1
|
Shayestefar M, Raiesdana N, Nobahar M. The experiences of patients with COVID-19 and their relatives from receiving professional home care nursing: a qualitative content analysis. BMC Nurs 2024; 23:352. [PMID: 38802918 PMCID: PMC11129399 DOI: 10.1186/s12912-024-02021-9] [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: 01/10/2024] [Accepted: 05/16/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND To overcome of patients with COVID-19 over the capacity of hospitals and mild to moderate severity of the disease in most cases, the World Health Organization and the Centers for Disease Control and Prevention in the United States, recommend home care for these patients. Receiving care at home will face challenges that can be context-based, especially in crises like the Coronavirus pandemic. The present study aimed to describe the experiences of patients with COVID-19 and their relatives from receiving professional home care nursing. METHODS This study was conducted using a qualitative content analysis method. Nine participants with COVID-19 who were receiving home care nursing in Semnan participated in this study. The purposive sampling method was used. Sampling continued until no new categories appeared, meaning the category's theoretical saturation. Deep and semi-structured interviews were used to collect data based on the research question. Data was analyzed using the conventional content analysis method using Graneheim and Lundman's approach. RESULTS After analyzing the interviews and comparing codes based on similarities and differences, three main themes, 11 categories, and 30 subcategories were identified. The main themes included "The value of home care" (personalization of care, being economical, providing intellectual security, and reducing the concern of family), "Comprehensive care" (professional commitment, empathy, mastery in care, and patronage), and "Care challenges" (cultural barriers, inadequate services, and lack of information about costs and conditions). CONCLUSION The patients with COVID-19 who received professional nursing care at home mentioned some challenges, such as the caregiver not being of the same sex as the patient, delay in receiving the service, the inadequacy of the centers, the limitation of the right to choose the care provider, and insufficient information about the cost of services received before receiving each care.
Collapse
Affiliation(s)
- Mina Shayestefar
- Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran
| | - Nayyereh Raiesdana
- Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran.
- Department of Nursing, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran.
| | - Monir Nobahar
- Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran
- Department of Nursing, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| |
Collapse
|
2
|
Vargas MH, Chávez J, Del-Razo-Rodríguez R, Muñoz-Perea C, Romo-Domínguez KJ, Báez-Saldaña R, Rumbo-Nava U, Guerrero-Zúñiga S. Glycine by enteral route does not improve major clinical outcomes in severe COVID-19: a randomized clinical pilot trial. Sci Rep 2024; 14:11566. [PMID: 38773199 PMCID: PMC11109244 DOI: 10.1038/s41598-024-62321-7] [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: 07/28/2023] [Accepted: 05/15/2024] [Indexed: 05/23/2024] Open
Abstract
There is a worrying scarcity of drug options for patients with severe COVID-19. Glycine possesses anti-inflammatory, cytoprotective, endothelium-protective, and platelet-antiaggregant properties, so its use in these patients seems promising. In this open label, controlled clinical trial, inpatients with severe COVID-19 requiring mechanical ventilation randomly received usual care (control group) or usual care plus 0.5 g/kg/day glycine by the enteral route (experimental group). Major outcomes included mortality, time to weaning from mechanical ventilation, total time on mechanical ventilation, and time from study recruitment to death. Secondary outcomes included laboratory tests and serum cytokines. Patients from experimental (n = 33) and control groups (n = 23) did not differ in basal characteristics. There were no differences in mortality (glycine group, 63.6% vs control group, 52.2%, p = 0.60) nor in any other major outcome. Glycine intake was associated with lower fibrinogen levels, either evaluated per week of follow-up (p < 0.05 at weeks 1, 2, and 4) or as weighted mean during the whole hospitalization (608.7 ± 17.7 mg/dl vs control 712.2 ± 25.0 mg/dl, p = 0.001), but did not modify any other laboratory test or cytokine concentration. In summary, in severe COVID-19 glycine was unable to modify major clinical outcomes, serum cytokines or most laboratory tests, but was associated with lower serum fibrinogen concentration.Registration: ClinicalTrials.gov NCT04443673, 23/06/2020.
Collapse
Affiliation(s)
- Mario H Vargas
- Departamento de Investigación en Hiperreactividad Bronquial, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Calzada de Tlalpan 4502, CP 14080, Ciudad de México, México.
| | - Jaime Chávez
- Departamento de Investigación en Hiperreactividad Bronquial, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Calzada de Tlalpan 4502, CP 14080, Ciudad de México, México
| | - Rosangela Del-Razo-Rodríguez
- Servicio Clínico de Neumología Pediátrica, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, México
| | - Carolina Muñoz-Perea
- Servicio de Urgencias, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, México
| | - Karina Julieta Romo-Domínguez
- Servicio de Urgencias, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, México
- Servicio de Neumología, Hospital Infantil del Estado de Sonora, Hermosillo, Sonora, México
| | - Renata Báez-Saldaña
- Servicio Clínico 3, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, México
| | - Uriel Rumbo-Nava
- Servicio Clínico 3, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, México
| | - Selene Guerrero-Zúñiga
- Unidad de Medicina del Sueño, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, México
| |
Collapse
|
3
|
Klingensmith LM, Goel S, Kampalath VN, Cohn KA. Clinical Outcomes of Children With COVID-19 by SARS-CoV-2 Strain: A Cohort Study. Pediatr Emerg Care 2024; 40:243-248. [PMID: 37665790 DOI: 10.1097/pec.0000000000003034] [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] [Indexed: 09/06/2023]
Abstract
OBJECTIVE We sought to investigate the disease outcomes and predictors of severe outcomes among children infected with the Delta variant of SARS-CoV-2 compared with pre-Delta strains. METHODS Single-center retrospective cohort study in an emergency department located within an urban academic children's hospital. Patients included children (0-18 years) who tested positive for SARS-CoV-2. Main outcomes measured include need for hospital admission or COVID-directed therapies. RESULTS There was a trend toward decreased hospital admission and no significant difference in the severity of outcomes in the Delta cohort relative to the pre-Delta cohort. The Delta cohort had lower odds of hospital admission (odds ratio [OR], 0.79; 95% confidence interval [CI], 0.51-1.23), but the result was not statistically significant. Logistic regression analyses showed that overall, age 1 to 4 years (OR, 2.35; 95% CI, 1.23-4.57) and public insurance (OR, 1.80, 95% CI, 1.08-3.01) were predictors of hospital admission. Within the Delta cohort, the presence of any comorbidity increased the odds of admission (OR, 2.52; 95% CI, 1.09-6.04). Black children had lower odds of admission than white children (overall OR, 0.53; 95% CI, 0.31-0.90; pre-Delta OR, 0.50; 95% CI, 0.26-0.95). CONCLUSIONS The severity of measured disease outcomes was similar in pediatric patients when comparing children infected with the pre-Delta and Delta variants of SARS-CoV-2, even among children with comorbidities once adjusting for acuity.Ongoing research is essential to determine disease severity and risk for children with comorbidities because SARS-CoV-2 continues to mutate, including with Omicron subvariants.
Collapse
Affiliation(s)
| | - Swati Goel
- From the Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Vinay N Kampalath
- Pediatrics Division, Emergency Medicine, Children's Hospital of Philadelphia, PA
| | - Keri A Cohn
- Pediatrics Division, Emergency Medicine, Children's Hospital of Philadelphia, PA
| |
Collapse
|
4
|
Huang X, Tan X, Xie X, Jiang T, Xiao Y, Liu Z. Successful salvage of a severe COVID-19 patient previously with lung cancer and radiation pneumonitis by mesenchymal stem cells: a case report and literature review. Front Immunol 2024; 15:1321236. [PMID: 38380312 PMCID: PMC10876893 DOI: 10.3389/fimmu.2024.1321236] [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: 10/13/2023] [Accepted: 01/04/2024] [Indexed: 02/22/2024] Open
Abstract
During the COVID-19 pandemic, elderly patients with underlying condition, such as tumors, had poor prognoses after progressing to severe pneumonia and often had poor response to standard treatment. Mesenchymal stem cells (MSCs) may be a promising treatment for patients with severe pneumonia, but MSCs are rarely used for patients with carcinoma. Here, we reported a 67-year-old female patient with lung adenocarcinoma who underwent osimertinib and radiotherapy and suffered from radiation pneumonitis. Unfortunately, she contracted COVID-19 and that rapidly progressed to severe pneumonia. She responded poorly to frontline treatment and was in danger. Subsequently, she received a salvage treatment with four doses of MSCs, and her symptoms surprisingly improved quickly. After a lung CT scan that presented with a significantly improved infection, she was discharged eventually. Her primary disease was stable after 6 months of follow-up, and no tumor recurrence or progression was observed. MSCs may be an effective treatment for hyperactive inflammation due to their ability related to immunomodulation and tissue repair. Our case suggests a potential value of MSCs for severe pneumonia that is unresponsive to conventional therapy after a COVID-19 infection. However, unless the situation is urgent, it needs to be considered with caution for patients with tumors. The safety in tumor patients still needs to be observed.
Collapse
Affiliation(s)
- Xiaohua Huang
- Department of Hematology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Hematology, Dongzhimen Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Xin Tan
- Department of Rehabilitation Medicine, Southern Theater General Hospital, Guangzhou, China
| | - Xiuwen Xie
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Tingshu Jiang
- Department of Respiratory and Critical Care Medicine, Yantai Yuhuangding Hospital, Yantai, China
| | - Yang Xiao
- Department of Hematology, Shenzhen Qianhai Shekou Pilot Free Trade Zone Hospital, Shenzhen, China
| | - Zenghui Liu
- Department of Hematology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| |
Collapse
|
5
|
Tshongo C, Baguma M, Mateso G, Makali SL, Bedha A, Mwene‐Batu P, Mihigo M, Nzabara F, Balola C, Kabuya P, Bapolisi A, Masimango MI, Bahizire E, Maheshe‐Balemba G, Shindano TA, Cirhuza C. Hyperglycemia and elevated C-reactive protein are independent predictors of hospital mortality in hospitalized COVID-19 patients in South-Kivu, eastern Democratic Republic of the Congo: A cross-sectional study. Health Sci Rep 2024; 7:e1803. [PMID: 38213779 PMCID: PMC10782469 DOI: 10.1002/hsr2.1803] [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: 08/10/2023] [Revised: 10/29/2023] [Accepted: 12/14/2023] [Indexed: 01/13/2024] Open
Abstract
Background and Aim The coronavirus disease 2019 (COVID-19) pandemic was a priority public health problem because of its high mortality rate. This study mainly aimed to determine factors associated with a poor outcome in COVID-19 hospitalized patients in South-Kivu, an eastern province of the Democratic Republic of the Congo (DRC). Methods This observational study retrospectively evaluated medical records of patients consecutively admitted for probable or confirmed COVID-19 between May 01 and July 31, 2020 at the Hôpital Provincial Général de Référence de Bukavu (HPGRB), a tertiary hospital located in South-Kivu. A binary logistic regression model was performed to determine the predictors of mortality. Results A total of 157 hospitalized COVID-19 patients aged 57.7 (13.2) years were included in this study. Male gender (69.4%), older age (52.9%), medical history of diabetes (38.2%), and arterial hypertension (35.1%) were the most frequent risk factors. Most patients presented with fever (73.3%), cough (72.6%), and dyspnea (66.2%). Overall, 45.1% of patients died. Intrahospital mortality was significantly associated with advanced age [odds ratio, OR (95% confidence interval, CI) = 2.34 (1.06-5.38)], hypoxemia [OR (95% CI) = 4.67 (2.02-10.77)], hyperglycemia [OR (95% CI) = 2.14 (1.06-4.31)], kidney failure [OR (95% CI) = 2.82 (1.4-5.68)], hyperleukocytosis [OR (95% CI) = 3.33 (1.67-6.66)], and higher C-reactive protein (CRP) levels [OR (95% CI) = 3.93 (1.93-8.01)]. After adjustment for various covariates, only higher CRP levels [OR (95% CI) = 3.23 (1.23-8.5)] and hyperglycemia [OR (95% CI) = 2.5 (1.02-6.11)] at admission were independently associated with mortality. Conclusion Hyperglycemia and marked inflammatory syndrome were the major predictors of poor outcomes in patients hospitalized for COVID-19 in South-Kivu. These two factors should be quantified at hospital admission to establish the patient's prognosis.
Collapse
Affiliation(s)
- Christian Tshongo
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Marius Baguma
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
- Center for Tropical Diseases and Global Health (CTDGH)Université Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
| | - Guy‐Quesney Mateso
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Samuel Lwamushi Makali
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
- École Régionale de Santé PubliqueUniversité Catholique de BukavuBukavuDemocratic Republic of the Congo
| | - Aline Bedha
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Pacifique Mwene‐Batu
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
- École Régionale de Santé PubliqueUniversité Catholique de BukavuBukavuDemocratic Republic of the Congo
| | - Martine Mihigo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Fabrice Nzabara
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Cordule Balola
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Pierre Kabuya
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Achille Bapolisi
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Mannix I. Masimango
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Esto Bahizire
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
| | - Ghislain Maheshe‐Balemba
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
- École Régionale de Santé PubliqueUniversité Catholique de BukavuBukavuDemocratic Republic of the Congo
| | - Tony A. Shindano
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
- Center for Tropical Diseases and Global Health (CTDGH)Université Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
| | - Cikomola Cirhuza
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
- Center for Tropical Diseases and Global Health (CTDGH)Université Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
| |
Collapse
|
6
|
Shafaei B, Nafei Z, Karimi M, Behniafard N, Shamsi F, Faisal M, Amel Shahbaz AP, Akbarian E. Which Groups of Children Are at More Risk of Fatality during COVID-19 Pandemic? A Case-Control Study in Yazd, Iran. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2023; 2023:8838056. [PMID: 38130842 PMCID: PMC10735732 DOI: 10.1155/2023/8838056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/02/2023] [Accepted: 12/02/2023] [Indexed: 12/23/2023]
Abstract
Introduction The study aims to investigate the characteristics, comorbidities, laboratory findings, and clinical manifestations of under 18-year-old patients who died with the diagnosis of COVID-19 and determination of the most prevalent risk factors. Method This case-control study was performed at a referral hospital in Yazd from March 2020 to August 2021. All patients under 18 years who were diagnosed through real-time RT-PCR, chest computed tomography, and the World Health Organization definition were divided into deceased and survived groups. The characteristics (age and sex), disease severity, comorbidities, laboratory findings, and clinical manifestations of the two groups were compared and analyzed using SPSS, version 18 (SPSS Inc., Chicago, III., USA). Results A total of 24 patients in the deceased group and 167 patients in the survived group were compared. The highest mortality rate was observed in the age group of 1 month to 5 years, although no statistically significant relationship was found between age groups and the risk of mortality. Disease severity, dyspnea, low oxygen saturation on admission, length of hospital stays, and hospitalization history before the last admission were significantly correlated with mortality (P < 0.05). Lymphopenia increased the probability of mortality by more than two times (OR: 2.568; 95% CI (0.962-6.852)), but this was not the case for D-dimer and C-reactive protein. Furthermore, 27.5% of survived patients had normal chest CT scans, which was a statistically significant difference compared to the deceased patients (P: 0.031). Conclusion Based on the findings of this study, dyspnea, low oxygen saturation, and lymphopenia are critical indicators for identifying high-risk children with COVID-19 and triaging them for better care and treatment.
Collapse
Affiliation(s)
- Behnam Shafaei
- Children Growth Disorder Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Zahra Nafei
- Children Growth Disorder Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mehran Karimi
- Children Growth Disorder Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nasrin Behniafard
- Children Growth Disorder Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Farimah Shamsi
- Center of Healthcare Data Modeling, Department of Biostatics and Epidemiology, School of Public Health, Shahid Sadoughi University of Sciences, Yazd, Iran
| | - Masoud Faisal
- Department of Radiology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amir Pasha Amel Shahbaz
- Department of Radiology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Elahe Akbarian
- Children Growth Disorder Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| |
Collapse
|
7
|
Huang YT, Steptoe A, Patel RS, Fuller Thomson E, Cadar D. The Impact of Long-Term Conditions and Comorbidity Patterns on COVID-19 Infection and Hospitalisation: A Cohort Study. Gerontology 2023; 69:1200-1210. [PMID: 37696249 PMCID: PMC10614230 DOI: 10.1159/000531848] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 06/26/2023] [Indexed: 09/13/2023] Open
Abstract
INTRODUCTION Older adults are more vulnerable to COVID-19 infections; however, little is known about which comorbidity patterns are related to a higher risk of COVID-19 infection. This study investigated the role of long-term conditions or comorbidity patterns on COVID-19 infection and related hospitalisations. METHODS This study included 4,428 individuals from Waves 8 (2016-2017) and 9 (2018-2019) of the English Longitudinal Study of Ageing (ELSA) who also participated in the ELSA COVID-19 Substudy in 2020. Comorbidity patterns were identified using an agglomerative hierarchical clustering method. The relationships between comorbidity patterns or long-term conditions and COVID-19-related outcomes were examined using multivariable logistic regression. RESULTS Among a representative sample of community-dwelling older adults in England, those with cardiovascular disease (CVD) and complex comorbidities had an almost double risk of COVID-19 infection (OR = 1.87, 95% CI = 1.42-2.46) but not of COVID-19-related hospitalisation. A similar pattern was observed for the heterogeneous comorbidities cluster (OR = 1.56, 95% CI = 1.24-1.96). The individual investigations of long-term conditions with COVID-19 infection highlighted primary associations with CVD (OR = 1.46, 95% CI = 1.23-1.74), lung diseases (OR = 1.40, 95% CI = 1.17-1.69), psychiatric conditions (OR = 1.40, 95% CI = 1.16-1.68), retinopathy/eye diseases (OR = 1.39, 95% CI = 1.18-1.64), and arthritis (OR = 1.27, 95% CI = 1.09-1.48). In contrast, metabolic disorders and diagnosed diabetes were not associated with any COVID-19 outcomes. CONCLUSION This study provides novel insights into the comorbidity patterns that are more vulnerable to COVID-19 infections and hospitalisations, highlighting the vulnerability of those with CVD and other complex comorbidities. These findings facilitate crucial new evidence that should be considered for appropriate screening measures and tailored interventions for older adults in the ongoing global outbreak.
