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Zheng X, Chen M, Zhuang Y, Xu J, Zhao L, Qian Y, Shen W. Smoking behaviors, physical activities, pulmonary diseases and COVID-19 severity: A Mendelian randomization study. Medicine (Baltimore) 2024; 103:e39416. [PMID: 39183391 PMCID: PMC11346890 DOI: 10.1097/md.0000000000039416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 08/01/2024] [Accepted: 08/02/2024] [Indexed: 08/27/2024] Open
Abstract
Smoking behaviors, physical activities, and pulmonary diseases have been revealed to be associated with COVID-19 severity through observational research. The possible causative effect remains undetermined. To investigate this, we thus carried out a Mendelian randomization (MR) analysis. We chose genetic variants from genome-wide association studies that are strongly linked to 5 exposures related to smoking, 1 exposure related to drinking, 3 levels of physical activity, and 3 pulmonary diseases. The COVID-19 Host Genetics Initiative provided summary-level data for severe COVID-19 (13,769 cases and 1,072,442 noncases), hospitalized COVID-19 (32,519 cases and 2,062,805 noncases), and COVID-19 susceptibility (122,616 cases and 2,475,240 noncases). Univariate and multivariate MR analyses were carried out. Significant associations were found between severe COVID-19 and cigarette smoking per day (OR = 1.357, 95% CI: 1.087-1.694), lifetime smoking index (OR = 2.277, 95% CI: 1.602-3.325), and interstitial lung disease (OR = 1.23, 95% CI: 1.112-1.362), hospitalized COVID-19 and lifetime smoking index (OR = 2.199, 95% CI: 1.738-2.781), smoking initiation (OR = 1.419, 95% CI: 1.230-1.637), and interstitial lung disease (OR = 1.146, 95% CI: 1.082-1.214), as well as COVID-19 susceptibility and lifetime smoking index (OR = 1.39, 95% CI: 1.252-1.543), smoking initiation (OR = 1.235, 95% CI: 1.163-1.311), and duration of vigorous activity per day (OR = 0.733, 95% CI: 0.574-0.935). Duration of vigorous activity per day was suggestively inversely linked to hospitalized COVID-19 (OR = 0.434, 95% CI: 0.221-0.853) and severe COVID-19 (OR = 0.323, 95% CI: 0.123-0.850). The association for lifetime smoking index remained consistent with severe COVID-19, hospitalized COVID-19, and COVID-19 susceptibility in multivariable MR analysis. Genetic liability to lifetime smoking index mediated the interstitial lung disease effects on severe COVID-19 risk (21.0%) and hospitalized COVID-19 risk (14.4%). This study identified several smoking behaviors, duration of vigorous activity per day, and interstitial lung disease that may be causally related to COVID-19 severity.
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Affiliation(s)
- Xuwen Zheng
- Emergency Department, Wujin People’s Hospital Affiliated with Jiangsu University and Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
| | - Maobing Chen
- Emergency Department, Wujin People’s Hospital Affiliated with Jiangsu University and Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
| | - Yi Zhuang
- Emergency Department, Wujin People’s Hospital Affiliated with Jiangsu University and Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
| | - Jin Xu
- Emergency Department, Wujin People’s Hospital Affiliated with Jiangsu University and Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
| | - Liang Zhao
- Emergency Department, Wujin People’s Hospital Affiliated with Jiangsu University and Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
| | - Yongjun Qian
- Emergency Department, Wujin People’s Hospital Affiliated with Jiangsu University and Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
| | - Wenming Shen
- Emergency Department, Wujin People’s Hospital Affiliated with Jiangsu University and Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
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Abbasian MH, Rahimian K, Mahmanzar M, Bayat S, Kuehu DL, Sisakht MM, Moradi B, Deng Y. Comparative Atlas of SARS-CoV-2 Substitution Mutations: A Focus on Iranian Strains Amidst Global Trends. Viruses 2024; 16:1331. [PMID: 39205305 DOI: 10.3390/v16081331] [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: 07/13/2024] [Revised: 08/12/2024] [Accepted: 08/17/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new emerging coronavirus that caused coronavirus disease 2019 (COVID-19). Whole-genome tracking of SARS-CoV-2 enhanced our understanding of the mechanism of the disease, control, and prevention of COVID-19. METHODS we analyzed 3368 SARS-CoV-2 protein sequences from Iran and compared them with 15.6 million global sequences in the GISAID database, using the Wuhan-Hu-1 strain as a reference. RESULTS Our investigation revealed that NSP12-P323L, ORF9c-G50N, NSP14-I42V, membrane-A63T, Q19E, and NSP3-G489S were found to be the most frequent mutations among Iranian SARS-CoV-2 sequences. Furthermore, it was observed that more than 94% of the SARS-CoV-2 genome, including NSP7, NSP8, NSP9, NSP10, NSP11, and ORF8, had no mutations when compared to the Wuhan-Hu-1 strain. Finally, our data indicated that the ORF3a-T24I, NSP3-G489S, NSP5-P132H, NSP14-I42V, envelope-T9I, nucleocapsid-D3L, membrane-Q19E, and membrane-A63T mutations might be responsible factors for the surge in the SARS-CoV-2 Omicron variant wave in Iran. CONCLUSIONS real-time genomic surveillance is crucial for detecting new SARS-CoV-2 variants, updating diagnostic tools, designing vaccines, and understanding adaptation to new environments.
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Affiliation(s)
- Mohammad Hadi Abbasian
- Department of Medical Genetics, National Institute for Genetic Engineering and Biotechnology, Tehran 1497716316, Iran
| | - Karim Rahimian
- Institute of Biochemistry and Biophysics (IBB), University of Tehran, Tehran 14174, Iran
| | - Mohammadamin Mahmanzar
- Department of Bioinformatics, Kish International Campus University of Tehran, Kish 7941639982, Iran
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96813, USA
| | - Saleha Bayat
- Department of Biology & Research Center for Animal Development Applied Biology, Mashhad Branch, Islamic Azad University, Mashhad 9187147578, Iran
| | - Donna Lee Kuehu
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96813, USA
| | - Mahsa Mollapour Sisakht
- Faculty of Pharmacy, Biotechnology Research Center, Tehran University of Medical Sciences, Tehran 1936893813, Iran
| | - Bahman Moradi
- Department of Biology, Faculty of Sciences, Shahid Bahonar University of Kerman, Kerman 7616913439, Iran
| | - Youping Deng
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96813, USA
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Akpoviroro O, Sauers NK, Uwandu Q, Castagne M, Akpoviroro OP, Humayun S, Mirza W, Woodard J. Severe COVID-19 infection: An institutional review and literature overview. PLoS One 2024; 19:e0304960. [PMID: 39163410 PMCID: PMC11335168 DOI: 10.1371/journal.pone.0304960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 05/21/2024] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND Our study aimed to describe the group of severe COVID-19 patients at an institutional level, and determine factors associated with different outcomes. METHODS A retrospective chart review of patients admitted with severe acute hypoxic respiratory failure due to COVID-19 infection. Based on outcomes, we categorized 3 groups of severe COVID-19: (1) Favorable outcome: progressive care unit admission and discharge (2) Intermediate outcome: ICU care (3) Poor outcome: in-hospital mortality. RESULTS Eighty-nine patients met our inclusion criteria; 42.7% were female. The average age was 59.7 (standard deviation (SD):13.7). Most of the population were Caucasian (95.5%) and non-Hispanic (91.0%). Age, sex, race, and ethnicity were similar between outcome groups. Medicare and Medicaid patients accounted for 62.9%. The average BMI was 33.5 (SD:8.2). Moderate comorbidity was observed, with an average Charlson Comorbidity index (CCI) of 3.8 (SD:2.6). There were no differences in the average CCI between groups(p = 0.291). Many patients (67.4%) had hypertension, diabetes (42.7%) and chronic lung disease (32.6%). A statistical difference was found when chronic lung disease was evaluated; p = 0.002. The prevalence of chronic lung disease was 19.6%, 27.8%, and 40% in the favorable, intermediate, and poor outcome groups, respectively. Smoking history was associated with poor outcomes (p = 0.04). Only 7.9% were fully vaccinated. Almost half (46.1%) were intubated and mechanically ventilated. Patients spent an average of 12.1 days ventilated (SD:8.5), with an average of 6.0 days from admission to ventilation (SD:5.1). The intermediate group had a shorter average interval from admission to ventilator (77.2 hours, SD:67.6), than the poor group (212.8 hours, SD:126.8); (p = 0.001). The presence of bacterial pneumonia was greatest in the intermediate group (72.2%), compared to the favorable group (17.4%), and the poor group (56%); this was significant (p<0.0001). In-hospital mortality was seen in 28.1%. CONCLUSION Most patients were male, obese, had moderate-level comorbidity, a history of tobacco abuse, and government-funded insurance. Nearly 50% required mechanical ventilation, and about 28% died during hospitalization. Bacterial pneumonia was most prevalent in intubated groups. Patients who were intubated with a good outcome were intubated earlier during their hospital course, with an average difference of 135.6 hours. A history of cigarette smoking and chronic lung disease were associated with poor outcomes.
