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Gebreegziabher E, Bui D, Cummings KJ, Frederick M, Nguyen A, Collins C, Melton D, Yang A, Jain S, Vergara X. Demographic changes in COVID-19 mortality during the pandemic: analysis of trends in disparities among workers using California's mortality surveillance system. BMC Public Health 2024; 24:1822. [PMID: 38977988 PMCID: PMC11232202 DOI: 10.1186/s12889-024-19257-4] [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] [Received: 01/14/2024] [Accepted: 06/24/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND There is limited information on the extent and patterns of disparities in COVID-19 mortality throughout the pandemic. We aimed to examine trends in disparities by demographics over variants in the pre- and post-vaccine availability period among Californian workers using a social determinants of health lens. METHODS Using death certificates, we identified all COVID-19 deaths that occurred between January 2020 and May 2022 among workers aged 18-64 years in California (CA). We derived estimates for at-risk worker populations using the Current Population Survey. The waves of COVID-19 mortality in the pre-vaccine availability period were March 2020-June 2020 (wave 1), and July 2020-November 2020 (wave 2), and in the post-vaccine availability period: December 2020-May 2021 (wave 3), June 2021-January 2022 (wave 4), and February 2022-May 2022 (wave 5). Poisson regression models with robust standard errors were used to determine wave-specific mortality rate ratios (MRRs). We examined the change in MRR across waves by including an interaction term between each demographic characteristic and wave period in different models. The role of potential misclassification of Race/ethnicity on death certificates was examined using probabilistic quantitative bias analysis as sensitivity analysis. RESULTS Among the 24.1 million working age CA population included in the study, there were 26,068 COVID-19 deaths in the period between January 2020 and May 2022. Compared with their respective reference groups, workers who were 50-64 years old, male, Native Hawaiian, Latino, or African American, foreign-born; individuals who had lower education; and unmarried were disproportionately affected by COVID-19 mortality. While disparities by sex, race/ethnicity and foreign-born status narrowed in later waves (post-vaccine availability), disparities by age, education level and marital status did not change substantially across waves. CONCLUSION Demographic disparities in COVID-19 mortality narrowed in the post-vaccine availability waves. However, the existence of disparities across all waves of the pandemic, even in an era of widespread vaccine coverage, could indicate remaining gaps in prevention and differential vulnerability. Addressing the underlying social, structural, and occupational factors that contribute to these disparities is critical for achieving health equity.
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Affiliation(s)
- Elisabeth Gebreegziabher
- Occupational Health Branch, California Department of Public Health, 850 Marina Bay Parkway, Richmond, CA, 94804, USA.
- Heluna Health, 13300 Crossroads Pkwy. N #450, City of Industry, CA, 91746, USA.
| | - David Bui
- Occupational Health Branch, California Department of Public Health, 850 Marina Bay Parkway, Richmond, CA, 94804, USA
- Heluna Health, 13300 Crossroads Pkwy. N #450, City of Industry, CA, 91746, USA
| | - Kristin J Cummings
- Occupational Health Branch, California Department of Public Health, 850 Marina Bay Parkway, Richmond, CA, 94804, USA
| | - Matthew Frederick
- Occupational Health Branch, California Department of Public Health, 850 Marina Bay Parkway, Richmond, CA, 94804, USA
- Public Health Institute, Oakland, CA, 94607, USA
| | - Alyssa Nguyen
- Infectious Diseases Branch, California Department of Public Health, Richmond, CA, 94804, USA
| | - Caroline Collins
- Heluna Health, 13300 Crossroads Pkwy. N #450, City of Industry, CA, 91746, USA
- Infectious Diseases Branch, California Department of Public Health, Richmond, CA, 94804, USA
| | - David Melton
- Heluna Health, 13300 Crossroads Pkwy. N #450, City of Industry, CA, 91746, USA
- Infectious Diseases Branch, California Department of Public Health, Richmond, CA, 94804, USA
| | - Alice Yang
- Heluna Health, 13300 Crossroads Pkwy. N #450, City of Industry, CA, 91746, USA
- Infectious Diseases Branch, California Department of Public Health, Richmond, CA, 94804, USA
| | - Seema Jain
- Infectious Diseases Branch, California Department of Public Health, Richmond, CA, 94804, USA
| | - Ximena Vergara
- Occupational Health Branch, California Department of Public Health, 850 Marina Bay Parkway, Richmond, CA, 94804, USA
- Heluna Health, 13300 Crossroads Pkwy. N #450, City of Industry, CA, 91746, USA
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Chikkahonnaiah P, Dallavalasa S, Tulimilli SV, Dubey M, Byrappa SH, Amachawadi RG, Madhunapantula SV, Veeranna RP. SARS-CoV-2 Infection Positively Correlates with Hyperglycemia and Inflammatory Markers in COVID-19 Patients: A Clinical Research Study. Diseases 2024; 12:143. [PMID: 39057114 PMCID: PMC11276363 DOI: 10.3390/diseases12070143] [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: 05/17/2024] [Revised: 06/22/2024] [Accepted: 07/01/2024] [Indexed: 07/28/2024] Open
Abstract
Diabetes mellitus (DM) is a common comorbidity in COVID-19 subjects. Hyperglycemia at hospital admission identified as a major risk factor and is responsible for poor prognosis. Hematological and inflammatory parameters have been recognized as predictive markers of severity in COVID-19. In this clinical study, we aimed to assess the impact of hyperglycemia at hospital admission on hematological and several inflammatory parameters in COVID-19 patients. A total of 550 COVID-19 subjects were primarily categorized into two major groups (normoglycemic and hyperglycemic) based on random blood sugar levels. On the first day of hospitalization, subjects' oxygen saturation, random blood sugar, hematological variables, and inflammatory parameters were recorded. The hyperglycemic group exhibited higher levels of serum ferritin, total leukocyte count (TLC), lactate dehydrogenase (LDH), neutrophil count, and neutrophil-to-lymphocyte ratio (NLR). In contrast, oxygen saturation and lymphocyte count were lower compared to the normoglycemic group. Significantly elevated levels of hematological variables (TLC, neutrophil count, NLR) and inflammatory parameters (serum ferritin) were observed in the hyperglycemic group. Among inflammatory parameters, only serum ferritin levels showed statistical significance. This study supports the clinical association between hyperglycemia and an increased severity of COVID-19. Consequently, the identification of these parameters is a crucial and valuable prognostic indicator for assessing disease severity in hyperglycemic subjects.
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Affiliation(s)
- Prashanth Chikkahonnaiah
- Department of Pulmonary Medicine, Mysore Medical College and Research Institute, Mysuru 570001, Karnataka, India;
| | - Siva Dallavalasa
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR) Laboratory (DST-FIST Supported Centre and ICMR Collaborating Center of Excellence–ICMR-CCoE), Department of Biochemistry (DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysuru 570015, Karnataka, India; (S.D.); (S.V.T.)
| | - SubbaRao V. Tulimilli
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR) Laboratory (DST-FIST Supported Centre and ICMR Collaborating Center of Excellence–ICMR-CCoE), Department of Biochemistry (DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysuru 570015, Karnataka, India; (S.D.); (S.V.T.)
| | - Muskan Dubey
- Xavier University School of Medicine, Xavier University School of Veterinary Medicine, Santa Helenastraat #23, Oranjestad, Aruba;
| | - Shashidhar H. Byrappa
- Department of Pathology, Mysore Medical College and Research Institute (MMC&RI), Mysuru 570001, Karnataka, India;
| | - Raghavendra G. Amachawadi
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA;
| | - SubbaRao V. Madhunapantula
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR) Laboratory (DST-FIST Supported Centre and ICMR Collaborating Center of Excellence–ICMR-CCoE), Department of Biochemistry (DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysuru 570015, Karnataka, India; (S.D.); (S.V.T.)
- Leader, Special Interest Group in Cancer Biology and Cancer Stem Cells (SIG-CBCSC), JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysuru 570004, Karnataka, India
| | - Ravindra P. Veeranna
- Xavier University School of Medicine, Xavier University School of Veterinary Medicine, Santa Helenastraat #23, Oranjestad, Aruba;
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Coşkun A, Erdem K, Can U. Association between COVID-19 and increased incidence of overactive bladder symptoms in female patients: A retrospective analysis. Actas Urol Esp 2024; 48:454-460. [PMID: 38185318 DOI: 10.1016/j.acuroe.2024.01.002] [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: 10/11/2023] [Revised: 11/17/2023] [Accepted: 11/20/2023] [Indexed: 01/09/2024]
Abstract
INTRODUCTION AND OBJECTIVES To investigate female patients' post-COVID-19 voiding symptoms and to research how they relate to overactive bladder (OAB). PATIENTS One hundred and forty patients aged 20-50 years who were hospitalised and discharged due to COVID-19 at Kartal Dr. Lütfi Kırdar City Hospital between 2021 and 2022 and 50 patients with a history of COVID-19 among two hundred female patients who presented to the urology outpatient clinic with symptoms related to OAB were retrospectively analysed. Bladder diary, overactive bladder symptom score (OABSS), uroflowmetry values and time of onset of symptoms of symptomatic patients were recorded for all patients. Disease-free individuals for control purposes were not included in the study. RESULTS It was observed that 38% of 140 hospitalized patients had a symptomatic change related to OAB, and there was a significant difference in voiding diary, OABSS, and uroflowmetry Qmax values between symptomatic and non-symptomatic patients after COVID-19. (p:0.001) There was a significant difference between the pre-COVID-19 (estimated) and post-COVID-19 (current) voiding diary and OABSS values of all symptomatic patients (with and without a history of hospitalization). (p:0.001) When these two groups were compared with each other, there was a significant difference between the post-COVID-19 voiding diary, OABSS values, and the meantime to the onset of symptoms in inpatients and outpatients (p:0.001) CONCLUSION: COVID-19 may be associated with urgency/urge incontinence and overactive bladder in female patients.
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Affiliation(s)
- A Coşkun
- Servicio de Urología, Universidad de Ciencias de la Salud, Hospital Kartal Dr. Lutfi Kirdar, Estambul, Turkey.
| | - K Erdem
- Servicio de Urología, Hospital de Formación e Investigación en Medicina Física y Rehabilitación Ankara Gaziler, Ankara, Turkey
| | - U Can
- Servicio de Urología, Universidad de Ciencias de la Salud, Hospital Kartal Dr. Lutfi Kirdar, Estambul, Turkey
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Alexandrov N, Scott ES, Janssen MF, Lubetkin EI, Yfantopoulos JN, Bonsel GJ, Haagsma JA. The relationship between healthcare access and change in health-related quality-of-life among the general population of five countries during the COVID-19 pandemic. Qual Life Res 2024:10.1007/s11136-024-03704-1. [PMID: 38861096 DOI: 10.1007/s11136-024-03704-1] [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] [Accepted: 05/28/2024] [Indexed: 06/12/2024]
Abstract
PURPOSE To determine whether (1) healthcare access at onset of the pandemic and (2) age, gender, socioeconomic status (SES), and pre-existing health status were associated with change in health-related quality-of-life (HRQoL) during the COVID-19 pandemic. The study includes a general population sample of five countries. METHODS An online questionnaire was administered to respondents from Greece, Italy, the Netherlands, the UK, and the US at the onset of the COVID-19 pandemic between April 22nd and May 5th of 2020, and 1 year later between May 23rd and June 29th of 2021. The questionnaire included questions on demographic background, health status, and HRQoL. The primary outcome was change in HRQoL as measured by the EQ-5D-5L instrument. Specifically, the EQ-5D-5L index and EQ VAS were used. Healthcare access was quantified with regard to the respondent's ease of getting an appointment, waiting time, and opportunity to contact the provider and during analysis dichotomized into "sufficient" versus "insufficient". Linear regression analysis was performed with change in HRQoL as dependent variable and background variables as independent variables. RESULTS In total, 6,765 respondents completed the second questionnaire. 19.8% of total respondents reported insufficient healthcare access. Respondents with insufficient healthcare had both more improved and deteriorated HRQoL compared to respondents with sufficient healthcare, whose HRQoL remained unchanged. We did not find significant interactions between age, gender, SES and/or chronic disease status with healthcare access at onset of the COVID-19 pandemic. CONCLUSION Healthcare access was not associated with cumulative differences in change in HRQoL over a 1-year period in strata of age, gender, SES, and chronic disease status.
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Affiliation(s)
- Nadja Alexandrov
- Department of Public Health, Erasmus MC, Rotterdam, The Netherlands
| | | | - Mathieu F Janssen
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
| | - Erica I Lubetkin
- Department of Community Health and Social Medicine, CUNY School of Medicine, New York City, NY, USA
| | - John N Yfantopoulos
- Health Department of Economics, National and Kapodistrian University of Athens, Athens, Greece
| | - Gouke J Bonsel
- Department Scientific Support, EuroQol Research Foundation, Rotterdam, The Netherlands
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Oncu S, Korkmaz D. Evaluation of the relationship of treatment and vaccination with prognosis in patients with a diagnosis of COVID-19. Inflammopharmacology 2024; 32:1817-1826. [PMID: 38493271 PMCID: PMC11136715 DOI: 10.1007/s10787-024-01457-4] [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: 02/07/2024] [Accepted: 03/01/2024] [Indexed: 03/18/2024]
Abstract
PURPOSE Coronavirus disease 2019 (COVID-19) has affected millions of people worldwide and caused mortality. Many factors have been reported to affect the prognosis of COVID-19. In this study, we aimed to investigate the effects of drug therapy and vaccination on prognosis in patients hospitalized with a COVID-19 diagnosis. METHODS In this single-center, cross-sectional study, data were retrospectively collected from patients receiving inpatient treatment at a university hospital with a diagnosis of COVID-19 between January 1, 2020, and April 30, 2022. The patients' demographic and clinical characteristics were recorded. The Chi-square, Cox and logistic regression was performed, P < 0.05 was considered statistically significant. RESULTS Total 1723 patients (50.1% were men, mean age: 60.6 ± 16.90) who had not been vaccinated rate was 27.0% (> 3 doses: 45.7%). Mortality rate was 17.0%. Increasing age, male, a high Charlson Comorbidity Index (CCI), and no vaccination significantly increased mortality (P < 0.05). The mortality rate was significantly lower in the chloroquine treatment group than in the other treatment groups. Increasing age, male, and a high CCI were determined to be factors that significantly increased the length of hospital stay (LOHS). LOHS found to be significantly lower in the favipiravir or chloroquine groups compared to the remaining treatment groups (P < 0.001). Both mortality and the LOHS significantly differed according to AST, d-dimer, ferritin, and GFR. CONCLUSION This study primarily investigated the effect of treatment and vaccination on the prognosis of COVID-19. This was determined to be prepared for another potential pandemic that may arise due to COVID-19.
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Affiliation(s)
- Seyma Oncu
- Department of Pharmacology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, 03030, Turkey.
| | - Derya Korkmaz
- Department of Infectious Disease, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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Topçu S, Emlek Sert Z. Intern nursing students' experiences in the COVID-19 vaccination unit and views on the COVID-19 vaccine: A phenomenological qualitative study. Work 2024:WOR220655. [PMID: 38701167 DOI: 10.3233/wor-220655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Improving acceptance of the COVID-19 vaccine among nursing students is an important strategy for both preventing infection and building public confidence in the vaccine. OBJECTIVE The aim of this study was to describe the views of intern nursing students on the COVID-19 vaccine and to evaluate their experiences in the COVID-19 vaccination unit. METHODS This was a phenomenological qualitative study with a descriptive design. The 46 intern nursing students included in this study were all trained in the COVID-19 vaccination unit. The data was collected at focus group interviews conducted during June 2021 and October 2021. RESULTS The mean age of intern nursing students was 22.78±0.91. From the focus group interviews, two themes were identified regarding the views of intern nursing students on the COVID-19 vaccine and their experiences in the COVID-19 vaccination unit: Theme 1. Positive views; Theme 2. Negative views. Intern nursing students described that they trust the COVID-19 vaccine and believe in its protection. Intern nursing students who performed their clinical practices in COVID-19 vaccination unit stated that they realized their responsibilities toward patients and the community. CONCLUSIONS From the INSs' point of view, confidence in the vaccine, responsibility towards patients, their families and the community, and VU practice experience, the health risk associated with COVID-19 positively affected their decision to be vaccinated against COVID-19. The participation of intern nursing students in clinical practice during the pandemic influenced both intern nursing students and population in terms of the uptake of COVID-19 vaccines.
