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Iqbal K, Banga A, Arif TB, Rathore SS, Bhurwal A, Naqvi SKB, Mehdi M, Kumar P, Salklan MM, Iqbal A, Ahmed J, Sharma N, Lal A, Kashyap R, Bansal V, Domecq JP. Anticoagulant use before COVID-19 diagnosis prevent COVID-19 associated acute venous thromboembolism or not: A systematic review and meta-analysis. World J Methodol 2024; 14:92983. [DOI: 10.5662/wjm.v14.i3.92983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 04/24/2024] [Accepted: 05/11/2024] [Indexed: 06/25/2024] Open
Abstract
BACKGROUND Coagulopathy and thromboembolic events are associated with poor outcomes in coronavirus disease 2019 (COVID-19) patients. There is conflicting evidence on the effects of chronic anticoagulation on mortality and severity of COVID-19 disease.
AIM To summarize the body of evidence on the effects of pre-hospital anticoagulation on outcomes in COVID-19 patients.
METHODS A Literature search was performed on LitCovid PubMed, WHO, and Scopus databases from inception (December 2019) till June 2023 for original studies reporting an association between prior use of anticoagulants and patient outcomes in adults with COVID-19. The primary outcome was the risk of thromboembolic events in COVID-19 patients taking anticoagulants. Secondary outcomes included COVID-19 disease severity, in terms of intensive care unit admission or invasive mechanical ventilation/intubation requirement in patients hospitalized with COVID-19 infection, and mortality. The random effects models were used to calculate crude and adjusted odds ratios (aORs) with 95% confidence intervals (95%CIs).
RESULTS Forty-six observational studies met our inclusion criteria. The unadjusted analysis found no association between prior anticoagulation and thromboembolic event risk [n = 43851, 9 studies, odds ratio (OR)= 0.67 (0.22, 2.07); P = 0.49; I2 = 95%]. The association between prior anticoagulation and disease severity was non-significant [n = 186782; 22 studies, OR = 1.08 (0.78, 1.49); P = 0.64; I2 = 89%]. However, pre-hospital anticoagulation significantly increased all-cause mortality risk [n = 207292; 35 studies, OR = 1.72 (1.37, 2.17); P < 0.00001; I2 = 93%]. Pooling adjusted estimates revealed a statistically non-significant association between pre-hospital anticoagulation and thromboembolic event risk [aOR = 0.87 (0.42, 1.80); P = 0.71], mortality [aOR = 0.94 (0.84, 1.05); P = 0.31], and disease severity [aOR = 0.96 (0.72, 1.26); P = 0.76].
CONCLUSION Prehospital anticoagulation was not significantly associated with reduced risk of thromboembolic events, improved survival, and lower disease severity in COVID-19 patients.
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Affiliation(s)
- Kinza Iqbal
- Department of Internal Medicine, Dow Medical College, Karachi 74200, Pakistan
| | - Akshat Banga
- Department of Internal Medicine, Sawai Man Singh Medical College, Jaipur 302004, India
| | - Taha Bin Arif
- Department of Internal Medicine, Dow Medical College, Karachi 74200, Pakistan
| | - Sawai Singh Rathore
- Department of Internal Medicine, Dr. Sampurnanand Medical College, Jodhpur 342003, Rajasthan, India
| | - Abhishek Bhurwal
- Department of Gastroenterology and Hepatology, Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ 08901, United States
| | | | - Muhammad Mehdi
- Department of Internal Medicine, Dow Medical College, Karachi 74200, Pakistan
| | - Pankaj Kumar
- Department of Internal Medicine, Dow Medical College, Karachi 74200, Pakistan
| | - Mitali Madhu Salklan
- Department of Internal Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak 124001, Haryana, India
| | - Ayman Iqbal
- Department of Internal Medicine, Dow Medical College, Karachi 74200, Pakistan
| | - Jawad Ahmed
- Department of Internal Medicine, Dow Medical College, Karachi 74200, Pakistan
| | - Nikhil Sharma
- Department of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905, United States
| | - Amos Lal
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, United States
| | - Rahul Kashyap
- Department of Research, Wellspan Health, York, PA 17403, United States
| | - Vikas Bansal
- Department of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905, United States
| | - Juan Pablo Domecq
- Department of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905, United States
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Fouda EAAM, Badr EA, Gawesh D, Mahmoud MA. The role of NOS3-rs1799983 and NOS3- rs2070744 SNP in occurrence of avascular necrosis as a post COVID-19 complication. BMC Med Genomics 2024; 17:217. [PMID: 39169347 DOI: 10.1186/s12920-024-01928-1] [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: 01/07/2024] [Accepted: 06/06/2024] [Indexed: 08/23/2024] Open
Abstract
Avascular necrosis (AVN) is a debilitating condition characterized by bone tissue death due to inadequate blood supply, leading to joint dysfunction and collapse. This study investigates the potential association between AVN and COVID-19, focusing on genetic factors such as NOS3 polymorphisms. A total of 180 individuals were included, comprising 120 COVID-19 patients and 60 healthy controls. Clinical, haematological, biochemical, and genetic parameters were assessed. Results revealed significant differences in respiratory and heart rates, haematological counts, and biochemical markers between AVN and control groups. Genetic analysis showed a higher prevalence of the TG genotype and G allele in NOS3 rs1799983 polymorphism among AVN patients. Additionally, NOS3 rs2070744 polymorphism correlated with various clinical parameters, including blood pressure, heart rate, and haematological indices. This study highlights the potential role of genetic factors in predisposing individuals to AVN following COVID-19 infection.
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Affiliation(s)
| | - Eman Ae Badr
- Department of Medical Biochemistry, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Doaa Gawesh
- Department of Chemistry, Biochemistry Division, Faculty of Science, Menoufia University, Menoufia, Egypt
| | - Mohammad A Mahmoud
- Department of Chemistry, Faculty of Science, Kafrelsheikh University, Kafrelsheikh, 33516, Egypt.
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3
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Yin XW, Hu JJ, Ren FC, Pu XD, Yang MY, Yang BY, Wang P, Shen CP. Anti-inflammatory Lindenane Sesquiterpene Dimers from the Roots of Chloranthus fortunei. ACS OMEGA 2024; 9:34869-34879. [PMID: 39157111 PMCID: PMC11325489 DOI: 10.1021/acsomega.4c04403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 07/24/2024] [Accepted: 07/25/2024] [Indexed: 08/20/2024]
Abstract
In this study, eight lindenane-type sesquiterpene dimers, including five previously undescribed sesquiterpene dimers (1-5), were isolated from the roots of Chloranthus fortunei, and their structures were elucidated using 1D/2D NMR, HRESIMS, and ECD calculations. Compound 1 presents the second example of a type of novel 8,9-seco lindenane-type sesquiterpene dimer, considered a product of 8/9-diketone oxidation. Compounds 2 and 3 represent the third and fourth examples, respectively, of this kind of C-11 methine dimer. Furthermore, compound 4 was considered as an artifact generated from the radical reaction of a known compound chlojaponilide F (6), which was explained by the density functional theory quantum calculation. All isolates were evaluated for their protective activity against the LPS-induced pulmonary epithelial cell line with compound 7 exhibiting the most potent bioactivity. Further in vitro biological evaluation demonstrated that 7 reduced the production of reactive oxygen species and interleukin-1β, further regulated by the expression of the NLRP3. These results show that compound 7 exhibits therapeutic potential for lung inflammatory diseases.
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Affiliation(s)
- Xiu-Wen Yin
- Anhui
Provincial Laboratory of Inflammatory and Immunity Disease, Anhui
Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei 230032, People’s Republic of China
| | - Jun-Jie Hu
- Anhui
Provincial Laboratory of Inflammatory and Immunity Disease, Anhui
Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei 230032, People’s Republic of China
| | - Fu-Cai Ren
- Anhui
Provincial Laboratory of Inflammatory and Immunity Disease, Anhui
Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei 230032, People’s Republic of China
| | - Xiang-Dong Pu
- Anhui
Provincial Laboratory of Inflammatory and Immunity Disease, Anhui
Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei 230032, People’s Republic of China
| | - Meng-Yu Yang
- Anhui
Provincial Laboratory of Inflammatory and Immunity Disease, Anhui
Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei 230032, People’s Republic of China
| | - Bing-Yuan Yang
- Guangxi
Key Laboratory of Plant Functional Phytochemicals and Sustainable
Utilization, Guangxi Institute of Botany,
Guangxi Zhuang Autonomous Region and Chinese Academy of Sciences, Guilin 541006, People’s Republic of China
| | - Peng Wang
- School
of Pharmacy, Yancheng Teachers University, Yancheng 224007, China
| | - Chuan-Pu Shen
- Anhui
Provincial Laboratory of Inflammatory and Immunity Disease, Anhui
Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei 230032, People’s Republic of China
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Xie K, Guan S, Kong X, Ji W, Du C, Jia M, Wang H. Predictors of mortality in severe pneumonia patients: a systematic review and meta-analysis. Syst Rev 2024; 13:210. [PMID: 39103964 DOI: 10.1186/s13643-024-02621-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 07/18/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Severe pneumonia has consistently been associated with high mortality. We sought to identify risk factors for the mortality of severe pneumonia to assist in reducing mortality for medical treatment. METHODS Electronic databases including PubMed, Web of Science, EMBASE, Cochrane Library, and Scopus were systematically searched till June 1, 2023. All human research were incorporated into the analysis, regardless of language, publication date, or geographical location. To pool the estimate, a mixed-effect model was used. The Newcastle-Ottawa Scale (NOS) was employed for assessing the quality of included studies that were included in the analysis. RESULTS In total, 22 studies with a total of 3655 severe pneumonia patients and 1107 cases (30.29%) of death were included in the current meta-analysis. Significant associations were found between age [5.76 years, 95% confidence interval [CI] (3.43, 8.09), P < 0.00001], male gender [odds ratio (OR) = 1.47, 95% CI (1.07, 2.02), P = 0.02], and risk of death from severe pneumonia. The comorbidity of neoplasm [OR = 3.37, 95% CI (1.07, 10.57), P = 0.04], besides the presence of complications such as diastolic hypotension [OR = 2.60, 95% CI (1.45, 4.67), P = 0.001], ALI/ARDS [OR = 3.63, 95% CI (1.78, 7.39), P = 0.0004], septic shock [OR = 9.43, 95% CI (4.39, 20.28), P < 0.00001], MOF [OR = 4.34, 95% CI (2.36, 7.95), P < 0.00001], acute kidney injury [OR = 2.45, 95% CI (1.14, 5.26), P = 0.02], and metabolic acidosis [OR = 5.88, 95% CI (1.51, 22.88), P = 0.01] were associated with significantly higher risk of death among patients with severe pneumonia. Those who died, compared with those who survived, differed on multiple biomarkers on admission including serum creatinine [Scr: + 67.77 mmol/L, 95% CI (47.21, 88.34), P < 0.00001], blood urea nitrogen [BUN: + 6.26 mmol/L, 95% CI (1.49, 11.03), P = 0.01], C-reactive protein [CRP: + 33.09 mg/L, 95% CI (3.01, 63.18), P = 0.03], leukopenia [OR = 2.63, 95% CI (1.34, 5.18), P = 0.005], sodium < 136 mEq/L [OR = 2.63, 95% CI (1.34, 5.18), P = 0.005], albumin [- 5.17 g/L, 95% CI (- 7.09, - 3.25), P < 0.00001], PaO2/FiO2 [- 55.05 mmHg, 95% CI (- 60.11, - 50.00), P < 0.00001], arterial blood PH [- 0.09, 95% CI (- 0.15, - 0.04), P = 0.0005], gram-negative microorganism [OR = 2.56, 95% CI (1.17, 5.62), P = 0.02], and multilobar or bilateral involvement [OR = 3.65, 95% CI (2.70, 4.93), P < 0.00001]. CONCLUSIONS Older age and male gender might face a greater risk of death in severe pneumonia individuals. The mortality of severe pneumonia may also be significantly impacted by complications such diastolic hypotension, ALI/ARDS, septic shock, MOF, acute kidney injury, and metabolic acidosis, as well as the comorbidity of neoplasm, and laboratory indicators involving Scr, BUN, CRP, leukopenia, sodium, albumin, PaO2/FiO2, arterial blood PH, gram-negative microorganism, and multilobar or bilateral involvement. SYSTEMATIC REVIEW REGISTRATION PROSPERO Protocol Number: CRD 42023430684.
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Affiliation(s)
- Kai Xie
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, The First Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou, China
- Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases By Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, China
| | - Shengnan Guan
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, The First Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou, China
- Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases By Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, China
| | - Xinxin Kong
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, The First Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou, China
- Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases By Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, China
| | - Wenshuai Ji
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, The First Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou, China
- Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases By Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, China
| | - Chen Du
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, The First Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou, China
- Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases By Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, China
| | - Mingyan Jia
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
- Academy of Chinese Medical Sciences, The First Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou, China
- Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases By Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, China
| | - Haifeng Wang
- Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China.
- Academy of Chinese Medical Sciences, The First Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou, China.
- Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases By Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, China.
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Lucaj T, Hay I, Samarbakhsh A, Bedi M, Iyer AK, Gavande NS. An overview of the development of pharmacotherapeutics targeting SARS-CoV-2. Drug Discov Today 2024; 29:104126. [PMID: 39097220 DOI: 10.1016/j.drudis.2024.104126] [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: 01/06/2024] [Revised: 07/18/2024] [Accepted: 07/29/2024] [Indexed: 08/05/2024]
Abstract
Coronavirus disease 2019 (COVID-19) was declared a global pandemic in March 2020, which precipitated urgent public health responses. The causative agent, SARS-CoV-2, spreads primarily via respiratory droplets, necessitating precautions to mitigate transmission risks. Biopharmaceutical industries and academic institutions worldwide swiftly redirected their research endeavors towards developing therapeutic interventions, focusing on monoclonal antibodies, antiviral agents, and immunomodulatory therapies. The evolving body of evidence surrounding these treatments has prompted successive updates and revisions from the FDA, delineating the evolving landscape of COVID-19 therapeutics. This review comprehensively examines each treatment modality within the context of their developmental trajectories and regulatory approvals throughout the pandemic. Furthermore, it elucidates their mechanisms of action and presents clinical data underpinning their utility in combating the COVID-19 crisis.
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Affiliation(s)
- Tom Lucaj
- Department of Pharmaceutical Sciences, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA
| | - Ian Hay
- Department of Pharmaceutical Sciences, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA
| | - Amirreza Samarbakhsh
- Department of Pharmaceutical Sciences, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA
| | - Mel Bedi
- Department of Pharmaceutical Sciences, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA
| | - Arun K Iyer
- Department of Pharmaceutical Sciences, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA
| | - Navnath S Gavande
- Department of Pharmaceutical Sciences, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA; Molecular Therapeutics Program, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI 48201, USA.
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6
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Eguchi T, Niiyama S, Kamikokuryo C, Madokoro Y, Shimono K, Hara S, Ichinose H, Kakihana Y. Comparative Study of Blood Neopterin and Biopterins in Patients with COVID-19 and Secondary Bacterial Infection. J Clin Med 2024; 13:4365. [PMID: 39124632 PMCID: PMC11312689 DOI: 10.3390/jcm13154365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Revised: 07/21/2024] [Accepted: 07/24/2024] [Indexed: 08/12/2024] Open
Abstract
Background/Objectives: As COVID-19 can be severe, early predictive markers of both severity and onset of secondary bacterial infections are needed. This study first examined changes over time in the levels of plasma neopterin (NP) and biopterins (BPs), among others, in patients with COVID-19 and then in those with secondary bacterial infection complications. Methods: Fifty-two patients with COVID-19 admitted to two tertiary care centers were included. They were divided into a severe group (intubated + mechanical ventilation) (n = 10) and a moderate group (non-intubated + oxygen administration) (n = 42), and changes over time in plasma NP, plasma BPs, IFN-γ, lymphocyte count, CRP, and IL-6 were investigated. Four of the patients in the severe group (n = 10) developed secondary bacterial infections during treatment. Plasma NP and plasma BPs of patients with bacterial sepsis (no viral infection) (n = 25) were also examined. Results: The plasma NP, IL-6, CRP, and SOFA levels were significantly higher in the severe group, while the IFN-γ level and lymphocyte count were significantly lower. The higher plasma NP in the severe group persisted only up to 1 week after symptom onset. The plasma BPs were higher in complications of bacterial infection. Conclusions: The timing of sample collection is important for assessing severity through plasma NP, while plasma BPs may be a useful diagnostic tool for identifying the development of secondary bacterial infection in patients with COVID-19. Further investigation is needed to clarify the mechanism by which NP and BPs, which are involved in the same biosynthetic pathway, are differentially activated depending on the type of pathogen.
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Affiliation(s)
- Tomohiro Eguchi
- Department of Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan; (T.E.)
- Emergency and Critical Care Center, Kagoshima City Hospital, Kagoshima 890-8760, Japan
| | - Shuhei Niiyama
- Department of Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan; (T.E.)
| | - Chinatsu Kamikokuryo
- Department of Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan; (T.E.)
| | - Yutaro Madokoro
- Department of Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan; (T.E.)
| | - Kenshin Shimono
- Department of Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan; (T.E.)
| | - Satoshi Hara
- Department of Life Science Research for Emergency Intensive Care, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan
| | - Hiroshi Ichinose
- School of Life Science and Technology, Tokyo Institute of Technology, Yokohama 226-8501, Japan
| | - Yasuyuki Kakihana
- Department of Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan; (T.E.)
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Marcus SM, Gardiner CV. Age, gender and household infrastructural inequality in COVID-19: Contextual analysis of Mamelodi. S Afr Fam Pract (2004) 2024; 66:e1-e8. [PMID: 39099259 PMCID: PMC11304177 DOI: 10.4102/safp.v66i1.5924] [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: 02/06/2024] [Revised: 04/14/2024] [Accepted: 04/15/2024] [Indexed: 08/06/2024] Open
Abstract
BACKGROUND Age, gender and household infrastructure are important social determinants affecting health inequalities. This study aims to assess the ways that age and gender of the household head and household infrastructure intersect to create relative advantage and disadvantage in COVID-19 vulnerability. METHODS Using household primary care survey data from Mamelodi, Gauteng, headed households were sorted into three risk categories for each of the relevant infrastructural determinants of COVID-19. Bivariate ordinal logistic regression was used to determine the odds of households falling into each risk category. The proportion of high-risk (HR) categories and dwelling types was also calculated. RESULTS Households headed by someone ≥ 65 years were less likely to be in all HR categories and more frequently had formal houses. Male-head households were more likely to be HR for water, sanitation and hygiene infrastructure and indoor pollution; however, female-headed households (FHHs) were at higher risk for crowding. In Mamelodi, households headed by ≥ 65 years olds were relatively infrastructurally protected, likely because of pro-equity housing policy, as were FHHs, except for crowding. The care load on FHHs results in their infrastructural protection benefiting more community members, while simultaneously incurring risk. CONCLUSION Infrastructural support based on the household head's age and gender could improve targeting and the effectiveness of health interventions. These results demonstrate the importance of a contextual understanding of gender and age inequalities and tailoring public health support based on this understanding.Contribution: This research describes patterns of health-related infrastructural inequality, identifies ways to improve health interventions, and demonstrates the importance of equity-focused policy in an African context.
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Affiliation(s)
- Simon M Marcus
- Department of Family Medicine, Faculty of Health Science, University of the Witwatersrand, Johannesburg.