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Affiliation(s)
- Ogheneyoma Akpoviroro
- Department of Internal Medicine, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, Pennsylvania, United States of America
| | - Nathan Kyle Sauers
- Department of Engineering, Pennsylvania State University, State College, Pennsylvania, United States of America
| | - Queeneth Uwandu
- Department of Internal Medicine, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, Pennsylvania, United States of America
| | - Myriam Castagne
- Clinical & Translational Science Institute, Boston University, Boston, Massachusetts, United States of America
| | | | - Sara Humayun
- Department of Internal Medicine, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, Pennsylvania, United States of America
| | - Wasique Mirza
- Department of Internal Medicine, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, Pennsylvania, United States of America
| | - Jameson Woodard
- Department of Internal Medicine, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, Pennsylvania, United States of America
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Shoaib N, Munir R. Cycle threshold (Ct)values of SARS-CoV2 vary with the type of symptoms and comorbidities of the patients. Mol Biol Rep 2024; 51:851. [PMID: 39052089 DOI: 10.1007/s11033-024-09804-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 07/18/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Literature depicts no association of cycle threshold values for SARS-CoV-2 with the patient's demographics or clinical history. However, the severity of the COVID-19 symptoms showed some associations with Ct values in previous studies. We aimed to study the relationship of Ct values with type of the symptoms and comorbidities of the patients. METHODS AND RESULTS We examined the individuals (n = 8660) that consulted a private diagnostic center for COVID-19 testing. Nasopharyngeal samples were collected from the patients and SARS-CoV-2 was detected by RT-PCR assays using Sansure Biotech kit. Clinical and demographic information was collected by the attending healthcare professional. The differences between groups were analyzed by t-test (unpaired). P-values < 0.05 were considered statistically significant. We found that the mean age of asymptomatic patients (41.47 ± 17.01 years) and symptomatic patients (47.75 ± 17.51) varies significantly (p value < 0.0001). Among the most prevalent symptoms were fever (77.74%) and cough (66.46%). The Ct values of COVID-19 patients with symptoms (25.70 for Orf1ab, 24.25 for N gene) were significantly lower than the Ct values of the patients without symptoms (28.99 for Orf1ab, 28.17 for N gene) (p value < 0.0001). Patients having co-occurrence of cough with fever (24.67 for Orf1ab, 22.86 for N gene) and solely fever (25.12 for Orf1ab, 24.01 for N gene) showed significantly lower Ct values than the patients without symptoms (28.99 for Orf1ab, 28.17 for N gene, p value < 0.0001). However, this difference was independent of patients sex and dependent upon patient's age and SARS-CoV-2 detected gene. The most prevalent comorbidities among COVID-19 patients were blood pressure (64.7%) and diabetes (50.5%). The patients having blood pressure and diabetes together showed significantly lower Ct values (23.37 for Orf1ab, 23.33 for N gene) than patients without comorbidities (27.65 for Orf1ab, 26.75 for N gene, p value < 0.001). CONCLUSION We conclude that the Ct values of the SARS-CoV-2 detected gene (either Orf1ab or N) is associated with the types of symptoms and comorbidities of the COVID-19 patients. Furthermore, the relationship between Ct values and symptomology or comorbidity of the patients is independent of patient's sex but dependent upon patient's age and SARS-CoV-2 detected gene.
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Affiliation(s)
- Naila Shoaib
- Cancer Biology Lab, Institute of Microbiology and Molecular Genetics (MMG), University of the Punjab, Quid-e-Azam campus, PO Box No. 54590, Lahore, Pakistan.
- Cancer Research Centre (CRC), University of the Punjab, Lahore, Pakistan.
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Saito Z, Kanai O, Okamoto N, Watanabe I, Tsukino M. Efficacy of corticosteroid therapy for oxygen-free coronavirus disease 2019-derived pneumonia. Medicine (Baltimore) 2024; 103:e38932. [PMID: 38996125 PMCID: PMC11245202 DOI: 10.1097/md.0000000000038932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 06/24/2024] [Indexed: 07/14/2024] Open
Abstract
Corticosteroid therapy for oxygen-free coronavirus disease 2019 (COVID-19) is not recommended due to its negative prognostic impact, but the efficacy of corticosteroids when limited to COVID-19 pneumonia is unclear. We aimed to evaluate the efficacy of corticosteroid monotherapy for patients with COVID-19 pneumonia without supplemental oxygen. We retrospectively reviewed patients with oxygen-free COVID-19 pneumonia at our institute between September 2020 and August 2021 and assessed the use of corticosteroids and the timing of initiation. We classified the patients into the following 2 groups: those who were initiated corticosteroids without developing respiratory failure (early steroid group) and those who were not (standard of care [SOC] group). We used inverse probability of treatment weighting (IPW) to balance between the groups. The primary outcome was the incidence of respiratory failure. A total of 144 patient records were reviewed; 63 patients were in the early steroid group and 81 patients were in the SOC group. Of all patients, 14 (22.2%) and 27 (33.3%) patients in the early steroid and SOC group, respectively, required supplemental oxygen (P = .192). After adjusted by the IPW method, 10 (16.0%) and 32 (40.1%) patients in the early steroid and SOC groups, respectively, required supplemental oxygen (P = .004). The logistic regression analysis indicated that early corticosteroid use was significantly associated with a decreased incidence of respiratory failure (odds ratio; 0.17, 95% confidence intervals; 0.06-0.46, P < .001). Corticosteroid monotherapy may suppress the development of exacerbation requiring oxygen supply in patients with oxygen-free COVID-19 pneumonia.
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Affiliation(s)
- Zentaro Saito
- Divison of Respiratory Medicine, Hikone Municipal Hospital, Hikone City, Japan
- Division of Respiratory Medicine, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Osamu Kanai
- Division of Respiratory Medicine, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Natsumi Okamoto
- Divison of Respiratory Medicine, Hikone Municipal Hospital, Hikone City, Japan
| | - Isao Watanabe
- Divison of Respiratory Medicine, Hikone Municipal Hospital, Hikone City, Japan
| | - Mitsuhiro Tsukino
- Divison of Respiratory Medicine, Hikone Municipal Hospital, Hikone City, Japan
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Kavikondala S, Haeussler K, Wang X, Bausch-Jurken MT, Nassim M, Mishra NK, Malmenäs M, Sharma P, Van de Velde N, Green N, Beck E. Comparative Effectiveness of mRNA-1273 and BNT162b2 COVID-19 Vaccines Among Older Adults: Systematic Literature Review and Meta-Analysis Using the GRADE Framework. Infect Dis Ther 2024; 13:779-811. [PMID: 38498109 PMCID: PMC11058186 DOI: 10.1007/s40121-024-00936-z] [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: 12/01/2023] [Accepted: 01/30/2024] [Indexed: 03/20/2024] Open
Abstract
INTRODUCTION The mRNA vaccines mRNA-1273 and BNT162b2 demonstrated high efficacy against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in phase 3 clinical trials, including among older adults. To inform coronavirus disease 2019 (COVID-19) vaccine selection, this systematic literature review (SLR) and meta-analysis assessed the comparative effectiveness of mRNA-1273 versus BNT162b2 in older adults. METHODS We systematically searched for relevant studies reporting COVID-19 outcomes with mRNA vaccines in older adults aged ≥ 50 years by first cross-checking relevant published SLRs. Based on the cutoff date from a previous similar SLR, we then searched the WHO COVID-19 Research Database for relevant articles published between April 9, 2022, and June 2, 2023. Outcomes of interest were SARS-CoV-2 infection, symptomatic SARS-CoV-2 infection, severe SARS-CoV-2 infection, COVID-19-related hospitalization, and COVID-19-related death following ≥ 2 vaccine doses. Random effects meta-analysis models were used to pool risk ratios (RRs) across studies. Heterogeneity was evaluated using chi-square testing. Evidence certainty was assessed per GRADE framework. RESULTS Twenty-four non-randomized real-world studies reporting clinical outcomes with mRNA vaccines in individuals aged ≥ 50 years were included in the meta-analysis. Vaccination with mRNA-1273 was associated with significantly lower risk of SARS-CoV-2 infection (RR 0.72 [95% confidence interval (CI) 0.64‒0.80]), symptomatic SARS-CoV-2 infection (RR 0.72 [95% CI 0.62‒0.83]), severe SARS-CoV-2 infection (RR 0.67 [95% CI 0.57‒0.78]), and COVID-19-related hospitalization (RR 0.65 [95% CI 0.53‒0.79]) but not COVID-19-related death (RR 0.80 [95% CI 0.64‒1.00]) compared with BNT162b2. There was considerable heterogeneity between studies for all outcomes (I2 > 75%) except death (I2 = 0%). Multiple subgroup and sensitivity analyses excluding specific studies generally demonstrated consistent results. Certainty of evidence across outcomes was rated as low (type 3) or very low (type 4), reflecting the lack of randomized controlled trial data. CONCLUSION Meta-analysis of 24 observational studies demonstrated significantly lower risk of asymptomatic, symptomatic, and severe infections and hospitalizations with the mRNA-1273 versus BNT162b2 vaccine in older adults aged ≥ 50 years.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Ekkehard Beck
- Moderna, Inc., 200 Technology Square, Cambridge, MA, 02139, USA.
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Chang Z, Wang S, Liu K, Lin R, Liu C, Zhang J, Wei D, Nie Y, Chen Y, He J, Li H, Cheng ZJ, Sun B. Peripheral blood indicators and COVID-19: an observational and bidirectional Mendelian randomization study. BMC Med Genomics 2024; 17:81. [PMID: 38549094 PMCID: PMC10979573 DOI: 10.1186/s12920-024-01844-4] [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: 05/05/2023] [Accepted: 03/01/2024] [Indexed: 04/01/2024] Open
Abstract
Blood is critical for health, supporting key functions like immunity and oxygen transport. While studies have found links between common blood clinical indicators and COVID-19, they cannot provide causal inference due to residual confounding and reverse causality. To identify indicators affecting COVID-19, we analyzed clinical data (n = 2,293, aged 18-65 years) from Guangzhou Medical University's first affiliated hospital (2022-present), identifying 34 significant indicators differentiating COVID-19 patients from healthy controls. Utilizing bidirectional Mendelian randomization analyses, integrating data from over 2.46 million participants from various large-scale studies, we established causal links for six blood indicators with COVID-19 risk, five of which is consistent with our observational findings. Specifically, elevated Troponin I and Platelet Distribution Width levels are linked with increased COVID-19 susceptibility, whereas higher Hematocrit, Hemoglobin, and Neutrophil counts confer a protective effect. Reverse MR analysis confirmed four blood biomarkers influenced by COVID-19, aligning with our observational data for three of them. Notably, COVID-19 exhibited a positive causal relationship with Troponin I (Tnl) and Serum Amyloid Protein A, while a negative association was observed with Plateletcrit. These findings may help identify high-risk individuals and provide further direction on the management of COVID-19.
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Affiliation(s)
- Zhenglin Chang
- Department of Clinical Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
- Guangzhou Laboratory, Guangzhou International Bio Island, XingDaoHuanBei Road, Guangdong Province, Guangzhou, 510005, China
| | - Suilin Wang
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Kemin Liu
- Department of Clinical Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Runpei Lin
- Department of Clinical Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Changlian Liu
- Department of Clinical Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Jiale Zhang
- Department of Clinical Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Daqiang Wei
- Guangzhou Medical University, Guangzhou, 510230, Guangdong, China
| | - Yuxi Nie
- Guangzhou Medical University, Guangzhou, 510230, Guangdong, China
| | - Yuerong Chen
- Department of Clinical Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Jiawei He
- Department of Clinical Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Haiyang Li
- Department of Clinical Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China.
| | - Zhangkai J Cheng
- Department of Clinical Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China.
- Guangzhou Laboratory, Guangzhou International Bio Island, XingDaoHuanBei Road, Guangdong Province, Guangzhou, 510005, China.
| | - Baoqing Sun
- Department of Clinical Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China.