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Seyedtabib M, Najafi-Vosough R, Kamyari N. The predictive power of data: machine learning analysis for Covid-19 mortality based on personal, clinical, preclinical, and laboratory variables in a case-control study. BMC Infect Dis 2024; 24:411. [PMID: 38637727 PMCID: PMC11025285 DOI: 10.1186/s12879-024-09298-w] [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: 12/22/2023] [Accepted: 04/05/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND AND PURPOSE The COVID-19 pandemic has presented unprecedented public health challenges worldwide. Understanding the factors contributing to COVID-19 mortality is critical for effective management and intervention strategies. This study aims to unlock the predictive power of data collected from personal, clinical, preclinical, and laboratory variables through machine learning (ML) analyses. METHODS A retrospective study was conducted in 2022 in a large hospital in Abadan, Iran. Data were collected and categorized into demographic, clinical, comorbid, treatment, initial vital signs, symptoms, and laboratory test groups. The collected data were subjected to ML analysis to identify predictive factors associated with COVID-19 mortality. Five algorithms were used to analyze the data set and derive the latent predictive power of the variables by the shapely additive explanation values. RESULTS Results highlight key factors associated with COVID-19 mortality, including age, comorbidities (hypertension, diabetes), specific treatments (antibiotics, remdesivir, favipiravir, vitamin zinc), and clinical indicators (heart rate, respiratory rate, temperature). Notably, specific symptoms (productive cough, dyspnea, delirium) and laboratory values (D-dimer, ESR) also play a critical role in predicting outcomes. This study highlights the importance of feature selection and the impact of data quantity and quality on model performance. CONCLUSION This study highlights the potential of ML analysis to improve the accuracy of COVID-19 mortality prediction and emphasizes the need for a comprehensive approach that considers multiple feature categories. It highlights the critical role of data quality and quantity in improving model performance and contributes to our understanding of the multifaceted factors that influence COVID-19 outcomes.
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Affiliation(s)
- Maryam Seyedtabib
- Department of Biostatistics and Epidemiology, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Roya Najafi-Vosough
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Naser Kamyari
- Department of Biostatistics and Epidemiology, School of Health, Abadan University of Medical Sciences, Abadan, Iran.
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Brandt F, Simone G, Loth J, Schilling D. COVID-19-associated costs and mortality in Germany: an incidence-based analysis from a payer's perspective. BMC Health Serv Res 2024; 24:321. [PMID: 38468304 PMCID: PMC10926608 DOI: 10.1186/s12913-024-10838-y] [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: 02/26/2023] [Accepted: 03/07/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND This study aims to estimate average COVID-19-associated healthcare costs per capita in Germany from a payer perspective. In addition, insights into COVID-19-associated mortality should be gained. METHODS For this purpose, a retrospective longitudinal analysis using health insurance claims data was performed. Patients affected by COVID-19 in Q1/2021 (investigation group (IG)) were compared to a matched non-COVID-19 control group (CG) (1:1 propensity score matching (PSM)). Mean values of healthcare costs in 2020 and 2021 were computed for both groups and then separated by age and by development of Post-COVID-19 Syndrome (PCS). Group differences were examined using Mann-Whitney U test (α = 0.05). Difference-in-Differences approach (DiD) was used to estimate average cost effects of COVID-19 in 2021. Concerning mortality, the number of deaths in 2021 was compared between IG and CG using χ2 test of independence. RESULTS A total of 8,014 insurants were included (n = 4,007 per group; n = 536 per group examining PCS patients only). Total healthcare costs varied a lot in the sample, were comparable between IG and CG in 2020, but were significantly higher in the IG in 2021 (DiD estimate = € 1,063 (in total); € 3,242 (PCS group)). This was more pronounced in the older age groups. High hospital costs of a minority of patients were the most influential driver of COVID-19-associated healthcare costs. Mortality was more than doubled in the IG (tripled in patients aged ≥ 60). CONCLUSIONS COVID-19 is associated with significantly increased healthcare costs and mortality, especially in older age groups. The additional development of PCS further increases the costs of COVID-19.
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Affiliation(s)
- Florian Brandt
- IKK Südwest, Europaallee 3-4, Saarbrücken, 66113, Germany.
| | | | - Jörg Loth
- IKK Südwest, Europaallee 3-4, Saarbrücken, 66113, Germany
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Blagoeva V, Hodzhev V, Dimova R, Stoyanova R, Bahariev D. Predictors of a severe course and mortality in patients with COVID-19-associated pneumonia. Folia Med (Plovdiv) 2024; 66:59-65. [PMID: 38426466 DOI: 10.3897/folmed.66.e111124] [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: 08/13/2023] [Accepted: 11/10/2023] [Indexed: 03/02/2024] Open
Abstract
INTRODUCTION Severe and critical forms of SARS-CoV-2 pneumonia are associated with high morbidity and mortality. Numerous research studies have been conducted around the world to investigate various variables (demographic, clinical, laboratory, etc.) in an attempt to understand the relationships between them and the course and outcome of patients with COVID-19 infection and pneumonia.
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Comunale BA, Hsu YJ, Larson RJ, Singh A, Jackson-Ward E, Engineer LD. Vitamin D Supplementation and Prior Oral Poliovirus Vaccination Decrease Odds of COVID-19 Outcomes among Adults Recently Inoculated with Inactivated Poliovirus Vaccine. Vaccines (Basel) 2024; 12:121. [PMID: 38400105 PMCID: PMC10892023 DOI: 10.3390/vaccines12020121] [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: 12/28/2023] [Revised: 01/15/2024] [Accepted: 01/19/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Structural and functional commonalities between poliovirus and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) suggest that poliovirus inoculation may induce antibodies that mitigate the coronavirus disease (COVID-19). No known studies have evaluated COVID-19 risk factors in adults recently vaccinated against poliovirus. STUDY OBJECTIVE Among adults with no history of COVID-19 infection or vaccination, who recently received an inactivated poliovirus vaccine (IPV), we sought to determine which biological factors and social determinants of health (SDOH) may be associated with (1) testing positive for SARS-CoV-2, (2) experiencing COVID-19 symptoms, and (3) a longer duration of COVID-19 symptoms. METHODS The influence of biological factors and SDOH on SARS-CoV-2 infection and COVID-19 symptoms were evaluated among 282 adults recently inoculated with IPV. Participant-reported surveys were analyzed over 12 months post-enrollment. Bivariate and multivariate linear and logistic regression models identified associations between variables and COVID-19 outcomes. RESULTS Adjusting for COVID-19 vaccinations, variants, and other SDOH, secondary analyses revealed that underlying conditions, employment, vitamin D, education, and the oral poliovirus vaccination (OPV) were associated with COVID-19 outcomes. The odds of testing positive for SARS-CoV-2 and experiencing symptoms were significantly reduced among participants who took vitamin D (OR 0.12 and OR 0.09, respectively). Unemployed or part-time working participants were 72% less likely to test positive compared with full-time workers. No prior dose of OPV was one of the strongest predictors of SARS-CoV-2 infection (OR 4.36) and COVID-19 symptoms (OR 6.95). CONCLUSIONS Findings suggest that prophylactic measures and mucosal immunity may mitigate the risk and severity of COVID-19 outcomes. Larger-scale studies may inform future policies.
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Affiliation(s)
- Brittany A. Comunale
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Yea-Jen Hsu
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Robin J. Larson
- Dartmouth-Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA
- Department of Palliative Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA
| | - Aditi Singh
- Department of Biological Sciences, University of California, San Diego, La Jolla, CA 92161, USA
| | - Erin Jackson-Ward
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
- Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Lilly D. Engineer
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
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Yavuz S, Duksal F. Identified Factors in COVID-19 Patients in Predicting Mortality. Niger J Clin Pract 2024; 27:62-67. [PMID: 38317036 DOI: 10.4103/njcp.njcp_418_23] [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: 06/01/2023] [Accepted: 12/16/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has led to a significant increase in global mortality rates. Numerous studies have been conducted to identify the factors associated with mortality in COVID-19 cases. In these studies, overall mortality was evaluated in patients, and no distinction was made as ward or intensive care mortality. AIM This study aims to determine mortality-related factors in patients who died while in the ward. This could enable us to review the indications for intensive care hospitalization in possible pandemics. MATERIALS AND METHOD This retrospective study was conducted on a cohort of 237 patients who applied to our institution between January 2020 and December 2021 with the diagnosis of COVID-19. Demographic characteristics, length of stay, type of admission (emergency ward or outpatient clinic), presence of comorbidities, thoracic computerized tomography (CT) findings, and laboratory findings were extracted from the hospital database. The demographic and laboratory results of both deceased and recovered patients were compared. RESULTS While many demographic and laboratory findings were statistically significant in the initial analysis, multiple logistic regression analysis showed that decreased albumin levels (adjusted OR = 0.23, 95% CI = 0.09 - 0.57), increased troponin (adjusted OR = 1.03, 95% CI = 1.02 - 1.05), and procalcitonin (adjusted OR = 3.46, 95% CI = 1.04 - 11.47) levels and higher partial thromboplastin time (PTT) (adjusted OR = 1.18, 95% CI = 1.09 - 1.28) values, presence of diabetes mellitus (DM) in patients (adjusted OR = 2.18, 95% CI = 1.01 - 4.69, P = 0.047), and admission to hospital from the emergency department (adjusted OR = 5.15, 95% CI = 1.45 - 18.27, P = 0.011) were significantly associated with mortality when adjusted for age. When a predictive model is constructed with these variables, this model predicted mortality statistically significant (AUC = 0.904, 95% CI = 0.856 - 0.938, P < 0.001), with a sensitivity of 77.2% (95% CI, 67.8 - 85), a specificity of 91.2% (95% CI, 85.1 - 95.4), a positive predictive value (PPV) of 86.7% (95% CI, 72 - 85.3), and an negative predictive value (NPV) of 84.4% (95% CI, 79.4 - 89.6). CONCLUSION In this study, we may predict mortality among COVID-19-diagnosed patients admitted to the ward via this model which has the potential to provide guidance for reconsidering the indications for intensive care unit (ICU) admission.
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Affiliation(s)
- S Yavuz
- Chest Disease Department, Beyhekim Training and Research Hospital, Konya, Turkey
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12
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Tunç AM, Çevirme A. Attitudes of healthcare workers toward the COVID-19 vaccine and related factors: A systematic review. Public Health Nurs 2024; 41:10-21. [PMID: 37668422 DOI: 10.1111/phn.13250] [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: 04/05/2023] [Revised: 08/01/2023] [Accepted: 08/16/2023] [Indexed: 09/06/2023]
Abstract
AIM AND OBJECTIVES This systematic review aims to examine healthcare professionals' attitudes toward the COVID-19 vaccine and related factors. BACKGROUND Healthcare workers have priority among risky groups accepted as candidates for early vaccination. Therefore, it is important to consider health professionals' attitudes toward COVID-19 vaccination to better address barriers to widespread vaccination. MATERIALS AND METHODS Six databases were searched for articles published between January 01, 2020, and February 31, 2022, and 1161 studies were reached. As a result of the evaluations, 10 studies were included in the systematic review. Nine studies are cross-sectional, and one is a descriptive study. A 9-item Critical Appraisal Checklist for Analytical Cross Sectional Studies from the Joanna Briggs Institute MAStARI Critical Assessment Tools (JBI-MAStARI) was used for quality assessment. High-quality studies with an average or higher methodological quality score were included in the systematic review. The PRISMA guideline was followed while selecting studies. RESULTS Positive attitudes of healthcare professionals toward the COVID-19 vaccine ranged from 10% to 93.7%, and negative attitudes varied between 6.3% and 41.0%. Factors such as the male gender, being a physician, advanced age, previous influenza vaccination history, and presence of chronic disease were found to be associated with vaccine acceptance. Factors such as doubt about the efficacy of the COVID-19 vaccine, safety concerns, and fear of unknown side effects of the vaccine were associated with COVID-19 vaccine hesitancy. CONCLUSION There is a need for confidence-building interventions and tailored communication strategies, including personalized training to change the ambiguous attitudes of healthcare professionals, increase vaccine uptake, and cope with the multifaceted impact of infection. PROSPERO REGISTRATION NUMBER CRD42021290482.
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Affiliation(s)
- Aylin Meşe Tunç
- Department of Public Health Nursing, Faculty of Health Science, Sakarya University, Sakarya, Turkey
| | - Ayşe Çevirme
- Department of Public Health Nursing, Faculty of Health Science, Sakarya University, Sakarya, Turkey
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13
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SeyedAlinaghi S, Mehraeen E. Can an International Student Group at TUMS in Iran Be a Role Model in the Development of Applied Scientific Evidence in the Era of COVID-19 through Mentorship? Infect Disord Drug Targets 2024; 24:e070224226751. [PMID: 38323614 DOI: 10.2174/0118715265277394240124070914] [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: 09/15/2023] [Revised: 12/21/2023] [Accepted: 01/05/2024] [Indexed: 02/08/2024]
Affiliation(s)
- SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran
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14
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Babaei M, Heidari B, Ghorbani H, Ahmadnia Z, Rouhi S, Zavareh MSH. Factors Associated with Mortality in Patients with Coronavirus Disease (COVID-19) in Babol, North of Iran. Infect Disord Drug Targets 2024; 24:e090224226818. [PMID: 38343046 DOI: 10.2174/0118715265209731240129042916] [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: 07/11/2022] [Revised: 01/10/2024] [Accepted: 01/10/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND The spectrum of the clinical features of coronavirus disease 2019 (COVID-19) spans from asymptomatic or mild disease to severe respiratory failure, while different factors are related to its mortality rate. This research aimed to determine the clinical and laboratory characteristics and the associated factors of mortality in patients with COVID-19. MATERIALS AND METHODS Data were collected from hospitalized patients (May to June 2020), and COVID-19 was confirmed in patients by real-time polymerase chain reaction (PCR). The patient group was classified into survivor and deceased groups. The chi-square and the independent t-test with Statistical Package for the Social Sciences (SPSS) software program, version 18, were used for analysis. RESULTS Mean age, hemoglobin, serum C-reactive protein (CRP), alkaline phosphatase (ALP), white blood cells, and level of procalcitonin in non-survivors were significantly higher than in survivors. Serum tumour necrosis factor-alpha (TNF-a) had a significant relationship with Ddimer (p = 0.0006). The risk of mortality in patients with serum CRP ≥ 100 mg/dl was significantly higher than those with CRP < 100 mg/dl (odds ratio (OR) = 4.8 (95% CI, 1.33-12.44, p = 0.01). CONCLUSION COVID-19 has different clinical features and can be an asymptomatic, mild, or severe disease. Thus, findings about the disease and the consequent outcomes differ in patients. Further studies are needed to evaluate the clinical features and consequences of COVID-19 infection.
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Affiliation(s)
- Mansour Babaei
- Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Behzad Heidari
- Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Hossein Ghorbani
- Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Ahmadnia
- Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Samaneh Rouhi
- Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
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15
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Sakai K, Okoda K, Nishii M, Saji R, Ogawa F, Abe T, Takeuchi I. Combining blood glucose and SpO 2/FiO 2 ratio facilitates prediction of imminent ventilatory needs in emergency room COVID-19 patients. Sci Rep 2023; 13:22718. [PMID: 38123659 PMCID: PMC10733355 DOI: 10.1038/s41598-023-50075-7] [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: 08/11/2021] [Accepted: 12/14/2023] [Indexed: 12/23/2023] Open
Abstract
The increasing requirement of mechanical ventilation (MV) due to the novel coronavirus disease (COVID-19) is still a global threat. The aim of this study is to identify markers that can easily stratify the impending use of MV in the emergency room (ER). A total of 106 patients with COVID-19 requiring oxygen support were enrolled. Fifty-nine patients were provided MV 0.5 h (interquartile range: 0.3 to 1.4) post-admission. Clinical and laboratory data before intubation were collected. Using a multivariate logistic regression model, we identified four markers associated with the impending use of MV, including the ratio of peripheral blood oxygen saturation to fraction of inspired oxygen (SpO2/FiO2 ratio), alanine aminotransferase, blood glucose (BG), and lymphocyte counts. Among these markers, SpO2/FiO2 ratio and BG, which can be measured easily and immediately, showed higher accuracy (AUC: 0.88) than SpO2/FiO2 ratio alone (AUC: 0.84), despite no significant difference (DeLong test: P = 0.591). Moreover, even in patients without severe respiratory failure (SpO2/FiO2 ratio > 300), BG (> 138 mg/dL) was predictive of MV use. Measuring BG and SpO2/FiO2 ratio may be a simple and versatile new strategy to accurately identify ER patients with COVID-19 at high risk for the imminent need of MV.
