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Vallée A. The impact of the COVID-19 pandemic on the socioeconomic gradient of hypertension. J Public Health Policy 2024; 45:413-430. [PMID: 38831023 DOI: 10.1057/s41271-024-00491-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2024] [Indexed: 06/05/2024]
Abstract
The COVID-19 pandemic has brought into sharp focus the impact of socioeconomic factors on hypertension outcomes. This review examines the implications of the pandemic on the socioeconomic gradient of hypertension and explores the physiological and pathophysiological processes underlying this relationship. Changes in socioeconomic factors have disproportionately affected individuals with lower socioeconomic status, leading to adverse hypertension outcomes. The pandemic-related stressors, coupled with social isolation and disrupted daily routines, have contributed to elevated stress levels among individuals, particularly those with lower socioeconomic status. Equitable access to healthcare, enhancing health literacy and patient empowerment, and addressing social determinants of health are essential components of hypertension management strategies. By recognizing the specific challenges faced by individuals with lower socioeconomic status and implementing targeted interventions, public health efforts can help reduce the socioeconomic gradient of hypertension.
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Affiliation(s)
- Alexandre Vallée
- Department of Epidemiology and Public Health, Foch Hospital, 92150, Suresnes, France.
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Bourhis M, Idir A, Machraoui S, Hachimi A, Elouardi Y, Jamil O, Khallouki M, Zahlane K, Guennouni M, Hazime R, Essaadouni L, Lourhlam B, Ennaji MM, Mouse HA, Admou B, Zyad A. Cytokine and chemokine profiles in the sera of COVID-19 patients with different stages of severity. Cytokine 2024; 180:156653. [PMID: 38781873 DOI: 10.1016/j.cyto.2024.156653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 05/08/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024]
Abstract
INTRODUCTION COVID-19 is a viral infection that disturbs the host's immune system and causes an overproduction of cytokines leading to a cytokine storm. The present study aimed to evaluate the serum levels of 27 protein biomarkers to determine their association with COVID-19 disease severity. METHODS The serum levels of 89 patients with different degrees of COVID-19 disease severity [asymptomatic (n = 14), moderate (n = 14), severe (n = 30), and critical (n = 31)] and 14 healthy individuals were tested for a panel of 27 cytokines and chemokines using Luminex assay (27 Bio‑Plex Pro Human Cytokine, Bio-rad™). RESULTS IL-12, IL-2 and IL-13, as well as IL-17 and GM-CSF were clearly undetectable in asymptomatic patients. IL-8 levels were higher in asymptomatic compared with other groups. Very high levels of IL-6, IL-10 and the chemokines MIP-1α, MCP-1 and IP10 were associated with disease progression, while IL-4 tends to decrease with disease severity. CONCLUSION Our study provides more evidence that excessive cytokine synthesis is linked to the disease progression.