Collapse
Affiliation(s)
- Yun-Ting Huang
- Department of Epidemiology and Public Health, University College London, London, UK
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, University of Manchester, Manchester, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| | - Riyaz S. Patel
- Institute of Cardiovascular Sciences, University College London, London, UK
- London Biomedical Research Centre, NIHR University College London, London, UK
- London and University College London Hospitals NHS Foundation Trust, London, UK
- UCL BHF Research Accelerator, University College London, London, UK
| | - Esme Fuller Thomson
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Institute for Life Course and Aging, University of Toronto, Toronto, ON, Canada
| | - Dorina Cadar
- Department of Behavioural Science and Health, University College London, London, UK
- Centre for Dementia Studies, Department of Neuroscience, Brighton and Sussex Medical School, Sussex, Brighton, UK
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Sussex, Brighton, UK
| |
Collapse
|
8
|
Aldahlawi SA, Homeida L. YouTube as a Source of Patient Information on Oral Manifestations of COVID-19: A Cross-Sectional Evaluation of Its Utility, Dependability, and Content. Cureus 2023; 15:e42885. [PMID: 37664281 PMCID: PMC10474609 DOI: 10.7759/cureus.42885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2023] [Indexed: 09/05/2023] Open
Abstract
Objectives This study aims to assess the quality of the most viewed videos on the YouTube website describing the oral manifestations of COVID-19 and appraise the medical information in the content. Materials and methods The top 200 most-viewed videos on YouTube using the keywords "COVID-19 oral manifestation," "oral symptoms of COVID-19," "oral lesions of COVID-19," "coronavirus and oral findings," and "dental manifestation of COVID-19" were analyzed. Two independent reviewers classified the English-language videos as useful, misleading, or personal views and identified the source of the videos. Reliability was calculated on a 5-point scale adapted from the DISCERN tool. The global quality scale (GQS) was used to determine the quality of the videos. In addition, the completeness of the information regarding the clinical presentation, pathogenesis, diagnostic tests, and treatment of COVID-19 oral manifestations was evaluated. Results After excluding non-English and irrelevant videos, 55 videos were analyzed. Thirty-two videos were classified as useful. Independent users uploaded the most videos (19, 51%). The mean reliability and GQS scores for useful videos were (3.24+1.4) and (2+0.75), respectively. The GQS score was significantly related to the reliability score (p<0.01). Videos scoring high in GQS also show high-reliability scores. In addition, videos with high GQS scores showed more comprehensive content, scoring >9 in the content aspect. The COVID tongue was the most discussed topic, followed by oral ulcers and oral mucormycosis. Conclusions Most of the YouTube videos were useful and had moderate quality. However, they show low reliability and lack comprehensive medical information on the topic. Healthcare providers should play a more active role in the educational information given on social media (SM) during global disease outbreaks.
Collapse
Affiliation(s)
- Salwa A Aldahlawi
- Department of Basic and Clinical Oral Sciences, Umm Al-Qura University, Makkah, SAU
| | - Lujain Homeida
- Department of Basic and Clinical Oral Sciences, Umm Al-Qura University, Makkah, SAU
| |
Collapse
|
9
|
Askarian M, Movahedi M, Vardanjani HM, Askarian A, Ghotbabadi ZR. Roadmap to recovery: Implemented and attitude toward school reopening strategies during the COVID-19 pandemic, a scoping review. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:235. [PMID: 37727417 PMCID: PMC10506747 DOI: 10.4103/jehp.jehp_1160_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/16/2022] [Indexed: 09/21/2023]
Abstract
The novel coronavirus disease 2019 (COVID-19) has had various financial and life impacts on the world's population. Schools' regular activity and function during the pandemic require balancing the repercussions of suspending in-person education versus health threats. Furthermore, children are one of the prominent victims of the restricted quarantine strategies' effects, which may make them vulnerable to various mental health problems. In this study, we reviewed previously reported strategies and roadmaps regarding the reopening of schools during the COVID-19 pandemic. The following databases were searched from October to December 2021, via multi-step search strategies for "COVID-19," "coronavirus," "school reopening," "roadmaps," "reopening," and "reopening strategies": Google Scholar, PubMed, Scopus, and Web of Science. A total of five papers with roadmaps focusing on reopening schools were included in this study. Fundamental issues and principles of these reviewed roadmaps were: 1) protecting the high-risk students and staff physically and mentally, 2) accelerating the vaccination of essential workers, staff, parents, and students, and 3) improving the COVID-19 testing capacity. Roadmaps for the reopening of the schools should describe some phases and steps for their strategies. Current roadmaps have not mentioned any phases and timelines for this process. Describing some health metrics in the roadmaps for progressing to the next step or returning to the previous ones is also necessary for all roadmaps and should be considered in further studies.
Collapse
Affiliation(s)
- Mehrdad Askarian
- Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran, Health Behavior Science Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Movahedi
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Hossein M. Vardanjani
- MPH Department, School of Medicine, Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ardalan Askarian
- Student, College of Arts and Science, University of Saskatchewan, Saskatoon, Canada
| | - Zahra R. Ghotbabadi
- MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
10
|
Shamsi F, Karimi M, Nafei Z, Akbarian E. Survival and Mortality in Hospitalized Children with COVID-19: A Referral Center Experience in Yazd, Iran. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2023; 2023:5205188. [PMID: 37492855 PMCID: PMC10365916 DOI: 10.1155/2023/5205188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/05/2023] [Accepted: 07/04/2023] [Indexed: 07/27/2023]
Abstract
Introduction COVID-19 prognostic risk factors, therapeutic protocols, and clinical outcomes in pediatric cases are still under investigation. Materials and Methods This historical cohort study evaluated the survival time of hospitalized children (1 month-18 years old) with COVID-19 admitted from March 2020 to August 2021 to an educational hospital in Yazd, Iran. The follow-up of patients was performed at least one month after discharge. Results From 183 hospitalized cases, 24 children were deceased. The median age of patients was 5.41, and 54.2% were male. The survival rate after one-month follow-up was 0.88, and the most significant predictors associated with survival time were the male sex, positive history of hospitalization, lymphopenia, hypoxia, and length of stay more than two weeks using Bayesian Cox regression analysis. Conclusion Accurate estimation of the impact of predictors on poor outcomes may help healthcare providers use therapeutic protocols based on risk factors and healthcare requirements of each patient to improve their survival.
Collapse
Affiliation(s)
- Farimah Shamsi
- Center for Healthcare Data Modeling, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mehran Karimi
- Children Growth Disorder Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Zahra Nafei
- Children Growth Disorder Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Elahe Akbarian
- Children Growth Disorder Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| |
Collapse
|
11
|
Chen KF, Feng TW, Wu CC, Yunusa I, Liu SH, Yeh CF, Han ST, Mao CY, Harika D, Rothman R, Pekosz A. Diagnostic accuracy of clinical signs and symptoms of COVID-19: A systematic review and meta-analysis to investigate the different estimates in a different stage of the pandemic outbreak. J Glob Health 2023; 13:06026. [PMID: 37441773 PMCID: PMC10344460 DOI: 10.7189/jogh.13.06026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023] Open
Abstract
Background The coronavirus (COVID-19) pandemic caused enormous adverse socioeconomic impacts worldwide. Evidence suggests that the diagnostic accuracy of clinical features of COVID-19 may vary among different populations. Methods We conducted a systematic review and meta-analysis of studies from PubMed, Embase, Cochrane Library, Google Scholar, and the WHO Global Health Library for studies evaluating the accuracy of clinical features to predict and prognosticate COVID-19. We used the National Institutes of Health Quality Assessment Tool to evaluate the risk of bias, and the random-effects approach to obtain pooled prevalence, sensitivity, specificity, and likelihood ratios. Results Among the 189 included studies (53 659 patients), fever, cough, diarrhoea, dyspnoea, and fatigue were the most reported predictors. In the later stage of the pandemic, the sensitivity in predicting COVID-19 of fever and cough decreased, while the sensitivity of other symptoms, including sputum production, sore throat, myalgia, fatigue, dyspnoea, headache, and diarrhoea, increased. A combination of fever, cough, fatigue, hypertension, and diabetes mellitus increases the odds of having a COVID-19 diagnosis in patients with a positive test (positive likelihood ratio (PLR) = 3.06)) and decreases the odds in those with a negative test (negative likelihood ratio (NLR) = 0.59)). A combination of fever, cough, sputum production, myalgia, fatigue, and dyspnea had a PLR = 10.44 and an NLR = 0.16 in predicting severe COVID-19. Further updating the umbrella review (1092 studies, including 3 342 969 patients) revealed the different prevalence of symptoms in different stages of the pandemic. Conclusions Understanding the possible different distributions of predictors is essential for screening for potential COVID-19 infection and severe outcomes. Understanding that the prevalence of symptoms may change with time is important to developing a prediction model.
Collapse
Affiliation(s)
- Kuan-Fu Chen
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan
- Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Tsai-Wei Feng
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chin-Chieh Wu
- Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Ismaeel Yunusa
- Department of Clinical Pharmacy and Outcomes Sciences, University of South Carolina College of Pharmacy, Columbia, South Carolina, USA
- Harvard T.H Chan School of Public Health, Boston, Massachusetts, USA
| | - Su-Hsun Liu
- Health Management Center, Far Eastern Memorial Hospital, Taipei, Taiwan
- School of Medicine, International Health Program, National Yang Ming University, Taipei, Taiwan
| | - Chun-Fu Yeh
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shih-Tsung Han
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chih-Yang Mao
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Dasari Harika
- Harvard T.H Chan School of Public Health, Boston, Massachusetts, USA
| | - Richard Rothman
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Andrew Pekosz
- Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| |
Collapse
|
12
|
Hassan NE, Moselhy WA, Eldomany EB, Kholef EFM. Evaluation of miRNA-16-2-3P, miRNA-618 levels and their diagnostic and prognostic value in the regulation of immune response during SARS Cov-2 infection. Immunogenetics 2023:10.1007/s00251-023-01308-6. [PMID: 37222789 DOI: 10.1007/s00251-023-01308-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 05/10/2023] [Indexed: 05/25/2023]
Abstract
Following the announcement of the pandemic of COVID-19 in December 2019, several studies focused on how to early predict the severity of the disease in symptomatic and asymptomatic patients. Many cytokines including interleukin-6, interleukin-8, and tumor necrotic factors have been concluded as strong indicators for COVID-19 infection. Additionally, miRNAs have been associated with dysregulation in the immune system. The aim of this study are the following: (1) to estimate the level of miRNA-16-2-3P, miRNA-618, IL-8, IL-1β as predictors for SARS-CoV-2 complications in PCR negative and positive patients; (2) to assess the biological role and effect of these miRNAs on SARS-CoV-2 pathogenicity. Our study showed that the level of IL-1β had been significantly associated with patient who need hospitalization, also the alteration of the level of miRNA-16-2-3P, miRNA-618 is positively correlated with the admission of these patients and influence the outcomes of SARS-cov-2 infection. Measurement of miRNA-16-2-3P, miRNA-618, IL-1β could be a good predictor of COVID-19 patient outcome. However the measurement of IL-8 levels during immune responses in the admitted and in ICU patients could have a prognostic value.
Collapse
Affiliation(s)
| | - Walaa A Moselhy
- Department of Biotechnology and Life Sciences, Faculty of Postgraduate Studies for Advanced Sciences, Beni-Suef University, Beni-Suef, Egypt
| | - Ehab B Eldomany
- Department of Biotechnology and Life Sciences, Faculty of Postgraduate Studies for Advanced Sciences, Beni-Suef University, Beni-Suef, Egypt
| | | |
Collapse
|
13
|
Huang YT, Steptoe A, Patel RS, Thomson EF, Cadar D. The impact of long-term conditions and comorbidity patterns on COVID-19 infection and hospitalisation: a cohort study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.25.23289035. [PMID: 37162831 PMCID: PMC10168488 DOI: 10.1101/2023.04.25.23289035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Introduction Older adults are usually more vulnerable to COVID-19 infections; however, little is known about which comorbidity patterns are related to a higher probability of COVID-19 infection. This study investigated the role of long-term conditions or comorbidity patterns on COVID-19 infection and related hospitalisations. Methods This study included 4,428 individuals from Waves 8 (2016-2017) and 9 (2018-2019) of the English Longitudinal Study of Ageing (ELSA), who also participated in the ELSA COVID-19 Substudy in 2020. Comorbidity patterns of chronic conditions were identified using an agglomerative hierarchical clustering method. The relationships between comorbidity patterns or long-term conditions and COVID-19 related outcomes were examined using multivariable logistic regression. Results Among a representative sample of community-dwelling older adults in England, those with cardiovascular disease (CVD) and complex comorbidities had an almost double risk of COVID-19 infection (OR=1.87, 95% CI=1.42-2.46) but not of COVID-19 related hospitalisation. A similar pattern was observed for the heterogeneous comorbidities cluster (OR=1.56, 95% CI=1.24-1.96). The individual investigations of long-term conditions with COVID-19 infection highlighted primary associations with CVD (OR=1.46, 95% CI=1.23-1.74), lung diseases (OR=1.40, 95% CI=1.17-1.69), psychiatric conditions (OR=1.40, 95% CI=1.16-1.68), retinopathy/eye diseases (OR=1.39, 95% CI=1.18-1.64), and arthritis (OR=1.27, 95% CI=1.09-1.48). In contrast, metabolic disorders and diagnosed diabetes were not associated with any COVID-19 outcomes. Discussion/Conclusion This study provides novel insights into the comorbidity patterns that are more vulnerable to COVID-19 infections and highlights the importance of CVD and complex comorbidities.These findings facilitate crucial new evidence for appropriate screening measures and tailored interventions for older adults in the ongoing global outbreak.
Collapse
|
14
|
Suhad Jumaa Abd-Alkareem, Saad Hikmat Abdullah, Noor Dhia Hasan. Serum Matrix Metalloproteinase-2: A Possible Link between COVID-19 and Periodontitis. AL MUSTANSIRIYAH JOURNAL OF PHARMACEUTICAL SCIENCES 2023; 23:33-44. [DOI: 10.32947/ajps.v23i1.985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Background: Coronavirus disease-19 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is a severe infection primarily targeting the respiratory system. However, many other extrapulmonary body organs are also
affected with a varying degree of severity. Some evidence indicated the development of periodontist in patients, although the pathogenesis is not well-defined.
Aims: This study aimed to investigate the association of COVID-19 severity and role of matrix metalloproteinase 2 in development of periodontitis.
Patients and Methods: This is a cross sectional study which included a total of 160 patients with COVID-19. Patients were categorized into severe and mild-moderated according to World Health Organization criteria. Periodontitis was diagnosed in those patients according to clinical criteria. Serum level of matrix metalloproteinase 2 was estimated in all patients using enzyme linked immunosorbent assay (ELISA). Demographic and laboratory data were obtained from the patients’ records.
Results: Forty-two patients (26.25%) had severe COVID-19. Demographically, older ages and the presence of comorbidities were significantly associated with COVID-19 severity. Besides the inflammatory markers, the median serum level of MMP-2 was higher in severe than mild-moderate COVID-19 cases (208.12 ng/ml vs. 196.33 ng/ml) with a significant difference. The PO rate in severe and mild-moderate COVID-19 was 23.81% and 10.17%, respectively, with a significant difference. The median serum MMP-2 in patients with PO was 228.5 ng/ml which was significantly higher than those without PO 193.81 ng/ml.
Conclusions: These data indicate the significant association between COVID-19 severity and development of PO. Matrix metalloproteinase-2 could be the possible link between severe COVID-19 and PO.
Collapse
|
15
|
Beltran DM, Villamil Osorio M, Fonseca SLG, Restrepo-Gualteros SM, Garcia MJR, Rodriguez-Martinez CE. Predictors of severity in severe respiratory infection in children with COVID-19 respiratory infection in a developing country. J Med Virol 2023; 95:e28453. [PMID: 36594415 DOI: 10.1002/jmv.28453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 12/13/2022] [Accepted: 12/29/2022] [Indexed: 01/04/2023]
Abstract
On March 11, 2020, the WHO declared the COVID-19 pandemic. This name was given to the disease caused by the SARS-CoV 2 virus at its outbreak in December 2019 in Wuhan, Hubei, China. In Colombia, a significant number of cases have been confirmed. The aim of this study was to evaluate children with respiratory symptoms caused by SARS-CoV2 infection, identifying independent predictors of risk of having a severe illness, thus leading to an early approach and intervention in our patients, especially in children with comorbidities. An analytical cross-sectional study was conducted between April 1, 2020 and March 31, 2021 at a fourth-level referral institution in Bogotá on patients under 18 years of age with respiratory symptoms and a COVID-19 diagnosis confirmed in the laboratory. An explanatory binary logistic regression model was performed with an outcome variable of admission to the intensive care unit. A total of 385 children were included in the study, with ages between 9 months and 17 years of age; 50.1% were male, and the ICR was 9.75 years. 41.6% had some comorbidity, 13.5% were admitted to the pediatric ICU, and 3.6% of the total number of patients died. The predictor variables were: use of antibiotics in the first 24 h, neurological comorbidity, and consolidation shown in the chest X-ray. This explains 38.7% of the variability of the variable. In this cohort of patients with COVID-19-associated respiratory symptoms, we identified predictors of severity, so we consider that these patients require a risk approach that allows timely and adequate care.
Collapse
Affiliation(s)
| | | | | | | | | | - Carlos E Rodriguez-Martinez
- Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia.,Department of Pediatric Pulmonology, School of Medicine, Universidad El Bosque, Bogotá, Colombia
| |
Collapse
|
16
|
Forgacova N, Holesova Z, Hekel R, Sedlackova T, Pos Z, Krivosikova L, Janega P, Kuracinova KM, Babal P, Radvak P, Radvanszky J, Gazdarica J, Budis J, Szemes T. Evaluation and limitations of different approaches among COVID-19 fatal cases using whole-exome sequencing data. BMC Genomics 2023; 24:12. [PMID: 36627554 PMCID: PMC9830622 DOI: 10.1186/s12864-022-09084-5] [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: 02/28/2022] [Accepted: 12/15/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND COVID-19 caused by the SARS-CoV-2 infection may result in various disease symptoms and severity, ranging from asymptomatic, through mildly symptomatic, up to very severe and even fatal cases. Although environmental, clinical, and social factors play important roles in both susceptibility to the SARS-CoV-2 infection and progress of COVID-19 disease, it is becoming evident that both pathogen and host genetic factors are important too. In this study, we report findings from whole-exome sequencing (WES) of 27 individuals who died due to COVID-19, especially focusing on frequencies of DNA variants in genes previously associated with the SARS-CoV-2 infection and the severity of COVID-19. RESULTS We selected the risk DNA variants/alleles or target genes using four different approaches: 1) aggregated GWAS results from the GWAS Catalog; 2) selected publications from PubMed; 3) the aggregated results of the Host Genetics Initiative database; and 4) a commercial DNA variant annotation/interpretation tool providing its own knowledgebase. We divided these variants/genes into those reported to influence the susceptibility to the SARS-CoV-2 infection and those influencing the severity of COVID-19. Based on the above, we compared the frequencies of alleles found in the fatal COVID-19 cases to the frequencies identified in two population control datasets (non-Finnish European population from the gnomAD database and genomic frequencies specific for the Slovak population from our own database). When compared to both control population datasets, our analyses indicated a trend of higher frequencies of severe COVID-19 associated risk alleles among fatal COVID-19 cases. This trend reached statistical significance specifically when using the HGI-derived variant list. We also analysed other approaches to WES data evaluation, demonstrating its utility as well as limitations. CONCLUSIONS Although our results proved the likely involvement of host genetic factors pointed out by previous studies looking into severity of COVID-19 disease, careful considerations of the molecular-testing strategies and the evaluated genomic positions may have a strong impact on the utility of genomic testing.