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8
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Bucher AM, Sieren MM, Meinel FG, Kloeckner R, Fink MA, Sähn MJ, Wienke A, Meyer HJ, Penzkofer T, Dietz J, Vogl TJ, Borggrefe J, Surov A. Prevalence and prognostic role of thoracic lymphadenopathy in Covid-19. ROFO-FORTSCHR RONTG 2024. [PMID: 39038457 DOI: 10.1055/a-2293-8132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
PURPOSE The prevalent coronavirus disease 2019 (COVID-19) pandemic has spread throughout the world and is considered a serious threat to global health. The prognostic role of thoracic lymphadenopathy in COVID-19 is unclear. The aim of the present meta-analysis was to analyze the prognostic role of thoracic lymphadenopathy for the prediction of 30-day mortality in patients with COVID-19. MATERIALS AND METHODS The MEDLINE library, Cochrane, and SCOPUS databases were screened for associations between CT-defined features and mortality in COVID-19 patients up to June 2021. In total, 21 studies were included in the present analysis. The quality of the included studies was assessed by the Newcastle-Ottawa Scale. The meta-analysis was performed using RevMan 5.3. Heterogeneity was calculated by means of the inconsistency index I2. DerSimonian and Laird random-effect models with inverse variance weights were performed without any further correction. RESULTS The included studies comprised 4621 patients. The prevalence of thoracic lymphadenopathy varied between 1 % and 73.4 %. The pooled prevalence was 16.7 %, 95 % CI = (15.6 %; 17.8 %). The hospital mortality was higher in patients with thoracic lymphadenopathy (34.7 %) than in patients without (20.0 %). The pooled odds ratio for the influence of thoracic lymphadenopathy on mortality was 2.13 (95 % CI = [1.80-2.52], p < 0.001). CONCLUSION The prevalence of thoracic lymphadenopathy in COVID-19 is 16.7 %. The presence of thoracic lymphadenopathy is associated with an approximately twofold increase in the risk for hospital mortality in COVID-19. KEY POINTS · The prevalence of lymphadenopathy in COVID-19 is 16.7 %.. · Patients with lymphadenopathy in COVID-19 have a higher risk of mortality during hospitalization.. · Lymphadenopathy nearly doubles mortality and plays an important prognostic role.. CITATION FORMAT · Bucher AM, Sieren M, Meinel F et al. Prevalence and prognostic role of thoracic lymphadenopathy in Covid-19. Fortschr Röntgenstr 2024; DOI: 10.1055/a-2293-8132.
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Affiliation(s)
- Andreas Michael Bucher
- Institute for Diagnostic and Interventional Radiology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Malte M Sieren
- Department of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein Campus Lübeck, Lübeck, Germany
- Institute for Interventional Radiology, University Hospital Schleswig-Holstein Campus Lübeck, Lübeck, Germany
| | - Felix G Meinel
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany
| | - Roman Kloeckner
- Institute for Interventional Radiology, University Hospital Schleswig-Holstein Campus Lübeck, Lübeck, Germany
| | - Matthias A Fink
- Institute for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Germany
| | | | - Andreas Wienke
- Institute of Medical Epidemiology, Biometry and Informatics, Martin Luther University Halle Wittenberg, Halle, Germany
| | - Hans-Jonas Meyer
- Diagnostic and Interventional Radiology, Universitätsklinikum Leipzig, Germany
| | - Tobias Penzkofer
- Department of Radiology, Charite University Hospital Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
| | - Julia Dietz
- Institute for Diagnostic and Interventional Radiology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Thomas J Vogl
- Institute for Diagnostic and Interventional Radiology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Jan Borggrefe
- University Institute of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling Hospital Minden, Germany
| | - Alexey Surov
- University Institute of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling Hospital Minden, Germany
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Kondo K, Suita A, Ohfuji S, Mukai E, Kase T, Fukushima W. Factors Related to Mortality in Patients with COVID-19 during the Early Phase of the Pandemic in Japan: An Observational Study Using the Osaka Prefectural Novel Coronavirus Response Status Management System. JMA J 2024; 7:364-374. [PMID: 39114622 PMCID: PMC11301106 DOI: 10.31662/jmaj.2023-0179] [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: 11/08/2023] [Accepted: 02/29/2024] [Indexed: 08/10/2024] Open
Abstract
Introduction Elucidating the epidemiological picture in the early phase of a pandemic is crucial to strengthening preparedness and public health responses to future emerging infectious diseases. Using data from the "Osaka Prefectural Novel Coronavirus Response Status Management System," we evaluated factors associated with mortality among patients with novel coronavirus disease 2019 (COVID-19) in Osaka Prefecture, Japan. Methods The study periods were from January 29 to June 13, 2020 (first surge), from June 14 to October 9, 2020 (second surge), and from October 10 to December 24, 2020 (up to the middle of the third surge). The odds ratios (ORs) and 95% confidence intervals (95% CIs) for mortality were calculated using logistic regression models. Results Of the 14,864 patients with COVID-19 (8,207 men, 6,657 women) registered, 297 (2%) died. The ORs for mortality were significantly higher in men (OR = 2.00, 95% CI = 1.54-2.60) than in women, in 70- to 79-year-olds (OR = 25.4, 95% CI = 16.8-38.2) and ≥80-year-olds (OR = 78.1, 95% CI = 53.3-114) than in 0- to 69-year-olds (P for trend < 0.001), and in those with underlying diseases (OR = 1.74, 95% CI = 1.34-2.27) than in those without. The ORs for the second surge (OR = 0.42, 95% CI = 0.31-0.57) and third surge (OR = 0.41, 95% CI = 0.29-0.58) decreased compared with the first surge. Detailed evaluation of underlying diseases by time period showed that "Diseases of the blood and blood-forming organs and certain disorders involving immune mechanisms," "Endocrine, nutritional, and metabolic diseases," "Diseases of the genitourinary system," and "Diseases of the respiratory system" were associated with increased risk of mortality. Conclusions Among those affected early in the COVID-19 epidemic, male sex, older age, first-surge infection, and underlying medical conditions were significantly associated with mortality. Our findings are expected to provide a useful reference for future countermeasures in the early stages of pandemics involving unknown emerging infectious diseases.
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Affiliation(s)
- Kyoko Kondo
- Management Bureau, Osaka Metropolitan University Hospital, Osaka, Japan
- Research Support Platform, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Asae Suita
- Department of Public Health, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Satoko Ohfuji
- Department of Public Health, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
- Research Center for Infectious Disease Sciences, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Emiko Mukai
- Department of Public Health, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Tetsuo Kase
- Department of Public Health, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
- Research Center for Infectious Disease Sciences, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Wakaba Fukushima
- Research Support Platform, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
- Department of Public Health, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
- Research Center for Infectious Disease Sciences, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
- Osaka International Research Center for Infectious Diseases, Osaka Metropolitan University, Osaka, Japan
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10
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Mineo R, Fukuda S, Suzuki S, Ito Y, Tamba S, Sugiyama T, Fujishima Y, Nishizawa H, Shimomura I, Yamamoto K, Matsuzawa Y. Association between COVID-19 severity and relatively high serum adiponectin levels at the time of admission. Endocr J 2024; 71:705-711. [PMID: 38735737 DOI: 10.1507/endocrj.ej24-0072] [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] [Indexed: 05/14/2024] Open
Abstract
At the beginning of 2020, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led to epidemics worldwide. Obesity and visceral fat accumulation have been reported to be independent risk factors for severe COVID-19. Several reports have focused on the levels of adipocytokines/adipokines, including adiponectin (APN), which is exclusively secreted from adipocytes, although the importance of these factors in acute disease conditions remains unclear. Therefore, we investigated the relationship between serum adiponectin levels and COVID-19 severity. Patients with COVID-19 who were admitted to Sumitomo Hospital (Osaka, Japan) from May through October 2021 were included. A total of 107 patients were enrolled in this study. We obtained the anthropometric and clinical laboratory data of the patients at the time of admission and examined the associations between various parameters and COVID-19 severity. The mean period from onset to admission was 6.5 ± 2.8 days. We divided the patients into "non-severe" (mild, moderate-I and moderate-II) (n = 80) and "severe" (n = 27) groups. The "severe" patients were significantly older than "non-severe" patients. Additionally, no significant differences were observed in BMI, sex, or the period from onset to admission. The serum adiponectin levels of "severe" patients at the time of admission were significantly greater than those of "non-severe" patients even after adjusting for age, sex, and BMI. These results suggest that the serum APN levels at the time of admission can predict COVID-19 severity. However, further investigations on the changes in APN levels in acute diseases are needed.
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Affiliation(s)
- Ryohei Mineo
- Department of Endocrinology and Metabolism, Sumitomo Hospital, Osaka 530-0005, Japan
| | - Shiro Fukuda
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Shigehito Suzuki
- Department of Endocrinology and Metabolism, Sumitomo Hospital, Osaka 530-0005, Japan
| | - Yoshito Ito
- Department of Endocrinology and Metabolism, Sumitomo Hospital, Osaka 530-0005, Japan
| | - Sachiko Tamba
- Department of Endocrinology and Metabolism, Sumitomo Hospital, Osaka 530-0005, Japan
| | - Takuya Sugiyama
- Department of Endocrinology and Metabolism, Sumitomo Hospital, Osaka 530-0005, Japan
| | - Yuya Fujishima
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Hitoshi Nishizawa
- Department of Metabolism and Atherosclerosis, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Koji Yamamoto
- Department of Endocrinology and Metabolism, Sumitomo Hospital, Osaka 530-0005, Japan
| | - Yuji Matsuzawa
- Department of Endocrinology and Metabolism, Sumitomo Hospital, Osaka 530-0005, Japan
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11
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Sha'ari NI, Ismail A, Abdul Aziz AF, Suddin LS, Azzeri A, Sk Abd Razak R, Mad Tahir NS. Cardiovascular diseases as risk factors of post-COVID syndrome: a systematic review. BMC Public Health 2024; 24:1846. [PMID: 38987743 PMCID: PMC11238467 DOI: 10.1186/s12889-024-19300-4] [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: 09/13/2023] [Accepted: 06/28/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND A growing proportion of people experience incomplete recovery months after contracting coronavirus disease 2019 (COVID-19). These COVID-19 survivors develop a condition known as post-COVID syndrome (PCS), where COVID-19 symptoms persist for > 12 weeks after acute infection. Limited studies have investigated PCS risk factors that notably include pre-existing cardiovascular diseases (CVD), which should be examined considering the most recent PCS data. This review aims to identify CVD as a risk factor for PCS development in COVID-19 survivors. METHODS Following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) checklist, systematic literature searches were performed in the PubMed, Scopus, and Web of Science databases from the earliest date available to June 2023. Data from observational studies in English that described the association between CVD and PCS in adults (≥ 18 years old) were included. A minimum of two authors independently performed the screening, study selection, data extraction, data synthesis, and quality assessment (Newcastle-Ottawa Scale). The protocol of this review was registered under PROSPERO (ID: CRD42023440834). RESULTS In total, 594 studies were screened after duplicates and non-original articles had been removed. Of the 11 included studies, CVD including hypertension (six studies), heart failure (three studies), and others (two studies) were significantly associated with PCS development with different factors considered. The included studies were of moderate to high methodological quality. CONCLUSION Our review highlighted that COVID-19 survivors with pre-existing CVD have a significantly greater risk of developing PCS symptomology than survivors without pre-existing CVD. As heart failure, hypertension and other CVD are associated with a higher risk of developing PCS, comprehensive screening and thorough examinations are essential to minimise the impact of PCS and improve patients' disease progression.
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Affiliation(s)
- Nur Insyirah Sha'ari
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras Campus, Bandar Tun Razak, Cheras, Kuala Lumpur, 56000, Malaysia
| | - Aniza Ismail
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras Campus, Bandar Tun Razak, Cheras, Kuala Lumpur, 56000, Malaysia.
- Faculty of Public Health, Universitas Sumatera Utara, North Sumatra, Jalan Universitas No. 21 Kampus USU, Medan, 20155, Indonesia.
| | - Aznida Firzah Abdul Aziz
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras Campus, Bandar Tun Razak, Cheras, Kuala Lumpur, 56000, Malaysia
| | - Leny Suzana Suddin
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Sungai Buloh, 47000, Selangor, Malaysia
| | - Amirah Azzeri
- Department of Primary Care, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Persiaran Ilmu, Putra Nilai, Negeri Sembilan, Nilai, 71800, Malaysia
| | - Ruhana Sk Abd Razak
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras Campus, Bandar Tun Razak, Cheras, Kuala Lumpur, 56000, Malaysia
| | - Nur Syazana Mad Tahir
- Federal Government Administrative Centre, Ministry of Health Malaysia, Pusat Pentadbiran Kerajaan Persekutuan, Wilayah Persekutuan Putrajaya, Putrajaya, 62000, Malaysia
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12
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Avila Dextre F, Morales Álvarez B, Aguirre Castañeda P, Alva IE, López G, Schwalb A, Gotuzzo E. Association between HTLV-1/2 infection and COVID-19 severity in a migrant Shipibo-Konibo population in Lima, Peru. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003442. [PMID: 38985713 PMCID: PMC11236200 DOI: 10.1371/journal.pgph.0003442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 06/12/2024] [Indexed: 07/12/2024]
Abstract
OBJECTIVES The migrant community of the Shipibo-Konibo indigenous people in Lima, Peru were extremely vulnerable during the COVID-19 pandemic. Additionally, infection with human T-cell lymphotropic virus type 1 and 2 (HTLV-1/2) is endemic in this population causing immunosuppression. The aim of the study was to describe the association between HTLV-1/2 infection and the clinical severity of COVID-19. METHODS This was a cross-sectional descriptive study involving a survey of adult Shipibo-Konibo indigenous migrants residing in Cantagallo-Rímac who were identified as suspected or confirmed cases of COVID-19. Blood samples were collected for SARS-CoV-2 antibody and HTLV-1/2 ELISA testing. A confirmatory Western Blot test was performed for those with a positive ELISA test. RESULTS A total of 182 individuals were surveyed and sampled. No significant association was found between HTLV-1/2 infection and the clinical severity of COVID-19. The prevalence of HTLV-1/2 was 8.8% (95%CI: 5.0-14.1) with Western Blot. Age was the only statistically significant risk factor for developing a more severe form of COVID-19 (OR: 1.03; 95%CI: 1.00-1.06; p = 0.032). CONCLUSIONS There was no association found between HTLV-1/2 infection and the clinical severity of COVID-19. The prevalence of HTLV-1/2 infection in the Shipibo-Konibo population is high and warrants continuous monitoring in the advent of other infectious disease outbreaks and the development of HTLV-associated comorbidities.
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Affiliation(s)
| | | | | | - Isaac Efrain Alva
- School of Public Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Giovanni López
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Alvaro Schwalb
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Eduardo Gotuzzo
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
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13
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Sahin M, Yilmaz M, Mert A, Naghili B, Ravanbakhsh F, Varshochi M, Darazam IA, Ebrahimi MJ, Moafi M, Tehrani HA, Mahboob A, Rashid N, Khan EA, Hakamifard A, Eser-Karlidag G, Babamahmoodi A, El-Kholy A, Mosawi SH, Albayrak A, Al Ramahi JW, Addepalli SK, Özer Balin Ş, Khan A, Pandya N, Gurbuz E, Sincan G, Azami H, Dumlu R, Khedr R, Ripon RK, Alkan S, Kose Ş, Ceylan B, Erdem H. Factors influencing mortality in COVID-19-associated mucormycosis: The international ID-IRI study. Med Mycol 2024; 62:myae064. [PMID: 38914466 DOI: 10.1093/mmy/myae064] [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: 04/20/2024] [Revised: 05/31/2024] [Accepted: 06/23/2024] [Indexed: 06/26/2024] Open
Abstract
The emergence of COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), triggered a global pandemic. Concurrently, reports of mucormycosis cases surged, particularly during the second wave in India. This study aims to investigate mortality factors in COVID-19-associated mucormycosis (CAM) cases, exploring clinical, demographic, and therapeutic variables across mostly Asian and partly African countries. A retrospective, cross-sectional analysis of CAM patients from 22 medical centers across eight countries was conducted, focusing on the first 3 months post-COVID-19 diagnosis. Data collected through the ID-IRI included demographics, comorbidities, treatments, and outcomes. A total of 162 CAM patients were included. The mean age was 54.29 ± 13.04 years, with 54% male. Diabetes mellitus (85%) was prevalent, and 91% had rhino-orbital-cerebral mucormycosis. Surgical debridement was performed in 84% of the cases. Mortality was 39%, with advanced age (hazard ratio [HR] = 1.06, [P < .001]), rituximab use (HR = 21.2, P = .05), and diabetic ketoacidosis (HR = 3.58, P = .009) identified as risk factors. The mortality risk increases by approximately 5.6% for each additional year of age. Surgical debridement based on organ involvement correlated with higher survival (HR = 8.81, P < .001). The utilization of rituximab and diabetic ketoacidosis, along with advancing age, has been associated with an increased risk of mortality in CAM patients. A combination of antifungal treatment and surgical intervention has demonstrated a substantial improvement in survival outcomes.
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Affiliation(s)
- Meyha Sahin
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medipol University, Istanbul, Turkey
| | - Mesut Yilmaz
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medipol University, Istanbul, Turkey
| | - Ali Mert
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medipol University, Istanbul, Turkey
| | - Behrouz Naghili
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Ravanbakhsh
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojtaba Varshochi
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ilad Alavi Darazam
- Department of Infectious Diseases and Tropical Medicine, Shahid Beheshti University of Medical Sciences, Loghman Hakim Hospital, Tehran, Iran
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Javad Ebrahimi
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maral Moafi
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Azhdari Tehrani
- Department of Hematology-Medical Oncology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amjad Mahboob
- Department of Medicine, Gajju Khan Medical College, Swabi, Pakistan
| | - Naveed Rashid
- Department of Infectious Diseases, Shifa Tameer-e-Millat University and Shifa International Hospital, Islamabad, Pakistan
| | - Ejaz Ahmed Khan
- Department of Infectious Diseases, Shifa Tameer-e-Millat University and Shifa International Hospital, Islamabad, Pakistan
| | - Atousa Hakamifard
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Infectious Diseases, Isfahan University of Medical Sciences, School of Medicine, Isfahan, Iran
| | - Gülden Eser-Karlidag
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Elazig Fethi Sekin City Hospital, Elazig, Turkey
| | - Abdolreza Babamahmoodi
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amani El-Kholy
- Department of Clinical Pathology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Sayed Hussain Mosawi
- Department of Molecular Research, Medical Sciences Research Center, Ghalib University, Kabul, Afghanistan
| | - Ayşe Albayrak
- Department of Infectious Diseases and Clinical Microbiology, Ataturk University, Faculty of Medicine, Erzurum, Turkey
| | - Jamal Wadi Al Ramahi
- Department of Medicine, Jordan University Hospital, School of Medicine, Amman, Jordan
| | - Syam Kumar Addepalli
- Department of Pharmacology, GITAM Institute of Medical Sciences and Research, Visakhapatnam, Andhra Pradesh, India
| | - Şafak Özer Balin
- Department of Infectious Diseases and Clinical Microbiology, Firat University, Faculty of Medicine, Elazig, Turkey
| | - Asfandiyar Khan
- Department of Cardiology, Lady Reading Hospital, Peshawar, Pakistan
| | - Nirav Pandya
- Consultant Microbiologist & Infection Preventionist Bhailal Amin General Hospital, Vadodara, India
| | - Esra Gurbuz
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Van Training and Research Hospital, Van, Turkey
| | - Gülden Sincan
- Department of Internal Medicine, Ataturk University, Faculty of Medicine, Erzurum, Turkey
| | - Hadia Azami
- Department of Molecular Research, Medical Sciences Research Center, Ghalib University, Kabul, Afghanistan
| | - Rıdvan Dumlu
- Department of Infectious Diseases and Clinical Microbiology, Medipol Mega Hospital, Istanbul, Turkey
| | - Reham Khedr
- Department of Pediatric Oncology, National Cancer Institute, Cairo University, Cairo, Egypt, Department of Pediatric Oncology, Children Cancer Hospital, Cairo, Egypt
| | - Rezaul Karim Ripon
- Department of Public Health and Informatics, Jahangirnagar University, Bangladesh
| | - Sevil Alkan
- Department of Infectious Diseases and Clinical Microbiology, Canakkale Onsekiz Mart University, Faculty of Medicine, Canakkale, Turkey
| | - Şükran Kose
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Bahadır Ceylan
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medipol University, Istanbul, Turkey
| | - Hakan Erdem
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Gulhane School of Medicine, Ankara, Turkey
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Brito C, de Araujo Mariz C, Freitas de Oliveira França R, Lopes EP, Silva LE, Neto RL, Viana IF, Montarroyos U, Duarte C, Lacerda HR, de Brito Ximenes P, de Oliveira Viana RC, Lima RGD, Carneiro APS, Braga C. Clinical-laboratory characteristics predictive of COVID-19 severity: a prospective hospital cohort, in Pernambuco, Northeast Brazil. Braz J Microbiol 2024:10.1007/s42770-024-01382-2. [PMID: 38955981 DOI: 10.1007/s42770-024-01382-2] [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: 01/30/2024] [Accepted: 05/13/2024] [Indexed: 07/04/2024] Open
Abstract
OBJECTIVE To describe the clinical-laboratory profile and analyze the factors associated with the severity of COVID-19. METHODS A prospective cohort study involving patients with COVID-19 admitted to a tertiary hospital in Recife, Brazil. All cases were confirmed by RT-PCR and classified according to severity criteria. A descriptive statistical analysis of the population's characteristics was conducted. Risk factors associated with the outcome of the case according to severity were analyzed by calculating the odds ratio (OR) using the general equation estimation (GEE) model. RESULTS Among the 75 cases included, 64% were female, and 62.7% were aged 65 years or older. The median length of stay was 9 days (6 - 14). Hypertension (65.3%) and Diabetes Mellitus (36%) were the most frequent comorbidities. Severe forms of COVID-19 constituted 41.3% of the sample. The factors associated with severity were a history of asthma (OR=4.58, 95%CI:1.13 - 18.7), report of anorexia (OR=1, 12, 95%CI:1.01-1.24), and laboratory changes that included elevated platelets (OR=1.00, 95% CI:1.00-1.01), elevated D'Dimer (OR=1, 26, 95% CI:1.04-1.52), elevated aspartate aminotransferase (OR=1.00, 95% CI:1.00-1.01), and gamma-glutamyl transferase (OR=1.22, IC95 %:0.98-1.51), hypernatremia (OR=1.31, 95%CI:1.12-1.52), and hyperkalemia (OR=1.21, 95% CI:1.04-1.41). CONCLUSION Multisystemic involvement with a tendency for thrombophilia, electrolyte disturbances, and hepatic aggression, reflected by laboratory changes, were factors associated with the severity of COVID-19.