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Affiliation(s)
- Maryam Bourhis
- Team of Experimental Oncology and Natural Substances, Cellular and Molecular Immunopharmacology, Laboratory of Agro-industrial and Medical Biotechnology, Faculty of Sciences and Techniques, Sultan Moulay Slimane University, BeniMellal, Morocco
| | - Abderrazak Idir
- Science and Technology Team, Higher School of Education and Training, Chouaîb Doukkali University, El Jadida, Morocco
| | - Safa Machraoui
- Laboratory of Immunology, Center of Clinical Research, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco
| | - Abdelhamid Hachimi
- Department of Intensive Care, Mohamed VI University Hospital, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco
| | - Youssef Elouardi
- Department of Anesthesia and Intensive Care Medicine, Ibn Tofail Hospital, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco
| | - Oumayma Jamil
- Department of Anesthesia and Intensive Care Medicine, Ibn Tofail Hospital, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco
| | - Mohammed Khallouki
- Department of Anesthesia and Intensive Care Medicine, Ibn Tofail Hospital, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco
| | - Kawtar Zahlane
- Laboratory of Medical Analysis, IbnTofail Hospital, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco
| | - Morad Guennouni
- Science and Technology Team, Higher School of Education and Training, Chouaîb Doukkali University, El Jadida, Morocco
| | - Raja Hazime
- Laboratory of Immunology, Center of Clinical Research, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco
| | - Lamiaa Essaadouni
- Internal Medicine Department, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco
| | - Bouchra Lourhlam
- Team of Experimental Oncology and Natural Substances, Cellular and Molecular Immunopharmacology, Laboratory of Agro-industrial and Medical Biotechnology, Faculty of Sciences and Techniques, Sultan Moulay Slimane University, BeniMellal, Morocco
| | - Moulay Mustapha Ennaji
- Team of Virology, Oncology and Biotechnology, Laboratory of Virology, Oncology, Biosciences, Environment and New Energies, Faculty of Sciences & Technologies Mohammedia, University Hassan II of Casablanca, Casablanca, Morocco
| | - Hassan Ait Mouse
- Team of Experimental Oncology and Natural Substances, Cellular and Molecular Immunopharmacology, Laboratory of Agro-industrial and Medical Biotechnology, Faculty of Sciences and Techniques, Sultan Moulay Slimane University, BeniMellal, Morocco
| | - Brahim Admou
- Laboratory of Immunology, Center of Clinical Research, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco
| | - Abdelmajid Zyad
- Team of Experimental Oncology and Natural Substances, Cellular and Molecular Immunopharmacology, Laboratory of Agro-industrial and Medical Biotechnology, Faculty of Sciences and Techniques, Sultan Moulay Slimane University, BeniMellal, Morocco.
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Shao HH, Yin RX. Pathogenic mechanisms of cardiovascular damage in COVID-19. Mol Med 2024; 30:92. [PMID: 38898389 PMCID: PMC11186295 DOI: 10.1186/s10020-024-00855-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 06/07/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND COVID-19 is a new infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS CoV-2). Since the outbreak in December 2019, it has caused an unprecedented world pandemic, leading to a global human health crisis. Although SARS CoV-2 mainly affects the lungs, causing interstitial pneumonia and severe acute respiratory distress syndrome, a number of patients often have extensive clinical manifestations, such as gastrointestinal symptoms, cardiovascular damage and renal dysfunction. PURPOSE This review article discusses the pathogenic mechanisms of cardiovascular damage in COVID-19 patients and provides some useful suggestions for future clinical diagnosis, treatment and prevention. METHODS An English-language literature search was conducted in PubMed and Web of Science databases up to 12th April, 2024 for the terms "COVID-19", "SARS CoV-2", "cardiovascular damage", "myocardial injury", "myocarditis", "hypertension", "arrhythmia", "heart failure" and "coronary heart disease", especially update articles in 2023 and 2024. Salient medical literatures regarding the cardiovascular damage of COVID-19 were selected, extracted and synthesized. RESULTS The most common cardiovascular damage was myocarditis and pericarditis, hypertension, arrhythmia, myocardial injury and heart failure, coronary heart disease, stress cardiomyopathy, ischemic stroke, blood coagulation abnormalities, and dyslipidemia. Two important pathogenic mechanisms of the cardiovascular damage may be direct viral cytotoxicity as well as indirect hyperimmune responses of the body to SARS CoV-2 infection. CONCLUSIONS Cardiovascular damage in COVID-19 patients is common and portends a worse prognosis. Although the underlying pathophysiological mechanisms of cardiovascular damage related to COVID-19 are not completely clear, two important pathogenic mechanisms of cardiovascular damage may be the direct damage of the SARSCoV-2 infection and the indirect hyperimmune responses.