Collapse
Affiliation(s)
- Natalia Forgacova
- grid.7634.60000000109409708Comenius University Science Park, Bratislava, 841 04 Slovakia ,grid.7634.60000000109409708Faculty of Natural Sciences, Comenius University, Bratislava, 841 04 Slovakia ,grid.419303.c0000 0001 2180 9405Institute of Clinical and Translational Research, Biomedical Research Centre, Slovak Academy of Sciences, Bratislava, 845 05 Slovakia
| | | | - Rastislav Hekel
- grid.7634.60000000109409708Comenius University Science Park, Bratislava, 841 04 Slovakia ,grid.7634.60000000109409708Faculty of Natural Sciences, Comenius University, Bratislava, 841 04 Slovakia ,grid.455020.6Geneton Ltd, Bratislava, 841 04 Slovakia ,grid.450672.20000 0001 2169 605XSlovak Centre of Scientific and Technical Information, Bratislava, 811 04 Slovakia
| | - Tatiana Sedlackova
- grid.7634.60000000109409708Comenius University Science Park, Bratislava, 841 04 Slovakia ,grid.455020.6Geneton Ltd, Bratislava, 841 04 Slovakia
| | - Zuzana Pos
- grid.7634.60000000109409708Comenius University Science Park, Bratislava, 841 04 Slovakia ,grid.419303.c0000 0001 2180 9405Institute of Clinical and Translational Research, Biomedical Research Centre, Slovak Academy of Sciences, Bratislava, 845 05 Slovakia ,grid.455020.6Geneton Ltd, Bratislava, 841 04 Slovakia
| | - Lucia Krivosikova
- grid.7634.60000000109409708Department of Pathology, Faculty of Medicine, Comenius University, Bratislava, 813 72 Slovakia
| | - Pavol Janega
- grid.7634.60000000109409708Department of Pathology, Faculty of Medicine, Comenius University, Bratislava, 813 72 Slovakia
| | - Kristina Mikus Kuracinova
- grid.7634.60000000109409708Department of Pathology, Faculty of Medicine, Comenius University, Bratislava, 813 72 Slovakia
| | - Pavel Babal
- grid.7634.60000000109409708Department of Pathology, Faculty of Medicine, Comenius University, Bratislava, 813 72 Slovakia
| | - Peter Radvak
- grid.7634.60000000109409708Comenius University Science Park, Bratislava, 841 04 Slovakia
| | - Jan Radvanszky
- grid.7634.60000000109409708Comenius University Science Park, Bratislava, 841 04 Slovakia ,grid.7634.60000000109409708Faculty of Natural Sciences, Comenius University, Bratislava, 841 04 Slovakia ,grid.419303.c0000 0001 2180 9405Institute of Clinical and Translational Research, Biomedical Research Centre, Slovak Academy of Sciences, Bratislava, 845 05 Slovakia ,grid.455020.6Geneton Ltd, Bratislava, 841 04 Slovakia
| | - Juraj Gazdarica
- grid.7634.60000000109409708Faculty of Natural Sciences, Comenius University, Bratislava, 841 04 Slovakia ,grid.455020.6Geneton Ltd, Bratislava, 841 04 Slovakia ,grid.450672.20000 0001 2169 605XSlovak Centre of Scientific and Technical Information, Bratislava, 811 04 Slovakia
| | - Jaroslav Budis
- grid.7634.60000000109409708Comenius University Science Park, Bratislava, 841 04 Slovakia ,grid.455020.6Geneton Ltd, Bratislava, 841 04 Slovakia ,grid.450672.20000 0001 2169 605XSlovak Centre of Scientific and Technical Information, Bratislava, 811 04 Slovakia
| | - Tomas Szemes
- grid.7634.60000000109409708Comenius University Science Park, Bratislava, 841 04 Slovakia ,grid.7634.60000000109409708Faculty of Natural Sciences, Comenius University, Bratislava, 841 04 Slovakia ,grid.455020.6Geneton Ltd, Bratislava, 841 04 Slovakia
| |
Collapse
|
17
|
Dibyachintan S, Nandy P, Das K, Vinjanampathy S, Mitra M. Unequal lives: a sociodemographic analysis of COVID-19 transmission and mortality in India. Public Health 2023; 214:133-139. [PMID: 36549022 PMCID: PMC9666378 DOI: 10.1016/j.puhe.2022.11.009] [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: 05/17/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Existing socio-economic inequalities shape, in very particular and measurable ways, the differential impact that a disease has on different sections of the same society. This is particularly true of COVID-19, which has rapidly exhausted the public health system in India, and magnified the gradient of vulnerability in an underserved populace. Using publicly available data, we have aimed to deconstruct this gradient into individual variables of inequality and quantify their impact on the transmission and mortality outcomes of COVID-19 in India. STUDY DESIGN Sociodemographic analysis. METHODS We quantify doubling times and case fatality ratios for all districts in India, then correlate them to 20 variables of socio-economic vulnerability and demographic structure. Variables that exhibit persistent correlation are then analysed using multivariate beta regression models to validate their impact on COVID-19 outcomes in India. RESULTS The transmission of COVID-19 in India is enhanced by the lack of access to indoor latrines, drainage facilities, electricity, and proximate sources of drinking water. Transmission is slowed by the presence of an elderly population. Fatality rates relate negatively to an area's medical infrastructure and the presence of a college-educated populace. CONCLUSIONS An interactive matrix of social inequalities, cultural practices, and behavioural patterns determines the path of COVID-19 through a community. Specific variables exhibit patterns of persistent vulnerability; others indicate a resistance to infection and mortality. This body of evidence, when incorporated into policy design, may lead to localised, need-sensitive models of intervention, both for preventive measures and medical care.
Collapse
Affiliation(s)
- S. Dibyachintan
- Department of Chemical Engineering, IIT Bombay, Mumbai, India,Département de Biochimie, de Microbiologie et de Bio-Informatique, Université Laval, Québec, QC, Canada
| | - P. Nandy
- Department of Chemical Engineering, IIT Bombay, Mumbai, India,Laureate Centre for History and Population, UNSW Sydney, Australia,Corresponding author. Postal Address: Laureate Centre for History and Population, University of New South Wales Sydney, Kensington 2052, NSW, Australia
| | - K. Das
- Department of Mathematics, IIT Bombay, Mumbai, India
| | | | - M.K. Mitra
- Department of Physics, IIT Bombay, Mumbai, India,Corresponding author. Postal Address: Department of Physics, IIT Bombay, Powai, Mumbai – 400076, India. Tel.: +91 22 2576-7565 (O), +91-7506187565 (M); Fax: +91 22 2576-7552
| |
Collapse
|
18
|
Amiri P, Montazeri M, Ghasemian F, Asadi F, Niksaz S, Sarafzadeh F, Khajouei R. Prediction of mortality risk and duration of hospitalization of COVID-19 patients with chronic comorbidities based on machine learning algorithms. Digit Health 2023; 9:20552076231170493. [PMID: 37312960 PMCID: PMC10259141 DOI: 10.1177/20552076231170493] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/31/2023] [Indexed: 06/15/2023] Open
Abstract
Background The severity of coronavirus (COVID-19) in patients with chronic comorbidities is much higher than in other patients, which can lead to their death. Machine learning (ML) algorithms as a potential solution for rapid and early clinical evaluation of the severity of the disease can help in allocating and prioritizing resources to reduce mortality. Objective The objective of this study was to predict the mortality risk and length of stay (LoS) of patients with COVID-19 and history of chronic comorbidities using ML algorithms. Methods This retrospective study was conducted by reviewing the medical records of COVID-19 patients with a history of chronic comorbidities from March 2020 to January 2021 in Afzalipour Hospital in Kerman, Iran. The outcome of patients, hospitalization was recorded as discharge or death. The filtering technique used to score the features and well-known ML algorithms were applied to predict the risk of mortality and LoS of patients. Ensemble Learning methods is also used. To evaluate the performance of the models, different measures including F1, precision, recall, and accuracy were calculated. The TRIPOD guideline assessed transparent reporting. Results This study was performed on 1291 patients, including 900 alive and 391 dead patients. Shortness of breath (53.6%), fever (30.1%), and cough (25.3%) were the three most common symptoms in patients. Diabetes mellitus(DM) (31.3%), hypertension (HTN) (27.3%), and ischemic heart disease (IHD) (14.2%) were the three most common chronic comorbidities of patients. Twenty-six important factors were extracted from each patient's record. Gradient boosting model with 84.15% accuracy was the best model for predicting mortality risk and multilayer perceptron (MLP) with rectified linear unit function (MSE = 38.96) was the best model for predicting the LoS. The most common chronic comorbidities among these patients were DM (31.3%), HTN (27.3%), and IHD (14.2%). The most important factors in predicting the risk of mortality were hyperlipidemia, diabetes, asthma, and cancer, and in predicting LoS was shortness of breath. Conclusion The results of this study showed that the use of ML algorithms can be a good tool to predict the risk of mortality and LoS of patients with COVID-19 and chronic comorbidities based on physiological conditions, symptoms, and demographic information of patients. The Gradient boosting and MLP algorithms can quickly identify patients at risk of death or long-term hospitalization and notify physicians to do appropriate interventions.
Collapse
Affiliation(s)
- Parastoo Amiri
- Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahdieh Montazeri
- Department of Health Information Sciences, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Fahimeh Ghasemian
- Computer Engineering Department, Faculty of Engineering, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Fatemeh Asadi
- Student Research Committee, School of Management and Medical Information, Kerman University of Medical Sciences, Kerman, Iran
| | - Saeed Niksaz
- Computer Engineering Department, Faculty of Engineering, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Farhad Sarafzadeh
- Infectious and Internal Medicine Department, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Reza Khajouei
- Department of Health Information Sciences, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran
| |
Collapse
|
19
|
Marsán-Suárez V, Casado-Hernández I, Hernández-Ramos E, Díaz-Domínguez G, Triana-Marrero Y, Duarte-Pérez Y, Miranda-Navarro J, Bringas-Pérez R, Simón-Pita AM, Hernández-Rego YDLM, Miguel-Morales M, Patria-Sánchez M, Zamora-González Y, Romero-Díaz Y, Aquino-Rojas S, González-Díaz I, Merlín-Linares JC, Leyva-Rodríguez A, Rodríguez-Pérez M, Benito-Caballero O, Navarro-Mariño JA, Elejalde-Larrinaga AR, Elejalde-Tamayo C, Tam-Rey LM, Ruiz-Villegas L, de la Guardia-Peña OM, Jerez-Barcel Y, Chang-Monteagudo A, Lam-Díaz RM, Macías-Abraham CM. Biomarkers of sequela in adult patients convalescing from COVID-19. ADVANCES IN BIOMARKER SCIENCES AND TECHNOLOGY 2022; 4:36-53. [PMID: 36404876 PMCID: PMC9645947 DOI: 10.1016/j.abst.2022.10.001] [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: 10/25/2021] [Revised: 09/18/2022] [Accepted: 10/28/2022] [Indexed: 11/11/2022] Open
Abstract
Different biomarkers for SARS-CoV-2 have been linked to detection, diagnosis, treatment, disease progression, and development of new drugs and vaccines. The objective of this research was to evaluate various hematological, biochemicals, immunological, radiological and spirometric parameters in 20 adult patients convalescing from COVID-19 and their possible relationship with the clinical course of the disease. The frequencies of categorical variables were compared using the chi-square and Fisher's exact test. The levels of statistical significance were denoted in each figure legend. Two-dimensional clustering analysis was performed using MeV software from TIGR. The tests with P value of ≤ 0.05 were considered statistically significant. Most of the patients studied presented alterations in dissimilar laboratory, radiological and spirometric parameters, which were related to the clinical evolution of the disease. The results obtained show that certain hematological, biochemical, immunological and radiological parameters can be considered as biomarkers of sequela in adult COVID-19 patients, which allows their stratification, according to the degree of involvement or sequela, into three groups: I (mild degree of involvement or sequela), without lung lesions on computerized axial tomography (CT scan) and high values of IgG, C3 and hemoglobin, II (moderate degree of involvement or sequel), without lung lesions on CT scan, characterized by high levels of CD3+/CD4+ T lymphocytes and the rest of the variables with low values and III (severe degree of involvement or sequela), with lung lesions on CT scan and high values of erythrocyte sedimentation rate, monocytes and neutrophils, associated with lymphopenia and decreased concentrations of IgG and C3.
Collapse
Affiliation(s)
- Vianed Marsán-Suárez
- Dr. in Medical Sciences, 1st and 2nd Degree Specialist in Immunology, Associated Professor, Assistant Researcher, Immunochemistry and Immunology Department, Institute of Hematology and Immunology, Cuba
| | - Imilla Casado-Hernández
- Degree in Biology, Assistant Professor, Assistant Researcher, Immunochemistry and Immunology Department, Institute of Hematology and Immunology, Cuba
| | - Elizabeth Hernández-Ramos
- Degree in Biochemistry and Molecular Biology, Immunochemistry and Immunology Department, Institute of Hematology and Immunology, Cuba
| | - Gabriela Díaz-Domínguez
- Degree in Biochemistry and Molecular Biology, Assistant Researcher, Department of Immunochemistry and Immunology, Institute of Hematology and Immunology, Cuba
| | - Yenisey Triana-Marrero
- 1st Degree Specialist Physician in Comprehensive General Medicine and Immunology, Instructor Teacher, Immunochemistry and Immunology Department, Institute of Hematology and Immunology, Cuba
| | - Yaneisy Duarte-Pérez
- 1st Degree Specialist Physician in Comprehensive General Medicine and Immunology, Instructor Teacher, Immunochemistry and Immunology Department, Institute of Hematology and Immunology, Cuba
| | - Jamilet Miranda-Navarro
- Assistant Researcher, Master of Science in Mathematics Bioinformatics Department, Center for Genetic Engineering and Biotechnology (CIGB), Cuba
| | - Ricardo Bringas-Pérez
- Doctor in Biological Sciences, Professor and Senior Researcher, Bioinformatics Department, Center for Genetic Engineering and Biotechnology (CIGB), Cuba
| | - Ana María Simón-Pita
- Graduate in Health Technology, Assistant Teacher, Assistant Researcher, Department of Morphology and Pathological Anatomy, Institute of Hematology and Immunology, Cuba
| | | | - Maydelín Miguel-Morales
- Degree in Biochemistry, Associated Research, Assistant Professor, Enzyme and Haemostasis Department, Institute of Hematology and Immunology, Cuba
| | - Mysleidis Patria-Sánchez
- Graduate in Health Technology, Enzyme e and Haemostasis Department, Institute of Hematology and Immunology, Cuba
| | - Yaneth Zamora-González
- Graduate in Health Technology, Assistant Teacher, Assistant Researcher, Enzyme and Haemostasis Department, Institute of Hematology and Immunology, Cuba
| | - Yisenia Romero-Díaz
- Degree in Biochemistry and Molecular Biology, Assistant Researcher, Immunohematology Department, Institute of Hematology and Immunology, Cuba
| | - Suharmi Aquino-Rojas
- Degree in Health Technology, Transfusion Medicine Specialist, Assistant Teacher, Immunohematology Department, Institute of Hematology and Immunology, Cuba
| | - Ihosvani González-Díaz
- Graduate in Clinical Laboratory, Immunohematology Department, Institute of Hematology and Immunology, Cuba
| | - Julio César Merlín-Linares
- Degree in Biochemistry, Assistant Researcher, Immunochemistry and Immunology Department, Institute of Hematology and Immunology, Cuba
| | - Aymara Leyva-Rodríguez
- Degree in Biology, Aspiring Researcher, Immunochemistry and Immunology Department, Institute of Hematology and Immunology, Cuba
| | - Maylín Rodríguez-Pérez
- 1th and 2nd Degree Specialist Physician in Microbiology, Assistant Researcher, Assistant Teacher, Master in Parasitology, Microbiology Department, Institute of Hematology and Immunology, Cuba
| | - Onasi Benito-Caballero
- 1th Degree Specialist Physician in Comprehensive General Medicine and Imaging, Imaging Department, Institute of Hematology and Immunology, Cuba
| | - José Antonio Navarro-Mariño
- 1th and 2nd Degree Specialist in Comprehensive General Medicine and 1st in Imaging, Master in Diagnostic Media, Imaging Department, Institute of Hematology and Immunology, Cuba
| | - Angel René Elejalde-Larrinaga
- 1th and 2nd Degree Specialist in Pneumology, Assistant Professor, Assistant Researcher, Master in Public Health and Population Aging, Imaging Department, Institute of Oncology and Radiobiology, Cuba
| | - Claudia Elejalde-Tamayo
- 1th Degree Specialist Physician in Comprehensive General Medicine and Pulmonology, Spirometry Department, "Clinical Surgical University Hospital" Comandante Manuel Fajardo, Cuba
| | - Lázara Minerva Tam-Rey
- Degree in Health Technology, Aspiring Researcher, External Services Department, Institute of Hematology and Immunology, Cuba
| | - Laura Ruiz-Villegas
- Degree in Biology, Aspiring Researcher, Coordinator of Clinical Trials, Department of Teaching and Research, Institute of Hematology and Immunology, Cuba
| | - Odalis María de la Guardia-Peña
- Medical Specialist of 1st and 2nd Degree in Immunology, Assistant Professor and Researcher, External Services Department, Institute of Hematology and Immunology, Cuba
| | - Yanet Jerez-Barcel
- 1th Degree Specialist Physician in Comprehensive General Medicine and Immunology, Instructor Teacher, Blood Bank Department, Institute of Hematology and Immunology, Cuba
| | - Arturo Chang-Monteagudo
- Specialist Physician of 1st Degree in Comprehensive General Medicine and 2nd Degree in Immunology, Master in Biochemistry, Mention in Immunology, Assistant Professor and Researcher, Technical Deputy Director, Institute of Hematology and Immunology, Cuba
| | - Rosa María Lam-Díaz
- Medical Specialist in Biostatistics, Assistant Researcher, Department of Teaching and Research, Institute of Hematology and Immunology, Cuba
| | - Consuelo Milagros Macías-Abraham
- Dr. in Medical Sciences, 1st and 2nd Degree Specialist in Immunology, Professor and Senior Researcher, Director of the Institute of Hematology and Immunology, Cuba
| |
Collapse
|
20
|
Takács AT, Bukva M, Gavallér G, Kapus K, Rózsa M, Bán‐Gagyi B, Sinkó M, Szűcs D, Terhes G, Bereczki C. Epidemiology and clinical features of SARS‐CoV‐2 infection in hospitalized children across four waves in Hungary: A retrospective, comparative study from March 2020 to December 2021. Health Sci Rep 2022; 5:e937. [PMID: 36425898 PMCID: PMC9679239 DOI: 10.1002/hsr2.937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/26/2022] [Accepted: 10/31/2022] [Indexed: 11/23/2022] Open
Abstract
Background and Aims From 2019 till the present, infections induced by the novel coronavirus and its mutations have posed a new challenge for healthcare. However, comparative studies on pediatric infections throughout waves are few. During four different pandemic waves, we intended to investigate the clinical and epidemiological characteristic of the pediatric population hospitalized for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) virus infection. Methods Between March 2020 and December 2021, we performed our retrospective research on children infected with the SARS‐CoV‐2 virus at the University of Szeged. We analyzed the data of all patients who required hospitalization due to positive results of SARS‐CoV‐2 tests (Nucleic Acid Amplification Test or rapid antigen test). Data analysis included demographic data, medical history, clinical findings, length of hospitalization, and complications, using medical records. Results In this study, data from 358 coronavirus‐infected children were analyzed. The most affected age group was children over 1 month and under 1 year (30.2%). The highest number of cases was recorded in the fourth wave (53.6%). Fever (65.6%), cough (51.4%), nasal discharge (35.3%), nausea and vomiting (31.3%), and decreased oral intake (28.9%) were the most common symptoms. The most common complications were dehydration (50.5%), pneumonia (14.9%), and bronchitis/bronchiolitis (14.5%). Based on RR values, there are considerable differences in the prevalence of the symptoms and complications between the different age groups and waves. Cox proportional hazard model analyzes showed that fever and tachypnoea had a relevant effect on days to recovery. Conclusions We found trends similar to those previously published, overall statistics. The proportion of children requiring hospitalization varied from wave to wave, with the fourth wave affecting the Hungarian child population the most. Our findings suggest that hospitalization time is unrelated to age, but that certain symptoms (fever and tachypnoea) are associated with longer hospitalization. The onset of certain symptoms may differ by age group.