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Affiliation(s)
- Kazuya Sakai
- Department of Emergency Medicine, Yokohama City University, School of Medicine, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Kai Okoda
- Yokohama City University, School of Medicine, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Mototsugu Nishii
- Department of Emergency Medicine, Yokohama City University, School of Medicine, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
| | - Ryo Saji
- Department of Emergency Medicine, Yokohama City University, School of Medicine, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Fumihiro Ogawa
- Department of Emergency Medicine, Yokohama City University, School of Medicine, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Takeru Abe
- Department of Emergency Medicine, Yokohama City University, School of Medicine, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Ichiro Takeuchi
- Department of Emergency Medicine, Yokohama City University, School of Medicine, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
- Yokohama City University, School of Medicine, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
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16
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Heydari M, Mehraeen E, Javaherikiyan E, Mehrabi N, Langarizadeh M, Aghamohammadi V, Moghaddam HR, Nasiri K. Design, development and evaluation of a mobile-based self-care application for patients with COVID-19 not requiring hospitalization; a study of Northwest of Iran. BMC Med Inform Decis Mak 2023; 23:280. [PMID: 38057860 PMCID: PMC10698913 DOI: 10.1186/s12911-023-02381-3] [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: 12/19/2021] [Accepted: 11/27/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Given the effective role of a mobile applications in disease management, disease monitoring, and self-care in patients with COVID-19 disease, we aimed to design, development and evaluation of a self-care Mobile app for COVID-19 patients not requiring hospitalization. METHODS The design, development and evaluation the usability of the self-care and education mobile app for patients with COVID-19 disease were conducted in two main phases at 2021 in Northwest of IRAN; (1) Determine the features and capabilities and (2) Design, development and evaluation of self-care mobile App. JAVA programming languages and Android Operating System were used and selected to design and development of a mobile app. There were 25 participants who conducted evaluations of the mobile app's usability and impact using the mobile health app usability a Questionnaire of User Interface Satisfaction was administered to assess the usability of the developed application. The results were analyzed via Excel 2013. RESULTS The model of developing a mobile app as an Information System was the Waterfall model. The smartphone application based on a set of capabilities and features was designed and consists of two main parts: the login screen for user registration, and the main home menu. The user interface includes three main pages or activities; (a) Main Menu for quick access to all of the pages, (b) Symptom management and monitoring to monitor the signs and symptoms during the illness, and (c) Set Reminders and Alarms to notify patients. The users' mean score of the application usability was calculated as 7.91 out of 9 indicating a good level of satisfaction. CONCLUSION This app can be a guideline and a useful tools for managing and monitoring symptoms, reminding medications, and implementing self-care instructions in outpatients. The authors suggest evaluating the efficacy and functionality test of mobile-based applications for COVID-19 in clinical trial studies.
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Affiliation(s)
- Mohammad Heydari
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran.
| | - Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran
| | | | - Nahid Mehrabi
- Department of Health Information Technology, Aja University of Medical Sciences, Tehran, Iran
| | - Mostafa Langarizadeh
- Department of health information management, School of health management and information sciences, Iran university of medical sciences, Tehran, Iran
| | | | | | - Khadijeh Nasiri
- Department of Nursing, Khalkhal University of Medical Sciences, Khalkhal, Iran.
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17
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Vanhelst J, Srour B, Bourhis L, Charreire H, VerdotDeschasaux-Tanguy CM, Druesne-Pecollo N, de Edelenyi FS, Allègre J, Allès B, Deschamps V, Bellicha A, Fezeu LK, Galan P, Julia C, Kesse-Guyot E, Hercberg S, Bajos N, Severi G, Zins M, de Lamballerie X, Carrat F, Oppert JM, Touvier M. Association of SARS-CoV-2 infection with physical activity domains and types. Sci Rep 2023; 13:19187. [PMID: 37932323 PMCID: PMC10628273 DOI: 10.1038/s41598-023-46162-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 10/28/2023] [Indexed: 11/08/2023] Open
Abstract
Lockdown imposed in the early phase of the SARS-CoV-2 outbreak represented a specific setting where activity was restricted but still possible. The aim was to investigate the cross-sectional associations between physical activity (PA) and SARS-CoV-2 infection in a French population-based cohort. Participants completed a PA questionnaire. PA was classified into: (i) total PA; (ii) aerobic PA by intensity; (iii) strengthening PA; (iv) PA by domain and type; and (vii) by location. Sedentary time was also recorded. Seroprevalence of anti-SARS-CoV-2 antibodies was assessed. Multivariable logistic regression models controlling for sociodemographic, lifestyle, anthropometric data, health status, and adherence to recommended protective anti-SARS-CoV-2 behaviours were computed. From 22,165 participants included, 21,074 (95.1%) and 1091 (4.9%) had a negative and positive ELISA-S test result, respectively. Total PA, vigorous PA, leisure-time PA, household PA, outdoor PA and indoor PA were all associated with lower probability of SARS-CoV-2 infection. Observations made in such a setting shed light on PA possibilities in a context of restricted mobility, where the health benefits of PA should not be overlooked. Along with already well-established benefits of PA for non-communicable disease prevention, these findings provide additional evidence for policies promoting all types of PA as a lever for population health.
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Affiliation(s)
- Jérémy Vanhelst
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France.
| | - Bernard Srour
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
| | - Laurent Bourhis
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
| | - Hélène Charreire
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
- MoISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
| | - Charlotte Mélanie VerdotDeschasaux-Tanguy
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
- Santé Publique France, Nutritional Surveillance and Epidemiology Team (ESEN), Sorbonne Paris Nord University, Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Nathalie Druesne-Pecollo
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
| | - Fabien Szabo de Edelenyi
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
| | - Julien Allègre
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
| | - Benjamin Allès
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
| | - Valérie Deschamps
- Santé Publique France, Nutritional Surveillance and Epidemiology Team (ESEN), Sorbonne Paris Nord University, Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Alice Bellicha
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
| | - Leopold K Fezeu
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
| | - Pilar Galan
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
| | - Chantal Julia
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
- Département de Santé Publique, APHP, Sorbonne Université, Paris, France
| | - Emmanuelle Kesse-Guyot
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
| | - Serge Hercberg
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
| | - Nathalie Bajos
- IRIS, UMR CNRS 8156, EHESS, Inserm U997, Aubervilliers, France
| | - Gianluca Severi
- Paris-Saclay University, UVSQ, Inserm, Gustave Roussy, "Exposome and Heredity" Team, CESP UMR1018, Villejuif, France
- Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Florence, Italy
| | - Marie Zins
- Paris University, Paris, France
- Inserm UMS 11, Paris Saclay University, Villejuif, France
| | - Xavier de Lamballerie
- Unité des Virus Emergents (UVE), Aix Marseille Univ, IRD 190, INSERM 1207, Marseille, France
| | - Fabrice Carrat
- Sorbonne Université, Inserm, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Jean-Michel Oppert
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
- Department of Nutrition, Human Nutrition Research Center Ile-de-France (CRNH IdF), Pitié-Salpêtrière Hospital (AP-HP), Sorbonne University, Paris, France
| | - Mathilde Touvier
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), 93017, Bobigny, France
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18
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Hryzhak I, Pryshliak O, Kobryn T, Fedorov S, Boichuk O, Marynchak O, Kvasniuk V, Protsyk A, Miziuk R, Kucher A, Simchych M, Hryzhak L, Kuravkin M. Clinical and echocardiographic findings in patients with COVID-19 across different severity levels. J Med Life 2023; 16:1692-1700. [PMID: 38406777 PMCID: PMC10893567 DOI: 10.25122/jml-2023-0206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/08/2023] [Indexed: 02/27/2024] Open
Abstract
Cardiovascular pathology can complicate the course of COVID-19. The study aimed to identify echocardiographic abnormalities and key prognostic factors influencing severe and fatal COVID-19 outcomes. This retrospective cohort study included clinical and echocardiogram data from 194 medical records of hospitalized patients with COVID-19: 100 moderate cases, 34 severe cases with favorable outcomes, and 60 severe cases with fatal outcomes. Severe patients with favorable outcomes had greater reductions in left ventricular systolic fraction of left ventricle compared to moderate cases (23.5% vs. 7.0%, respectively, p=0.008) and ejection fraction of left ventricle (14.7% vs. 3.0%, respectively, p=0.013), grade I diastolic dysfunction of the left ventricle (20.6% vs. 8.0%, respectively, p=0.044), and pulmonary hypertension (29.41% vs. 10.0%, respectively, p=0.006). Patients with fatal outcomes had a mean age of 67.1±1.51 years, chronic heart failure functional class II (58.3%), hypertension (50.0%), type 2 diabetes (43.3%), and obesity (33.3%). Compared to severe cases but with favorable outcomes, fatal cases had a greater decrease in left ventricular ejection fraction (36.7% vs. 14.7%, respectively, p=0.024), various types of myocardial dysfunction (51.7% vs. 29.4%, respectively, p=0.037) and a trend towards increased pulmonary hypertension (48.3% vs. 29.4%, respectively, p=0.074). Consequently, chronic heart failure class II, reduced left ventricular ejection fraction, various myocardial dysfunctions, and pulmonary hypertension emerged as key cardiac risk factors for severe disease progression and mortality in patients with COVID-19.
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Affiliation(s)
- Ihor Hryzhak
- Infectious Diseases and Epidemiology Department, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Oleksandra Pryshliak
- Infectious Diseases and Epidemiology Department, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Taras Kobryn
- Infectious Diseases and Epidemiology Department, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Sergiy Fedorov
- Department of Therapy, Family and Emergency Medicines of Postgraduate Education, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Oleksandr Boichuk
- Infectious Diseases and Epidemiology Department, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Oleksandra Marynchak
- Infectious Diseases and Epidemiology Department, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Viktoriia Kvasniuk
- Infectious Diseases and Epidemiology Department, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Andrii Protsyk
- Infectious Diseases and Epidemiology Department, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Ruslan Miziuk
- Infectious Diseases and Epidemiology Department, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Andrii Kucher
- Department of Airborne Infections of Communal Non-Commercial Enterprise, Ivano-Frankivsk Phthisiatry-Pulmonology Center, Ivano-Frankivsk, Ukraine
| | - Marianna Simchych
- Department of Airborne Infections of Communal Non-Commercial Enterprise, Ivano-Frankivsk Phthisiatry-Pulmonology Center, Ivano-Frankivsk, Ukraine
| | - Lilia Hryzhak
- Department of Airborne Infections of Communal Non-Commercial Enterprise, Ivano-Frankivsk Phthisiatry-Pulmonology Center, Ivano-Frankivsk, Ukraine
| | - Mariia Kuravkin
- Infectious Diseases and Epidemiology Department, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
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19
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Vig S, Meena JK, Kumar A, Rathore P, Bhan S, Sirohiya P, Goswami G, Elavarasi A, Sagiraju HKR, Gupta N, Ratre B, Pandit A, Singh R, Kumar B, Garg R, Meena VP, Paul SS, Mohan A, Guleria R, Bhatnagar S. Mortality in Two Waves of COVID-19: A Comparative Analysis of a Tertiary Care Hospital in India. Cureus 2023; 15:e45025. [PMID: 37829991 PMCID: PMC10566229 DOI: 10.7759/cureus.45025] [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] [Accepted: 09/11/2023] [Indexed: 10/14/2023] Open
Abstract
Background COVID-19 has spread as two distinct surges of cases in many countries. Several countries have reported differences in disease severity and mortality in the two waves. Objective Compare the in-hospital mortality in the two COVID-19 waves at a tertiary care hospital in India. Methods We conducted a retrospective data collection. Distinct periods of surges in cases and admissions were defined as the first wave spanning from March 2020 to December 2020 and the second wave from April 2021 to June 21, 2021. The primary outcome of this study was to compare mortality rates in terms of total hospital mortality rate (TMR) and case fatality rate (CFR). Results Mortality rates of wave 2 were approximately 10 times that of wave 1 (TMR of 20.3% in wave 2 versus 2.4% in wave 1 and CFR of 1.5% versus 17.7% in wave 1 and 2, respectively). Mortalities in wave 2 had a larger proportion of severe disease at presentation, faster progression of symptoms to death, and more patients without any chronic comorbid condition dying due to the direct effect of COVID-19 acute respiratory distress syndrome (ARDS). Conclusion Our data matches the worldwide reported pooled hospital mortality figures and shows the comparative difference in disease severity between the two waves.
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Affiliation(s)
- Saurabh Vig
- Onco-Anesthesiology and Palliative Medicine, National Cancer Institute, All India Institute of Medical Sciences (AIIMS), New Delhi, IND
| | - Jitendra K Meena
- Preventive Oncology, National Cancer Institute, All India Institute of Medical Sciences (AIIMS), New Delhi, IND
| | - Abhishek Kumar
- Anesthesiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, IND
| | - Puneet Rathore
- Onco-Anesthesiology and Palliative Medicine, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences (AIIMS), New Delhi, IND
| | - Swati Bhan
- Anesthesiology, Vardhaman Mahavir Medical College (VMMC) and Safdarjung Hospital, New Delhi, IND
| | - Prashant Sirohiya
- Onco-Anesthesiology and Palliative Medicine, National Cancer Institute, All India Institute of Medical Sciences (AIIMS), New Delhi, IND
| | - Gitartha Goswami
- Onco-Anesthesiology and Palliative Medicine, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences (AIIMS), New Delhi, IND
| | | | - Hari Krishna Raju Sagiraju
- Preventive Oncology, National Cancer Institute, All India Institute of Medical Sciences (AIIMS), New Delhi, IND
| | - Nishkarsh Gupta
- Onco-Anesthesiology and Palliative Medicine, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences (AIIMS), Delhi, IND
| | - Brajesh Ratre
- Onco-Anesthesiology and Palliative Medicine, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences (AIIMS), New Delhi, IND
| | - Anuja Pandit
- Onco-Anesthesiology and Palliative Medicine, National Cancer Institute, All India Institute of Medical Sciences (AIIMS), New Delhi, IND
| | - Ram Singh
- Anesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS) New Delhi, New Delhi, IND
| | - Balbir Kumar
- Onco-Anesthesiology and Palliative Medicine, National Cancer Institute, All India Institute of Medical Sciences (AIIMS), New Delhi, IND
| | - Rakesh Garg
- Onco-Anesthesiology and Palliative Medicine, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences (AIIMS), New Delhi, IND
| | - Ved P Meena
- Internal Medicine, All India Institute of Medical Sciences (AIIMS) New Delhi, New Delhi, IND
| | - Saurav S Paul
- Medicine, All India Institute of Medical Sciences (AIIMS) New Delhi, New Delhi, IND
| | - Anant Mohan
- Pulmonary Medicine, All India Institute of Medical Sciences (AIIMS) New Delhi, New Delhi, IND
| | - Randeep Guleria
- Pulmonary Medicine, All India Institute of Medical Sciences (AIIMS) New Delhi, New Delhi, IND
| | - Sushma Bhatnagar
- Onco-Anesthesiology and Palliative Medicine, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences (AIIMS), New Delhi, IND
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20
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Riziki Ghislain M, Muzumbukilwa WT, Magula N. Risk factors for death in hospitalized COVID-19 patients in Africa: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e34405. [PMID: 37657047 PMCID: PMC10476721 DOI: 10.1097/md.0000000000034405] [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: 04/13/2023] [Accepted: 06/28/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 has quickly spread worldwide since it first appeared in Wuhan, China, in late 2019. The most affected country in Africa was South Africa. This study aimed to identify the risk factors for death in hospitalized COVID-19 patients in Africa. METHODS We conducted a systematic review following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. We searched articles from the following database: PubMed, Embase, Cochrane Library, Medline, and COVID-19 Research Database. We used Google Scholar for gray literature. The language used in this article was English. The last search was conducted on January 15, 2023. Pooled HRs, or ORs, and 95% confidence intervals, were calculated separately to identify the risk factors for death in hospitalized COVID-19 patients. Heterogeneity was assessed by Cochran's Q statistic and the I2 test. The Egger test was used to assess publication bias. Subgroup analysis was performed to determine the source of heterogeneity. Data analysis was performed using Stata version 17. A P value < .05 was considered significant. RESULTS A total of 16,600 articles were obtained from the database search; finally, 16 articles met the inclusion criteria and were eligible for data extraction. The analysis revealed that the pooled prevalence of mortality in hospitalized COVID-19 patients was 13.9%. Advanced age was a significant risk factor for death in hospitalized COVID-19 patients, with the pooled coronavirus mortality HR and OR being 3.73 (95% CI: 2.27-5.19) and 1.04 (95% CI: 1.02-1.06), respectively. In addition, male gender (pOR 1.23; 95% CI: 1.07-1.40), patients with diabetes mellitus (DM) (pOR 1.26; 95% CI: 1.01-1.51), hypertension (HTN) (pOR 1.56; 95% CI: 1.27-1.85), chronic kidney disease (CKD) (pHR 5.43; 95% CI: 0.18-10.67), severe or critical conditions (pOR 9.04; 95% CI: 3.14-14.94) had a significantly increased risk of coronavirus-related mortality. The main limitations of the present study stem from the predominant use of published studies, which could introduce publication bias. CONCLUSION According to this study, advanced age, male gender, hypertension, diabetes mellitus, chronic kidney disease, and severe or critical condition were clinical risk factors associated with death outcomes in hospitalized COVID-19 patients in Africa.
