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Zhao M, Wang B, Zhou F, Fang C, Zhu B, Zhou M, Ye X, Chen Y, Ding Z. Modeling "Two-Hit" Severe Pneumonia in Mice: Pathological Characteristics and Mechanistic Studies. Inflammation 2024:10.1007/s10753-024-02136-w. [PMID: 39212889 DOI: 10.1007/s10753-024-02136-w] [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: 06/13/2024] [Revised: 08/21/2024] [Accepted: 08/22/2024] [Indexed: 09/04/2024]
Abstract
Severe pneumonia is one of the most common critical diseases in clinical practice. Existing models for severe pneumonia have limitations, leading to limited clinical translation. In this study, a two-hit severe pneumonia mouse model was established by inducing primary pneumonia through intratracheal instillation of 800 μg lipopolysaccharide (LPS), followed by intraperitoneal injection of 10 mg/kg LPS. The effectiveness of various inflammatory indicators and the lung tissue damage during the time course of this model were confirmed and evaluated. At 3 h post two-hit, the IL-6, TNF-α levels in peripheral blood and bronchoalveolar lavage fluid (BALF), and the white blood cells, neutrophils, and lymphocytes in BALF notably exhibited the most pronounced elevation. At 12 h post two-hit, the white blood cells and neutrophils in peripheral blood significantly increased, accompanied by notable alterations in splenic immune cells and worsened pulmonary histopathological damage. Transcriptomics of lung tissue, microbiota analysis of lung and gut, as well as plasma metabolomics analyses further indicated changes in transcriptional profiles, microbial composition, and metabolites due to the two-hit modeling. These results validate that the two-hit model mimics the clinical presentation of severe pneumonia and serves as a robust experimental tool for studying the pathogenesis of severe pneumonia and developing and assessing treatment strategies.
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Affiliation(s)
- Mengjia Zhao
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Bixu Wang
- Ningbo Yinzhou Center for Disease Control and Prevention, Ningbo, 315199, China
| | - Fangmei Zhou
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Chengnan Fang
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Bingqi Zhu
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Mingyuan Zhou
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Xiaoqing Ye
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Yuchi Chen
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
| | - Zhishan Ding
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
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Kumar N, Syed Sulaiman SA, Hashmi FK, Noor A, Ahmad R, Qureshi A, Jhatial F, Sheikh Ghadzi SM. Exploring the Clinical Features, Management of Hypertension, and Predictors of Severity in Hospitalized Hypertensive COVID-19 Patients. Cureus 2024; 16:e61356. [PMID: 38947593 PMCID: PMC11214652 DOI: 10.7759/cureus.61356] [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: 05/30/2024] [Indexed: 07/02/2024] Open
Abstract
Background Hypertension significantly contributes to the severity, prolonged hospitalization, the need for intensive care, and mortality of COVID-19 patients. However, the data is still evolving. This study investigated the predictors of severity among hypertensive COVID-19 patients. Methodology This cohort study included 333 hospitalized hypertensive COVID-19 patients at the Indus Hospital, Karachi, Pakistan, from April 2021 to October 2021. The study evaluated the clinical features, antihypertensive therapy, and predictors of severity. A multivariable binary logistic regression model was used to determine severity predictors using IBM SPSS Statistics for Windows, Version 27.0 (Released 2020; IBM Corp., Armonk, NY, USA). Results The majority of hypertensive COVID-19 patients were females (54.7%), aged <65 years (55.8%), and coexisted with diabetes mellitus (56.5%). The independent predictors of severity were male (aOR 2.65, 95% CI, 1.08-6.51; p < 0.033), fever (aOR 3.52, 95% CI, 1.24-9.92; p = 0.017), shortness of breath (aOR 4.49, 95% CI, 1.73-11.63; p = 0.002), oxygen saturation (<90%) (aOR 87.39, 95% CI, 19.15-398.75; p < 0.001), and D-dimer (>0.5 mcg/ml) (aOR 3.03, 95% CI, 1.19-7.71; p = 0.020). Conclusions Our study concluded that males with fever before admission, shortness of breath, lower oxygen saturation, and elevated D-dimer are the predictors of severity among hypertensive COVID-19 patients.
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Affiliation(s)
- Narendar Kumar
- Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang, MYS
- Pharmacy Practice, Faculty of Pharmacy, University of Sindh, Jamshoro, PAK
| | - Syed Azhar Syed Sulaiman
- Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang, MYS
| | | | - Ahmed Noor
- Cardiology, Indus Hospital & Health Network, Karachi, PAK
| | - Rabbiya Ahmad
- Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang, MYS
| | - Ali Qureshi
- Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang, MYS
| | - Faheem Jhatial
- Pharmacy Services, Indus Hospital & Health Network, Karachi, PAK
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Yang T, Zhao X, Sun Q, Zhang Y, Xie J. Elucidating the anti-inflammatory activity of platycodins in lung inflammation through pulmonary distribution dynamics and grey relational analysis of cytokines. JOURNAL OF ETHNOPHARMACOLOGY 2024; 323:117706. [PMID: 38176670 DOI: 10.1016/j.jep.2024.117706] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 12/28/2023] [Accepted: 01/02/2024] [Indexed: 01/06/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Platycodonis Radix (PR) is a traditional herbal remedy used to prevent and treat lung inflammation, and platycodins are speculated to be the major active constituents. However, concrete experimental verification for this assertion remains absent thus far. AIM OF THE STUDY This study aims to compare the pulmonary distribution dynamics of five platycodins and analyze their effects on cytokines. Through the grey relational analysis (GRA) between pulmonary active components and cytokines, the study ascertains platycodins as the potential effective component against lung inflammation. MATERIALS AND METHODS A rat lung inflammation model was created using lipopolysaccharides (LPS). Pulmonary distribution dynamics were analyzed via LC-MS/MS. Cytokine changes and distribution patterns in lung tissues were studied by multi-factor reagent kit. GRA was applied to determine correlations between pulmonary components and cytokines. Finally, the anti-inflammatory properties of platycodins were further studied using LPS-induced BEAS-2B cells in vitro. RESULTS The results showed that five platycodins (Platycodin D, Platycodin D3, Deapio Platycodin D, 3-O-β-D-Glucopyranosyl Platycodigenin, and Platycodigenin) featured fast absorption rate, short time to peak, and slow metabolism rate. The pulmonary distribution dynamics were significantly affected within 2 h after LPS modeling. At the same time, PR altered the relationships among different cytokines induced by LPS stimulation, particularly inflammatory cytokines IL-6 and IFN-γ. The GRA results indicated good correlation between the pulmonary distribution dynamics of the five platycodins components and the changing patterns of cytokine levels, with Platycodin D3 contributing the most. Additionally, Platycodin D3 exhibited a protective role against LPS-induced inflammation by reducing the production of pro-inflammatory mediators such as IL-1β, IL-8, and ROS, as well as increasing the expression of the anti-inflammatory mediator IL-10. CONCLUSIONS Platycodins are the main anti-inflammatory agents in PR and there is a good correlation with cytokines. This contributes to the anti-pneumonia effect of PR.
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Affiliation(s)
- Tan Yang
- College of Traditional Chinese Pharmacy, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Xiaotong Zhao
- Chemistry of Department, Cleveland State University, Cleveland, OH, 44115, USA
| | - Qing Sun
- College of Traditional Chinese Pharmacy, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Yanqing Zhang
- College of Biotechnology and Food Science, Tianjin University of Commerce, Tianjin, 300134, China
| | - Junbo Xie
- College of Traditional Chinese Pharmacy, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China.