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Affiliation(s)
- Hong-Hua Shao
- Department of Infectious Diseases, HIV/AIDS Clinical Treatment Center of Guangxi (Nanning), The Fourth People's Hospital of Nanning, No. 1 Erli, Changgang Road, Nanning, Guangxi, 530023, People's Republic of China
| | - Rui-Xing Yin
- Department of Infectious Diseases, HIV/AIDS Clinical Treatment Center of Guangxi (Nanning), The Fourth People's Hospital of Nanning, No. 1 Erli, Changgang Road, Nanning, Guangxi, 530023, People's Republic of China.
- Department of Cardiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, Guangxi Medical University, 6 Shuangyong Road, Nanning, Guangxi, 530021, People's Republic of China.
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Hamdan M, Haddad BI, Almohtasib J, Eid M, Al-Din TJ, Rayyan HA, Altantawi AM, Akaheal AS, Alshrouf MA. Postoperative pneumonia after femoral fracture surgery: an in-depth retrospective analysis. BMC Musculoskelet Disord 2024; 25:413. [PMID: 38802816 PMCID: PMC11129372 DOI: 10.1186/s12891-024-07529-4] [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: 12/30/2023] [Accepted: 05/17/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Femoral fractures significantly contribute to disability, predominantly in the elderly. Despite this, data on postoperative pneumonia following femoral fracture surgeries remains sparse. Our study sought to explore the incidence and impact of postoperative pneumonia on outcomes following such surgeries. METHODS A retrospective study analyzed femoral fracture patients hospitalized from 2016 to 2022. We scrutinized postoperative outcomes, including pneumonia, hospital stay duration, intensive care unit (ICU) admissions, and in-hospital mortality. We established stringent diagnostic criteria for postoperative pneumonia, incorporating both clinical signs and radiological evidence, excluding patients with prior infections or those discharged within 24 h post-surgery. Statistical analyses involved Chi-square and t-tests, linear regression, and logestic regression using SPSS. RESULTS Out of 636 patients, 10.8% were diagnosed with postoperative pneumonia. The average age was 79.55 ± 8.57 years, with a male prevalence of 47.8%. Common comorbidities were hypertension (78.3%), diabetes (60.9%), and cardiovascular diseases (40.6%). Surgical interventions were categorized as intramedullary nailing (40.6%), partial hip replacement (37.7%), and dynamic hip screw (21.7%). Postoperative pneumonia was associated with older age (AOR = 1.053, 95% CI 1.020 to 1.087, p = 0.002), ICU admission (AOR = 2.283, 95% CI 1.256 to 4.148, p = 0.007), and longer length of hospital stay (AOR = 1.079, 95% CI 1.030 to 1.130, p = 0.001). The presence of pneumonia was associated with a 2.621-day increase in hospitalization after adjusting for other variables (p < 0.001, 95% CI: 1.454 to 3.789). CONCLUSION This study accentuates the clinical significance of postoperative pneumonia in femoral fracture patients, with a noted incidence of 10.8%. A notable association with older age, prolonged hospital stays, and ICU admissions was observed, underscoring the necessity of addressing this complication to improve patient outcomes and healthcare resource allocation.