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Affiliation(s)
- Manimani Riziki Ghislain
- The Department of Internal Medicine, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Willy Tambwe Muzumbukilwa
- The Discipline of Pharmaceutical Sciences, Westville Campus, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Nombulelo Magula
- The Department of Internal Medicine, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
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21
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Binsaleh NK, Eltayeb R, Sherwani S, Almishaal AA, Hindi EA, Qanash H, Bazaid AS, Alharbi AO, Bazaid MB, Altamimi SA. Comparison of Hematological Parameters Between Survivors and Non-Survivors COVID-19 Patients in Saudi Arabia. Int J Gen Med 2023; 16:3955-3962. [PMID: 37670931 PMCID: PMC10476863 DOI: 10.2147/ijgm.s421418] [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: 05/15/2023] [Accepted: 08/15/2023] [Indexed: 09/07/2023] Open
Abstract
Objective Coronavirus disease 2019, caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is a communicable disease transmitted through the respiratory route and bodily contact. The severity of infection and mortality rate of COVID-19 cases was significantly high in the initial stages of the pandemic. This study aims to investigate the hematological profile of COVID-19 survivors and non-survivors. Methods This is a single-center retrospective study. A total of 108 hospitalized patients with laboratory-confirmed COVID-19 at East Jeddah Hospital between April and August 2020 were categorized into two groups based on outcome as survivors (n = 54) and non-survivors (n = 54). Hematological parameters and clinical profiles were analyzed and compared between the two groups. Results The mean age and standard deviation of the survived (30-71 years) and non-survived (33-83) groups was 53 ± 10.8 and 57.9 ± 12.2 years, respectively, with no statistically significant difference in age between groups (p = 0.0513). Non-survivors had a significantly longer median length of stay in the intensive care unit (ICU) (7 days, IQR: 4.24 to 12) compared to survivors COVID-19 patients (5 days, IQR: 0 to 11.75) (p = 0.0151). For the survivors group, the participant's age positively correlated with the length of hospital stay (r(52) = 0.21, p = 0.0005) and ICU length of stay r(52) = 0.18, p = 0.001). The median red blood cells (RBC) counts were significantly higher in the survived group (4.56x109/L, IQR: 4.02 to 5.11) in comparison with the non-survived (4.23x109/L, IQR: 3.75 to 4.23) group (p = 0.0011). All COVID-19 patients exhibited lymphocytopenia and a significant negative correlation was observed between the lymphocyte values and length of hospital stay among the survived group (p < 0.001) as well as length of ICU stay among the survived group (p < 0.0480). Disease-related mortality was significantly associated with reduced white blood cells (WBCs) (8.5×109/L, IQR: 6.1 to 11.7) and reduced basophils (0.09%, IQR: 0.02 to 0.19). Additionally, statistically significant differences were found between the survived and non-survived groups with respect to prothrombin time (PT) (12.5 sec. vs 14 sec., p < 0.0001) and partial thromboplastin time (PTT) (31.8 sec. vs 40 sec., p = 0.0008). Conclusion Hematological parameters can serve as valuable indicators to identify patients with severe COVID-19 and expected poor-prognosis/outcomes upon hospital admission. Cell counts of lymphocytes, WBCs, basophils and parameters such as PT and PTT can serve as clinical indicators to assess disease severity and predict progression to critical illness.
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Affiliation(s)
- Naif K Binsaleh
- Department of Medical Laboratory Science, College of Applied Medical Sciences, University of Ha'il, Hail, Saudi Arabia
- Medical and Diagnostic Research Centre, University of Ha’il, Hail, 55476, Saudi Arabia
| | - Reem Eltayeb
- Department of Medical Laboratory Science, College of Applied Medical Sciences, University of Ha'il, Hail, Saudi Arabia
| | - Subuhi Sherwani
- Medical and Diagnostic Research Centre, University of Ha’il, Hail, 55476, Saudi Arabia
- Department of Biology, College of Sciences, University of Hail, Hail, Saudi Arabia
| | - Ali A Almishaal
- Department of Speech-Language Pathology and Audiology, College of Applied Medical Sciences, University of Hail, Hail, Saudi Arabia
| | - Emad A Hindi
- Department of Clinical Anatomy, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Husam Qanash
- Department of Medical Laboratory Science, College of Applied Medical Sciences, University of Ha'il, Hail, Saudi Arabia
- Medical and Diagnostic Research Centre, University of Ha’il, Hail, 55476, Saudi Arabia
| | - Abdulrahman S Bazaid
- Department of Medical Laboratory Science, College of Applied Medical Sciences, University of Ha'il, Hail, Saudi Arabia
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22
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Minami S, Matsumoto N, Omori H, Nakamura Y, Tamiya S, Nouda R, Nurdin JA, Yamasaki M, Kotaki T, Kanai Y, Okamoto T, Tachibana T, Ushijima H, Kobayashi T, Sato S. Effective SARS-CoV-2 replication of monolayers of intestinal epithelial cells differentiated from human induced pluripotent stem cells. Sci Rep 2023; 13:11610. [PMID: 37463955 DOI: 10.1038/s41598-023-38548-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 07/10/2023] [Indexed: 07/20/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes severe acute respiratory symptoms in humans. Controlling the coronavirus disease pandemic is a worldwide priority. The number of SARS-CoV-2 studies has dramatically increased, and the requirement for analytical tools is higher than ever. Here, we propose monolayered-intestinal epithelial cells (IECs) derived from human induced pluripotent stem cells (iPSCs) instead of three-dimensional cultured intestinal organoids as a suitable tool to study SARS-CoV-2 infection. Differentiated IEC monolayers express high levels of angiotensin-converting enzyme 2 and transmembrane protease serine 2 (TMPRSS2), host factors essential for SARS-CoV-2 infection. SARS-CoV-2 efficiently grows in IEC monolayers. Using this propagation system, we confirm that TMPRSS2 inhibition blocked SARS-CoV-2 infection in IECs. Hence, our iPSC-derived IEC monolayers are suitable for SARS-CoV-2 research under physiologically relevant conditions.
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Affiliation(s)
- Shohei Minami
- Department of Virology, Research Institute for Microbial Diseases, Osaka University, Osaka, 565-0871, Japan
| | - Naomi Matsumoto
- Department of Virology, Research Institute for Microbial Diseases, Osaka University, Osaka, 565-0871, Japan
| | - Hiroko Omori
- Core Instrumentation Facility, Research Institute for Microbial Diseases, Osaka University, Osaka, 565-0871, Japan
| | - Yutaka Nakamura
- Department of Microbiology and Immunology, School of Pharmaceutical Sciences, Wakayama Medical University, Wakayama, 640-8156, Japan
| | - Shigeyuki Tamiya
- Department of Microbiology and Immunology, School of Pharmaceutical Sciences, Wakayama Medical University, Wakayama, 640-8156, Japan
| | - Ryotaro Nouda
- Department of Virology, Research Institute for Microbial Diseases, Osaka University, Osaka, 565-0871, Japan
| | - Jeffery A Nurdin
- Department of Virology, Research Institute for Microbial Diseases, Osaka University, Osaka, 565-0871, Japan
| | - Moeko Yamasaki
- Department of Virology, Research Institute for Microbial Diseases, Osaka University, Osaka, 565-0871, Japan
| | - Tomohiro Kotaki
- Department of Virology, Research Institute for Microbial Diseases, Osaka University, Osaka, 565-0871, Japan
| | - Yuta Kanai
- Department of Virology, Research Institute for Microbial Diseases, Osaka University, Osaka, 565-0871, Japan
| | - Toru Okamoto
- Institute for Advanced Co-creation Studies, Research Institute for Microbial Diseases, Osaka University, Osaka, 565-0871, Japan
- Center for Infectious Disease Education and Research, Osaka University, Osaka, 565-0871, Japan
| | - Taro Tachibana
- Cell Engineering Corporation, Osaka, 532-0011, Japan
- Department of Bioengineering, Graduate School of Engineering, Osaka Metropolitan University, Osaka, 558-8585, Japan
| | - Hiroshi Ushijima
- Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, 173-8610, Japan
| | - Takeshi Kobayashi
- Department of Virology, Research Institute for Microbial Diseases, Osaka University, Osaka, 565-0871, Japan.
- Center for Infectious Disease Education and Research, Osaka University, Osaka, 565-0871, Japan.
| | - Shintaro Sato
- Department of Virology, Research Institute for Microbial Diseases, Osaka University, Osaka, 565-0871, Japan.
- Department of Microbiology and Immunology, School of Pharmaceutical Sciences, Wakayama Medical University, Wakayama, 640-8156, Japan.
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23
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Thompson C, Porter Starr KN, Kemp EC, Chan J, Jackson E, Phun J. Feasibility of Virtually Delivering Functional Fitness Assessments and a Fitness Training Program in Community-Dwelling Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5996. [PMID: 37297600 PMCID: PMC10252352 DOI: 10.3390/ijerph20115996] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/07/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023]
Abstract
The COVID-19 pandemic limited older adults' access to preventative and diagnostic services and negatively affected accessibility to age-appropriate exercise programs. The purpose of this study was to assess the feasibility of conducting guided virtual functional fitness assessments before and after participation in an 8-week virtual, live fitness program (Vivo) designed for older adults. It was hypothesized there would be no significant difference between in-person and virtual functional fitness assessments and function would improve following the program. Thirteen community-dwelling older adults were recruited, screened, and randomly assigned to in-person-first or virtual-first fitness assessment groups. Validated assessments were delivered using standardized scripts by trained researchers and included Short Physical Performance Battery (SPPB) balance, a 30 s Chair Stand Test, 8 Foot Up-and-Go Test, 30 s Arm Curl Test, and 2 min Step Test. The eight-week, twice-a-week live virtual fitness program involved cardiovascular, balance, agility, Dual-Task, and strength training. Results showed no significant differences between all but one assessment measures, and several measures improved following the eight-week program. Fidelity checks demonstrated the high fidelity of program delivery. These findings illustrate that virtual assessments can be a feasible method to measure functional fitness in community-dwelling older adults.
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Affiliation(s)
- Christian Thompson
- Department of Kinesiology, University of San Francisco, San Francisco, CA 94117, USA
| | - Kathryn N. Porter Starr
- Department of Medicine, Duke University School of Medicine, Durham, NC 27710, USA
- Geriatric Research Education and Clinical Center, Durham VA Health Care System, Durham, NC 27710, USA
| | | | - June Chan
- Department of Kinesiology, University of San Francisco, San Francisco, CA 94117, USA
| | - Emily Jackson
- Department of Kinesiology, University of San Francisco, San Francisco, CA 94117, USA
| | - Justin Phun
- Department of Kinesiology, University of San Francisco, San Francisco, CA 94117, USA
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24
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González Villarreal SE, Salas Pacheco SM, Vázquez Alaniz F, Betancourt Conde MI, Salas Pacheco JM, Castillo Vazquez KC, Salas Leal AC, Tremillo Maldonado OA, Rojas Contreras JA, Hernández Cosain EI, García Montelongo M. Risk Factors Associated with COVID-19 Mortality in the State of Durango, Mexico. Int J Med Sci 2023; 20:993-999. [PMID: 37484800 PMCID: PMC10357438 DOI: 10.7150/ijms.82591] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 04/18/2023] [Indexed: 07/25/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) has caused over six million deaths worldwide since its emergence in Wuhan China, factors associated with COVID-19 mortality, such as comorbidities, age, and observed symptomatology still remain a major subject of study. In the present work, a total of 16,345 SARS-CoV-2 positive cases from Durango Mexico diagnosed from May 2020 to December 2021 were analyzed to establish an association of COVID-19 mortality with clinical and demographic variables in a case-control study. Selected variables include patient age, smoking status, sex, presence of comorbidities such as hypertension, diabetes and obesity, as well as patient symptomatology such as fever, dyspnea, abdominal pain and diarrhea. Results indicate that among analyzed data, the median age was 43 years; 54% were female, with a mortality rate of 5.66%. Multivariate regression analysis indicated that the comorbidities associated with the highest risk factor were advanced age (>60) with an odds ratio of 4.127 (IC 95%, 3.37-5.05), hypertension with 1.961 (IC 95%, 1.57-2.45), diabetes with 1.753 (IC 95%, 1.39-2.20) and obesity with 1.413 (IC 95%, 1.11-1.78) respectively. On the other hand, the symptom associated with the highest risk factor was dyspnea with an odds ratio of 18.369 (IC 95%, 14.42-23.39). Our data suggests an association between hypertension and old age with COVID-19 mortality. Other findings include the prevalence of dyspnea, polypnea and cyanosis as a major predictor for COVID-19 mortality, as well as lower mortality risks among health workers.
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Affiliation(s)
| | - Sergio Manuel Salas Pacheco
- Laboratorio Estatal de Salud Pública de Durango, Secretaría de Salud, Servicios de Salud de Durango, Zip Code 34206, Durango, México
| | - Fernando Vázquez Alaniz
- Unidad de Investigación, Hospital General 450. Servicios de Salud, Zip Code 34206, Durango, México
| | | | - José Manuel Salas Pacheco
- Instituto de Investigación Científica, Universidad Juárez del Estado de Durango, Zip Code 34000, Durango, México
| | | | - Alma Cristina Salas Leal
- Instituto de Investigación Científica, Universidad Juárez del Estado de Durango, Zip Code 34000, Durango, México
| | | | | | - Erik Iván Hernández Cosain
- Facultad de Medicina y Nutrición, Universidad Juárez del Estado de Durango, Zip Code 34000, Durango, México
| | - Mónica García Montelongo
- Laboratorio Estatal de Salud Pública de Durango, Secretaría de Salud, Servicios de Salud de Durango, Zip Code 34206, Durango, México
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25
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Syrimi N, Sourri F, Giannakopoulou MC, Karamanis D, Pantousas A, Georgota P, Rokka E, Vladeni Z, Tsiantoula E, Soukara E, Lavda N, Gkaragkanis D, Zisaki A, Vakalidis P, Goula V, Loupou E, Palaiodimos L, Hatzigeorgiou D. Humoral and Cellular Response and Associated Variables Nine Months following BNT162b2 Vaccination in Healthcare Workers. J Clin Med 2023; 12:jcm12093172. [PMID: 37176612 PMCID: PMC10179201 DOI: 10.3390/jcm12093172] [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: 03/03/2023] [Revised: 04/21/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
In this study, we aimed to illustrate the trajectory of humoral and cellular immunity nine months after primary vaccination with the BNT162b2 mRNA vaccine among 189 healthcare workers (HCWs). Additionally, we endeavored to identify correlations between immunity parameters and a number of common variables and comorbidities. A total of 189 healthcare workers (HCWs), vaccinated against COVID-19, were finally included in the study. All of the subjects had received two doses of the BNT162b2 vaccine; had undergone antibody tests one, four and nine months post-vaccination; and had completed a medical questionnaire. Further samples taken at nine months were tested for cellular immunity. No participants had evidence of COVID-19 infection pre- or post-vaccination. An anti-S1 receptor binding domain (RBD) antibody assay was used to assess humoral response, and cellular immunity was estimated with an INF-γ release assay (IGRA). Statistical analysis was performed using STATA. We report a statistically significant antibody drop over time. Being above the age of 40 or a smoker reduces the rise of antibodies by 37% and 28%, respectively. More than half of the participants did not demonstrate T-cell activation at nine months. Female gender and antibody levels at four months predispose detection of cellular immunity at nine months post-immunization. This study furthers the qualitative, quantitative, and temporal understanding of the immune response to the BNT162b2 mRNA vaccine and the effect of correlated factors.
