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Moukambi LA, Kande Yatara M, Lendoye E, Padzys GS, Ndeboko B, Maloupazoa Siawaya AC, Nzoghe AM, Oliveira S, Ivala Mendome Y, Biyie Bi Ngoghe P, Mvoundza Ndjindji O, Avome Houechenou RM, Leboueny M, Djoba Siawaya JF. Biochemical Alterations Associated With the Severity of COVID-19 in Sub-Saharan Black African Individuals. J Appl Lab Med 2024; 9:201-211. [PMID: 38029353 DOI: 10.1093/jalm/jfad077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 06/21/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Biochemical markers are essential in the monitoring and the clinical care of patients as they inform clinicians. Here, we characterized biochemical alterations in sub-Saharan Black African individuals with COVID-19. METHODS The study includes COVID-19 patients cared for at the Akanda Army Hospital in Libreville (Gabon). A total of 2237 patient records were extracted and reviewed. Patients were classified based on hospital admission (intensive care unit [ICU], internal medicine ward, and outpatient). RESULTS One thousand six hundred seventy-one were included in the study. ICU patients were significantly older than non-ICU hospitalized patients (P < 0.001) and outpatients (P < 0.0001). Hyperglycemic patients had 6.4 odds of being in ICU (P < 0.0001). Patients with abnormally high urea had 54.7 odds of being in ICU (P < 0.0001). Patients with abnormally high aspartate aminotransferase (AST) (>33 IU/L) had 3.5 odds of being in ICU (P < 0.0001). Hyperlactatemia (>246 IU/L) odds in ICU patients were 14 (P < 0.0001). The odds of abnormally high alkaline phosphatase (ALP) (>147 IU/L) in ICU patients were 4.6 (P < 0.0001). Odds for hypochloremia (<98 mmol/L) were 1.6 in ICU (P < 0.05). Dysnatremia patients (<135 or >145 mmol/L) had 9.5 odds of being found in ICU patients (P < 0.0001). The odds of potassium imbalance (<3.6 or >5 mmol/L) in ICU patients were 12.2 (P < 0.0001). CONCLUSIONS COVID-19-associated biochemical alterations observed in the Black African population are similar to those observed in other populations, and the association between COVID-19 severity, hyperglycemia, and multi-organ affection is confirmed.
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Affiliation(s)
- Lydie Armelle Moukambi
- Service Laboratoire, CHU-Mère-Enfant, Fondation Jeanne EBORI, Libreville, Gabon
- Unité de Recherche et Diagnostics Spécialisé, Laboratoire National de Santé Publique, Libreville, Gabon
| | | | - Elisabeth Lendoye
- Service Laboratoire, CHU-Mère-Enfant, Fondation Jeanne EBORI, Libreville, Gabon
- Département de Biochimie, Université des Sciences de la Santé, Libreville, Gabon
| | - Guy-Stéphane Padzys
- Département de Biologie Cellulaire et Physiologie, Faculté des Sciences, Université des Sciences et Techniques de Masuku, Franceville, Gabon
| | - Benedict Ndeboko
- Service Laboratoire, CHU-Mère-Enfant, Fondation Jeanne EBORI, Libreville, Gabon
- Département de Biologie Cellulaire and Moléculaire - Génétique, Faculté de Médecine, Université Des Sciences de La Santé, Libreville, Gabon Université des Sciences de la Santé, Libreville, Gabon
| | - Anicet Christel Maloupazoa Siawaya
- Service Laboratoire, CHU-Mère-Enfant, Fondation Jeanne EBORI, Libreville, Gabon
- Unité de Recherche et Diagnostics Spécialisé, Laboratoire National de Santé Publique, Libreville, Gabon
| | - Amandine Mveang Nzoghe
- Service Laboratoire, CHU-Mère-Enfant, Fondation Jeanne EBORI, Libreville, Gabon
- Unité de Recherche et Diagnostics Spécialisé, Laboratoire National de Santé Publique, Libreville, Gabon
| | | | | | | | - Ofilia Mvoundza Ndjindji
- Service Laboratoire, CHU-Mère-Enfant, Fondation Jeanne EBORI, Libreville, Gabon
- Unité de Recherche et Diagnostics Spécialisé, Laboratoire National de Santé Publique, Libreville, Gabon
| | - Rotimi Myrabelle Avome Houechenou
- Service Laboratoire, CHU-Mère-Enfant, Fondation Jeanne EBORI, Libreville, Gabon
- Unité de Recherche et Diagnostics Spécialisé, Laboratoire National de Santé Publique, Libreville, Gabon
| | - Marielle Leboueny
- Service Laboratoire, CHU-Mère-Enfant, Fondation Jeanne EBORI, Libreville, Gabon
- Unité de Recherche et Diagnostics Spécialisé, Laboratoire National de Santé Publique, Libreville, Gabon
| | - Joel Fleury Djoba Siawaya
- Service Laboratoire, CHU-Mère-Enfant, Fondation Jeanne EBORI, Libreville, Gabon
- Unité de Recherche et Diagnostics Spécialisé, Laboratoire National de Santé Publique, Libreville, Gabon
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Tobi M, Bluth MH, Rossi NF, Demian E, Talwar H, Tobi YY, Sochacki P, Levi E, Lawson M, McVicker B. In the SARS-CoV-2 Pandora Pandemic: Can the Stance of Premorbid Intestinal Innate Immune System as Measured by Fecal Adnab-9 Binding of p87:Blood Ferritin, Yielding the FERAD Ratio, Predict COVID-19 Susceptibility and Survival in a Prospective Population Database? Int J Mol Sci 2023; 24:7536. [PMID: 37108697 PMCID: PMC10145175 DOI: 10.3390/ijms24087536] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/03/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
SARS-CoV-2 severity predictions are feasible, though individual susceptibility is not. The latter prediction allows for planning vaccination strategies and the quarantine of vulnerable targets. Ironically, the innate immune response (InImS) is both an antiviral defense and the potential cause of adverse immune outcomes. The competition for iron has been recognized between both the immune system and invading pathogens and expressed in a ratio of ferritin divided by p87 (as defined by the Adnab-9 ELISA stool-binding optical density, minus the background), known as the FERAD ratio. Associations with the FERAD ratio may allow predictive modeling for the susceptibility and severity of disease. We evaluated other potential COVID-19 biomarkers prospectively. Patients with PCR+ COVID-19 tests (Group 1; n = 28) were compared to three other groups. In Group 2 (n = 36), and 13 patients displayed COVID-19-like symptoms but had negative PCR or negative antibody tests. Group 3 (n = 90) had no symptoms and were negative when routinely PCR-tested before medical procedures. Group 4 (n = 2129) comprised a pool of patients who had stool tests and symptoms, but their COVID-19 diagnoses were unknown; therefore, they were chosen to represent the general population. Twenty percent of the Group 4 patients (n = 432) had sufficient data to calculate their FERAD ratios, which were inversely correlated with the risk of COVID-19 in the future. In a case report of a neonate, we studied three biomarkers implicated in COVID-19, including p87, Src (cellular-p60-sarcoma antigen), and Abl (ABL-proto-oncogene 2). The InImS of the first two were positively correlated. An inverse correlation was found between ferritin and lysozyme in serum (p < 0.05), suggesting that iron could have impaired an important innate immune system anti-viral effector and could partially explain future COVID-19 susceptibility.
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Affiliation(s)
- Martin Tobi
- Research and Development Service, Detroit VAMC, 4747 John R Street, Detroit, MI 48602, USA
| | - Martin H. Bluth
- Blood Transfusion and Donor Services, Department of Pathology, Maimonides Medical Center, 4802 10th Avenue, Brooklyn, NY 11219, USA
- School of Medicine, Wayne State University, 540 E Canfield St, Detroit, MI 48201, USA
| | - Noreen F. Rossi
- Research and Development Service, Detroit VAMC, 4747 John R Street, Detroit, MI 48602, USA
- Division of Nephrology, Department of Physiology, School of Medicine, Wayne State University, 540 E. Canfield Ave., Detroit, MI 48201, USA
| | - Ereny Demian
- Department of Internal Medicine, Pennsylvania State University College of Medicine, 700 HMC Cres Rd., Hershey, PA 17033, USA
| | - Harvinder Talwar
- Research and Development Service, Detroit VAMC, 4747 John R Street, Detroit, MI 48602, USA
- School of Medicine, Wayne State University, 540 E Canfield St, Detroit, MI 48201, USA
| | - Yosef Y. Tobi
- Department of Thoracic Oncology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065, USA
| | - Paula Sochacki
- Department of Pathology, Detroit VAMC, 4747 John R Street, Detroit, MI 48602, USA
| | - Edi Levi
- Research and Development Service, Detroit VAMC, 4747 John R Street, Detroit, MI 48602, USA
| | - Michael Lawson
- Division of Gastroenterology and Hepatology, University of California at Sacramento, Sacramento, CA 95819, USA
| | - Benita McVicker
- Research Service, VA Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
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Chander S, Deepak V, Kumari R, Leys L, Wang HY, Mehta P, Sadarat FNU. Glycemic Control in Critically Ill COVID-19 Patients: Systematic Review and Meta-Analysis. J Clin Med 2023; 12:jcm12072555. [PMID: 37048638 PMCID: PMC10094858 DOI: 10.3390/jcm12072555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/01/2023] [Accepted: 03/06/2023] [Indexed: 03/31/2023] Open
Abstract
Background: Given the mortality risk in COVID-19 patients, it is necessary to estimate the impact of glycemic control on mortality rates among inpatients by designing and implementing evidence-based blood glucose (BG) control methods. There is evidence to suggest that COVID-19 patients with hyperglycemia are at risk of mortality, and glycemic control may improve outcomes. However, the optimal target range of blood glucose levels in critically ill COVID-19 patients remains unclear, and further research is needed to establish the most effective glycemic control strategies in this population. Methods: The investigation was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Data sources were drawn from Google Scholar, ResearchGate, PubMed (MEDLINE), Cochrane Library, and Embase databases. Randomized controlled trials, non-randomized controlled trials, retrospective cohort studies, and observational studies with comparison groups specific to tight glycemic control in COVID-19 patients with and without diabetes. Results: Eleven observational studies (26,953 patients hospitalized for COVID-19) were included. The incidence of death was significantly higher among COVID-19 patients diagnosed with diabetes than those without diabetes (OR = 2.70 [2.11, 3.45] at a 95% confidence interval). Incidences of death (OR of 3.76 (3.00, 4.72) at a 95% confidence interval) and complications (OR of 0.88 [0.76, 1.02] at a 95% confidence interval) were also significantly higher for COVID-19 patients with poor glycemic control. Conclusion: These findings suggest that poor glycemic control in critically ill patients leads to an increased mortality rate, infection rate, mechanical ventilation, and prolonged hospitalization.
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Affiliation(s)
- Subhash Chander
- Department of Internal Medicine, Mount Sinai Beth Israel, New York, NY 10003, USA
- Correspondence:
| | - Vishal Deepak
- Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, School of Medicine, West Virginia University, Morgantown, WV 26506, USA
| | - Roopa Kumari
- Department of Pathology, Mount Sinai Morningside, and Mount Sinai West, New York, NY 10025, USA
| | - Lorenzo Leys
- Department of Internal Medicine, Mount Sinai Beth Israel, New York, NY 10003, USA
- Department of Medicine, Section of Pulmonary and Critical Care Medicine, Mount Sinai Beth Israel, New York, NY 10003, USA
- Department of Medicine, Section of Pulmonary and Critical Care Medicine, Mount Sinai Morningside, and Mount Sinai West, New York, NY 10025, USA
| | - Hong Yu Wang
- Department of Internal Medicine, Mount Sinai Beth Israel, New York, NY 10003, USA
| | - Puja Mehta
- Department of Internal Medicine, Section of Nephrology, Yale School of Medicine, New Haven, CT 06510, USA
| | - FNU Sadarat
- Department of Internal Medicine, University of Buffalo, New York, NY 14215, USA
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Pari B, Gallucci M, Ghigo A, Brizzi MF. Insight on Infections in Diabetic Setting. Biomedicines 2023; 11:971. [PMID: 36979949 PMCID: PMC10046483 DOI: 10.3390/biomedicines11030971] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/08/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
The correlation between diabetes mellitus and infectious diseases is widely recognized. DM patients are characterized by the impaired function of the immune system. This translates into the occurrence of a variety of infections, including urinary tract, skin and surgical site infections, pneumonia, tuberculosis, and, more recently, SARS-CoV-2. Hyperglycemia has been identified as a relevant factor contributing to unfavorable outcomes in hospitalized patients including SARS-CoV-2 patients. Several studies have been performed proving that to maintain the proper and stringent monitoring of glycemia, a balanced diet and physical activity is mandatory to reduce the risk of infections and their associated complications. This review is focused on the mechanisms accounting for the increased susceptibility of DM patients to infections, with particular attention to the impact of newly introduced hypoglycemic drugs in sepsis management.
