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Hsieh TYJ, Chang R, Yong SB, Liao PL, Hung YM, Wei JCC. COVID-19 Vaccination Prior to SARS-CoV-2 Infection Reduced Risk of Subsequent Diabetes Mellitus: A Real-World Investigation Using U.S. Electronic Health Records. Diabetes Care 2023; 46:2193-2200. [PMID: 37851392 DOI: 10.2337/dc23-0936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/06/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVE Previous studies have indicated a bidirectional correlation between diabetes and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, no investigation has comprehensively explored the potential of coronavirus disease 2019 (COVID-19) vaccination to reduce the risk of new-onset diabetes in infected individuals. RESEARCH DESIGN AND METHODS In the first of 2 cohorts, we compared the risk of new-onset diabetes between individuals infected with SARS-CoV-2 and noninfected individuals (N = 1,562,606) using the TriNetX database to validate findings in prior literature. For the second cohort, we identified 83,829 vaccinated and 83,829 unvaccinated COVID-19 survivors from the same period. Diabetes, antihyperglycemic drug use, and a composite of both were defined as outcomes. We conducted Cox proportional hazard regression analysis for the estimation of hazard ratios (HRs) and 95% CIs. Kaplan-Meier analysis was conducted to calculate the incidence of new-onset diabetes. Subgroup analyses based on age (18-44, 45-64, ≥65 years), sex (female, male), race (White, Black or African American, Asian), and BMI categories (<19.9, 20-29, 30-39, ≥40), sensitivities analyses, and a dose-response analysis were conducted to validate the findings. RESULTS The initial cohort of patients infected with SARS-CoV-2 had a 65% increased risk (HR 1.65; 95% CI 1.62-1.68) of developing new-onset diabetes relative to noninfected individuals. In the second cohort, we observed that vaccinated patients had a 21% lower risk of developing new-onset diabetes in comparison with unvaccinated COVID-19 survivors (HR 0.79; 95% CI 0.73-0.86). Subgroup analyses by sex, age, race, and BMI yielded similar results. These findings were consistent in sensitivity analyses and cross-validation with an independent data set from TriNetX. CONCLUSIONS In conclusion, this study validates a 65% higher risk of new-onset diabetes in SARS-CoV-2-infected individuals compared to noninfected counterparts. Furthermore, COVID-19 survivors who received COVID-19 vaccinations experienced a reduced risk of new-onset diabetes, with a dose-dependent effect. Notably, the protective impact of COVID-19 vaccination is more pronounced among the Black/African American population than other ethnic groups. These findings emphasize the imperative of widespread vaccination to mitigate diabetes risk and the need for tailored strategies for diverse demographic groups to ensure equitable protection.
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Affiliation(s)
- Tina Yi Jin Hsieh
- Department of Bioinformatics, Harvard Medical School, Boston, MA
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA
| | - Renin Chang
- Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Recreation and Sports Management, Tajen University, Pintung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Su-Boon Yong
- Department of Allergy and Immunology, China Medical University Children's Hospital, Taichung, Taiwan
| | - Pei-Lun Liao
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Center for Health Data Science, Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yao-Min Hung
- Department of Internal Medicine, Division of Nephrology, Taipei Veterans General Hospital Taitung Branch, Taitung, Taiwan
- Master Program in Biomedicine, College of Science and Engineering, National Taitung University, Taitung, Taiwan
- College of Health and Nursing, Meiho University, Pingtung, Taiwan
| | - James Cheng-Chung Wei
- Department of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan
- Department of Nursing, Chung Shan Medical University, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
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Azarbakhsh H, Moftakhar L, Valipour A, Mirahmadizadeh A, Moradi HA, Piraee E. Epidemiological features and consequences of COVID-19 in patients with and without gastrointestinal symptoms in southwestern Iran. A retrospective observational study. Health Sci Rep 2023; 6:e1499. [PMID: 37732104 PMCID: PMC10507146 DOI: 10.1002/hsr2.1499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 09/22/2023] Open
Abstract