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Affiliation(s)
- Natalia Syrimi
- Paediatric Department, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
- Infection Prevention and Control Department, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Flora Sourri
- Infection Prevention and Control Department, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Maria-Christina Giannakopoulou
- COVID-19 Ward, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
- Medical Directorate, Hellenic National and Defence General Staff, Mesogeion 227-231, 15561 Athens, Greece
| | - Dimitrios Karamanis
- Department of Health Informatics, Rutgers School of Health Professions, 65 Bergen St., Newark, NJ 07107, USA
- Department of Economics, University of Piraeus, Karaoli and Dimitriou 80, 18534 Piraeus, Greece
| | - Asterios Pantousas
- Department of Electrical and Computer Engineering, Democritus University of Thrace, 69100 Komotini, Greece
| | - Persefoni Georgota
- Immunology Laboratory, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Eleni Rokka
- Oncology Ward, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Zoe Vladeni
- Infection Prevention and Control Department, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Euaggelia Tsiantoula
- Biochemistry Laboratory, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Evangelia Soukara
- COVID-19 Ward, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Nikoletta Lavda
- COVID-19 Ward, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Dimitrios Gkaragkanis
- COVID-19 Ward, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Aikaterini Zisaki
- Infection Prevention and Control Department, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Panagiotis Vakalidis
- Biochemistry Laboratory, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Vasiliki Goula
- Biochemistry Laboratory, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Evdokia Loupou
- Biochemistry Laboratory, 251 Hellenic Air Force General Hospital, P. Kanellopoulou Avenue, 11525 Athens, Greece
| | - Leonidas Palaiodimos
- Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USA
| | - Dimitrios Hatzigeorgiou
- Medical Directorate, Hellenic National and Defence General Staff, Mesogeion 227-231, 15561 Athens, Greece
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26
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Keller GA, Colaianni I, Coria J, Di Girolamo G, Miranda S. Clinical and biochemical short-term effects of hyperbaric oxygen therapy on SARS-Cov-2+ hospitalized patients with hypoxemic respiratory failure. Respir Med 2023; 209:107155. [PMID: 36796547 PMCID: PMC9927797 DOI: 10.1016/j.rmed.2023.107155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/11/2023] [Accepted: 02/14/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Hyperbaric oxygen therapy (HBOT) has been proposed to address COVID-19- associated respiratory failure. However, its biochemical effects are poorly known. METHOD 50 patients with hypoxemic COVID-19 pneumonia were divided into C group (standard care) and H group (standard care plus HBOT). Blood was obtained at t = 0 and t = 5 days. Oxygen saturation (O2 Sat) was followed up. White blood cell (WC) count, lymphocytes (L) and platelets (P) and serum analysis (glucose, urea, creatinine, sodium, potassium, ferritin, D dimer, LDH and CRP) were carried out. Plasma levels of sVCAM, sICAM, sPselectin, SAA and MPO, and of cytokines (IL-1β, IL-1RA, IL-6, TNFα, IFNα, IFNγ, IL-15, VEGF, MIP1α, IL-12p70, IL-2 and IP-10) were measured by multiplex assays. Angiotensin Converting Enzyme 2 (ACE-2) levels were determined by ELISA. RESULTS The average basal O2 Sat was 85 ± 3%. The days needed to reach O2 Sat >90% were: H: 3 ± 1 and C: 5 ± 1 (P < 0,01). At term, H increased WC, L and P counts (all, H vs C: P < 0,01). Also, H diminished D dimer levels (H vs C, P < 0,001) and LDH concentration (H vs C, P < 0.01]. At term, H showed lower levels of sVCAM, sPselectin and SAA than C with respect to basal values (H vs C: ΔsVCAM: P < 0,01; ΔsPselectin: P < 0,05; ΔSAA: P < 0,01). Similarly, H showed diminished levels of TNFα (ΔTNFα: P < 0,05) and increased levels of IL-1RA and VEGF than C respect to basal values (H vs C: ΔIL-1RA and ΔVEGF: P < 0,05). CONCLUSION Patients underwent HBOT improved O2 Sat with lower levels of severity markers (WC and platelets count, D dimer, LDH, SAA). Moreover, HBOT reduced proinflammatory agents (sVCAM, sPselectin, TNFα) and increased anti-inflammatory and pro-angiogenic ones (IL-1RA and VEGF).
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Affiliation(s)
- Guillermo A Keller
- Universidad de Buenos Aires, Facultad de Medicina, Centro de Vigilancia y Seguridad de Medicamentos, Argentina; Hospital General de Agudos Donación Francisco J. Santojanni, Departamento de Urgencias, Argentina
| | - Ivana Colaianni
- Hospital General de Agudos Donación Francisco J. Santojanni, Departamento de Urgencias, Argentina
| | - Javier Coria
- Universidad de Buenos Aires- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto Alberto C. Taquini de Investigaciones en Medicina Traslacional (IATIMET), Argentina
| | - Guillermo Di Girolamo
- Universidad de Buenos Aires- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto Alberto C. Taquini de Investigaciones en Medicina Traslacional (IATIMET), Argentina
| | - Silvia Miranda
- Universidad de Buenos Aires- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto Alberto C. Taquini de Investigaciones en Medicina Traslacional (IATIMET), Argentina.
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Léger C, Deslauriers F, Gosselin Boucher V, Phillips M, Bacon SL, Lavoie KL. Prevalence and Motivators of Getting a COVID-19 Booster Vaccine in Canada: Results from the iCARE Study. Vaccines (Basel) 2023; 11:vaccines11020291. [PMID: 36851169 PMCID: PMC9960725 DOI: 10.3390/vaccines11020291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023] Open
Abstract
Studies have shown that the protection afforded by COVID-19 vaccines against hospitalization and death decreases slowly over time due to the emergence of new variants and waning immunity. Accordingly, booster doses remain critical to minimizing the health impacts of the pandemic. This study examined the prevalence rate, sociodemographic determinants, and motivators of getting a COVID-19 booster vaccine within the Canadian population. We recruited a representative sample of 3001 Canadians aged 18+ years as part of the iCARE study using an online polling form between 20 January and 2 February 2022. Participants self-reported their booster status and were dichotomized into two groups: those who did vs. did not receive at least one booster dose. A total of 67% of participants received a booster dose. Chi-square analyses revealed that older age (p < 0.001) and having a chronic disease diagnosis (p < 0.001) were associated with being more likely to get a booster. Boosted individuals reported motivators tied to efficacy and altruism, whereas non-boosted individuals reported motivators tied to efficacy and safety. Results suggest that messaging will require careful tailoring to address the identified behavioral motivators among non-boosted individuals who emphasize safety and efficacy of additional vaccine doses.
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Affiliation(s)
- Camille Léger
- Department of Psychology, University of Québec at Montreal (UQAM), Montréal, QC C3H 3P8, Canada
- Montreal Behavioural Medicine Centre, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord de l’Ile de Montréal (CIUSSS-NIM), Montréal, QC H4J 1C5, Canada
| | - Frédérique Deslauriers
- Department of Psychology, University of Québec at Montreal (UQAM), Montréal, QC C3H 3P8, Canada
- Montreal Behavioural Medicine Centre, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord de l’Ile de Montréal (CIUSSS-NIM), Montréal, QC H4J 1C5, Canada
| | | | - Meghane Phillips
- Montreal Behavioural Medicine Centre, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord de l’Ile de Montréal (CIUSSS-NIM), Montréal, QC H4J 1C5, Canada
- Department of Health, Kinesiology & Applied Physiology, Concordia University, Montréal, QC H4B 1R6, Canada
| | - Simon L. Bacon
- Montreal Behavioural Medicine Centre, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord de l’Ile de Montréal (CIUSSS-NIM), Montréal, QC H4J 1C5, Canada
- Department of Health, Kinesiology & Applied Physiology, Concordia University, Montréal, QC H4B 1R6, Canada
| | - Kim L. Lavoie
- Department of Psychology, University of Québec at Montreal (UQAM), Montréal, QC C3H 3P8, Canada
- Montreal Behavioural Medicine Centre, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord de l’Ile de Montréal (CIUSSS-NIM), Montréal, QC H4J 1C5, Canada
- Correspondence:
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Galanis P, Vraka I, Katsiroumpa A, Siskou O, Konstantakopoulou O, Zogaki E, Kaitelidou D. Psychosocial Predictors of COVID-19 Vaccine Uptake among Pregnant Women: A Cross-Sectional Study in Greece. Vaccines (Basel) 2023; 11:269. [PMID: 36851147 PMCID: PMC9967309 DOI: 10.3390/vaccines11020269] [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: 12/26/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 01/28/2023] Open
Abstract
An understanding of the factors associated with the COVID-19 vaccine uptake in pregnant women is paramount to persuade women to get vaccinated against COVID-19. We estimated the vaccination rate of pregnant women against COVID-19 and evaluated psychosocial factors associated with vaccine uptake among them. We conducted a cross-sectional study with a convenience sample. In particular, we investigated socio-demographic data of pregnant women (e.g., age, marital status, and educational level), COVID-19 related variables (e.g., previous COVID-19 diagnosis and worry about the side effects of COVID-19 vaccines), and stress due to COVID-19 (e.g., danger and contamination fears, fears about economic consequences, xenophobia, compulsive checking and reassurance seeking, and traumatic stress symptoms about COVID-19) as possible predictors of COVID-19 vaccine uptake. Among pregnant women, 58.6% had received a COVID-19 vaccine. The most important reasons that pregnant women were not vaccinated were doubts about the safety and effectiveness of the COVID-19 vaccines (31.4%), fear that COVID-19 vaccines could be harmful to the fetus (29.4%), and fear of adverse side effects of COVID-19 vaccines (29.4%). Increased danger and contamination fears, increased fears about economic consequences, and higher levels of trust in COVID-19 vaccines were related with vaccine uptake. On the other hand, increased compulsive checking and reassurance seeking and increased worry about the adverse side effects of COVID-19 vaccines reduced the likelihood of pregnant women being vaccinated. An understanding of the psychosocial factors associated with increased COVID-19 vaccine uptake in pregnant women could be helpful for policy makers and healthcare professionals in their efforts to persuade women to get vaccinated against COVID-19. There is a need for targeted educational campaigns to increase knowledge about COVID-19 vaccines and reduce vaccine hesitancy in pregnancy.
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Affiliation(s)
- Petros Galanis
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Irene Vraka
- Department of Radiology, P. & A. Kyriakou Children’s Hospital, 11527 Athens, Greece
| | - Aglaia Katsiroumpa
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Olga Siskou
- Department of Tourism Studies, University of Piraeus, 18534 Piraeus, Greece
| | - Olympia Konstantakopoulou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Eleftheria Zogaki
- Faculty of Midwifery, University of West Attica, West Attica, 12243 Aigaleo, Greece
| | - Daphne Kaitelidou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Dallavalasa S, Tulimilli SV, Prakash J, Ramachandra R, Madhunapantula SV, Veeranna RP. COVID-19: Diabetes Perspective-Pathophysiology and Management. Pathogens 2023; 12:pathogens12020184. [PMID: 36839456 PMCID: PMC9967788 DOI: 10.3390/pathogens12020184] [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: 11/21/2022] [Revised: 01/05/2023] [Accepted: 01/19/2023] [Indexed: 01/26/2023] Open
Abstract
Recent evidence relating to the impact of COVID-19 on people with diabetes is limited but continues to emerge. COVID-19 pneumonia is a newly identified illness spreading rapidly throughout the world and causes many disabilities and fatal deaths. Over the ensuing 2 years, the indirect effects of the pandemic on healthcare delivery have become prominent, along with the lingering effects of the virus on those directly infected. Diabetes is a commonly identified risk factor that contributes not only to the severity and mortality of COVID-19 patients, but also to the associated complications, including acute respiratory distress syndrome (ARDS) and multi-organ failure. Diabetic patients are highly affected due to increased viral entry into the cells and decreased immunity. Several hypotheses to explain the increased incidence and severity of COVID-19 infection in people with diabetes have been proposed and explained in detail recently. On the other hand, 20-50% of COVID-19 patients reported new-onset hyperglycemia without diabetes and new-onset diabetes, suggesting the two-way interactions between COVID-19 and diabetes. A systematic review is required to confirm diabetes as a complication in those patients diagnosed with COVID-19. Diabetes and diabetes-related complications in COVID-19 patients are primarily due to the acute illness caused during the SARS-CoV-2 infection followed by the release of glucocorticoids, catecholamines, and pro-inflammatory cytokines, which have been shown to drive hyperglycemia positively. This review provides brief insights into the potential mechanisms linking COVID-19 and diabetes, and presents clinical management recommendations for better handling of the disease.
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Affiliation(s)
- Siva Dallavalasa
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR) Laboratory (DST-FIST Supported Centre), Department of Biochemistry (DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education and Research (JSS AHER), Mysuru 570015, India
| | - SubbaRao V. Tulimilli
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR) Laboratory (DST-FIST Supported Centre), Department of Biochemistry (DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education and Research (JSS AHER), Mysuru 570015, India
| | - Janhavi Prakash
- Department of Biochemistry, Council of Scientific and Industrial Research (CSIR)-Central Food Technological Research Institute (CFTRI), Mysuru 570020, India
| | - Ramya Ramachandra
- Department of Biochemistry, Council of Scientific and Industrial Research (CSIR)-Central Food Technological Research Institute (CFTRI), Mysuru 570020, India
| | - SubbaRao V. Madhunapantula
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR) Laboratory (DST-FIST Supported Centre), Department of Biochemistry (DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education and Research (JSS AHER), Mysuru 570015, India
- Leader, Special Interest Group in Cancer Biology and Cancer Stem Cells (SIG-CBCSC), JSS Medical College, JSS Academy of Higher Education and Research (JSS AHER), Mysuru 570015, India
| | - Ravindra P. Veeranna
- Department of Biochemistry, Council of Scientific and Industrial Research (CSIR)-Central Food Technological Research Institute (CFTRI), Mysuru 570020, India
- Correspondence:
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Muacevic A, Adler JR, Bahakeem R, Batarjee R, Mubaraki W, Alsaedi A, Alghamdi LA, Al Nufaiei ZF. Factors Affecting Confirmed COVID-19 Patient's Recovery Time at King Abdulaziz Medical City, Jeddah. Cureus 2023; 15:e34130. [PMID: 36843699 PMCID: PMC9947720 DOI: 10.7759/cureus.34130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2023] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic has become a threat to the public's health, especially to the elderly and those with chronic conditions. It is capable of spreading from carriers who are both asymptomatic and symptomatic. Associated factors such as age, sex, severe symptoms of COVID-19 disease, and chronic disease have a significant impact on the recovery time of patients. AIM The study aimed to determine associated factors on recovery time in COVID-19 patients hospitalized at King Abdulaziz Medical city. METHODS A single-center retrospective study was utilized to recruit 1776 confirmed COVID-19 patients from 13 September to 24 October 2020 at King Abdulaziz Medical City (KAMC) in Jeddah. RESULTS The patients were categorized into three age groups: below 5 years, 5 to 65 years, and above 65 years. The number of male patients in each group was 49, 764, and 73, and the number of female patients in each group was 54, 754, and 82, respectively. Impact recovery time on female patients was 11.75 days; with male patients was 10.95 days. Symptoms such as sore throat, diarrhea, and fever in female patients declined the recovery time. On the other hand, symptoms such as runny nose, diarrhea, fever, and headache in male patients declined the recovery time. DISCUSSION AND CONCLUSION It was revealed that older aged COVID-19 patients, male sex, and some symptoms decline recovery time. The study findings show an independent predictor of particular symptoms and sign which delay the time of recovery in the COVID-19 patients enrolled in the study differently, for male and female patients. Thus, patients who are infected with COVID-19 should be monitored keenly to prevent a prolonged rate of recovery and should be eligible for priority management to enhance a good clinical outcome.
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Mutekanga A, Nuwagira E, Kumbakumba E, Nyaiteera V, Asiimwe S, Gasumuni M, Wandera N, Natumanya R, Akena D, Senoga S, Kyobe Kiwanuka J, Kateregga G, Munyarugero E, Abeya FC, Obwoya PS, Ttendo S, Muhindo R. Factors Associated with 30-Day in-Hospital Mortality Among Patients Admitted with Severe Covid-19 in Mbarara Regional Referral Hospital. Infect Drug Resist 2022; 15:7157-7164. [PMID: 36510588 PMCID: PMC9738092 DOI: 10.2147/idr.s379443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Background COVID-19 has created a burden on the healthcare system globally. Severe COVID-19 is linked with high hospital mortality. Data regarding 30-day in-hospital mortality and its factors has not been explored in southwestern Uganda. Methods We carried out a retrospective, single-center cohort study, and included all in-patients with laboratory-confirmed, radiological, or clinical severe COVID-19 admitted between April 2020 and September 2021 at Mbarara Regional Referral Hospital (MRRH). Demographic, laboratory, treatment, and clinical outcome data were extracted from patients' files. These data were described comparing survivors and non-survivors. We used logistic regression to explore the factors associated with 30-day in-hospital mortality. Results Of the 283 patients with severe COVID-19 admitted at MRRH COVID-19 unit, 58.1% were male. The mean age ± standard deviation (SD) was 61±17.4 years; there were no differences in mean age between survivors and non-survivors (59 ± 17.2 versus 64.4 ±17.3, respectively, p=0.24) The median length of hospital stay was 7 (IQR 3-10) days (non-survivors had a shorter median length of stay 5 (IQR 2-9) days compared to the survivors; 8 (IQR 5-11) days, p<0.001. The most frequent comorbidities were hypertension (30.5%) and diabetes mellitus (30%). The overall 30-day in-hospital mortality was 134 of 279 (48%) mortality rate of 47,350×105 with a standard error of 2.99%. The factors associated with 30-day in-hospital mortality were age: 65 years and above (aOR, 3.88; 95% CI, 1.24-11.70; P =0.020) a neutrophil to lymphocyte ratio above 5 (aOR, 4.83; 95% CI, 1.53-15.28; P =0.007) and oxygen requirement ≥15L/min (aOR, 15.80; 95% CI, 5.17-48.25; P <0.001). Conclusion We found a high 30-day in-hospital mortality among patients with severe forms of COVID-19. The identified factors could help clinicians to identify patients with poor prognosis at an early stage of admission.