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Affiliation(s)
| | | | | | - Maria Felice Brizzi
- Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126 Turin, Italy
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Ntambara J, Munyanshongore C, Ndahindwa V. Severity Status of COVID-19 and Its Associated Factors at the Nyarugenge Treatment Center in Rwanda. Cureus 2023; 15:e35627. [PMID: 37007413 PMCID: PMC10064020 DOI: 10.7759/cureus.35627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2023] [Indexed: 03/05/2023] Open
Abstract
Background The COVID-19 pandemic has continued to be a public health emergency currently; on March 11, 2020, the World Health Organization (WHO) declared it a global pandemic. Despite the Rwanda National Health Measures that have been put in place to protect the public including lockdowns, curfew, face mask mandate, handwashing sensitization, etc., severe morbidity and mortality cases of COVID-19 are continued to be seen. Some studies have linked COVID-19 complications to its direct chain of mechanism; however, other studies have linked comorbidity or underlying disease conditions to its poor prognosis. Studies have not yet been conducted in Rwanda on the severe status of COVID-19 and its associated factors among patients. Therefore, this study aimed to assess the severe status of COVID-19 and its associated factors at the Nyarugenge Treatment Center. Methods A descriptive cross-sectional study was done. All patients admitted to the Nyarugenge Treatment Center from January 8, 2021, when the hospital opened, until the end of May 2021 were recruited in the study. The eligible participants were all patients who were admitted and tested positive for COVID-19 by RT-PCR method according to the Rwanda Ministry of Health criteria. Results All data were analyzed using the Statistical Package for the Social Sciences (SPSS) software, version 25 (IBM Corp., Armonk, NY). The number of patients admitted during the study period was 648, with a median age of 53; 45.2% of them were females, and 54.2% were males. Of these, 81.2% (526) were discharged from the hospital, while 18.8% (122) died. The proportion of severe status of COVID-19 was 42.1%. The factors that showed a risk of severe COVID-19 status were age and the number of comorbidities. Patients aged above 60 years (OR = 11.7, 95% CI: 5.35-25.67, p-value < 0.001) and those between the age of 51 and 60 (OR = 6.86, 95% CI: 2.96-15.93, p-value < 0.001) were 12 and seven times more likely to have severe COVID-19 status compared to those aged below 30 years. Having two comorbidities had twice the risk of developing a severe COVID-19 status compared to those with no comorbidity (OR = 2.13, 95% CI: 1.20-3.77, p-value < 0.001). Conclusion Elderly people and those with comorbidities are encouraged to obtain all standard operating procedures and comply with the vaccination program.
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Matias AA, Manique I, Sabino T, Rego T, Mihon C, Panarra A, Rizzo M, Silva-Nunes J. Absolute Hyperglycemia versus Stress Hyperglycemia Ratio for the Prognosis of Hospitalized Patients with COVID-19 in the First Months of the Pandemic: A Retrospective Study. Diabetes Ther 2023; 14:335-346. [PMID: 36574200 PMCID: PMC9793808 DOI: 10.1007/s13300-022-01347-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/21/2022] [Indexed: 12/28/2022] Open
Abstract
Diabetes is a risk factor for greater severity of coronavirus disease 2019 (COVID-19). The stress hyperglycemia ratio (SHR) is an independent predictor of critical illness, and it is reported to have a stronger association than absolute hyperglycemia. The aim of this study was to assess the relationship of absolute hyperglycemia and SHR with the severity of COVID-19, since there are no studies investigating SHR in patients with COVID-19. We conducted a retrospective observational study on hospitalized patients with COVID-19 in the first months of the pandemic, regarding absolute hyperglycemia, SHR, and severity outcomes. Of the 374 patients, 28.1% had a previous diagnosis of type 2 diabetes. Absolute hyperglycemia (64.8% versus 22.7%; p < 0.01) and SHR [1.1 (IQR 0.9-1.3) versus 1.0 (IQR 0.9-1.2); p < 0.001] showed a statistically significant association with previous diabetes. Absolute hyperglycemia showed a significant association with clinical severity of COVID-19 (79.0% versus 62.7%; p < 0.001), need for oxygen therapy (74.8% versus 54.4%; p < 0.001), invasive mechanical ventilation (28.6% versus 11.6%; p < 0.001), and intensive care unit (30.3% versus 14.9%; p = 0.002), but not with mortality; by contrast, there was no statistically significant association between SHR and all these parameters. Our results are in agreement with the literature regarding the impact of absolute hyperglycemia on COVID-19 severity outcomes, while SHR was not a significant marker. We therefore suggest that SHR should not be evaluated in all patients admitted in the hospital for COVID-19, and we encourage the standard measures at admission of blood glucose and HbA1c levels.
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Affiliation(s)
- Alexandra A Matias
- Department of Endocrinology, Diabetes and Metabolism, Hospital de Curry Cabral, Centro Hospitalar Universitário Lisboa Central, 1069-166, Lisbon, Portugal.
| | - Inês Manique
- Department of Endocrinology, Diabetes and Metabolism, Hospital de Curry Cabral, Centro Hospitalar Universitário Lisboa Central, 1069-166, Lisbon, Portugal
| | - Teresa Sabino
- Department of Endocrinology, Diabetes and Metabolism, Hospital de Curry Cabral, Centro Hospitalar Universitário Lisboa Central, 1069-166, Lisbon, Portugal
| | - Teresa Rego
- Department of Endocrinology, Diabetes and Metabolism, Hospital de Curry Cabral, Centro Hospitalar Universitário Lisboa Central, 1069-166, Lisbon, Portugal
| | - Claudia Mihon
- Functional Unit of Internal Medicine 7.2, Hospital de Curry Cabral, Centro Hospitalar Universitário Lisboa Central, 1069-166, Lisbon, Portugal
| | - António Panarra
- Functional Unit of Internal Medicine 7.2, Hospital de Curry Cabral, Centro Hospitalar Universitário Lisboa Central, 1069-166, Lisbon, Portugal
| | - Manfredi Rizzo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90100, Palermo, Italy
| | - José Silva-Nunes
- Department of Endocrinology, Diabetes and Metabolism, Hospital de Curry Cabral, Centro Hospitalar Universitário Lisboa Central, 1069-166, Lisbon, Portugal.
- Nova Medical School/Faculdade de Ciências Médicas, Nova University of Lisbon, 1169-056, Lisbon, Portugal.
- Health and Technology Research Center (H&TRC), Escola Superior de Tecnologia da Saúde de Lisboa, 1990-096, Lisbon, Portugal.
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Krumpolec P, Kodada D, Nyáriová N, Repiská V, Minárik G. COVID-19 and Diabetes Mellitus: Mutual Interplay of Two Diseases. Curr Diabetes Rev 2023; 19:e130922208761. [PMID: 36100987 DOI: 10.2174/1573399819666220913113146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/16/2022] [Accepted: 08/09/2022] [Indexed: 11/22/2022]
Abstract
Currently, when the world is fighting against the rapidly spreading pandemic of COVID-19, the silent epidemic of diabetes should not be set aside. In comparison, while COVID- 19 led to about 6 million deaths in 2021, diabetes caused 6.7 million deaths in the same year. Diabetes mellitus is a serious risk factor for worse outcomes in COVID-19 patients. Moreover, it seems that there is a bidirectional relationship between pre-existing diabetes pandemic and the rapidly spreading COVID-19 pandemic. In this article, we summarize mechanisms by which SARS-CoV-2 infects the host cell and discuss the bidirectional relationship between diabetes and COVID-19. We also focus on clinical variables in which diabetic patients differ from non-diabetic patients and which could have promising predictive value for the course and outcome of diabetic COVID-19 patients' therapy management.
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Affiliation(s)
| | - Dominik Kodada
- Medirex Group Academy n.p.o., Novozamocka 67, Nitra, Slovakia
- Faculty of Medicine, Department of Clinical Biology, Genetics and Clinical Genetics, Comenius University in Bratislava, Sasinkova 4, Bratislava, Slovakia
| | - Nikola Nyáriová
- Medirex Group Academy n.p.o., Novozamocka 67, Nitra, Slovakia
- Faculty of Medicine, Department of Clinical Biology, Genetics and Clinical Genetics, Comenius University in Bratislava, Sasinkova 4, Bratislava, Slovakia
| | - Vanda Repiská
- Faculty of Medicine, Department of Clinical Biology, Genetics and Clinical Genetics, Comenius University in Bratislava, Sasinkova 4, Bratislava, Slovakia
| | - Gabriel Minárik
- Medirex Group Academy n.p.o., Novozamocka 67, Nitra, Slovakia
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Kim Y, Kim BI, Tak S. Time-series comparison of COVID-19 case fatality rates across 21 countries with adjustment for multiple covariates. Osong Public Health Res Perspect 2022; 13:424-434. [PMID: 36617548 DOI: 10.24171/j.phrp.2022.0212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/18/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Although it is widely used as a measure for mortality, the case fatality rate (CFR) ofcoronavirus disease 2019 (COVID-19) can vary over time and fluctuate for many reasons otherthan viral characteristics. To compare the CFRs of different countries in equal measure, weestimated comparable CFRs after adjusting for multiple covariates and examined the mainfactors that contributed to variability in the CFRs among 21 countries. METHODS For statistical analysis, time-series cross-sectional data were collected from OurWorld in Data, CoVariants.org, and GISAID. Biweekly CFRs of COVID-19 were estimated bypooled generalized linear squares regression models for the panel data. Covariates includedthe predominant virus variant, reproduction rate, vaccination, national economic status,hospital beds, diabetes prevalence, and population share of individuals older than age 65. Intotal, 21 countries were eligible for analysis. RESULTS Adjustment for covariates reduced variation in the CFRs of COVID-19 across countriesand over time. Regression results showed that the dominant spread of the Omicron variant,reproduction rate, and vaccination were associated with lower country-level CFRs, whereasage, the extreme poverty rate, and diabetes prevalence were associated with higher countrylevel CFRs. CONCLUSION A direct comparison of crude CFRs among countries may be fallacious, especiallyin a cross-sectional analysis. Our study presents an adjusted comparison of CFRs over timefor a more proper comparison. In addition, our findings suggest that comparing CFRs amongdifferent countries without considering their context, such as the epidemic phase, medicalcapacity, surveillance strategy, and socio-demographic traits, should be avoided.