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Alsayed AR, Ahmed SI, AL Shweiki AO, Al-Shajlawi M, Hakooz N. The laboratory parameters in predicting the severity and death of COVID-19 patients: Future pandemic readiness strategies. BIOMOLECULES & BIOMEDICINE 2024; 24:238-255. [PMID: 37712883 PMCID: PMC10950347 DOI: 10.17305/bb.2023.9540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/30/2023] [Accepted: 09/14/2023] [Indexed: 09/16/2023]
Abstract
The range of clinical manifestations associated with the infection by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) encompasses a broad spectrum, ranging from flu-like symptoms to the occurrence of multiple organ failure and death. The severity of the coronavirus disease 2019 (COVID-19) is categorized based on clinical presentation and is divided into three distinct levels of severity identified as non-severe, severe, and critical. Although individuals of all age groups are susceptible to SARS-CoV-2 infection, middle-aged and older adults are more frequently impacted, with the latter being more likely to develop severe illness. Various laboratory characteristics observed in hospitalized COVID-19 patients have been correlated with adverse outcomes. These include elevated levels of D-dimer, liver enzymes, lactate dehydrogenase, C-reactive protein, ferritin, prothrombin time, and troponin, as well as decreased lymphocyte and platelets counts. This review investigated the relationship between baseline clinical characteristics, initial laboratory parameters upon hospital admission, and the severity of illness and mortality rates among COVID-19 patients. Although the COVID-19 pandemic has concluded, understanding the laboratory predictors of virus severity and mortality remains crucial, and examining these predictors can have long-term effects. Such insights can help healthcare systems manage resources more effectively and deliver timely and appropriate care by identifying and targeting high-risk individuals. This knowledge can also help us better prepare for future pandemics. By examining these predictors, we can take steps to protect public health and mitigate the impact of future pandemics.
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Affiliation(s)
- Ahmad R Alsayed
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Syed Imran Ahmed
- College of Health and Science, School of Pharmacy, University of Lincoln, Lincoln, United Kingdom
| | - Anas Osama AL Shweiki
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Mustafa Al-Shajlawi
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Nancy Hakooz
- School of Pharmacy, The University of Jordan, Amman, Jordan
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Elamin MY, Maslamani YA, Alsheikh FA, Sailah MA, Samm MA, Motanbk AM, Hejri YM, Alameer AA, Khalid OH, Dahlan AA, Gosadi IM. Impact of vaccination on morbidity and mortality in adults hospitalized with COVID-19 during the omicron wave in the Jazan Region, Saudi Arabia. Saudi Med J 2024; 45:179-187. [PMID: 38309738 PMCID: PMC11115406 DOI: 10.15537/smj.2024.45.2.20230530] [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: 07/17/2023] [Accepted: 01/04/2024] [Indexed: 02/05/2024] Open
Abstract
OBJECTIVES To evaluate the impact of coronavirus disease-19 (COVID-19) vaccination on morbidity and mortality in adults hospitalized with COVID-19 during the omicron wave in the Jazan Region, Saudi Arabia. METHODS A 6-month record-based historical prospective study enrolled COVID-19 adult patients admitted between January and June 2022. Individuals were classified into 3 groups according to their immunity status (immunized, partially immunized, and not immunized). Death, intensive care unit (ICU) admission, and mechanical ventilation were identified as the primary outcomes, collectively referred to as "serious outcomes". On the other hand, the length of hospital stays longer than 5 days was categorized as a secondary outcome. Multiple logistic regression analysis was used to evaluate independent factors and the relationship between the outcomes and vaccination status. RESULTS Among the 634 COVID-19 patients admitted to Jazan hospitals, 46.4% were fully immunized, 19.7% were partially immunized, and 33.9% were not immunized. Not being immunized was significantly associated with ICU admission (odds ratio [OR]=1.91, 95% confidence interval [CI]: [1.17-3.11]; p=0.009), mechanical ventilation (OR=2.11, 95% CI: [1.25-3.56]; p=0.005), increased length of hospital stays (OR=1.79, 95% CI: [1.24-2.59]; p=0.002), and death (OR=3.03, 95% CI: [1.85-4.98]; p<0.001). CONCLUSION Our study underscores the importance of a comprehensive approach for managing COVID-19 patients that includes vaccination against the disease.
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Affiliation(s)
- Mohammed Y. Elamin
- From the Public Health Administration (Elamin, Maslamani, Alsheikh, Sailah, Hejri, Alameer, Khalid, Dahlan); from the Command and Control Center (Samm); from the Emergency Administration (Motanbk), Jazan Health Directorate, and from the Department of Family and Community Medicine (Gosadi), Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia.
| | - Yahya A. Maslamani
- From the Public Health Administration (Elamin, Maslamani, Alsheikh, Sailah, Hejri, Alameer, Khalid, Dahlan); from the Command and Control Center (Samm); from the Emergency Administration (Motanbk), Jazan Health Directorate, and from the Department of Family and Community Medicine (Gosadi), Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia.
| | - Feras A. Alsheikh
- From the Public Health Administration (Elamin, Maslamani, Alsheikh, Sailah, Hejri, Alameer, Khalid, Dahlan); from the Command and Control Center (Samm); from the Emergency Administration (Motanbk), Jazan Health Directorate, and from the Department of Family and Community Medicine (Gosadi), Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia.
| | - Mohsen A. Sailah
- From the Public Health Administration (Elamin, Maslamani, Alsheikh, Sailah, Hejri, Alameer, Khalid, Dahlan); from the Command and Control Center (Samm); from the Emergency Administration (Motanbk), Jazan Health Directorate, and from the Department of Family and Community Medicine (Gosadi), Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia.
| | - Mussab A. Samm
- From the Public Health Administration (Elamin, Maslamani, Alsheikh, Sailah, Hejri, Alameer, Khalid, Dahlan); from the Command and Control Center (Samm); from the Emergency Administration (Motanbk), Jazan Health Directorate, and from the Department of Family and Community Medicine (Gosadi), Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia.
| | - Ahmed M. Motanbk
- From the Public Health Administration (Elamin, Maslamani, Alsheikh, Sailah, Hejri, Alameer, Khalid, Dahlan); from the Command and Control Center (Samm); from the Emergency Administration (Motanbk), Jazan Health Directorate, and from the Department of Family and Community Medicine (Gosadi), Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia.
| | - Yehya M. Hejri
- From the Public Health Administration (Elamin, Maslamani, Alsheikh, Sailah, Hejri, Alameer, Khalid, Dahlan); from the Command and Control Center (Samm); from the Emergency Administration (Motanbk), Jazan Health Directorate, and from the Department of Family and Community Medicine (Gosadi), Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia.
| | - Anwar A. Alameer
- From the Public Health Administration (Elamin, Maslamani, Alsheikh, Sailah, Hejri, Alameer, Khalid, Dahlan); from the Command and Control Center (Samm); from the Emergency Administration (Motanbk), Jazan Health Directorate, and from the Department of Family and Community Medicine (Gosadi), Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia.
| | - Osama H. Khalid
- From the Public Health Administration (Elamin, Maslamani, Alsheikh, Sailah, Hejri, Alameer, Khalid, Dahlan); from the Command and Control Center (Samm); from the Emergency Administration (Motanbk), Jazan Health Directorate, and from the Department of Family and Community Medicine (Gosadi), Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia.
| | - Abdu A. Dahlan
- From the Public Health Administration (Elamin, Maslamani, Alsheikh, Sailah, Hejri, Alameer, Khalid, Dahlan); from the Command and Control Center (Samm); from the Emergency Administration (Motanbk), Jazan Health Directorate, and from the Department of Family and Community Medicine (Gosadi), Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia.
| | - Ibrahim M. Gosadi
- From the Public Health Administration (Elamin, Maslamani, Alsheikh, Sailah, Hejri, Alameer, Khalid, Dahlan); from the Command and Control Center (Samm); from the Emergency Administration (Motanbk), Jazan Health Directorate, and from the Department of Family and Community Medicine (Gosadi), Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia.