Background and Aims Some studies have shown that in addition to respiratory symptoms, gastrointestinal (GI) manifestations reported in patients with coronavirus disease 2019 (COVID-19). The aim of this study was to compare the epidemiological features and consequences of COVID-19 in patients with and without GI symptoms. Methods This retrospective observational study concluded on 15,323 COVID-19 patients with GI symptoms and 95,724 patients without symptoms. All symptoms and comorbidities of the patients collected. To investigate the differences between qualitative variables in the two groups, χ 2 test was used. Logistic regression analysis also used to identify determinants of mortality in patients with COVID-19. Results During the course of the study, 111,047 cases of COVID-19 occurred. Of these, 13.8% of patients had GI symptoms, and 9.9% of deaths due to COVID-19 occurred in these patients. The most common reported GI symptoms among COVID-19 patients were nausea, vomiting, and diarrhea. In addition, comorbidities, such as diabetes, cardiovascular disease, and thyroid disease were significantly higher in patients with GI symptoms. The result of multiple logistic regression showed that the chance of mortality is higher in a patient with COVID-19 who have dyspnea, fever, cough, hypertension, cardiovascular disease, diabetes, immunodeficiency, chronic kidney disease, thyroid disease, chronic pulmonary disease, and male gender. The chance of death was lower in people with GI symptoms. Conclusion According to the findings of this study, nausea, vomiting, and diarrhea were the most common GI symptoms. Also, the chance of death is higher in people with co-morbidities such as cardiovascular diseases, diabetes, and high blood pressure. Therefore, it is necessary to follow these people closely.
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Affiliation(s)
| | - Leila Moftakhar
- Department of Public Health, Student Research CommitteeShiraz University of Medical SciencesShirazIran
| | | | - Alireza Mirahmadizadeh
- Department of Epidemiology, Non‐communicable Diseases Research CenterShiraz University of Medical SciencesShirazIran
| | - Hekmat Allah Moradi
- Department of Disaster and Emergency Health, Health Human Resources Research Center, School of Health Management and Information SciencesShiraz University of Medical SciencesShirazIran
| | - Elahe Piraee
- Department of Public HealthSocial Determinants of Health Research Center, Yasuj University of Medical SciencesYasujIran
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Mirahmadizadeh A, Ghelichi-Ghojogh M, Jokari K, Amiri S, Moftakhar L, Moradian MJ, Habibi M, Dehghani SS, Hassani AH, Jafari A, Rezaei F. Correlation Between Diabetes and COVID-19 Indices: A Global Level Ecological
Study. SAGE Open Nurs 2023; 9:23779608231165485. [PMID: 37032958 PMCID: PMC10074615 DOI: 10.1177/23779608231165485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 02/27/2023] [Accepted: 03/05/2023] [Indexed: 04/07/2023] Open
Abstract
Introduction Coronavirus is threatening the global public health as a new and widespread crisis. The
researchers must keep in mind that one of the most vulnerable groups to COVID-19 are the
people with underlying diseases, especially diabetes. Objective This ecological study aimed to investigate the correlation between diabetes and the
epidemiological indices of COVID-19. Methods This ecological study included 144 countries. Their available data consists of the
cumulative incidence rate of cases, cumulative incidence rate of death, recovery rate,
case fatality rate, and performed tests of COVID-19, and diabetes. To collect the
variables, a data set was provided which included the information of 144 countries based
on diabetes and COVID-19 indices. Spearman coefficients were used for assess correlation
between diabetes and COVID-19 indices. Also, Scatter plots of diabetes for the studied
countries were drawn based on cumulative incidence rate of cases, cumulative incidence
rate of death, tests, recovery rate, and case fatality rate of COVID-19. Results The results of this ecological study showed in total countries, there was a weak
positive correlation between diabetes and cumulative incidence rate of cases and also
cumulative incidence rate of death. Correlation between diabetes with test of COVID-19
was very weak. Scatter plots showed a weak liner correlation between diabetes and
cumulative incidence rate of cases, cumulative incidence rate of death and test of
COVID-19. Conclusions In this study, there was a weak positive correlation between diabetes and cumulative
incidence rate of cases, cumulative incidence rate of death, and performed test of
COVID-19. This disease is an enormous challenge for health policymakers; therefore, it
is necessary to develop strategies and practical guidelines specific to each region to
take the necessary care, especially for diabetic patients.