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Affiliation(s)
- Yongmoon Kim
- Division of Risk Assessment, Bureau of Public Health Emergency Preparedness, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Bryan Inho Kim
- Division of Risk Assessment, Bureau of Public Health Emergency Preparedness, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Sangwoo Tak
- Division of Risk Assessment, Bureau of Public Health Emergency Preparedness, Korea Disease Control and Prevention Agency, Cheongju, Korea
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Tolossa T, Lema M, Wakuma B, Turi E, Fekadu G, Mulisa D, Fetensa G. Incidence and predictors of diabetes mellitus among severe COVID-19 patients in western Ethiopia: a retrospective cohort study. JOURNAL OF ENDOCRINOLOGY, METABOLISM AND DIABETES OF SOUTH AFRICA 2022. [DOI: 10.1080/16089677.2022.2144016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Tadesse Tolossa
- Department of Public Health, Wollega University, Nekemte, Ethiopia
| | - Matiyos Lema
- Department of Public Health, Wollega University, Nekemte, Ethiopia
| | - Bizuneh Wakuma
- Department of Nursing, Wollega University, Nekemte, Ethiopia
| | - Ebisa Turi
- Department of Public Health, Wollega University, Nekemte, Ethiopia
| | - Ginenus Fekadu
- Department of Clinical Pharmacy, Wollega University, Nekemte, Ethiopia
| | - Diriba Mulisa
- Department of Nursing, Wollega University, Nekemte, Ethiopia
| | - Getahun Fetensa
- Department of Nursing, Wollega University, Nekemte, Ethiopia
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Muacevic A, Adler JR. COVID-19 and Diabetes Mellitus: From Pathophysiology to Clinical Management. Cureus 2022; 14:e31895. [PMID: 36579192 PMCID: PMC9792302 DOI: 10.7759/cureus.31895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/25/2022] [Indexed: 11/27/2022] Open
Abstract
An increase in the severity of the coronavirus disease 2019 (COVID-19) was observed in patients infected with the acute severe metabolism syndrome coronavirus type 2 (SARS-CoV-2). Patients who have COVID-19 infection may also be more susceptible to hyperglycemia. When paired with other risk factors, hyperglycemia might alter immune and inflammatory responses, predisposing people to significant COVID-19 and perhaps deadly outcomes. Angiotensin-converting accelerator 2 (ACE2), a component of the renin-angiotensin-aldosterone system (RAAS), is the principal entry receptor for SARS-CoV-2; nevertheless, dipeptidyl enzyme 4 (DPP4) may potentially serve as a binding target. However, preliminary data did not indicate a substantial effect on the susceptibility to SARS-CoV-2 using glucose-lowering DPP4 inhibitors. Because of their pharmacologic characteristics, salt-glucose cotransporter 2 (SGLT2) inhibitors should not be advised for COVID-19 patients because they may have adverse effects. Currently, taking a hypoglycemic drug should be the most efficient way to manage acute glycemia. The majority of market proof is said to categorize two diabetes mellitus (DM) and fails to distinguish between the two primary categories of DM due to its widespread use. For grouping one DM and COVID-19, there is now some constrained proof available. Most of those findings are just preliminary, so further research will undoubtedly be required to determine the best course of action for DM patients.
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Mustafa M, Attaallah A, Amir O, Elbalal M, Gibriel AAAL. The characteristics and outcomes of COVID-19 among diabetic patients in Wad-Medani isolation center from September to December 2020: A cross-sectional study. Health Sci Rep 2022; 5:e889. [PMID: 36324424 PMCID: PMC9621469 DOI: 10.1002/hsr2.889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND AND AIMS Corona virus disease-19 (COVID-19) is a recently discovered infection that transmitted briskly worldwide. In this disease (COVID-19), it was discovered that several disorders, such diabetes, increased the severity and fatality rate. Until now, studies investigating the correlation between diabetes and COVID-19 in Sudan have not yet been conducted. Thus we aimed to evaluated the characteristics and outcomes of COVID-19 among diabetic patients. METHODS A prospective study included 70 diabetic patients with COVID-19 in Wad-Medani Isolation Center from September to December 2020. Data concerning demographics and clinical characteristics, as well as outcomes were collected. RESULTS Out of 70 patients, 46 (66%) were men and 24 (34%) were women; the average age was 63 ± 12 years. In diabetes mellitus (DM) types, 69 (98.6%) patient were T2DM. The average of DM duration was 10 ± 6.2 years. Insulin was the major DM medication used by more one-half of study patients (n = 37; 52.9%). Newly discovered DM after COVD-19 infection was encountered in 5 (7.1%) patients. Most of the study subjects (n = 44; 63%) had moderately severe form of disease. Hypertension was the commonest comorbid in 29 (41.4%) patients. The intensive care unit admission rate among our study group was 10% (n = 7). The mortality rate among our study patients was found to be 11.4% (n = 8). Dead patients were significantly had high HbA1c levels (11.6 ± 7% vs. 8.8 ± 5%; p = 0.001). Additionally, all individuals with a severe COVID-19 illness (n = 6; 100%) were dead comparing to no patient died with mild covid illness and 4.5% patients with moderately severe infection (p < 0.001). CONCLUSION The majority of COVID-19 diabetic patients were males and older in age. Most of the patients presented with moderate severity and moderately uncontrolled DM. Hypertension was the major comorbidity. The mortality rate was as high as 11.4% and associated with high HbA1c levels and severe form of COVID-19 as well.
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Affiliation(s)
- Maali Mustafa
- Department of MedicineWad Medani Teaching HospitalWad MedaniSudan
| | | | - Osman Amir
- Department of HematologyFaculty of Medical Laboratory Sciences, Al‐Neelain UniversityKhartoumSudan
| | - Moawia Elbalal
- Internal MedicineFaculty of Medicine, University of GeziraWad MedaniSudan
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12
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Carrondo MC, Moita JJ. Clinical profile of patients with type 2 diabetes after COVID-19 vaccination: A prospective study. OBESITY MEDICINE 2022; 35:100458. [PMID: 36268222 PMCID: PMC9561417 DOI: 10.1016/j.obmed.2022.100458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/23/2022] [Accepted: 10/10/2022] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to characterize the clinical profile of patients with type 2 diabetes after COVID-19 vaccination. This prospective study has involved 100 adult diabetic patients followed in the primary health care. SARS-CoV-2 infection after COVID-19 vaccination was the outcome indicator.
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Affiliation(s)
- Maria Cristina Carrondo
- Polytechnic Institute of Coimbra College of Health Technology of Coimbra, Department Medical, Social, and Human Sciences, Portugal
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13
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B DJ. Historical aspects and current understanding of the connections and implications of viruses and diabetes: A narrative review. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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14
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Colombo C, Cipolli M, Daccò V, Medino P, Alghisi F, Ambroni M, Badolato R, Battistini F, Bignamini E, Casciaro R, Ciciriello F, Collura M, Comello I, Francalanci M, Ficili F, Folino A, Leonardi S, Leonetti G, Lucanto MC, Lucca F, Maschio M, Mencarini V, Messore B, Pisi G, Pizzamiglio G, Poli P, Raia V, Riberi L, Ros M, Rotolo N, Sepe A, Taccetti G, Vitullo P, Alicandro G. Clinical course and risk factors for severe COVID-19 among Italian patients with cystic fibrosis: a study within the Italian Cystic Fibrosis Society. Infection 2022; 50:671-679. [PMID: 34874541 PMCID: PMC8649681 DOI: 10.1007/s15010-021-01737-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 11/23/2021] [Indexed: 12/28/2022]
Abstract
PURPOSE To describe the clinical course of COVID-19 in patients with cystic fibrosis (CF) and to identify risk factors for severe COVID-19. METHODS We conducted a prospective study within the Italian CF Society. CF centers collected baseline and follow-up data of patients with virologically confirmed SARS-CoV-2 infection between March 2020 and June 2021. Odds ratios (ORs) for severe SARS-CoV-2 (as defined by hospital admission) were estimated by logistic regression models. RESULTS The study included 236 patients with positive molecular test for SARS-CoV-2. Six patients died, 43 patients were admitted to hospital, 4 admitted to intensive care unit. Pancreatic insufficiency was associated with increased risk of severe COVID-19 (OR 4.04, 95% CI 1.52; 10.8). After adjusting for age and pancreatic insufficiency, forced expiratory volume in one second (FEVp) < 40% (OR 4.54, 95% CI 1.56; 13.2), oxygen therapy (OR 12.3, 95% CI 2.91-51.7), underweight (OR 2.92, 95% CI 1.12; 7.57), organ transplantation (OR 7.31, 95% CI 2.59; 20.7), diabetes (OR 2.67, 95% CI 1.23; 5.80) and liver disease (OR 3.67, 95% CI 1.77; 7.59) were associated with increased risk of severe COVID-19, while use of dornase alfa was associated with a reduced risk (OR 0.34, 95% CI 0.13-0.88). No significant changes were observed in FEVp from baseline to a median follow-up of 2 months (median difference: 0, interquartile range: - 4; 5, P = 0.62). CONCLUSION Clinical features indicative of severe form of CF are associated with increased risk of COVID-19 hospitalization. SARS-CoV-2 infected patients do not experience a deterioration of respiratory function.
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Affiliation(s)
- Carla Colombo
- Pediatric Cystic Fibrosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, 20122, Milano, Italy.
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milano, Italy.
| | - Marco Cipolli
- Cystic Fibrosis Center, Azienda Opedaliera-Universitaria Integrata Di Verona, Verona, Italy
| | - Valeria Daccò
- Pediatric Cystic Fibrosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, 20122, Milano, Italy
| | - Paola Medino
- Pediatric Cystic Fibrosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, 20122, Milano, Italy
| | - Federico Alghisi
- Cystic Fibrosis Center, Ospedale Pediatrico Bambin Gesù, Roma, Italy
| | - Maura Ambroni
- Cystic Fibrosis Center, Ospedale Maurizio Bufalini, Cesena, Italy
| | - Raffaele Badolato
- Cystic Fibrosis Center, ASST Spedali Civili Di Brescia and Università Degli Studi Di Brescia, Brescia, Italy
| | | | - Elisabetta Bignamini
- Pediatric Cystic Fibrosis Center, Ospedale Infantile Regina Margherita, Torino, Italy
| | - Rosaria Casciaro
- Cystic Fibrosis Center, Istituto Giannina Gaslini, Genova, Italy
| | | | - Mirella Collura
- Cystic Fibrosis Center, Ospedale Giovanni Di Cristina, Palermo, Italy
| | - Isabella Comello
- Cystic Fibrosis Support Center, Ospedale S. Maria Di Ca' Foncello, Treviso, Italy
| | - Michela Francalanci
- Cystic Fibrosis Center, Azienda Opedaliero-Universitaria Meyer, Firenze, Italy
| | - Francesca Ficili
- Cystic Fibrosis Center, Ospedale Giovanni Di Cristina, Palermo, Italy
| | - Anna Folino
- Pediatric Cystic Fibrosis Center, Ospedale Infantile Regina Margherita, Torino, Italy
| | - Salvatore Leonardi
- Cystic Fibrosis Center, Azienda Opedaliero-Universitaria Policlinico Vittorio Emanuele, Catania, Italy
| | - Giuseppina Leonetti
- Pediatric Cystic Fibrosis Center, Azienda Universitaria Ospedaliera Consorziale Policlinico, Bari, Italy
| | - Maria Cristina Lucanto
- Cystic Fibrosis Hub Center, Azienda Ospedaliera Universitaria Policlinico G. Martino, Messina, Italy
| | - Francesca Lucca
- Cystic Fibrosis Center, Azienda Opedaliera-Universitaria Integrata Di Verona, Verona, Italy
| | - Massimo Maschio
- Cystic Fibrosis Center, IRCCS Materno Infantile Burlo Garofolo, Trieste, Italy
| | - Valeria Mencarini
- Cystic Fibrosis Center, Presidio Ospedaliero di Gubbio e Gualdo Tadino, Gubbio, Italy
| | - Barbara Messore
- Adult Cystic Fibrosis Center, Azienda Ospedaliero-Universitaria San Luigi Gonzaga, Orbassano, Italy
| | - Giovanna Pisi
- Cystic Fibrosis Center, Azienda Opedaliero-Universitaria di Parma, Parma, Italy
| | - Giovanna Pizzamiglio
- Adult Cystic Fibrosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Piercarlo Poli
- Cystic Fibrosis Center, ASST Spedali Civili Di Brescia and Università Degli Studi Di Brescia, Brescia, Italy
| | - Valeria Raia
- Cystic Fibrosis Center, Azienda Opedaliera-Universitaria Federico II, Napoli, Italy
| | - Luca Riberi
- Adult Cystic Fibrosis Center, Azienda Ospedaliero-Universitaria San Luigi Gonzaga, Orbassano, Italy
| | - Mirco Ros
- Cystic Fibrosis Support Center, Ospedale S. Maria Di Ca' Foncello, Treviso, Italy
| | - Novella Rotolo
- Cystic Fibrosis Center, Azienda Opedaliero-Universitaria Policlinico Vittorio Emanuele, Catania, Italy
| | - Angela Sepe
- Cystic Fibrosis Center, Azienda Opedaliera-Universitaria Federico II, Napoli, Italy
| | - Giovanni Taccetti
- Cystic Fibrosis Center, Azienda Opedaliero-Universitaria Meyer, Firenze, Italy
| | - Pamela Vitullo
- Cystic Fibrosis Support Center, Ospedale G. Tatarella di Cerignola, Cerignola, Italy
| | - Gianfranco Alicandro
- Pediatric Cystic Fibrosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, 20122, Milano, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milano, Italy
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15
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Pawar A, Russo M, Rani I, Goswami K, Russo GL, Pal A. A critical evaluation of risk to reward ratio of quercetin supplementation for COVID-19 and associated comorbid conditions. Phytother Res 2022; 36:2394-2415. [PMID: 35393674 PMCID: PMC9111035 DOI: 10.1002/ptr.7461] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 03/19/2022] [Accepted: 03/26/2022] [Indexed: 01/08/2023]
Abstract
The interim results of the large, multinational trials on coronavirus disease 2019 (COVID‐19) using a combination of antiviral drugs appear to have little to no effect on the 28‐day mortality or the in‐hospital course. Therefore, there is a still vivid interest in finding alternate re‐purposed drugs and nutrition supplements, which can halt or slow the disease severity. We review here the multiple preclinical studies, partially supported by clinical evidence showing the quercetin's possible therapeutic/prophylaxis efficacy against severe acute respiratory syndrome coronavirus (SARS‐CoV) as well as comorbidities like chronic obstructive pulmonary disease (COPD), diabetes mellitus, obesity, coagulopathy, and hypertension. Currently, 14 interventional clinical trials are underway assessing the efficacy of quercetin along with other antiviral drugs/nutritional supplements as prophylaxis/treatment option against COVID‐19. The present review is tempting to suggest that, based on circumstantial scientific evidence and preliminary clinical data, the flavonoid quercetin can ameliorate COVID‐19 infection and symptoms acting in concert on two parallel and independent paths: inhibiting key factors responsible for SARS‐CoV‐2 infections and mitigating the clinical manifestations of the disease in patients with comorbid conditions. Despite the broad therapeutic properties of quercetin, further high power randomized clinical trials are needed to firmly establish its clinical efficacy against COVID‐19.