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Zhang H, Weng Z, Zheng Y, Zheng M, Chen W, He H, Ye X, Zheng Y, Xie J, Zheng K, Zhang J, Zhuang X, Su Z, Zhou Y, Yu X. Epidemiological and clinical features of SARS-CoV-2 Omicron variant infection in Quanzhou, Fujian province: a retrospective study. Sci Rep 2023; 13:22152. [PMID: 38092887 PMCID: PMC10719353 DOI: 10.1038/s41598-023-49098-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 12/04/2023] [Indexed: 12/17/2023] Open
Abstract
Epidemiological and clinical data of patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant (BA.2) admitted to three designated hospitals in Quanzhou City, Fujian Province, China, were collected and analyzed. Overall, 2,541 patients infected with BA.2, comprising 1,060 asymptomatic, 1,287 mild, and 194 moderate infections, were enrolled. The percentage of moderate infections was higher in patients aged ≥ 60 years than in those aged < 18 years and 18-59 years. The median hospitalization duration was 17 days. Among the 2,541 patients, 43.52% had a clear history of close contact. The vaccination rate was 87.92%, and the percentage of asymptomatic infections was higher in vaccinated than in unvaccinated patients. Moreover, patients with underlying diseases, including hypertension and diabetes mellitus, had more moderate infections than those without underlying diseases. The three most common clinical manifestations were fever, dry cough, and sore throat. The albumin-to-globulin (A/G) ratio and lymphocyte count decreased in cases with mild and moderate infections, while procalcitonin, erythrocyte sedimentation rate, interleukin-6, D-dimer, and C4 levels increased. Advanced age, non-vaccination, and underlying comorbid diseases were high-risk factors for disease progression in patients. However, dynamic monitoring of blood routine parameters, A/G ratio, and inflammatory indicators facilitated the prediction of disease progression.
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Affiliation(s)
- Huatang Zhang
- Department of Infection Disease, Fujian Medical University Affiliated First Quanzhou Hospital, No. 250 East Street, Licheng District, Quanzhou, 362000, Fujian, China
| | - Zhangyan Weng
- Department of Infection Disease, Fujian Medical University Affiliated First Quanzhou Hospital, No. 250 East Street, Licheng District, Quanzhou, 362000, Fujian, China
| | - Yijuan Zheng
- Department of Infection Disease, Fujian Medical University Affiliated First Quanzhou Hospital, No. 250 East Street, Licheng District, Quanzhou, 362000, Fujian, China
| | - Minghui Zheng
- Department of Infection Disease, Fujian Medical University Affiliated First Quanzhou Hospital, No. 250 East Street, Licheng District, Quanzhou, 362000, Fujian, China
| | - Wenhuang Chen
- Department of Infection Disease, Fujian Medical University Affiliated First Quanzhou Hospital, No. 250 East Street, Licheng District, Quanzhou, 362000, Fujian, China
- Department of Infection Disease, Quanzhou Guangqian Hospital, Guangqian South Street, Nan'an, Quanzhou, 362000, Fujian, China
| | - Haoyi He
- Department of Infection Disease, Fujian Medical University Affiliated First Quanzhou Hospital, No. 250 East Street, Licheng District, Quanzhou, 362000, Fujian, China
| | - Xiaoyi Ye
- Department of Respiratory Disease, Fujian Medical University Affiliated First Quanzhou Hospital, No. 250 East Street, Licheng District, Quanzhou, 362000, Fujian, China
| | - Youxian Zheng
- Department of Clinical Laboratory, Quanzhou Center for Disease Control and Prevention, No. 21 Jinhuai Street, Fengze District, Quanzhou, 362000, Fujian, China
| | - Jianfeng Xie
- Fujian Provincial Key Laboratory of Zoonosis Research, Fujian Center for Disease Control and Prevention, No. 76 Jintai Road, Gulou District, Fuzhou, 350001, Fujian, China
| | - Kuicheng Zheng
- Fujian Provincial Key Laboratory of Zoonosis Research, Fujian Center for Disease Control and Prevention, No. 76 Jintai Road, Gulou District, Fuzhou, 350001, Fujian, China
| | - Jiming Zhang
- Department of Infection Disease, Huashan Hospital Fudan University, No. 12 Wulumuqi Middle Road, Shanghai, 200040, China
| | - Xibin Zhuang
- Department of Respiratory Disease, Fujian Medical University Affiliated First Quanzhou Hospital, No. 250 East Street, Licheng District, Quanzhou, 362000, Fujian, China.
| | - Zhijun Su
- Department of Infection Disease, Fujian Medical University Affiliated First Quanzhou Hospital, No. 250 East Street, Licheng District, Quanzhou, 362000, Fujian, China.
| | - Yongjun Zhou
- Institute of Bioengineering and Biotechnology, College of Life Sciences and Chemistry, Minnan Science and Technology University, Quanzhou, 362000, China.
| | - Xueping Yu
- Department of Infection Disease, Fujian Medical University Affiliated First Quanzhou Hospital, No. 250 East Street, Licheng District, Quanzhou, 362000, Fujian, China.
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Dada SA, Dele-Ojo BF, Raimi TH, Ojo P, Adeoti AO, Fadare JO, Rafiu MO, Dada OE, Olabanji JK. Clinical and Epidemiological Characteristics of Hospitalized COVID-19 Patients in an Isolation Centre in South-West Nigeria. Cureus 2023; 15:e46992. [PMID: 38021567 PMCID: PMC10640905 DOI: 10.7759/cureus.46992] [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: 10/11/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION The clinical presentation of coronavirus disease 2019 (COVID-19) can vary widely, and while the primary infection involves the respiratory system, other organs can also be affected. This study presents the clinical and epidemiological characteristics of hospitalized COVID-19 patients in a tertiary hospital in Ado Ekiti, South-West Nigeria. MATERIALS AND METHODS This is a retrospective study involving COVID-19 patients admitted to the isolation ward between August 2020 and January 2021. The data used for this study was obtained from the patient's medical record, which includes demographic characteristics, clinical presentation, baseline co-morbidities, and laboratory investigations. RESULTS The average age of the patients was 60.3 years, and more than two-thirds were male. The most common symptoms were fever, shortness of breath, cough, and tiredness. Comorbidities identified among the patients included diabetes mellitus, heart disease, obesity, and chronic kidney disease. The most common radiological findings were bilateral homogeneous patchy opacities and peripheral fluffy infiltrates. The overall mortality rate was 21.9%, with 13 deaths in patients with severe disease. Age and duration of admission were found to be significant predictors of death. CONCLUSION The results of this study provide valuable insights into the clinical presentation of COVID-19 in Nigeria and may guide future management strategies for similar infections.