Collapse
Affiliation(s)
- Andrea T. Takács
- Department of Paediatrics and Paediatric Health Center University of Szeged Szeged Hungary
| | - Mátyás Bukva
- Laboratory of Microscopic Image Analysis and Machine Learning, Biological Research Centre, Eötvös Loránd Research Network Institute of Biochemistry Szeged Hungary
- Department of Immunology University of Szeged Szeged Hungary
- Data Science and Me Ltd Szeged Hungary
| | - Gabriella Gavallér
- Department of Paediatrics and Paediatric Health Center University of Szeged Szeged Hungary
| | - Katalin Kapus
- Department of Paediatrics and Paediatric Health Center University of Szeged Szeged Hungary
| | - Mária Rózsa
- Department of Paediatrics and Paediatric Health Center University of Szeged Szeged Hungary
| | - Boglárka Bán‐Gagyi
- Department of Paediatrics and Paediatric Health Center University of Szeged Szeged Hungary
| | - Mária Sinkó
- Department of Paediatrics and Paediatric Health Center University of Szeged Szeged Hungary
| | - Dániel Szűcs
- Department of Paediatrics and Paediatric Health Center University of Szeged Szeged Hungary
| | - Gabriella Terhes
- Department of Medical Microbiology University of Szeged Szeged Hungary
| | - Csaba Bereczki
- Department of Paediatrics and Paediatric Health Center University of Szeged Szeged Hungary
| |
Collapse
|
21
|
Afshari P, Beheshti-Nasab M, Maraghi E, Sadeghi S, Sanjari N, Zarea K. Home care in COVID-19 patients with the home-quarantined condition: A study from Iran. Front Public Health 2022; 10:952618. [PMID: 36148335 PMCID: PMC9485635 DOI: 10.3389/fpubh.2022.952618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 08/01/2022] [Indexed: 01/24/2023] Open
Abstract
Objectives During the COVID-19 home-quarantines, home care services may act as an auxiliary component of health care system, which reduces the burden on the formal health care system. This study aimed to investigate the status of informal home care provided for home quarantined patients with COVID-19 in southwest Iran. Methods This descriptive study was conducted on 288 patients with COVID-19 in Ahvaz (southwest Iran). Inclusion criteria included a known case of COVID-19, willingness to participate in the study, recommendation of home quarantine from a health center, having a smartphone, and fluency in reading and writing in Persian, and the exclusion criterion was a history of COVID-19 longer than 3 months. The data collection method was structured interviews based on a questionnaire (face-to-face-telephone calls-video call). SPSS software was used for the analysis of data. Results 45.5% of the participants in the study were women with a mean age of 37.82 (10.48%) and 55.5% were men with a mean age of 36.12 (11.93%). Findings showed that in most cases, the spouse (61.4) is responsible for the care of the patient, and in other cases, parents are responsible for this duty. 57.3% of the patients stated that they themselves had to leave home to provide for necessities of life, and 37.2% stated that they were in charge of cooking. 47.9% of the patients evaluated the quality of quality of care provided at home as good. Most of patients and caregivers referred to hospital for getting information (35.8% patients and 34% caregivers). Most of patients recovered from diseases (60.8%) and 39.2% were hospitalized. Although 43.9% of men and 33.6% of women were hospitalized and a there was a significant difference between men and women (P < 0.04). Conclusion During COVID-19 pandemic home care to reduce the burden on the health system are very important. We must also know that this type of care requires informed and planned support and sufficient community education. The health care system needs to put self-care and family care among its top priorities. The focus should be on educational and mental support of informal caregivers along with measures that protect their relatives from COVID-19.
Collapse
Affiliation(s)
- Poorandokht Afshari
- Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Beheshti-Nasab
- Nursing and Midwifery Faculty, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Elham Maraghi
- Department of Biostatistics and Epidemiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Simin Sadeghi
- Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Kourosh Zarea
- Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| |
Collapse
|
22
|
D’Ascenzi F, Castelletti S, Adami PE, Cavarretta E, Sanz-de la Garza M, Maestrini V, Biffi A, Kantor P, Pieles G, Verhagen E, Tiberi M, Hanssen H, Papadakis M, Niebauer J, Halle M. Cardiac screening prior to return to play after SARS-CoV-2 infection: focus on the child and adolescent athlete: A Clinical Consensus Statement of the Task Force for Childhood Health of the European Association of Preventive Cardiology. Eur J Prev Cardiol 2022; 29:2120-2124. [PMID: 36059208 PMCID: PMC9494331 DOI: 10.1093/eurjpc/zwac180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 08/10/2022] [Accepted: 08/16/2022] [Indexed: 01/11/2023]
Abstract
Cardiac sequelae after COVID-19 have been described in athletes, prompting the need to establish a return-to-play (RTP) protocol to guarantee a safe return to sports practice. Sports participation is strongly associated with multiple short- and long-term health benefits in children and adolescents and plays a crucial role in counteracting the psychological and physical effects of the current pandemic. Therefore, RTP protocols should be balanced to promote safe sports practice, particularly after an asymptomatic SARS-CoV-2 infection that represents the common manifestation in children. The present consensus document aims to summarize the current evidence on the cardiac sequelae of COVID-19 in children and young athletes, providing key messages for conducting the RTP protocol in paediatric athletes to promote a safe sports practice during the COVID-19 era.
Collapse
Affiliation(s)
| | - Silvia Castelletti
- IRCCS Istituto Auxologico Italiano, Cardiomyopathy Unit and Department of Cardiovascular, Neural and Metabolic Sciences, Milan, Italy
| | - Paolo Emilio Adami
- Health and Science Department, World Athletics, Monaco, Principality of Monaco
| | - Elena Cavarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy,Mediterranea Cardiocentro, Naples, Italy
| | - María Sanz-de la Garza
- Cardiovascular Institute, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Viviana Maestrini
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Alessandro Biffi
- Med-Ex, Medicine and Exercise srl, Medical Partner Scuderia Ferrari, Rome, Italy
| | - Paul Kantor
- Division of Cardiology, Department of Pediatrics, Children’s Hospital of Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Guido Pieles
- Sports Medicine Department, Aspetar, Orthopaedic and Sports Medicine Hospital, Doh, Qatar,Institute of Sport Exercise and Health (ISEH), University College London, London, UK
| | - Evert Verhagen
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Monica Tiberi
- Sport Medicine, Department of Prevention, ASUR Marche Area Vasta 1, Pesaro, Italy
| | - Henner Hanssen
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Michael Papadakis
- Cardiovascular Clinical Academic Group, St George’s, University of London, London, UK
| | - Josef Niebauer
- University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University of Salzburg, Salzburg, Austria
| | | |
Collapse
|
23
|
RACHDI R, HANNACHI S, ZRIBI S, AYED O, ABID R, MOATEMRI Z, MHAMDI S, DABBOUSSI S, GHARSALLAH H, SELLAMI W, SAMMOUD W, MASSOUDI H, LAMINE K, DJEBBI O, HAMMAMI R, BEN MOUSSA M, BELLAAJ R, BATTIKH R, RACHDI MR, FERJANI M. [Comparative study of patients hospitalized for SARS-CoV-2 infection in two consecutive waves in Tunisia]. MEDECINE TROPICALE ET SANTE INTERNATIONALE 2022; 2:mtsi.v2i3.2022.207. [PMID: 36284562 PMCID: PMC9557822 DOI: 10.48327/mtsi.v2i3.2022.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 07/11/2022] [Indexed: 11/19/2022]
Abstract
Introduction Since December 2019, a novel coronavirus (SARS-CoV-2) has triggered a global pandemic with a heavy medical and societal-economic toll. The health consequences were not similar during the successive waves that affected several countries. The aim of our study was to compare the sociodemographic, clinical and evolutionary features of COVID-19 patients hospitalized at the Military Hospital of Tunis (HMPIT) during the 2nd and 3rd waves that affected the country. Patients and methods Observational prospective study involving 1,527 COVID-19 patients hospitalized at HMPIT over 11 months, divided into two periods: from July 2020 to December 2020 called the second wave (V2) and from January 2021 to May 2021 called the third wave (V3). We compared the epidemiological data, the clinical form and the evolution of the patients for each period. Results The number of hospitalized patients was 636 during V2 compared to 891 during V3. Average age was 63.5 ± 15.3 years during V2 versus 65.8 ± 17.8 years during V3 (P = not significant [NS]). The percentage of young adults [18-40 years] was 6.5% during V2 compared to 6.7% during V3 (P = NS). The gender ratio (M/F) was 1.59 for V2 and 1.42 for V3 (P = NS). Comorbidities were present in 65% of V2 patients and 66.3% of V3 patients (P = NS), with hypertension being the most prevalent one in both groups (47.2% for V2 versus 44.9% for V3; P = NS), followed by overweight, dyslipidemia and diabetes (33% for V2 versus 39.3% for V3; P = 0.012). The median duration between symptoms onset and hospitalization was 7 days [5-10] during V2 versus 8.5 days during V3 [5-12] (P = 0.0004). The severe clinical form was present in 49% of patients admitted during V2 compared to 34.8% during V3 (P < 10-3). The critical form represented 18.6% of cases during V2 against 16.8% during V3 (P = NS). The average hospital length of stay in COVID units (outside of intensive care unit) was 8.4 ± 5.4 days during V2 and 9.8 ± 5.7 days during V3. The average length of stay was significantly longer for the intensive care unit (11.3 ± 3.4 days for V2 versus 13.8 ± 3.9 days for V3; P = 0.01). The case fatality rate was 24.5% during V2 and 20.7% during V3 (P = NS). Median age of death was 70.2 years [42-88] during V2 and 70.4 years [22-96] during V3 with 2 patients less than 40 years of age (1%) for the latter period. The gender ratio (M/F) of deceased patients was 3.21 for V2 and 1.5 for V3 (P = 0.001). The case fatality rate was higher in the intensive care unit (65.4% for V2 versus 69.7% for V3; P = NS). Causes of death were dominated by ARDS (acute respiratory distress syndrome) for both periods (55.1% for V2 versus 70.8% for V3; P = 0.002), followed by septic shock (12.8% for V2 versus 10.8% for V3; P = NS) and multi-organ failure (9.6% for V2 versus 7.0% for V3; P = NS). Conclusion This study revealed a decrease in severe and critical clinical forms during the 3rd wave, as well as a decrease in the case fatality rate compared to the previous wave, due to improved management and vaccination. On the other hand, the percentage of ARDS was significantly higher during this wave probably related to the beginning of circulation in our country of the Delta variant causing more severe clinical cases.
Collapse
Affiliation(s)
- Rim RACHDI
- Service d'hygiène hospitalière et de protection de l'environnement, Hôpital militaire principal d'instruction de Tunis (HMPIT), 1008 Montfleury, Tunis, Tunisie,*
| | - Souha HANNACHI
- Service des maladies infectieuses, HMPIT,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Sabrine ZRIBI
- Service d'hygiène hospitalière et de protection de l'environnement, Hôpital militaire principal d'instruction de Tunis (HMPIT), 1008 Montfleury, Tunis, Tunisie,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Oumaima AYED
- Service d'hygiène hospitalière et de protection de l'environnement, Hôpital militaire principal d'instruction de Tunis (HMPIT), 1008 Montfleury, Tunis, Tunisie,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Rim ABID
- Service des maladies infectieuses, HMPIT,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Zied MOATEMRI
- Service de pneumo-phtisiologie, HMPIT,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Samira MHAMDI
- Service de pneumo-phtisiologie, HMPIT,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Salsabil DABBOUSSI
- Service de pneumo-phtisiologie, HMPIT,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Hédi GHARSALLAH
- Service d'anesthésie-réanimation, HMPIT,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Walid SELLAMI
- Service d'anesthésie-réanimation, HMPIT,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | | | - Hakim MASSOUDI
- Service d'anesthésie-réanimation, HMPIT,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Khaled LAMINE
- Service d'accueil des urgences, HMPIT,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Olfa DJEBBI
- Service d'accueil des urgences, HMPIT,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Rim HAMMAMI
- Service d'accueil des urgences, HMPIT,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | | | - Ridha BELLAAJ
- Service d'hygiène hospitalière et de protection de l'environnement, Hôpital militaire principal d'instruction de Tunis (HMPIT), 1008 Montfleury, Tunis, Tunisie,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Riadh BATTIKH
- Service des maladies infectieuses, HMPIT,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Mohamed Radhouane RACHDI
- Service de gynécologie obstétrique, HMPIT,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Mustapha FERJANI
- Service d'anesthésie-réanimation, HMPIT,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| |
Collapse
|
24
|
Xie Y, Butler M. Serum N-glycomic profiling may provide potential signatures for surveillance of COVID-19. Glycobiology 2022; 32:871-885. [PMID: 35925863 PMCID: PMC9487901 DOI: 10.1093/glycob/cwac051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 07/19/2022] [Accepted: 07/21/2022] [Indexed: 01/08/2023] Open
Abstract
Disease development and progression are often associated with aberrant glycosylation, indicating that changes in biological fluid glycome may potentially serve as disease signatures. The corona virus disease-2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) represents a significant threat to global human health. However, the effect of SARS-CoV-2 infection on the overall serum N-glycomic profile has been largely unexplored. Here, we extended our 96-well-plate-based high-throughput, high-sensitivity N-glycan profiling platform further with the aim of elucidating potential COVID-19-associated serum N-glycomic alterations. Use of this platform revealed both similarities and differences between the serum N-glycomic fingerprints of COVID-19 positive and control cohorts. Although there were no specific glycan peaks exclusively present or absent in COVID-19 positive cohort, this cohort showed significantly higher levels of glycans and variability. On the contrary, the overall N-glycomic profiles for healthy controls were well-contained within a narrow range. From the serum glycomic analysis, we were able to deduce changes in different glycan subclasses sharing certain structural features. Of significance was the hyperbranched and hypersialylated glycans and their derived glycan subclass traits. T-distributed stochastic neighbour embedding (tSNE) and hierarchical heatmap clustering analysis were performed to identify 13 serum glycomic variables that potentially distinguished the COVID-19 positive from healthy controls. Such serum N-glycomic changes described herein may indicate or correlate to the changes in serum glycoproteins upon COVID-19 infection. Furthermore, mapping the serum N-glycome following SARS-CoV-2 infection may help us better understand the disease and enable "Long-COVID" surveillance to capture the full spectrum of persistent symptoms.