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Affiliation(s)
- Mohammad Hamdan
- Department of Special Surgery, Division of Orthopedics, School of Medicine, The University of Jordan, Amman, 11942, Jordan
| | - Bassem I Haddad
- Department of Special Surgery, Division of Orthopedics, School of Medicine, The University of Jordan, Amman, 11942, Jordan
| | - Jamil Almohtasib
- School of Medicine, The University of Jordan, Amman, 11942, Jordan
| | - Mira Eid
- School of Medicine, The University of Jordan, Amman, 11942, Jordan
| | | | - Hashem A Rayyan
- School of Medicine, The University of Jordan, Amman, 11942, Jordan
| | | | - Abdussalam S Akaheal
- Department of Special Surgery, Division of Orthopedics, School of Medicine, The University of Jordan, Amman, 11942, Jordan
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Md Hanif SA, Hassan MR, Rafi’i MR, Abdul Halim AFN, Ahmad Zamzuri M‘AI, Ismail M, Ibrahim SS, Mihat M, Rejali L, Zubir MH, Mahadi MS, Ahmad Ismail S, Ganesan V, Mohd Fadzil MF. Understanding The Mimicker: Epidemiological Pattern and Determinant of Melioidosis Mortality in Negeri Sembilan, Malaysia. PLoS Negl Trop Dis 2024; 18:e0012147. [PMID: 38709822 PMCID: PMC11098469 DOI: 10.1371/journal.pntd.0012147] [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: 11/02/2023] [Revised: 05/16/2024] [Accepted: 04/15/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Melioidosis, a tropical infectious disease caused by Burkholderia pseudomallei, is epidemic in most region in Southeast Asia with high case fatality. However, there is scanty information regarding the disease's epidemiological pattern, demographics, and underlying risk factors. METHOD This 5-year retrospective study of 185 confirmed cases which were taken from the Negeri Sembilan Melioidosis Registry between 2018 and 2022. We aim to describe the incidence, mortality rate, case fatality, relationship with meteorology, and factors that influence mortality in this central region of Peninsular Malaysia. RESULTS Incidence rate (IR) of melioidosis in Negeri Sembilan is varied at 1.9 to 5.1 with mean of 3.1 in 100,000 population per year. IR varied between districts in the state from zero to 22.01 in 100,000 population per year. Mortality rate were ranged from 0.17 to 0.74 cases with mean of 0.44 cases in 100,000 population per year. The case fatality rate of this state scattered from 8.70% to 16.67%. There were no significant linear associations between cases and deaths with monthly rainfall and humidity. The mean age of patients was 52.8 years, predominated with age around 41-60 years old. Males (77.8%) predominated, and the majority of cases were Malays (88.9%) and had exposed to soil related activities (74.6%). Mortality from melioidosis was more likely in Bumiputera and non-Malaysians (p<0.05). Patients who had at least one comorbidity were at a higher risk of death from melioidosis (p<0.05). Diabetes mellitus was found in 41.1% of all identified cases, making it a major underlying risk factor for both developing and dying from melioidosis (aOR:19.32, 95%CI:1.91-195.59, p<0.05). Hypertension and mortality status in melioidosis are also significantly correlated (aOR: 7.75, 95% CI: 2.26-26.61, p<0.05). CONCLUSION The epidemiological patterns of cases reported from Negeri Sembilan are consistent for the most part from previous studies in other states in Malaysia and global with regard to its incidence, case fatality, demographic and predisposing chronic diseases. Diabetes mellitus and hypertension were significantly linked to increased mortality among all determinants.
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Affiliation(s)
- Shahrul Azhar Md Hanif
- Department of Public Health Medicine, Faculty of Medicine, National University of Malaysia Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Public Health Medicine, Faculty of Medicine, National University of Malaysia Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur, Malaysia
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Muhammad Ridzwan Rafi’i
- Department of Public Health Medicine, Faculty of Medicine, National University of Malaysia Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur, Malaysia
| | - Ahmad Farid Nazmi Abdul Halim
- Department of Public Health Medicine, Faculty of Medicine, National University of Malaysia Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur, Malaysia