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Affiliation(s)
- Samuel A Dada
- Department of Medicine, Ekiti State University Teaching Hospital, Ado Ekiti, NGA
| | - Bolade F Dele-Ojo
- Department of Medicine, Ekiti State University Teaching Hospital, Ado Ekiti, NGA
| | - Taiwo H Raimi
- Department of Medicine, Ekiti State University Teaching Hospital, Ado Ekiti, NGA
| | - Peter Ojo
- Department of Medicine, Ekiti State University Teaching Hospital, Ado Ekiti, NGA
| | - Adekunle O Adeoti
- Department of Medicine, Ekiti State University Teaching Hospital, Ado Ekiti, NGA
| | - Joseph O Fadare
- Department of Medicine, Ekiti State University Teaching Hospital, Ado Ekiti, NGA
| | - Mojeed O Rafiu
- Department of Internal Medicine, Institute of Viral Haemorrhagic Fever and Emergent Pathogens, Irrua Specialist Teaching Hospital, Irrua Edo State, NGA
| | - Oluwamayowa E Dada
- Department of Health Information Management, Federal Teaching Hospital, Ido Ekiti, NGA
| | - Jimoh K Olabanji
- Department of Surgery, Ekiti State University Teaching Hospital, Ado Ekiti, NGA
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8
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Li H, Jia X, Wang Y, Lv Y, Wang J, Zhai Y, Xue X. Differences in the severity and mortality risk factors for patients hospitalized for COVID-19 pneumonia between the early wave and the very late stage of the pandemic. Front Med (Lausanne) 2023; 10:1238713. [PMID: 37841011 PMCID: PMC10568453 DOI: 10.3389/fmed.2023.1238713] [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: 06/12/2023] [Accepted: 09/13/2023] [Indexed: 10/17/2023] Open
Abstract
Background Since China's dynamic zero-COVID policy is cancelled on December 7, 2022, the rapidly growing number of patients has brought a major public health challenge. This study aimed to assess whether there were differences in the severity and mortality risk factors for patients hospitalized for COVID-19 pneumonia between the early wave and the very late stage of the pandemic. Methods A retrospective cross-sectional study was carried out using data from 223 hospitalized patients diagnosed with COVID-19 pneumonia during the Omicron surge in Xi'an People's Hospital (Xi'an Fourth Hospital) from December 8, 2022, to January 31, 2023. Univariable and multivariable logistic regression analyses were used to identify potential risk factors associated with the severity and mortality of COVID-19 pneumonia during the first wave of the pandemic after the dynamic zero-COVID policy was retracted. Differences in the severity and mortality risk factors were assessed at different stages of the pandemic, mainly from demographic, clinical manifestation, laboratory tests and radiological findings of patients on admission. Results The mean age of the 223 participants was 71.2 ± 17.4. Compared with the patients in the initial stage of the pandemic, the most common manifestation among patients in this study was cough (90.6%), rather than fever (79.4%). Different from the initial stage of the pandemic, older age, chest tightness, elevated neutrophil-to-lymphocyte ratio (NLR), decreased albumin (ALB) level and ground glass opacification (GGO) in radiological finding were identified as severity risk factors, instead of mortality risk factors for COVID-19 patients in the very late stage of the pandemic. Arterial partial pressure of oxygen/fraction of inspired oxygen (PaO2/FiO2) ≤300 mmHg, cardiovascular disease and laboratory findings including elevated levels of D-dimer, α-hydroxybutyrate dehydrogenase (α-HBDH), total bilirubin (TBIL), alanine aminotransferase (ALT), urea nitrogen (BUN), creatinine (CR), fasting blood glucose (FBG) and decreased platelet count (PLT) were still associated with mortality in the very late stage of the pandemic. Conclusion Monitoring continuously differences in the severity and mortality risk factors for COVID-19 patients between different stages of the pandemic could provide evidence for exploring uncharted territory in the coming post-pandemic era.
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Affiliation(s)
- Haiyan Li
- Department of Pharmacy, Xi’an People’s Hospital (Xi’an Fourth Hospital), Xi’an, China
| | - Xiaoni Jia
- Department of Science and Education, Xi’an Mental Health Center, Xi’an, China
- Department of Pharmacy, Xi’an Mental Health Center, Xi’an, China
| | - Yu Wang
- Department of Endocrinology, Xi’an People’s Hospital (Xi’an Fourth Hospital), Xi’an, China
| | - Yali Lv
- Department of Neurology, Xi’an People’s Hospital (Xi’an Fourth Hospital), Xi’an, China
| | - Jing Wang
- Department of Endocrinology, Xi’an People’s Hospital (Xi’an Fourth Hospital), Xi’an, China
| | - Yuyao Zhai
- Department of Pharmacy, Xi’an People’s Hospital (Xi’an Fourth Hospital), Xi’an, China
| | - Xiaorong Xue
- Department of Pharmacy, Xi’an People’s Hospital (Xi’an Fourth Hospital), Xi’an, China
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Wang J, Li D, Tang B, Sun X, Shi W, Li H, Zhang Z, Wu Y, Zhang Y, Qiao Q. The clinical and immunological characteristics of COVID-19 patients with delayed SARS-CoV-2 virus clearance. Immun Inflamm Dis 2023; 11:e999. [PMID: 37773701 PMCID: PMC10540562 DOI: 10.1002/iid3.999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 08/09/2023] [Accepted: 08/20/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has posed a great threat to human health. Some severe COVID-19 patients still carried detectable levels of SARS-CoV-2 even after prolonged intensive care unit treatment. However, the immunological features of these COVID-19 patients with delayed virus clearance (CDVC) are still unclear. METHODS We retrospectively reviewed the clinical and immunological data of 13 CDVC cases, who were admitted into one hospital in Wuhan from February to April 2020. These data were also compared to those of perished (n = 9) and recovered (n = 52) cases. The expression of the exhaustion marker PD-1 on circulating T cells of these patients was measured by flow cytometry. RESULTS High levels of serum interleukin-6 (IL-6), IL-1β, IL-8, as well as other inflammatory mediators, were seen in CDVC cases. Severe lymphopenia was observed in CDVC patients with the counts of total lymphocytes (0.9 × 109 /L), CD4+ T cells (0.35 × 109 /L), and CD8+ T cells (0.28 × 109 /L) below their corresponding lower limits of normal range. Similar to the perished group, CDVC cases have higher percentages of CD25+ Foxp3+ regulatory T cells (Treg) in circulation. Moreover, enhanced expression of the exhaustion marker PD-1 on CCR7- CD45RA+ effector, CCR7+ CD45RA- central memory, and CCR7- CD45RA- effector memory CD4+ and CD8+ T cells were also observed in CDVC cases. CONCLUSION CDVC patients still have SARS-CoV-2 and these cases manifest with severe clinical symptoms due to persistent inflammation. Augmentation of the frequency of circulating Treg, severe lymphopenia, and functional exhaustion of T cells might lead to inefficient clearance of SARS-CoV-2. Therefore, enhancing lymphocyte counts and reversing T-cell exhaustion might be key methods to boost immune responses and eliminate SARS-CoV-2 in CDVC patients.
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Affiliation(s)
- Jinsong Wang
- Institute of Immunology, PLAArmy Medical UniversityChongqingChina
| | - Debao Li
- Department of ImmunologyMedical College of Qingdao UniversityQingdaoShandongChina
| | - Bo Tang
- Chongqing International Institute for ImmunologyChongqingChina
| | - Xuemin Sun
- Institute of Immunology, PLAArmy Medical UniversityChongqingChina
| | - Wenjiong Shi
- Chongqing International Institute for ImmunologyChongqingChina
| | - Hao Li
- Pingdingshan Medical Districtthe 989th Hospital of the PLA Joint Logistic Support ForcePingdingshanHenanChina
| | - Zhenhua Zhang
- Department of Radiologythe 989th Hospital of the PLA Joint Logistic Support ForceLuoyangHenanChina
| | - Yuzhang Wu
- Institute of Immunology, PLAArmy Medical UniversityChongqingChina
| | - Yi Zhang
- Chongqing International Institute for ImmunologyChongqingChina
- School of Pharmacy and BioengineeringChongqing University of TechnologyChongqingChina
| | - Qinghua Qiao
- Pingdingshan Medical Districtthe 989th Hospital of the PLA Joint Logistic Support ForcePingdingshanHenanChina
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Ci T, Xiong Y, Zhang J, Zang J, Feng N. Immunosuppressive dead cell as lung-targeting vehicle and cytokine absorption material for cytokine storm attenuation of pneumonia. Mater Today Bio 2023; 20:100684. [PMID: 37304577 PMCID: PMC10250915 DOI: 10.1016/j.mtbio.2023.100684] [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: 02/08/2023] [Revised: 05/26/2023] [Accepted: 05/26/2023] [Indexed: 06/13/2023] Open
Abstract
Effectively controlling cytokine storm is important to reduce the mortality of severe pneumonia. In this work a bio-functional dead cell was engineered by one-time quick shock of live immune cells in liquid nitrogen, and the obtained immunosuppressive dead cell could server as both lung-targeting vehicle and cytokine absorption material. After loading the anti-inflammatory drugs of dexamethasone (DEX) and baicalin (BAI), the drug-loaded dead cell (DEX&BAI/Dead cell) could first passively target to the lung after intravenous administration and quickly release the drugs under high shearing stress of pulmonary capillaries, realizing drug enrichment in the lung. Then, the immunosuppressive dead cell acted as the camouflage of normal immune cells with various cytokine receptors exposing on their surface, to "capture" the cytokines and further reduce the state of inflammation. With above formulation design, a synergic anti-inflammatory effect between drugs and carrier could be achieved. In a lipopolysaccharide-induced pneumonia mice model, this system could calm down the cytokine storm with high efficacy and elongate the survival of mice.