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Affiliation(s)
- Carlos Brito
- Postgraduate Program in Tropical Medicine, Center of Medical Sciences, Universidade Federal de Pernambuco (UFPE), Recife, Brazil.
- Department of Internal Medicine, Center of Medical Sciences, Universidade Federal de Pernambuco (UFPE), Recife, Brazil.
- Department of Immunology, Autoimune Research Institute, Recife, Pernambuco, Brazil.
| | | | | | - Edmundo Pessoa Lopes
- Postgraduate Program in Tropical Medicine, Center of Medical Sciences, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
- Department of Internal Medicine, Center of Medical Sciences, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
| | - Laura Emanuelle Silva
- Postgraduate Program in Tropical Medicine, Center of Medical Sciences, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
| | - Roberto Lins Neto
- Aggeu Magalhães Institute, Oswaldo Cruz Foundation - FIOCRUZ, Recife, Pernambuco, Brazil
| | - Isabelle Freire Viana
- Aggeu Magalhães Institute, Oswaldo Cruz Foundation - FIOCRUZ, Recife, Pernambuco, Brazil
| | - Ulisses Montarroyos
- Aggeu Magalhães Institute, Oswaldo Cruz Foundation - FIOCRUZ, Recife, Pernambuco, Brazil
| | - Claudio Duarte
- Servidores do Estado Hospital, Recife, Pernambuco, Brazil
| | - Heloisa Ramos Lacerda
- Postgraduate Program in Tropical Medicine, Center of Medical Sciences, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
| | | | | | | | | | - Cynthia Braga
- Aggeu Magalhães Institute, Oswaldo Cruz Foundation - FIOCRUZ, Recife, Pernambuco, Brazil
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Volz PM, Viero VDSF, Saes-Silva E, Vargas BL, Meller FO, Schäfer AA, Paludo SDS, Demenech LM, Neiva-Silva L, Dumith SC. Adherence to social distancing measures in southern Brazil, 2020/2021: a cross-sectional study. EINSTEIN-SAO PAULO 2024; 22:eAO0223. [PMID: 38958337 PMCID: PMC11196087 DOI: 10.31744/einstein_journal/2024ao0223] [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: 09/28/2022] [Accepted: 01/04/2024] [Indexed: 07/04/2024] Open
Abstract
OBJECTIVE We aimed to analyze the frequency of adherence to social distancing and individual protection measures of adult and older populations in two cities in southern Brazil and to characterize the sociodemographic aspects of these individuals. METHODS This cross-sectional, population-based study was conducted in the cities of Rio Grande, RS, and Criciúma, SC, Brazil. The outcome measure was the frequency of adherence to social distancing measures. Fisher's exact test (5% significance) was used to calculate the differences in prevalence according to exposure variables. RESULTS Among the 2,170 participants over the age of 18, the prevalence of adherence to social distancing was 18.5%. Adherence was significantly higher among women; older adults; single, divorced, or widowed people with a low educational level; people of lower socioeconomic status; and people affected by multiple chronic diseases. CONCLUSION Approximately one in five respondents adhered to measures of social distancing, and adherence was more prevalent among the risk groups.
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Affiliation(s)
- Pâmela Moraes Volz
- Universidade Federal do Rio GrandeRio Grande do SulRSBrazilPostgraduate Program in Health Sciences, Universidade Federal do Rio Grande, Rio Grande do Sul, RS, Brazil.
| | | | - Elizabet Saes-Silva
- Universidade Federal do Rio GrandeRio Grande do SulRSBrazilPostgraduate Program in Health Sciences, Universidade Federal do Rio Grande, Rio Grande do Sul, RS, Brazil.
| | - Bianca Languer Vargas
- Universidade Federal do Rio GrandeRio Grande do SulRSBrazilPostgraduate Program in Health Sciences, Universidade Federal do Rio Grande, Rio Grande do Sul, RS, Brazil.
| | - Fernanda Oliveira Meller
- Universidade do Extremo Sul CatarinenseCriciúmaSCBrazilPostgraduate Program in Public Health, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil.
| | - Antônio Augusto Schäfer
- Universidade do Extremo Sul CatarinenseCriciúmaSCBrazilPostgraduate Program in Public Health, Universidade do Extremo Sul Catarinense, Criciúma, SC, Brazil.
| | - Simone dos Santos Paludo
- Universidade Federal do Rio GrandeInstituto de Ciências Humanas e da InformaçãoRio Grande do SulRSBrazilInstituto de Ciências Humanas e da Informação, Universidade Federal do Rio Grande, Rio Grande do Sul, RS, Brazil.
| | - Lauro Miranda Demenech
- Universidade Federal do Rio GrandeInstituto de Ciências Humanas e da InformaçãoRio Grande do SulRSBrazilInstituto de Ciências Humanas e da Informação, Universidade Federal do Rio Grande, Rio Grande do Sul, RS, Brazil.
| | - Lucas Neiva-Silva
- Universidade Federal do Rio GrandeCenter for Psychological StudiesRio Grande do SulRSBrazilCenter for Psychological Studies, Universidade Federal do Rio Grande, Rio Grande do Sul, RS, Brazil.
| | - Samuel Carvalho Dumith
- Universidade Federal do Rio GrandeRio Grande do SulRSBrazilPostgraduate Program in Health Sciences, Universidade Federal do Rio Grande, Rio Grande do Sul, RS, Brazil.
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Christodoulou A, Katsarou MS, Emmanouil C, Gavrielatos M, Georgiou D, Tsolakou A, Papasavva M, Economou V, Nanou V, Nikolopoulos I, Daganou M, Argyraki A, Stefanidis E, Metaxas G, Panagiotou E, Michalopoulos I, Drakoulis N. A Machine Learning-Based Web Tool for the Severity Prediction of COVID-19. BIOTECH 2024; 13:22. [PMID: 39051337 PMCID: PMC11270362 DOI: 10.3390/biotech13030022] [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: 12/31/2023] [Revised: 06/13/2024] [Accepted: 06/20/2024] [Indexed: 07/27/2024] Open
Abstract
Predictive tools provide a unique opportunity to explain the observed differences in outcome between patients of the COVID-19 pandemic. The aim of this study was to associate individual demographic and clinical characteristics with disease severity in COVID-19 patients and to highlight the importance of machine learning (ML) in disease prognosis. The study enrolled 344 unvaccinated patients with confirmed SARS-CoV-2 infection. Data collected by integrating questionnaires and medical records were imported into various classification machine learning algorithms, and the algorithm and the hyperparameters with the greatest predictive ability were selected for use in a disease outcome prediction web tool. Of 111 independent features, age, sex, hypertension, obesity, and cancer comorbidity were found to be associated with severe COVID-19. Our prognostic tool can contribute to a successful therapeutic approach via personalized treatment. Although at the present time vaccination is not considered mandatory, this algorithm could encourage vulnerable groups to be vaccinated.
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Affiliation(s)
- Avgi Christodoulou
- Research Group of Clinical Pharmacology and Pharmacogenomics Faculty of Pharmacy, School oh Health Sciences, National and Kapodistrian University of Athens, 15771 Athens, Greece; (A.C.); (M.-S.K.); (A.T.); (V.E.); (N.D.)
- Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece; (V.N.); (I.N.); (M.D.); (A.A.); (E.S.); (G.M.); (E.P.)
| | - Martha-Spyridoula Katsarou
- Research Group of Clinical Pharmacology and Pharmacogenomics Faculty of Pharmacy, School oh Health Sciences, National and Kapodistrian University of Athens, 15771 Athens, Greece; (A.C.); (M.-S.K.); (A.T.); (V.E.); (N.D.)
| | - Christina Emmanouil
- Centre of Systems Biology, Biomedical Research Foundation, Academy of Athens, 11527 Athens, Greece; (C.E.); (M.G.); (D.G.)
- Department of Biology, National and Kapodistrian University of Athens, 15772 Athens, Greece
- Institute for Bioinnovation, Biomedical Sciences Research Center ‘Alexander Fleming’, 16672 Vari, Greece
| | - Marios Gavrielatos
- Centre of Systems Biology, Biomedical Research Foundation, Academy of Athens, 11527 Athens, Greece; (C.E.); (M.G.); (D.G.)
- Department of Informatics and Telecommunications, National and Kapodistrian University of Athens, 16122 Athens, Greece
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Dimitrios Georgiou
- Centre of Systems Biology, Biomedical Research Foundation, Academy of Athens, 11527 Athens, Greece; (C.E.); (M.G.); (D.G.)
- School of Electrical and Computer Engineering, National and Technical University of Athens, 15773 Athens, Greece
| | - Annia Tsolakou
- Research Group of Clinical Pharmacology and Pharmacogenomics Faculty of Pharmacy, School oh Health Sciences, National and Kapodistrian University of Athens, 15771 Athens, Greece; (A.C.); (M.-S.K.); (A.T.); (V.E.); (N.D.)
| | - Maria Papasavva
- Department of Pharmacy, School of Health Sciences, Frederick University, 1036 Nicosia, Cyprus;
| | - Vasiliki Economou
- Research Group of Clinical Pharmacology and Pharmacogenomics Faculty of Pharmacy, School oh Health Sciences, National and Kapodistrian University of Athens, 15771 Athens, Greece; (A.C.); (M.-S.K.); (A.T.); (V.E.); (N.D.)
| | - Vasiliki Nanou
- Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece; (V.N.); (I.N.); (M.D.); (A.A.); (E.S.); (G.M.); (E.P.)
| | - Ioannis Nikolopoulos
- Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece; (V.N.); (I.N.); (M.D.); (A.A.); (E.S.); (G.M.); (E.P.)
| | - Maria Daganou
- Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece; (V.N.); (I.N.); (M.D.); (A.A.); (E.S.); (G.M.); (E.P.)
| | - Aikaterini Argyraki
- Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece; (V.N.); (I.N.); (M.D.); (A.A.); (E.S.); (G.M.); (E.P.)
| | - Evaggelos Stefanidis
- Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece; (V.N.); (I.N.); (M.D.); (A.A.); (E.S.); (G.M.); (E.P.)
| | - Gerasimos Metaxas
- Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece; (V.N.); (I.N.); (M.D.); (A.A.); (E.S.); (G.M.); (E.P.)
| | - Emmanouil Panagiotou
- Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece; (V.N.); (I.N.); (M.D.); (A.A.); (E.S.); (G.M.); (E.P.)
| | - Ioannis Michalopoulos
- Centre of Systems Biology, Biomedical Research Foundation, Academy of Athens, 11527 Athens, Greece; (C.E.); (M.G.); (D.G.)
| | - Nikolaos Drakoulis
- Research Group of Clinical Pharmacology and Pharmacogenomics Faculty of Pharmacy, School oh Health Sciences, National and Kapodistrian University of Athens, 15771 Athens, Greece; (A.C.); (M.-S.K.); (A.T.); (V.E.); (N.D.)
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Assaf AR, Sidhu GS, Soni A, Cappelleri JC, Draica F, Herbert C, Arham I, Bader M, Jimenez C, Bois M, Silvester E, Meservey J, Eng V, Nelson M, Cai Y, Nangarlia A, Tian Z, Liu Y, Watt S. Cross-Sectional Survey of Factors Contributing to COVID-19 Testing Hesitancy Among US Adults at Risk of Severe Outcomes from COVID-19. Infect Dis Ther 2024; 13:1683-1701. [PMID: 38869840 PMCID: PMC11219613 DOI: 10.1007/s40121-024-01001-5] [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: 02/01/2024] [Accepted: 05/29/2024] [Indexed: 06/14/2024] Open
Abstract
INTRODUCTION The United States Centers for Disease Control and Prevention (CDC) advises testing individuals for COVID-19 after exposure or if they display symptoms. However, a deeper understanding of demographic factors associated with testing hesitancy is necessary. METHODS A US nationwide cross-sectional survey of adults with risk factors for developing severe COVID-19 ("high-risk" individuals) was conducted from August 18-September 5, 2023. Objectives included characterizing demographics and attitudes associated with COVID-19 testing. Inverse propensity weighting was used to weight the data to accurately reflect the high-risk adult US population as reflected in IQVIA medical claims data. We describe here the weighted results modeled to characterize demographic factors driving hesitancy. RESULTS In the weighted sample of 5019 respondents at high risk for severe COVID-19, 58.2% were female, 37.8% were ≥ 65 years old, 77.1% were White, and 13.9% had a postgraduate degree. Overall, 67% were Non-testers (who indicated that they were unlikely or unsure of their likelihood of being tested within the next 6 months); these respondents were significantly more likely than Testers (who indicated a higher probability of testing within 6 months) to be female (60.2 vs. 54.1%; odds ratio [OR] [95% confidence interval (CI)], 1.3 [1.1‒1.4]), aged ≥ 65 years old (41.5 vs. 30.3%; OR [95% CI] compared with ages 18‒34 years, 0.6 [0.5‒0.7]), White (82.1 vs. 66.8%; OR [95% CI], 1.4 [1.1‒1.8]), and to identify as politically conservative (40.9 vs. 18.1%; OR [95% CI], 2.6 [2.3‒2.9]). In contrast, Testers were significantly more likely than Non-testers to have previous experience with COVID-19 testing, infection, or vaccination; greater knowledge regarding COVID-19 and testing; greater healthcare engagement; and concerns about COVID-19. CONCLUSIONS Older, female, White, rural-dwelling, and politically conservative high-risk adults are the most likely individuals to experience COVID-19 testing hesitancy. Understanding these demographic factors will help guide strategies to improve US testing rates.
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Affiliation(s)
- Annlouise R Assaf
- Global Medical Patient Impact Assessment, Worldwide Medical and Safety, Pfizer Inc, Groton, CT, USA
- Brown University School of Public Health, Providence, RI, USA
| | - Gurinder S Sidhu
- US Medical Affairs, Pfizer Inc, 537 Alandele Ave, Los Angeles, CA, 90036, USA.
| | - Apurv Soni
- Program in Digital Medicine, University of Massachusetts, North Worcester, MA, USA
| | | | | | - Carly Herbert
- Program in Digital Medicine, University of Massachusetts, North Worcester, MA, USA
| | - Iqra Arham
- US Medical Affairs, Pfizer Inc, New York, NY, USA
| | - Mehnaz Bader
- Global Medical Patient Impact Assessment, Worldwide Medical and Safety, Pfizer Inc, New York, NY, USA
| | - Camille Jimenez
- Global Medical Grants/Institute of Translational Equitable Medicine, Worldwide Medical and Safety, Pfizer Inc, New York, NY, USA
| | - Michael Bois
- US Medical Affairs, Pfizer Inc, New York, NY, USA
| | | | | | - Valerie Eng
- Strategy Consulting, IQVIA, New York, NY, USA
| | | | - Yong Cai
- Advanced Analytics, IQVIA, Wayne, PA, USA
| | | | - Zhiyi Tian
- Advanced Analytics, IQVIA, Wayne, PA, USA
| | | | - Stephen Watt
- Global Medical Patient Impact Assessment, Worldwide Medical and Safety, Pfizer Inc, New York, NY, USA
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18
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Alsaffar SF, Baqer NN. Association between Methylenetetrahydrofolate Reductase ( MTHFR) and 5-Methyltetrahydrofolate-Homocysteine Methyltransferase Reductase ( MTRR) Polymorphisms in Iraqi Patients with COVID-19. IRANIAN JOURNAL OF MEDICAL SCIENCES 2024; 49:430-440. [PMID: 39114635 PMCID: PMC11300940 DOI: 10.30476/ijms.2023.99555.3162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 08/20/2023] [Accepted: 09/15/2023] [Indexed: 08/10/2024]
Abstract
Background The methylenetetrahydrofolate reductase (MTHFR) gene is an essential gene in the metabolism of folate-homocysteine. Recently, the level of homocysteine was found to be a significant marker in the follow-up of COVID-19 infection. Thus, this study aimed to detect the effect of genetic polymorphisms for single nucleotide polymorphisms (SNPs) (c.66A>G, c.1298A>C, and c.677CT) on COVID-19 infection. Methods Blood samples were collected from 270 patients with COVID-19 in the medical center of Al-Shifa (Baghdad, Iraq) from November 2020 to March 2021. Tetra-primer amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) technique was used for the detection of genotypes of SNPs. The odds ratio (OR) was used to detect the relationship between SNPs and COVID-19 infections. Haplotype analysis was performed by SHEsis software. Results There was a significant difference between mild/moderate cases and severe/critical cases for ages (35-45), (46-55), and (56-65) years (P<0.0001, P=0.01, and P=0.006, respectively). The results showed significant differences in the T allele for SNP c.677>C (P<0.0001 and OR=4.58). The C allele for SNP c.1298A>C indicated significant differences (P<0.001 and OR=3.15). Besides, the G allele for SNP c.677C>T showed significant differences (P<0.001 and OR=6.64). Consequently, these SNPs showed a predisposition to the development of COVID-19 infection. With regard to the C-A-A, T-A-A and T-C-G haplotypes indicated significant differences between the control and patient groups. The C-A-A was related to a decreased risk and indicated a protective effect against COVID-19 infection development (P<0.0001 and OR=0.218). The increased risk was associated with T-A-A and T-C-G haplotypes and indicated the risk impact on COVID-19 infection development (P<0.0001, P=0.004, and OR=15.5, OR=6.772, respectively). Furthermore, the linkage disequilibrium (LD) for SNPs was studied, and the complete D' value was 99. Conclusion The genetic polymorphisms of SNPs (c.66A>G, c.1298A>C, and c.677C>T) in the Iraqi population were associated with COVID-19 infection.