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Affiliation(s)
- Anil Pawar
- Department of Zoology, DAV University, Jalandhar, India
| | - Maria Russo
- National Research Council, Institute of Food Sciences, Avellino, Italy
| | - Isha Rani
- Department of Biochemistry, Maharishi Markandeshwar Institute of Medical Sciences and Research (MMIMSR), Maharishi Markandeshwar University (MMU), Ambala, India
| | | | - Gian Luigi Russo
- National Research Council, Institute of Food Sciences, Avellino, Italy
| | - Amit Pal
- Department of Biochemistry, AIIMS, Kalyani, India
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16
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Butkiewicz S, Zaczyński A, Hampel M, Pańkowski I, Gałązkowski R, Rzońca P. Analysis of Risk Factors for In-Hospital Death Due to COVID-19 in Patients Hospitalised at the Temporary Hospital Located at the National Stadium in Warsaw: A Retrospective Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073932. [PMID: 35409617 PMCID: PMC8998082 DOI: 10.3390/ijerph19073932] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/23/2022] [Accepted: 03/24/2022] [Indexed: 02/04/2023]
Abstract
The outbreak of the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pandemic has affected all aspects of social life and brought massive changes to the healthcare sector. The aim of this study was to identify the factors affecting the mortality of COVID-19 patients at a temporary hospital in Warsaw (Poland). The present study was conducted based on a retrospective analysis of the medical records of patients hospitalised at the temporary hospital located at the National Stadium in Warsaw between 1 March 2020 and 30 April 2021. The study included all cases of patients who were brought directly or transferred to the National Hospital from other hospitals for further treatment. With regard to comorbidities, the analysis found that five comorbidities—namely, diabetes (OR = 1.750, 95% CI: 1.009−2.444, p < 0.05), stroke history (OR = 2.408, 95% CI: 1.208−4.801, p < 0.05), renal failure (OR = 2.141, 95% CI: 1.052−4.356, p < 0.05), chronic obstructive pulmonary disease (OR = 2.044, 95% CI: 1.133−3.690, p < 0.05) and heart failure (OR = 1.930, 95% CI: 1.154−3.227, p < 0.05)—had a significant impact on the survival of COVID-19 patients. The analysis identified 14 factors that had a significant impact on the prognosis and mortality of the COVID-19 patients studied.
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Affiliation(s)
- Sławomir Butkiewicz
- Emergency Department, Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, 137 Wołoska St., 02-004 Warsaw, Poland; (S.B.); (I.P.)
| | - Artur Zaczyński
- Clinical Department of Neurosurgery, Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, 137 Wołoska St., 02-004 Warsaw, Poland;
| | - Michał Hampel
- Department of Gastroenterological and Transplant Surgery, Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, 137 Wołoska St., 02-004 Warsaw, Poland;
| | - Igor Pańkowski
- Emergency Department, Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, 137 Wołoska St., 02-004 Warsaw, Poland; (S.B.); (I.P.)
| | - Robert Gałązkowski
- Department of Emergency Medical Services, Faculty of Health Sciences, Medical University of Warsaw, 14/16 Litewska St., 00-575 Warsaw, Poland;
| | - Patryk Rzońca
- Department of Human Anatomy, Faculty of Health Sciences, Medical University of Warsaw, 5 Chałubińskiego St., 02-004 Warsaw, Poland
- Correspondence: ; Tel.: +48-22-629-98-92
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17
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Clinical Significance of COVID-19 and Diabetes: In the Pandemic Situation of SARS-CoV-2 Variants including Omicron (B.1.1.529). BIOLOGY 2022; 11:biology11030400. [PMID: 35336774 PMCID: PMC8945151 DOI: 10.3390/biology11030400] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 03/01/2022] [Accepted: 03/03/2022] [Indexed: 02/06/2023]
Abstract
Simple Summary Amidst the dual pandemics of diabetes and coronavirus disease 2019 (COVID-19), with the constant emergence of novel variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a vicious cycle has been created, i.e., a hyperglycemic state contributes to the severe clinical course of COVID-19, which in turn has deleterious effects on glycometabolism and in some cases causes new-onset diabetes. Here, we present a comprehensive review of the current literature on the clinical and experimental findings associated with the interrelationship between diabetes and COVID-19. To control disease outcomes and glucometabolic complications in COVID-19, this issue is still being investigated. Abstract The coronavirus disease 2019 (COVID-19) global pandemic, which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), remains uncontrolled, with the spread of emerging variants. According to accumulating evidence, diabetes is one of the leading risk factors for a severe COVID-19 clinical course, depending on the glycemic state before admission and during COVID-19 hospitalization. Multiple factors are thought to be responsible, including an altered immune response, coexisting comorbidity, and disruption of the renin-angiotensin system through the virus–host interaction. However, the precise underlying mechanisms remain under investigation. Alternatively, the focus is currently on the diabetogenic and ketosis-prone potential of SARS-CoV-2 itself, even for probable triggers of stress and steroid-induced hyperglycemia in COVID-19. In this article, we present a comprehensive review of the recent literature on the clinical and experimental findings associated with diabetes and COVID-19, and we discuss their bidirectional relationship, i.e., the risk for an adverse prognosis and the deleterious effects on glycometabolism. Accurate assessments of the incidence of new-onset diabetes induced by COVID-19 and its pathogenicity are still unknown, especially in the context of the circulation of SARS-CoV-2 variants, such as Omicron (B.1.1.529), which is a major challenge for the future.
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Watts P, Sagandira CR. Rapid Multigram-Scale End-to-End Continuous-Flow Synthesis of Sulfonylurea Antidiabetes Drugs: Gliclazide, Chlorpropamide, and Tolbutamide. SYNTHESIS-STUTTGART 2022. [DOI: 10.1055/a-1664-2282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AbstractA multigram-scale robust, efficient, and safe end-to-end continuous-flow process for the diabetes sulfonylurea drugs gliclazide, chlorpropamide, and tolbutamide is reported. The drugs were prepared by the treatment of an amine with a haloformate affording carbamate, which was subsequently treated with a sulfonamide to afford sulfonylurea. Gliclazide was obtained in 87% yield within 2.5 minutes total residence time with 26 g/h throughput; 0.2 kg of the drug was produced in 8 hours of running the system continuously. Chlorpropamide and tolbutamide were both obtained in 94% yield within 1 minute residence time with 184–188 g/h throughput; 1.4–1.5 kg of the drugs was produced in 8 hours of running the system continuously. N-Substituted carbamates were used as safe alternatives to the hazardous isocyanates in constructing the sulfonyl urea moiety.
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19
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Pelle MC, Zaffina I, Provenzano M, Moirano G, Arturi F. COVID-19 and diabetes-Two giants colliding: From pathophysiology to management. Front Endocrinol (Lausanne) 2022; 13:974540. [PMID: 36060943 PMCID: PMC9437522 DOI: 10.3389/fendo.2022.974540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 08/01/2022] [Indexed: 01/08/2023] Open
Abstract
Since December 2019, a new coronavirus, called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread around the world, causing the coronavirus 2019 (COVID-19) pandemic. From the beginning, SARS-CoV-2 has put a strain on the health system. In fact, many patients have had severe forms of the disease with the need for hospitalization due to respiratory failure. To contain the pandemic, the most widely used approach has been lockdowns. Social restrictions have been reduced thanks to the development of vaccines and targeted therapies. However, fatal events still occur among people at high risk of serious infection, such as patients with concomitant diabetes. Different mechanisms have been proposed to explain the poor prognosis of patients with diabetes and COVID-19, but the specific cause is unclear. It is now known that insulin resistance, inflammation, and cytokine storm are involved. Moreover, SARS-CoV-2 uses the angiotensin-converting enzyme 2 receptors to enter cells. This receptor is expressed on pancreatic beta cells and, during infection, it appears that receptor involvement may induce hyperglycemia in patients with or without diabetes. In this study, we discuss the mechanisms underlying the poor prognosis in people with COVID-19 and diabetes and what may improve the outcome in these patients.
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Affiliation(s)
- Maria Chiara Pelle
- Department of Medical and Surgical Sciences, University ‘Magna Graecia’ of Catanzaro, Catanzaro, Italy
| | - Isabella Zaffina
- Department of Medical and Surgical Sciences, University ‘Magna Graecia’ of Catanzaro, Catanzaro, Italy
| | - Michele Provenzano
- Nephrology, Dialysis and Transplantation Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Giovenale Moirano
- Department of Medical Sciences, University of Turin, CPO-Piemonte, Turin, Italy
| | - Franco Arturi
- Department of Medical and Surgical Sciences, University ‘Magna Graecia’ of Catanzaro, Catanzaro, Italy
- Research Center for the Prevention and Treatment of Metabolic Diseases (CR METDIS), University ‘Magna Graecia’ of Catanzaro, Catanzaro, Italy
- *Correspondence: Franco Arturi,
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20
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Gogolewski K, Miasojedow B, Sadkowska-Todys M, Stepień M, Demkow U, Lech A, Szczurek E, Rabczenko D, Rosińska M, Gambin A. Data-driven case fatality rate estimation for the primary lineage of SARS-CoV-2 in Poland. Methods 2022; 203:584-593. [PMID: 35085741 PMCID: PMC8785264 DOI: 10.1016/j.ymeth.2022.01.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 12/05/2021] [Accepted: 01/18/2022] [Indexed: 12/28/2022] Open
Abstract
After more than one and a half year since the COVID-19 pandemics outbreak the scientific world is constantly trying to understand its dynamics. In this paper of the case fatality rates (CFR) for COVID-19 we study the historic data regarding mortality in Poland during the first six months of pandemic, when no SARS-CoV-2 variants of concern were present among infected. To this end, we apply competing risk models to perform both uni- and multivariate analyses on specific subpopulations selected by different factors including the key indicators: age, sex, hospitalization. The study explores the case fatality rate to find out its decreasing trend in time. Furthermore, we describe the differences in mortality among hospitalized and other cases indicating a sudden increase of mortality among hospitalized cases at the end of the 2020 spring season. Exploratory and multivariate analysis revealed the real impact of each variable and besides the expected factors indicating increased mortality (age, comorbidities) we track more non-obvious indicators. Recent medical care as well as the identification of the source contact, independently of the comorbidities, significantly impact an individual mortality risk. As a result, the study provides a twofold insight into the COVID-19 mortality in Poland. On one hand we explore mortality in different groups with respect to different variables, on the other we indicate novel factors that may be crucial in reducing mortality. The later can be coped, e.g. by more efficient contact tracing and proper organization and management of the health care system to accompany those who need medical care independently of comorbidities or COVID-19 infection.