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11
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Tudora A, Lungeanu D, Pop-Moldovan A, Puschita M, Lala RI. Successive Waves of the COVID-19 Pandemic Had an Increasing Impact on Chronic Cardiovascular Patients in a Western Region of Romania. Healthcare (Basel) 2023; 11:healthcare11081183. [PMID: 37108017 PMCID: PMC10138635 DOI: 10.3390/healthcare11081183] [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: 02/27/2023] [Revised: 04/11/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
Three years since the COVID-19 pandemic started, there is still little information about patients with chronic medical conditions, such as cardiovascular diseases (CVDs), who become infected with SARS-CoV-2. A retrospective analysis was performed to evaluate the impact of the COVID-19 pandemic on patients with cardiovascular comorbidities hospitalized with positive RT-PCR results for SARS-CoV-2 during the highest peaks of the first three pandemic waves: April 2020, October 2020, and November 2021. The primary outcome was in-hospital mortality; the secondary outcomes were length of hospitalization and required mechanical ventilation to assess the disease severity. Data were extracted from the hospital electronic database system: 680 eligible cases were identified out of 2919 patients. Mortality was the highest in wave 3 (31.9%) compared to the previous waves (13.6% and 25.8%). Hospitalization was also significantly longer in wave 3 (11.58 ± 5.34 vs. 8.94 ± 4.74 and 10.19 ± 5.06; p < 0.001), and so was the need for mechanical ventilation (21.7% vs. 8.2% and 9%; p < 0.001). Older age and male gender were confirmed as highly significant predictors of unfavorable outcomes. Ischemic heart disease worsened the odds of patients' survival irrespective of the three pandemic waves (Breslow-Day test, p = 0.387), with a marginally significant Mantel-Haenszel common estimate for risk: OR = 1.604, 95% (0.996; 2.586). The significantly worse outcomes in wave 3 could have been influenced by a combination of factors: the low percentage of vaccinations in Romanian population, the more virulent delta strain, and pandemic attrition in the care provided to these patients with chronic CVDs.
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Affiliation(s)
- Adelina Tudora
- Arad County Clinical Emergency Hospital, 310037 Arad, Romania
- Faculty of Medicine, "Vasile Goldis" Western University, 310025 Arad, Romania
| | - Diana Lungeanu
- Center for Modeling Biological Systems and Data Analysis, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Functional Sciences, Faculty of Medicine, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Adina Pop-Moldovan
- Arad County Clinical Emergency Hospital, 310037 Arad, Romania
- Faculty of Medicine, "Vasile Goldis" Western University, 310025 Arad, Romania
| | - Maria Puschita
- Arad County Clinical Emergency Hospital, 310037 Arad, Romania
- Faculty of Medicine, "Vasile Goldis" Western University, 310025 Arad, Romania
| | - Radu I Lala
- Arad County Clinical Emergency Hospital, 310037 Arad, Romania
- Faculty of Medicine, "Vasile Goldis" Western University, 310025 Arad, Romania
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12
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Chen Y, Wang J, Yi M, Xu H, Liang H. The COVID-19 vaccination decision-making preferences of elderly people: a discrete choice experiment. Sci Rep 2023; 13:5242. [PMID: 37002340 PMCID: PMC10063931 DOI: 10.1038/s41598-023-32471-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
COVID-19 is a continuing threat to global public health security. For elderly people, timely and effective vaccination reduces infection rates in this group and safeguards their health. This paper adopted an offline Discrete Choice Experiment (DCE) to research the preference for COVID-19 vaccination amongst Chinese adults aged 50 years and above. Through multinomial logistic regression analysis, our DCE leverages five attributes-the risk of adverse reactions, protective duration, injection doses, injection period, and effectiveness-each of which is split into three to four levels. The risk of adverse reaction and the protective duration were demonstrated to be determinants of vaccination preference. Moreover, it was found that socio demographic factors like region, self-health assessment and the number of vaccinated household members can strengthen or weaken the effects of vaccine attributes. In conclusion, the preferences of the elderly population should be considered when developing COVID-19 vaccination programs for this population in China. Accordingly, the results may provide useful information for policymakers to develop tailored, effectively vaccination strategies.
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Affiliation(s)
- Yuhan Chen
- School of Public Administration and Policy, Renmin University of China, Beijing, 100872, China
| | - Jimeng Wang
- School of Philosophy, Renmin University of China, Beijing, China
| | - Meixi Yi
- School of Public Administration and Policy, Renmin University of China, Beijing, 100872, China
| | - Hongteng Xu
- Gaoling School of Artificial Intelligence, Renmin University of China, Beijing, China
| | - Hailun Liang
- School of Public Administration and Policy, Renmin University of China, Beijing, 100872, China.
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13
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Tworek A, Jaroń K, Cicha M, Rydzewski A, Wierzba W, Zaczyński A, Król Z, Rydzewska G. The persistence of SARS-CoV-2 neutralizing antibodies after COVID-19: A one-year observation. Is a SARS-CoV-2 vaccination booster dose necessary? Cent Eur J Immunol 2023; 48:92-96. [PMID: 37692027 PMCID: PMC10485689 DOI: 10.5114/ceji.2023.126206] [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: 07/03/2022] [Accepted: 02/27/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction The aim of this study was to investigate the persistence of SARS-CoV-2 neutralizing antibodies (NAbs) one year after contracting COVID-19. Material and methods The study included 38 patients - 34 men and 4 women - suffering from COVID-19 between March 15 and May 26, 2020. The median age in the group was 31 years, ranging from 22 to 67 years. The levels of neutralizing antibodies were measured at three time-points - baseline, 6 months, and 12 months. The primary endpoint was a post-infection positive result for NAbs (> 15 AU/ml; Liaison SARS-CoV-2 S1/S2 IgG quantitative test) 12 months after infection. Results The median level of NAbs after 12 months was 26.5 AU/ml. At the end of observation (12 months), 21 of the 38 patients had a NAb level of >15 AU/ml (positive). The median antibody half-life was 5.8 months. Conclusions A high percentage of the patients maintained positive levels of antibodies 6 and 12 months after COVID-19 infection. The dynamics of the antibody level decline suggests the need for booster vaccination at least once a year.