Collapse
Affiliation(s)
- Yongjing Xie
- National Institute for Bioprocessing Research and Training, Foster Avenue, Mount Merrion, Blackrock, Co. Dublin, Ireland
| | - Michael Butler
- National Institute for Bioprocessing Research and Training, Foster Avenue, Mount Merrion, Blackrock, Co. Dublin, Ireland
| |
Collapse
|
25
|
Ranucci M, Parati G, Di Dedda U, Bussotti M, Agricola E, Menicanti L, Bombace S, De Martino F, Giovinazzo S, Zambon A, Menè R, La Rovere MT. When Outcomes Diverge: Age and Cardiovascular Risk as Determinants of Mortality and ICU Admission in COVID-19. J Clin Med 2022; 11:jcm11144099. [PMID: 35887864 PMCID: PMC9316345 DOI: 10.3390/jcm11144099] [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: 06/17/2022] [Revised: 07/09/2022] [Accepted: 07/12/2022] [Indexed: 12/10/2022] Open
Abstract
Background: Hospital mortality and admission to the Intensive Care Unit (ICU) are markers of disease severity in COVID-19 patients. Cardiovascular co-morbidities are one of the main determinants of negative outcomes. In this study we investigated the impact of cardiovascular co-morbidities on mortality and admission to the ICU in first-wave COVID-19 patients. Methods: A multicenter, retrospective, cohort study. A total of 1077 patients were analyzed for mortality and ICU admission. Cardiovascular risk factors were explored as determinants of the outcomes after correction for other confounders. Results: In the multivariable model, after correction for age, only a history of heart failure remained independently associated (p = 0.0013) with mortality (hazard ratio 2.22, 95% confidence interval 1.37 to 3.62). Age showed a mortality risk increase of 8% per year (hazard ratio 1.08, 95% confidence interval 1.05 to 1.10, p = 0.001). The transition from ward to the ICU had, as a single determinant, the age, but in a reversed fashion (hazard ratio 0.96, 95% confidence interval 0.94 to 0.98, p = 0.0002). Conclusions: Once adjusted for the main determinant of mortality (age) heart failure only remained independently associated with mortality. Admission to the ICU was less likely for elderly patients. This may reflect the catastrophic impact of the first wave of COVID-19 pandemic in terms of ICU bed availability in Lombardy, leading to a selection process for ICU admission.
Collapse
Affiliation(s)
- Marco Ranucci
- Department of Cardiovascular Anesthesia and ICU, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy;
- Correspondence: ; Tel.: +39-02-52774754
| | - Gianfranco Parati
- Department of Cardiovascular Neural and Metabolic Sciences, Department of Medicine and Surgery, IRCCS Istituto Auxologico Italiano, University of Milano-Bicocca, 20126 Milan, Italy;
| | - Umberto Di Dedda
- Department of Cardiovascular Anesthesia and ICU, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy;
| | - Maurizio Bussotti
- Department of Cardiac Rehabilitation, IRCCS Istituti Clinici Scientifici Maugeri, 20138 Milan, Italy;
| | - Eustachio Agricola
- Cardiovascular Imaging Unit, Cardio-Thoracic-Vascular Department, Vita-Salute University, IRCCS San Raffaele Hospital, 20132 Milan, Italy;
| | - Lorenzo Menicanti
- Scientific Directorate, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy;
| | - Sara Bombace
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy;
- IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Fabiana De Martino
- Heart Failure Unit, Centro Cardiologico Monzino Istituto di Ricovero e Cura a Carattere Scientifico, 20138 Milan, Italy;
| | - Stefano Giovinazzo
- Cardiovascular Disease Unit, Cardiac, Thoracic and Vascular Department, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy;
| | - Antonella Zambon
- Biostatistics Unit, IRCCS Istituto Auxologico Italiano, 20126 Milan, Italy;
- Department of Statistics and Quantitative Methods, Università di Milano-Bicocca, 20126 Milan, Italy
| | - Roberto Menè
- Department of Cardiology, IRCCS Istituto Auxologico Italiano, Università di Milano-Bicocca, 20126 Milan, Italy;
| | - Maria Teresa La Rovere
- Department of Cardiac Rehabilitation, IRCCS Istituti Clinici Scientifici Maugeri, 28843 Montescano, Italy;
| |
Collapse
|
26
|
Multisystem Inflammatory Syndrome Associated With COVID-19 in Children (MIS-C): A Systematic Review of Studies From India. Indian Pediatr 2022. [PMID: 35869878 PMCID: PMC9379896 DOI: 10.1007/s13312-022-2559-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
27
|
Silva CA, Lopes AJ, Papathanasiou J, Reis LFF, Ferreira AS. Association of Functional Characteristics and Physiotherapy with COVID-19 Mortality in Intensive Care Unit in Inpatients with Cardiovascular Diseases. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58060823. [PMID: 35744086 PMCID: PMC9229782 DOI: 10.3390/medicina58060823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/30/2022] [Accepted: 06/17/2022] [Indexed: 11/26/2022]
Abstract
Background and Objectives: To estimate the association between admission functional outcomes and exposure to physiotherapy interventions with mortality rate in intensive care unit (ICU) inpatients with cardiovascular diseases and new coronavirus disease (COVID-19). Materials and Methods: Retrospective cohort including 100 ICU inpatients (mean (standard deviation), age 75 (16) years) split into COVID-19+ or COVID-19−. The association of in-ICU death with admission functional outcomes and physiotherapy interventions was investigated using univariable and multivariable regression models. Results: In total, 42 (42%) patients tested positive for COVID-19. In-ICU mortality rate was 37%, being higher for the COVID-19+ group (odds ratio, OR (95% CI): 3.15 (1.37−7.47), p = 0.008). In-ICU death was associated with lower admission ICU Mobility Scale score (0.81 (0.71−0.91), p = 0.001). Restricted mobility (24.90 (6.77−161.94), p < 0.001) and passive kinesiotherapy (30.67 (9.49−139.52), p < 0.001) were associated with in-ICU death, whereas active kinesiotherapy (0.13 (0.05−0.32), p < 0.001), standing (0.12 (0.05−0.30), p < 0.001), or walking (0.10 (0.03−0.27), p < 0.001) were associated with in-ICU discharge. Conclusions: In-ICU mortality was higher for inpatients with cardiovascular diseases who had COVID-19+, were exposed to invasive mechanical ventilation, or presented with low admission mobility scores. Restricted mobility or passive kinesiotherapy were associated with in-ICU death, whereas active mobilizations (kinesiotherapy, standing, or walking) were associated with in-ICU discharge in this population.
Collapse
Affiliation(s)
- Chiara Andrade Silva
- Postgraduate Program of Rehabilitation Sciences, Centro Universitário Augusto Motta/UNISUAM, Rio de Janeiro 20080-003, Brazil; (C.A.S.); (A.J.L.); (L.F.F.R.)
| | - Agnaldo José Lopes
- Postgraduate Program of Rehabilitation Sciences, Centro Universitário Augusto Motta/UNISUAM, Rio de Janeiro 20080-003, Brazil; (C.A.S.); (A.J.L.); (L.F.F.R.)
| | - Jannis Papathanasiou
- Department of Medical Imaging, Allergology & Physiotherapy, Faculty of Dental Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria;
- Department of Kinesitherapy, Faculty of Public Health “Prof. Dr. Tzecomir Vodenicharov, DSc.”, Medical University of Sofia, 1431 Sofia, Bulgaria
| | - Luis Felipe Fonseca Reis
- Postgraduate Program of Rehabilitation Sciences, Centro Universitário Augusto Motta/UNISUAM, Rio de Janeiro 20080-003, Brazil; (C.A.S.); (A.J.L.); (L.F.F.R.)
| | - Arthur Sá Ferreira
- Postgraduate Program of Rehabilitation Sciences, Centro Universitário Augusto Motta/UNISUAM, Rio de Janeiro 20080-003, Brazil; (C.A.S.); (A.J.L.); (L.F.F.R.)
- Correspondence: ; Tel.: +5521-38829797 (ext. 2012)
| |
Collapse
|
28
|
Giner-Galvañ V, Pomares-Gómez FJ, Quesada JA, Rubio-Rivas M, Tejada-Montes J, Baltasar-Corral J, Taboada-Martínez ML, Sánchez-Mesa B, Arnalich-Fernández F, Del Corral-Beamonte E, López-Sampalo A, Pesqueira-Fontán PM, Fernández-Garcés M, Gómez-Huelgas R, Ramos-Rincón JM. C-Reactive Protein and Serum Albumin Ratio: A Feasible Prognostic Marker in Hospitalized Patients with COVID-19. Biomedicines 2022; 10:biomedicines10061393. [PMID: 35740416 PMCID: PMC9219981 DOI: 10.3390/biomedicines10061393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/06/2022] [Accepted: 06/08/2022] [Indexed: 11/25/2022] Open
Abstract
(1) Background: C-reactive protein (CRP) and albumin are inflammatory markers. We analyzed the prognostic capacity of serum albumin (SA) and CRP for an outcome comprising mortality, length of stay, ICU admission, and non-invasive mechanical ventilation in hospitalized COVID-19 patients. (2) Methods: We conducted a retrospective cohort study based on the Spanish national SEMI-COVID-19 Registry. Two multivariate logistic models were adjusted for SA, CRP, and their combination. Training and testing samples were used to validate the models. (3) Results: The outcome was present in 41.1% of the 3471 participants, who had lower SA (mean [SD], 3.5 [0.6] g/dL vs. 3.8 [0.5] g/dL; p < 0.001) and higher CRP (108.9 [96.5] mg/L vs. 70.6 [70.3] mg/L; p < 0.001). In the adjusted multivariate model, both were associated with poorer evolution: SA, OR 0.674 (95% CI, 0.551−0.826; p < 0.001); CRP, OR 1.002 (95% CI, 1.001−1.004; p = 0.003). The CRP/SA model had a similar predictive capacity (honest AUC, 0.8135 [0.7865−0.8405]), with a continuously increasing risk and cutoff value of 25 showing the highest predictive capacity (OR, 1.470; 95% CI, 1.188−1.819; p < 0.001). (4) Conclusions: SA and CRP are good independent predictors of patients hospitalized with COVID-19. For the CRP/SA ratio value, 25 is the cutoff for poor clinical course.
Collapse
Affiliation(s)
- Vicente Giner-Galvañ
- Department of Internal Medicine, Hospital Clínico Universitario San Juan de Alicante, 03550 Alicante, Spain
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO), 46020 Valencia, Spain;
- Departamento de Medicina Clínica, Medicine School, University Miguel Hernández, 03550 Alicante, Spain; (J.A.Q.); (J.M.R.-R.)
- Correspondence: or ; Tel.: +34-680-588-421
| | - Francisco José Pomares-Gómez
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO), 46020 Valencia, Spain;
- Departamento de Medicina Clínica, Medicine School, University Miguel Hernández, 03550 Alicante, Spain; (J.A.Q.); (J.M.R.-R.)
- Department of Endocrinology, Hospital Clínico Universitario San Juan de Alicante, 03550 Alicante, Spain
| | - José Antonio Quesada
- Departamento de Medicina Clínica, Medicine School, University Miguel Hernández, 03550 Alicante, Spain; (J.A.Q.); (J.M.R.-R.)
| | - Manuel Rubio-Rivas
- Department of Internal Medicine, Bellvitge University Hospital, 08097 L’Hospitalet de Llobregat, Spain;
| | - Javier Tejada-Montes
- Department of Internal Medicine, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain;
| | | | | | - Blanca Sánchez-Mesa
- Department of Internal Medicine, Hospital Costa del Sol, 20603 Marbella, Spain;
| | | | | | - Almudena López-Sampalo
- Department of Internal Medicine, Regional University Hospital of Málaga, 29010 Málaga, Spain; (A.L.-S.); (R.G.-H.)
- Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA), 29590 Málaga, Spain
| | - Paula María Pesqueira-Fontán
- Department of Internal Medicine, Complejo Hospitalario Universitario de Santiago, 15706 Santiago de Compostela, Spain;
| | - Mar Fernández-Garcés
- Department of Internal Medicine, Doctor Peset University Hospital, 46017 Valencia, Spain;
| | - Ricardo Gómez-Huelgas
- Department of Internal Medicine, Regional University Hospital of Málaga, 29010 Málaga, Spain; (A.L.-S.); (R.G.-H.)
- Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA), 29590 Málaga, Spain
| | - José Manuel Ramos-Rincón
- Departamento de Medicina Clínica, Medicine School, University Miguel Hernández, 03550 Alicante, Spain; (J.A.Q.); (J.M.R.-R.)
| | | |
Collapse
|
29
|
Impact of COVID-19 Infection on Children and Adolescents after Liver Transplantation in a Latin American Reference Center. Microorganisms 2022; 10:microorganisms10051030. [PMID: 35630472 PMCID: PMC9143523 DOI: 10.3390/microorganisms10051030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/12/2022] [Accepted: 05/13/2022] [Indexed: 02/01/2023] Open
Abstract
Background: The COVID-19 infection has received the attention of the scientific community due to its respiratory manifestations and association with evolution to severe acute respiratory syndrome (SARS-CoV-2). There are few studies characterizing SARS-CoV-2 in pediatric immunocompromised patients, such as liver transplanted patients. The aim of this study was to analyze the outcomes of the largest cohort of pediatric liver transplant recipients (PLTR) from a single center in Brazil who were infected with COVID-19 during the pandemic. Methods: Cross-sectional study. Primary outcomes: COVID-19 severity. The Cox regression method was used to determine independent predictors associated with the outcomes. Patients were divided into two groups according to the severity of COVID-19 disease: moderate−severe COVID and asymptomatic−mild COVID. Results: Patients categorized as having moderate−severe COVID-19 were younger (12.6 months vs. 82.1 months, p = 0.03), had a higher prevalence of transplantation from a deceased donor (50% vs. 4.3%, p = 0.02), and had a higher prevalence of COVID infection within 6 months after liver transplantation (LT) (75% vs. 5.7%, p = 0.002). The independent predictor of COVID-19 severity identified in the multivariate analysis was COVID-19 infection <6 months after LT (HR = 0.001, 95% CI = 0.001−0.67, p = 0.03). Conclusion: The time interval of less than 6 months between COVID-19 infection and LT was the only predictor of disease severity in pediatric patients who underwent liver transplantation.
Collapse
|
30
|
Pence MC, Avdan Aslan A, Tunccan OG, Erbas G. Prognostic value of semi-quantitative CT-based score integrated with cardiovascular risk factors during the first peak of the COVID-19 pandemic: A new score to predict poor outcome. Eur J Radiol 2022; 150:110238. [PMID: 35278978 PMCID: PMC8900877 DOI: 10.1016/j.ejrad.2022.110238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/26/2022] [Accepted: 03/03/2022] [Indexed: 01/08/2023]
Abstract
Purpose Predicting the clinical course of COVID-19 pneumonia is of high clinical importance and may change treatment strategies. This study aimed to compare the semi-quantitative CT score (radiological score), mCHA2DS2-VASc score (clinical score), and R-mCHA2DS2-VASc score (clinical and radiological score) to predict the risk of ICU admission and mortality in COVID 19 pneumonia. Methods This study retrospectively evaluated 901 COVID-19 pneumonia cases with positive PCR results. The mCHA2DS2-VASc score was calculated based on clinical risk factors. CT images were evaluated, and the semi-quantitative CT scores were obtained. A new scoring method (R-mCHA2DS2-VASc score) was developed by combining these scores. The performance of the mCHA2DS2-VASc score, semi-quantitative CT score, and a combination of these scores (R-mCHA2DS2-VASc score) was evaluated using ROC analysis. Results The ROC curves of the semi-quantitative CT, mCHA2DS2-VASc, and R-mCHA2DS2-VASc scores were examined. The semi-quantitative CT, mCHA2DS2-VASc, and R-mCHA2DS2-VASc scores were significant in predicting intensive care unit (ICU) admission and mortality (p < 0.001). The R-mCHA2DS2-VASc score performed best in predicting a severe clinical course, and the cut-off value of 8 for the R-mCHA2DS2-VASc score had 83.9% sensitivity and 91.6% specificity for mortality. Conclusions The R-mCHA2DS2-VASc score includes both clinical and radiological parameters. It is a feasible scoring method for predicting a severe clinical course at an early stage with high sensitivity and specificity values. However, prospective studies with larger sample sizes are warranted.
Collapse
|
31
|
Eidininkienė M, Cesarskaja J, Talačkaitė S, Traškaitė-Juškevičienė V, Macas A. Mini Review: Co-Existing Diseases and COVID-19—A One Way Ticket? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084738. [PMID: 35457604 PMCID: PMC9029116 DOI: 10.3390/ijerph19084738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/10/2022] [Accepted: 04/13/2022] [Indexed: 01/25/2023]
Abstract
Background and aims. Many patients with SARS-CoV-2 virus infection have various comorbidities. Their presence in the background of coronavirus has a tendency to worsen the course of the disease and increase the risk of unfavorable outcomes. Understanding the interactions between SARS-CoV-2 and the most common comorbidities is key to the successful management of these patients. Methods. We systematically searched Medline, Springer and Elsevier databases and accessed the full text on SARS-CoV-2 virus infection and the following conditions: cardiovascular, renal, immunosuppression, metabolic disorder and hematological in order to prepare a narrative review on this topic. Results. Patients with underlying cardiovascular diseases are more likely to suffer from severe forms of COVID-19. Cardiovascular diseases were also noted as the most frequent comorbidities among coronavirus patients. Metabolic syndrome and its components have been identified as the second most common comorbidity among fatal cases of COVID-19. Infected patients with acute kidney injury also show a higher mortality rate among the others. Immunocompromised patients, such as organ recipients and cancer and hematologic patients, develop more severe forms of COVID-19 and are at higher risk of admission to ICUs and requiring mechanical ventilation. Higher mortality rates among those patients have also been observed. Conclusions. Based on recent studies, patients with co-existing diseases are at higher risk for severe courses of COVID-19 virus infection and unfavorable outcomes. Cardiovascular diseases, metabolic syndrome and immunosuppressive and kidney diseases in the presence of coronavirus may lead to longer and more aggressive treatment in the ICU and increased mortality rate.
Collapse
Affiliation(s)
- Mantė Eidininkienė
- Medical Academy, Faculty of Medicine, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania; (J.C.); (S.T.); (V.T.-J.); (A.M.)
- Correspondence: ; Tel.: +370-606-797-54
| | - Jelena Cesarskaja
- Medical Academy, Faculty of Medicine, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania; (J.C.); (S.T.); (V.T.-J.); (A.M.)
| | - Simona Talačkaitė
- Medical Academy, Faculty of Medicine, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania; (J.C.); (S.T.); (V.T.-J.); (A.M.)
| | - Vilma Traškaitė-Juškevičienė
- Medical Academy, Faculty of Medicine, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania; (J.C.); (S.T.); (V.T.-J.); (A.M.)
- Department of Anesthesiology, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, LT-50160 Kaunas, Lithuania
| | - Andrius Macas
- Medical Academy, Faculty of Medicine, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania; (J.C.); (S.T.); (V.T.-J.); (A.M.)