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Affiliation(s)
- Sura F. Alsaffar
- Department of Biology, College of Science, University of Baghdad, Baghdad, Iraq
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19
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Zhao F, Wang M, Zhou Q, Du Y, Cheng Q, Sun X, Zhang J, Liang Y, Shen N, Sun Y. Analysis of risk factors for weaning failure from mechanical ventilation in critically ill older patients with coronavirus disease 2019. Heliyon 2024; 10:e32835. [PMID: 38975064 PMCID: PMC11225823 DOI: 10.1016/j.heliyon.2024.e32835] [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: 01/15/2024] [Revised: 06/09/2024] [Accepted: 06/10/2024] [Indexed: 07/09/2024] Open
Abstract
Objective This study aimed to investigate the factors influencing weaning failure from invasive mechanical ventilation (IMV) in critically ill older patients with coronavirus disease 2019 (COVID-19). Methods We enrolled critically ill older patients with COVID-19 who were admitted to the medical intensive care unit (ICU) and received IMV between December 2022 and June 2023. Results We included 68 critically ill older patients with COVID-19 (52 male [76.5 %] and 16 female individuals [23.5 %]). The patients' median age (interquartile range) was 75.5 (70.3-82.8) years. The median length of ICU stay was 11.5 (7.0-17.8) days; 34 cases (50.0 %) were successfully weaned from IMV. The successfully weaned group had a higher proportion of underlying chronic obstructive pulmonary disease [6 (17.6 %) vs. 0, P = 0.033] and fewer cases of diabetes [7 (20.6 %) vs. 16 (47.1 %), P = 0.021] compared with the weaning failure group. Serum lactate levels [1.5 (1.2-2.3) vs. 2.6 (1.9-3.1) mmol/L, P < 0.001], blood urea nitrogen [8.2 (6.3-14.4) vs. 11.4 (8.0-21.3) mmol/L, P = 0.033], Acute Physiology and Chronic Health Evaluation (APACHE) II score [19.0 (12.0-23.3) vs. 22.5 (16.0-29.3), P = 0.014], and hospitalization days before endotracheal intubation [1.0 (0.0-5.0) vs. 3.0 (0.0-11.0), P = 0.023] were significantly decreased in the successfully weaned group, whereas PaO2/FiO2 [148.3 (94.6-200.3) vs. 101.1 (67.0-165.1), P = 0.038] and blood lymphocyte levels [0.6 (0.4-1.0) vs. 0.5 (0.2-0.6) 109/L, P = 0.048] were significantly increased, compared with the weaning failure group. Multivariate logistic regression analysis showed that diabetes (OR= 3.413, 95 %CI 1.029-11.326), P = 0.045), APACHE II Score (OR = 1.089, 95 % CI 1.008-1.175), P = 0.030), and hospitalization days before endotracheal intubation (OR = 1.137, 95 % CI 1.023-1.264), P = 0.017) were independent risk factors for weaning failure. Conclusion In critically ill older patients with COVID-19 with diabetes, higher APACHE II Score, and longer hospitalization days before endotracheal intubation, weaning from IMV was more challenging. The study could help develop strategies for improving COVID-19 treatment.
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Affiliation(s)
- Feifan Zhao
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Meng Wang
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Qingtao Zhou
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Yipeng Du
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Qin Cheng
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Xiaoyan Sun
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Jing Zhang
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Ying Liang
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Ning Shen
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Yongchang Sun
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, China
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20
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Bersano-Reyes PA, Nieto G, Cana-Poyatos A, Guerrero Sanz P, García-Maset R, García-Testal A. Nutritional status and its relationship with COVID-19 prognosis in hemodialysis patients. NUTR HOSP 2024; 41:628-635. [PMID: 38666342 DOI: 10.20960/nh.04850] [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] [Indexed: 06/28/2024] Open
Abstract
Introduction Introduction: among the groups more affected by the COVID-19 pandemic were patients undergoing chronic hemodialysis (HD) treatment due to their comorbidities, advanced age, impaired innate and adaptive immune function, and increased nutritional risk due to their underlying inflammatory state. All of these factors contribute to a higher risk of severe complications and worse outcomes compared to the general population when infected with SARS-CoV-2. Objective: the objective of this study was to describe the nutritional characteristics of and their potential association with the prognosis of COVID-19 in patients undergoing chronic HD treatment. Method: a descriptive, retrospective, observational design. All cases of COVID-19 in patients undergoing chronic treatment at the Hemodialysis Unit of Hospital de Manises, Valencia, Spain, from the start of the pandemic to before vaccination were included. Results: for that, 189 patients were studied, who received chronic HD treatment in the hospital unit, 22 patients were diagnosed with COVID-19 (12 %) in that period. The mean age was 71 years, 10 were women, the Charlson index was 6.59 points, diabetes mellitus 10, vintage HD 51.6 months, 2 patients had previously received a currently non-functioning kidney transplant, 16 had arteriovenous fistula as vascular access, and 6 had central vascular access. The mean dialysis session time was 220.14 minutes and the initial value of the single dose of the Kt/V pool was 1.7. 16 patients had body composition measurement, a strong association (p < 0.05) was identified between mortality and BMI, as well as mortality and FTI. Furthermore, the differences between deceased and surviving groups in the serum levels of various variables related to nutritional status were analyzed, finding significant differences with p < 0.05 in the value of triglycerides and ferritin. Conclusions: higher body mass index and higher body fat content, along with lower baseline levels of triglycerides and ferritin, were significantly associated with higher COVID-19 mortality in patients on chronic hemodialysis. These findings suggest that the initial nutritional status of these patients can significantly influence the prognosis of SARS-CoV-2 infection.
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Affiliation(s)
| | - Gema Nieto
- Department of Food Technology, Food Science, and Nutrition. Universidad de Murcia
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21
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Lou X, Gao C, Wu L, Wu T, He L, Shen J, Hua M, Xu M. Prediction of short-term progression of COVID-19 pneumonia based on chest CT artificial intelligence: during the Omicron epidemic. BMC Infect Dis 2024; 24:595. [PMID: 38886649 PMCID: PMC11181585 DOI: 10.1186/s12879-024-09504-9] [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: 09/06/2023] [Accepted: 06/12/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND AND PURPOSE The persistent progression of pneumonia is a critical determinant of adverse outcomes in patients afflicted with COVID-19. This study aimed to predict personalized COVID-19 pneumonia progression between the duration of two weeks and 1 month after admission by integrating radiological and clinical features. METHODS A retrospective analysis, approved by the Institutional Review Board, encompassed patients diagnosed with COVID-19 pneumonia between December 2022 and February 2023. The cohort was divided into training and validation groups in a 7:3 ratio. A trained multi-task U-Net network was deployed to segment COVID-19 pneumonia and lung regions in CT images, from which quantitative features were extracted. The eXtreme Gradient Boosting (XGBoost) algorithm was employed to construct a radiological model. A clinical model was constructed by LASSO method and stepwise regression analysis, followed by the subsequent construction of the combined model. Model performance was assessed using ROC and decision curve analysis (DCA), while Shapley's Additive interpretation (SHAP) illustrated the importance of CT features. RESULTS A total of 214 patients were recruited in our study. Four clinical characteristics and four CT features were identified as pivotal components for constructing the clinical and radiological models. The final four clinical characteristics were incorporated as well as the RS_radiological model to construct the combined prediction model. SHAP analysis revealed that CT score difference exerted the most significant influence on the predictive performance of the radiological model. The training group's radiological, clinical, and combined models exhibited AUC values of 0.89, 0.72, and 0.92, respectively. Correspondingly, in the validation group, these values were observed to be 0.75, 0.72, and 0.81. The DCA curve showed that the combined model exhibited greater clinical utility than the clinical or radiological models. CONCLUSION Our novel combined model, fusing quantitative CT features with clinical characteristics, demonstrated effective prediction of COVID-19 pneumonia progression from 2 weeks to 1 month after admission. This comprehensive model can potentially serve as a valuable tool for clinicians to develop personalized treatment strategies and improve patient outcomes.
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Affiliation(s)
- Xinjing Lou
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Hangzhou, Zhejiang, 310006, China
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, 548 Binwen Road, Hangzhou, Zhejiang, 310053, China
| | - Chen Gao
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Hangzhou, Zhejiang, 310006, China
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, 548 Binwen Road, Hangzhou, Zhejiang, 310053, China
| | - Linyu Wu
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Hangzhou, Zhejiang, 310006, China
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, 548 Binwen Road, Hangzhou, Zhejiang, 310053, China
| | - Ting Wu
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Hangzhou, Zhejiang, 310006, China
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, 548 Binwen Road, Hangzhou, Zhejiang, 310053, China
| | - Linyang He
- Hangzhou Jianpei Technology Company Ltd. Xiaoshan District, Hangzhou, Zhejiang, 311200, China
| | - Jiahao Shen
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Hangzhou, Zhejiang, 310006, China
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, 548 Binwen Road, Hangzhou, Zhejiang, 310053, China
| | - Meiqi Hua
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Hangzhou, Zhejiang, 310006, China
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, 548 Binwen Road, Hangzhou, Zhejiang, 310053, China
| | - Maosheng Xu
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Hangzhou, Zhejiang, 310006, China.
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, 548 Binwen Road, Hangzhou, Zhejiang, 310053, China.
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22
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Zhou HH, Tang YL, Xu TH, Cheng B. C-reactive protein: structure, function, regulation, and role in clinical diseases. Front Immunol 2024; 15:1425168. [PMID: 38947332 PMCID: PMC11211361 DOI: 10.3389/fimmu.2024.1425168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 06/03/2024] [Indexed: 07/02/2024] Open
Abstract
C-reactive protein (CRP) is a plasma protein that is evolutionarily conserved, found in both vertebrates and many invertebrates. It is a member of the pentraxin superfamily, characterized by its pentameric structure and calcium-dependent binding to ligands like phosphocholine (PC). In humans and various other species, the plasma concentration of this protein is markedly elevated during inflammatory conditions, establishing it as a prototypical acute phase protein that plays a role in innate immune responses. This feature can also be used clinically to evaluate the severity of inflammation in the organism. Human CRP (huCRP) can exhibit contrasting biological functions due to conformational transitions, while CRP in various species retains conserved protective functions in vivo. The focus of this review will be on the structural traits of CRP, the regulation of its expression, activate complement, and its function in related diseases in vivo.
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Affiliation(s)
- Hai-Hong Zhou
- Centre for Translational Medicine, Gansu Provincial Academic Institute for Medical Research, Lanzhou, China
- Centre for Translational Medicine, Gansu Provincial Cancer Hospital, Lanzhou, China
- Centre for Translational Medicine, Sun Yat-sen University Cancer Center Gansu Hospital, Lanzhou, China
| | - Yu-Long Tang
- Ministry of Education (MOE), Key Laboratory of Cell Activities and Stress Adaptations, School of Life Sciences, Lanzhou University, Lanzhou, China
| | - Tian-Hao Xu
- Ministry of Education (MOE), Key Laboratory of Cell Activities and Stress Adaptations, School of Life Sciences, Lanzhou University, Lanzhou, China
| | - Bin Cheng
- Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Research Unit of Peptide Science, Chinese Academy of Medical Sciences, Lanzhou University, Lanzhou, China
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23
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Rohweder R, Pereira NG, Micheletti BH, Mosello J, Campos JRM, Pereira MG, Santos CN, Simões NL, Matielo RLB, Bernardes LS, Oppermann MLR, Wender MCO, Lupattelli A, Nordeng H, Schuler-Faccini L. Medication Use Among Pregnant Women With SARS-CoV-2 Infection and Risk of Hospitalization-A Study in Two Brazilian Hospitals. J Pregnancy 2024; 2024:8915166. [PMID: 39021875 PMCID: PMC11254464 DOI: 10.1155/2024/8915166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 07/20/2024] Open
Abstract
There is limited evidence about the use of medications among pregnant women with COVID-19, as well as risk factors for hospitalization due to COVID-19 in pregnancy. We aimed to describe the use of medications among SARS-CoV-2-positive pregnant women at the time around infection and identify predictors for hospitalization due to COVID-19 in two hospitals in Brazil. This is a hospital record-based study among pregnant women with positive SARS-CoV-2 tests between March 2020 and August 2022 from two Brazilian hospitals. Characteristics of sociodemographic, obstetrical, and COVID-19 symptoms were extracted retrospectively. The prevalence use of medications was based on self-reported use, and this was administered at the hospital. Logistic regression was used to estimate predictors of hospitalization due to COVID-19. There were 278 pregnant women included in the study, of which 41 (14.7%) required hospitalization due to COVID-19. The remaining 237 (85.3%) had mild symptoms or were asymptomatic. Most of the women had the infection in the third trimester (n = 149; 53.6%). The most prevalent medications used across all trimesters were analgesics (2.4% to 20.0%), antibacterials (15.0% to 23.1%), and corticosteroids (7.2% to 10.4%). Pre- or gestational hypertensive disorder (odds ratio (OR) 4.94, 95% confidence interval (CI) 1.65, 14.87) and having at least one dose of vaccine against SARS-CoV-2 (OR 0.13, 95% CI 0.04, 0.39) were associated with hospitalization due to COVID-19. Analgesics, antibacterials, and corticosteroids were the most frequently used medications among pregnant women with COVID-19. Women with hypertensive disorders have almost a five-fold increased risk of hospitalization due to COVID-19. Vaccination was the strongest protective factor for severe COVID-19. The COVID-19 vaccination among pregnant women should be promoted, and pregnant women diagnosed with COVID-19 who have hypertensive disorders should be closely monitored.
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Affiliation(s)
- Ricardo Rohweder
- Graduate Program in Genetics and Molecular BiologyDepartment of GeneticsUniversidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Natálya G. Pereira
- Department of Obstetrics and NeonatologyHospital e Maternidade SEPACO, São Paulo, Brazil
| | - Bruna H. Micheletti
- Department of Obstetrics and NeonatologyHospital e Maternidade SEPACO, São Paulo, Brazil
| | - Jéssica Mosello
- Department of Obstetrics and NeonatologyHospital e Maternidade SEPACO, São Paulo, Brazil
| | - Júlia R. M. Campos
- Department of Obstetrics and NeonatologyHospital e Maternidade SEPACO, São Paulo, Brazil
| | - Matheus G. Pereira
- Department of Obstetrics and NeonatologyHospital e Maternidade SEPACO, São Paulo, Brazil
| | - Cristina N. Santos
- Department of Obstetrics and NeonatologyHospital e Maternidade SEPACO, São Paulo, Brazil
| | - Natália L. Simões
- Department of Obstetrics and NeonatologyHospital e Maternidade SEPACO, São Paulo, Brazil
| | - Regina L. B. Matielo
- Department of Obstetrics and NeonatologyHospital e Maternidade SEPACO, São Paulo, Brazil
| | - Lisandra S. Bernardes
- Department of Obstetrics and NeonatologyHospital e Maternidade SEPACO, São Paulo, Brazil
- Center for Klinisk Forskning and Afdeling for Kvindesygdomme, Graviditet og FødselNorth Denmark Regional Hospital, Hjørring, Denmark
| | - Maria L. R. Oppermann
- Gynecology and Obstetrics ServiceHospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Maria C. O. Wender
- Gynecology and Obstetrics ServiceHospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Angela Lupattelli
- PharmacoEpidemiology and Drug Safety Research GroupDepartment of PharmacyUniversity of Oslo, Oslo, Norway
| | - Hedvig Nordeng
- PharmacoEpidemiology and Drug Safety Research GroupDepartment of PharmacyUniversity of Oslo, Oslo, Norway
| | - Lavinia Schuler-Faccini
- Graduate Program in Genetics and Molecular BiologyDepartment of GeneticsUniversidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Vera-Delgado V, García-Rosado D, Pérez-Hernández O, Martín-Ponce E, de La Paz-Estrello AM, García-Marichal C, Pérez-Fernández S, Rodríguez-Morón V, Alemán-Valls R, González-Reimers E, Martín-González C. Mortality and COVID Infection: Predictors of Mortality 10 Months after Discharge. Diseases 2024; 12:123. [PMID: 38920555 PMCID: PMC11203287 DOI: 10.3390/diseases12060123] [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: 05/11/2024] [Revised: 05/22/2024] [Accepted: 05/27/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND The long-term survival of patients hospitalized with COVID-19 and the factors associated with poorer survival months after infection are not well understood. The aims of the present study were to analyze the overall mortality 10 months after admission. METHODS 762 patients with COVID-19 disease were included. Patients underwent a complete clinical evaluation, routine laboratory analysis and chest X-ray. Data collected included demographic and clinical data, such as vascular risk factors, tobacco or alcohol use, comorbidity, and institutionalization. RESULTS Ten-month mortality was 25.6%: 108 deaths occurred in-hospital, while 87 patients died after discharge. In-hospital mortality was independently related to NT-proBNP values > 503.5 pg/mL [OR = 4.67 (2.38-9.20)], urea > 37 mg/dL [3.21 (1.86-7.31)] and age older than 71 years [OR = 1.93 (1.05-3.54)]. NT-proBNP values > 503.5 pg/mL [OR = 5.00 (3.06-8.19)], urea > 37 mg/dL [3.51 (1.97-6.27)], cognitive impairment [OR = 1.96 (1.30-2.95), cancer [OR = 2.23 (1.36-3.68), and leukocytes > 6330/mm3 [OR = 1.64 (1.08-2.50)], were independently associated with long-term mortality. CONCLUSIONS the risk of death remains high even months after COVID-19 infection. Overall mortality of COVID-19 patients during 10 months after hospital discharge is nearly as high as that observed during hospital admission. Comorbidities such as cancer or cognitive impairment, organ dysfunction and inflammatory reaction are independent prognostic markers of long-term mortality.
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Affiliation(s)
- Víctor Vera-Delgado
- Servicio de Medicina Interna, Hospital Universitario de Canarias, 38320 San Cristóbal de La Laguna, Spain; (V.V.-D.); (D.G.-R.); (O.P.-H.); (E.M.-P.); (A.M.d.L.P.-E.); (S.P.-F.); (V.R.-M.); (R.A.-V.)
| | - Dácil García-Rosado
- Servicio de Medicina Interna, Hospital Universitario de Canarias, 38320 San Cristóbal de La Laguna, Spain; (V.V.-D.); (D.G.-R.); (O.P.-H.); (E.M.-P.); (A.M.d.L.P.-E.); (S.P.-F.); (V.R.-M.); (R.A.-V.)
| | - Onán Pérez-Hernández
- Servicio de Medicina Interna, Hospital Universitario de Canarias, 38320 San Cristóbal de La Laguna, Spain; (V.V.-D.); (D.G.-R.); (O.P.-H.); (E.M.-P.); (A.M.d.L.P.-E.); (S.P.-F.); (V.R.-M.); (R.A.-V.)
| | - Esther Martín-Ponce
- Servicio de Medicina Interna, Hospital Universitario de Canarias, 38320 San Cristóbal de La Laguna, Spain; (V.V.-D.); (D.G.-R.); (O.P.-H.); (E.M.-P.); (A.M.d.L.P.-E.); (S.P.-F.); (V.R.-M.); (R.A.-V.)
| | - Alejandro Mario de La Paz-Estrello
- Servicio de Medicina Interna, Hospital Universitario de Canarias, 38320 San Cristóbal de La Laguna, Spain; (V.V.-D.); (D.G.-R.); (O.P.-H.); (E.M.-P.); (A.M.d.L.P.-E.); (S.P.-F.); (V.R.-M.); (R.A.-V.)
| | | | - Sergio Pérez-Fernández
- Servicio de Medicina Interna, Hospital Universitario de Canarias, 38320 San Cristóbal de La Laguna, Spain; (V.V.-D.); (D.G.-R.); (O.P.-H.); (E.M.-P.); (A.M.d.L.P.-E.); (S.P.-F.); (V.R.-M.); (R.A.-V.)
| | - Valle Rodríguez-Morón
- Servicio de Medicina Interna, Hospital Universitario de Canarias, 38320 San Cristóbal de La Laguna, Spain; (V.V.-D.); (D.G.-R.); (O.P.-H.); (E.M.-P.); (A.M.d.L.P.-E.); (S.P.-F.); (V.R.-M.); (R.A.-V.)
| | - Remedios Alemán-Valls
- Servicio de Medicina Interna, Hospital Universitario de Canarias, 38320 San Cristóbal de La Laguna, Spain; (V.V.-D.); (D.G.-R.); (O.P.-H.); (E.M.-P.); (A.M.d.L.P.-E.); (S.P.-F.); (V.R.-M.); (R.A.-V.)