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Affiliation(s)
- Adam Tworek
- Clinical Department of Internal Medicine and Gastroenterology with Inflammatory Bowel Disease Unit, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Krzysztof Jaroń
- Clinical Department of Internal Medicine and Gastroenterology with Inflammatory Bowel Disease Unit, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Małgorzata Cicha
- Diagnostic Laboratory of Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Andrzej Rydzewski
- Department of Internal Medicine, Nephrology and Transplantation Medicine, Central Clinical Hospital of the Ministry of Interior and Administration, Warsaw, Poland
- Department of Internal Medicine, Nephrology and Transplantation Medicine, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Waldemar Wierzba
- Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland
- University of Humanities and Economics in Łódz, Satellite Campus in Warsaw, Warsaw, Poland
| | - Artur Zaczyński
- Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Zbigniew Król
- Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Grażyna Rydzewska
- Clinical Department of Internal Medicine and Gastroenterology with Inflammatory Bowel Disease Unit, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
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14
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Sex differences in D-dimer and critical illness in patients with COVID-19: A systematic review and meta-analysis. Res Pract Thromb Haemost 2023; 7:100042. [PMID: 36685003 PMCID: PMC9840223 DOI: 10.1016/j.rpth.2023.100042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 11/23/2022] [Accepted: 12/09/2022] [Indexed: 01/15/2023] Open
Abstract
Background Observed sex differences in COVID-19 outcomes suggest that men are more likely to experience critical illness and mortality. Thrombosis is common in severe COVID-19, and D-dimer is a significant marker for COVID-19 severity and mortality. It is unclear whether D-dimer levels differ between men and women, and the effect of D-dimer levels on disease outcomes remains under investigation. Objectives We aimed to evaluate the sex difference in the D-dimer level among hospitalized patients with COVID-19 and the effect of sex and D-dimer level on disease outcomes. Methods We meta-analyzed articles reporting D-dimer levels in men and women hospitalized for COVID-19, until October 2021, using random effects. Primary outcomes were mortality, critical illness, and thrombotic complications. Results In total, 11,682 patients from 10 studies were analyzed (N = 5606 men (55.7%), N = 5176 women (44.3%)). Men had significantly higher odds of experiencing mortality (odds ratios (OR) = 1.41, 95% CI: [1.25, 1.59], P ≤ .001, I2 = 0%) and critical illness (OR = 1.76, 95% CI: [1.43, 2.18], P ≤ .001, I2 = 61%). The mean D-dimer level was not significantly different between men and women (MD = 0.08, 95% CI: [-0.23, 0.40], P = .61, I2 = 52%). In the subgroup analysis, men had significantly higher odds of experiencing critical illness compared with women in both the "higher" (P = .006) and "lower" (P = .001) D-dimer subgroups. Conclusion Men have significantly increased odds of experiencing poor COVID-19 outcomes compared with women. No sex difference was found in the D-dimer level between men and women with COVID-19. The diversity in D-dimer reporting impacts data interpretation and requires further attention.
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15
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Ustebay S, Sarmis A, Kaya GK, Sujan M. A comparison of machine learning algorithms in predicting COVID-19 prognostics. Intern Emerg Med 2023; 18:229-239. [PMID: 36116079 PMCID: PMC9483274 DOI: 10.1007/s11739-022-03101-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 09/05/2022] [Indexed: 02/01/2023]
Abstract
ML algorithms are used to develop prognostic and diagnostic models and so to support clinical decision-making. This study uses eight supervised ML algorithms to predict the need for intensive care, intubation, and mortality risk for COVID-19 patients. The study uses two datasets: (1) patient demographics and clinical data (n = 11,712), and (2) patient demographics, clinical data, and blood test results (n = 602) for developing the prediction models, understanding the most significant features, and comparing the performances of eight different ML algorithms. Experimental findings showed that all prognostic prediction models reported an AUROC value of over 0.92, in which extra tree and CatBoost classifiers were often outperformed (AUROC over 0.94). The findings revealed that the features of C-reactive protein, the ratio of lymphocytes, lactic acid, and serum calcium have a substantial impact on COVID-19 prognostic predictions. This study provides evidence of the value of tree-based supervised ML algorithms for predicting prognosis in health care.
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Affiliation(s)
- Serpil Ustebay
- Department of Computer Engineering, Istanbul Medeniyet University, Istanbul, Turkey
| | - Abdurrahman Sarmis
- Department of Microbiology Laboratory, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Gulsum Kubra Kaya
- Department of Industrial Engineering, Istanbul Medeniyet University, Istanbul, Turkey.
- School of Aerospace, Transport and Manufacturing, Cranfield University, Bedford, MK430AL, UK.
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16
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Ginikopoulou E. Plasma exchange and COVID 19. Transfus Apher Sci 2022; 61:103598. [PMID: 36379843 PMCID: PMC9652706 DOI: 10.1016/j.transci.2022.103598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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17
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Rico-Llanos G, Porras-Perales Ó, Escalante S, Vázquez-Calero DB, Valiente L, Castillo MI, Pérez-Tejeiro JM, Baglietto-Vargas D, Becerra J, Reguera JM, Duran I, Csukasi F. Cellular stress modulates severity of the inflammatory response in lungs via cell surface BiP. Front Immunol 2022; 13:1054962. [DOI: 10.3389/fimmu.2022.1054962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 10/27/2022] [Indexed: 11/21/2022] Open
Abstract
Inflammation is a central pathogenic feature of the acute respiratory distress syndrome (ARDS) in COVID-19. Previous pathologies such as diabetes, autoimmune or cardiovascular diseases become risk factors for the severe hyperinflammatory syndrome. A common feature among these risk factors is the subclinical presence of cellular stress, a finding that has gained attention after the discovery that BiP (GRP78), a master regulator of stress, participates in the SARS-CoV-2 recognition. Here, we show that BiP serum levels are higher in COVID-19 patients who present certain risk factors. Moreover, early during the infection, BiP levels predict severe pneumonia, supporting the use of BiP as a prognosis biomarker. Using a mouse model of pulmonary inflammation, we observed increased levels of cell surface BiP (cs-BiP) in leukocytes during inflammation. This corresponds with a higher number of neutrophiles, which show naturally high levels of cs-BiP, whereas alveolar macrophages show a higher than usual exposure of BiP in their cell surface. The modulation of cellular stress with the use of a clinically approved drug, 4-PBA, resulted in the amelioration of the lung hyperinflammatory response, supporting the anti-stress therapy as a valid therapeutic strategy for patients developing ARDS. Finally, we identified stress-modulated proteins that shed light into the mechanism underlying the cellular stress-inflammation network in lungs.
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18
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Al-Shajlawi M, Alsayed AR, Abazid H, Awajan D, Al-Imam A, Basheti I. Using laboratory parameters as predictors for the severity and mortality of COVID-19 in hospitalized patients. Pharm Pract (Granada) 2022; 20:2721. [PMID: 36733508 PMCID: PMC9851820 DOI: 10.18549/pharmpract.2022.3.2721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 08/30/2022] [Indexed: 02/05/2023] Open
Abstract
Objective The aim of this study was to explore association of initial laboratory parameters of hospitalized patients with COVID-19, with the severity and death incident. Methods In this retrospective study, patients were classified based on mortality outcome (survivor and non-survivor) and disease severity (non-severe, severe, and critical). The initial laboratory data (within the first two days of hospital admission) were compared between these categories. Results Of 362 COVID-19 patients hospitalized between January-2021 and May-2021, 39.0% were non-severe, 32.2% severe, and 28.7% critical. 77.3% were lived and 22.7% died in hospital. Non-survivors were significantly older than survivors. There was a statistically significant association between exceeding the cut-points of laboratory parameters and the severity of the disease or even death. These laboratory parameters included D-dimer, C-reactive protein, prothrombin time, ferritin, white blood cells, neutrophil count, aspartate aminotransferase, creatinine, blood urea nitrogen, lymphocyte count, and albumin. Also, exceeding the cut-points of these parameters showed high odds of death. The highest odds ratio was reported for albumin <3.5 g/dL (OR=14.318 [4.784-42.851], p<0.001). Conclusion The cut-points of the laboratory parameters could effectively be used as predictors to assess the severity and risk of death to improve the management of COVID-19 patients.
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Affiliation(s)
- Mustafa Al-Shajlawi
- MSc. Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman 11931-166, Jordan.
| | - Ahmad R Alsayed
- PhD, MSc, PharmD. Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman 11931-166, Jordan. ;
| | - Husam Abazid
- PhD. Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman 11931-166, Jordan.
| | - Dima Awajan
- PharmD. Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman 11931-166, Jordan.
| | | | - Iman Basheti
- PhD, BPharm. Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman 11931-166, Jordan.