- Department of Anesthesiology, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, LT-50160 Kaunas, Lithuania
| |
Collapse
|
32
|
Assessment of Gastrointestinal Symptoms and Dyspnea in Patients Hospitalized due to COVID-19: Contribution to Clinical Course and Mortality. J Clin Med 2022; 11:jcm11071821. [PMID: 35407430 PMCID: PMC8999487 DOI: 10.3390/jcm11071821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/15/2022] [Accepted: 03/23/2022] [Indexed: 01/08/2023] Open
Abstract
Gastrointestinal manifestations may accompany the respiratory symptoms of COVID-19. Abdominal pain (AP) without nausea and vomiting is one of the most common. To date, its role and prognostic value in patients with COVID-19 is still debated. Therefore, we performed a retrospective analysis of 2184 individuals admitted to hospital due to COVID-19. We divided the patients into four groups according to presented symptoms: dyspnea, n = 871 (39.9%); AP, n = 97 (4.4%); AP with dyspnea together, n = 50 (2.3%); and patients without dyspnea and AP, n = 1166 (53.4%). The patients with AP showed tendency to be younger than these with dyspnea, but without AP (63.0 [38.0−70.0] vs. 65.0 [52.0−74.0] years, p = 0.061), and they were more often females as compared to patients with dyspnea (57.7% vs. 44.6%, p = 0.013, for females). Patients with AP as a separate sign of COVID-19 significantly less often developed pneumonia as compared to individuals with dyspnea or with dyspnea and AP together (p < 0.0001). Patients with AP or AP with dyspnea were significantly less frequently intubated or transferred to the intensive care unit (p = 0.003 and p = 0.031, respectively). Individuals with AP alone or with dyspnea had significantly lower rate of mortality as compared to patients with dyspnea (p = 0.003). AP as a separate symptom and also as a coexisting sign with dyspnea does not predispose the patients with COVID-19 to the worse clinical course and higher mortality.
Collapse
|
33
|
Malundo AFG, Abad CLR, Salamat MSS, Sandejas JCM, Planta JEG, Poblete JB, Morales SJL, Gabunada RRW, Evasan ALM, Cañal JPA, Santos JA, Manto JT, Rojo RD, Ornos EDB, Severino MEL, Mercado MEP, Alejandria MM. Clinical characteristics of patients with asymptomatic and symptomatic COVID-19 admitted to a tertiary referral centre in the Philippines. IJID REGIONS (ONLINE) 2022; 2:204-211. [PMID: 35721425 PMCID: PMC8818128 DOI: 10.1016/j.ijregi.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 01/25/2022] [Accepted: 02/04/2022] [Indexed: 11/06/2022]
Abstract
Asymptomatic infection is common. Bimodal age distribution of coronavirus disease 2019 (COVID-19) was observed at the University of the Philippines–Philippine General Hospital. Universal testing impacts infection control measures in resource-limited settings. Further blood testing is likely to be unnecessary for mild and asymptomatic cases of COVID-19. Symptom-based isolation protocol reduces length of hospitalization.
Objectives To describe the clinical profile and outcomes of hospitalized patients with coronavirus disease 2019 (COVID-19) across the spectrum of disease severity. Methods This retrospective study included adult patients with confirmed COVID-19 infection admitted to a referral hospital. Descriptive statistics, tests for trend, Kaplan–Meier curve and log-rank test were used to compare characteristics and outcomes across disease severity categories. Results Of 1500 patients with COVID-19, 14.8% were asymptomatic, 13.5% had mild disease, 36.6% had moderate disease, 12.3% had severe disease and 22.7% had critical disease. Asymptomatic patients were admitted for a concurrent condition or for isolation. Patients aged >60 years, male gender and with co-morbidities had more severe disease. Fever, cough, shortness of breath, malaise, gastrointestinal symptoms and decreased sensorium were more common in patients with severe disease. Bilateral pulmonary infiltrates were common (51.1%), with sicker patients having more abnormal findings. The overall mortality rate was 15.1%. Adopting a symptom-based strategy reduced the length of hospitalization from a median of 13 [interquartile range (IQR) 7–21] days to 9 (IQR 5–14) days. Conclusion The clinical profile and outcomes for this cohort of patients with COVID-19 was consistent with published reports. Asymptomatic infection was common, and universal testing may be a valuable strategy in the correct context, given the implications for infection control. A symptom-based strategy was found to reduce the length of hospitalization considerably.
Collapse
Affiliation(s)
- Anna Flor G Malundo
- Division of Infectious Diseases, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Cybele Lara R Abad
- Division of Infectious Diseases, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Maria Sonia S Salamat
- Division of Infectious Diseases, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Joanne Carmela M Sandejas
- Division of Infectious Diseases, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Jose Eladio G Planta
- Division of Infectious Diseases, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Jonnel B Poblete
- Department of Medicine, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Shayne Julieane L Morales
- Division of Infectious Diseases, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Ron Rafael W Gabunada
- Division of Infectious Diseases, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Agnes Lorrainne M Evasan
- Division of Infectious Diseases, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Johanna Patricia A Cañal
- Department of Radiology, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Julian A Santos
- Department of Radiology, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Jeffrey T Manto
- Department of Radiology, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Raniv D Rojo
- College of Medicine, University of the Philippines, Manila, Philippines
| | | | | | - Maria Elizabeth P Mercado
- Department of Clinical Epidemiology, Faculty of Medicine and Surgery, University of Santo Tomas, Manila, Philippines
| | - Marissa M Alejandria
- Division of Infectious Diseases, University of the Philippines-Philippine General Hospital, Manila, Philippines
| |
Collapse
|
34
|
Kucher AN, Koroleva IA, Zarubin AA, Nazarenko MS. MicroRNAs as the Potential Regulators of SARS-CoV-2 Infection and Modifiers of the COVID-19 Clinical Features. Mol Biol 2022; 56:29-45. [PMID: 35464324 PMCID: PMC9016216 DOI: 10.1134/s0026893322010034] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/14/2021] [Accepted: 05/25/2021] [Indexed: 12/27/2022]
Abstract
The pandemic of coronavirus disease 2019 (COVID-19) warrants the identification of factors that may determine both risk and severity of infection. The factors include microRNAs that have a wide regulatory potential and hence are particularly interesting. The review focuses on the potential roles of human microRNAs and the viral genome as well as microRNAs in SARS-CoV-2 infection and clinical features of COVID-19. The review summarizes the information about the human microRNAs that are thought to specifically bind to the SARS-CoV-2 genome and considers their expression levels in various organs (cells) in both healthy state and pathologies that are risk factors for severe COVID-19. Potential mechanisms whereby SARS-CoV-2 may affect the clinical features of COVID-19 are discussed in brief. The mechanisms include blocking of human microRNAs and RNA-binding proteins, changes in gene expression in infected cells, and possible epigenetic modifications of the human genome with the participation of coronavirus microRNAs.
Collapse
Affiliation(s)
- A. N. Kucher
- Research Institute of Medical Genetics, Tomsk National Research Medical Center, Russian Academy of Sciences, 634050 Tomsk, Russia
| | - Iu. A. Koroleva
- Research Institute of Medical Genetics, Tomsk National Research Medical Center, Russian Academy of Sciences, 634050 Tomsk, Russia
| | - A. A. Zarubin
- Research Institute of Medical Genetics, Tomsk National Research Medical Center, Russian Academy of Sciences, 634050 Tomsk, Russia
| | - M. S. Nazarenko
- Research Institute of Medical Genetics, Tomsk National Research Medical Center, Russian Academy of Sciences, 634050 Tomsk, Russia
| |
Collapse
|
35
|
Rusak E, Seget S, Macherski M, Furgał N, Dyś P, Jarosz-Chobot P. Has the COVID-19 Pandemic Affected the Prevalence of Diabetic Ketoacidosis in Polish Children with Newly Diagnosed Type 1 Diabetes? An Example of the Largest Polish Pediatric Diabetes Center (Upper Silesia—Katowice, Poland). Healthcare (Basel) 2022; 10:healthcare10020348. [PMID: 35206962 PMCID: PMC8872196 DOI: 10.3390/healthcare10020348] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/03/2022] [Accepted: 02/07/2022] [Indexed: 01/25/2023] Open
Abstract
Purpose: The aim of this study was to analyze the prevalence of diabetic ketoacidosis (DKA) in children with newly disclosed type 1 diabetes (T1D) during the COVID-19 pandemic in 2020 compared to 2019. Methods: A retrospective analysis of the history database of all hospitalized children in our department. The International Society for Pediatric and Adolescent Diabetes (ISPAD) guidelines were used for the diagnosis of DKA. Results: The database of children with newly disclosed T1D included 196 patients (89 girls and 107 boys) from 2019, and 223 patients (113 girls and 110 boys) from 2020 (a total of 419 patients—202 girls and 217 boys) aged 0 to 18 years. A significantly higher percentage of DKA was observed in 2020 compared to the previous year (47.53% vs. 35.2% [p = 0.005]). The percentage of severe DKA increased in 2020 compared to 2019 (18.39% vs. 14.07% [p = 0.118]). Compared to 2019, the average HbA1c level was higher in 2020 (12.57 ± 2.75% vs. 11.95 ± 2.89% [p < 0.025]), and the average pH level (7.26 vs. 7.31 [p = 0.002], and average HCO3 level (16.40 vs. 18.66 [p = 0.001]) were lower, respectively. Conclusions: During the COVID-19 (2020) pandemic, the incidence of DKA increased in Polish children with newly diagnosed T1D. The conclusions from the analysis of the functioning of health systems during the pandemic should be used in the future to prevent, in similar periods, an increase in severe complications of delayed diagnosis of T1D.
Collapse
Affiliation(s)
- Ewa Rusak
- Correspondence: ; Tel.: +48-32-207-1654
| | | | | | | | | | | |
Collapse
|
36
|
Batista KS, Cintra VM, Lucena PAF, Manhães-de-Castro R, Toscano AE, Costa LP, Queiroz MEBS, de Andrade SM, Guzman-Quevedo O, Aquino JDS. The role of vitamin B12 in viral infections: a comprehensive review of its relationship with the muscle-gut-brain axis and implications for SARS-CoV-2 infection. Nutr Rev 2022; 80:561-578. [PMID: 34791425 PMCID: PMC8689946 DOI: 10.1093/nutrit/nuab092] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
This comprehensive review establishes the role of vitamin B12 as adjunct therapy for viral infections in the treatment and persistent symptoms of COVID-19, focusing on symptoms related to the muscle-gut-brain axis. Vitamin B12 can help balance immune responses to better fight viral infections. Furthermore, data from randomized clinical trials and meta-analysis indicate that vitamin B12 in the forms of methylcobalamin and cyanocobalamin may increase serum vitamin B12 levels, and resulted in decreased serum methylmalonic acid and homocysteine concentrations, and decreased pain intensity, memory loss, and impaired concentration. Among studies, there is much variation in vitamin B12 doses, chemical forms, supplementation time, and administration routes. Larger randomized clinical trials of vitamin B12 supplementation and analysis of markers such as total vitamin B12, holotranscobalamin, total homocysteine and methylmalonic acid, total folic acid, and, if possible, polymorphisms and methylation of genes need to be conducted with people with and without COVID-19 or who have had COVID-19 to facilitate the proper vitamin B12 form to be administered in individual treatment.
Collapse
Affiliation(s)
- Kamila S Batista
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| | - Vanessa M Cintra
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| | - Paulo A F Lucena
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| | - Raul Manhães-de-Castro
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| | - Ana E Toscano
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| | - Larissa P Costa
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| | - Maria E B S Queiroz
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| | - Suellen M de Andrade
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| | - Omar Guzman-Quevedo
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| | - Jailane de S Aquino
- K.S. Batista and J.d.S. Aquino are with the Experimental Nutrition Laboratory, Department of Nutrition and Post Graduate Program in Nutrition Sciences, Federal University of Paraíba, Paraíba, Brazil. V.M. Cintra and P.A.F Lucena are with the Department of Medicine, Faculty of Medical Sciences of Paraíba, and the Department of Nutrition, Integrated Colleges of Patos, Paraíba, Brazil. V.M. Cintra is with the the Multiprofessional Residence in Child Health of Secretariat of Health of the State of Paraíba, Brazil. P.A.F Lucena is with Coordination of Neurology Services, Hospital Metropolitano Dom José Maria Pires, Santa Rita, Paraíba and Emergency, Trauma Hospital Senador Humberto Lucena, João Pessoa, Paraíba, Brazil. R. Manhães-de-Castro is with the Studies in Nutrition and Phenotypic Plasticity Unit, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil. R. Manhães-de-Castro and A.E. Toscano are with the Post Graduate Program in Nutrition, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. A.E. Toscano is with the Department of Nursing, CAV, Federal University of Pernambuco, Pernambuco, Brazil. A.E. Toscano and O. Guzman-Quevedo are with the Post Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil. L.P. Costa, M.E.B.S. Queirozj, and S.M. de Andrade are with the Ageing and Neuroscience Laboratory, Health Sciences Center, Federal University of Paraíba, Paraíba, Brazil. O. Guzman-Quevedo is with the Higher Technological Institute of Tacámbaro, Tacámbaro, Michoacán, Mexico. O. Guzman-Quevedo is with the Center for Biomedical Research of Michoacán, Mexican Institute of Social Security, Morelia, Michoacán, Mexico
| |
Collapse
|
37
|
Puerta JL, Torrego-Ellacuría M, Del Rey-Mejías A, Biénzobas López C. Comorbidities of Primary Care patients with COVID-19 during the first wave of the SARS-CoV-2 pandemic in the Community of Madrid. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2022; 35:63-70. [PMID: 34889087 PMCID: PMC8790647 DOI: 10.37201/req/114.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/21/2021] [Accepted: 10/28/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Recent publications on inpatients with COVID-19 describing their comorbidities and demographic profile exists, but data from large populations requiring only primary care (PC) are scarce. This paper aims to fill this gap and report the prevalence of eight comorbidities (high blood pressure, diabetes mellitus, cancer, cardiovascular disease, asthma, chronic kidney disease, chronic obstructive pulmonary disease, and chronic heart failure) among patients attending PC during the onset of the SARS-CoV-2 pandemic in the Community of Madrid (CoM), Spain. METHODS This is an observational retrospective study that collects data registered in the CoM between February 25th and May 31st, 2020. Data are divided in two groups: Group-1 (N=339,890) consist of all patients with suspected or proven SARS-CoV-2 infection; and Group-2 is the subgroup (N=48,556, 14.3% of Group-1) of individuals with COVID-19 confirmed by positive RT-PCR test. RESULTS Comparing Group-1 with Group-2, 339,890/48,556 patients, respectively, the main results were as follows: average age (60.9/69.9 years), presence of at least one comorbidity (33.51%/47.69%), high blood pressure (19.74%/32.74%), diabetes mellitus (7.13%/13.75%), cancer (6.56%/10.6%), cardiovascular disease (4.52%/9.26%), asthma (7.98%/6.56%), chronic kidney disease (1.84%/4.41%), chronic obstructive pulmonary disease (2%/4.03%), and chronic heart failure (1.14%/2.77%). High blood pressure and diabetes mellitus were seen to be the most frequent (6.56%/8.38%) association. CONCLUSIONS Patients requiring PC attention during the first wave of the COVID-19 pandemic in the CoM presented with a very high rate of comorbidities, with marked differences among those with or without a confirmed SARS-CoV-2 infection.
Collapse
Affiliation(s)
- J L Puerta
- José Luis Puerta, Consejería de Sanidad, Calle de la Aduana, 29, 28013 Madrid. Spain.
| | | | | | | |
Collapse
|
38
|
Ali S, Nedvědová Š, Badshah G, Afridi MS, Abdullah, Dutra LM, Ali U, Faria SG, Soares FL, Rahman RU, Cançado FA, Aoyanagi MM, Freire LG, Santos AD, Barison A, Oliveira CA. NMR spectroscopy spotlighting immunogenicity induced by COVID-19 vaccination to mitigate future health concerns. CURRENT RESEARCH IN IMMUNOLOGY 2022; 3:199-214. [PMID: 36032416 PMCID: PMC9393187 DOI: 10.1016/j.crimmu.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/01/2022] [Indexed: 11/16/2022] Open
Abstract
In this review, the disease and immunogenicity affected by COVID-19 vaccination at the metabolic level are described considering the use of nuclear magnetic resonance (NMR) spectroscopy for the analysis of different biological samples. Consistently, we explain how different biomarkers can be examined in the saliva, blood plasma/serum, bronchoalveolar-lavage fluid (BALF), semen, feces, urine, cerebrospinal fluid (CSF) and breast milk. For example, the proposed approach for the given samples can allow one to detect molecular biomarkers that can be relevant to disease and/or vaccine interference in a system metabolome. The analysis of the given biomaterials by NMR often produces complex chemical data which can be elucidated by multivariate statistical tools, such as PCA and PLS-DA/OPLS-DA methods. Moreover, this approach may aid to improve strategies that can be helpful in disease control and treatment management in the future. NMR analysis of various bio-samples can explore disease course and vaccine interaction. Immunogenicity and reactogenicity caused by COVID-19 vaccination can be studied by NMR. Vaccine interaction alters metabolic pathway(s) at a certain stage, and this mechanism can be probed at the metabolic level.