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Affiliation(s)
- Krzysztof Gogolewski
- Faculty of Mathematics, Informatics and Mechanics, University of Warsaw, Warsaw, Poland
| | - Błażej Miasojedow
- Faculty of Mathematics, Informatics and Mechanics, University of Warsaw, Warsaw, Poland
| | - Małgorzata Sadkowska-Todys
- Department of Infectious Disease Epidemiology and Surveillance, National Institute of Public Health NIH - National Research Institute, Warsaw, Poland
| | - Małgorzata Stepień
- Department of Infectious Disease Epidemiology and Surveillance, National Institute of Public Health NIH - National Research Institute, Warsaw, Poland
| | - Urszula Demkow
- Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Medical University of Warsaw, Warsaw, Poland
| | - Agnieszka Lech
- Department of Medical Microbiology, Medical University of Warsaw, Warsaw, Poland
| | - Ewa Szczurek
- Faculty of Mathematics, Informatics and Mechanics, University of Warsaw, Warsaw, Poland
| | - Daniel Rabczenko
- Department for Monitoring and Analysis of Population Health Status, National Institute of Public Health NIH - National Research Institute, Warsaw, Poland
| | - Magdalena Rosińska
- Department of Infectious Disease Epidemiology and Surveillance, National Institute of Public Health NIH - National Research Institute, Warsaw, Poland
| | - Anna Gambin
- Faculty of Mathematics, Informatics and Mechanics, University of Warsaw, Warsaw, Poland
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21
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Srinivasan K, Pandey AK, Livingston A, Venkatesh S. Roles of host mitochondria in the development of COVID-19 pathology: Could mitochondria be a potential therapeutic target? MOLECULAR BIOMEDICINE 2021; 2:38. [PMID: 34841263 PMCID: PMC8608434 DOI: 10.1186/s43556-021-00060-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 11/04/2021] [Indexed: 02/07/2023] Open
Abstract
The recent emergence of severe acute respiratory syndrome-Corona Virus 2 (SARS-CoV-2) in late 2019 and its spread worldwide caused an acute pandemic of Coronavirus disease 19 (COVID-19). Since then, COVID-19 has been under intense scrutiny as its outbreak led to significant changes in healthcare, social activities, and economic settings worldwide. Although angiotensin-converting enzyme-2 (ACE-2) receptor is shown to be the primary port of SARS-CoV-2 entry in cells, the mechanisms behind the establishment and pathologies of COVID-19 are poorly understood. As recent studies have shown that host mitochondria play an essential role in virus-mediated innate immune response, pathologies, and infection, in this review, we will discuss in detail the entry and progression of SARS-CoV-2 and how mitochondria could play roles in COVID-19 disease. We will also review the potential interactions between SARS-CoV-2 and mitochondria and discuss possible treatments, including whether mitochondria as a potential therapeutic target in COVID-19. Understanding SARS-CoV-2 and mitochondrial interactions mediated virus establishment, inflammation, and other consequences may provide a unique mechanism and conceptual advancement in finding a novel treatment for COVID-19.
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Affiliation(s)
- Kavya Srinivasan
- Department of Microbiology, Biochemistry and Molecular Genetics, Rutgers -New Jersey Medical School, The State University of New Jersey, Newark, NJ USA
- New York Institute of Technology, Old Westbury, NY USA
| | - Ashutosh Kumar Pandey
- Department of Pharmacology, Physiology and Neuroscience, Rutgers -New Jersey Medical School, The State University of New Jersey, Newark, NJ USA
| | | | - Sundararajan Venkatesh
- Department of Microbiology, Biochemistry and Molecular Genetics, Rutgers -New Jersey Medical School, The State University of New Jersey, Newark, NJ USA
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Banerjee Y, Pantea Stoian A, Silva-Nunes J, Sonmez A, Rizvi AA, Janez A, Rizzo M. The role of GLP-1 receptor agonists during COVID-19 pandemia: a hypothetical molecular mechanism. Expert Opin Drug Saf 2021; 20:1309-1315. [PMID: 34424130 PMCID: PMC8425441 DOI: 10.1080/14740338.2021.1970744] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 08/17/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION A number of anti-diabetic treatments have been favored during the continuing spread of the current SARS-CoV-2 pandemic. Glucagon like peptide-1 receptor agonists (GLP1-RAs) are a group of antidiabetic drugs, the glucose reducing effect of which is founded on augmenting glucose-dependent insulin secretion with concomitant reduction of glucagon secretion and delayed gastric emptying. Apart from their glucose lowering effects, GLP1-RAs also exert a plethora of pleiotropic activities in the form of anti-inflammatory, anti-thrombotic and anti-obesogenic properties, with beneficial cardiovascular and renal impact. All these make this class of drugs a preferred option for managing patients with type 2 diabetes (T2D), and potentially helpful in those with SARS-CoV2 infection. AREAS COVERED In the present article we propose a hypothetical molecular mechanism by which GLP1-RAs may interact with SARS-CoV-2 activity. EXPERT OPINION The beneficial properties of GLP1-RAs may be of specific importance during COVID-19 infection for the most fragile patients with chronic comorbid conditions such as T2D, and those at higher cardiovascular and renal disease risk. Yet, further studies are needed to confirm our hypothesis and preliminary findings available in the literature.
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Affiliation(s)
- Yajnavalka Banerjee
- Biochemistry, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
- Centre of Medical Education, University of Dundee, UK
| | - Anca Pantea Stoian
- Department of Diabetes, Nutrition and Metabolic Diseases, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - José Silva-Nunes
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário De Lisboa Central, Lisbon, Portugal
- Nova Medical School-Faculdade De Ciências Medicas, New University of Lisbon, Lisbon, Portugal
- Health and Technology Research Center (H&TRC), Escola Superior De Tecnologia Da Saude De Lisboa, Lisbon, Portugal
| | - Alper Sonmez
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Ali A Rizvi
- Division of Endocrinology, Metabolism, and Lipids Emory, University School of Medicine, Atlanta, GA, USA
- Division of Endocrinology, Diabetes and Metabolism, University of South Carolina School of Medicine, Columbia, SC, USA
| | - Andrej Janez
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Faculty of Medicine, University of Ljubljana, Slovenia
| | - Manfredi Rizzo
- Department of Diabetes, Nutrition and Metabolic Diseases, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Division of Endocrinology, Diabetes and Metabolism, University of South Carolina School of Medicine, Columbia, SC, USA
- Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
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Caycho-Rodríguez T, Vilca LW, Corrales-Reyes IE, Hernández-García F, Pérez AP, Quintana PG, Pérez García ER, Lazo Herrera LA, White M. COVID-19 contagion concern scale (PRE-COVID-19): Validation in Cuban patients with type 2 diabetes. Diabetes Metab Syndr 2021; 15:102245. [PMID: 34416467 PMCID: PMC8363424 DOI: 10.1016/j.dsx.2021.102245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 08/11/2021] [Indexed: 12/16/2022]
Abstract
AIMS It is important to have valid and reliable measures to determine the psychological impact of COVID-19 in patients with diabetes; however, few instruments have been developed and validated for this population. Therefore, the aim of this study was to validate the Scale of Worry for Contagion of COVID-19 (PRE-COVID-19) in a sample of patients with diabetes mellitus (DM). MATERIALS AND METHODS A total of 219 patients (66.2% female, mean age 58.5 SD = 18.2) participated, selected through non-probabilistic sampling. The PRE-COVID-19 and the Generalized Anxiety Disorder Scale-2 were applied. Reliability analysis was performed for internal consistency, structural equation modeling and item response theory modeling. RESULTS The results show that a unidimensional 5-item model presents satisfactory goodness-of-fit indices and excellent reliability values. Likewise, convergent validity between the PRE-COVID-19 and a measure of anxiety is evident. All items present adequate discrimination parameters, allowing for discerning between those patients with critical concern about COVID-19 contagion from those with severe concern. CONCLUSION It is concluded that the PRE-COVID-19 is an instrument with adequate psychometric properties to measure concern about COVID-19 infection and the emotional impact in patients with DM.
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Affiliation(s)
| | - Lindsey W Vilca
- Departamento de Psicología, Universidad Peruana Unión, Lima, Perú
| | - Ibraín Enrique Corrales-Reyes
- Servicio de Cirugía Maxilofacial, Hospital General Universitario Carlos Manuel de Céspedes, Universidad de Ciencias Médicas de Granma, Bayamo, Granma, Cuba
| | - Frank Hernández-García
- Centro Provincial de Atención y Educación al Paciente Diabético, Hospital Provincial General Docente "Dr. Antonio Luaces Iraola", Facultad de Ciencias Médicas "Dr. José Asse Yara", Universidad de Ciencias Médicas de Ciego de Ávila, Ciego de Ávila, Cuba
| | - Antonio Pupo Pérez
- Facultad de Ciencias Médicas "General Calixto García", Universidad de Ciencias Médicas de La Habana, La Habana, Cuba
| | | | - Enrique Rolando Pérez García
- Policlínico Universitario Área Norte, Facultad de Ciencias Médicas "Dr. José Assef Yara", Universidad de Ciencias Médicas de Ciego de Ávila, Ciego de Ávila, Cuba
| | - Luis Alberto Lazo Herrera
- Facultad de Ciencias Médicas "Dr. Ernesto Che Guevara de la Serna" Universidad de Ciencias Médicas de Pinar del Río Pinar del Río Cuba
| | - Michael White
- Dirección General de Investigación, Universidad Peruana Unión, Perú
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24
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Ortega E, Corcoy R, Gratacòs M, Cos Claramunt FX, Mata-Cases M, Puig-Treserra R, Real J, Vlacho B, Castelblanco E, Domingo P, Khunti K, Franch-Nadal J, Mauricio D. Risk factors for severe outcomes in people with diabetes hospitalised for COVID-19: a cross-sectional database study. BMJ Open 2021; 11:e051237. [PMID: 34301668 PMCID: PMC8300551 DOI: 10.1136/bmjopen-2021-051237] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
AIM This study's objective was to assess the risk of severe in-hospital complications of patients admitted for COVID-19 and diabetes mellitus (DM). DESIGN This was a cross-sectional study. SETTINGS We used pseudonymised medical record data provided by six general hospitals from the HM Hospitales group in Spain. OUTCOME MEASURES Multiple logistic regression analyses were used to identify variables associated with mortality and the composite of mortality or invasive mechanical ventilation (IMV) in the overall population, and stratified for the presence or absence of DM. Spline analysis was conducted on the entire population to investigate the relationship between glucose levels at admission and outcomes. RESULTS Overall, 1621 individuals without DM and 448 with DM were identified in the database. Patients with DM were on average 5.1 years older than those without. The overall in-hospital mortality was 18.6% (N=301), and was higher among patients with DM than those without (26.3% vs 11.3%; p<0.001). DM was independently associated with death, and death or IMV (OR=2.33, 95% CI: 1.7 to 3.1 and OR=2.11, 95% CI: 1.6 to 2.8, respectively; p<0.001). In subjects with DM, the only variables independently associated with both outcomes were age >65 years, male sex and pre-existing chronic kidney disease. We observed a non-linear relationship between blood glucose levels at admission and risk of in-hospital mortality and death or IMV. The highest probability for each outcome (around 50%) was at random glucose of around 550 mg/dL (30.6 mmol/L), and the risks flattened above this value. CONCLUSION The results confirm the high burden associated with DM in patients hospitalised with COVID-19 infection, particularly among men, the elderly and those with impaired kidney function. Moreover, hyperglycaemia on admission was strongly associated with poor outcomes, suggesting that personalised optimisation could help to improve outcome during the hospital stay.