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19
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Jafrin S, Aziz MA, Islam MS. Elevated Levels of Pleiotropic Interleukin-6 (IL-6) and Interleukin-10 (IL-10) are Critically Involved With the Severity and Mortality of COVID-19: An Updated Longitudinal Meta-Analysis and Systematic Review on 147 Studies. Biomark Insights 2022; 17:11772719221106600. [PMID: 35747885 PMCID: PMC9209786 DOI: 10.1177/11772719221106600] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 05/26/2022] [Indexed: 01/08/2023] Open
Abstract
Objectives Disruption in the natural immune reaction due to SARS-CoV-2 infection can initiate a potent cytokine storm among COVID-19 patients. An elevated level of IL-6 and IL-10 during a hyperinflammatory state plays a vital role in increasing the risk of severity and mortality. In this study, we aimed to evaluate the potential of circulating IL-6 and IL-10 levels as biomarkers for detecting the severity and mortality of COVID-19. Methods This study was conducted according to the Cochrane Handbook and PRISMA guidelines. Authorized databases were searched to extract suitable studies using specific search terms. RevMan 5.4 was applied for performing the meta-analysis. Mean differences in IL-6 and IL-10 levels were calculated among COVID-19 patients via a random-effects model. NOS scoring, publication bias and sensitivity analyses were checked to ensure study quality. Results A total of 147 studies were selected, with 31 909 COVID-19 patients under investigation. In the severity analysis, the mean concentration of IL-6 was significantly higher in the severe COVID-19 cases than in the non-severe cases (MD: 19.98; P < .001; 95% CI: 17.56, 22.40). Similar result was observed for IL-10 mean concentration in severe COVID-19 cases (MD: 1.35; P < .001; 95% CI: 0.90, 1.80). In terms of mortality analysis, circulating IL-6 showed sharp elevation in the deceased patients (MD: 42.11; P < .001; 95% CI: 36.86, 47.36). IL-10 mean concentration was higher in the dead patients than in the survived patients (MD: 4.79; P < .001; 95% CI: 2.83, 6.75). Publication bias was not found except for comparing IL-6 levels with disease severity. Sensitivity analysis also reported no significant deviation from the pooled outcomes. Conclusions Elevated levels of circulating IL-6 and IL-10 signifies worsening of COVID-19. To monitor the progression of SARS-CoV-2 infection, IL-6 and IL-10 should be considered as potential biomarkers for severity and mortality detection in COVID-19. Systematic review registration INPLASY registration number: INPLASY202240046.
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Affiliation(s)
- Sarah Jafrin
- Laboratory of Pharmacogenomics and Molecular Biology, Department of Pharmacy, Faculty of Science, Noakhali Science and Technology University, Sonapur, Noakhali, Bangladesh
| | - Md. Abdul Aziz
- Department of Pharmacy, Faculty of Pharmacy and Health Sciences, State University of Bangladesh, Dhaka, Bangladesh
| | - Mohammad Safiqul Islam
- Laboratory of Pharmacogenomics and Molecular Biology, Department of Pharmacy, Faculty of Science, Noakhali Science and Technology University, Sonapur, Noakhali, Bangladesh
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20
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Alshammary AF, Alsughayyir JM, Alharbi KK, Al-Sulaiman AM, Alshammary HF, Alshammary HF. T-Cell Subsets and Interleukin-10 Levels Are Predictors of Severity and Mortality in COVID-19: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2022; 9:852749. [PMID: 35572964 PMCID: PMC9096099 DOI: 10.3389/fmed.2022.852749] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/01/2022] [Indexed: 01/08/2023] Open
Abstract
Background Many COVID-19 patients reveal a marked decrease in their lymphocyte counts, a condition that translates clinically into immunodepression and is common among these patients. Outcomes for infected patients vary depending on their lymphocytopenia status, especially their T-cell counts. Patients are more likely to recover when lymphocytopenia is resolved. When lymphocytopenia persists, severe complications can develop and often lead to death. Similarly, IL-10 concentration is elevated in severe COVID-19 cases and may be associated with the depression observed in T-cell counts. Accordingly, this systematic review and meta-analysis aims to analyze T-cell subsets and IL-10 levels among COVID-19 patients. Understanding the underlying mechanisms of the immunodepression observed in COVID-19, and its consequences, may enable early identification of disease severity and reduction of overall morbidity and mortality. Methods A systematic search was conducted covering PubMed MEDLINE, Scopus, Web of Science, and EBSCO databases for journal articles published from December 1, 2019 to March 14, 2021. In addition, we reviewed bibliographies of relevant reviews and the medRxiv preprint server for eligible studies. Our search covered published studies reporting laboratory parameters for T-cell subsets (CD4/CD8) and IL-10 among confirmed COVID-19 patients. Six authors carried out the process of data screening, extraction, and quality assessment independently. The DerSimonian-Laird random-effect model was performed for this meta-analysis, and the standardized mean difference (SMD) and 95% confidence interval (CI) were calculated for each parameter. Results A total of 52 studies from 11 countries across 3 continents were included in this study. Compared with mild and survivor COVID-19 cases, severe and non-survivor cases had lower counts of CD4/CD8 T-cells and higher levels of IL-10. Conclusion Our findings reveal that the level of CD4/CD8 T-cells and IL-10 are reliable predictors of severity and mortality in COVID-19 patients. The study protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO); registration number CRD42020218918. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020218918, identifier: CRD42020218918.
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Affiliation(s)
- Amal F. Alshammary
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Jawaher M. Alsughayyir
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Khalid K. Alharbi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | | | - Haifa F. Alshammary
- College of Applied Medical Sciences, Riyadh Elm University, Riyadh, Saudi Arabia
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21
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Aiewsakun P, Nilplub P, Wongtrakoongate P, Hongeng S, Thitithanyanont A. SARS-CoV-2 genetic variations associated with COVID-19 pathogenicity. Microb Genom 2021; 7. [PMID: 34870573 PMCID: PMC8767342 DOI: 10.1099/mgen.0.000734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
In this study, we performed genome-wide association analyses on SARS-CoV-2 genomes to identify genetic mutations associated with pre-symptomatic/asymptomatic COVID-19 cases. Various potential covariates and confounding factors of COVID-19 severity, including patient age, gender and country, as well as virus phylogenetic relatedness were adjusted for. In total, 3021 full-length genomes of SARS-CoV-2 generated from original clinical samples and whose patient status could be determined conclusively as either ‘pre-symptomatic/asymptomatic’ or ‘symptomatic’ were retrieved from the GISAID database. We found that the mutation 11 083G>T, located in the coding region of non-structural protein 6, is significantly associated with asymptomatic COVID-19. Patient age is positively correlated with symptomatic infection, while gender is not significantly correlated with the development of the disease. We also found that the effects of the mutation, patient age and gender do not vary significantly among countries, although each country appears to have varying baseline chances of COVID-19 symptom development.