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Affiliation(s)
- Andrew Mutekanga
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Edwin Nuwagira
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Elias Kumbakumba
- Department of Pediatrics and Child Health, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Victoria Nyaiteera
- Department of ENT, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Stephen Asiimwe
- Global Health Collaborative, Massachusetts General Hospital, Boston, MA, USA
| | - Medal Gasumuni
- Department of Medicine, Mbarara Regional Referral Hospital, Mbarara, Uganda
| | - Nelson Wandera
- Department of Medicine, Mbarara Regional Referral Hospital, Mbarara, Uganda
| | - Robert Natumanya
- Department of Medicine, Mbarara Regional Referral Hospital, Mbarara, Uganda
| | - Denis Akena
- Department of Medicine, Mbarara Regional Referral Hospital, Mbarara, Uganda
| | - Siraje Senoga
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Joseph Kyobe Kiwanuka
- Department of Anesthesiology and Critical Care, Mbarara University of Science and Technology, Mbarara, Uganda
| | - George Kateregga
- Department of Anesthesiology and Critical Care, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Emmanuel Munyarugero
- Department of Anesthesiology and Critical Care, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Fardous Charles Abeya
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Paul Stephen Obwoya
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Stephen Ttendo
- Department of Anesthesiology and Critical Care, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Rose Muhindo
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
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Ayubi E, Torkaman Asadi F, Borzouei S, Alafchi B, Faghih Soleimani M, Khosronejad S, Khazaei S, Talebi SS. Effects of Hypertension Alone and in Comorbidity with Diabetes on Death within 30 Days among Inpatients with COVID-19 Infection. J Res Health Sci 2022; 22:e00565. [PMID: 37571936 PMCID: PMC10422163 DOI: 10.34172/jrhs.2022.100] [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: 10/09/2022] [Revised: 11/15/2022] [Accepted: 12/07/2022] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Hypertension and diabetes are common comorbidities in patients with COVID-19 and could be influencing the mortality of such patients. The present study aimed to evaluate the effects of hypertension alone and in comorbidity with diabetes on the death within 30 days among inpatients with COVID-19 in presence of well-known determinates of COVID-19 death. STUDY DESIGN A case-control study. METHODS Four groups of COVID-19 inpatients including controls, diabetes alone, hypertension alone, and hypertension and diabetes comorbidities were defined. Each study groups did not have underlying diseases other than hypertension and diabetes. Demographic and general characteristics, underlying diseases, and hospital course events were extracted from medical records. The outcome of interest was alive at discharge/ death within 30 days after admission. Multivariable binary logistic analysis was employed to estimate the effect measures. RESULTS The number of death within 30 days among controls (n=1359), diabetes alone (159), hypertension alone (406) and hypertension and diabetes comorbidities (188) were 12.68%, 15.72%, 20.74% and 26.74%, respectively. According to three multivariable analyses after adjusting older age, hospital length of stay, and intensive care unit (ICU) admission separately, the odds of death within 30 days in COVID-19 patients with having hypertension and diabetes comorbidities was 1.58, 2.13 and 1.91 times of patients without such comorbidities, respectively (P<0.015). The effect of hypertension alone was also significant after adjusting hospital length of stay and ICU admission but not for older age. CONCLUSION Our results suggest that comorbidities, such as hypertension and diabetes may be associated with COVID-19-related deaths independent of other underlying diseases, older age, and adverse hospital course events.
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Affiliation(s)
- Erfan Ayubi
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fatemeh Torkaman Asadi
- Department of Infectious Disease, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
- Infectious Disease Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Shiva Borzouei
- Department of Internal Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Behnaz Alafchi
- Modeling Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Saman Khosronejad
- Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Salman Khazaei
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyed Saman Talebi
- Department of Internal Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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Santer DM, Li D, Ghosheh Y, Zahoor MA, Prajapati D, Hansen BE, Tyrrell DLJ, Feld JJ, Gehring AJ. Interferon-λ treatment accelerates SARS-CoV-2 clearance despite age-related delays in the induction of T cell immunity. Nat Commun 2022; 13:6992. [PMID: 36385011 PMCID: PMC9667439 DOI: 10.1038/s41467-022-34709-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 11/02/2022] [Indexed: 11/17/2022] Open
Abstract
Interferons induced early after SARS-CoV-2 infection are crucial for shaping immunity and preventing severe COVID-19. We previously demonstrated that injection of pegylated interferon-lambda accelerated viral clearance in COVID-19 patients (NCT04354259). To determine if the viral decline is mediated by enhanced immunity, we assess in vivo responses to interferon-lambda by single cell RNA sequencing and measure SARS-CoV-2-specific T cell and antibody responses between placebo and interferon-lambda-treated patients. Here we show that interferon-lambda treatment induces interferon stimulated genes in peripheral immune cells expressing IFNLR1, including plasmacytoid dendritic cells and B cells. Interferon-lambda does not affect SARS-CoV-2-specific antibody levels or the magnitude of virus-specific T cells. However, we identify delayed T cell responses in older adults, suggesting that interferon-lambda can overcome delays in adaptive immunity to accelerate viral clearance in high-risk patients. Altogether, interferon-lambda offers an early COVID-19 treatment option for outpatients to boost innate antiviral defenses without dampening peripheral adaptive immunity.
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Affiliation(s)
- Deanna M. Santer
- grid.21613.370000 0004 1936 9609Department of Immunology, University of Manitoba, Winnipeg, MB Canada
| | - Daniel Li
- grid.17063.330000 0001 2157 2938Institute of Medical Science, University of Toronto, Toronto, ON Canada ,grid.231844.80000 0004 0474 0428Toronto Centre for Liver Disease, University Health Network, Toronto, ON Canada
| | - Yanal Ghosheh
- grid.231844.80000 0004 0474 0428Toronto Centre for Liver Disease, University Health Network, Toronto, ON Canada
| | - Muhammad Atif Zahoor
- grid.231844.80000 0004 0474 0428Toronto Centre for Liver Disease, University Health Network, Toronto, ON Canada
| | - Dhanvi Prajapati
- grid.21613.370000 0004 1936 9609Department of Immunology, University of Manitoba, Winnipeg, MB Canada
| | - Bettina E. Hansen
- grid.231844.80000 0004 0474 0428Toronto Centre for Liver Disease, University Health Network, Toronto, ON Canada
| | - D. Lorne J. Tyrrell
- grid.17089.370000 0001 2190 316XDepartment of Medical Microbiology & Immunology, Li Ka Shing Institute of Virology, University of Alberta, Edmonton, AB Canada
| | - Jordan J. Feld
- grid.17063.330000 0001 2157 2938Institute of Medical Science, University of Toronto, Toronto, ON Canada ,grid.231844.80000 0004 0474 0428Toronto Centre for Liver Disease, University Health Network, Toronto, ON Canada
| | - Adam J. Gehring
- grid.17063.330000 0001 2157 2938Institute of Medical Science, University of Toronto, Toronto, ON Canada ,grid.231844.80000 0004 0474 0428Toronto Centre for Liver Disease, University Health Network, Toronto, ON Canada
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Prognostic comparison of COVID-19 outpatients and inpatients treated with Remdesivr: A retrospective cohort study. PLoS One 2022; 17:e0277413. [PMID: 36356035 PMCID: PMC9648785 DOI: 10.1371/journal.pone.0277413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 10/26/2022] [Indexed: 11/12/2022] Open
Abstract
Introduction Since the late COVID-19, many countries have faced various surges and peaks within the number of infected. Iran was one of the countries that faced many surges and peaks within these years and faced many inadequacies and shortages of resources and hospital beds. Hence the healthcare system started using in-hospital medication such as Remdesivir in outpatients to reduce the load of patients admitted to the hospital. This study aimed to evaluate and compare the reported signs, symptoms, and outcomes of COVID-infected hospitalized and out-patients receiving Remdesivir. Methods In this retrospective cohort study, 214 patients (121 outpatient and 93 hospitalized) with moderate levels of Covid infection between October 2021 and February 2022 were studied. Both groups were treated with 200mg of Remdesivir, followed by 100 mg daily intravenous injections for five days; signs and symptoms, such as pain, shortness of breath, cough, fever and etc., of patients at the initiation and the end of treatment were recorded. Moreover, the patients’ blood oxygen saturation was assessed two to three times a day, and the mean of the recorded measures was considered as the daily oxygen saturation. The outpatient group had to visit the hospital daily for treatment and assessment. At the treatment’s end, mortality rates, disease signs, and symptoms alleviations were compared between the groups. Results The outpatient and hospitalized group’s mean age was 40.30 ± 12.25 and 37.70 ± 12.00 years, and 51.2% and 55.9% were males, respectively. There was no statistical difference between baseline and clinical characteristics in the outpatients and hospitalized groups. After adjusting for oxygen saturation at baseline and gender in the multivariable Cox regression analysis, the risk of death did not statistically differ between the hospitalized and outpatient group (hazard ratio: 0.99, 95% confidence interval: 0.39–2.50)) at the end of the study. Conclusion Based on the results of this study, the outcome, signs, and symptoms of inpatient and outpatient Remdesivir treatment groups did not differ significantly. Hence in COVID-19 surges where we have limitations in admitting patients, outpatient Remdesivir treatment for those without any underlying diseases can be a proper management method.
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Nori W. C-Reactive protein role in assessing COVID-19 deceased geriatrics and survivors of severe and critical illness. World J Clin Cases 2022; 10:11210-11213. [PMID: 36338205 PMCID: PMC9631145 DOI: 10.12998/wjcc.v10.i30.11210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 02/05/2023] Open
Abstract
Numerous risk variables, including age, medical co-morbidities, and deranged inflammatory response, lead to higher mortality in a senior population with coronavirus disease 2019. C-reactive protein (CRP), an acute phase inflammatory protein secreted by the liver, was tested in the elderly, showing a diagnostic and prognostic role. However, recent research has shed light on new applications for CRP in geriatrics. It was used as a follow-up marker and as a therapeutic target. Early and accurate identification of patients' risks may mitigate the devastation of the invading virus in older cases and permit the implementation of a quick treatment plan for those most likely to deteriorate.
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Affiliation(s)
- Wassan Nori
- Department of Obstetrics and Gynecology, Mustansiriyah University, Baghdad 10052, AL-Saydyiah, Iraq
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Abdi Tazeh A, Mohammadpoorasl A, Sarbakhsh P, Abbasi M, Dorosti A, Khayatzadeh S, Akbari H. Investigation of the Factors Related to Mortality and Length of Hospitalization among COVID-19 Patients in East Azerbaijan Hospitals, Iran. J Res Health Sci 2022; 22:e00557. [PMID: 36511375 PMCID: PMC10422152 DOI: 10.34172/jrhs.2022.92] [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: 08/12/2022] [Revised: 09/01/2022] [Accepted: 09/18/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND It is of utmost importance to identify populations with an elevated risk for COVID-19 and the factors influencing its outcomes. The present study aimed to investigate factors affecting mortality and length of stay (LOS) among COVID-19 patients in the hospitals of East Azerbaijan province, Iran, during 15 months of this pandemic. STUDY DESIGN The present study followed a retrospective cohort design. METHODS This retrospective study was conducted using data in the integrated syndromic surveillance system (ISSS) on patients admitted to the hospitals from February 21, 2020, to April 11, 2021. The association between variables of interest and death, as well as LOS, was investigated via multiple logistic regression and multiple linear regression analyses. RESULTS In total, 24 293 inpatients with a mean age of 54.0 ± 19.4 years were included in this study. About 15% of them lost their lives, whose mean age was 69.0 ± 14.6 years, significantly higher than the recovered ones (P < 0.001). Factors, such as above 49 years of age (P < 0.001), male gender (OR = 1.17; 95% CI: 1.08-1.26), and having chronic diseases (OR = 1.32; 95% CI: 1.22-1.42), were correlated with patient mortality. In addition, having chronic diseases (Beta = 0.06; 95% CI: 0.03-0.08) was associated with higher LOS in hospitals. CONCLUSION In conclusion, older patients were at a higher risk of mortality and prolonged hospitalization. Furthermore, patients' underlying diseases could cause a severe form of COVID-19, which can lead to death and increase patients' LOS.
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Affiliation(s)
- Ali Abdi Tazeh
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Asghar Mohammadpoorasl
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parvin Sarbakhsh
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Madineh Abbasi
- Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Abbasali Dorosti
- Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Simin Khayatzadeh
- East Azerbaijan Province Health Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Akbari
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
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Bepouka B, Mayasi N, Mandina M, Longokolo M, Odio O, Mangala D, Mbula M, Kayembe JM, Situakibanza H. Risk factors for mortality in COVID-19 patients in sub-Saharan Africa: A systematic review and meta-analysis. PLoS One 2022; 17:e0276008. [PMID: 36251715 PMCID: PMC9576083 DOI: 10.1371/journal.pone.0276008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 09/27/2022] [Indexed: 11/05/2022] Open
Abstract
Aim Mortality rates of coronavirus-2019 (COVID-19) disease continue to increase worldwide and in Africa. In this study, we aimed to summarize the available results on the association between sociodemographic, clinical, biological, and comorbidity factors and the risk of mortality due to COVID-19 in sub-Saharan Africa. Methods We followed the PRISMA checklist (S1 Checklist). We searched PubMed, Google Scholar, and European PMC between January 1, 2020, and September 23, 2021. We included observational studies with Subjects had to be laboratory-confirmed COVID-19 patients; had to report risk factors or predictors of mortality in COVID-19 patients, Studies had to be published in English, include multivariate analysis, and be conducted in the sub-Saharan region. Exclusion criteria included case reports, review articles, commentaries, errata, protocols, abstracts, reports, letters to the editor, and repeat studies. The methodological quality of the studies included in this meta-analysis was assessed using the methodological items for nonrandomized studies (MINORS). Pooled hazard ratios (HR) or odds ratios (OR) and 95% confidence intervals (CI) were calculated separately to identify mortality risk. In addition, publication bias and subgroup analysis were assessed. Results and discussion Twelve studies with a total of 43598 patients met the inclusion criteria. The outcomes of interest were mortality. The results of the analysis showed that the pooled prevalence of mortality in COVID-19 patients was 4.8%. Older people showed an increased risk of mortality from SARS-Cov-2. The pooled hazard ratio (pHR) and odds ratio (pOR) were 9.01 (95% CI; 6.30–11.71) and 1.04 (95% CI; 1.02–1.06), respectively. A significant association was found between COVID-19 mortality and men (pOR = 1.52; 95% CI 1.04–2). In addition, the risk of mortality in patients hospitalized with COVID-19 infection was strongly influenced by chronic kidney disease (CKD), hypertension, severe or critical infection on admission, cough, and dyspnea. The major limitations of the present study are that the data in the meta-analysis came mainly from studies that were published, which may lead to publication bias, and that the causal relationship between risk factors and poor outcome in patients with COVID-19 cannot be confirmed because of the inherent limitations of the observational study. Conclusions Advanced age, male sex, CKD, hypertension, severe or critical condition on admission, cough, and dyspnea are clinical risk factors for fatal outcomes associated with coronavirus. These findings could be used for research, control, and prevention of the disease and could help providers take appropriate measures and improve clinical outcomes in these patients.
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Affiliation(s)
- Ben Bepouka
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
- * E-mail:
| | - Nadine Mayasi
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Madone Mandina
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Murielle Longokolo
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Ossam Odio
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Donat Mangala
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Marcel Mbula
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Jean Marie Kayembe
- Pneumology Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Hippolyte Situakibanza
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
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Koc S, Deveci M, Kayadibi H, Dokur M, Yildiz I, Kupeli I, Yilmaz B. Biruni Index as a Novel Diagnostic Tool for the Early Prediction of Mortality in Critical Patients With COVID-19: A Cohort Study. Cureus 2022; 14:e30705. [PMID: 36439611 PMCID: PMC9693929 DOI: 10.7759/cureus.30705] [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] [Accepted: 10/26/2022] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND The aim of this study was to find out the potential risk factors associated with mortality in severe coronavirus disease 2019 (COVID-19) patients hospitalized due to viral bronchopneumonia, and to establish a novel COVID-19 mortality index for daily use. METHODS The study included 431 quantitative real-time polymerase chain reaction (qRT-PCR)-confirmed COVID-19-positive patients admitted to the intensive care unit in a tertiary care hospital. Patients were divided into training and validation cohorts at random (n= 285 and n= 130, respectively). Biruni Index was developed by multivariate logistic regression analysis for predicting COVID-19-related mortality. RESULTS In univariate logistic regression analysis, age, systolic and diastolic blood pressures, respiratory and pulse rates per minute, D-dimer, pH, urea, ferritin, and lactate dehydrogenase levels at first admission were statistically significant factors for the prediction of mortality in the training cohort. By using multivariate logistic regression analysis, all of these statistically significant parameters were used to produce Biruni Index. Statistically significant differences in Biruni Index were observed between ex and non-ex groups in both training and validation cohorts (P < 0.001 for both comparisons). Areas under receiver operating characteristic (ROC) curve for Biruni Index were 0.901 (95CI%: 0.864-0.938, P < 0.001) and 0.860 (95CI%: 0.795-0.926, P < 0.001) in training and validation cohorts, respectively. CONCLUSION As a pioneering clinical study, Biruni Index may be a useful diagnostic tool for clinicians to predict the mortality in critically ill patients with COVID-19 hospitalized due to severe viral bronchopneumonia. However, Biruni Index should be validated with larger series of multicenter prospective clinical studies.