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Affiliation(s)
- Emilio Ortega
- DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clinic, Barcelona, Spain
| | - Rosa Corcoy
- Department of Endocrinology and Nutrition, Hospital Universitari de la Santa Creu i Sant Pau, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBER of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Mònica Gratacòs
- DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Francesc Xavier Cos Claramunt
- DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Innovation office, Institut Català de la Salut, Barcelona, Spain
| | - Manel Mata-Cases
- DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Primary Health Care Center La Mina, Gerència d'Àmbit d'Atenció Primària Barcelona Ciutat, Institut Català de la Salut, Sant Adrià de Besòs, Spain
- CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Ramon Puig-Treserra
- DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Jordi Real
- DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Bogdan Vlacho
- DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Esmeralda Castelblanco
- DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Pere Domingo
- Infectious Diseases, Hospital Universitari de la Santa Creu i Sant Pau, Institut de Recerca Hospital Universitari de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Josep Franch-Nadal
- DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Primary Health Care Center Raval Sud, Gerència d'Atenció Primaria, Institut Català de la Salut, Barcelona, Spain
| | - Didac Mauricio
- DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Department of Endocrinology and Nutrition, Hospital Universitari de la Santa Creu i Sant Pau, Barcelona, Spain
- CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Departament of Medicine, University of Vic - Central University of Catalonia, Vic, Barcelona, Spain
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25
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Palanisamy S, Xue C, Ishiyama S, Naga Prasad SV, Gabrielson K. GPCR-ErbB transactivation pathways and clinical implications. Cell Signal 2021; 86:110092. [PMID: 34303814 DOI: 10.1016/j.cellsig.2021.110092] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 07/18/2021] [Accepted: 07/19/2021] [Indexed: 11/18/2022]
Abstract
Cell surface receptors including the epidermal growth factor receptor (EGFR) family and G-protein coupled receptors (GPCRs) play quintessential roles in physiology, and in diseases, including cardiovascular diseases. While downstream signaling from these individual receptor families has been well studied, the cross-talk between EGF and GPCR receptor families is still incompletely understood. Including members of both receptor families, the number of receptor and ligand combinations for unique interactions is vast, offering a frontier of pharmacologic targets to explore for preventing and treating disease. This molecular cross-talk, called receptor transactivation, is reviewed here with a focus on the cardiovascular system featuring the well-studied GPCR receptors, but also discussing less-studied receptors from both families for a broad understanding of context of expansile interactions, repertoire of cellular signaling, and disease consequences. Attention is given to cell type, level of chronicity, and disease context given that transactivation and comorbidities, including diabetes, hypertension, coronavirus infection, impact cardiovascular disease and health outcomes.
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Affiliation(s)
| | - Carolyn Xue
- University of California, Los Angeles, 101 Hershey Hall, 612 Charles E. Young Drive South, Los Angeles, CA 90095, USA.
| | - Shun Ishiyama
- Sidney Kimmel Cancer Center, Department of Surgery, Department of Molecular and Comparative Pathobiology, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; Department of Coloproctological Surgery, Juntendo University School of Medicine, Tokyo, Japan.
| | - Sathyamangla Venkata Naga Prasad
- NB50, Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue, 1, Cleveland, OH 44195, USA.
| | - Kathleen Gabrielson
- Department of Molecular and Comparative Pathobiology, Johns Hopkins University, School of Medicine, 733 North Broadway, Miller Research Building, Room 807, Baltimore, MD 21205-2196, USA.
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26
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Oliva C, Di Maddaloni F, Marcellusi A, Favato G. Cross-regional variations of Covid-19 mortality in Italy: an ecological study. J Public Health (Oxf) 2021; 43:261-269. [PMID: 33458758 PMCID: PMC7928707 DOI: 10.1093/pubmed/fdaa248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 12/02/2020] [Accepted: 12/07/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Disparities in cross-regional coronavirus disease 2019 (Covid-19) mortality remain poorly understood. The association between pre-epidemic health and epidemic mortality can inform a policy response to future outbreaks. METHOD We conducted an ecological study of the association between the cumulative deaths attributed to Covid-19 epidemic in the 20 Italian regions and nine determinants of population health derived from a systematic review of the literature. We used a multiple least square regression to predict the cross-regional variation in mortality observed from the onset of the epidemic to 23 September 2020. RESULTS Four independent variables best explained the cross-regional differences in the number of deaths attributed to Covid-19: the force of infection, population density, number of elderly living in assisted facilities and the standard rate of diabetes. The semi-partial correlation coefficients suggest that the force of infection and the number of elderly residents in nursing homes were the dominant predictors of the number of deaths attributed to Covid-19. Statistical controls and validation confirmed the generalizability of the predictive model. CONCLUSIONS Our findings indicate that a significant reduction of social contacts in main metropolitan areas and the timely isolation of elderly and diabetic residents could significantly reduce the death toll of the next wave of Covid-19 infection in Italy.
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Affiliation(s)
- Cristina Oliva
- Institute for Leadership and Management in Health, Kingston Business School, Kingston University London, Kingston Hill, Kingston upon Thames KT2 7LB, United Kingdom
| | - Francesco Di Maddaloni
- Institute for Leadership and Management in Health, Kingston Business School, Kingston University London, Kingston Hill, Kingston upon Thames KT2 7LB, United Kingdom
| | - Andrea Marcellusi
- Institute for Leadership and Management in Health, Kingston Business School, Kingston University London, Kingston Hill, Kingston upon Thames KT2 7LB, United Kingdom.,Faculty of Economics, Economic Evaluation and HTA (EEHTA), CEIS, University of Rome "Tor Vergata", Via Columbia 2, 00133, Rome, RM, Italy
| | - Giampiero Favato
- Institute for Leadership and Management in Health, Kingston Business School, Kingston University London, Kingston Hill, Kingston upon Thames KT2 7LB, United Kingdom
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27
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Mirjalili H, Dastgheib SA, Shaker SH, Bahrami R, Mazaheri M, Sadr-Bafghi SMH, Sadeghizadeh-Yazdi J, Neamatzadeh H. Proportion and mortality of Iranian diabetes mellitus, chronic kidney disease, hypertension and cardiovascular disease patients with COVID-19: a meta-analysis. J Diabetes Metab Disord 2021; 20:905-917. [PMID: 33654683 PMCID: PMC7907796 DOI: 10.1007/s40200-021-00768-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/14/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Currently, the number of patients with SARS-COV-2 infection has increased rapidly in Iran, but the risk and mortality of SARS-COV-2 infection in Iranian patients with diabetes mellitus (DM), chronic kidney disease (CKD), hypertension and cardiovascular diseases (CVDs) still not clear. The aim of this meta-analysis was to estimate the proportion and mortality of SARS-COV-2 in these patients. METHODS A comprehensive literature search was carried out in PubMed, Web of Sciences, Cochrane Library, EMBASE, CNKI, SciELO, and other databases to identify all relevant studies published up to 10 January, 2020. The proportion and mortality in the patients were assessed by odd ratio (OR) and the corresponding 95 % confidence interval (95 % CI). RESULTS A total of ten case-series including 11,755 cases with SARS-COV-2 infection and 942 deaths were selected. Among them, there were total of 791 DM patients with 186 deaths, 225 CKD patients with 45 deaths, 790 hypertension cases with 86 deaths, and 471 CVDs cases with 60 deaths. Pooled data revealed that the proportion of SARS-COV-2 infection in the patients with hypertension, DM, CVDs and CKD were 21.1 %, 16.3 %, 14.0 % and 5.0 %, respectively. Moreover, the SARS-COV-2 infection were associated with an increased risk of mortality in DM (OR = 0.549, CI 95 % 0.448-0.671, p ≤ 0.001) and CKD (OR = 0.552, 95 % CI 0.367-0.829, p = 0.004) patients, but not hypertension and CVDs. There was no publication bias. CONCLUSIONS Our pooled data showed that the proportion of SARS-COV-2 infection was the highest in the Iranian patients with hypertension (21.1 %) followed by DM (16.3 %), CVDs (14.0 %) and CKD (5.0 %). Moreover, DM and CKD in patients with SARS-COV-2 infection were associated with a 0.549 and 0.552-fold increase in mortality, respectively. Clinicians in Iran should be aware of these findings, to identifying patients at higher risk and inform interventions to reduce the risk of death. Moreover, well-designed, large-scale and multicenter studies are needed to improve and validate our findings.
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Affiliation(s)
- Hamid Mirjalili
- Department of Emergency Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyed Alireza Dastgheib
- Department of Medical Genetics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Hossein Shaker
- Department of Emergency Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Bahrami
- Neonatal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahta Mazaheri
- Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Medical Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Jalal Sadeghizadeh-Yazdi
- Department of Food Science and Technology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hossein Neamatzadeh
- Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Medical Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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28
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Borchers C, Thyagarajan A, Rapp CM, Travers JB, Sahu RP. Evaluation of SARS-CoV-2 Spike S1 Protein Response on PI3K-Mediated IL-8 Release. Med Sci (Basel) 2021; 9:medsci9020030. [PMID: 34069835 PMCID: PMC8162560 DOI: 10.3390/medsci9020030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/05/2021] [Accepted: 05/08/2021] [Indexed: 01/19/2023] Open
Abstract
A novel coronavirus related to a condition known as a severe acute respiratory syndrome (SARS) was termed as SARS Coronavirus-19 (SARS-CoV-2 or COVID-19), which has caused an unprecedented global pandemic. Extensive efforts have been dedicated worldwide towards determining the mechanisms of COVID-19 associated pathogenesis with the goals of devising potential therapeutic approaches to mitigate or overcome comorbidities and mortalities. While the mode of SARS-CoV-2 infection, its structural configuration, and mechanisms of action, including the critical roles of the Spike protein have been substantially explored, elucidation of signaling pathways regulating its cellular responses is yet to be fully determined. Notably, phosphoinositide 3-kinases (PI3K) and its downstream pathway have been exploited among potential therapeutic targets for SARS-CoV-2, and its activation modulates the release of cytokines such as IL-8. To that end, the current studies were sought to determine the response of the SARS-CoV-2 Spike S1 protein on PI3K-mediated IL-8 release using relevant and widely used cellular models. Overall, these studies indicate that PI3K signaling does not directly mediate Spike S1 protein-induced IL-8 release in these cellular models.
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Affiliation(s)
- Christina Borchers
- Department of Pharmacology and Toxicology, Boonshoft School of Medicine, Wright State University, Dayton, OH 45345, USA; (C.B.); (A.T.); (C.M.R.); (J.B.T.)
| | - Anita Thyagarajan
- Department of Pharmacology and Toxicology, Boonshoft School of Medicine, Wright State University, Dayton, OH 45345, USA; (C.B.); (A.T.); (C.M.R.); (J.B.T.)
| | - Christine M. Rapp
- Department of Pharmacology and Toxicology, Boonshoft School of Medicine, Wright State University, Dayton, OH 45345, USA; (C.B.); (A.T.); (C.M.R.); (J.B.T.)
| | - Jeffrey B. Travers
- Department of Pharmacology and Toxicology, Boonshoft School of Medicine, Wright State University, Dayton, OH 45345, USA; (C.B.); (A.T.); (C.M.R.); (J.B.T.)
- Department of Dermatology, Wright State Physicians, Wright State University, Dayton, OH 45345, USA
| | - Ravi P. Sahu
- Department of Pharmacology and Toxicology, Boonshoft School of Medicine, Wright State University, Dayton, OH 45345, USA; (C.B.); (A.T.); (C.M.R.); (J.B.T.)
- Correspondence:
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29
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García de Guadiana-Romualdo L, Morell-García D, Morales-Indiano C, Bauça JM, Alcaide Martín MJ, Esparza del Valle C, Gutiérrez Revilla JI, Urrechaga E, Álamo JM, Hernando Holgado AM, Lorenzo-Lozano MC, Sánchez Fdez-Pacheco S, de la Hera Cagigal P, Juncos Tobarra MA, Vílchez JA, Vírseda Chamorro I, Gutiérrez Garcia I, Pastor Murcia Y, Sahuquillo Frías L, Altimira Queral L, Nuez-Zaragoza E, Adell Ruiz de León J, Ruiz Ripa A, Salas Gómez-Pablos P, Cebreiros López I, Fernández Uriarte A, Larruzea Á, López Yepes ML, Esteban Torrella P, Zamorano Andrés MC, Pedregosa Díaz J, Acevedo Alcaraz C, Blazquez-Manzanera AL, Padilla Jiménez AML, Baamonde Calzada MC, Vera M, Cháfer Rudilla M, Canalda Campás M, García Muñoz S, Vicente Gutiérrez L, Jiménez Añón L, Pérez Martínez A, Pons Castillo A, González Tamayo R, Férriz Vivancos J, Rodríguez-Fraga O, Ferrer Díaz de Brito Fernández V, Aguadero V, García Arévalo MG, Arnaldos Carrillo M, González Morales M, Núñez Gárate M, Ruiz Iruela C, Sancho-Rodríguez N, Vila Pérez M, Egea-Caparrós JM, Sáenz L, Blasco Barbero Á, Galán Ortega A. Characteristics and laboratory findings on admission to the emergency department among 2873 hospitalized patients with COVID-19: the impact of adjusted laboratory tests in multicenter studies. A multicenter study in Spain (BIOCOVID-Spain study). Scand J Clin Lab Invest 2021; 81:187-193. [PMID: 33591234 PMCID: PMC7898295 DOI: 10.1080/00365513.2021.1881997] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/31/2020] [Accepted: 01/24/2021] [Indexed: 02/08/2023]
Abstract
Identification of predictors for severe disease progression is key for risk stratification in COVID-19 patients. We aimed to describe the main characteristics and identify the early predictors for severe outcomes among hospitalized patients with COVID-19 in Spain. This was an observational, retrospective cohort study (BIOCOVID-Spain study) including COVID-19 patients admitted to 32 Spanish hospitals. Demographics, comorbidities and laboratory tests were collected. Outcome was in-hospital mortality. For analysis, laboratory tests values were previously adjusted to assure the comparability of results among participants. Cox regression was performed to identify predictors. Study population included 2873 hospitalized COVID-19 patients. Nine variables were independent predictors for in-hospital mortality, including creatinine (Hazard ratio [HR]:1.327; 95% Confidence Interval [CI]: 1.040-1.695, p = .023), troponin (HR: 2.150; 95% CI: 1.155-4.001; p = .016), platelet count (HR: 0.994; 95% CI: 0.989-0.998; p = .004) and C-reactive protein (HR: 1.037; 95% CI: 1.006-1.068; p = .019). This is the first multicenter study in which an effort was carried out to adjust the results of laboratory tests measured with different methodologies to guarantee their comparability. We reported a comprehensive information about characteristics in a large cohort of hospitalized COVID-19 patients, focusing on the analytical features. Our findings may help to identify patients early at a higher risk for an adverse outcome.