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Affiliation(s)
- Alireza Mirahmadizadeh
- Non-communicable Diseases Research Center,
School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mousa Ghelichi-Ghojogh
- Neonatal and Children's Health Research
Center, Golestan University of Medical
Sciences, Gorgan, Iran
| | - Kimia Jokari
- Student Research Committee, Shiraz University
of Medical Sciences, Shiraz, Iran
| | - Sanaz Amiri
- Student Research Committee, Shiraz University
of Medical Sciences, Shiraz, Iran
| | - Leila Moftakhar
- Student Research Committee, Shiraz University
of Medical Sciences, Shiraz, Iran
| | - Mohammad Javad Moradian
- Trauma Research Center, Shahid Rajaee
(Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | | | - Alireza Jafari
- Department of Health Education and Health
Promotion, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical
Sciences, Gonabad, Iran
| | - Fatemeh Rezaei
- Research Center for Social Determinants of
Health, Jahrom University of Medical Sciences, Jahrom, Iran
- Fatemeh Rezaei, Department of Social Medicine,
Jahrom University of Medical Sciences, Jahrom, Iran.
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Atwah B, Iqbal MS, Kabrah S, Kabrah A, Alghamdi S, Tabassum A, Baghdadi MA, Alzahrani H. Susceptibility of Diabetic Patients to COVID-19 Infections: Clinico-Hematological and Complications Analysis. Vaccines (Basel) 2023; 11:vaccines11030561. [PMID: 36992148 DOI: 10.3390/vaccines11030561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/26/2023] [Accepted: 02/27/2023] [Indexed: 03/05/2023] Open
Abstract
Background: Coronavirus disease 2019 has become a global health threat resulting in a catastrophic spread and more than 3.8 million deaths worldwide. It has been suggested that there is a negative influence of diabetes mellites (DM), which is a complex chronic disease, on COVID-19 severe outcomes. Other factors in diabetic patients may also contribute to COVID-19 disease outcomes, such as older age, obesity, hyperglycaemia, hypertension, and other chronic conditions. Methods: A cohort study was conducted on the demographics, clinical information, and laboratory findings of the hospitalised COVID-19 with DM and non-DM patients were obtained from the medical records in King Faisal Specialist Hospital and Research Centre, Saudi Arabia. Results: Among the study population, 108 patients had DM, and 433 were non-DM patients. Patients with DM were more likely to present symptoms such as fever (50.48%), anorexia (19.51%), dry cough (47.96%), shortness of breath (35.29%), chest pain (16.49%), and other symptoms. There was a significant decrease in the mean of haematological and biochemical parameters, such as haemoglobin, calcium, and alkaline phosphate in people with diabetes compared to non-diabetics and a considerable increase in other parameters, such as glucose, potassium, and cardiac troponin. Conclusions: According to the findings of this study, patients who have diabetes have a greater risk of developing more severe symptoms associated with COVID-19 disease. This could result in more patients being admitted to the intensive care unit as well as higher mortality rates.
