysis, and reporting of this systematic review and meta-analysis. A comprehensive literature search was performed for the published papers in PubMed/Medline, Scopus, medRxiv, Embase, and Web of Science (WoS) databases. SARS-CoV-2 infection pooled incidence in the cancer populations and the risk ratio (RR) of ICU admission rates/mortality in cancer and non-cancer groups, with 95% confidence intervals (CIs), were calculated using the random-effects model. Results A total of 58 studies, involving 709,908 participants and 31,732 cancer patients, were included in this study. The incidence in cancer patients was calculated as 8% (95% CI: 8–9%). Analysis results showed that mortality and ICU admission rate was significantly higher in patients with cancer (RR = 2.26, 95% CI: 1.94–2.62, P < 0.001; RR = 1.45, 95% CI: 1.28–1.64, p < 0.001, respectively). Conclusion As a result, cancer was an important comorbidity and risk factor for all SARS-CoV-2 infected patients. This infection could result in severe and even fatal events in cancer patients. Cancer is associated with a poor prognosis in the COVID-19 pandemic. Cancer patients should be assessed more sensitively in the COVID-19 outbreak. Supplementary Information The online version contains supplementary material available at 10.1007/s00432-022-04191-y.
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Affiliation(s)
- Mehmet Emin Arayici
- Department of Preventive Oncology, Institute of Health Sciences, Dokuz Eylul University, 15 July Medicine and Art Campus, Inciralti-Balcova 35340, Izmir, Turkey
| | - Nazlican Kipcak
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Ufuktan Kayacik
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Cansu Kelbat
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Deniz Keskin
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | | | - Ahmet Veli Kilinc
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Sumeyye Kirgoz
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Anil Kirilmaz
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Melih Alihan Kizilkaya
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Irem Gaye Kizmaz
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Enes Berkin Kocak
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Enver Kochan
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Begum Kocpinar
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Fatmanur Kordon
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Batuhan Kurt
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Hulya Ellidokuz
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
- Department of Preventive Oncology, Institute of Oncology, Dokuz Eylul University, Izmir, Turkey
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Khari S, Salimi Akin Abadi A, Pazokian M, Yousefifard M. CURB-65, qSOFA, and SIRS Criteria in Predicting In-Hospital Mortality of Critically Ill COVID-19 Patients; a Prognostic Accuracy Study. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2022; 10:e36. [PMID: 35765619 PMCID: PMC9187131 DOI: 10.22037/aaem.v10i1.1565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
INTRODUCTION Outcome prediction of intensive care unit (ICU)-admitted patients is one of the important issues for physicians. This study aimed to compare the accuracy of Quick Sequential Organ Failure Assessment (qSOFA), Confusion, Urea, Respiratory Rate, Blood Pressure and Age Above or Below 65 Years (CURB-65), and Systemic Inflammatory Response Syndrome (SIRS) scores in predicting the in-hospital mortality of COVID-19 patients. METHODS This prognostic accuracy study was performed on 225 ICU-admitted patients with a definitive diagnosis of COVID-19 from July to December 2021 in Tehran, Iran. The patients' clinical characteristics were evaluated at the time of ICU admission, and they were followed up until discharge from ICU. The screening performance characteristics of CURB-65, qSOFA, and SIRS in predicting their mortality was compared. RESULTS 225 patients with the mean age of 63.27±14.89 years were studied (56.89% male). The in-hospital mortality rate of this series of patients was 39.10%. The area under the curve (AUC) of SIRS, CURB-65, and qSOFA were 0.62 (95% CI: 0.55 - 0.69), 0.66 (95% CI: 0.59 - 0.73), and 0.61(95% CI: 0.54 - 0.67), respectively (p = 0.508). In cut-off ≥1, the estimated sensitivity values of SIRS, CURB-65, and qSOFA were 85.23%, 96.59%, and 78.41%, respectively. The estimated specificity of scores were 34.31%, 6.57%, and 38.69%, respectively. In cut-off ≥2, the sensitivity values of SIRS, CURB-65, and qSOFA were evaluated as 39.77%, 87.50%, and 15.91%, respectively. Meanwhile, the specificity of scores were 72.99%, 34.31%, and 92.70%. CONCLUSIONS It seems that the performance of SIRS, CURB-65, and qSOFA is similar in predicting the ICU mortality of COVID-19 patients. However, the sensitivity of CURB-65 is higher than qSOFA and SIRS.
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Affiliation(s)
- Sorour Khari
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atefe Salimi Akin Abadi
- Clinical Research Development Center, Shahid Modarres Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marzieh Pazokian
- Department of Medical- Surgical Nursing, School of Nursing and Midwifery, Clinical Research Development Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. ,Corresponding author: Marzieh Pazokian; Department of Medical- Surgical Nursing, School of Nursing and Midwifery, Clinical Research Development Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. , ORCID: 0000-0002-7583-1824, Tel: 0098-21-88202519, Fax: 0098-21-88202518
| | - Mahmoud Yousefifard
- Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran.,Corresponding author: Marzieh Pazokian; Department of Medical- Surgical Nursing, School of Nursing and Midwifery, Clinical Research Development Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. , ORCID: 0000-0002-7583-1824, Tel: 0098-21-88202519, Fax: 0098-21-88202518
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