- Guangzhou Laboratory, Guangzhou International Bio Island, XingDaoHuanBei Road, Guangdong Province, Guangzhou, 510005, China.
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Ashique S, Mishra N, Garg A, Garg S, Farid A, Rai S, Gupta G, Dua K, Paudel KR, Taghizadeh-Hesary F. A Critical Review on the Long-Term COVID-19 Impacts on Patients With Diabetes. Am J Med 2024:S0002-9343(24)00133-5. [PMID: 38485111 DOI: 10.1016/j.amjmed.2024.02.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 02/20/2024] [Accepted: 02/23/2024] [Indexed: 04/30/2024]
Abstract
BACKGROUND The world is currently grappling with the potentially life-threatening coronavirus disease 2019 (COVID-19), marking it as the most severe health crisis in the modern era. COVID-19 has led to a pandemic, with the World Health Organization (WHO) predicting that individuals with diabetes are at a higher risk of contracting the virus compared to the general population. This review aims to provide a practical summary of the long-term impacts of COVID-19 on patients with diabetes. Specifically, it focuses on the effects of SARS-CoV-2 on different types of diabetic patients, the associated mortality rate, the underlying mechanisms, related complications, and the role of vitamin D and zinc in therapeutic and preventive approaches. METHODS Relevant literature was identified through searches on PubMed, Web of Science, and Science Direct in English, up to April 2023. RESULTS COVID-19 can lead to distressing symptoms and pose a significant challenge for individuals living with diabetes. Older individuals and those with pre-existing conditions such as diabetes, coronary illness, and asthma are more susceptible to COVID-19 infection. Managing COVID-19 in individuals with diabetes presents challenges, as it not only complicates the fight against the infection but also potentially prolongs the recovery time. Moreover, the virus may thrive in individuals with high blood glucose levels. Various therapeutic approaches, including antidiabetic drugs, are available to help prevent COVID-19 in diabetic patients. CONCLUSIONS Diabetes increases the morbidity and mortality risk for patients with COVID-19. Efforts are globally underway to explore therapeutic interventions aimed at reducing the impact of diabetes on COVID-19.
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Affiliation(s)
- Sumel Ashique
- Department of Pharmaceutical Sciences, Bengal College of Pharmaceutical Sciences & Research, Durgapur, West Bengal, India
| | - Neeraj Mishra
- Amity Institute of Pharmacy, Amity University Madhya Pradesh (AUMP), Gwalior, Madhya Pradesh, India
| | - Ashish Garg
- Drug Delivery and Nanotechnology Laboratories, Department of Pharmaceutics, Guru Ramdas Khalsa Institute of Science and Technology (Pharmacy), Kukrikheda, Barela, Jabalpur, Madhya Pradesh, India
| | - Sweta Garg
- Guru Ramdas Khalsa Institute of Science and Technology, Pharmacy, Jabalpur, Madhya Pradesh, India
| | - Arshad Farid
- Gomal Center of Biochemistry and Biotechnology, Gomal University, Dera Ismail Khan, Pakistan
| | - Shweta Rai
- Department of Pharmaceutics, ISF College of Pharmacy, Moga, Punjab, India
| | - Gaurav Gupta
- School of Pharmacy, Suresh Gyan Vihar University, Gyan Vihar Marg, Jagatpura, Jaipur, Rajasthan 302017, India
| | - Kamal Dua
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, NSW, Australia; Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, NSW, Australia
| | - Keshav Raj Paudel
- Centre for Inflammation, Centenary Institute and University of Technology Sydney, Faculty of Science, School of Life Sciences, Sydney, NSW, Australia
| | - Farzad Taghizadeh-Hesary
- ENT and Head and Neck Research Center, The Five Senses Health Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
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Alsagaff MY, Wardhani LFK, Nugraha RA, Putra TS, Khrisna BPD, Al-Farabi MJ, Gunadi RI, Azmi Y, Budianto CP, Fagi RA, Luthfah N, Subagjo A, Oktaviono YH, Lefi A, Dharmadjati BB, Alkaff FF, Pikir BS. Quantification of hs-Troponin Levels and Global Longitudinal Strain among Critical COVID-19 Patients with Myocardial Involvement. J Clin Med 2024; 13:352. [PMID: 38256486 PMCID: PMC10816186 DOI: 10.3390/jcm13020352] [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: 10/20/2023] [Revised: 12/29/2023] [Accepted: 12/30/2023] [Indexed: 01/24/2024] Open
Abstract
Background. Myocardial involvement among critically ill patients with coronavirus disease 2019 (COVID-19) often has worse outcomes. An imbalance in the oxygen supply causes the excessive release of pro-inflammatory cytokines, which results in increased ventilation requirements and the risk of death in COVID-19 patients. Purpose. We evaluated the association between the hs-troponin I levels and global longitudinal strain (GLS) as evidence of myocardial involvement among critical COVID-19 patients. Methods. We conducted a prospective cohort study from 1 February to 31 July 2021 at RSUD Dr. Soetomo, Surabaya, as a COVID-19 referral center. Of the 65 critical COVID-19 patients included, 41 (63.1%) were men, with a median age (interquartile range) of 51.0 years (20.0-75.0). Subjects were recruited based on WHO criteria for severe COVID-19, and myocardial involvement in the form of myocarditis was assessed using CDC criteria. Subjects were examined using echocardiography to measure the GLS, and blood samples were taken to measure the hs-troponin. Subjects were then followed for their need for mechanical ventilation and in-hospital mortality. Results. Severe COVID-19 patients with cardiac injury were associated with an increased need for intubation (78.5%) and an increased incidence of myocarditis (50.8%). There was a relationship between the use of intubation and the risk of death in patients (66.7% vs. 33.3%, p-value < 0.001). Decreased GLS and increased hs-troponin were associated with increased myocarditis (p values < 0.001 and 0.004, respectively). Decreased GLS was associated with a higher need for mechanical ventilation (12.17 + 4.79 vs. 15.65 + 4.90, p-value = 0.02) and higher mortality (11.36 + 4.64 vs. 14.74 + 4.82; p-value = 0.005). Elevated hs-troponin was associated with a higher need for mechanical ventilation (25.33% vs. 3.56%, p-value = 0.002) and higher mortality (34.57% vs. 5.76%, p-value = 0.002). Conclusions. Critically ill COVID-19 patients with myocardial involvement and elevated cardiac troponin levels are associated with a higher need for mechanical ventilation and higher mortality.
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Affiliation(s)
- Mochamad Yusuf Alsagaff
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Louisa Fadjri Kusuma Wardhani
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Ricardo Adrian Nugraha
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Tony Santoso Putra
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Bagus Putra Dharma Khrisna
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Makhyan Jibril Al-Farabi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Ruth Irena Gunadi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Yusuf Azmi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Christian Pramudita Budianto
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Rosi Amrilla Fagi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Nadya Luthfah
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Agus Subagjo
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Yudi Her Oktaviono
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Achmad Lefi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Budi Baktijasa Dharmadjati
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | | | - Budi Susetyo Pikir
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
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10
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Lu B, Ma R, Xu J, Zhang Y, Guo H, Chen H, Miao P, Qian Y, Xu B, Shen Y, Chen B. Primary healthcare workers' COVID-19 infection status following implementation of adjusted epidemic prevention and control strategies: a cross-sectional study in Jiangsu, China. Front Public Health 2023; 11:1297770. [PMID: 38186700 PMCID: PMC10770863 DOI: 10.3389/fpubh.2023.1297770] [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: 09/20/2023] [Accepted: 12/04/2023] [Indexed: 01/09/2024] Open
Abstract
Introduction In times of epidemic outbreaks, healthcare workers (HCWs) emerge as a particularly vulnerable group. This cross-sectional study endeavors to assess the COVID-19 infection rate among the primary HCWs in Jiangsu Province subsequent to the implementation of adjusted epidemic prevention and control strategies. Methods From January 17 to February 2, 2023, an extensive survey was conducted among primary HCWs in Jiangsu Province, employing a self-designed questionnaire. Logistic regression analysis was utilized to identify the factors associated with COVID-19 infection. Results The overall infection rate among primary HCWs stood at 81.05%, with a 95% confidence interval (CI) of 80.61-81.48%. Among those afflicted, cough, fatigue, and fever emerged as the three most prevalent symptoms, each with an incidence rate exceeding 80%. In the context of multivariate logistic regression, an elevated risk of COVID-19 infection was observed in correlation with female gender (adjusted odds ratio [aOR] = 1.12, 95% CI: 1.04-1.21), possessing a bachelor's degree or higher (aOR = 1.32, 95% CI: 1.23-1.41), accumulating over 10 years of work experience (aOR = 1.28, 95% CI: 1.11-1.47), holding a middle-level cadre position (aOR = 1.22, 95% CI: 1.11-1.35), assuming the role of a unit leader (aOR = 1.30, 95% CI: 1.11-1.54), and working in a fever clinic for 1 to 10 days per month (aOR = 1.42, 95% CI: 1.29-1.57). Conversely, advanced age (aOR = 0.76, 95% CI: 0.70-0.82), being underweight (aOR = 0.78, 95% CI: 0.69-0.90), current smoking (aOR = 0.64, 95% CI: 0.57-0.71), receiving 4 doses of COVID-19 vaccine (aOR = 0.49, 95% CI: 0.37-0.66), and pregnancy or perinatal status (aOR = 0.85, 95% CI: 0.72-0.99) were associated with a diminished risk of infection. Conclusion Following the implementation of adjusted policies, a substantial proportion of primary HCWs in Jiangsu province contracted COVID-19. Female gender and younger age emerged as risk factors for COVID-19 infection, while no discernible link was established between professions and COVID-19 susceptibility. The receipt of COVID-19 vaccines demonstrated efficacy in curtailing the infection rate, underscoring the significance of bolstering prevention knowledge and heightening self-protective awareness among primary HCWs.