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Affiliation(s)
- Banan Atwah
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Mohammad Shahid Iqbal
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Saeed Kabrah
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Ahmed Kabrah
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Saad Alghamdi
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Aisha Tabassum
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Mohammed A Baghdadi
- Research Center, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Jeddah 23431, Saudi Arabia
| | - Hissah Alzahrani
- Mathematical Sciences Department, Faculty of Applied Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia
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Tang Q, Gao L, Tong Z, Li W. Hyperlipidemia, COVID-19 and acute pancreatitis: A tale of three entities. Am J Med Sci 2022; 364:257-263. [PMID: 35381217 PMCID: PMC8977370 DOI: 10.1016/j.amjms.2022.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 01/04/2022] [Accepted: 03/30/2022] [Indexed: 01/09/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the ongoing pandemic of coronavirus disease 2019 (COVID-19), which presented as not only respiratory symptoms, but various digestive manifestations including pancreatic injury and acute pancreatitis (AP). The underlying mechanism is still unclear. Hypertriglyceridemia has become one of the leading causes of AP in recent years and hyperlipidemia is highly reported in COVID-19 cases. The current narrative review aimed to explore the associations between AP, COVID-19 and hyperlipidemia. Substantial cases of COVID-19 patients complicated with AP were reported, while the incidence of AP in the COVID-19 population was relatively low. Hyperlipidemia was common in COVID-19 patients with a pooled incidence of 32.98%. Hyperlipidemia could be a mediating factor in the pathogenesis of AP in COVID-19 patients. Further studies are warranted to clarify the relationship among AP, lipid metabolism disorders and COVID-19.
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Affiliation(s)
- Qiuyi Tang
- Medical School, Southeast University, Nanjing, Jiangsu, China; Center of Severe Acute Pancreatitis (CSAP), Department of Intensive Care Unit, Jinling Hospital, Nanjing, Jiangsu, China
| | - Lin Gao
- Center of Severe Acute Pancreatitis (CSAP), Department of Intensive Care Unit, Jinling Hospital, Nanjing, Jiangsu, China
| | - Zhihui Tong
- Center of Severe Acute Pancreatitis (CSAP), Department of Intensive Care Unit, Jinling Hospital, Nanjing, Jiangsu, China.
| | - Weiqin Li
- Medical School, Southeast University, Nanjing, Jiangsu, China; Center of Severe Acute Pancreatitis (CSAP), Department of Intensive Care Unit, Jinling Hospital, Nanjing, Jiangsu, China.
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Moftakhar L, Piraee E, Mohammadi Abnavi M, Moftakhar P, Azarbakhsh H, Valipour A. Epidemiological Features and Predictors of Mortality in Patients with COVID-19 with and without Underlying Hypertension. Int J Hypertens 2021; 2021:7427500. [PMID: 34676114 PMCID: PMC8526257 DOI: 10.1155/2021/7427500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 09/03/2021] [Accepted: 09/12/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUNDS Individuals with hypertension are at higher risk of COVID-19 infection and related mortality. This study was carried out to assess the epidemiological features and predictors of mortality in patients with COVID-19 with hypertension. METHODS In this retrospective study, the epidemiological characteristics of two groups of patients with COVID-19 with hypertension (1927) and without hypertension (39030) were compared. Chi-square test was applied to evaluate the differences between qualitative variables in two study groups. Logistic regression was also used to determine predictors of mortality in patients with COVID-19 and in patients with COVID-19 with hypertension. RESULTS The prevalence of hypertension in patients with COVID-19 was 4.7%, and 24.37% of COVID-19 related deaths occurred in these individuals. The average age of hypertension and nonhypertension patients was 61 and 37 years, respectively. Fever, cough, headache, anorexia, fatigue, and comorbid diseases, such as cardiovascular disease, chronic lung and kidney disease, diabetes, immunodeficiency disease, and thyroid disease, were significantly more frequent in people with hypertension than those without hypertension. The chances of mortality in patient with COVID-19 were 1.8 times higher in individuals with dyspnea, 1.25 in individuals with fever, 1.33 in individuals with cough, 3.6 in patients with hypertension, 2.21 in diabetics, and 2.2 in individuals with cardiovascular disease. Also, individuals with COVID-19 with hypertension that had dyspnea, immunodeficiency, and cardiovascular disease were at higher risk of mortality. CONCLUSION Hypertension is a serious threat to patients with COVID-19. Therefore, in order to control these patients more precisely and reduce mortality in them, it is extremely important to develop prevention and treatment strategies.
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Affiliation(s)
- Leila Moftakhar
- Abadan University of Medical Sciences, Abadan, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elahe Piraee
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Parisa Moftakhar
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | | | - Aliasghar Valipour
- Department of Public Health, Abadan Faculty of Medical Sciences, Abadan, Iran
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