Collapse
|
39
|
Shcherbak SG, Anisenkova AY, Mosenko SV, Glotov OS, Chernov AN, Apalko SV, Urazov SP, Garbuzov EY, Khobotnikov DN, Klitsenko OA, Minina EM, Asaulenko ZP. Basic Predictive Risk Factors for Cytokine Storms in COVID-19 Patients. Front Immunol 2021; 12:745515. [PMID: 34858403 PMCID: PMC8631447 DOI: 10.3389/fimmu.2021.745515] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 10/11/2021] [Indexed: 11/13/2022] Open
Abstract
Objective A critical role in coronavirus disease 2019 (COVID-19) pathogenesis is played by immune dysregulation that leads to a generalized uncontrolled multisystem inflammatory response, caused by overproduction of proinflammatory cytokines, known as "a cytokine storm" (CS), strongly associated with a severe course of disease. The aim of this study is to identify prognostic biomarkers for CS development in COVID-19 patients and integrate them into a prognostic score for CS-associated risk applicable to routine clinical practice. Materials and Methods The authors performed a review of 458 medical records from COVID-19 patients (241 men and 217 women aged 60.0 ± 10.0) who received treatment in the St. Petersburg State Budgetary Institution of Healthcare City Hospital 40 (City Hospital 40, St. Petersburg), from Apr. 18, 2020 to Nov. 21, 2020. The patients were split in two groups: one group included 100 patients with moderate disease symptoms; the other group included 358 patients with progressive moderately severe, severe, and extremely severe disease. The National Early Warning Score (NEWS) score was used alongside with clinical assessment, chest computed tomographic (CT) scans, electrocardiography (ECG), and lab tests, like ferritin, C-reactive protein (CRP), interleukin (IL)-6, lactate dehydrogenase (LDH), and D-dimer. Results The basic risk factors for cytokine storms in COVID-19 patients are male gender, age over 40 years, positive test result for replicative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA, absolute lymphocyte count, dynamics in the NEWS score, as well as LDH, D-dimer, ferritin, and IL-6 levels. These clinical and instrumental findings can be also used as laboratory biomarkers for diagnosis and dynamic monitoring of cytokine storms. The suggested prognostic scale (including the NEWS score dynamics; serum IL-6 greater than 23 pg/ml; serum CRP 50 mg/L or greater; absolute lymphocyte count less than 0.72 × 109/L; positive test result for replicative coronavirus (SARS-CoV-2) RNA; age 40 years and over) is a useful tool to identify patients at a high risk for cytokine storm, requiring an early onset of anti-inflammatory therapy.
Collapse
Affiliation(s)
- Sergey G Shcherbak
- City Hospital №40, Saint Petersburg, Russia.,Department of Postgraduate Medical Education, Saint Petersburg State University, Saint Petersburg, Russia
| | - Anna Yu Anisenkova
- City Hospital №40, Saint Petersburg, Russia.,Department of Postgraduate Medical Education, Saint Petersburg State University, Saint Petersburg, Russia
| | - Sergei V Mosenko
- City Hospital №40, Saint Petersburg, Russia.,Department of Postgraduate Medical Education, Saint Petersburg State University, Saint Petersburg, Russia
| | - Oleg S Glotov
- City Hospital №40, Saint Petersburg, Russia.,Federal State-Financed Institution Pediatric Research and Clinical Center for Infectious Diseases under the Federal Medical Biological Agency, Saint Petersburg, Russia
| | - Alexander N Chernov
- City Hospital №40, Saint Petersburg, Russia.,Department of Pathphysiology, Institute of Experimental Medicine, Saint Petersburg, Russia
| | | | | | | | | | - Olga A Klitsenko
- North-Western State Medical University named after Ivan Ivanovich (I.I.) Mechnikov, Saint Petersburg, Russia
| | | | - Zakhar P Asaulenko
- City Hospital №40, Saint Petersburg, Russia.,North-Western State Medical University named after Ivan Ivanovich (I.I.) Mechnikov, Saint Petersburg, Russia
| |
Collapse
|
40
|
Paulino MR, Moreira JADS, Correia MG, dos Santos LRA, Duarte IP, Sabioni LR, Mucillo FB, Garrido RQ, Pacheco SL, de Lorenzo A, Lamas CDC. COVID-19 in patients with cardiac disease: Impact and variables associated with mortality in a cardiology center in Brazil. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2021; 12:100069. [PMID: 34841378 PMCID: PMC8604803 DOI: 10.1016/j.ahjo.2021.100069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 09/26/2021] [Accepted: 10/29/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Cardiovascular disease is associated with severe COVID-19. Our aim was to describe clinical and laboratory features (including electrocardiographic and echocardiographic ones) and outcomes of patients with cardiac disease hospitalized with COVID-19. METHODS This is an observational retrospective study of consecutive adult patients admitted, between March and September of 2020, with confirmed SARSCoV-2 infection. Data were collected as per the ISARIC case report form and complemented with variables related to heart disease. RESULTS One hundred twenty-one patients were included. Mean age was 60 SD 15.2 years and 80/121(66.1%) were male. Two-thirds of the patients (80/121, 66.1%) had COVID-19 at the time of hospital admission and COVID-19 was the reason for hospitalization in 42 (34.7%). Other reasons for hospital admission were acute coronary syndrome (26%) and decompensated heart failure (14.8%). Chronic cardiac diseases were found in 106/121 (87.6%), mostly coronary artery disease (62%) or valve disease (33.9%). A transthoracic echocardiogram was performed in 93/121(76.8%) and enlarged cardiac chambers were found in 71% (66/93); admission ECG was done in 93 cases (93/121, 76.8%), and 89.2% (83/93) were abnormal. Hospital-acquisition of COVID-19 occurred in 20 (16.5%) of patients and their mortality was 50%. On bivariate analysis for mortality, BNP levels and troponin levels were NOT associated with mortality. On multivariate analysis, only C reactive protein levels and creatinine levels were significant. CONCLUSIONS COVID-19 impacted the profile of hospital admissions in cardiac patients. BNP and troponin levels were not associated with mortality and may not be good prognostic discriminators in cardiac patients.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Andrea de Lorenzo
- Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cristiane da Cruz Lamas
- Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil
- Universidade do Grande Rio (UNIGRANRIO), Rio de Janeiro, Brazil
- Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Rio de Janeiro, Brazil
| |
Collapse
|
41
|
Zhong Y, Wang K, Zhu Y, Lyu D, Yu Y, Li S, Yao K. Ocular manifestations in COVID-19 patients: A systematic review and meta-analysis. Travel Med Infect Dis 2021; 44:102191. [PMID: 34763068 PMCID: PMC8574127 DOI: 10.1016/j.tmaid.2021.102191] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 07/09/2021] [Accepted: 10/26/2021] [Indexed: 01/08/2023]
Abstract
Introduction With the accumulating evidence of ocular manifestations of the 2019 novel coronavirus disease (COVID-19), the study aimed to systematically summarize the ocular manifestations in COVID-19 patients. Methods The PubMed, EMBASE, Web of Science databases were searched through June 2021. Studies that provided clinical characteristics and outcomes and reported on the ocular manifestations or conjunctival swab RT-PCR tests among COVID-19 patients were included. Results A total of 30 studies involving 5,717 patients were identified. Ocular manifestations including conjunctival hyperemia (7.6%, 95% confidence interval [CI] 1.8–8.9%), conjunctival discharge (4.8%, 95% CI 1.8–8.9%), epiphora (6.9%, 95% CI 2.8–12.8%), and foreign body sensation (6.9%, 95% CI 2.4–13.0%) were observed. The positive rate of conjunctival swab tests was 3.9% (95% CI 0.2–6.4%). Severe cases of COVID-19 were associated with an increased risk of developing ocular complications (odds ratio [OR] = 2.77, 95% CI 1.75–4.40). Conclusions Despite their relatively low incidence rate in COVID-19 patients, ocular manifestations may be non-specific and present as the initial symptoms of infection. The presence of SARS-CoV-2 in the conjunctival swabs implicates the eye as a potential source of infection. Early diagnosis and proper eye protection would help prevent viral transmission.
Collapse
Affiliation(s)
- Yueyang Zhong
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Kai Wang
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Yanan Zhu
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Danni Lyu
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Yinhui Yu
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Su Li
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Ke Yao
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
| |
Collapse
|
42
|
Sharma J, Rajput R, Bhatia M, Arora P, Sood V. Clinical Predictors of COVID-19 Severity and Mortality: A Perspective. Front Cell Infect Microbiol 2021; 11:674277. [PMID: 34760713 PMCID: PMC8573222 DOI: 10.3389/fcimb.2021.674277] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 09/28/2021] [Indexed: 12/11/2022] Open
Abstract
The COVID-19 pandemic has caused huge socio-economic losses and continues to threat humans worldwide. With more than 4.5 million deaths and more than 221 million confirmed COVID-19 cases, the impact on physical, mental, social and economic resources is immeasurable. During any novel disease outbreak, one of the primary requirements for effective mitigation is the knowledge of clinical manifestations of the disease. However, in absence of any unique identifying characteristics, diagnosis/prognosis becomes difficult. It intensifies misperception and leads to delay in containment of disease spread. Numerous clinical research studies, systematic reviews and meta-analyses have generated considerable data on the same. However, identification of some of the distinct clinical signs and symptoms, disease progression biomarkers and the risk factors leading to adverse COVID-19 outcomes warrant in-depth understanding. In view of this, we assessed 20 systematic reviews and meta-analyses with an intent to understand some of the potential independent predictors/biomarkers/risk factors of COVID-19 severity and mortality.
Collapse
Affiliation(s)
- Jitender Sharma
- Department of Biochemistry, All India Institute of Medical Sciences, Bathinda, India
| | - Roopali Rajput
- Department of Biochemistry, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi, India
| | - Manika Bhatia
- Department of Zoology, Hansraj College, University of Delhi, Delhi, India
| | - Pooja Arora
- Department of Zoology, Hansraj College, University of Delhi, Delhi, India
| | - Vikas Sood
- Department of Biochemistry, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi, India
| |
Collapse
|
43
|
Early Adoption of Longitudinal Surveillance for SARS-CoV-2 among Staff in Long-Term Care Facilities: Prevalence, Virologic and Sequence Analysis. Microbiol Spectr 2021; 9:e0100321. [PMID: 34756092 PMCID: PMC8579921 DOI: 10.1128/spectrum.01003-21] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in 2019 and has become a major global pathogen in an astonishingly short period of time. The emergence of SARS-CoV-2 has been notable due to its impacts on residents in long-term care facilities (LTCFs). LTCF residents tend to possess several risk factors for severe outcomes of SARS-CoV-2 infection, including advanced age and the presence of comorbidities. Indeed, residents of LTCFs represent approximately 40% of SARS-CoV-2 deaths in the United States. Few studies have focused on the prevalence and transmission dynamics of SARS-CoV-2 among LTCF staff during the early months of the pandemic, prior to mandated surveillance testing. To assess the prevalence and incidence of SARS-CoV-2 among LTCF staff, characterize the extent of asymptomatic infections, and investigate the genomic epidemiology of the virus within these settings, we sampled staff for 8 to 11 weeks at six LTCFs with nasopharyngeal swabs from March through June of 2020. We determined the presence and levels of viral RNA and infectious virus and sequenced 54 nearly complete genomes. Our data revealed that over 50% of infections were asymptomatic/mildly symptomatic and that there was a strongly significant relationship between viral RNA (vRNA) and infectious virus, prolonged infections, and persistent vRNA (4+ weeks) in a subset of individuals, and declining incidence over time. Our data suggest that asymptomatic SARS-CoV-2-infected LTCF staff contributed to virus persistence and transmission within the workplace during the early pandemic period. Genetic epidemiology data generated from samples collected during this period support that SARS-CoV-2 was commonly spread between staff within an LTCF and that multiple-introduction events were less common. IMPORTANCE Our work comprises unique data on the characteristics of SARS-CoV-2 dynamics among staff working at LTCFs in the early months of the SARS-CoV-2 pandemic prior to mandated staff surveillance testing. During this time period, LTCF residents were largely sheltering-in-place. Given that staff were able to leave and return daily and could therefore be a continued source of imported or exported infection, we performed weekly SARS-CoV-2 PCR on nasal swab samples collected from this population. There are limited data from the early months of the pandemic comprising longitudinal surveillance of staff at LTCFs. Our data reveal the surprisingly high level of asymptomatic/presymptomatic infections within this cohort during the early months of the pandemic and show genetic epidemiological analyses that add novel insights into both the origin and transmission of SARS-CoV-2 within LTCFs.
Collapse
|
44
|
Ulloque-Badaracco JR, Hernandez-Bustamante EA, Herrera-Añazco P, Benites-Zapata VA. Prognostic value of apolipoproteins in COVID-19 patients: A systematic review and meta-analysis. Travel Med Infect Dis 2021; 44:102200. [PMID: 34752921 PMCID: PMC8575373 DOI: 10.1016/j.tmaid.2021.102200] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/02/2021] [Accepted: 11/03/2021] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Apolipoproteins are predictive biomarkers for cardiovascular, neoplasms and cerebrovascular diseases and are postulated as prognostic biomarkers in infectious diseases, as COVID-19. Thus, we assessed the prognosis value of apolipoproteins for COVID-19 severity and mortality. METHODS We conducted a systematic review and meta-analysis using observational studies that reported the association between apolipoproteins and severity or mortality in COVID-19 patients. Newcastle-Ottawa was used for the quality assessment of included studies. Effects measurements were shown as odds ratios (ORs) with 95% confidence intervals (CIs), and Egger-test was developed for assessing the risk of bias publication. RESULTS We analyzed 12 cohort studies (n = 3580). Patients with low ApoliproteinA1 (ApoA1) (OR 0.35; 95%CI 0.24 to 0.49; P < 0.001) and ApoliproteinB (ApoB) (OR = 0.78; 95%CI 0.69 to 0.87; P < 0.001) values had a higher risk of developing severe disease. ApoB/ApoA1 ratio showed no statistically significant association with higher odds of severity. Low ApoA1 levels were associated with higher odds of all-cause mortality (OR = 0.34; 95%CI 0.20 to 0.57; P < 0.001). ApoB values showed no statistically significant association with a high risk of all-cause mortality. CONCLUSION We suggest that adequate levels of ApoA1 and ApoB can be a protective factor for severity in COVID-19, and ApoB/ApoA1 ratio did not show predictive utility for severity.
Collapse
Affiliation(s)
| | - Enrique A Hernandez-Bustamante
- Sociedad Cientifica de Estudiantes de Medicina de la Universidad Nacional de Trujillo, Trujillo, Peru; Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | - Percy Herrera-Añazco
- Universidad Privada San Juan Bautista, Lima, Peru; Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, EsSalud, Lima, Peru
| | | |
Collapse
|
45
|
Khwatenge CN, Pate M, Miller LC, Sang Y. Immunometabolic Dysregulation at the Intersection of Obesity and COVID-19. Front Immunol 2021; 12:732913. [PMID: 34737743 PMCID: PMC8560738 DOI: 10.3389/fimmu.2021.732913] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/28/2021] [Indexed: 12/24/2022] Open
Abstract
Obesity prevails worldwide to an increasing effect. For example, up to 42% of American adults are considered obese. Obese individuals are prone to a variety of complications of metabolic disorders including diabetes mellitus, hypertension, cardiovascular disease, and chronic kidney disease. Recent meta-analyses of clinical studies in patient cohorts in the ongoing coronavirus-disease 2019 (COVID-19) pandemic indicate that the presence of obesity and relevant disorders is linked to a more severe prognosis of COVID-19. Given the significance of obesity in COVID-19 progression, we provide a review of host metabolic and immune responses in the immunometabolic dysregulation exaggerated by obesity and the viral infection that develops into a severe course of COVID-19. Moreover, sequela studies of individuals 6 months after having COVID-19 show a higher risk of metabolic comorbidities including obesity, diabetes, and kidney disease. These collectively implicate an inter-systemic dimension to understanding the association between obesity and COVID-19 and suggest an interdisciplinary intervention for relief of obesity-COVID-19 complications beyond the phase of acute infection.
Collapse
Affiliation(s)
- Collins N Khwatenge
- Department of Agricultural and Environmental Sciences, College of Agriculture, Tennessee State University, Nashville, TN, United States
| | - Marquette Pate
- Department of Agricultural and Environmental Sciences, College of Agriculture, Tennessee State University, Nashville, TN, United States
| | - Laura C Miller
- Virus and Prion Research Unit, National Animal Disease Center, United States Department of Agriculture, Agricultural Research Service, Ames, IA, United States
| | - Yongming Sang
- Department of Agricultural and Environmental Sciences, College of Agriculture, Tennessee State University, Nashville, TN, United States
| |
Collapse
|
46
|
Shi Q, Wang Z, Liu J, Wang X, Zhou Q, Li Q, Yu Y, Luo Z, Liu E, Chen Y. Risk factors for poor prognosis in children and adolescents with COVID-19: A systematic review and meta-analysis. EClinicalMedicine 2021; 41:101155. [PMID: 34693233 PMCID: PMC8523335 DOI: 10.1016/j.eclinm.2021.101155] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND This study provides the first systematic review and meta-analysis to identify the predictors of unfavorable prognosis of COVID-19 in children and adolescents. METHODS We searched literature databases until July 2021 for studies that investigated risk factors for unfavorable prognosis of children and adolescents with COVID-19. We used random-effects models to estimate the effect size with 95% confidence interval (CI). FINDINGS We identified 56 studies comprising 79,104 individuals. Mortality was higher in patients with multisystem inflammatory syndrome (MIS-C) (odds ratio [OR]=58.00, 95% CI 6.39-526.79) and who were admitted to intensive care (OR=12.64, 95% CI 3.42-46.68). Acute respiratry distress syndrme (ARDS) (OR=29.54, 95% CI 12.69-68.78) and acute kidney injury (AKI) (OR=55.02, 95% CI 6.26-483.35) increased the odds to be admitted to intensive care; shortness of breath (OR=16.96, 95% CI 7.66-37.51) increased the need of respiratory support; and neurological diseases (OR=5.16, 95% CI 2.30-11.60), C-reactive protein (CRP) level ≥80 mg/L (OR=11.70, 95% CI 4.37-31.37) and D-dimer level ≥0.5ug/mL (OR=20.40, 95% CI 1.76-236.44) increased the odds of progression to severe or critical disease. INTERPRETATION Congenital heart disease, chronic pulmonary disease, neurological diseases, obesity, MIS-C, shortness of breath, ARDS, AKI, gastrointestinal symptoms, elevated CRP and D-dimer are associated with unfavourable prognosis in children and adolescents with COVID-19.