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Affiliation(s)
- Beier Lu
- Department of Biostatistics, School of Public Health, Southeast University, Nanjing, China
| | - Rongji Ma
- Department of Biostatistics, School of Public Health, Southeast University, Nanjing, China
| | - Jinshui Xu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yongjie Zhang
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Haijian Guo
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Hualing Chen
- Department of Biostatistics, School of Public Health, Southeast University, Nanjing, China
| | - Pengcheng Miao
- Department of Biostatistics, School of Public Health, Southeast University, Nanjing, China
| | - Yongkang Qian
- Department of Biostatistics, School of Public Health, Southeast University, Nanjing, China
| | - Biyun Xu
- Medical Statistics and Analysis Center, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Ya Shen
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Bingwei Chen
- Department of Biostatistics, School of Public Health, Southeast University, Nanjing, China
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11
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Marschall J, Snyders RE, Sax H, Newland JG, Guimarães T, Kwon JH. Perspectives on research needs in healthcare epidemiology and antimicrobial stewardship: what's on the horizon - Part I. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2023; 3:e199. [PMID: 38028931 PMCID: PMC10654935 DOI: 10.1017/ash.2023.473] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 12/01/2023]
Abstract
In this overview, we articulate research needs and opportunities in the field of infection prevention that have been identified from insights gained during operative infection prevention work, our own research in healthcare epidemiology, and from reviewing the literature. The 10 areas of research need are: 1) transmissions and interruptions, 2) personal protective equipment and other safety issues in occupational health, 3) climate change and other crises, 4) device, diagnostic, and antimicrobial stewardship, 5) implementation and de-implementation, 6) health care outside the acute care hospital, 7) low- and middle-income countries, 8) networking with the "neighbors", 9) novel research methodologies, and 10) the future state of surveillance. An introduction and chapters 1-5 are presented in part I of the article, and chapters 6-10 and the discussion in part II. There are many barriers to advancing the field, such as finding and motivating the future IP workforce including professionals interested in conducting research, a constant confrontation with challenges and crises, the difficulty of performing studies in a complex environment, the relative lack of adequate incentives and funding streams, and how to disseminate and validate the often very local quality improvement projects. Addressing research gaps now (i.e., in the postpandemic phase) will make healthcare systems more resilient when facing future crises.
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Affiliation(s)
- Jonas Marschall
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
- BJC Healthcare, St. Louis, MO, USA
| | | | - Hugo Sax
- Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jason G. Newland
- Division of Infectious Diseases, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Thais Guimarães
- Infection Control Department, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil
| | - Jennie H. Kwon
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
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12
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da Silva BC, Cordioli RL, dos Santos BFC, Guerra JCDC, Rodrigues RDR, de Souza GM, Ashihara C, Midega TD, Campos NS, Carneiro BV, Campos FND, Guimarães HP, de Matos GFJ, de Aranda VF, Ferraz LJR, Corrêa TD. COVID-19-associated coagulopathy and acute kidney injury in critically ill patients. EINSTEIN-SAO PAULO 2023; 21:eAO0119. [PMID: 37729353 PMCID: PMC10501765 DOI: 10.31744/einstein_journal/2023ao0119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 02/07/2023] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVE The incidence of thrombotic events and acute kidney injury is high in critically ill patients with COVID-19. We aimed to evaluate and compare the coagulation profiles of patients with COVID-19 developing acute kidney injury versus those who did not, during their intensive care unit stay. METHODS Conventional coagulation and platelet function tests, fibrinolysis, endogenous inhibitors of coagulation tests, and rotational thromboelastometry were conducted on days 0, 1, 3, 7, and 14 following intensive care unit admission. RESULTS Out of 30 patients included, 13 (43.4%) met the criteria for acute kidney injury. Comparing both groups, patients with acute kidney injury were older: 73 (60-84) versus 54 (47-64) years, p=0.027, and had a lower baseline glomerular filtration rate: 70 (51-81) versus 93 (83-106) mL/min/1.73m2, p=0.004. On day 1, D-dimer and fibrinogen levels were elevated but similar between groups: 1780 (1319-5517) versus 1794 (726-2324) ng/mL, p=0.145 and 608 (550-700) versus 642 (469-722) g/dL, p=0.95, respectively. Rotational thromboelastometry data were also similar between groups. However, antithrombin activity and protein C levels were lower in patients who developed acute kidney injury: 82 (75-92) versus 98 (90-116), p=0.028 and 70 (52-82) versus 88 (78-101) µ/mL, p=0.038, respectively. Mean protein C levels were lower in the group with acute kidney injury across multiple time points during their stay in the intensive care unit. CONCLUSION Critically ill patients experiencing acute kidney injury exhibited lower endogenous anticoagulant levels. Further studies are needed to understand the role of natural anticoagulants in the pathophysiology of acute kidney injury within this population.
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Affiliation(s)
- Bruno Caldin da Silva
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Ricardo Luiz Cordioli
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | | | | | - Roseny dos Reis Rodrigues
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Guilherme Martins de Souza
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Carolina Ashihara
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Thais Dias Midega
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Niklas Söderberg Campos
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Bárbara Vieira Carneiro
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Flávia Nunes Dias Campos
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Hélio Penna Guimarães
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | | | - Valdir Fernandes de Aranda
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Leonardo José Rolim Ferraz
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Thiago Domingos Corrêa
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
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13
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Dickson A, Geerling E, Stone ET, Hassert M, Steffen TL, Makkena T, Smither M, Schwetye KE, Zhang J, Georges B, Roberts MS, Suschak JJ, Pinto AK, Brien JD. The role of vaccination route with an adenovirus-vectored vaccine in protection, viral control, and transmission in the SARS-CoV-2/K18-hACE2 mouse infection model. Front Immunol 2023; 14:1188392. [PMID: 37662899 PMCID: PMC10469340 DOI: 10.3389/fimmu.2023.1188392] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/22/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction Vaccination is the most effective mechanism to prevent severe COVID-19. However, breakthrough infections and subsequent transmission of SARS-CoV-2 remain a significant problem. Intranasal vaccination has the potential to be more effective in preventing disease and limiting transmission between individuals as it induces potent responses at mucosal sites. Methods Utilizing a replication-deficient adenovirus serotype 5-vectored vaccine expressing the SARS-CoV-2 RBD (AdCOVID) in homozygous and heterozygous transgenic K18-hACE2, we investigated the impact of the route of administration on vaccine immunogenicity, SARS-CoV-2 transmission, and survival. Results Mice vaccinated with AdCOVID via the intramuscular or intranasal route and subsequently challenged with SARS-CoV-2 showed that animals vaccinated intranasally had improved cellular and mucosal antibody responses. Additionally, intranasally vaccinated animals had significantly better viremic control, and protection from lethal infection compared to intramuscularly vaccinated animals. Notably, in a novel transmission model, intranasal vaccination reduced viral transmission to naïve co-housed mice compared to intramuscular vaccination. Discussion Our data provide convincing evidence for the use of intranasal vaccination in protecting against SARS-CoV-2 infection and transmission.
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Affiliation(s)
- Alexandria Dickson
- Department of Molecular Microbiology and Immunology, Saint Louis University, St Louis, MO, United States
| | - Elizabeth Geerling
- Department of Molecular Microbiology and Immunology, Saint Louis University, St Louis, MO, United States
| | - E. Taylor Stone
- Department of Molecular Microbiology and Immunology, Saint Louis University, St Louis, MO, United States
| | - Mariah Hassert
- Department of Molecular Microbiology and Immunology, Saint Louis University, St Louis, MO, United States
| | - Tara L. Steffen
- Department of Molecular Microbiology and Immunology, Saint Louis University, St Louis, MO, United States
| | - Taneesh Makkena
- Department of Molecular Microbiology and Immunology, Saint Louis University, St Louis, MO, United States
| | - Madeleine Smither
- Department of Molecular Microbiology and Immunology, Saint Louis University, St Louis, MO, United States
| | - Katherine E. Schwetye
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, United States
| | | | | | | | | | - Amelia K. Pinto
- Department of Molecular Microbiology and Immunology, Saint Louis University, St Louis, MO, United States
| | - James D. Brien
- Department of Molecular Microbiology and Immunology, Saint Louis University, St Louis, MO, United States
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14
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Sertbas Y, Solak EE, Dagci S, Kizilay V, Yazici Z, Elarslan S, Ozdil K. Clinical outcomes of COVID-19 in patients with chronic diseases. North Clin Istanb 2023; 10:401-410. [PMID: 37719255 PMCID: PMC10500237 DOI: 10.14744/nci.2022.64436] [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: 07/06/2022] [Revised: 08/31/2022] [Accepted: 10/10/2022] [Indexed: 09/19/2023] Open
Abstract
OBJECTIVE This study was carried out to evaluate the clinical outcomes of patients having chronic diseases (CD) and COVID-19 infection. METHODS The study was carried out retrospectively by including 1.516 patients with CDs who applied to two education and research hospitals between June 01, 2021, and August 01, 2021, and were diagnosed with COVID-19. As CDs; cardiovascular diseases, diabetes mellitus (DM), hyperlipidemia, asthma, chronic obstructive pulmonary diseases, rheumatological diseases, malignancy, cerebrovascular disease, and chronic kidney diseases (CKD) were screened and evaluated statistically. RESULTS A total of 1.516 patients with a mean age of 58.05±18.51 years were included in the study. It has been observed that 68.9% of COVID-19 patients have at least one CD. Women were more tend to have CDs than men (73.8% vs. 64.8%). Patients with a history of CD were significantly older and had a longer hospital stay than those without. Patients with CDs were 5.49 times more likely to be hospitalized in the intensive care unit (ICU) and their death rate was 2.52 times higher than the other patients. After the regression analysis, while hypertension (HT) (Odds Ratio [OR]: 2.39), DM (OR: 3.64), and any type of cancer (OR: 2.75) were seen as independent risk factors in hospitalizations in the ICU, cardiovascular diseases (OR: 2.27), CKD (OR: 3.69) and psychiatric disorders (OR: 2.18) were seen as independent risk factors associated with mortality. CONCLUSION The follow-up of COVID-19 patients with CDs should be done more cautiously than others. It should be kept in mind that patients with HT, DM, and cancer may need intensive care at any time of hospitalization, while those with cerebrovascular disease, CKD, and psychiatric problems may have a higher mortality rate than other patients.