- Departamento de Medicina Interna, Dermatología y Psiquiatría, Universidad de La Laguna, 38320 San Cristóbal de La Laguna, Spain;
| | - Emilio González-Reimers
- Departamento de Medicina Interna, Dermatología y Psiquiatría, Universidad de La Laguna, 38320 San Cristóbal de La Laguna, Spain;
| | - Candelaria Martín-González
- Servicio de Medicina Interna, Hospital Universitario de Canarias, 38320 San Cristóbal de La Laguna, Spain; (V.V.-D.); (D.G.-R.); (O.P.-H.); (E.M.-P.); (A.M.d.L.P.-E.); (S.P.-F.); (V.R.-M.); (R.A.-V.)
- Departamento de Medicina Interna, Dermatología y Psiquiatría, Universidad de La Laguna, 38320 San Cristóbal de La Laguna, Spain;
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La-Beck NM, Lee YR, Patel J, Yang H, Stout M, Kologey A, Ruesewald A, Alvarez CA. Clinical Characteristics and Patterns of Immune Responses in COVID-19 Patients From a Rural Community Hospital. Cureus 2024; 16:e61600. [PMID: 38962589 PMCID: PMC11221625 DOI: 10.7759/cureus.61600] [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: 05/30/2024] [Indexed: 07/05/2024] Open
Abstract
Background Although demographic and clinical factors such as age, certain comorbidities, and sex have been associated with COVID-19 outcomes, these studies were largely conducted in urban populations affiliated with large academic medical centers. There have been very few studies focusing on rural populations that also characterize broader changes in inflammatory cytokines and chemokines. Methodology A single-center study was conducted between June 2020 and March 2021 in Abilene, Texas, USA. Patients were included if they presented to the hospital for treatment of COVID-19, had extra biological materials from routine care available, and were between the ages of 0 to 110 years. There were no exclusion criteria. Patient characteristics, symptom presentation, and clinical laboratory results were extracted from electronic health records. Blood specimens were analyzed by protein microarray to quantitate 40 immunological biomarkers. Results A total of 122 patients were enrolled, of whom 81 (66%) were admitted to the general non-critical inpatient unit, 37 (30%) were admitted to the intensive or critical care units, and four (3.2%) were treated outpatient. Most hospitalized COVID-19 patients in this rural population were elderly, male, obese, and retired individuals. Predominant symptoms for non-critical patients were shortness of breath, fever, and fatigue. Ferritin levels for outpatient patients were lower on average than those in an inpatient setting and lactate dehydrogenase (LDH) levels were noted to be lower in non-critical and outpatient than those in the intensive care unit setting. Inflammatory biomarkers were positively correlated and consistent with inflammatory cascade. Interleukin (IL)-10 was positively correlated while platelet-derived growth factor was negatively correlated with inflammatory biomarkers. Patients ≥65 years had significantly higher levels of LDH and seven cytokines/chemokines (granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin IL-1b, IL-6, IL-10, IL-11, macrophage inflammatory protein (MIP)-1d, and IL-8) while levels of five other immune molecules (intercellular adhesion molecule 1 (ICAM-1), monocyte chemoattractant protein 1 (MCP-1), tissue inhibitor of metalloproteinase 2 (TIMP-2), IL-2, and IL-4) were significantly lower compared to those <65 years. Females had significantly higher levels of LDH and 10 cytokines/chemokines (GM-CSF, IL-1b, IL-6, IL-10, IL-11, IL-15, IL-16, MIP-1a, MIP-1d, and IL-8) while levels of TIMP-2 and IL-4 were significantly lower than male patients. Conclusions The clinical characteristics of this rural cohort of hospitalized patients differed somewhat from nationally reported data. The contributions of social, environmental, and healthcare access factors should be investigated. We identified age and sex-associated differences in immunological response markers that warrant further investigation to identify the underlying molecular mechanisms and impact on COVID-19 pathogenesis.
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Affiliation(s)
- Ninh M La-Beck
- Department of Immunotherapeutics and Biotechnology, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center, Abilene, USA
- Center of Excellence in Real-World Evidence, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center, Dallas, USA
| | - Young R Lee
- Ben and Maytee Fisch College of Pharmacy, University of Texas at Tyler, Tyler, USA
| | - Jalpa Patel
- Department of Immunotherapeutics and Biotechnology, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center, Abilene, USA
| | - Hui Yang
- Department of Pharmacy Practice, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center, Dallas, USA
- Center of Excellence in Real-World Evidence, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center, Dallas, USA
| | - Michal Stout
- Ben and Maytee Fisch College of Pharmacy, University of Texas at Tyler, Tyler, USA
| | - Alanna Kologey
- Ben and Maytee Fisch College of Pharmacy, University of Texas at Tyler, Tyler, USA
| | - Amanda Ruesewald
- Ben and Maytee Fisch College of Pharmacy, University of Texas at Tyler, Tyler, USA
| | - Carlos A Alvarez
- Department of Pharmacy Practice, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center, Dallas, USA
- Center of Excellence in Real-World Evidence, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center, Dallas, USA
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Hoenigsperger H, Sivarajan R, Sparrer KM. Differences and similarities between innate immune evasion strategies of human coronaviruses. Curr Opin Microbiol 2024; 79:102466. [PMID: 38555743 DOI: 10.1016/j.mib.2024.102466] [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: 01/11/2024] [Revised: 02/20/2024] [Accepted: 03/12/2024] [Indexed: 04/02/2024]
Abstract
So far, seven coronaviruses have emerged in humans. Four recurring endemic coronaviruses cause mild respiratory symptoms. Infections with epidemic Middle East respiratory syndrome-related coronavirus or severe acute respiratory syndrome coronavirus (SARS-CoV)-1 are associated with high mortality rates. SARS-CoV-2 is the causative agent of the coronavirus disease 2019 pandemic. To establish an infection, coronaviruses evade restriction by human innate immune defenses, such as the interferon system, autophagy and the inflammasome. Here, we review similar and distinct innate immune manipulation strategies employed by the seven human coronaviruses. We further discuss the impact on pathogenesis, zoonotic emergence and adaptation. Understanding the nature of the interplay between endemic/epidemic/pandemic coronaviruses and host defenses may help to better assess the pandemic potential of emerging coronaviruses.
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Affiliation(s)
- Helene Hoenigsperger
- Institute of Molecular Virology, Ulm University Medical Center, 89081 Ulm, Germany
| | - Rinu Sivarajan
- Institute of Molecular Virology, Ulm University Medical Center, 89081 Ulm, Germany
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Deng X, Tang K, Wang Z, He S, Luo Z. Impacts of Inflammatory Cytokines Variants on Systemic Inflammatory Profile and COVID-19 Severity. J Epidemiol Glob Health 2024; 14:363-378. [PMID: 38376765 PMCID: PMC11176143 DOI: 10.1007/s44197-024-00204-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: 07/03/2023] [Accepted: 01/30/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Cytokine storm is known to impact the prognosis of coronavirus disease 2019 (COVID-19), since pro-inflammatory cytokine variants are associated with cytokine storm. It is tempting to speculate that pro-inflammatory cytokines variants may impact COVID-19 outcomes by modulating cytokine storm. Here, we verified this hypothesis via a comprehensive analysis. METHODS PubMed, Cochrane Library, Central, CINAHL, and ClinicalTrials.gov were searched until December 15, 2023. Case-control or cohort studies that investigated the impacts of rs1800795 or rs1800629 on COVID-19 susceptibility, severity, mortality, IL-6, TNF-α, or CRP levels were included after an anonymous review by two independent reviewers and consultations of disagreement by a third independent reviewer. RESULTS 47 studies (8305 COVID-19 individuals and 17,846 non-COVID-19 individuals) were analyzed. The rs1800629 A allele (adenine at the -308 position of the promoter was encoded by the A allele) was associated with higher levels of tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP). In contrast, the rs1800795 C allele (cytosine at the -174 position of the promoter was encoded by the C allele) was linked to higher levels of interleukin-6 (IL-6) and CRP. In addition, the A allele of rs1800629 increased the severity and mortality of COVID-19. However, the C allele of rs1800795 only increased COVID-19 susceptibility. CONCLUSIONS rs1800629 and rs1800795 variants of pro-inflammatory cytokines have significant impacts on systemic inflammatory profile and COVID-19 clinical outcomes. rs1800629 may serve as a genetic marker for severe COVID-19.
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Affiliation(s)
- XueJun Deng
- Department of Cardiology, Suining Central Hospital, Suining, 629000, Sichuan, China
| | - Kai Tang
- Department of Cardiology, Suining Central Hospital, Suining, 629000, Sichuan, China
| | - Zhiqiang Wang
- Orthopedic Center 1 Department of Orthopedic Trauma, Suining Central Hospital, Suining, Sichuan, China.
| | - Suyu He
- The Fourth Department of Digestive Disease Center, Suining Central Hospital, Suining, 629000, Sichuan, China.
| | - Zhi Luo
- Department of Cardiology, Suining Central Hospital, Suining, 629000, Sichuan, China.
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Qadar SMZ, Naz H, Shamim S, Hashim F, Ahmed S, Kumar Mehraj S. Prevalence of Obesity and its Effects in Patients With COVID-19: A Systematic Review and Meta-analysis. Hosp Pharm 2024; 59:341-348. [PMID: 38764990 PMCID: PMC11097928 DOI: 10.1177/00185787231220318] [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: 05/21/2024]
Abstract
Background: Coronavirus disease 2019 (COVID-19) is an emerging infectious disease worldwide. Obesity has been proven to increase the susceptibility of an individual to infections, but the relationship between obesity and COVID-19 is still unclear. This study aimed to conduct a systematic review and meta-analysis of the prevalence of obesity and its effects in patients with COVID-19. Methods: Web of Science, PubMed and Embase were searched for English language studies up to May 22, 2020. We used a random or fixed-effects model to calculate pooled prevalence rates and odds ratio (OR) with 95% confidence intervals (CI). Results: Twelve studies with a total of 14 364 patients met the inclusion criteria. The pooled prevalence of obesity in patients with COVID-19 was 32.0% (95% CI, 26%-38%, P < .001). The prevalence of obesity in ICU COVID-19 patients were 37.0% (95% CI, 29%-46%, P < .001). Comparing between obese and non-obese patients, the meta-analysis showed that obesity was an important risk factor associated with COVID-19 patients needed for ICU care (OR: 1.36, 95% CI 1.22-1.52, P < .001). Conclusion: Obesity was highly prevalent (32.0%) in patients with COVID-19, especially in ICU patients (37.0%), and was an important risk factor for COVID-19 patients needed for ICU care.
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Affiliation(s)
| | - Hina Naz
- Ibne Seena Medical Centre, Karachi, Pakistan
| | - Sana Shamim
- Dow University of Health Sciences, Ojha, Karachi, Pakistan
| | | | - Sohail Ahmed
- The Health Department of Sindh, Government of Sindh, Karachi, Pakistan
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Wang X, Cao X, Liang S, Cai G. Clinical Presentation and Outcomes of Hospitalized Patients with Chronic Kidney Disease and COVID-19 Variant Omicron. Ther Clin Risk Manag 2024; 20:275-288. [PMID: 38779588 PMCID: PMC11110823 DOI: 10.2147/tcrm.s458859] [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: 01/10/2024] [Accepted: 05/12/2024] [Indexed: 05/25/2024] Open
Abstract
Purpose To investigate the clinical characteristics of hospitalized patients with chronic kidney disease (CKD) and novel coronavirus (SARS-CoV-2) infection and identify potential risk factors that contribute to mortality. Patients and Methods This is a retrospective study, conducted on patients with CKD who were admitted to the First Medical Center of the People's Liberation Army General Hospital between December 1, 2022, and February 28, 2023. All patients were also infected with SARS-CoV-2. We analyzed the clinical characteristics of patients, and the patients were categorized into a survival group and a death group whose characteristics were compared. Cox regression analysis was used to identify risk factors that affected patient prognosis. Results A total of 406 patients were enrolled in this study, including 298 males (73.4%). The average age was 80.5 (67.0, 88.0) years, and the patients had an average estimated glomerular filtration rate (eGFR) of 50.3 (25.0-79.0) mL/min/1.73m². A total of 158 individuals died during hospitalization, resulting in a mortality rate of 38.9%. Renal function was worse in the death group than in the survival group (P < 0.001). Patients in the death group had more severe COVID-19 disease and higher CKD staging than those in the survival group (all P values < 0.001). Multivariate Cox regression analysis identified several risk factors that affected patient mortality, including being male, a higher resting heart rate (RHR) upon admission, dyspnea, a low lymphocyte count (Lym), a high international standardized ratio (INR), a high Acute Physiology and Chronic Health Evaluation II (APACHE II) score, heart failure, and the need for mechanical ventilation during the disease. Conclusion Hospitalized patients with CKD who were infected with SARS-CoV-2 (38.9%) had a relatively high mortality rate (38.9%). Furthermore, a marked correlation was observed between a reduced eGFR and an increased risk of mortality.
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Affiliation(s)
- Xiaolong Wang
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases, Beijing, People’s Republic of China
| | - Xueying Cao
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases, Beijing, People’s Republic of China
| | - Shuang Liang
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases, Beijing, People’s Republic of China
| | - Guangyan Cai
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases, Beijing, People’s Republic of China
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Kircheis R. In Silico Analyses Indicate a Lower Potency for Dimerization of TLR4/MD-2 as the Reason for the Lower Pathogenicity of Omicron Compared to Wild-Type Virus and Earlier SARS-CoV-2 Variants. Int J Mol Sci 2024; 25:5451. [PMID: 38791489 PMCID: PMC11121871 DOI: 10.3390/ijms25105451] [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: 03/27/2024] [Revised: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
The SARS-CoV-2 Omicron variants have replaced all earlier variants, due to increased infectivity and effective evasion from infection- and vaccination-induced neutralizing antibodies. Compared to earlier variants of concern (VoCs), the Omicron variants show high TMPRSS2-independent replication in the upper airway organs, but lower replication in the lungs and lower mortality rates. The shift in cellular tropism and towards lower pathogenicity of Omicron was hypothesized to correlate with a lower toll-like receptor (TLR) activation, although the underlying molecular mechanisms remained undefined. In silico analyses presented here indicate that the Omicron spike protein has a lower potency to induce dimerization of TLR4/MD-2 compared to wild type virus despite a comparable binding activity to TLR4. A model illustrating the molecular consequences of the different potencies of the Omicron spike protein vs. wild-type spike protein for TLR4 activation is presented. Further analyses indicate a clear tendency for decreasing TLR4 dimerization potential during SARS-CoV-2 evolution via Alpha to Gamma to Delta to Omicron variants.
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31
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Benedicto JP, Cruz EJM, Quinto ML. A Descriptive Study on the Clinical Profile and Outcomes of Patients with COVID-19 and Tuberculosis Co-infection. ACTA MEDICA PHILIPPINA 2024; 58:42-49. [PMID: 38812770 PMCID: PMC11132287 DOI: 10.47895/amp.vi0.7855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
Background Tuberculosis (TB) control has been a challenge in the country and its overall health impact remains significant. COVID-19 has caused significant morbidity and mortality especially among hospitalized patients. TB and COVID-19 co-infection (COVID-TB) may cause more catastrophic consequences and outcomes among afflicted individuals and management may be daunting. There is limited local data on COVID-TB. Objectives The clinical profile of COVID-TB patients who were admitted were described. Comparison of the clinical outcomes was also done versus the general admitted COVID-19 patients without concomitant TB in the same institution. Relevant patient outcomes were reported which included admission to an intensive care unit (ICU), length of hospital stay, and mortality rate. Methods This is a descriptive study on the demographics and clinical outcomes of patients admitted in the Philippine General Hospital (PGH) for COVID-19 with TB co-infection from March 2020 to September 2020. We aimed to characterize patients with COVID-TB and analyzed their outcomes. Results There was a total of 79 patients who were admitted for COVID-19 (confirmed with RT-PCR) with TB co-infection during the study period. Majority of them were males (70.9%) with a median age of 54 (IQR 42 to 64) years. In terms of TB affliction, 75 (94.9%) patients were identified to have pulmonary tuberculosis. Majority of patients had at least one co-morbid illness with hypertension (16.5%), diabetes mellitus (13.9%), and heart failure (11.4%) as the most common. Respiratory symptoms (dyspnea and cough) were the predominant presenting complaint during hospital admission. Majority of the patients were classified as severe (8 or 10.1%) and critical (36 or 45.57%) COVID-19 disease. Fifty-six (70.9%) were bacteriologically confirmed tuberculosis. Radiologic imaging studies revealed findings consistent with pulmonary tuberculosis in 70 (88.61%) through plain radiograph. Forty-seven underwent HRCT and 46 of these (97.8%) had findings suggestive of PTB. Overall, 61 patients (77%) subsequently required oxygen supplementation. The in-hospital mortality within the study population was 36.7% (29/79) in contrast to the general COVID patients admitted in the same period which revealed significantly less fatality at 17.5% (35/200). The length of hospital stay was found to be 21.1 days ± 14.75 days across all study patients, and with median of 20 days for surviving patients. TB treatment outcomes were tracked in the 50 surviving COVID-19 patients where cure was declared in 8/50 (16%) while 22/50 (44%) successfully completed their six-month treatment regimen. Conclusions This study of COVID-TB provides an initial evaluation of the potential association between active TB infection and COVID-19 severity and mortality. The data generated from this study may be a starting point to assess the interaction of these two diseases. Furthermore, bidirectional screening may be recommended even at hospitals' triage areas since both diseases may have similar presentations.
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Affiliation(s)
- Jubert P Benedicto
- Division of Pulmonary Medicine, Department of Medicine, Philippine General Hospital, University of the Philippines Manila
| | - Enrick Joshua M Cruz
- Division of Pulmonary Medicine, Department of Medicine, Philippine General Hospital, University of the Philippines Manila
| | - Milraam L Quinto
- Division of Pulmonary Medicine, Department of Medicine, Philippine General Hospital, University of the Philippines Manila
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Quadra MR, Schäfer AA, Maciel EB, Vargas BL, Schlemper LAS, Petry SG, Meller FO. Infodemic and sources of information about COVID-19 in a Brazilian population: what are the associated factors? JOURNAL OF COMMUNICATION IN HEALTHCARE 2024:1-8. [PMID: 38738839 DOI: 10.1080/17538068.2024.2352982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
BACKGROUND With the COVID-19 pandemic, social isolation, and information search have increased dramatically. This increased search for information about the Coronavirus, called infodemic, was greatly affected by fake news and information without scientific evidence. This article aimed to assess the infodemic amid the COVID-19 pandemic and its association with sociodemographic and pandemic-related variables, as well as describe the main sources from which people obtained information about COVID-19. METHODS A cross-sectional population-based study was performed in Criciúma, Brazil. All individuals aged 18 years or older, residing in the 607 households systematically selected, were invited to answer the questionnaire. Infodemic and sources to seek information about COVID-19 were evaluated, as well as sociodemographic and pandemic-related variables. Adjusted Poisson regression with robust variance was used to evaluate associations. RESULTS A total of 863 individuals participated in the study. The prevalence of infodemic was 22.1%, and television was the main source of information (58.9%). Three groups presented a higher prevalence of infodemic: older adults (PR: 1.65), individuals with low income (PR: 2.97), and those who had had contact with someone infected (PR: 2.20). CONCLUSIONS The findings reflect how some groups are more exposed to infodemic, and underline the responsibility and importance of intersectoral actions for dissemination of information about COVID-19.