Collapse
Affiliation(s)
- Qianling Shi
- The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China
- Lanzhou University Institute of Health Data Science, Lanzhou 730000, China
| | - Zijun Wang
- Lanzhou University Institute of Health Data Science, Lanzhou 730000, China
- Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Jiao Liu
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400000, China
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400000, China
- Chongqing Key Laboratory of Pediatrics, Chongqing 400000, China
| | - Xingmei Wang
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400000, China
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400000, China
- Chongqing Key Laboratory of Pediatrics, Chongqing 400000, China
| | - Qi Zhou
- Lanzhou University Institute of Health Data Science, Lanzhou 730000, China
- Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Qinyuan Li
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400000, China
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400000, China
- Chongqing Key Laboratory of Pediatrics, Chongqing 400000, China
| | - Yang Yu
- Department of Tumor Surgery, Lanzhou University Second Hospital, Lanzhou 730000, China
- The Second School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China
| | - Zhengxiu Luo
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400000, China
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400000, China
- Chongqing Key Laboratory of Pediatrics, Chongqing 400000, China
| | - Enmei Liu
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400000, China
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400000, China
- Chongqing Key Laboratory of Pediatrics, Chongqing 400000, China
| | - Yaolong Chen
- Lanzhou University Institute of Health Data Science, Lanzhou 730000, China
- Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou 730000, China
- Lanzhou University GRADE Center, Lanzhou 730000, China
- Guideline International Network Asia, Lanzhou 730000, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou 730000, China
- Affiliate of the Cochrane China Network, Lanzhou University, Lanzhou 730000, China
| | | |
Collapse
|
47
|
Tan EH, Sena AG, Prats-Uribe A, You SC, Ahmed WUR, Kostka K, Reich C, Duvall SL, Lynch KE, Matheny ME, Duarte-Salles T, Bertolin SF, Hripcsak G, Natarajan K, Falconer T, Spotnitz M, Ostropolets A, Blacketer C, Alshammari TM, Alghoul H, Alser O, Lane JCE, Dawoud DM, Shah K, Yang Y, Zhang L, Areia C, Golozar A, Recalde M, Casajust P, Jonnagaddala J, Subbian V, Vizcaya D, Lai LYH, Nyberg F, Morales DR, Posada JD, Shah NH, Gong M, Vivekanantham A, Abend A, Minty EP, Suchard M, Rijnbeek P, Ryan PB, Prieto-Alhambra D. COVID-19 in patients with autoimmune diseases: characteristics and outcomes in a multinational network of cohorts across three countries. Rheumatology (Oxford) 2021; 60:SI37-SI50. [PMID: 33725121 PMCID: PMC7989171 DOI: 10.1093/rheumatology/keab250] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/07/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE Patients with autoimmune diseases were advised to shield to avoid coronavirus disease 2019 (COVID-19), but information on their prognosis is lacking. We characterized 30-day outcomes and mortality after hospitalization with COVID-19 among patients with prevalent autoimmune diseases, and compared outcomes after hospital admissions among similar patients with seasonal influenza. METHODS A multinational network cohort study was conducted using electronic health records data from Columbia University Irving Medical Center [USA, Optum (USA), Department of Veterans Affairs (USA), Information System for Research in Primary Care-Hospitalization Linked Data (Spain) and claims data from IQVIA Open Claims (USA) and Health Insurance and Review Assessment (South Korea). All patients with prevalent autoimmune diseases, diagnosed and/or hospitalized between January and June 2020 with COVID-19, and similar patients hospitalized with influenza in 2017-18 were included. Outcomes were death and complications within 30 days of hospitalization. RESULTS We studied 133 589 patients diagnosed and 48 418 hospitalized with COVID-19 with prevalent autoimmune diseases. Most patients were female, aged ≥50 years with previous comorbidities. The prevalence of hypertension (45.5-93.2%), chronic kidney disease (14.0-52.7%) and heart disease (29.0-83.8%) was higher in hospitalized vs diagnosed patients with COVID-19. Compared with 70 660 hospitalized with influenza, those admitted with COVID-19 had more respiratory complications including pneumonia and acute respiratory distress syndrome, and higher 30-day mortality (2.2-4.3% vs 6.32-24.6%). CONCLUSION Compared with influenza, COVID-19 is a more severe disease, leading to more complications and higher mortality.
Collapse
Affiliation(s)
- Eng Hooi Tan
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, OX3 7LD, UK
| | - Anthony G Sena
- Janssen Research and Development, Titusville, NJ USA
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Albert Prats-Uribe
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, OX3 7LD, UK
| | - Seng Chan You
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Korea
| | - Waheed-Ul-Rahman Ahmed
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Oxford, OX3, 7LD, UK
- College of Medicine and Health, University of Exeter, St Luke’s, 2LU, USA
| | | | | | - Scott L Duvall
- VA Informatics and Computing Infrastructure, VA Salt Lake City Health Care System, UT, USA
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Kristine E Lynch
- VA Informatics and Computing Infrastructure, VA Salt Lake City Health Care System, UT, USA
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Michael E Matheny
- Tennessee Valley Healthcare System, Veterans Affairs Medical Center, Nashville, TN, USA
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Talita Duarte-Salles
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Sergio Fernandez Bertolin
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - George Hripcsak
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
- New York-Presbyterian Hospital, New York, NY, USA
| | - Karthik Natarajan
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
- New York-Presbyterian Hospital, New York, NY, USA
| | - Thomas Falconer
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
| | - Matthew Spotnitz
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
| | - Anna Ostropolets
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
| | - Clair Blacketer
- Janssen Research and Development, Titusville, NJ USA
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Thamir M Alshammari
- Medication Safety Research Chair, King Saud University, Riyadh, Saudi Arabia
| | - Heba Alghoul
- Faculty of Medicine, Islamic University of Gaza, Palestine
| | - Osaid Alser
- Massachusetts General Hospital, Harvard Medical School, Boston, 02114, MA, USA
| | - Jennifer C E Lane
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, OX3 7LD, UK
| | | | - Karishma Shah
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Oxford, OX3, 7LD, UK
| | - Yue Yang
- Digital China Health Technologies Co., LTD, Beijing 100085, China
| | - Lin Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China
- Melbourne School of Population and Global Health, The University of Melbourne, Victoria 3015, Australia
| | - Carlos Areia
- Nuffield Department of Clinical Neurosciences, University of Oxford, OX3 9DU, UK
| | - Asieh Golozar
- Regeneron Pharmaceuticals, NY, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health,, Baltimore, MD, USA
| | - Martina Recalde
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autonoma de Barcelona, Bellaterra, Spain
| | - Paula Casajust
- Real-World Evidence, Trial Form Support, Barcelona, Spain
| | | | - Vignesh Subbian
- College of Engineering, The University of Arizona Tucson, Arizona, USA
| | - David Vizcaya
- Bayer Pharmaceuticals, Sant Joan Despi, Barcelona, Spain
| | - Lana Y H Lai
- School of Medical Sciences, University of Manchester, UK
| | - Fredrik Nyberg
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Daniel R Morales
- Division of Population Health Sciences, University of Dundee, Dundee, Scotland, UK
| | - Jose D Posada
- Stanford Center for Biomedical Informatics Research, Department of Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - Nigam H Shah
- Stanford Center for Biomedical Informatics Research, Department of Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - Mengchun Gong
- Health Management Institute, Southern Medical University, Guangzhou, China
| | - Arani Vivekanantham
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Oxford, OX3, 7LD, UK
| | - Aaron Abend
- Autoimmune Registry Inc., Guilford, CT 06437, USA
| | - Evan P Minty
- O’Brien School for Public Health, Faculty of Medicine, University of Calgary, Calgary, Alberta, T2N, 1N4, Canada
| | - Marc Suchard
- Department of Biostatistics, UCLA Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Peter Rijnbeek
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Patrick B Ryan
- Janssen Research and Development, Titusville, NJ USA
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
| | - Daniel Prieto-Alhambra
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, OX3 7LD, UK
| |
Collapse
|
48
|
Roel E, Pistillo A, Recalde M, Sena AG, Fernández-Bertolín S, Aragón M, Puente D, Ahmed WUR, Alghoul H, Alser O, Alshammari TM, Areia C, Blacketer C, Carter W, Casajust P, Culhane AC, Dawoud D, DeFalco F, DuVall SL, Falconer T, Golozar A, Gong M, Hester L, Hripcsak G, Tan EH, Jeon H, Jonnagaddala J, Lai LYH, Lynch KE, Matheny ME, Morales DR, Natarajan K, Nyberg F, Ostropolets A, Posada JD, Prats-Uribe A, Reich CG, Rivera DR, Schilling LM, Soerjomataram I, Shah K, Shah NH, Shen Y, Spotniz M, Subbian V, Suchard MA, Trama A, Zhang L, Zhang Y, Ryan PB, Prieto-Alhambra D, Kostka K, Duarte-Salles T. Characteristics and Outcomes of Over 300,000 Patients with COVID-19 and History of Cancer in the United States and Spain. Cancer Epidemiol Biomarkers Prev 2021; 30:1884-1894. [PMID: 34272262 PMCID: PMC8974356 DOI: 10.1158/1055-9965.epi-21-0266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/26/2021] [Accepted: 07/07/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND We described the demographics, cancer subtypes, comorbidities, and outcomes of patients with a history of cancer and coronavirus disease 2019 (COVID-19). Second, we compared patients hospitalized with COVID-19 to patients diagnosed with COVID-19 and patients hospitalized with influenza. METHODS We conducted a cohort study using eight routinely collected health care databases from Spain and the United States, standardized to the Observational Medical Outcome Partnership common data model. Three cohorts of patients with a history of cancer were included: (i) diagnosed with COVID-19, (ii) hospitalized with COVID-19, and (iii) hospitalized with influenza in 2017 to 2018. Patients were followed from index date to 30 days or death. We reported demographics, cancer subtypes, comorbidities, and 30-day outcomes. RESULTS We included 366,050 and 119,597 patients diagnosed and hospitalized with COVID-19, respectively. Prostate and breast cancers were the most frequent cancers (range: 5%-18% and 1%-14% in the diagnosed cohort, respectively). Hematologic malignancies were also frequent, with non-Hodgkin's lymphoma being among the five most common cancer subtypes in the diagnosed cohort. Overall, patients were aged above 65 years and had multiple comorbidities. Occurrence of death ranged from 2% to 14% and from 6% to 26% in the diagnosed and hospitalized COVID-19 cohorts, respectively. Patients hospitalized with influenza (n = 67,743) had a similar distribution of cancer subtypes, sex, age, and comorbidities but lower occurrence of adverse events. CONCLUSIONS Patients with a history of cancer and COVID-19 had multiple comorbidities and a high occurrence of COVID-19-related events. Hematologic malignancies were frequent. IMPACT This study provides epidemiologic characteristics that can inform clinical care and etiologic studies.
Collapse
Affiliation(s)
- Elena Roel
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Spain
| | - Andrea Pistillo
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Martina Recalde
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Spain
| | - Anthony G Sena
- Janssen Research and Development, Titusville, New Jersey
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Sergio Fernández-Bertolín
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Maria Aragón
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Diana Puente
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Spain
| | - Waheed-Ul-Rahman Ahmed
- NDORMS, University of Oxford, Botnar Research Centre, Windmill Road, Oxford, United Kingdom
- College of Medicine and Health, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, United Kingdom
| | - Heba Alghoul
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Osaid Alser
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Thamir M Alshammari
- Medication Safety Research Chair, King Saud University, Riyadh, Saudi Arabia
| | - Carlos Areia
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | | | - William Carter
- Data Science to Patient Value Program, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Paula Casajust
- Real-World Evidence, Trial Form Support, Barcelona, Spain
| | - Aedin C Culhane
- Department of Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Dalia Dawoud
- Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Frank DeFalco
- Janssen Research and Development, Titusville, New Jersey
| | - Scott L DuVall
- VA Informatics and Computing Infrastructure, VA Salt Lake City Health Care System, Salt Lake City, Utah
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Thomas Falconer
- Department of Biomedical Informatics, Columbia University, New York, New York
- New York-Presbyterian Hospital, New York, New York
| | - Asieh Golozar
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland
- Pharmacoepidemiology, Regeneron Pharmaceuticals, Westchester County, New York
| | - Mengchun Gong
- Digital Health China Technologies Co., Ltd., Beijing, China
| | - Laura Hester
- Janssen Research and Development, LLC, Raritan, New Jersey
| | - George Hripcsak
- Department of Biomedical Informatics, Columbia University, New York, New York
- New York-Presbyterian Hospital, New York, New York
| | - Eng Hooi Tan
- Centre for Statistics in Medicine, NDORMS, University of Oxford, Oxford, United Kingdom
| | - Hokyun Jeon
- Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, Gyeonggi-do, Republic of Korea
| | | | - Lana Y H Lai
- School of Medical Sciences, University of Manchester, Manchester, United Kingdom
| | - Kristine E Lynch
- VA Informatics and Computing Infrastructure, VA Salt Lake City Health Care System, Salt Lake City, Utah
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Michael E Matheny
- Tennessee Valley Healthcare System, Veterans Affairs Medical Center, Nashville, Tennessee
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Daniel R Morales
- Division of Population Health and Genomics, University of Dundee, Dundee, United Kingdom
- University of Southern Denmark, Odense, Denmark
| | - Karthik Natarajan
- Department of Biomedical Informatics, Columbia University, New York, New York
- New York-Presbyterian Hospital, New York, New York
| | - Fredrik Nyberg
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Ostropolets
- Department of Biomedical Informatics, Columbia University, New York, New York
| | - José D Posada
- Department of Medicine, School of Medicine, Stanford University, Redwood City, California
| | - Albert Prats-Uribe
- Centre for Statistics in Medicine, NDORMS, University of Oxford, Oxford, United Kingdom
| | | | - Donna R Rivera
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland
| | - Lisa M Schilling
- Data Science to Patient Value Program, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Isabelle Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Karishma Shah
- NDORMS, University of Oxford, Botnar Research Centre, Windmill Road, Oxford, United Kingdom
| | - Nigam H Shah
- Department of Medicine, School of Medicine, Stanford University, Redwood City, California
| | - Yang Shen
- Digital Health China Technologies Co., Ltd., Beijing, China
| | - Matthew Spotniz
- Department of Biomedical Informatics, Columbia University, New York, New York
| | - Vignesh Subbian
- College of Engineering, University of Arizona, Tucson, Arizona
| | - Marc A Suchard
- Fielding School of Public Health, University of California, Los Angeles, California
| | - Annalisa Trama
- Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy
| | - Lin Zhang
- School of Population Medicine and Public Health, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- School of Population Health and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Ying Zhang
- Digital Health China Technologies Co., Ltd., Beijing, China
| | - Patrick B Ryan
- Janssen Research and Development, Titusville, New Jersey
- Department of Biomedical Informatics, Columbia University, New York, New York
| | | | | | - Talita Duarte-Salles
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.
| |
Collapse
|
49
|
Kaminsky LW, Dalessio S, Al-Shaikhly T, Al-Sadi R. Penicillin Allergy Label Increases Risk of Worse Clinical Outcomes in COVID-19. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2021; 9:3629-3637.e2. [PMID: 34293501 PMCID: PMC8288230 DOI: 10.1016/j.jaip.2021.06.054] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 06/10/2021] [Accepted: 06/29/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Coronavirus disease-2019 (COVID-19) ranges from asymptomatic to severe. Several comorbidities are associated with worse clinical outcomes. Antibiotic use is common in COVID-19 and penicillin (PCN) allergy can affect antibiotic choice and may influence COVID-19 outcomes. OBJECTIVE To investigate the impact of PCN allergy label on COVID-19 outcomes. METHODS For this retrospective, cohort study, a Web-based tool for population cohort research, TriNetX, was used to identify adult COVID-19 patients with and without PCN allergy label. The two cohorts were matched using 1:1 propensity score matching for baseline demographics and conditions associated with risk for severe COVID-19. The 30-day risks for hospitalization, acute respiratory failure, intensive care unit requirement, mechanical ventilation requirement, and mortality were then compared between groups. Because bacterial infection can drive alternative antibiotic regimens, additional analyses focused on patients without bacterial infection. RESULTS After propensity score matching, each cohort consisted of 13,183 patients. COVID-19 patients with PCN allergy had higher risks for hospitalization (risk ratio [RR] = 1.46; 95% confidence interval [CI], 1.41-1.52) acute respiratory failure (RR = 1.25; 95% CI, 1.19-1.31), intensive care unit requirement (RR = 1.20; 95% CI, 1.08-1.34), and mechanical ventilation (RR = 1.17; 95% CI 1.03-1.32) compared with patients without PCN allergy; however, there was no mortality difference (RR = 1.09; 95% CI, 0.96-1.23). Although the bacterial infection risk was higher in PCN allergic COVID-19 patients, exclusion of patients with bacterial infections yielded similar results. CONCLUSIONS Penicillin allergic patients have higher risk for worse COVID-19 outcomes and should be considered for risk mitigation strategies.
Collapse
Affiliation(s)
- Lauren W Kaminsky
- Section of Allergy, Asthma, and Immunology, Department of Medicine, Pennsylvania State University College of Medicine, Hershey, Pa.
| | - Shannon Dalessio
- Division of Gastroenterology and Hepatology, Pennsylvania State University College of Medicine, Hershey, Pa
| | - Taha Al-Shaikhly
- Section of Allergy, Asthma, and Immunology, Department of Medicine, Pennsylvania State University College of Medicine, Hershey, Pa
| | - Rana Al-Sadi
- Division of Gastroenterology and Hepatology, Pennsylvania State University College of Medicine, Hershey, Pa
| |
Collapse
|
50
|
Schiller M, Solger K, Leipold S, Kerl HU, Kick W. Diabetes-associated nephropathy and obesity influence COVID-19 outcome in type 2 diabetes patients. J Community Hosp Intern Med Perspect 2021; 11:590-596. [PMID: 34567446 PMCID: PMC8462845 DOI: 10.1080/20009666.2021.1957555] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 has rapidly spread around the globe and various comorbidities, such as diabetes have been recognized as risk factors for an unfavorable outcome. We analyzed a cohort of COVID-19 patients (n = 75) treated at a German community hospital. With a focus on diabetes mellitus, we evaluated the impact of distinct comorbidities on the COVID-19 disease course. The duration of hospital stay was prolonged if diabetes was present. An older age was associated with a poor outcome. The percentage of non-survivors increased in the presence of congestive heart failure or chronic kidney disease. In the group of diabetes patients, mortality was increased if any organ complication was present and diabetic nephropathy or the combination of obesity plus diabetes were by far the most important risk factors. Taken together, an older age, congestive heart failure, and chronic kidney disease significantly influenced COVID-19 disease course and survival. Diabetic nephropathy or the combination of obesity plus diabetes had the strongest impact on patients' outcome.
Collapse
Affiliation(s)
- Martin Schiller
- Internal Medicine, HochFranken Hospitals, Munchberg, Germany
| | - Kim Solger
- Internal Medicine, HochFranken Hospitals, Munchberg, Germany
| | | | - Hans Ulrich Kerl
- Department of Radiology, HochFranken Hospitals, Munchberg, Germany
| | - Wolfgang Kick
- Internal Medicine, HochFranken Hospitals, Munchberg, Germany
| |
Collapse
|