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Affiliation(s)
- Yasar Sertbas
- Department of Internal Medicine, Health Sciences University, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkiye
| | - Ebru Elci Solak
- Department of Cardiology, Health Sciences University, Siyami Ersek Training and Research Hospital, Istanbul, Turkiye
| | - Selma Dagci
- Department of Gastroenterology, Health Sciences University, Umraniye Training and Research Hospital, Istanbul, Turkiye
| | - Volkan Kizilay
- Department of Statistics, Health Sciences University, Umraniye Training and Research Hospital, Istanbul, Turkiye
| | - Zeynep Yazici
- Department of Cardiology, Health Sciences University, Siyami Ersek Training and Research Hospital, Istanbul, Turkiye
| | - Serkan Elarslan
- Department of Internal Medicine, Health Sciences University, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkiye
| | - Kamil Ozdil
- Department of Gastroenterology, Health Sciences University, Umraniye Training and Research Hospital, Istanbul, Turkiye
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15
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Dong Y, Luo S, Wang Y, Shi Y. Retrospective analysis of COVID-19 among 391 hospitalized patients in the Henan province of China. Medicine (Baltimore) 2023; 102:e34325. [PMID: 37478231 PMCID: PMC10662902 DOI: 10.1097/md.0000000000034325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/22/2023] [Indexed: 07/23/2023] Open
Abstract
This study investigated the clinical characteristics and risk factors of coronavirus disease 2019 (COVID-19) in patients in designated hospitals (Port Hospital) in the Henan province. A total of 391 COVID-19 patients with complete case information from August 6, 2021 to February 26, 2022 were selected. Logistic regression was used to analyze the differences between the clinical types, ages, and sex of the patients. Multivariate regression analysis of the severe group indicated that underlying diseases [odds ratio (OR):6.76, 95% confidence interval (CI):1.83-24.93], increased urea levels (OR: 1.41, 95% CI: 1.04-1.91), old age (OR: 1.05, 95% CI: 1.00-1.10), and increased lactic dehydrogenase (OR: 1.02, 95% CI: 1.01-1.03) levels and decreased hemoglobin (OR: 0.95, 95% CI: 0.91-1.00) levels were predictors of illness severity. Multivariate regression analysis for those > 50 years of age showed that underlying diseases (OR: 7.06, 95% CI: 2.79-17.89) and increased urea (OR: 1.91, 95% CI: 1.47-2.48), total bilirubin (OR: 1.14, 95% CI: 1.08-1.21), total protein (OR: 1.08, 95% CI: 1.00-1.17), and lactic dehydrogenase (OR: 1.01, 95% CI: 1.00-1.02) levels and decreased albumin (OR: 0.66, 95% CI: 0.58-0.76) levels were characteristics of COVID-19. Multivariate regression analysis stratified by sex showed that the characteristics of COVID-19 patients were increased white blood cell count in males (OR: 0.66, 95% CI: 0.55-0.78) as well as increased creatinine levels (OR: 0.89, 95% CI: 0.87-0.91). This retrospective analysis provides useful information to support the clinical management of patients with COVID-19.
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Affiliation(s)
- Yang Dong
- Department of Clinical Pathology, Henan Provincial People's Hospital, Department of Clinical Pathology of Central China Fuwai Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Suyan Luo
- Department of Clinical Microbiology, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yali Wang
- Department of Clinical Microbiology, Henan Provincial Chest Hospital, Zhengzhou, China
| | - Yujie Shi
- Department of Clinical Pathology, Henan Provincial People's Hospital, Department of Clinical Pathology of Central China Fuwai Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, China
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16
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Fatmawati F, Mulyanti S. Risk Factors Associated with the Severity of COVID-19. Malays J Med Sci 2023; 30:84-92. [PMID: 37425387 PMCID: PMC10325129 DOI: 10.21315/mjms2023.30.3.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/01/2022] [Indexed: 07/11/2023] Open
Abstract
The case of coronavirus disease (COVID-19) has become a global crisis. In addition, more variants of the virus have been discovered with easier transmission and more harmful effects. Thus, understanding the risk factors associated with the susceptibility and severity of COVID-19 is critical for disease control. This review article aims to describe the risk factors associated with the severity of COVID-19. This study uses the article review method from research results obtained through searching the journal sites Google Scholar, PubMed, ProQuest and ScientDirect in the 2020-2021 period. To find articles that match the inclusion criteria we used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) strategy. A total of nine studies met the inclusion criteria for this review. These nine studies were assessed for quality, data extraction and synthesis. Risk factors that contribute to the severity of COVID-19 are age, gender, chronic comorbidities, cardiovascular disease, diabetes, hypertension, kidney failure, cancer and a history of smoking. New findings, unvaccinated patients are at higher risk of severity. Risk factors associated with the severity of COVID-19 include a person's individual characteristics, co-morbidities, smoking history and unvaccinated.
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Affiliation(s)
- Fitri Fatmawati
- Department of Nursing, Politeknik Kesehatan Kemenkes Surakarta, Surakarta, Indonesia
| | - Sri Mulyanti
- Department of Nursing, Politeknik Kesehatan Kemenkes Surakarta, Surakarta, Indonesia
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17
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Mirahmadizadeh A, Ghelichi-Ghojogh M, Jokari K, Amiri S, Moftakhar L, Moradian MJ, Habibi M, Dehghani SS, Hassani AH, Jafari A, Rezaei F. Correlation Between Diabetes and COVID-19 Indices: A Global Level Ecological
Study. SAGE Open Nurs 2023; 9:23779608231165485. [PMID: 37032958 PMCID: PMC10074615 DOI: 10.1177/23779608231165485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 02/27/2023] [Accepted: 03/05/2023] [Indexed: 04/07/2023] Open
Abstract
Introduction Coronavirus is threatening the global public health as a new and widespread crisis. The
researchers must keep in mind that one of the most vulnerable groups to COVID-19 are the
people with underlying diseases, especially diabetes. Objective This ecological study aimed to investigate the correlation between diabetes and the
epidemiological indices of COVID-19. Methods This ecological study included 144 countries. Their available data consists of the
cumulative incidence rate of cases, cumulative incidence rate of death, recovery rate,
case fatality rate, and performed tests of COVID-19, and diabetes. To collect the
variables, a data set was provided which included the information of 144 countries based
on diabetes and COVID-19 indices. Spearman coefficients were used for assess correlation
between diabetes and COVID-19 indices. Also, Scatter plots of diabetes for the studied
countries were drawn based on cumulative incidence rate of cases, cumulative incidence
rate of death, tests, recovery rate, and case fatality rate of COVID-19. Results The results of this ecological study showed in total countries, there was a weak
positive correlation between diabetes and cumulative incidence rate of cases and also
cumulative incidence rate of death. Correlation between diabetes with test of COVID-19
was very weak. Scatter plots showed a weak liner correlation between diabetes and
cumulative incidence rate of cases, cumulative incidence rate of death and test of
COVID-19. Conclusions In this study, there was a weak positive correlation between diabetes and cumulative
incidence rate of cases, cumulative incidence rate of death, and performed test of
COVID-19. This disease is an enormous challenge for health policymakers; therefore, it
is necessary to develop strategies and practical guidelines specific to each region to
take the necessary care, especially for diabetic patients.
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Affiliation(s)
- Alireza Mirahmadizadeh
- Non-communicable Diseases Research Center,
School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mousa Ghelichi-Ghojogh
- Neonatal and Children's Health Research
Center, Golestan University of Medical
Sciences, Gorgan, Iran
| | - Kimia Jokari
- Student Research Committee, Shiraz University
of Medical Sciences, Shiraz, Iran
| | - Sanaz Amiri
- Student Research Committee, Shiraz University
of Medical Sciences, Shiraz, Iran
| | - Leila Moftakhar
- Student Research Committee, Shiraz University
of Medical Sciences, Shiraz, Iran
| | - Mohammad Javad Moradian
- Trauma Research Center, Shahid Rajaee
(Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | | | - Alireza Jafari
- Department of Health Education and Health
Promotion, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical
Sciences, Gonabad, Iran
| | - Fatemeh Rezaei
- Research Center for Social Determinants of
Health, Jahrom University of Medical Sciences, Jahrom, Iran
- Fatemeh Rezaei, Department of Social Medicine,
Jahrom University of Medical Sciences, Jahrom, Iran.
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18
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Keskin O, Oral H, Sahin T, Kav T, Parlak E. The impact of COVID-19 disease on the natural course of cirrhosis: Before and after starting vaccination. Front Med (Lausanne) 2023; 9:1039202. [PMID: 36816721 PMCID: PMC9932027 DOI: 10.3389/fmed.2022.1039202] [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: 09/07/2022] [Accepted: 12/09/2022] [Indexed: 02/05/2023] Open
Abstract
Background Cirrhosis has been reported as an important risk factor for death in coronavirus disease 2019 (COVID-19) disease. In this study, we aimed to investigate the effects of COVID-19 on the natural course of cirrhosis before and after starting vaccination. Methods The cirrhosis patients in our cohort (n: 140; median age:56; 71 female) were included in this study. The median MELD (Model For End-stage Liver Disease) score was 11 (6-25) and CCI (Charlson Comorbidity Index) score was 4 (1-11). In total, 85 had CTP (Child-Turcotte-Pugh)-A, 44 had CTP-B and 11 had CTP-C cirrhosis. The course of COVID-19 in this patient group was evaluated before and after COVID-19 vaccination. Results Between March 2020 and January 2021, 36 of the 140 cirrhosis patients had developed COVID-19. Cirrhosis (+)/COVID-19 (+) and Cirrhosis (+)/COVID-19 (-) groups did not differ in terms of age, CCI and MELD-Na scores, or gender. There were six deaths in the Cirrhosis (+)/COVID-19 (+) group and five in the Cirrhosis (+)/COVID-19 (-) group [6/36 (16.6%) vs. 5/104 (4.8%); p: 0.03]. Patients who died were older, had higher CCI and MELD-Na scores, and lower albumin levels. Having had COVID-19 [6.45 (1.43-29.4); p: 0.015], higher MELD-Na score [1.35 (1.18-1.60); p: 0.001] and higher CCI score [1.65 (1.14-2.39); p: 0.008] were found to be independent predictors of mortality. After effective vaccination started in Turkey, only 11 of the remaining 129 patients developed COVID-19, and only one patient died, who was unvaccinated. Discussion In our cirrhotic cohort, COVID-19 disease was associated with 16% mortality in the pre-vaccination period. COVID-19 vaccination prevents serious illness and death due to COVID-19 in cirrhotic patients.
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Affiliation(s)
- Onur Keskin
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey,*Correspondence: Onur Keskin,
| | - Hakan Oral
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Tevhide Sahin
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Taylan Kav
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Erkan Parlak
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey
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19
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Zhang JJ, Dong X, Liu GH, Gao YD. Risk and Protective Factors for COVID-19 Morbidity, Severity, and Mortality. Clin Rev Allergy Immunol 2023; 64:90-107. [PMID: 35044620 PMCID: PMC8767775 DOI: 10.1007/s12016-022-08921-5] [Citation(s) in RCA: 210] [Impact Index Per Article: 210.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2022] [Indexed: 02/06/2023]
Abstract
The outbreak of the coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become an evolving global health crisis. Currently, a number of risk factors have been identified to have a potential impact on increasing the morbidity of COVID-19 in adults, including old age, male sex, pre-existing comorbidities, and racial/ethnic disparities. In addition to these factors, changes in laboratory indices and pro-inflammatory cytokines, as well as possible complications, could indicate the progression of COVID-19 into a severe and critical stage. Children predominantly suffer from mild illnesses due to COVID-19. Similar to adults, the main risk factors in pediatric patients include age and pre-existing comorbidities. In contrast, supplementation with a healthy diet and sufficient nutrition, COVID-19 vaccination, and atopic conditions may act as protective factors against the infection of SARS-CoV-2. COVID-19 vaccination not only protects vulnerable individuals from SARS-CoV-2 infection, more importantly, it may also reduce the development of severe disease and death due to COVID-19. Currently used therapies for COVID-19 are off-label and empiric, and their impacts on the severity and mortality of COVID-19 are still unclear. The interaction between asthma and COVID-19 may be bidirectional and needs to be clarified in more studies. In this review, we highlight the clinical evidence supporting the rationale for the risk and protective factors for the morbidity, severity, and mortality of COVID-19.