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Affiliation(s)
| | - Daniel Morell-García
- Laboratory Medicine Department, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | | | - Josep Miquel Bauça
- Laboratory Medicine Department, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | | | - Clara Esparza del Valle
- Laboratory Medicine Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | | | - José M. Álamo
- Biochemical Laboratory, Hospital Marina Baixa, Villajoyosa, Spain
| | | | | | | | | | - María A. Juncos Tobarra
- Laboratory Medicine Department, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Juan A. Vílchez
- Laboratory Medicine Department. Hospital, Universitario Morales Meseguer, Murcia, Spain
| | | | | | - Yolanda Pastor Murcia
- Laboratory Medicine Department, Consorci Hospital General Universitari de València, Valencia, Spain
| | | | - Laura Altimira Queral
- Laboratory Medicine Department, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Elisa Nuez-Zaragoza
- Clinical Laboratory Department, Parc Tauli Hospital Universitari, Sabadell, Spain
| | | | - Alicia Ruiz Ripa
- Laboratory Medicine Department, Hospital de Mataró, Mataró, Spain
| | | | - Iria Cebreiros López
- Laboratory Medicine Department, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
| | | | - Álex Larruzea
- Laboratory Medicine Deparment, Hospital Fundació Sanitària Mollet, Barcelona, Spain
| | | | | | | | | | - Cristina Acevedo Alcaraz
- Laboratory Medicine Department. Hospital, Universitario Los Arcos del Mar Menor, San Javier, Spain
| | | | | | | | - Marina Vera
- Biochemical Laboratory, Hospital Marina Baixa, Villajoyosa, Spain
| | | | | | - Sara García Muñoz
- Laboratory Medicine Department, Hospital Universitario de Basurto, Bilbao, Spain
| | - Luis Vicente Gutiérrez
- Laboratory Medicine Department, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Laura Jiménez Añón
- Laboratory Medicine Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | | | | | - Ruth González Tamayo
- Laboratory Medicine Department, Hospital Universitario de Torrevieja, Torrevieja, Spain
| | - Jorge Férriz Vivancos
- Laboratory Medicine Department, Consorci Hospital General Universitari de València, Valencia, Spain
| | | | | | - Vicente Aguadero
- Clinical Laboratory Department, Parc Tauli Hospital Universitari, Sabadell, Spain
| | | | | | | | | | - Cristina Ruiz Iruela
- Laboratory Medicine Deparment, Hospital Fundació Sanitària Mollet, Barcelona, Spain
| | | | - Marti Vila Pérez
- Laboratory Medicine Department, Hospital Verge de la Cinta, Tortosa, Spain
| | - José M. Egea-Caparrós
- Laboratory Medicine Department. Hospital, Universitario Los Arcos del Mar Menor, San Javier, Spain
| | - Luis Sáenz
- Laboratory Medicine Department. Hospital General, Universitario Rafael Méndez, Lorca, Spain
| | | | - Amparo Galán Ortega
- Comisión de Magnitudes Biológicas relacionadas con la Urgencia Médica, Sociedad Española de Medicina de Laboratorio (SEQC-ML), Barcelona, Spain
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Magallón-Botaya R, Oliván-Blázquez B, Ramírez-Cervantes KL, Méndez-López-de-la-Manzanara F, Aguilar-Palacio I, Casajuana-Closas M, Andrés-Esteban E. Geographic Factors Associated with Poorer Outcomes in Patients Diagnosed with COVID-19 in Primary Health Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3842. [PMID: 33917578 PMCID: PMC8038835 DOI: 10.3390/ijerph18073842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/31/2021] [Accepted: 04/02/2021] [Indexed: 12/16/2022]
Abstract
Background: The prognosis of older age COVID-19 patients with comorbidities is associated with a more severe course and higher fatality rates but no analysis has yet included factors related to the geographical area/municipality in which the affected patients live, so the objective of this study was to analyse the prognosis of patients with COVID-19 in terms of sex, age, comorbidities, and geographic variables. Methods: A retrospective cohort of 6286 patients diagnosed with COVID-19 was analysed, considering demographic data, previous comorbidities and geographic variables. The main study variables were hospital admission, intensive care unit (ICU) admission and death due to worsening symptoms; and the secondary variables were sex, age, comorbidities and geographic variables (size of the area of residence, distance to the hospital and the driving time to the hospital). A comparison analysis and a multivariate Cox model were performed. Results: The multivariate Cox model showed that women had a better prognosis in any type of analysed prognosis. Most of the comorbidities studied were related to a poorer prognosis except for dementia, which is related to lower admissions and higher mortality. Suburban areas were associated with greater mortality and with less hospital or ICU admission. Distance to the hospital was also associated with hospital admission. Conclusions: Factors such as type of municipality and distance to hospital act as social health determinants. This fact must be taken account in order to stablish specifics prevention measures and treatment protocols.
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Affiliation(s)
- Rosa Magallón-Botaya
- GAIAP Research Group, Institute for Health Research Aragon (IIS Aragon), 50009 Zaragoza, Spain; (R.M.-B.); (F.M.-L.-d.-l.-M.); (I.A.-P.)
- Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, 50009 Zaragoza, Spain
- Research Network on Preventive Activities and Health Promotion (RedIAPP), 08007 Barcelona, Spain;
| | - Bárbara Oliván-Blázquez
- GAIAP Research Group, Institute for Health Research Aragon (IIS Aragon), 50009 Zaragoza, Spain; (R.M.-B.); (F.M.-L.-d.-l.-M.); (I.A.-P.)
- Research Network on Preventive Activities and Health Promotion (RedIAPP), 08007 Barcelona, Spain;
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
| | - Karen Lizzette Ramírez-Cervantes
- Department of Applied Economics, Rey Juan Carlos University, 28300 Madrid, Spain; (K.L.R.-C.); (E.A.-E.)
- Bleeding Patient Research Group, Idi-Paz Research Institute, 28029 Madrid, Spain
- Prevention Department, Spanish Association against Cancer, 28040 Madrid, Spain
| | | | - Isabel Aguilar-Palacio
- GAIAP Research Group, Institute for Health Research Aragon (IIS Aragon), 50009 Zaragoza, Spain; (R.M.-B.); (F.M.-L.-d.-l.-M.); (I.A.-P.)
- Department of Preventive Medicine and Public Health, University of Zaragoza, 50009 Zaragoza, Spain
- GRISSA Research Group, 50009 Zaragoza, Spain
| | - Marc Casajuana-Closas
- Research Network on Preventive Activities and Health Promotion (RedIAPP), 08007 Barcelona, Spain;
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
| | - Eva Andrés-Esteban
- Department of Applied Economics, Rey Juan Carlos University, 28300 Madrid, Spain; (K.L.R.-C.); (E.A.-E.)
- Bleeding Patient Research Group, Idi-Paz Research Institute, 28029 Madrid, Spain
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Leso V, Fontana L, Iavicoli I. Susceptibility to Coronavirus (COVID-19) in Occupational Settings: The Complex Interplay between Individual and Workplace Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1030. [PMID: 33503829 PMCID: PMC7908348 DOI: 10.3390/ijerph18031030] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 01/08/2023]
Abstract
In the current coronavirus (COVID-19) pandemic, the definition of risk factors for susceptibility to adverse outcomes seems essential to support public and occupational health policies. Some specific issues need to be addressed to understand vulnerability in occupational settings. Among these, individual factors, e.g., age, sex, and preexisting comorbidities (hypertension, cardiovascular diseases, diabetes, obesity, cancer), that can predispose individuals to more severe outcomes and post-COVID-19 symptoms that may represent conditions of acquired susceptibility, possibly impacting the return to-and fitness for-work. Additionally, the risk of contracting COVID-19 through work should be addressed, considering the probability of being in contact with infected people, physical proximity to others, and social aggregation during work. Occupational health settings may represent appropriate scenarios for the early identification of vulnerable subjects, with the final aim to guide risk assessment and management procedures. These should include the systematic surveillance of work-related risk factors, collective preventive policies, stringent actions for specific groups of workers, decisions on occupational placement of employees, and health promotion activities. Concerted actions of general practitioners, hospital specialists, occupational physicians, and all the stakeholders involved in the occupational health and safety management should be focused on planning suitable preventive measures for susceptible subjects.
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Affiliation(s)
| | | | - Ivo Iavicoli
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (V.L.); (L.F.)
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Nafakhi H, Alareedh M, Al-Buthabhak K, Shaghee F, Nafakhi A, Kasim S. Predictors of adverse in-hospital outcome and recovery in patients with diabetes mellitus and COVID-19 pneumonia in Iraq. Diabetes Metab Syndr 2021; 15:33-38. [PMID: 33296788 PMCID: PMC7832757 DOI: 10.1016/j.dsx.2020.12.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 11/26/2020] [Accepted: 12/04/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS There is limited data about the prognosis and impact of COVID-19 pneumonia on patients with diabetes mellitus (DM). We aimed to assess blood indices, ECG markers of sudden death and malignant arrhythmias on admission, and diabetes lowering drugs as possible predictors of adverse in-hospital outcome and COVID-19 pneumonia recovery status. METHODS A retrospective study included patients with newly diagnosed COVID-19 pneumonia from August 20, to October 5, 2020. RESULTS A total of 192 patients with COVID-19 pneumonia were included in the present study, of whom 67 patients had DM. Low lymphocytes % [0.4(0.1-0.9), P = .011] and QTc interval prolongation [0.4(0.1-0.8), P = .022] were associated with increased length of ICU stay. On the other hand, metformin use [0.3(0.2-4), P = .032] and DPP-4 inhibitors use [0.3(0.2-3), P = .040] were associated with decreased length of ICU stay. QTc interval prolongation [0.4(0.1-0.9), P = .017] was associated with increased length of hospital stay, while using metformin [0.4(0.2-3), P = .022] was associated with decreased length of hospital stay. Low lymphocytes % [0.5(0.4-1.6), P = .001], insulin use [0.4(0.3-5), P = .003], and old age [0.5(0.1-2.3), P = .025] were associated with extensive lung injury. The risk for in-hospital death was associated with high neutrophil% [1(1-1.4), P = .045], while metformin use was associated with decreased risk for in-hospital death [0.1(0.1-0.6), P = .025]. Insulin use [0.3(0.2-4), P = .013] was associated with partial recovery following acute COVID pneumonia. CONCLUSIONS Metformin and DPP-4 inhibitors use were associated with favorable in-hospital outcomes, while insulin use was associated with extensive lung injury and post-acute COVID-19 pneumonia partial recovery.