| | | | - Muhammad Ismail
- State Health Department of Negeri Sembilan, Ministry of Health Malaysia, Jalan Rasah, Seremban, Negeri Sembilan, Malaysia
| | - Siti Salwa Ibrahim
- State Health Department of Negeri Sembilan, Ministry of Health Malaysia, Jalan Rasah, Seremban, Negeri Sembilan, Malaysia
| | - Massitah Mihat
- State Health Department of Negeri Sembilan, Ministry of Health Malaysia, Jalan Rasah, Seremban, Negeri Sembilan, Malaysia
| | - Lokman Rejali
- State Health Department of Negeri Sembilan, Ministry of Health Malaysia, Jalan Rasah, Seremban, Negeri Sembilan, Malaysia
| | - Muhammad Habiruddin Zubir
- State Health Department of Negeri Sembilan, Ministry of Health Malaysia, Jalan Rasah, Seremban, Negeri Sembilan, Malaysia
| | | | - Shazwanis Ahmad Ismail
- Department of Public Health Medicine, Faculty of Medicine, National University of Malaysia Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur, Malaysia
| | - Veshny Ganesan
- Universiti Malaysia Sabah, Jalan UMS, Kota Kinabalu, Sabah, Malaysia
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Gehring S, Kowalzik F, Okasha O, Engelmann T, Schreiner D, Jensen C, Mähringer-Kunz A, Hartig-Merkel W, Mai Phuong Tran T, Oostvogels C, Verstraeten T. A prospective cohort study of SARS-CoV-2 infection-induced seroconversion and disease incidence in German healthcare workers before and during the rollout of COVID-19 vaccines. PLoS One 2024; 19:e0294025. [PMID: 38289913 PMCID: PMC10826949 DOI: 10.1371/journal.pone.0294025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 07/22/2023] [Indexed: 02/01/2024] Open
Abstract
We assessed the seroepidemiology of SARS-CoV-2 infection and the incidence of coronavirus disease 2019 (COVID-19) before and during the rollout of COVID-19 vaccines, in a prospective observational cohort study on healthcare workers (HCWs) in a large tertiary hospital in Mainz, Germany. Antibody status was assessed during six visits between September 2020 and February 2022. Self-reported symptoms were collected using a smartphone application; symptomatic HCWs were tested using real-time polymerase chain reaction (RT-PCR) assays for SARS-CoV-2. Rates of virologically confirmed and severe COVID-19 were estimated using the U.S. Food and Drug Administration (FDA) and Coalition for Epidemic Preparedness Innovations (CEPI) case definitions, respectively, and were contrasted to background community transmission and circulating SARS-CoV-2 variants. A total of 3665 HCWs were enrolled (mean follow-up time: 18 months); 97 met the FDA definition of virologically confirmed COVID-19 (incidence rate (IR) 2.3/1000 person-months (PMs), one severe case). Most cases reported ≥2 symptoms, commonly, cough and anosmia or ageusia. Overall, 263 individuals seroconverted (IR 6.6/1000 PMs-2.9 times the estimated IR of COVID-19), indicating many cases were missed, either due to asymptomatic infections or to an atypical presentation of symptoms. A triphasic trend in anti-SARS-CoV-2 seroprevalence and seroconversion was observed, with an initial increase following the rollout of COVID-19 vaccines, a two-fold decline six months later, and finally a six-fold increase by the end of the study when Omicron was the dominant circulating variant. Despite the increase in infection rates at the end of the study due to the circulation of the Omicron variant, the infection and disease rates observed were lower than the published estimates in HCWs and rates in the general local population. Preferential vaccination of HCWs and the strict monitoring program for SARS-CoV-2 infection are the most likely reasons for the successful control of COVID-19 in this high-risk population.
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Affiliation(s)
- Stephan Gehring
- Zentrum für Kinder- und Jugendmedizin, Universitätsmedizin Mainz, Mainz, Germany
| | - Frank Kowalzik
- Zentrum für Kinder- und Jugendmedizin, Universitätsmedizin Mainz, Mainz, Germany
| | - Omar Okasha
- P95 Pharmacovigilance and Epidemiology, Leuven, Belgium
| | - Tobias Engelmann
- Zentrum für Kinder- und Jugendmedizin, Universitätsmedizin Mainz, Mainz, Germany
| | - Daniel Schreiner
- Zentrum für Kinder- und Jugendmedizin, Universitätsmedizin Mainz, Mainz, Germany
| | - Christian Jensen
- Zentrum für Kinder- und Jugendmedizin, Universitätsmedizin Mainz, Mainz, Germany
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