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Affiliation(s)
- Jin-Jin Zhang
- Department of Allergology, Zhongnan Hospital of Wuhan University, Donghu Road 169, Wuhan, 430071, Hubei, China
- Hubei Province Key Laboratory of Allergy and Immunology, Wuhan University, Wuhan, 430071, Hubei, China
| | - Xiang Dong
- Department of Allergology, Zhongnan Hospital of Wuhan University, Donghu Road 169, Wuhan, 430071, Hubei, China
- Hubei Province Key Laboratory of Allergy and Immunology, Wuhan University, Wuhan, 430071, Hubei, China
| | - Guang-Hui Liu
- Department of Allergology, Zhongnan Hospital of Wuhan University, Donghu Road 169, Wuhan, 430071, Hubei, China
- Hubei Province Key Laboratory of Allergy and Immunology, Wuhan University, Wuhan, 430071, Hubei, China
| | - Ya-Dong Gao
- Department of Allergology, Zhongnan Hospital of Wuhan University, Donghu Road 169, Wuhan, 430071, Hubei, China.
- Hubei Province Key Laboratory of Allergy and Immunology, Wuhan University, Wuhan, 430071, Hubei, China.
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20
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Özdemir Ö, Arsoy HEM. Commentary on COVID-19-induced liver injury in various age and risk groups. World J Virol 2023; 12:44-52. [PMID: 36743662 PMCID: PMC9896590 DOI: 10.5501/wjv.v12.i1.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 11/15/2022] [Accepted: 12/21/2022] [Indexed: 01/18/2023] Open
Abstract
Towards the end of 2019, a new type of coronavirus, severe acute respiratory syndrome, emerged in the city of Wuhan in China's Hubei Province. The first occurrence was described as a case of pneumonia. Coronavirus disease 2019 (COVID-19) can progress primarily with symptoms varying from a mild upper respiratory tract infection to severe pneumonia, acute respiratory distress syndrome, and death. Determining the mechanisms of action of this virus, which can affect all systems including gastrointestinal, is vital for predicting the progression of the disease and managing its treatment. It is important to demonstrate the mechanisms of action of COVID-19 in patients without a previously known chronic or systemic disease. Although there is still no specific treatment for the virus, various algorithms have been created. As a result of the applied algorithms, the response to the treatment was satisfactory in some patients, while unexpected side effects occurred in some patients. It helps to clarify whether the unwanted effects that occur are due to the effect of the disease or the side effects of the drugs used in the treatment. There is currently increasing interest in COVID-19 interaction with liver tissue. Therefore, we would like to discuss the details of liver injury/dysfunction in the current literature.
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Affiliation(s)
- Öner Özdemir
- Department of Pediatrics, Sakarya University, Medical Faculty, Sakarya 54100, Türkiye
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21
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Donniacuo M, De Angelis A, Rafaniello C, Cianflone E, Paolisso P, Torella D, Sibilio G, Paolisso G, Castaldo G, Urbanek K, Rossi F, Berrino L, Cappetta D. COVID-19 and atrial fibrillation: Intercepting lines. Front Cardiovasc Med 2023; 10:1093053. [PMID: 36755799 PMCID: PMC9899905 DOI: 10.3389/fcvm.2023.1093053] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/09/2023] [Indexed: 01/24/2023] Open
Abstract
Almost 20% of COVID-19 patients have a history of atrial fibrillation (AF), but also a new-onset AF represents a frequent complication in COVID-19. Clinical evidence demonstrates that COVID-19, by promoting the evolution of a prothrombotic state, increases the susceptibility to arrhythmic events during the infective stages and presumably during post-recovery. AF itself is the most frequent form of arrhythmia and is associated with substantial morbidity and mortality. One of the molecular factors involved in COVID-19-related AF episodes is the angiotensin-converting enzyme (ACE) 2 availability. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) uses ACE2 to enter and infect multiple cells. Atrial ACE2 internalization after binding to SARS-CoV-2 results in a raise of angiotensin (Ang) II, and in a suppression of cardioprotective Ang(1-7) formation, and thereby promoting cardiac hypertrophy, fibrosis and oxidative stress. Furthermore, several pharmacological agents used in COVID-19 patients may have a higher risk of inducing electrophysiological changes and cardiac dysfunction. Azithromycin, lopinavir/ritonavir, ibrutinib, and remdesivir, used in the treatment of COVID-19, may predispose to an increased risk of cardiac arrhythmia. In this review, putative mechanisms involved in COVID-19-related AF episodes and the cardiovascular safety profile of drugs used for the treatment of COVID-19 are summarized.
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Affiliation(s)
- Maria Donniacuo
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy,*Correspondence: Maria Donniacuo,
| | - Antonella De Angelis
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Concetta Rafaniello
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Eleonora Cianflone
- Department of Medical and Surgical Sciences, Magna Græcia University, Catanzaro, Italy
| | - Pasquale Paolisso
- Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium,Department of Advanced Biomedical Sciences, University of Naples “Federico II”, Naples, Italy
| | - Daniele Torella
- Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy
| | | | - Giuseppe Paolisso
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Giuseppe Castaldo
- Department of Molecular Medicine and Medical Biotechnology, University of Naples “Federico II”, Naples, Italy,CEINGE Advanced Biotechnologies, Naples, Italy
| | - Konrad Urbanek
- Department of Molecular Medicine and Medical Biotechnology, University of Naples “Federico II”, Naples, Italy,CEINGE Advanced Biotechnologies, Naples, Italy
| | - Francesco Rossi
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Liberato Berrino
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Donato Cappetta
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy,Department of Biological and Environmental Sciences and Technologies, University of Salento, Lecce, Italy
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22
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Ali FEM, Abd El-Aziz MK, Ali MM, Ghogar OM, Bakr AG. COVID-19 and hepatic injury: cellular and molecular mechanisms in diverse liver cells. World J Gastroenterol 2023; 29:425-449. [PMID: 36688024 PMCID: PMC9850933 DOI: 10.3748/wjg.v29.i3.425] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/15/2022] [Accepted: 12/23/2022] [Indexed: 01/12/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) represents a global health and economic challenge. Hepatic injuries have been approved to be associated with severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection. The viral tropism pattern of SARS-CoV-2 can induce hepatic injuries either by itself or by worsening the conditions of patients with hepatic diseases. Besides, other factors have been reported to play a crucial role in the pathological forms of hepatic injuries induced by SARS-CoV-2, including cytokine storm, hypoxia, endothelial cells, and even some treatments for COVID-19. On the other hand, several groups of people could be at risk of hepatic COVID-19 complications, such as pregnant women and neonates. The present review outlines and discusses the interplay between SARS-CoV-2 infection and hepatic injury, hepatic illness comorbidity, and risk factors. Besides, it is focused on the vaccination process and the role of developed vaccines in preventing hepatic injuries due to SARS-CoV-2 infection.
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Affiliation(s)
- Fares E M Ali
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Al-Azhar University, Assiut 71524, Egypt
| | | | - Mahmoud M Ali
- Department of Pharmacology, Al-Azhar University, Assiut 71524, Egypt
| | - Osama M Ghogar
- Department of Biochemistry Faculty of Pharmacy, Badr University in Assiut, Egypt
| | - Adel G Bakr
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Al-Azhar University, Assiut 71524, Egypt
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23
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Li X, Yuan X, Xu Z, Shi L, Huang L, Lu X, Fu J. Effect of Methylprednisolone on Mortality and Clinical Courses in Patients with Severe COVID-19: A Propensity Score Matching Analysis. INFECTIOUS DISEASES & IMMUNITY 2023; 3:20-28. [PMID: 36789030 PMCID: PMC9912987 DOI: 10.1097/id9.0000000000000076] [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: 06/24/2022] [Indexed: 06/18/2023]
Abstract
Background Whether methylprednisolone therapy can reduce the mortality rate of patients with severe coronavirus disease 2019 (COVID-19) remains controversial, and its effects on the length of hospital stay and virus shedding time are also unknown. This retrospective study investigates the previous issues to provide more evidence for methylprednisolone treatment in severe COVID-19. Methods This retrospective study included 563 of 4827 patients with confirmed COVID-19 admitted to Wuhan Huoshenshan Hospital or Wuhan Guanggu Hospital between February 3, 2020 and March 30, 2020 who met the screening criteria. The participants' epidemiological and demographic data, comorbidities, laboratory test results, treatments, outcomes, and vital clinical time points were extracted from electronic medical records. The primary outcome was in-hospital death, and the secondary outcomes were 2 clinical courses: length from admission to viral clearance and discharge. Univariate and multivariate logistic or linear regression analyses were used to assess the role of methylprednisolone in different outcomes. Propensity score matching was performed to control for confounding factors. Results Of the 563 patients who met the screening criteria and were included in the subsequent analysis, 138 were included in the methylprednisolone group and 425 in the nonmethylprednisolone group. The in-hospital death rate between the methylprednisolone and nonmethylprednisolone groups showed a significant difference (23.91% vs. 1.65%, P < 0.001), which was maintained after propensity score matching (13.98% vs. 5.38%, P = 0.048). However, univariate logistic analysis in the matched groups showed that methylprednisolone treatment (odds ratio [OR], 5.242; 95% confidence interval [CI], 0.802 to 34.246; P = 0.084) was not a risk factor for in-hospital death in severe patients. Further multivariate logistic regression analysis found comorbidities (OR, 3.327; 95% CI, 1.702 to 6.501; P < 0.001), lower lymphocyte count (OR, 0.076; 95% CI, 0.012 to 0.461; P = 0.005), higher lactate dehydrogenase (LDH) levels (OR, 1.008; 95% CI, 1.003 to 1.013; P = 0.002), and anticoagulation therapy (OR, 11.187; 95% CI, 2.459 to 50.900; P = 0.002) were associated with in-hospital mortality. Multivariate linear regression analysis in the matched groups showed that methylprednisolone treatment was not a risk factor for a prolonged duration from admission to viral clearance (β Value 0.081; 95% CI, -1.012 to 3.657; P = 0.265) or discharge (β Value 0.114; 95% CI, -0.723 to 6.408; P = 0.117). d-dimer (β Value, 0.144; 95% CI, 0.012 to 0.817; P = 0.044), LDH (β Value 0.260; 95% CI, 0.010 to 0.034; P < 0.001), and antiviral therapy (β Value 0.220; 95% CI, 1.373 to 6.263; P = 0.002) were associated with a longer length from admission to viral clearance. The lymphocyte count (β Value -0.206; 95% CI, -6.248 to -1.197; P = 0.004), LDH (β Value 0.231; 95% CI, 0.012 to 0.048; P = 0.001), antiviral therapy (β Value 0.143; 95% CI, 0.058 to 7.497; P = 0.047), and antibacterial therapy (β Value 0.152; 95% CI, 0.133 to 8.154; P = 0.043) were associated with a longer hospitalization duration from admission to discharge. Further stratified analysis revealed that the low daily dose group (≤60 mg/d) and the low total dose group (≤200 mg) had shorter duration from admission to viral clearance (Z=-2.362, P = 0.018; Z=-2.010, P = 0.044) and a shorter hospital stay (Z=-2.735, P = 0.006; Z=-3.858, P < 0.001). Conclusions In patients with severe COVID-19, methylprednisolone is safe and does not prolong the duration from admission to viral clearance or discharge. Low-dose, short-term methylprednisolone treatment may be more beneficial in shortening the disease course.