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Affiliation(s)
- Hussein Nafakhi
- Internal Medicine Department, Medicine College, University of Kufa, Najaf, Iraq.
| | - Mohammed Alareedh
- Internal Medicine Department, Medicine College, University of Kufa, Najaf, Iraq.
| | - Karrar Al-Buthabhak
- Internal Medicine Department, Medicine College, University of Kufa, Najaf, Iraq.
| | - Foaad Shaghee
- Internal Medicine Department, Jabir Ibn Hayyan Medical University Faculty of Medicine, Kufa, Iraq.
| | - Ahmed Nafakhi
- Research Unit, Najaf Health Bureau, Ministry of Health, Iraq.
| | - Samet Kasim
- Internal Medicine Department, Medicine College, University of Kufa, Najaf, Iraq.
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Abstract
Diabetes is one of the most common comorbidities in hospitalized patients with coronavirus disease 2019 (COVID-19). Inpatient hyperglycemia during this pandemic has been associated with worse outcomes, so it is mandatory to implement effective glycemic control treatment approaches for inpatients with COVID-19. The shortage of personal protective equipment, the need to prevent staff exposure, or the fact that many of the healthcare professionals might be relatively unfamiliar with the management of hyperglycemia may lead to worse glycemic control and, consequently, a worse prognosis. In order to reduce these barriers, we intend to adapt established recommendations to manage hyperglycemia during this pandemic in critical and noncritical care settings.
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Affiliation(s)
- Virginia Bellido
- Department of Endocrinology and Nutrition, Cruces University Hospital, Vizcaya, Spain
- Biocruces Bizkaia Health Research Institute, Vizcaya, Spain
- University of the Basque Country (UPV/EHU), Vizcaya, Spain
| | - Antonio Pérez
- Department of Endocrinology and Nutrition, Santa Creu I Sant Pau Hospital, Barcelona, Spain.
- Sant Pau Institute of Biomedical Research, Barcelona, Spain.
- Autonomous University of Barcelona, Barcelona, Spain.
- CIBER de Diabetes Y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain.
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Lazarus G, Audrey J, Wangsaputra VK, Tamara A, Tahapary DL. High admission blood glucose independently predicts poor prognosis in COVID-19 patients: A systematic review and dose-response meta-analysis. Diabetes Res Clin Pract 2021; 171:108561. [PMID: 33310127 PMCID: PMC7725108 DOI: 10.1016/j.diabres.2020.108561] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/11/2020] [Accepted: 11/16/2020] [Indexed: 01/08/2023]
Abstract
AIMS To investigate the prognostic value of admission blood glucose (BG) in predicting COVID-19 outcomes, including poor composite outcomes (mortality/severity), mortality, and severity. METHODS Eligible studies evaluating the association between admission fasting BG (FBG) and random BG (RBG) levels with COVID-19 outcomes were included and assessed for risk of bias with the Quality in Prognosis Studies tool. Random-effects dose-response meta-analysis was conducted to investigate potential linear or non-linear exposure-response gradient. RESULTS The search yielded 35 studies involving a total of 14,502 patients. We discovered independent association between admission FBG and poor COVID-19 prognosis. Furthermore, we demonstrated non-linear relationship between admission FBG and severity (Pnon-linearity < 0.001), where each 1 mmol/L increase augmented the risk of severity by 33% (risk ratio 1.33 [95% CI: 1.26-1.40]). Albeit exhibiting similar trends, study scarcity limited the evidence strength on the independent prognostic value of admission RBG. GRADE assessment yielded high-quality evidence for the association between admission FBG and COVID-19 severity, and moderate-quality evidence for its association with mortality and poor outcomes. CONCLUSION High admission FBG level independently predicted poor COVID-19 prognosis. Further research to confirm the prognostic value of admission RBG and to ascertain the estimated dose-response risk between admission FBG and COVID-19 severity are required.
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Affiliation(s)
- Gilbert Lazarus
- Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
| | - Jessica Audrey
- Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | | | - Alice Tamara
- Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; Metabolic, Cardiovascular and Aging Cluster, The Indonesian Medical Education and Research Institute, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Dicky L Tahapary
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; Metabolic, Cardiovascular and Aging Cluster, The Indonesian Medical Education and Research Institute, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
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Orioli L, Servais T, Belkhir L, Laterre PF, Thissen JP, Vandeleene B, Maiter D, Yombi JC, Hermans MP. Clinical characteristics and short-term prognosis of in-patients with diabetes and COVID-19: A retrospective study from an academic center in Belgium. Diabetes Metab Syndr 2021; 15:149-157. [PMID: 33352454 PMCID: PMC7833262 DOI: 10.1016/j.dsx.2020.12.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/05/2020] [Accepted: 12/09/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS We describe the characteristics and short-term prognosis of in-patients with diabetes and COVID-19 admitted to a Belgian academic care center. METHODS We retrospectively reviewed the data on admission from patients with known or newly-diagnosed diabetes and confirmed COVID-19. First, survivors were compared to non-survivors to study the predictive factors of in-hospital death in patients with diabetes. Secondly, diabetic patients with SARS-CoV-2 pneumonia were matched for age and sex with non-diabetic patients with SARS-CoV-2 pneumonia, to study the prognosis and predictive factors of in-hospital death related to diabetes. RESULTS Seventy-three diabetic patients were included. Mean age was 69 (±14) years. Women accounted for 52%. Most patients had type 2 diabetes (89.0%), long-term complications of hyperglycemia (59.1%), and hypertension (80.8%). The case-fatality rate (CFR) was 15%. Non-survivors had more severe pneumonia based on imaging (p 0.029) and were less often treated with metformin (p 0.036). In patients with SARS-CoV-2 pneumonia, CFR was 15.6% in diabetic (n = 64) and 25.0% in non-diabetic patients (n = 128), the difference being non-significant (p 0.194). Predictive factors of in-hospital death were elevated white blood cells count (HR 9.4, CI 1.50-58.8, p 0.016) and severe pneumonia on imaging (HR 25.0, CI 1.34-466, p 0.031) in diabetic patients, and cognitive impairment (HR 5.80, CI 1.61-20.9, p 0.007) and cardiovascular disease (HR 5.63, CI 1.54-20.6, p 0.009) in non-diabetic patients. CONCLUSION In this monocentric cohort from Belgium, diabetic in-patients with COVID-19 had mostly type 2 diabetes, prevalent hyperglycemia-related vascular complications and comorbidities including hypertension. In this cohort, the CFR was not statistically different between patients with and without diabetes.
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Affiliation(s)
- Laura Orioli
- Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200, Brussels, Belgium; Department of Endocrinology, Diabetology and Nutrition, IREC, UCLouvain, Avenue Hippocrate 55, 1200, Brussels, Belgium.
| | - Thomas Servais
- Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200, Brussels, Belgium
| | - Leïla Belkhir
- Department of Internal Medicine, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200, Brussels, Belgium
| | - Pierre-François Laterre
- Department of Acute Medicine, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200, Brussels, Belgium
| | - Jean-Paul Thissen
- Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200, Brussels, Belgium; Department of Endocrinology, Diabetology and Nutrition, IREC, UCLouvain, Avenue Hippocrate 55, 1200, Brussels, Belgium
| | - Bernard Vandeleene
- Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200, Brussels, Belgium
| | - Dominique Maiter
- Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200, Brussels, Belgium; Department of Endocrinology, Diabetology and Nutrition, IREC, UCLouvain, Avenue Hippocrate 55, 1200, Brussels, Belgium
| | - Jean C Yombi
- Department of Internal Medicine, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200, Brussels, Belgium
| | - Michel P Hermans
- Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200, Brussels, Belgium
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Zhang N, Shi N, Li S, Liu G, Han Y, Liu L, Zhang X, Kong X, Zhang B, Yuan W, Liu Y, Deng D, Zheng M, Zhang Y, Li L, Wang X, Wu J, Lin X, Nian H, Wu X, Wang H, Liu F, Wang H, Wang H, Liu Y, Liu L, Zeng W, Yang M, Wang Y, Zhai H, Wang Y. A Retrospective Study on the Use of Chinese Patent Medicine in 24 Medical Institutions for COVID-19 in China. Front Pharmacol 2020; 11:574562. [PMID: 33776751 PMCID: PMC7990099 DOI: 10.3389/fphar.2020.574562] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 09/30/2020] [Indexed: 12/24/2022] Open
Abstract
Objective: This research aims to analyze the application regularity of Chinese patent medicine during the COVID-19 epidemic by collecting the names of the top three Chinese patent medicines used by 24 hospitals in 14 provinces of China in four time periods (January 20-22, February 16-18, March 01-03, April 01-03, 2020), and explore its contribution to combating the disease. Methods: 1) We built a database of the top three Chinese patent medicines used by 24 hospitals. 2) The frequency and efficacy distribution of Chinese patent medicine were analyzed with risk areas, regions, and hospitals of different properties as three factors. 3) Finally, we analyzed the differences in the use of heat-clearing and non-heat-clearing medicines among the three factors (χ2 test) and the correlation between the Chinese patent medicine and COVID-19 epidemic (correlation analysis) with SPSS 23.0 statistical software. Results: 1) The heat-clearing medicine was the main use category nationwide during January 20-22, 2020. Meanwhile, there was a significant difference in the utilization rate of heat-clearing and non-heat-clearing medicine in different risk areas (p < 0.01). 2) The variety of Chinese patent medicine was increased nationwide during February 16-18, 2020, mainly including tonics, blood-activating and resolving-stasis, and heat-clearing medicines. Meanwhile, there was a significant difference in the utilization rate of heat-clearing and non-heat-clearing medicine in the southern and northern regions (p < 0.05). 3) Tonics, and blood-activating and resolving-stasis medicines became the primary use categories nationwide during March 01-03, 2020. 4) The tonics class, and blood-activating and resolving-stasis medicine were still the primary categories nationwide during April 01-03, 2020. Meanwhile, there was a significant difference in the utilization rate of heat-clearing and non-heat-clearing medicine in different risk areas (p < 0.01). Conclusion: Chinese patent medicine has a certain degree of participation in fighting against the COVID-19. The efficacy distribution is related to the risk area, region, and hospital of different properties, among which the risk area is the main influencing factor. It is hoped that future research can further collect the application amount of Chinese patent medicine used in hospitals all over the country, so as to perfectly reflect the relationship between Chinese patent medicine and the epidemic situation.
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Affiliation(s)
- Nan Zhang
- Beijing University of Traditional Chinese Medicine, Beijing, China
| | - Nannan Shi
- China Academy of Chinese Medical Sciences, Beijing, China
| | - Siyu Li
- Beijing University of Traditional Chinese Medicine, Beijing, China
| | - Guoxiu Liu
- Beijing University of Traditional Chinese Medicine, Beijing, China
| | - Yonglong Han
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Li Liu
- Hospital of Chengdu University of Traditional Chinese Medicine, Sichuan, China
| | - Xin Zhang
- Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangdong, China
| | - Xiangwen Kong
- Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, China
| | | | | | - Yi Liu
- Traditional Chinese Medicine Hospital of Urumqi, Xinjiang, China
| | - Deqiang Deng
- Traditional Chinese Medicine Hospital of Urumqi, Xinjiang, China
| | - Minxia Zheng
- Zhejiang Provincial Hospital of Traditional Chinese Medicine, Zhejiang, China
| | - Ying Zhang
- Eye Hospital, China Academy of Traditional Chinese Medicine, Beijing, China
| | - Lihua Li
- The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Anhui, China
| | - Xiaoping Wang
- Shaanxi Provincial Hospital of Traditional Chinese Medicine, Shaanxi, China
| | - Jiankun Wu
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Xiaolan Lin
- Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Hua Nian
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaohong Wu
- Affiliated Hospital of Shanxi University of Traditional Chinese Medicine, Shanxi, China
| | - Hua Wang
- The Second Affiliated Hospital of Changchun University of Chinese Medicine, Jilin, China
| | - Fang Liu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Hongli Wang
- Gansu Provincial Hospital of Traditional Chinese Medicine, Gansu, China
| | - Hongshun Wang
- Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Jiangxi, China
| | - Ying Liu
- Peking University Third Hospital, Beijing, China
| | - Li Liu
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Weixin Zeng
- Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Manqin Yang
- The Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Anhui, China
| | - Yanping Wang
- China Academy of Chinese Medical Sciences, Beijing, China
| | - Huaqiang Zhai
- Beijing University of Traditional Chinese Medicine, Beijing, China
| | - Yongyan Wang
- China Academy of Chinese Medical Sciences, Beijing, China
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