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Affiliation(s)
- Suna Koc
- Department of Anesthesiology and Reanimation, Biruni University Medical Faculty, Istanbul, TUR
| | - Murat Deveci
- Department of Gastroenterology, Biruni University Medical Faculty, Istanbul, TUR
| | - Huseyin Kayadibi
- Department of Medical Biochemistry, Eskisehir Osmangazi University Medical Faculty, Eskisehir, TUR
| | - Mehmet Dokur
- Department of Emergency Medicine, Biruni University Medical Faculty, Istanbul, TUR
| | - Ismail Yildiz
- Department of Anesthesiology and Reanimation, Biruni University Medical Faculty, Istanbul, TUR
| | - Ilke Kupeli
- Department of Anesthesiology and Reanimation, Biruni University Medical Faculty, Istanbul, TUR
| | - Baris Yilmaz
- Department of Gastroenterology, Biruni University Medical Faculty, Istanbul, TUR
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Galanis P, Vraka I, Katsiroumpa A, Siskou O, Konstantakopoulou O, Katsoulas T, Mariolis-Sapsakos T, Kaitelidou D. COVID-19 Vaccine Uptake among Healthcare Workers: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2022; 10:1637. [PMID: 36298502 PMCID: PMC9610263 DOI: 10.3390/vaccines10101637] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 09/24/2022] [Accepted: 09/26/2022] [Indexed: 11/17/2022] Open
Abstract
The vaccine-induced immunity of healthcare workers (HCWs) is crucial to controlling the COVID-19 pandemic. Therefore, we conducted a systematic review and meta-analysis to assess the COVID-19 vaccine uptake among HCWs worldwide and to identify predictors of vaccination. We searched Scopus, Web of Science, Medline, PubMed, ProQuest, CINAHL, and medRxiv up to 25 August 2022. We applied the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We found 25 studies including 491,624 vaccinated HCWs, while the full sample included 555,561 HCWs. The overall proportion of vaccinated HCWs was 77.3%. Vaccine uptake for studies that were conducted in North America (85.6%) was higher than the proportion for studies that were conducted in Asia (79.5%), Europe (72.8%), and Africa (65.6%). The overall prevalence of COVID-19 vaccine uptake was 83.6% and 77.4% for physicians and nurses, respectively. Older age, white race, physicians' profession, seasonal influenza vaccine, direct COVID-19 patient care, and confidence in COVID-19 vaccine safety and effectiveness were positive predictors of vaccine uptake, while history of SARS-CoV-2 infection was a negative predictor. Deep understanding of the factors that influence HCWs' decisions to receive a COVID-19 vaccine is critical to implementing tailored communication strategies for HCWs who are at risk for not getting vaccinated.
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Affiliation(s)
- Petros Galanis
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Irene Vraka
- Department of Radiology, P. & A. Kyriakou Children’s Hospital, 11527 Athens, Greece
| | - Aglaia Katsiroumpa
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Olga Siskou
- Department of Tourism Studies, University of Piraeus, 18534 Piraeus, Greece
| | - Olympia Konstantakopoulou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Theodoros Katsoulas
- Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | | | - Daphne Kaitelidou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Cardiovascular Factors Associated with COVID-19 from an International Registry of Primarily Japanese Patients. Diagnostics (Basel) 2022; 12:diagnostics12102350. [PMID: 36292038 PMCID: PMC9600010 DOI: 10.3390/diagnostics12102350] [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: 09/08/2022] [Revised: 09/17/2022] [Accepted: 09/23/2022] [Indexed: 11/17/2022] Open
Abstract
Aims: We developed an international registry to examine cardiovascular complications of COVID-19. Methods: A REDCap form was created in March 2020 at Mayo Clinic in collaboration with the International Society of Cardiomyopathy, Myocarditis and Heart Failure (ISCMF) and data were entered from April 2020 through April 2021. Results: Of the 696 patients in the COVID-19 Registry, 411 (59.2%) were male and 283 (40.8%) were female, with a sex ratio of 1.5:1 male to female. In total, 95.5% of the patients were from Japan. The average age was 52 years with 31.5% being >65 years of age. COVID-19 patients with a history of cardiovascular disease (CVD) had more pre-existing conditions including type II diabetes (p < 0.0001), cancer (p = 0.0003), obesity (p = 0.001), and kidney disease (p = 0.001). They also had a greater mortality of 10.1% compared to 1.7% in those without a history of CVD (p < 0.0001). The most common cardiovascular conditions in patients with a history of CVD were hypertension (33.7%), stroke (5.7%) and arrhythmias (5.1%). We found that troponin T, troponin I, brain natriuretic peptide (BNP), N-terminal pro-BNP (NT-proBNP), C-reactive protein (CRP), IL-6 and lambda immunoglobulin free light chains (Ig FLC) were elevated above reference levels in patients with COVID-19. Myocarditis is known to occur mainly in adults under the age of 50, and when we examined biomarkers in patients that were ≤50 years of age and had no history of CVD we found that a majority of patients had elevated levels of troponin T (71.4%), IL-6 (59.5%), creatine kinase/CK-MB (57.1%), D-dimer (57.8%), kappa Ig FLC (75.0%), and lambda Ig FLC (71.4%) suggesting myocardial injury and possible myocarditis. Conclusions: We report the first findings to our knowledge of cardiovascular complications from COVID-19 in the first year of the pandemic in a predominantly Japanese population. Mortality was increased by a history of CVD and pre-existing conditions including type II diabetes, cancer, obesity, and kidney disease. Our findings indicate that even in cases where no abnormalities are found in ECG or ultrasound cardiography that myocardial damage may occur, and cardiovascular and inflammatory biomarkers may be useful for the diagnosis.
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Adejumo OA, Ogunniyan T, Adetola AV, Mba SC, Ogunbayo O, Oladokun OD, Oluwadun OB, Erinoso O, Adesola S, Bowale A. Factors associated with death among hospitalized COVID-19 patients in Lagos State, Nigeria: a retrospective cross-sectional study. Afr Health Sci 2022; 22:486-494. [PMID: 36910372 PMCID: PMC9993304 DOI: 10.4314/ahs.v22i3.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Lagos State has the highest burden of COVID-19 in Nigeria. We assessed associated factors with death from COVID-19 among hospitalized patients in Lagos, Nigeria. Methods A retrospective cross-sectional study was conducted using de-identified records of laboratory-confirmed COVID-19 patients admitted into 15 isolation centers in Lagos State between February 27, 2020, and September 30, 2020. Results A total of 2,858 COVID -19 patients were included in this study. The mean age of the patients was 41.9±15.5 years. A higher proportion of patients were males (65.8%), asymptomatic (55.5%), had no comorbid condition (72.2%) and had the mild disease (73.8%). The case fatality rate was 6.5%. The odds of death from COVID-19 infection increased by 4% with every increase in age (AOR 1.04, 95%CI 1.03-1.05, p<0.001). The chance of dying was 50% fold more among males (AOR 1.5, 95%CI 1.0 - 2.2, p = 0.042), 60% fold more among patients with comorbidity (AOR 1.6, 95%CI 1.3 - 2.4, p = 0.037) and 9 fold more among patients with severe COVID-19 infection (AOR 9.6, 95% CI 4.9 - 19.1, p <0.001). Conclusion The odds of dying was higher among males, the elderly, patients with comorbidity and severe COVID-19.
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Affiliation(s)
| | | | | | - Sandra Chizoba Mba
- Nigeria Centre for Disease Control. Nigeria Field Epidemiology and Laboratory Training Program Abuja Nigeria
| | | | | | | | - Olufemi Erinoso
- Department of Dentistry, Lagos State University Teaching Hospital Ikeja Lagos Nigeria
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Kamali K, Hoseinzade Z, Hajimiri K, Hoveidamanesh S, Zahraei SM, Gouya MM, Bavandpouri SM, Mohamadi T, Mohamadi S, Bigdeli Z, Maleki A, Shirzad M, Heidari Z, Farsadegi M, Shoghli A. Determinants of COVID-19 vaccine acceptance in healthcare workers in Iran: National Survey. BMC Infect Dis 2022; 22:703. [PMID: 35996088 PMCID: PMC9395894 DOI: 10.1186/s12879-022-07675-x] [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: 09/20/2021] [Accepted: 08/09/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND AIM It seems that acceptance of COVID-19 vaccination is the most effective way to tackle the COVID-19 pandemic now. Health care workers (HCWs) are one of the most important groups who are at risk for COVID-19 infection. This study aimed to assess the COVID-19 vaccine acceptance among HCWs in Iran and its determinants. METHODS A cross-sectional survey was carried out among 3600 HCWs in Iran. Data were collected through a self-administered questionnaire by a trained team from February to March 2021. Multi-stage cluster sampling method was used for selecting respondents of the study. Multivariate logistic regression analysis was used to determine the key factors of COVID-19 vaccine acceptance among participants. P-value < 0.05 was considered statistically significant. RESULTS Out of the 3536 respondents, 2191 (62.1%) intended to uptake the COVID-19 vaccine. Only about 10 percent of respondents said they did not trust any vaccine (domestic or foreign). Willing to accept a COVID-19 vaccine was relatively high among males, doctors, and those who had a history of hospitalization due to COVID-19 infection. The multivariate regression analysis showed respondents who were 40-50 years (aOR: 1.56; 95% CI: 1.47-1.66), had a history of COVID-19 infection (aOR: 0.85; 95% CI: 0.83-0.88), and hospitalized due to COVID-19 infection (aOR: 2.18; 95% CI: 1.97-2.39), were significantly associated with vaccine acceptance (p < 0.05). CONCLUSION Our study showed moderate acceptance of COVID-19 vaccination in the HCWs in the Islamic Republic of Iran. The most important factor in the acceptance of the COVID-19 vaccine by the health staff is having a history of hospitalization. Further training and justification of health personnel is needed to increase the acceptance of COVID 19 vaccine.
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Affiliation(s)
- Koorosh Kamali
- School of Public Health, Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Zarrintaj Hoseinzade
- Social Medicine, School of Medicine, Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Khadijeh Hajimiri
- Health Education and Promotion, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Soodabeh Hoveidamanesh
- Community Medicine, Burn Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohsen Zahraei
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Mohammad Mehdi Gouya
- Infectious Disease, School of Medicine, Iran University of Medical Sciences, Teheran, Iran
| | | | - Tahereh Mohamadi
- Business Administration, Health Insurance Organization, Zanjan, Iran
| | - Soraya Mohamadi
- Biostatistics, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Zohre Bigdeli
- Biostatistics, Social Determinant of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Azam Maleki
- Reproductive Health, Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mahboubeh Shirzad
- Health Education and Promotion, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Zahra Heidari
- Social Determinant of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mahya Farsadegi
- School of Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Alireza Shoghli
- Social Medicine, School of Medicine, Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran.
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Goel H, Shah K, Kothari J, Daly T, Saraiya P, Taha I, Le M, Shirani J. Premorbid echocardiography and risk of hospitalization in COVID-19. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2022; 38:1733-1739. [PMID: 37726514 PMCID: PMC8982906 DOI: 10.1007/s10554-022-02565-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 02/12/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND COVID-19 has caused a global pandemic unprecedented in a century. Though primarily a respiratory illness, cardiovascular risk factors predict adverse outcomes. We aimed to investigate the role of baseline echocardiographic abnormalities in further refining risk in addition to clinical risk factors. METHODS Adults with COVID-19 positive RT-PCR test across St Luke's University Health Network between March 1st 2020-October 31st 2020 were identified. Those with trans-thoracic echocardiography (TTE) within 15-180 days preceding COVID-19 positivity were selected, excluding severe valvular disease, acute cardiac event between TTE and COVID-19, or asymptomatic patients positive on screening. Demographic, clinical, and echocardiographic variables were manually extracted from patients' EHR and compared between groups stratified by disease severity. Logistic regression was used to identify independent predictors of hospitalization. RESULTS 192 patients met inclusion criteria. 87 (45.3%) required hospitalization, 34 (17.7%) suffered severe disease (need for ICU care/mechanical ventilation/in-hospital death). Age, co-morbidities, and several echocardiographic abnormalities were more prevalent in those with moderate-severe disease than in mild disease, with notable exceptions of systolic/diastolic dysfunction. On multivariate analysis, age (OR 1.039, 95% CI 1.011-1.067), coronary artery disease (OR 4.184, 95% CI 1.451-12.063), COPD (OR 6.886, 95% CI 1.396-33.959) and left atrial diameter ≥ 4.0 cm (OR 2.379, 95% CI 1.031-5.493) predicted need for hospitalization. Model showed excellent discrimination (ROC AUC 0.809, 95% CI 0.746-0.873). CONCLUSIONS Baseline left atrial enlargement is an independent risk factor for risk of hospitalization among patients with COVID-19. When available, baseline LA enlargement may identify patients for (1) closer outpatient follow up, and (2) counseling vaccine-hesitancy.
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Affiliation(s)
- Harsh Goel
- Department of Medicine, St. Luke's University Hospital, 801 Ostrum Street, Bethlehem, PA, USA, 18015
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA, 19140
| | - Kashyap Shah
- Department of Medicine, St. Luke's University Hospital, 801 Ostrum Street, Bethlehem, PA, USA, 18015.
| | - Janish Kothari
- Division of Cardiovascular Medicine, St. Luke's University Hospital, Bethlehem, PA, USA, 18015
| | - Timothy Daly
- Department of Medicine, St. Luke's University Hospital, 801 Ostrum Street, Bethlehem, PA, USA, 18015
| | - Pooja Saraiya
- Department of Medicine, St. Luke's University Hospital, 801 Ostrum Street, Bethlehem, PA, USA, 18015
| | - Israa Taha
- Department of Medicine, St. Luke's University Hospital, 801 Ostrum Street, Bethlehem, PA, USA, 18015
| | - Marjolein Le
- Department of Medicine, St. Luke's University Hospital, 801 Ostrum Street, Bethlehem, PA, USA, 18015
| | - Jamshid Shirani
- Division of Cardiovascular Medicine, St. Luke's University Hospital, Bethlehem, PA, USA, 18015
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA, 19140
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Keri VC, Jorwal P, Verma R, Ranjan P, Upadhyay AD, Aggarwal A, Sarda R, Sharma K, Sahni S, Rajanna C. Novel Scoring Systems to Predict the Need for Oxygenation and ICU Care, and Mortality in Hospitalized COVID-19 Patients: A Risk Stratification Tool. Cureus 2022; 14:e27459. [PMID: 36060343 PMCID: PMC9424646 DOI: 10.7759/cureus.27459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2022] [Indexed: 01/08/2023] Open
Abstract
Introduction: A rapid surge in cases during the COVID-19 pandemic can overwhelm any healthcare system. It is imperative to triage patients who would require oxygen and ICU care, and predict mortality. Specific parameters at admission may help in identifying them. Methodology: A prospective observational study was undertaken in a COVID-19 ward of a tertiary care center. All baseline clinical and laboratory data were captured. Patients were followed till death or discharge. Univariable and multivariable logistic regression was used to find predictors of the need for oxygen, need for ICU care, and mortality. Objective scoring systems were developed for the same using the predictors. Results: The study included 209 patients. Disease severity was mild, moderate, and severe in 98 (46.9%), 74 (35.4%), and 37 (17.7%) patients, respectively. The neutrophil-to-lymphocyte ratio (NLR) >4 was a common independent predictor of the need for oxygen (p<0.001), need for ICU transfer (p=0.04), and mortality (p=0.06). Clinical risk scores were developed (10*c-reactive protein (CRP) + 14.8*NLR + 12*urea), (10*aspartate transaminase (AST) + 15.7*NLR + 14.28*CRP), (10*NLR + 10.1*creatinine) which, if ≥14.8, ≥25.7, ≥10.1 predicted need for oxygenation, need for ICU transfer and mortality with a sensitivity and specificity (81.6%, 70%), (73.3%, 75.7%), (61.1%, 75%), respectively. Conclusion: The NLR, CRP, urea, creatinine, and AST are independent predictors in identifying patients with poor outcomes. An objective scoring system can be used at the bedside for appropriate triaging of patients and utilization of resources.