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Affiliation(s)
- Xiaoyan Li
- Medical School of Chinese PLA, Beijing 100853, China
- Senior Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
- National Clinical Research Center for Infectious Diseases, Beijing 100039, China
| | - Xin Yuan
- Medical School of Chinese PLA, Beijing 100853, China
- Senior Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
- National Clinical Research Center for Infectious Diseases, Beijing 100039, China
| | - Zhe Xu
- Medical School of Chinese PLA, Beijing 100853, China
- Senior Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
- National Clinical Research Center for Infectious Diseases, Beijing 100039, China
| | - Lei Shi
- Medical School of Chinese PLA, Beijing 100853, China
- Senior Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
- National Clinical Research Center for Infectious Diseases, Beijing 100039, China
| | - Lei Huang
- Medical School of Chinese PLA, Beijing 100853, China
- Senior Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
- National Clinical Research Center for Infectious Diseases, Beijing 100039, China
| | - Xuechun Lu
- Department of Hematology, the Second Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Junliang Fu
- Medical School of Chinese PLA, Beijing 100853, China
- Senior Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
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24
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Sinha S, Ajayababu A, Thukral H, Gupta S, Guha SK, Basu A, Gupta G, Thakur P, Lingaiah R, Das BK, Singh UB, Singh R, Narang R, Bhowmik D, Wig N, Modak DC, Bandyopadhyay B, Chakrabarty B, Kapoor A, Tewari S, Prasad N, Hashim Z, Nath A, Kumari N, Goswami R, Pandey S, Pandey RM. Efficacy of Bacillus Calmette-Guérin (BCG) Vaccination in Reducing the Incidence and Severity of COVID-19 in High-Risk Population (BRIC): a Phase III, Multi-centre, Quadruple-Blind Randomised Control Trial. Infect Dis Ther 2022; 11:2205-2217. [PMID: 36242739 PMCID: PMC9568923 DOI: 10.1007/s40121-022-00703-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 09/20/2022] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION Universal coverage of vaccines alone cannot be relied upon to protect at-risk populations in lower- and middle-income countries against the impact of the coronavirus disease 2019 (COVID-19) pandemic and newer variants. Live vaccines, including Bacillus Calmette-Guérin (BCG), are being studied for their effectiveness in reducing the incidence and severity of COVID-19 infection. METHODS In this multi-centre quadruple-blind, parallel assignment randomised control trial, 495 high-risk group adults (aged 18-60 years) were randomised into BCG and placebo arms and followed up for 9 months from the date of vaccination. The primary outcome was the difference in the incidence of COVID-19 infection at the end of 9 months. Secondary outcomes included the difference in the incidence of severe COVID-19 infections, hospitalisation rates, intensive care unit stay, oxygen requirement and mortality at the end of 9 months. The primary analysis was done on an intention-to-treat basis, while safety analysis was done per protocol. RESULTS There was no significant difference in the incidence rates of cartridge-based nucleic acid amplification test (CB-NAAT) positive COVID-19 infection [odds ratio (OR) 1.08, 95% confidence interval (CI) 0.54-2.14] in the two groups, but the BCG arm showed a statistically significant decrease in clinically diagnosed (symptomatic) probable COVID-19 infections (OR 0.38, 95% CI 0.20-0.72). Compared with the BCG arm, significantly more patients developed severe COVID-19 pneumonia (CB-NAAT positive) and required hospitalisation and oxygen in the placebo arm (six versus none; p = 0.03). One patient belonging to the placebo arm required intensive care unit (ICU) stay and died. BCG had a protective efficacy of 62% (95% CI 28-80%) for likely symptomatic COVID-19 infection. CONCLUSIONS BCG is protective in reducing the incidence of acute respiratory illness (probable symptomatic COVID-19 infection) and severity of the disease, including hospitalisation, in patients belonging to the high-risk group of COVID-19 infection, and the antibody response persists for quite a long time. A multi-centre study with a larger sample size will help to confirm the findings in this study. CLINICAL TRIALS REGISTRY Clinical Trials Registry India (CTRI/2020/07/026668).
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Affiliation(s)
- Sanjeev Sinha
- Department of Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029 India
| | - Anuj Ajayababu
- Department of Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029 India
| | - Himanshu Thukral
- Department of Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029 India
| | - Sushil Gupta
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGI), Lucknow, UP India
| | | | - Ayan Basu
- Department of Infectious Diseases, Institute of Post Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, India
| | - Gaurav Gupta
- Department of Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029 India
| | - Prashant Thakur
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGI), Lucknow, UP India
| | | | | | | | | | - Rajiv Narang
- Department of Cardiology, AIIMS, New Delhi, India
| | | | - Naveet Wig
- Department of Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029 India
| | | | | | | | | | | | | | - Zia Hashim
- Department of Pulmonary Medicine, SGPGI, Lucknow, UP India
| | - Alok Nath
- Department of Pulmonary Medicine, SGPGI, Lucknow, UP India
| | - Niraj Kumari
- Department of Pathology, SGPGI, Lucknow, UP India
| | | | - Shivam Pandey
- Department of Biostatistics, AIIMS, New Delhi, India
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Choi KY, Kim DH, Jin KN, Lee HJ, Park TY, Ryu B, Lee JK, Heo EY, Kim DK, Lee HW. Different treatment response to systemic corticosteroids according to white blood cell counts in severe COVID-19 patients. Ann Med 2022; 54:2998-3006. [PMID: 36453635 PMCID: PMC9721443 DOI: 10.1080/07853890.2022.2137736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Limited data are available in COVID-19 patients on the prediction of treatment response to systemic corticosteroid therapy based on systemic inflammatory markers. There is a concern whether the response to systemic corticosteroid is different according to white blood cell (WBC) counts in COVID-19 patients. We aimed to assess whether WBC count is related with the clinical outcomes after treatment with systemic corticosteroids in severe COVID-19. METHODS We conducted a retrospective cohort study and analysed the patients hospitalised for severe COVID-19 and received systemic corticosteroids between July 2020 and June 2021. The primary endpoint was to compare the composite poor outcome of mechanical ventilation, extracorporeal membrane oxygenation, and mortality among the patients with different WBC counts. RESULTS Of the 585 COVID-19 patients who required oxygen supplementation and systemic corticosteroids, 145 (24.8%) belonged to the leukopoenia group, 375 (64.1%) belonged to the normal WBC group, and 65 (11.1%) belonged to the leukocytosis group. In Kaplan-Meier curve, the composite poor outcome was significantly reduced in leukopoenia group compared to leukocytosis group (log-rank p-value < 0.001). In the multivariable Cox regression analysis, leukopoenia group was significantly associated with a lower risk of the composite poor outcome compared to normal WBC group (adjusted hazard ratio [aHR] = 0.32, 95% CI 0.14-0.76, p-value = 0.009) and leukocytosis group (aHR = 0.30, 95% CI = 0.12-0.78, p-value = 0.013). There was no significant difference in aHR for composite poor outcome between leukocytosis and normal WBC group. CONCLUSION Leukopoenia may be related with a better response to systemic corticosteroid therapy in COVID-19 patients requiring oxygen supplementation.KEY MESSAGESIn severe COVID-19 treated with systemic corticosteroids, patients with leukopoenia showed a lower hazard for composite poor outcome compared to patients with normal white blood cell counts or leukocytosis.Leukopoenia may be a potential biomarker for better response to systemic corticosteroid therapy in COVID-19 pneumonia.
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Affiliation(s)
- Kwang Yong Choi
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Dong Hyun Kim
- Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Kwang Nam Jin
- Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Hyo Jin Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Tae Yun Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Borim Ryu
- Biomedical Research Institute, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Jung-Kyu Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Eun Young Heo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Deog Kyeom Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Hyun Woo Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
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Petakh P, Griga V, Mohammed IB, Loshak K, Poliak I, Kamyshnyiy A. Effects of Metformin, Insulin on Hematological Parameters of COVID-19 Patients with Type 2 Diabetes. Med Arch 2022; 76:329-332. [PMID: 36545453 PMCID: PMC9760238 DOI: 10.5455/medarh.2022.76.329-332] [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: 07/04/2022] [Accepted: 08/10/2022] [Indexed: 11/08/2022] Open
Abstract
Background COVID-19 infection caused by SARS-COV-2 can result in multi-organ injuries and significant mortality in severe and critical patients, particularly those with type 2 diabetes as a comorbidity. Metformin and insulin are the main diabetes medications that affect the outcome of patients with COVID-19. Objective The purpose of our study was to find out the features of the hematological indicators of patients with COVID-19 patients and type 2 diabetes. Methods This is a retrospective study of the hospital confirmed COVID-19 patients between January to March 2022, who were admitted to Transcarpathian Regional Clinical Infectious Diseases Hospital (Uzhhorod, Ukraine). Results The effect of type 2 diabetes, metformin, and insulin on COVID-19 were analyzed, respectively. Demographics and blood laboratory indices were collected. In patients who took metformin, the level of CRP was significantly lower than in patients who did not take metformin (24 mg/L [IQR 15 - 58] vs 52 mg/L, [IQR 22-121], P = 0.046). Conclusion Our findings suggest that pre-admission metformin use may benefit COVID-19 patients with type 2 diabetes.