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Affiliation(s)
- Pakorn Aiewsakun
- Department of Microbiology, Faculty of Science, Mahidol University, 272, Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand.,Pornchai Matangkasombut Center for Microbial Genomics, Department of Microbiology, Faculty of Science, Mahidol University, 272, Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand
| | - Patrawee Nilplub
- Pornchai Matangkasombut Center for Microbial Genomics, Department of Microbiology, Faculty of Science, Mahidol University, 272, Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand
| | - Patompon Wongtrakoongate
- Department of Biochemistry, Faculty of Science, Mahidol University, 272, Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand.,Center for Neuroscience, Faculty of Science, Mahidol University, 272, Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand
| | - Suradej Hongeng
- Division of Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270, Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand
| | - Arunee Thitithanyanont
- Department of Microbiology, Faculty of Science, Mahidol University, 272, Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand.,Pornchai Matangkasombut Center for Microbial Genomics, Department of Microbiology, Faculty of Science, Mahidol University, 272, Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand
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22
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Šikić J, Planinić Z, Matišić V, Friščić T, Molnar V, Jagačić D, Vujičić L, Tudorić N, Postružin Gršić L, Ljubičić Đ, Primorac D. COVID-19: The Impact on Cardiovascular System. Biomedicines 2021; 9:1691. [PMID: 34829920 PMCID: PMC8615470 DOI: 10.3390/biomedicines9111691] [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] [Received: 09/08/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 01/08/2023] Open
Abstract
SARS-CoV-2 has been circulating in population worldwide for the past year and a half, and thus a vast amount of scientific literature has been produced in order to study the biology of the virus and the pathophysiology of COVID-19, as well as to determine the best way to prevent infection, treat the patients and eliminate the virus. SARS-CoV-2 binding to the ACE2 receptor is the key initiator of COVID-19. The ability of SARS-CoV-2 to infect various types of cells requires special attention to be given to the cardiovascular system, as it is commonly affected. Thorough diagnostics and patient monitoring are beneficial in reducing the risk of cardiovascular morbidity and to ensure the most favorable outcomes for the infected patients, even after they are cured of the acute disease. The multidisciplinary nature of the fight against the COVID-19 pandemic requires careful consideration from the attending clinicians, in order to provide fast and reliable treatment to their patients in accordance with evidence-based medicine principles. In this narrative review, we reviewed the available literature on cardiovascular implications of COVID-19; both the acute and the chronic.
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Affiliation(s)
- Jozica Šikić
- Department of Cardiology, Clinical Hospital Sveti Duh, 10000 Zagreb, Croatia; (Z.P.); (T.F.)
- St. Catherine Specialty Hospital, 10000 Zagreb, Croatia; (V.M.); (V.M.); (D.J.); (L.V.); (N.T.); (Đ.L.); (D.P.)
| | - Zrinka Planinić
- Department of Cardiology, Clinical Hospital Sveti Duh, 10000 Zagreb, Croatia; (Z.P.); (T.F.)
| | - Vid Matišić
- St. Catherine Specialty Hospital, 10000 Zagreb, Croatia; (V.M.); (V.M.); (D.J.); (L.V.); (N.T.); (Đ.L.); (D.P.)
| | - Tea Friščić
- Department of Cardiology, Clinical Hospital Sveti Duh, 10000 Zagreb, Croatia; (Z.P.); (T.F.)
| | - Vilim Molnar
- St. Catherine Specialty Hospital, 10000 Zagreb, Croatia; (V.M.); (V.M.); (D.J.); (L.V.); (N.T.); (Đ.L.); (D.P.)
| | - Dorijan Jagačić
- St. Catherine Specialty Hospital, 10000 Zagreb, Croatia; (V.M.); (V.M.); (D.J.); (L.V.); (N.T.); (Đ.L.); (D.P.)
| | - Lovro Vujičić
- St. Catherine Specialty Hospital, 10000 Zagreb, Croatia; (V.M.); (V.M.); (D.J.); (L.V.); (N.T.); (Đ.L.); (D.P.)
| | - Neven Tudorić
- St. Catherine Specialty Hospital, 10000 Zagreb, Croatia; (V.M.); (V.M.); (D.J.); (L.V.); (N.T.); (Đ.L.); (D.P.)
| | | | - Đivo Ljubičić
- St. Catherine Specialty Hospital, 10000 Zagreb, Croatia; (V.M.); (V.M.); (D.J.); (L.V.); (N.T.); (Đ.L.); (D.P.)
- Clinical Hospital Dubrava, 10000 Zagreb, Croatia
| | - Dragan Primorac
- St. Catherine Specialty Hospital, 10000 Zagreb, Croatia; (V.M.); (V.M.); (D.J.); (L.V.); (N.T.); (Đ.L.); (D.P.)
- Eberly College of Science, The Pennsylvania State University, University Park, State College, PA 16802, USA
- The Henry C. Lee College of Criminal Justice and Forensic Sciences, University of New Haven, West Haven, CT 06516, USA
- Medical School, University of Split, 21000 Split, Croatia
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Medical School, University of Rijeka, 51000 Rijeka, Croatia
- Medical School REGIOMED, 96 450 Coburg, Germany
- Medical School, University of Mostar, 88000 Mostar, Bosnia and Herzegovina
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23
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Htun YM, Win TT, Aung A, Latt TZ, Phyo YN, Tun TM, Htun NS, Tun KM, Htun KA. Initial presenting symptoms, comorbidities and severity of COVID-19 patients during the second wave of epidemic in Myanmar. Trop Med Health 2021; 49:62. [PMID: 34362468 PMCID: PMC8343344 DOI: 10.1186/s41182-021-00353-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 08/01/2021] [Indexed: 12/22/2022] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) caused by a highly contagious virus called severe acute respiratory syndrome coronavirus 2 emerged in China at the end of 2019 and became a major threat to health around the world. The health experts are still learning more about the detailed knowledge of the natural course and the severity of COVID-19. The study aimed to assess the prevalence and association of severity of disease with demographic characteristics, initial presenting symptoms, and comorbidities among COVID-19 patients in treatment centers, Myanmar. Methods A cross-sectional study was conducted at Hmawbi and Indine treatment centers, Yangon Region, Myanmar, from November to December 2020. Data were collected by using standardized case report forms and then, a total of 222 confirmed COVID-19 inpatients were included in this study. The odds ratio with a 95% confidence interval (CI) was used as a measure of association and the independent associated factors for severity of disease were investigated using logistic regression analysis. Results In total, 81.5% were symptomatic patients and of these, the most common presenting symptoms were fever 54.1%, loss of smell 50.3%, and cough 30.9%. Among 37.8% of COVID-19 patients with comorbidities, the most common comorbidities were hypertension 58.3%, diabetes mellitus 29.8%, and heart diseases 26.2%, respectively. As a severity, 20.7% of patients had signs of severe pneumonia. The associated factors of severe pneumonia were aged 60 years and older [Adjusted odds ratio (AOR) = 2.88, 95% CI 1.14–7.29], overweight or obesity (AOR: 3.87, 95%CI 1.80–8.33), and current smoking (AOR: 6.74, 95% CI 2.72–16.75). Conclusions In this study, one-fifth of the patients developed severe pneumonia. The COVID-19 patients who were aged 60 years and older, overweight or obesity, and current smokers should be monitored carefully during the course of treatment to reduce the disease severity.
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Affiliation(s)
- Ye Minn Htun
- Department of Prevention and Research Development of Hepatitis, AIDS and Other Viral Diseases, Health and Disease Control Unit, Nay Pyi Taw, 15011, Myanmar.
| | - Tun Tun Win
- Department of Preventive and Social Medicine, Defence Services Medical Academy, Mingalardon, Yangon, Myanmar
| | - Aung Aung
- Department of Research and Development, Defence Services Medical School, Hmawbi, Yangon, Myanmar
| | - Thant Zin Latt
- Department of Research and Development, Defence Services Medical School, Hmawbi, Yangon, Myanmar
| | - Yan Naung Phyo
- Outpatient Department, No. 3 Military Hospital (100 Bedded), Hlegu, Yangon, Myanmar
| | - Thet Min Tun
- Department of Preventive and Social Medicine, Defence Services Medical Academy, Mingalardon, Yangon, Myanmar
| | - Nyan Sint Htun
- Department of Preventive and Social Medicine, Defence Services Medical Academy, Mingalardon, Yangon, Myanmar
| | - Kyaw Myo Tun
- Department of Preventive and Social Medicine, Defence Services Medical Academy, Mingalardon, Yangon, Myanmar
| | - Khin Aung Htun
- Department of Surgery, Defence Services Medical Academy, Mingalardon, Yangon, Myanmar
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