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Lebedeva A, Molodtsov I, Anisimova A, Berestovskaya A, Dukhin O, Elizarova A, Fitzgerald W, Fomina D, Glebova K, Ivanova O, Kalinskaya A, Lebedeva A, Lysenko M, Maryukhnich E, Misyurina E, Protsenko D, Rosin A, Sapozhnikova O, Sokorev D, Shpektor A, Vorobyeva D, Vasilieva E, Margolis L. Comprehensive Cytokine Profiling of Patients with COVID-19 Receiving Tocilizumab Therapy. Int J Mol Sci 2022; 23:ijms23147937. [PMID: 35887283 PMCID: PMC9316906 DOI: 10.3390/ijms23147937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/13/2022] [Accepted: 07/14/2022] [Indexed: 02/05/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is characterized by immune activation in response to viral spread, in severe cases leading to the development of cytokine storm syndrome (CSS) and increased mortality. Despite its importance in prognosis, the pathophysiological mechanisms of CSS in COVID-19 remain to be defined. Towards this goal, we analyzed cytokine profiles and their interrelation in regard to anti-cytokine treatment with tocilizumab in 98 hospitalized patients with COVID-19. We performed a multiplex measurement of 41 circulating cytokines in the plasma of patients on admission and 3–5 days after, during the follow-up. Then we analyzed the patient groups separated in two ways: according to the clusterization of their blood cytokines and based on the administration of tocilizumab therapy. Patients with and without CSS formed distinct clusters according to their cytokine concentration changes. However, the tocilizumab therapy, administered based on the standard clinical and laboratory criteria, did not fully correspond to those clusters of CSS. Furthermore, among all cytokines, IL-6, IL-1RA, IL-10, and G-CSF demonstrated the most prominent differences between patients with and without clinical endpoints, while only IL-1RA was prognostically significant in both groups of patients with and without tocilizumab therapy, decreasing in the former and increasing in the latter during the follow-up period. Thus, CSS in COVID-19, characterized by a correlated release of multiple cytokines, does not fully correspond to the standard parameters of disease severity. Analysis of the cytokine signature, including the IL-1RA level in addition to standard clinical and laboratory parameters may be useful to define the onset of a cytokine storm in COVID-19 as well as the indications for anti-cytokine therapy.
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Affiliation(s)
- Anna Lebedeva
- Laboratory of Atherothrombosis, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 20 Delegatskaya Str., 127473 Moscow, Russia; (O.I.); (A.K.); (E.M.); (D.V.)
- Correspondence: (A.L.); (E.V.)
| | - Ivan Molodtsov
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
| | - Alexandra Anisimova
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
| | - Anastasia Berestovskaya
- Clinical City Hospital №40, Moscow Department of Healthcare, 7 Kasatkina Str., 129301 Moscow, Russia; (A.B.); (D.P.)
| | - Oleg Dukhin
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
| | - Antonina Elizarova
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
| | - Wendy Fitzgerald
- Section on Intercellular Interactions, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 29B Lincoln Dr., Bethesda, MD 20892, USA; (W.F.); (L.M.)
| | - Darya Fomina
- Clinical City Hospital №52, Moscow Department of Healthcare, 3 Pekhotnaya Str., 123182 Moscow, Russia; (D.F.); (M.L.); (E.M.)
| | - Kseniya Glebova
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
| | - Oxana Ivanova
- Laboratory of Atherothrombosis, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 20 Delegatskaya Str., 127473 Moscow, Russia; (O.I.); (A.K.); (E.M.); (D.V.)
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
| | - Anna Kalinskaya
- Laboratory of Atherothrombosis, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 20 Delegatskaya Str., 127473 Moscow, Russia; (O.I.); (A.K.); (E.M.); (D.V.)
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
- Department of Cardiology, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 20 Delegatskaya Str., 127473 Moscow, Russia
| | - Anastasia Lebedeva
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
- Clinical City Hospital №40, Moscow Department of Healthcare, 7 Kasatkina Str., 129301 Moscow, Russia; (A.B.); (D.P.)
| | - Maryana Lysenko
- Clinical City Hospital №52, Moscow Department of Healthcare, 3 Pekhotnaya Str., 123182 Moscow, Russia; (D.F.); (M.L.); (E.M.)
| | - Elena Maryukhnich
- Laboratory of Atherothrombosis, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 20 Delegatskaya Str., 127473 Moscow, Russia; (O.I.); (A.K.); (E.M.); (D.V.)
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
| | - Elena Misyurina
- Clinical City Hospital №52, Moscow Department of Healthcare, 3 Pekhotnaya Str., 123182 Moscow, Russia; (D.F.); (M.L.); (E.M.)
| | - Denis Protsenko
- Clinical City Hospital №40, Moscow Department of Healthcare, 7 Kasatkina Str., 129301 Moscow, Russia; (A.B.); (D.P.)
| | - Alexander Rosin
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
| | - Olga Sapozhnikova
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
| | - Denis Sokorev
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
| | - Alexander Shpektor
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
- Department of Cardiology, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 20 Delegatskaya Str., 127473 Moscow, Russia
| | - Daria Vorobyeva
- Laboratory of Atherothrombosis, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 20 Delegatskaya Str., 127473 Moscow, Russia; (O.I.); (A.K.); (E.M.); (D.V.)
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
| | - Elena Vasilieva
- Laboratory of Atherothrombosis, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 20 Delegatskaya Str., 127473 Moscow, Russia; (O.I.); (A.K.); (E.M.); (D.V.)
- Clinical City Hospital Named after I.V. Davidovsky, Moscow Department of Healthcare, 11/6 Yauzskaya Str., 109240 Moscow, Russia; (I.M.); (A.A.); (O.D.); (A.E.); (K.G.); (A.L.); (A.R.); (O.S.); (D.S.); (A.S.)
- Correspondence: (A.L.); (E.V.)
| | - Leonid Margolis
- Section on Intercellular Interactions, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 29B Lincoln Dr., Bethesda, MD 20892, USA; (W.F.); (L.M.)
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First COVID-19 Booster Dose in the General Population: A Systematic Review and Meta-Analysis of Willingness and Its Predictors. Vaccines (Basel) 2022; 10:vaccines10071097. [PMID: 35891260 PMCID: PMC9323526 DOI: 10.3390/vaccines10071097] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 02/01/2023] Open
Abstract
The emergence of breakthrough infections and new highly contagious variants of SARS-CoV-2 threaten the immunization in individuals who had completed the primary COVID-19 vaccination. This systematic review and meta-analysis investigated, for the first time, acceptance of the first COVID-19 booster dose and its associated factors among fully vaccinated individuals. We followed the PRISMA guidelines. We searched Scopus, Web of Science, Medline, PubMed, ProQuest, CINAHL and medrxiv from inception to 21 May 2022. We found 14 studies including 104,047 fully vaccinated individuals. The prevalence of individuals who intend to accept a booster was 79.0%, while the prevalence of unsure individuals was 12.6%, and the prevalence of individuals that intend to refuse a booster was 14.3%. The main predictors of willingness were older age, flu vaccination in the previous season, and confidence in COVID-19 vaccination. The most important reasons for decline were adverse reactions and discomfort experienced after previous COVID-19 vaccine doses and concerns for serious adverse reactions to COVID-19 booster doses. Considering the burden of COVID-19, a high acceptance rate of booster doses could be critical in controlling the pandemic. Our findings are innovative and could help policymakers to design and implement specific COVID-19 vaccination programs in order to decrease booster vaccine hesitancy.
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47
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D’Ecclesiis O, Gavioli C, Martinoli C, Raimondi S, Chiocca S, Miccolo C, Bossi P, Cortinovis D, Chiaradonna F, Palorini R, Faciotti F, Bellerba F, Canova S, Jemos C, Salé EO, Gaeta A, Zerbato B, Gnagnarella P, Gandini S. Vitamin D and SARS-CoV2 infection, severity and mortality: A systematic review and meta-analysis. PLoS One 2022; 17:e0268396. [PMID: 35793346 PMCID: PMC9258852 DOI: 10.1371/journal.pone.0268396] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 04/28/2022] [Indexed: 12/12/2022] Open
Abstract
To assess the evidence on SARS-CoV2 infection and Covid-19 in relation to deficiency and supplementation of vitamin D, we conducted a systematic review up to April 2021. We summarised data from 38 eligible studies, which presented risk estimates for at least one endpoint, including two RCT and 27 cohort-studies: 205565 patients with information on 25OHD status and 2022 taking vitamin D supplementation with a total of 1197 admitted to the ICU or who needed invasive mechanical ventilation or intubation and hospital stay, and more than 910 Covid-19 deaths. Primary outcomes were severity and mortality and the main aim was to evaluate the association with vitamin D supplementation. Random effects models showed that supplementation was associated with a significant lower risk of both Covid-19 severe disease (SRR 0.38, 95% CI 0.20-0.72, 6 studies) and mortality (SRR 0.35, 95% CI 0.17-0.70, 8 studies). There were no statistically significant dose differences between studies: summary estimates with regular doses remain statistically significant, suggesting that higher doses are not necessary. For patients on vitamin D supplementation, a greater reduction in mortality risk emerged in older individuals and at higher latitudes. Regarding the quality of studies, assessed using the New Castle-Ottawa quality scale, the analysis revealed in most cases no statistically significant differences between low, medium or high quality studies. We found significant associations of vitamin D supplementation with Covid-19, encompassing risks of disease worsening and mortality, especially in seasons characterized by 25OHD deficiency and with not severe patients. Dedicated randomized clinical studies are encouraged to confirm these results.
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Affiliation(s)
- Oriana D’Ecclesiis
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Costanza Gavioli
- Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Chiara Martinoli
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Sara Raimondi
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Susanna Chiocca
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Claudia Miccolo
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Paolo Bossi
- Medical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, ASST-Spedali Civili, Brescia, Italy
| | | | | | - Roberta Palorini
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Milan, Italy
| | - Federica Faciotti
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Federica Bellerba
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | | | - Costantino Jemos
- Department of Clinical Pharmacy, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Emanuela Omodeo Salé
- Department of Clinical Pharmacy, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Aurora Gaeta
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Barbara Zerbato
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Milan, Italy
| | - Patrizia Gnagnarella
- Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Sara Gandini
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
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48
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Aljuaid M, Alotair H, Alnajjar F, Alonazi W, Sharaf H, Sheshah E, Alashgar L, Alshaikh M. Risk factors associated with in-hospital mortality patients with COVID-19 in Saudi Arabia. PLoS One 2022; 17:e0270062. [PMID: 35749537 PMCID: PMC9231697 DOI: 10.1371/journal.pone.0270062] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 06/02/2022] [Indexed: 12/15/2022] Open
Abstract
Risk factors for in-hospital mortality of COVID-19 patients in Saudi Arabia have not been well studied. Previous reports from other countries have highlighted the effect of age, gender, clinical presentation and health conditions on the outcome of COVID-19 patients. Saudi Arabia has a different epidemiological structure with a predominance of young population, which calls for separate study. The objective of this study is to assess the predictors of mortality among hospitalized patients with COVID-19 in Saudi Arabia. This is a retrospective observational cohort study of hospitalized adult COVID-19 patients at two tertiary hospitals in Saudi Arabia between May to July 2020. Electronic charts were retrospectively reviewed comparing survivors and non-survivors in terms of demographic and clinical variables and comorbid conditions. A total of 564 hospitalized patients with COVID-19 were included in the study. The overall in-hospital mortality rate was 20%. The non-survivors were significantly older than survivors (59.4 ± 13.7 years and 50.5 ± 13.9 years respectively P< 0.001). Diabetes mellitus, hypertension, heart failure and ischemic heart disease were more prevalent among non-survivors (P< 0.001). The mean values of glycosylated hemoglobin HgA1C, D-dimer, ferritin, lactate dehydrogenase LDH, Alanin aminotransferase ALT and creatinine were significantly higher among non-survivors (P < 0.05). Multivariate logistic regression analysis revealed that age (aOR = 1.04; 95% CI 1.02–1.08; P < 0.01), chronic kidney disease (aOR = 4.04; 95% CI 1.11–14.77; P < 0.05), acute respiratory distress syndrome ARDS (aOR = 14.53; 95% CI 5.42–38.69; P < 0.01), Mechanical Ventilation (aOR = 10.57; 95% CI 5.74–23.59; P < 0.01), Shock (aOR = 3.85; 95% CI 1.02–14.57; P < 0.05), admission to intensive care unit (ICU) (aOR = 0.12; 95% CI 0.04–0.33; P < 0.01) and length of stay (aOR = 0.96; 95% CI 0.93–0.99; P < 0.05) were significant contributors towards mortality. The in-hospital mortality rate of COVID-19 patients admitted to tertiary hospitals in Saudi Arabia is high. Older age, chronic kidney disease and ARDS were the most important predictors of mortality.
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Affiliation(s)
- Mohammed Aljuaid
- Department of Health Administration, College of Business Administration, King Saud University, Riyadh, Saudi Arabia
- * E-mail:
| | - Hadil Alotair
- Department of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Farrah Alnajjar
- Yanbu General Hospital, Ministry of Health, Riyadh, Saudi Arabia
| | - Wadi Alonazi
- Department of Health Administration, College of Business Administration, King Saud University, Riyadh, Saudi Arabia
| | - Hanaa Sharaf
- Department of Cytogenetics Laboratory, Ministry of Health, Riyadh, Saudi Arabia
| | - Eman Sheshah
- Department of Internal Medicine, King Salman Hospital, Ministry of Health, Riyadh, Saudi Arabia
| | - Lolwah Alashgar
- Department of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Mashael Alshaikh
- Department of Pharmacy Services, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
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49
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Kristensen NM, Gribsholt SB, Andersen AL, Richelsen B, Bruun JM. Obesity augments the disease burden in COVID-19: Updated data from an umbrella review. Clin Obes 2022; 12:e12508. [PMID: 35137524 PMCID: PMC9111579 DOI: 10.1111/cob.12508] [Citation(s) in RCA: 14] [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: 08/26/2021] [Revised: 12/03/2021] [Accepted: 12/26/2021] [Indexed: 12/16/2022]
Abstract
The ongoing coronavirus disease 2019 (COVID-19) pandemic calls for identification of risk factors, which may help to identify people at enhanced risk for severe disease outcomes to improve treatment and, if possible, establish prophylactic measures. This study aimed to determine whether individuals with obesity compared to individuals with normal weight have an increased risk for severe COVID-19. We conducted a systematic literature search of PubMed, Embase and Cochrane Library and critically reviewed the secondary literature using AMSTAR-2. We explored 27 studies. Findings indicate that individuals with obesity (body mass index ≥ 30 kg/m2 ), as compared to individuals without obesity, experience an increased risk for hospitalization (odds ratio [OR]: 1.40-2.45), admission to the intensive care unit (OR: 1.30-2.32), invasive mechanical ventilation (OR: 1.47-2.63), and the composite outcome 'severe outcome' (OR or risk ratio: 1.62-4.31). We found diverging results concerning death to COVID-19, but data trended towards increased mortality. Comparing individuals with obesity to individuals without obesity, findings suggested younger individuals (<60 years) experience a higher risk of severe disease compared to older individuals (≥60 years). Obesity augments the severity of COVID-19 including a tendency to increased mortality and, thus, contributes to an increased disease burden, especially among younger individuals.
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Affiliation(s)
- Nickolai M. Kristensen
- Steno Diabetes Centre AarhusAarhus University HospitalAarhusDenmark
- Danish National Centre for ObesityAarhusDenmark
| | - Sigrid B. Gribsholt
- Steno Diabetes Centre AarhusAarhus University HospitalAarhusDenmark
- Danish National Centre for ObesityAarhusDenmark
| | - Anton L. Andersen
- Steno Diabetes Centre AarhusAarhus University HospitalAarhusDenmark
- Danish National Centre for ObesityAarhusDenmark
| | - Bjørn Richelsen
- Steno Diabetes Centre AarhusAarhus University HospitalAarhusDenmark
- Department of Endocrinology and Internal MedicineAarhus University HospitalAarhusDenmark
- Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Jens M. Bruun
- Steno Diabetes Centre AarhusAarhus University HospitalAarhusDenmark
- Danish National Centre for ObesityAarhusDenmark
- Department of Clinical MedicineAarhus UniversityAarhusDenmark
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50
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Plasma Levels and Renal Handling of Amino Acids Contribute to Determination of Risk of Mortality or Feed of Ventilation in Patients with COVID-19. Metabolites 2022; 12:metabo12060486. [PMID: 35736419 PMCID: PMC9228241 DOI: 10.3390/metabo12060486] [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: 04/10/2022] [Revised: 05/02/2022] [Accepted: 05/23/2022] [Indexed: 12/13/2022] Open
Abstract
COVID-19 infection may lead to serious complications, e.g., need for mechanical ventilation or death in some cases. A retrospective analysis of patients referred to our COVID Emergency Department, indiscriminately, was performed. A routine lab analysis measured amino acids in plasma and urine of patients. Data of surviving and deceased patients and those requiring or not requiring mechanical ventilation were compared, and logistic regression analyses have been performed. Deceased patients were older, had higher blood glucose, potassium, AST, LDH, troponin, d-dimer, hsCRP, procalcitonin, interleukin-6 levels (p < 0.05 for all). They had lower plasma serine, glycine, threonine, tryptophan levels (p < 0.01), higher tyrosine and phenylalanine levels (p < 0.05), and higher fractional excretion of arginine, methionine, and proline (p < 0.05) than survivors. In a regression model, age, severity score of COVID-pneumonia, plasma levels of threonine and phenylalanine were predictors of in-hospital mortality. There was a difference in ventilated vs. non-ventilated patients in CT-scores, glucose, and renal function (p < 0.001). Using logistic regression, CT-score, troponin, plasma level, and fractional excretion of glycine were predictors of ventilation. Plasma levels and renal excretion of certain amino acids are associated with the outcome of COVID-19 infection beside other parameters such as the CT-score or age.
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