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Affiliation(s)
- Micaela Rabelo Quadra
- Health Sciences Graduate Program, University of Southern Santa Catarina, Criciúma, Santa Catarina, Brazil
| | - Antônio Augusto Schäfer
- Public Health Graduate Program, University of Southern Santa Catarina, Criciúma, Santa Catarina, Brazil
| | | | - Bianca Languer Vargas
- Health Sciences Graduate Program, Federal University of Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | | | - Sofia Garbin Petry
- Medical College, University of Southern Santa Catarina, Criciúma, Santa Catarina, Brazil
| | - Fernanda Oliveira Meller
- Public Health Graduate Program, University of Southern Santa Catarina, Criciúma, Santa Catarina, Brazil
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Bucher AM, Henzel K, Meyer HJ, Ehrengut C, Müller L, Schramm D, Akinina A, Drechsel M, Kloeckner R, Isfort P, Sähn MJ, Fink M, More D, Melekh B, Meinel FG, Dreger F, May M, Siegler L, Münzfeld H, Ruppel R, Penzkofer T, Kim MS, Balzer M, Borggrefe J, Surov A. Pericardial Effusion Predicts Clinical Outcomes in Patients with COVID-19: A Nationwide Multicenter Study. Acad Radiol 2024; 31:1784-1791. [PMID: 38155024 DOI: 10.1016/j.acra.2023.12.003] [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: 08/28/2023] [Revised: 11/25/2023] [Accepted: 12/01/2023] [Indexed: 12/30/2023]
Abstract
RATIONALE AND OBJECTIVES The prognostic role of pericardial effusion (PE) in Covid 19 is unclear. The aim of the present study was to estimate the prognostic role of PE in patients with Covid 19 in a large multicentre setting. MATERIALS AND METHODS This retrospective study is a part of the German multicenter project RACOON (Radiological Cooperative Network of the Covid 19 pandemic). The acquired sample comprises 1197 patients, 363 (30.3%) women and 834 (69.7%) men. In every case, chest computed tomography was analyzed for PE. Data about 30-day mortality, need for mechanical ventilation and need for intensive care unit (ICU) admission were collected. Data were evaluated by means of descriptive statistics. Group differences were calculated with Mann-Whitney test and Fisher exact test. Uni-and multivariable regression analyses were performed. RESULTS Overall, 46.4% of the patients were admitted to ICU, mechanical lung ventilation was performed in 26.6% and 30-day mortality was 24%. PE was identified in 159 patients (13.3%). The presence of PE was associated with 30-day mortality: HR= 1.54, CI 95% (1.05; 2.23), p = 0.02 (univariable analysis), and HR= 1.60, CI 95% (1.03; 2.48), p = 0.03 (multivariable analysis). Furthermore, density of PE was associated with the need for intubation (OR=1.02, CI 95% (1.003; 1.05), p = 0.03) and the need for ICU admission (OR=1.03, CI 95% (1.005; 1.05), p = 0.01) in univariable regression analysis. The presence of PE was associated with 30-day mortality in male patients, HR= 1.56, CI 95%(1.01-2.43), p = 0.04 (multivariable analysis). In female patients, none of PE values predicted clinical outcomes. CONCLUSION The prevalence of PE in Covid 19 is 13.3%. PE is an independent predictor of 30-day mortality in male patients with Covid 19. In female patients, PE plays no predictive role.
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Affiliation(s)
- Andreas Michael Bucher
- Institute of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfut, Germany (A.M.B., K.H.)
| | - Kristina Henzel
- Institute of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfut, Germany (A.M.B., K.H.)
| | - Hans Jonas Meyer
- Department of Radiology, University Hospital of Leipzig, Leipzig, Germany (H.J.M., C.E.)
| | - Constantin Ehrengut
- Department of Radiology, University Hospital of Leipzig, Leipzig, Germany (H.J.M., C.E.)
| | - Lukas Müller
- Department of Diagnostic and Interventional Radiology, University Medical Center Mainz, Mainz, Germany (L.M.)
| | - Dominik Schramm
- Department of Radiology University Hospital of Halle, Halle, Germany (D.S., A.A., M.D.)
| | - Alena Akinina
- Department of Radiology University Hospital of Halle, Halle, Germany (D.S., A.A., M.D.)
| | - Michelle Drechsel
- Department of Radiology University Hospital of Halle, Halle, Germany (D.S., A.A., M.D.)
| | - Roman Kloeckner
- Department of Radiology University Hospital Schleswig-Holstein-Campus Luebeck, Luebeck, Germany (R.K.)
| | - Peter Isfort
- Department of Radiology University Hospital of Aachen, Aachen, Germany (P.I., M.J.S.)
| | - Marwin-Jonathan Sähn
- Department of Radiology University Hospital of Aachen, Aachen, Germany (P.I., M.J.S.)
| | - Matthias Fink
- Clinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (M.F., D.M.)
| | - Dorottya More
- Clinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (M.F., D.M.)
| | - Bohdan Melekh
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany (B.M., A.S.)
| | - Felix G Meinel
- Department of Radiology University Hospital of Rostock, Rostock, Germany (F.G.M., F.D.)
| | - Franziska Dreger
- Department of Radiology University Hospital of Rostock, Rostock, Germany (F.G.M., F.D.)
| | - Matthias May
- Department of Radiology University Hospital of Erlangen, Erlangen, Germany (M.M., L.S.)
| | - Lisa Siegler
- Department of Radiology University Hospital of Erlangen, Erlangen, Germany (M.M., L.S.)
| | - Hanna Münzfeld
- Department of Radiology University Hospital of Berlin, Berlin, Germany (H.M., R.R., T.P.)
| | - Richard Ruppel
- Department of Radiology University Hospital of Berlin, Berlin, Germany (H.M., R.R., T.P.)
| | - Tobias Penzkofer
- Department of Radiology University Hospital of Berlin, Berlin, Germany (H.M., R.R., T.P.)
| | - Moon-Sung Kim
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany (M.S.K., B.M.)
| | - Miriam Balzer
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany (M.S.K., B.M.)
| | - Jan Borggrefe
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr-University-Bochum, Bochum, Germany (J.B., A.S.)
| | - Alexey Surov
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany (B.M., A.S.); Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr-University-Bochum, Bochum, Germany (J.B., A.S.).
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Zou J, Shi Y, Xue S, Jiang H. Use of serum KL-6 and chest radiographic severity grade to predict 28-day mortality in COVID-19 patients with pneumonia: a retrospective cohort study. BMC Pulm Med 2024; 24:187. [PMID: 38637771 PMCID: PMC11027533 DOI: 10.1186/s12890-024-02992-0] [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: 10/19/2023] [Accepted: 04/02/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has had a global social and economic impact. An easy assessment procedure to handily identify the mortality risk of inpatients is urgently needed in clinical practice. Therefore, the aim of this study was to develop a simple nomogram model to categorize patients who might have a poor short-term outcome. METHODS A retrospective cohort study of 189 COVID-19 patients was performed at Shanghai Ren Ji Hospital from December 12, 2022 to February 28, 2023. Chest radiography and biomarkers, including KL-6 were assessed. Risk factors of 28-day mortality were selected by a Cox regression model. A nomogram was developed based on selected variables by SMOTE strategy. The predictive performance of the derived nomogram was evaluated by calibration curve. RESULTS In total, 173 patients were enrolled in this study. The 28-day mortality event occurred in 41 inpatients (23.7%). Serum KL-6 and radiological severity grade (RSG) were selected as the final risk factors. A nomogram model was developed based on KL-6 and RSG. The calibration curve suggested that the nomogram model might have potential clinical value. The AUCs for serum KL-6, RSG, and the combined score in the development group and validation group were 0.885 (95% CI: 0.804-0.952), 0.818 (95% CI: 0.711-0.899), 0.868 (95% CI: 0.776-0.942) and 0.932 (95% CI: 0.862-0.997), respectively. CONCLUSIONS Our results suggested that the nomogram based on KL-6 and RSG might be a potential method for evaluating 28-day mortality in COVID-19 patients. A high combined score might indicate a poor outcome in COVID-19 patients with pneumonia.
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Affiliation(s)
- Jing Zou
- Department of Respirology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, No.160 Pujian Rd, 200127, Shanghai, China
| | - Yiping Shi
- Department of Nuclear Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shan Xue
- Department of Respirology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, No.160 Pujian Rd, 200127, Shanghai, China
| | - Handong Jiang
- Department of Respirology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, No.160 Pujian Rd, 200127, Shanghai, China.
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Yin X, Zhu W, Tang X, Yang G, Zhao X, Zhao K, Jiang L, Li X, Zhao H, Wang X, Yan Y, Xing L, Yu J, Meng X, Zhao H. Phase I/II clinical trial of efficacy and safety of EGCG oxygen nebulization inhalation in the treatment of COVID-19 pneumonia patients with cancer. BMC Cancer 2024; 24:486. [PMID: 38632501 PMCID: PMC11022442 DOI: 10.1186/s12885-024-12228-3] [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: 11/14/2023] [Accepted: 04/05/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND The antiviral drug Nirmatrelvir was found to be a key drug in controlling the progression of pneumonia during the infectious phase of COVID-19. However, there are very few options for effective treatment for cancer patients who have viral pneumonia. Glucocorticoids is one of the effective means to control pneumonia, but there are many adverse events. EGCG is a natural low toxic compound with anti-inflammatory function. Thus, this study was designed to investigate the safety and efficacy of epigallocatechin-3-gallate (EGCG) aerosol to control COVID-19 pneumonia in cancer populations. METHODS The study was designed as a prospective, single-arm, open-label phase I/II trial at Shandong Cancer Hospital and Institute, between January 5, 2023 to March 31,2023 with viral pneumonia on radiographic signs after confirmed novel coronavirus infection. These patients were treated with EGCG nebulization 10 ml three times daily for at least seven days. EGCG concentrations were increased from 1760-8817umol/L to 4 levels with dose escalation following a standard Phase I design of 3-6 patients per level. Any grade adverse event caused by EGCG was considered a dose-limiting toxicity (DLT). The maximum tolerated dose (MTD) is defined as the highest dose with less than one-third of patients experiencing dose limiting toxicity (DLT) due to EGCG. The primary end points were the toxicity of EGCG and CT findings, and the former was graded by Common Terminology Criteria for Adverse Events (CTCAE) v. 5.0. The secondary end point was the laboratory parameters before and after treatment. RESULT A total of 60 patients with high risk factors for severe COVID-19 pneumonia (factors such as old age, smoking and combined complications)were included in this phase I-II study. The 54 patients in the final analysis were pathologically confirmed to have tumor burden and completed the whole course of treatment. A patient with bucking at a level of 1760 umol/L and no acute toxicity associated with EGCG has been reported at the second or third dose gradients. At dose escalation to 8817umol/L, Grade 1 adverse events of nausea and stomach discomfort occurred in two patients, which resolved spontaneously within 1 hour. After one week of treatment, CT showed that the incidence of non-progression of pneumonia was 82% (32/39), and the improvement rate of pneumonia was 56.4% (22/39). There was no significant difference in inflammation-related laboratory parameters (white blood cell count, lymphocyte count, IL-6, ferritin, C-reactive protein and lactate dehydrogenase) before and after treatment. CONCLUSION Aerosol inhalation of EGCG is well tolerated, and preliminary investigation in cancer population suggests that EGCG may be effective in COVID-19-induced pneumonia, which can promote the improvement of patients with moderate pneumonia or prevent them from developing into severe pneumonia. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05758571. Date of registration: 8 February 2023.
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Affiliation(s)
- Xiaoyan Yin
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jiyan Road 440, 250117, Jinan, Shandong, China
| | - Wanqi Zhu
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jiyan Road 440, 250117, Jinan, Shandong, China
| | - Xiaoyong Tang
- Department of Medical Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Science, 250117, Jinan, Shandong Province, China
| | - Guangjian Yang
- Department of Medical Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Science, 250117, Jinan, Shandong Province, China
| | - Xianguang Zhao
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jiyan Road 440, 250117, Jinan, Shandong, China
| | - Kaikai Zhao
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jiyan Road 440, 250117, Jinan, Shandong, China
| | - Liyang Jiang
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jiyan Road 440, 250117, Jinan, Shandong, China
| | - Xiaolin Li
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jiyan Road 440, 250117, Jinan, Shandong, China
| | - Hong Zhao
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jiyan Road 440, 250117, Jinan, Shandong, China
| | - Xin Wang
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jiyan Road 440, 250117, Jinan, Shandong, China
| | - Yuanyuan Yan
- Department of Radiology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Science, 250117, Jinan, Shandong Province, China
| | - Ligang Xing
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jiyan Road 440, 250117, Jinan, Shandong, China
| | - Jinming Yu
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jiyan Road 440, 250117, Jinan, Shandong, China
| | - Xiangjiao Meng
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jiyan Road 440, 250117, Jinan, Shandong, China.
| | - Hanxi Zhao
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jiyan Road 440, 250117, Jinan, Shandong, China.
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Ramos-González R, Cano-Pérez E, Loyola S, Sierra-Merlano R, Gómez-Camargo D. Cytokine expression and mortality risk among COVID-19 hospitalized patients over 60 years of age in a referral hospital in Cartagena, Colombia. Heliyon 2024; 10:e29028. [PMID: 38601541 PMCID: PMC11004873 DOI: 10.1016/j.heliyon.2024.e29028] [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: 07/25/2023] [Revised: 03/26/2024] [Accepted: 03/28/2024] [Indexed: 04/12/2024] Open
Abstract
Background Cytokine dysregulation in COVID-19 patients aged over 60 has been associated to adverse outcomes. While serum levels have been studied, cellular expression, particularly in Afro-Colombians, remains understudied. This research aims to describe cytokine expression in peripheral blood leukocytes and its association with adverse outcomes in COVID-19 patients aged over 60 at Cartagena's referral hospital. Methods A cohort study was conducted, encompassing severe and critical cases of COVID-19 between November 2021 and February 2022. At baseline, the cellular expression level of cytokines IL-2, IL-4, IL-6, IL-10, TNF-α and IFN-γ was assessed using flow cytometry. Additionally, various biochemical, hematological, and coagulation markers were evaluated. The main outcome was time to death. Results Among the 50 enrolled participants, the median age was 76.5 years, 60% were male, 60% were admitted to the ICU, and 42% died. Lactate dehydrogenase and hemoglobin were the only markers that differed between fatal and surviving cases. Regarding cytokines, the level of IL-6 expression was associated with an increased risk of death. Specifically, a one percent increase in the expression was associated with a 7.3% increase in the risk of death. Stratifying the analysis by death and ICU admission, the median expression level remained high in fatal cases who were admitted to the ICU. Conclusions Our findings revealed a significant association between high cellular expression levels of IL-6 and an increased risk of mortality. These results provide valuable scientific insights that could inform the prioritization of case management, providing especially advantageous for the vulnerable Afro-Colombian group.
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Affiliation(s)
- Remberto Ramos-González
- Departamento de Medicina Interna, Facultad de Medicina, Universidad de Cartagena, Cartagena, Colombia
| | - Eder Cano-Pérez
- Grupo de Investigación UNIMOL, Facultad de Medicina, Universidad de Cartagena, Cartagena, Colombia
- Doctorado en Medicina Tropical, Facultad de Medicina, Universidad de Cartagena, Cartagena, Colombia
| | - Steev Loyola
- Grupo de Investigación UNIMOL, Facultad de Medicina, Universidad de Cartagena, Cartagena, Colombia
- Doctorado en Medicina Tropical, Facultad de Medicina, Universidad de Cartagena, Cartagena, Colombia
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Rita Sierra-Merlano
- Departamento de Medicina Interna, Facultad de Medicina, Universidad de Cartagena, Cartagena, Colombia
| | - Doris Gómez-Camargo
- Grupo de Investigación UNIMOL, Facultad de Medicina, Universidad de Cartagena, Cartagena, Colombia
- Doctorado en Medicina Tropical, Facultad de Medicina, Universidad de Cartagena, Cartagena, Colombia
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Angulo-Aguado M, Carrillo-Martinez JC, Contreras-Bravo NC, Morel A, Parra-Abaunza K, Usaquén W, Fonseca-Mendoza DJ, Ortega-Recalde O. Next-generation sequencing of host genetics risk factors associated with COVID-19 severity and long-COVID in Colombian population. Sci Rep 2024; 14:8497. [PMID: 38605121 PMCID: PMC11009356 DOI: 10.1038/s41598-024-57982-3] [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: 10/29/2023] [Accepted: 03/24/2024] [Indexed: 04/13/2024] Open
Abstract
Coronavirus disease 2019 (COVID-19) was considered a major public health burden worldwide. Multiple studies have shown that susceptibility to severe infections and the development of long-term symptoms is significantly influenced by viral and host factors. These findings have highlighted the potential of host genetic markers to identify high-risk individuals and develop target interventions to reduce morbimortality. Despite its importance, genetic host factors remain largely understudied in Latin-American populations. Using a case-control design and a custom next-generation sequencing (NGS) panel encompassing 81 genetic variants and 74 genes previously associated with COVID-19 severity and long-COVID, we analyzed 56 individuals with asymptomatic or mild COVID-19 and 56 severe and critical cases. In agreement with previous studies, our results support the association between several clinical variables, including male sex, obesity and common symptoms like cough and dyspnea, and severe COVID-19. Remarkably, thirteen genetic variants showed an association with COVID-19 severity. Among these variants, rs11385942 (p < 0.01; OR = 10.88; 95% CI = 1.36-86.51) located in the LZTFL1 gene, and rs35775079 (p = 0.02; OR = 8.53; 95% CI = 1.05-69.45) located in CCR3 showed the strongest associations. Various respiratory and systemic symptoms, along with the rs8178521 variant (p < 0.01; OR = 2.51; 95% CI = 1.27-4.94) in the IL10RB gene, were significantly associated with the presence of long-COVID. The results of the predictive model comparison showed that the mixed model, which incorporates genetic and non-genetic variables, outperforms clinical and genetic models. To our knowledge, this is the first study in Colombia and Latin-America proposing a predictive model for COVID-19 severity and long-COVID based on genomic analysis. Our study highlights the usefulness of genomic approaches to studying host genetic risk factors in specific populations. The methodology used allowed us to validate several genetic variants previously associated with COVID-19 severity and long-COVID. Finally, the integrated model illustrates the importance of considering genetic factors in precision medicine of infectious diseases.
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Affiliation(s)
- Mariana Angulo-Aguado
- School of Medicine and Health Sciences, Center for Research in Genetics and Genomics (CIGGUR), Institute of Translational Medicine (IMT), Universidad Del Rosario, Bogotá, D.C, Colombia
| | - Juan Camilo Carrillo-Martinez
- School of Medicine and Health Sciences, Center for Research in Genetics and Genomics (CIGGUR), Institute of Translational Medicine (IMT), Universidad Del Rosario, Bogotá, D.C, Colombia
| | - Nora Constanza Contreras-Bravo
- School of Medicine and Health Sciences, Center for Research in Genetics and Genomics (CIGGUR), Institute of Translational Medicine (IMT), Universidad Del Rosario, Bogotá, D.C, Colombia
| | - Adrien Morel
- School of Medicine and Health Sciences, Center for Research in Genetics and Genomics (CIGGUR), Institute of Translational Medicine (IMT), Universidad Del Rosario, Bogotá, D.C, Colombia
| | | | - William Usaquén
- Populations Genetics and Identification Group, Institute of Genetics, Universidad Nacional de Colombia, Bogotá, D.C, Colombia
| | - Dora Janeth Fonseca-Mendoza
- School of Medicine and Health Sciences, Center for Research in Genetics and Genomics (CIGGUR), Institute of Translational Medicine (IMT), Universidad Del Rosario, Bogotá, D.C, Colombia
| | - Oscar Ortega-Recalde
- School of Medicine and Health Sciences, Center for Research in Genetics and Genomics (CIGGUR), Institute of Translational Medicine (IMT), Universidad Del Rosario, Bogotá, D.C, Colombia.
- Departamento de Morfología, Facultad de Medicina e Instituto de Genética, Universidad Nacional de Colombia, Bogotá, D.C, Colombia.
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Mazzilli S, Paparatto G, Chieti A, Nannavecchia AM, Bisceglia L, Lopalco PL, Martinelli D, Tavoschi L. Comparison of geographical and individual deprivation index to assess the risk of Sars-CoV-2 infection and disease severity: a retrospective cohort study. Int J Health Geogr 2024; 23:8. [PMID: 38575967 PMCID: PMC10993505 DOI: 10.1186/s12942-024-00367-6] [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: 09/28/2023] [Accepted: 03/13/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND It has been shown that COVID-19 affects people at socioeconomic disadvantage more strongly. Previous studies investigating the association between geographical deprivation and COVID-19 outcomes in Italy reported no differences in case-hospitalisation and case-fatality. The objective of this research was to compare the usefulness of the geographic and individual deprivation index (DI) in assessing the associations between individuals' deprivation and risk of Sars-CoV-2 infection and disease severity in the Apulia region from February to December 2020. METHODS This was a retrospective cohort study. Participants included individuals tested for SARS-CoV-2 infection during the study period. The individual DI was calculated employing polychoric principal component analysis on four census variables. Multilevel logistic models were used to test associations between COVID-19 outcomes and individual DI, geographical DI, and their interaction. RESULTS In the study period, 139,807 individuals were tested for COVID-19 and 56,475 (43.5%) tested positive. Among those positive, 7902 (14.0%) have been hospitalised and 2215 (4.2%) died. During the first epidemic wave, according the analysis done with the individual DI, there was a significant inversely proportional trend between the DI and the risk of testing positive. No associations were found between COVID-19 outcomes and geographic DI. During the second wave, associations were found between COVID-19 outcomes and individual DI. No associations were found between the geographic DI and the risk of hospitalisation and death. During both waves, there were no association between COVID-19 outcomes and the interaction between individual and geographical DI. CONCLUSIONS Evidence from this study shows that COVID-19 pandemic has been experienced unequally with a greater burden among the most disadvantaged communities. The results of this study remind us to be cautious about using geographical DI as a proxy of individual social disadvantage because may lead to inaccurate assessments. The geographical DI is often used due to a lack of individual data. However, on the determinants of health and health inequalities, monitoring has to have a central focus. Health inequalities monitoring provides evidence on who is being left behind and informs equity-oriented policies, programmes and practices. Future research and data collection should focus on improving surveillance systems by integrating individual measures of inequalities into national health information systems.
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Affiliation(s)
- Sara Mazzilli
- Scuola Normale Superiore, Pisa, Italy.
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
| | - Gianluca Paparatto
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
- Health Science Interdisciplinary Research Centre, Sant'Anna School of Advanced Studies, Pisa, Italy
| | - Antonio Chieti
- Strategic Regional Health and Social Agency of Puglia (AReSS Puglia), Bari, Italy
| | | | - Lucia Bisceglia
- Strategic Regional Health and Social Agency of Puglia (AReSS Puglia), Bari, Italy
| | - Pier Luigi Lopalco
- Department of Biological and Environmental Sciences and Technology, University of Salento, Lecce, Italy
| | - Domenico Martinelli
- Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Lara Tavoschi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
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Surov A, Meyer HJ, Ehrengut C, Zimmermann S, Schramm D, Hinnerichs M, Bär C, Borggrefe J. Myosteatosis predicts short-term mortality in patients with COVID-19: A multicenter analysis. Nutrition 2024; 120:112327. [PMID: 38341908 DOI: 10.1016/j.nut.2023.112327] [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: 06/20/2023] [Revised: 10/29/2023] [Accepted: 12/06/2023] [Indexed: 02/13/2024]
Abstract
OBJECTIVES Body composition on computed tomography can predict prognosis in patients with COVID-19. The reported data are based on small retrospective studies. The aim of the present study was to analyze the prognostic relevance of skeletal muscle parameter derived from chest computed tomography for prediction of 30-d mortality in patients with COVID-19 in a multicenter setting. METHODS The clinical databases of three centers were screened for patients with COVID-19 between 2020 and 2022. Overall, 447 patients (142 female; 31.7%) were included into the study. The mean age at the time of computed tomography acquisition was 63.8 ± 14.7 y and median age was 65 y. Skeletal muscle area and skeletal muscle density were defined on level T12 of the chest. RESULTS Overall, 118 patients (26.3%) died within the 30-d observation period. Of the patient sample, 255 patients (57.0%) were admitted to an intensive care unit and 122 patients needed mechanical ventilation (27.3%). The mean skeletal muscle area of all patients was 96.1 ± 27.2 cm² (range = 23.2-200.7 cm²). For skeletal muscle density, the mean was 24.3 ± 11.1 Hounsfield units (range = -5.6 to 55.8 Hounsfield units). In survivors, the mean skeletal muscle density was higher compared with the lethal cases (mean 25.8 ± 11.2 versus 20.1 ± 9.6; P < 0.0001). Presence of myosteatosis was independently associated with 30-d mortality: odds ratio = 2.72 (95% CI, 1.71-4.32); P = 0.0001. CONCLUSIONS Myosteatosis is strongly associated with 30-d mortality in patients COVID-19. Patients with COVID-19 with myosteatosis should be considered a risk group.
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Affiliation(s)
- Alexey Surov
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling Medical Center, Ruhr University Bochum, Germany.
| | - Hans Jonas Meyer
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany
| | - Constantin Ehrengut
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany
| | - Silke Zimmermann
- Department of Laboratory Medicine, University of Leipzig, Leipzig, Germany
| | - Dominik Schramm
- Department of Diagnostic and Interventional Radiology, University of Halle-Wittenberg, Halle (Saale), Germany
| | - Mattes Hinnerichs
- Department of Radiology and Nuclear Medicine, Otto von Guericke University, Magdeburg, Germany
| | - Caroline Bär
- Department of Radiology and Nuclear Medicine, Otto von Guericke University, Magdeburg, Germany
| | - Jan Borggrefe
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling Medical Center, Ruhr University Bochum, Germany
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Pintos-Rodríguez S, Visos-Varela I, Rodríguez-Fernández A, Zapata-Cachafeiro M, Piñeiro-Lamas M, Herdeiro MT, García-Álvarez RM, Figueiras A, Salgado-Barreira Á. Outpatient Antipsychotic Use and Severe COVID-19: Avoiding the Impact of Age in a Real-World Data Study. Int J Neuropsychopharmacol 2024; 27:pyae020. [PMID: 38600711 PMCID: PMC11059787 DOI: 10.1093/ijnp/pyae020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/10/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND The association between use of antipsychotics and COVID-19 outcomes is inconsistent, which may be linked to use of these drugs in age-related diseases. Furthermore, there is little evidence regarding their effect in the nongeriatric population. We aim to assess the association between antipsychotic use and risk of disease progression and hospitalization due to COVID-19 among the general population, stratifying by age. METHODS We conducted a population-based, multiple case-control study to assess risk of hospitalization, with cases being patients with a PCR(+) test who required hospitalization and controls being individuals without a PCR(+) test; and risk of progression to hospitalization, with cases being the same as those used in the hospitalization substudy and controls being nonhospitalized PCR(+) patients. We calculated adjusted odds-ratios (aOR) and 95% confidence intervals (CI), both overall and stratified by age. RESULTS Antipsychotic treatment in patients younger than 65 years was not associated with a higher risk of hospitalization due to COVID-19 (aOR 0.94 [95%CI = 0.69-1.27]) and disease progression among PCR(+) patients (aOR 0.96 [95%CI = 0.70-1.33]). For patients aged 65 years or older, however, there was a significant, increased risk of hospitalization (aOR 1.58 [95% CI = 1.38-1.80]) and disease progression (aOR 1.31 [95% CI = 1.12-1.55]). CONCLUSIONS The results of our large-scale real-world data study suggest that antipsychotic use is not associated with a greater risk of hospitalization due to COVID-19 and progression to hospitalization among patients younger than 65 years. The effect found in the group aged 65 years or older might be associated with off-label use of antipsychotics.
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Affiliation(s)
- Samuel Pintos-Rodríguez
- Department of Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Irene Visos-Varela
- Department of Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Almudena Rodríguez-Fernández
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health - CIBERESP), Madrid, Spain
- Department of Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Maruxa Zapata-Cachafeiro
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health - CIBERESP), Madrid, Spain
- Department of Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - María Piñeiro-Lamas
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - María Teresa Herdeiro
- Department of Medical Sciences, iBiMED-Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
| | - Rosa María García-Álvarez
- Santiago de Compostela Health Area, Galician Health Service (Servizo Galego de Saúde - SERGAS), Santiago de Compostela, Spain
- Department of Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Adolfo Figueiras
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health - CIBERESP), Madrid, Spain
- Department of Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Ángel Salgado-Barreira
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health - CIBERESP), Madrid, Spain
- Department of Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
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Sila T, Suriyaamorn W, Toh C, Rajborirug S, Surasombatpattana S, Thongsuksai P, Kongkamol C, Chusri S, Sornsenee P, Wuthisuthimethawee P, Chaowanawong R, Sangkhathat S, Ingviya T. Factors associated with the worsening of COVID-19 symptoms among cohorts in community- or home-isolation care in southern Thailand. Front Public Health 2024; 12:1350304. [PMID: 38572011 PMCID: PMC10987961 DOI: 10.3389/fpubh.2024.1350304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/09/2024] [Indexed: 04/05/2024] Open
Abstract
Introduction This study aimed to investigate factors associated with time-to-referral due to worsening symptoms in patients with laboratory-confirmed COVID-19 in southern Thailand. While underlying diseases have been evaluated to assess COVID-19 severity, the influence of vaccinations and treatments is also crucial. Methods A cohort of 8,638 patients quarantined in home or community isolation with laboratory-confirmed COVID-19 was analyzed. Survival analysis and the Cox proportional hazard ratio were employed to assess factors influencing time-toreferral. Results Age ≥ 60 years, neurologic disorders, cardiovascular disease, and human immunodeficiency virus infection were identified as significant risk factors for severe COVID-19 referral. Patients who received full- or booster-dose vaccinations had a lower risk of experiencing severe symptoms compared to unvaccinated patients. Notably, individuals vaccinated during the Omicron-dominant period had a substantially lower time-to-referral than those unvaccinated during the Delta-dominant period. Moreover, patients vaccinated between 1 and 6 months prior to infection had a significantly lower risk of time-to-referral than the reference group. Discussion These findings demonstrate early intervention in high-risk COVID-19 patients and the importance of vaccination efficacy to reduce symptom severity. The study provides valuable insights for guiding future epidemic management strategies and optimising patient care during infectious disease outbreaks.
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Affiliation(s)
- Thanit Sila
- Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
- Department of Health Science and Clinical Research, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Wisanuwee Suriyaamorn
- Division of Digital Innovation and Data Analytics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Chanavee Toh
- Department of Health Science and Clinical Research, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Songyos Rajborirug
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | | | - Paramee Thongsuksai
- Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
- Department of Health Science and Clinical Research, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Chanon Kongkamol
- Division of Digital Innovation and Data Analytics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
- Department of Family Medicine and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Sarunyou Chusri
- Department of Internal Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Phoomjai Sornsenee
- Faculty of Medicine, Department of Family Medicine and Preventive Medicine, Prince of Songkla University, Hat Yai, Songkla, Thailand
| | - Prasit Wuthisuthimethawee
- Department of Emergency Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Raya Chaowanawong
- Faculty of Nursing, Prince of Songkla University, Hat Yai, Songkla, Thailand
| | - Surasak Sangkhathat
- Department of Biomedical Sciences and Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
- Faculty of Medicine, Translational Medicine Research Center, Prince of Songkla University, Songkhla, Thailand
| | - Thammasin Ingviya
- Division of Digital Innovation and Data Analytics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
- Department of Family Medicine and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
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Somayaji R, Luke DR, Lau A, Guner R, Tabak ŎF, Hepokoski M, Gardetto N, Conrad SA, Kumar SD, Ghosh K, Robbins SM, Senger DL, Sun D, Lim RKS, Liu J, Eser F, Karaali R, Tremblay A, Muruve D. Multicentre, randomised, double-blind, placebo-controlled, proof of concept study of LSALT peptide as prevention of acute respiratory distress syndrome and acute kidney injury in patients infected with SARS-CoV-2 (COVID-19). BMJ Open 2024; 14:e076142. [PMID: 38490660 PMCID: PMC10946381 DOI: 10.1136/bmjopen-2023-076142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 02/26/2024] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVE Dipeptidase-1 (DPEP-1) is a recently discovered leucocyte adhesion receptor for neutrophils and monocytes in the lungs and kidneys and serves as a potential therapeutic target to attenuate inflammation in moderate-to-severe COVID-19. We aimed to evaluate the safety and efficacy of the DPEP-1 inhibitor, LSALT peptide, to prevent specific organ dysfunction in patients hospitalised with COVID-19. DESIGN Phase 2a randomised, placebo-controlled, double-blinded, trial. SETTING Hospitals in Canada, Turkey and the USA. PARTICIPANTS A total of 61 subjects with moderate-to-severe COVID-19. INTERVENTIONS Randomisation to LSALT peptide 5 mg intravenously daily or placebo for up to 14 days. PRIMARY AND SECONDARY OUTCOME MEASURES The primary endpoint was the proportion of subjects alive and free of respiratory failure and/or the need for renal replacement therapy (RRT). Numerous secondary and exploratory endpoints were assessed including ventilation-free days, and changes in kidney function or serum biomarkers. RESULTS At 28 days, 27 (90.3%) and 28 (93.3%) of subjects in the placebo and LSALT groups were free of respiratory failure and the need for RRT (p=0.86). On days 14 and 28, the number of patients still requiring more intensive respiratory support (O2 ≥6 L/minute, non-invasive or invasive mechanical ventilation or extracorporeal membrane oxygenation) was 6 (19.4%) and 3 (9.7%) in the placebo group versus 2 (6.7%) and 2 (6.7%) in the LSALT group, respectively (p=0.14; p=0.67). Unadjusted analysis of ventilation-free days demonstrated 22.8 days for the LSALT group compared with 20.9 in the placebo group (p=0.4). LSALT-treated subjects had a significant reduction in the fold expression from baseline to end of treatment of serum CXCL10 compared with placebo (p=0.02). Treatment-emergent adverse events were similar between groups. CONCLUSION In a Phase 2 study, LSALT peptide was demonstrated to be safe and tolerated in patients hospitalised with moderate-to-severe COVID-19. TRIAL REGISTRATION NUMBER NCT04402957.
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Affiliation(s)
- Ranjani Somayaji
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Microbiology, Immunology and Infectious Disease, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Snyder Insititute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
| | | | - Arthur Lau
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Arch Biopartners Inc, Toronto, Ontario, Canada
| | - Rahmet Guner
- Istanbul University-Cerrahpasa School of Medicine, Ankara, Turkey
| | - Ŏ Fehmi Tabak
- Istanbul University-Cerrahpasa School of Medicine, Ankara, Turkey
| | - Mark Hepokoski
- University of California San Diego Medical Center, San Diego, California, USA
- Veterans Administration San Diego Healthcare System, San Diego, California, USA
| | - Nancy Gardetto
- University of California San Diego Medical Center, San Diego, California, USA
- Veterans Administration San Diego Healthcare System, San Diego, California, USA
| | - Steven A Conrad
- Departments of Medicine, Pediatrics, and Emergency Medicine, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
| | - Sunil D Kumar
- Broward Health Medical Center, Ft. Lauderdale, Florida, USA
| | | | - Stephen M Robbins
- Department of Oncology, University of Calgary, Calgary, Alberta, Canada
- Lady Davis Institute for Medical Research - Jewish General Hospital, Montreal, Quebec, Canada
- Gerald Bronfman Department of Oncology, McGIll University, Montreal, Quebec, Canada
| | - Donna L Senger
- Department of Oncology, University of Calgary, Calgary, Alberta, Canada
- Lady Davis Institute for Medical Research - Jewish General Hospital, Montreal, Quebec, Canada
- Gerald Bronfman Department of Oncology, McGIll University, Montreal, Quebec, Canada
| | - Daisy Sun
- Arch Biopartners Inc, Toronto, Ontario, Canada
| | - Rachel K S Lim
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jonathan Liu
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Fatma Eser
- Departments of Medicine, Infectious Diseases and Clinical Microbiology - Ankara City Hospital, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Ridvan Karaali
- Istanbul University-Cerrahpasa School of Medicine, Ankara, Turkey
| | - Alain Tremblay
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Snyder Insititute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Daniel Muruve
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Microbiology, Immunology and Infectious Disease, University of Calgary, Calgary, Alberta, Canada
- Snyder Insititute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
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Kaneko K, Ishizaka M, Chiba K, Yamashita T, Nomi A, Kubo A, Takahashi H. Age and period of ventilator use are related to walking independence at the time of discharge in patients with severe COVID-19 pneumonia: a single-center retrospective observational study. J Phys Ther Sci 2024; 36:142-150. [PMID: 38434997 PMCID: PMC10904214 DOI: 10.1589/jpts.36.142] [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: 11/10/2023] [Accepted: 12/10/2023] [Indexed: 03/05/2024] Open
Abstract
[Purpose] This study aimed to identify the factors and cutoffs associated with walking independence in patients with severe COVID-19 pneumonia. [Participants and Methods] In total, 112 patients with COVID-19 pneumonia (98 males and 14 females) who were hospitalized between March 2020 and August 2021 and underwent physiotherapy during mechanical ventilation were included in the study. Attributes, respiratory function, physical function, and bed-withdrawal status were compared between two groups of patients, who were classified according to their ability to walk independently at discharge. The independent variables were reduced to four components by principal component analysis. Logistic regression analysis was performed with walking independence at discharge as the dependent variable. Receiver operating characteristic curves for the extracted factors were drawn, and cutoff values were calculated. [Results] At discharge, 76 patients were able to walk independently, while 36 were not. The logistic regression analysis was adjusted according to age and mechanical ventilation time. Cutoffs were an age of 56 years and a ventilation period of 7.5 days. [Conclusion] In cases of patients with severe COVID-19 pneumonia who required ventilators, age and mechanical ventilation time were associated with ambulatory independence at discharge, indicating the importance of reducing the ventilation period by providing respiratory physiotherapy, including expectoration, positioning, and weaning.
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Affiliation(s)
- Kento Kaneko
- Department of Rehabilitation Medicine, Japanese Red Cross
Medical Center: 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences,
International University of Health and Welfare, Japan
| | - Kouhei Chiba
- Department of Rehabilitation Medicine, Japanese Red Cross
Medical Center: 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935, Japan
| | - Tomoyuki Yamashita
- Department of Emergency Medicine, Japanese Red Cross
Medical Center, Japan
| | - Akira Nomi
- Department of Emergency Medicine, Japanese Red Cross
Medical Center, Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences,
International University of Health and Welfare, Japan
| | - Hitomi Takahashi
- Department of Physical Therapy, School of Health Sciences,
Fukushima Medical University, Japan
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Khedmati Morasae E, Derbyshire DW, Amini P, Ebrahimi T. Social determinants of spatial inequalities in COVID-19 outcomes across England: A multiscale geographically weighted regression analysis. SSM Popul Health 2024; 25:101621. [PMID: 38420111 PMCID: PMC10899060 DOI: 10.1016/j.ssmph.2024.101621] [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: 11/06/2023] [Revised: 02/01/2024] [Accepted: 02/02/2024] [Indexed: 03/02/2024] Open
Abstract
A variety of factors are associated with greater COVID-19 morbidity or mortality, due to how these factors influence exposure to (in the case of morbidity) or severity of (in the case of mortality) COVID-19 infections. We use multiscale geographically weighted regression to study spatial variation in the factors associated with COVID-19 morbidity and mortality rates at the local authority level across England (UK). We investigate the period between March 2020 and March 2021, prior to the rollout of the COVID-19 vaccination program. We consider a variety of factors including demographic (e.g. age, gender, and ethnicity), health (e.g. rates of smoking, obesity, and diabetes), social (e.g. Index of Multiple Deprivation), and economic (e.g. the Gini coefficient and economic complexity index) factors that have previously been found to impact COVID-19 morbidity and mortality. The Index of Multiple Deprivation has a significant impact on COVID-19 cases and deaths in all local authorities, although the effect is the strongest in the south of England. Higher proportions of ethnic minorities are associated with higher levels of COVID-19 mortality, with the strongest effect being found in the west of England. There is again a similar pattern in terms of cases, but strongest in the north of the country. Other factors including age and gender are also found to have significant effects on COVID-19 morbidity and mortality, with differential spatial effects across the country. The results provide insights into how national and local policymakers can take account of localized factors to address spatial health inequalities and address future infectious disease pandemics.
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Affiliation(s)
- Esmaeil Khedmati Morasae
- Research Fellow in Operational Research, Exeter University Business School, University of Exeter, UK
| | - Daniel W. Derbyshire
- Department of Public Health and Sports Science, Faculty of Health and Life Science, University of Exeter, UK
| | - Payam Amini
- School of Medicine, Keele University, Keele, Staffordshire, UK
| | - Tahera Ebrahimi
- Lecturer in Finance, Business School, Manchester Metropolitan University, UK
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Yuan S, He W, Liu B, Liu Z. Research Progress on the Weak Immune Response to the COVID-19 Vaccine in Patients with Type 2 Diabetes. Viral Immunol 2024; 37:79-88. [PMID: 38498797 DOI: 10.1089/vim.2023.0097] [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] [Indexed: 03/20/2024] Open
Abstract
Coronavirus Disease 2019 (COVID-19) is generally susceptible to the population, highly infectious, rapidly transmitted, and highly fatal. There is a lack of specific drugs against the virus at present and vaccination is the most effective strategy to prevent infection. However, studies have found that some groups, particularly patients with diabetes, show varying degrees of weak immune reactivity to various COVID-19 vaccines, resulting in poor preventive efficacy against the novel coronavirus in patients with diabetes. Therefore, in this study, patients with type 2 diabetes mellitus (T2DM) who had weak immune response to the COVID-19 vaccine in recent years were analyzed. This article reviews the phenomenon, preliminary mechanism, and related factors affecting weak vaccine response in patients with T2DM, which is expected to help in the development of new vaccines for high-risk groups for COVID-19.
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Affiliation(s)
- Shiqi Yuan
- Department of Laboratory Medicine, Hengyang Medical School, The Second Affiliated Hospital, University of South China, Hengyang, China
| | - Wenwen He
- Department of Laboratory Medicine, Hengyang Medical School, The Second Affiliated Hospital, University of South China, Hengyang, China
| | - Bin Liu
- Department of Laboratory Medicine, Hengyang Medical School, The Second Affiliated Hospital, University of South China, Hengyang, China
| | - Zhuoran Liu
- Department of Laboratory Medicine, Hengyang Medical School, The Second Affiliated Hospital, University of South China, Hengyang, China
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46
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Ali S, Khan OS, Youssef AM, Saba I, Alqahtani L, Alduhaim RA, Almesned R. Predicting COVID-19 outcomes with the Edmonton Obesity Staging System. Ann Saudi Med 2024; 44:116-125. [PMID: 38615185 PMCID: PMC11016153 DOI: 10.5144/0256-4947.2024.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 12/23/2023] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND Multiple studies have demonstrated a correlation between a high body mass index and discriminatory COVID-19 outcomes. Studies appear to indicate that there is a correlation between obesity-related comorbidities and less favorable outcomes. OBJECTIVES The primary aim of the current investigation is to conduct a thorough assessment of the correlation between BMI and comorbidities associated with obesity, and their potential impact on the severity and consequences of COVID-19 infection among patients receiving care in a tertiary healthcare setting. DESIGN Retrospective cohort. SETTINGS Tertiary rehabilitation center, Riyadh, Saudi Arabia. PATIENTS AND METHODS The study included all individuals who received medical treatment and tested positive for COVID-19 by means of RT-PCR during the period from March to September 2020. COVID-19 patients were classified using Edmonton Obesity Staging System (EOSS). MAIN OUTCOME MEASURES COVID-19-related complications, including pneumonia and cytokine release syndrome, as well as the time length to COVID-19 negativization. SAMPLE SIZE 315 patients. RESULTS The median (25th-75th percentiles) age of the patients was 38 (31.5-49) years old. Males outnumbered females, and 66% of patients were non-Saudis. Forty-eight patients (15.2%) had obesity class I, whereas 13 patients (4.1%) had class II. Thirty-two patients (10.2%) were classified as EOSS stage 1, 105 patients (33.3%) were classified as EOSS stage 2, and 25 patients (7.9%) were assigned to EOSS stage 3. Males predominated in EOSS stages 1 and 2, whereas females predominated in stage 3. In EOSS stage 3, 52% of cases had moderate severity and 48% had severe illness. CONCLUSIONS EOSS distinguishes the COVID-19 risks of poor outcomes beyond BMI. Patients who were overweight or obese but remained in the stage 1 of the EOSS had a lower risk of a poor COVID-19 outome than normal-weight patients. The health status of obese patients is a more precise indicator of the progression of COVID-19 during hospitalization than BMI alone. LIMITATIONS Given the limited capacity of urgent care facilities to conduct a comprehensive evaluation of comorbidities and other relevant outcomes in all patients, it is plausible that certain patients may have been erroneously classified with an EOSS stage 2 diagnosis, when in fact they ought to have been assigned a stage 3 diagnosis.
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Affiliation(s)
- Sajjad Ali
- From the Infectious Diseases Department, Sultan Bin Abdulaziz Humanitarian City, Riyadh, Saudi Arabia
| | - Omar Sufyan Khan
- From the Infectious Diseases Department, Sultan Bin Abdulaziz Humanitarian City, Riyadh, Saudi Arabia
| | - Amira M. Youssef
- From the Research and Scientific Center, Sultan Bin Abdulaziz Humanitarian City, Riyadh, Saudi Arabia
| | - Iram Saba
- From the Research and Scientific Center, Sultan Bin Abdulaziz Humanitarian City, Riyadh, Saudi Arabia
| | - Leena Alqahtani
- From the College of Medicine, Princess Nourah bint Abdulrahman University
| | | | - Renad Almesned
- From the College of Medicine, Imam Muhammad Ibn Saud Islamic University
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Bakthavatchalam R, Bakthavatchalam S, Ravikoti S, Shanmukham B, Reddy KS, Pallavali JR, Gaur A, Geetha J, Varatharajan S. Analyzing the Outcomes of COVID-19 Infection on Patients With Comorbidities: Insights From Hospital-Based Study. Cureus 2024; 16:e55358. [PMID: 38562329 PMCID: PMC10982082 DOI: 10.7759/cureus.55358] [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: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction COVID-19 exhibits a broad spectrum of clinical manifestations, ranging from asymptomatic or mild cases to severe respiratory distress and, in some instances, fatal outcomes. The pre-existing inflammatory state in the patient prior to exposure to COVID-19, which could be because of any etiology or comorbidity, has been associated with prolonged morbidity, and adverse outcomes like increased mortality have been found. This study endeavors to investigate the principal risk factors linked to the morbidity and mortality of COVID-19, such as age, gender, and co-morbidities such as hypertension, diabetes mellitus, and others. Material and methods Patient demographic data like age, gender, and co-morbidities like diabetes mellitus, hypertension, respiratory illness, and coronary artery diseases, cerebrovascular accident was observed. The patient clinical profile, hematological, inflammatory markers at the time of admission, and outcome were noticed. Patients were divided into two groups - patients with comorbidity and those without comorbidity. Results In each cohort of COVID-19 patients, comprising those with and without comorbidities, there were 145 participants. The mean age of patients without comorbidities was found to be 49.97 years, whereas the mean age of those with comorbidities was 64.35 years. Within the comorbidity group, males formed the majority, accounting for 77.2% of the cohort; in the group without comorbidity also males predominated, representing 68.3% of the participants. Hypertension was the most common co-morbidity (89.7%), followed by diabetes mellitus (39.3%), and ischemic heart disease (8.3%). The multivariate logistic regression analysis for prediction of mortality showed hypothyroidism with odds ratio (OR) of 336.26 and confidence intervals (CI) (1.19-9477.13), ischemic heart disease with OR of 320.94 (CI 3.19-3237.4) and presence greater than two co-morbidities with OR of 42.14 (CI 1.34-1325.76). Cox regression analysis showed a statistically significant hazard ratio of 0.294 in patients with greater than two co-morbidities. Conclusion Hypothyroidism, ischemic heart disease, and the presence of multiple comorbid conditions were associated with the severity of COVID-19 illness and mortality.
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Affiliation(s)
| | | | - Shyamala Ravikoti
- Microbiology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, IND
| | - Bhaskaran Shanmukham
- General Medicine, Melamruvathur Adhiparasakthi Institute of Medical Sciences and Research, Melmaruvathur, IND
| | - Kotha S Reddy
- General Medicine, All India Institute of Medical Sciences, Bibinagar, Hyderabad, IND
| | | | - Archana Gaur
- Physiology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, IND
| | - Jeganathan Geetha
- General Medicine, Karpaga Vinayaga Institute of Medical sciences and Research Center, Maduranthagam, IND
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Xie L, Luo G, Yang Z, Wu WC, Chen J, Ren Y, Zeng Z, Ye G, Pan Y, Zhao WJ, Chen YQ, Hou W, Sun Y, Guo D, Yang Z, Li J, Holmes EC, Li Y, Chen L, Shi M. The clinical outcome of COVID-19 is strongly associated with microbiome dynamics in the upper respiratory tract. J Infect 2024; 88:106118. [PMID: 38342382 DOI: 10.1016/j.jinf.2024.01.017] [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: 07/20/2023] [Revised: 01/24/2024] [Accepted: 01/30/2024] [Indexed: 02/13/2024]
Abstract
OBJECTIVES The respiratory tract is the portal of entry for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although a variety of respiratory pathogens other than SARS-CoV-2 have been associated with severe cases of COVID-19 disease, the dynamics of the upper respiratory microbiota during disease the course of disease, and how they impact disease manifestation, remain uncertain. METHODS We collected 349 longitudinal upper respiratory samples from a cohort of 65 COVID-19 patients (cohort 1), 28 samples from 28 recovered COVID-19 patients (cohort 2), and 59 samples from 59 healthy controls (cohort 3). All COVID-19 patients originated from the earliest stage of the epidemic in Wuhan. Based on a modified clinical scale, the disease course was divided into five clinical disease phases (pseudotimes): "Healthy" (pseudotime 0), "Incremental" (pseudotime 1), "Critical" (pseudotime 2), "Complicated" (pseudotime 3), "Convalescent" (pseudotime 4), and "Long-term follow-up" (pseudotime 5). Using meta-transcriptomics, we investigated the features and dynamics of transcriptionally active microbes in the upper respiratory tract (URT) over the course of COVID-19 disease, as well as its association with disease progression and clinical outcomes. RESULTS Our results revealed that the URT microbiome exhibits substantial heterogeneity during disease course. Two clusters of microbial communities characterized by low alpha diversity and enrichment for multiple pathogens or potential pathobionts (including Acinetobacter and Candida) were associated with disease progression and a worse clinical outcome. We also identified a series of microbial indicators that classified disease progression into more severe stages. Longitudinal analysis revealed that although the microbiome exhibited complex and changing patterns during COVID-19, a restoration of URT microbiomes from early dysbiosis toward more diverse status in later disease stages was observed in most patients. In addition, a group of potential pathobionts were strongly associated with the concentration of inflammatory indicators and mortality. CONCLUSION This study revealed strong links between URT microbiome dynamics and disease progression and clinical outcomes in COVID-19, implying that the treatment of severe disease should consider the full spectrum of microbial pathogens present.
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Affiliation(s)
- Linlin Xie
- Wuhan Research Center for Infectious Diseases and Tumors of the Chinese Academy of Medical Sciences/Hubei Engineering Center for Infectious Disease Prevention, Control and Treatment/Department of Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Gengyan Luo
- State key laboratory for biocontrol, Shenzhen Key Laboratory of Systems Medicine for inflammatory diseases, School of Medicine, Shenzhen campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen, China
| | - Zhongzhou Yang
- State key laboratory for biocontrol, Shenzhen Key Laboratory of Systems Medicine for inflammatory diseases, School of Medicine, Shenzhen campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen, China
| | - Wei-Chen Wu
- State key laboratory for biocontrol, Shenzhen Key Laboratory of Systems Medicine for inflammatory diseases, School of Medicine, Shenzhen campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen, China
| | - Jintao Chen
- State Key Laboratory of Virology/Department of Laboratory Medicine/Hubei Province Key Laboratory of Allergy and Immunology, School of Basic Medical Sciences/Zhongnan Hospital, Wuhan University, Wuhan, China
| | - Yuting Ren
- State Key Laboratory of Virology/Department of Laboratory Medicine/Hubei Province Key Laboratory of Allergy and Immunology, School of Basic Medical Sciences/Zhongnan Hospital, Wuhan University, Wuhan, China
| | - Zhikun Zeng
- Wuhan Research Center for Infectious Diseases and Tumors of the Chinese Academy of Medical Sciences/Hubei Engineering Center for Infectious Disease Prevention, Control and Treatment/Department of Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Guangming Ye
- Wuhan Research Center for Infectious Diseases and Tumors of the Chinese Academy of Medical Sciences/Hubei Engineering Center for Infectious Disease Prevention, Control and Treatment/Department of Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yunbao Pan
- Wuhan Research Center for Infectious Diseases and Tumors of the Chinese Academy of Medical Sciences/Hubei Engineering Center for Infectious Disease Prevention, Control and Treatment/Department of Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Wen-Jing Zhao
- State key laboratory for biocontrol, Shenzhen Key Laboratory of Systems Medicine for inflammatory diseases, School of Medicine, Shenzhen campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen, China
| | - Yao-Qing Chen
- School of Public Health (Shenzhen), Shenzhen campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen, China
| | - Wei Hou
- State Key Laboratory of Virology/Department of Laboratory Medicine/Hubei Province Key Laboratory of Allergy and Immunology, School of Basic Medical Sciences/Zhongnan Hospital, Wuhan University, Wuhan, China
| | - Yanni Sun
- Department of Electrical Engineering, City University of Hong Kong, Hong Kong, China
| | - Deying Guo
- State key laboratory for biocontrol, Shenzhen Key Laboratory of Systems Medicine for inflammatory diseases, School of Medicine, Shenzhen campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen, China
| | - Zifeng Yang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jun Li
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, China
| | - Edward C Holmes
- Sydney Institute for Infectious Diseases, School of Medical Sciences, The University of Sydney, Sydney, Australia
| | - Yirong Li
- Wuhan Research Center for Infectious Diseases and Tumors of the Chinese Academy of Medical Sciences/Hubei Engineering Center for Infectious Disease Prevention, Control and Treatment/Department of Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.
| | - Liangjun Chen
- Wuhan Research Center for Infectious Diseases and Tumors of the Chinese Academy of Medical Sciences/Hubei Engineering Center for Infectious Disease Prevention, Control and Treatment/Department of Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.
| | - Mang Shi
- State key laboratory for biocontrol, Shenzhen Key Laboratory of Systems Medicine for inflammatory diseases, School of Medicine, Shenzhen campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen, China.
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Huang Y, Zhou W, Du H. Association between hypertension and pressure ulcer: A systematic review and meta-analysis. Int Wound J 2024; 21:e14829. [PMID: 38494175 PMCID: PMC10944688 DOI: 10.1111/iwj.14829] [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: 01/21/2024] [Revised: 02/27/2024] [Accepted: 02/27/2024] [Indexed: 03/19/2024] Open
Abstract
This review aims to systematically evaluate the association between hypertension and pressure ulcer (PU). PubMed, Embase, Web of Science, and Cochrane Library were searched for studies from their inception until September 12, 2023. Literature search, data extraction, and quality assessment were conducted independently by two researchers. The random-effects model was used to calculate the combined odds ratio (OR) and corresponding 95% confidence interval (CI) of hypertension in patients with PU; subgroup analyses were performed to explore the source of between-study heterogeneity; sensitivity analysis was used to test the robust of the combined result; and funnel plot and Egger's test were used to assess the publication bias. Finally, a total of 19 studies with 564 716 subjects were included; the overall pooled result showed no significant association between hypertension and risk of developing PU (OR = 1.15, 95% CI = 0.90-1.47, p = 0.27); and the sensitivity analysis and publication bias analysis showed robust of the combined result. Subgroup analysis indicated a significant association between hypertension and PU when the primary disease was COVID-19 (OR = 1.73, 95% CI = 1.35-2.22, p < 0.0001). No association between hypertension and PU was seen in subgroup analysis on the patient source and study design. In sum, there is no significantly statistical association between hypertension and the occurrence of PU in most cases, while the risk of PU significantly elevates among COVID-19 patients combined with hypertension regardless of patient source and study design.
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Affiliation(s)
- Yanting Huang
- Department of Ultrasound, Xiangyang No.1 People's HospitalHubei University of MedicineXiangyangChina
| | - Wei Zhou
- Department of Rehabilitation MedicineXiangyang No.1 People's Hospital, Hubei University of MedicineXiangyangChina
| | - Haiyang Du
- Department of Rehabilitation MedicineXiangyang No.1 People's Hospital, Hubei University of MedicineXiangyangChina
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Hata T, Goto T, Yamanaka S, Matsumoto T, Yamamura O, Hayashi H. Prognostic value of initial serum sodium level in predicting disease severity in patients with COVID-19: A multicenter retrospective study. J Infect Chemother 2024; 30:181-187. [PMID: 37802152 DOI: 10.1016/j.jiac.2023.10.002] [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: 06/11/2023] [Revised: 08/09/2023] [Accepted: 10/02/2023] [Indexed: 10/08/2023]
Abstract
INTRODUCTION Early prediction of coronavirus disease (COVID-19) severity is crucial. Hyponatremia has been linked to poor outcomes in hospitalized COVID-19 patients, but its association with mild cases is unclear. This study aimed to investigate whether initial serum sodium level is a risk factor for COVID-19 severity in patients with mild-to-moderate disease. METHODS A multicenter retrospective cohort study was conducted in 10 hospitals in Fukui City, Japan, from July 1, 2020, to October 31, 2021. The study included 1055 adult patients with asymptomatic, mild, or moderate COVID-19 confirmed by a positive RT-PCR test. The primary outcome was the need for oxygen therapy after hospitalization, and the secondary outcome was the composite of in-hospital death and critical care interventions. The association between initial serum sodium level (at the emergency department or on admission) and outcomes was examined, adjusting for age, sex, hypertension, and pneumonia presence. RESULTS Of the 1267 patients diagnosed with COVID-19 during the study period, 1055 were eligible (median age: 45 years; 54 % male). Hyponatremia was observed in 5.2 % of patients upon admission. A lower initial serum sodium level was associated with an increased risk of the need for oxygen therapy after hospitalization (adjusted odds ratio [OR] per 1 mmol/L lower, 1.12 [95 % confidence interval {CI}, 1.05-1.19]) and the composite of critical care and in-hospital death (adjusted OR per 1 mmol/L lower, 1.09 [95 % CI, 0.99-1.20]). CONCLUSIONS Among patients with mild COVID-19, lower initial serum sodium level was a risk factor for COVID-19 progression.
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Affiliation(s)
- Tatsuhiko Hata
- Department of Emergency Medicine & General Internal Medicine, University of Fukui, Fukui, Japan.
| | - Tadahiro Goto
- Department of Emergency Medicine & General Internal Medicine, University of Fukui, Fukui, Japan; TXP Medical, Co. Ltd., Tokyo, Japan.
| | - Syunsuke Yamanaka
- Department of Emergency Medicine & General Internal Medicine, University of Fukui, Fukui, Japan.
| | - Tatsuki Matsumoto
- School of Knowledge and Information Systems, College of Sustainable System Sciences, Osaka Metropolitan University, Osaka, Japan.
| | - Osamu Yamamura
- Department of Community Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan; Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan.
| | - Hiroyuki Hayashi
- Department of Emergency Medicine & General Internal Medicine, University of Fukui, Fukui, Japan.
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