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Affiliation(s)
- Pavlo Petakh
- Department of Microbiology, Virology, and Immunology, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine,Department of Biochemistry and Pharmacology, Uzhhorod National University, Uzhhorod, Ukraine
| | - Vasilij Griga
- Department of Biochemistry and Pharmacology, Uzhhorod National University, Uzhhorod, Ukraine
| | | | - Kateryna Loshak
- Department of Internal Diseases, Uzhhorod National University, Uzhhorod, Ukraine
| | - Ivan Poliak
- Transcarpathian Regional Clinical Infectious Hospital, Uzhhorod, Ukraine
| | - Aleksandr Kamyshnyiy
- Department of Microbiology, Virology, and Immunology, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
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Aburto S, Cisterna M, Acuña J, Ruíz C, Viscardi S, Márquez JL, Villano I, Letelier P, Guzmán N. Obesity as a Risk Factor for Severe COVID-19 in Hospitalized Patients: Epidemiology and Potential Mechanisms. Healthcare (Basel) 2022; 10:1838. [PMID: 36292285 PMCID: PMC9601462 DOI: 10.3390/healthcare10101838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/14/2022] [Accepted: 09/17/2022] [Indexed: 12/15/2022] Open
Abstract
SARS-CoV-2 infection is a global public health problem, causing significant morbidity and mortality. Evidence shows that obesity is a recognized risk factor for hospitalization, admission to critical care units, and the development of serious complications from COVID-19. This review analyzes the available epidemiological evidence that relates obesity to a higher risk of severity and mortality from COVID-19, examining the possible pathophysiological mechanisms that explain this phenomenon on a cellular and molecular level.
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Affiliation(s)
- Scarleth Aburto
- Laboratorio de Investigación en Salud de Precisión, Departamento de Procesos Diagnósticos y Evaluación, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Temuco 4780000, Chile
| | - Mischka Cisterna
- Laboratorio de Investigación en Salud de Precisión, Departamento de Procesos Diagnósticos y Evaluación, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Temuco 4780000, Chile
| | - Javiera Acuña
- Laboratorio de Investigación en Salud de Precisión, Departamento de Procesos Diagnósticos y Evaluación, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Temuco 4780000, Chile
| | - Camila Ruíz
- Laboratorio de Investigación en Salud de Precisión, Departamento de Procesos Diagnósticos y Evaluación, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Temuco 4780000, Chile
| | - Sharon Viscardi
- Laboratorio de Investigación en Salud de Precisión, Departamento de Procesos Diagnósticos y Evaluación, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Temuco 4780000, Chile
- Núcleo de Investigación en Producción Alimentaria, Universidad Católica de Temuco, Temuco 4780000, Chile
- Biotechnology of Functional Foods Laboratory, Camino Sanquilco, Parcela 18, Padre Las Casas 4850000, Chile
| | - José Luis Márquez
- Escuela de Kinesiología, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, Santiago 9160000, Chile
| | - Ines Villano
- Dipartimento di Medicina Sperimentale, Università degli Studi della Campania Luigi Vanvitelli, 81100 Caserta, Italy
| | - Pablo Letelier
- Laboratorio de Investigación en Salud de Precisión, Departamento de Procesos Diagnósticos y Evaluación, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Temuco 4780000, Chile
| | - Neftalí Guzmán
- Laboratorio de Investigación en Salud de Precisión, Departamento de Procesos Diagnósticos y Evaluación, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Temuco 4780000, Chile
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Araújo DC, Veloso AA, Borges KBG, Carvalho MDG. Prognosing the risk of COVID-19 death through a machine learning-based routine blood panel: A retrospective study in Brazil. Int J Med Inform 2022; 165:104835. [PMID: 35908372 PMCID: PMC9327247 DOI: 10.1016/j.ijmedinf.2022.104835] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/17/2022] [Accepted: 07/19/2022] [Indexed: 01/08/2023]
Abstract
BACKGROUND Despite an extensive network of primary care availability, Brazil has suffered profoundly during the COVID-19 pandemic, experiencing the greatest sanitary collapse in its history. Thus, it is important to understand phenotype risk factors for SARS-CoV-2 infection severity in the Brazilian population in order to provide novel insights into the pathogenesis of the disease. OBJECTIVE This study proposes to predict the risk of COVID-19 death through machine learning, using blood biomarkers data from patients admitted to two large hospitals in Brazil. METHODS We retrospectively collected blood biomarkers data in a 24-h time window from 6,979 patients with COVID-19 confirmed by positive RT-PCR admitted to two large hospitals in Brazil, of whom 291 (4.2%) died and 6,688 (95.8%) were discharged. We then developed a large-scale exploration of risk models to predict the probability of COVID-19 severity, finally choosing the best performing model regarding the average AUROC. To improve generalizability, for each model five different testing scenarios were conducted, including two external validations. RESULTS We developed a machine learning-based panel composed of parameters extracted from the complete blood count (lymphocytes, MCV, platelets and RDW), in addition to C-Reactive Protein, which yielded an average AUROC of 0.91 ± 0.01 to predict death by COVID-19 confirmed by positive RT-PCR within a 24-h window. CONCLUSION Our study suggests that routine laboratory variables could be useful to identify COVID-19 patients under higher risk of death using machine learning. Further studies are needed for validating the model in other populations and contexts, since the natural history of SARS-CoV-2 infection and its consequences on the hematopoietic system and other organs is still quite recent.
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Affiliation(s)
- Daniella Castro Araújo
- Huna, São Paulo, SP, Brazil; Departamento de Ciência da Computação, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
| | - Adriano Alonso Veloso
- Departamento de Ciência da Computação, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Abumweis S, Alrefai W, Alzoughool F. Association of obesity with COVID-19 diseases severity and mortality: A meta-analysis of studies. OBESITY MEDICINE 2022; 33:100431. [PMID: 35702736 PMCID: PMC9181395 DOI: 10.1016/j.obmed.2022.100431] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 05/31/2022] [Accepted: 06/03/2022] [Indexed: 11/17/2022]
Abstract
Background The literature on COVID-19 infection is growing every single day, and evidence of presence or absence of association between obesity and COVID-19 adverse outcomes should be revisited. Therefore, this study summarizes the pooled association of obesity with COVID-19 adverse outcomes and mortality. Methods We searched PubMed and Science direct databases using specific terms and defined criteria. Data were analyzed using Comprehensive Meta-Analysis V2 (Biostat, Englewood, NJ, USA)) random-effect models were used to calculate the odds ratio (OR) with 95% confidence intervals (95% CIs) of infection severity and mortality associated with obesity. Results Results revealed that obesity is not associated with COVID-19 mortality (OR = 1.1; 95%CI: 0.8 to 1.3) but with other adverse outcomes (OR = 2.4; 95%CI: 1.7 to 3.3). Conclusion Our findings support previous findings that obesity is associated with COVID-19 severity.
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Affiliation(s)
- Suhad Abumweis
- College of Pharmacy, Al Ain University, 64141, Abu Dhabi, United Arab Emirates
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, P.O. Box 330127, Zarqa, 13133, Jordan
| | - Waed Alrefai
- Department of Health Science and Biostatistics, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
| | - Foad Alzoughool
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, The Hashemite University, P.O. Box 330127, Zarqa, 13133, Jordan
- Faculty of Health Sciences, Fujairah Women's College, Higher Colleges of Technology, United Arab Emirates
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COVID-19 Severity and Mortality in Two Pandemic Waves in Poland and Predictors of Poor Outcomes of SARS-CoV-2 Infection in Hospitalized Young Adults. Viruses 2022; 14:v14081700. [PMID: 36016322 PMCID: PMC9413321 DOI: 10.3390/v14081700] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 02/08/2023] Open
Abstract
SARS-CoV-2 variants pose a significant threat to global public health. However, their influence on disease severity, especially among young adults who may exhibit different clinical characteristics, is debatable. In this retrospective study of 229 young adults hospitalized with COVID-19, we investigated the differences between Poland's second and third waves of the pandemic. To identify potential predictors of severe COVID-19 in young adults, we analyzed patient characteristics and laboratory findings between survivors and non-survivors and we performed logistic regression to assess the risk of death, mechanical ventilation, and intensive care unit treatment. We found no increase in COVID-19 severity comparing the third and second waves of the pandemic, indicating that the alpha variant had no influence on disease severity. In addition, we found that factors, such as obesity, comorbidities, lung involvement, leukocytosis, neutrophilia, lymphopenia, higher IG count, the neutrophil-to-lymphocyte ratio, C-reactive protein, procalcitonin, interleukin-6, D-Dimer, lactate dehydrogenase, high-sensitive troponin I, creatine kinase-myocardial band, myoglobin, N-terminal-pro-B-type natriuretic peptide, creatinine, urea and gamma-glutamyl transferase, lower estimated glomerular filtration rate, albumin, calcium and vitamin D3, possibly a decrease in red blood cell counts, hemoglobin and hematocrit, and an increase in creatine kinase during hospitalization may be associated with poor outcomes of COVID-19.
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Hernández-Regino LM, De Jesús Castillejos-López M, Aquino-Gálvez A, Velasco-Hidalgo L, García-Guzmán A, Aguilar-Ortiz M, Cárdenas-Cardos R, Torres-Espíndola LM. Clinical characteristics and mortality predictors of patients with cancer hospitalized by COVID-19 in a pediatric third-level referral center. Front Pediatr 2022; 10:960334. [PMID: 35967576 PMCID: PMC9366048 DOI: 10.3389/fped.2022.960334] [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: 06/02/2022] [Accepted: 07/07/2022] [Indexed: 11/23/2022] Open
Abstract
Background More than 135 million COVID-19 cases (coronavirus disease 2019) have been reported worldwide until today, with over 2.9 million deaths. Several studies have demonstrated that disease severity is lower in the pediatric population than in adults; however, differences are described in patients with chronic diseases, including oncological patients. Current world literature suggests patients with comorbidities, including cancer, have an increased risk of unfortunate outcomes. Therefore, our objective was to describe the clinical characteristics and epidemiological factors associated with mortality in a cohort of pediatric cancer patients hospitalized for COVID-19. Methods This is a retrospective, descriptive study of the cases of patients with cancer hospitalized for COVID-19. A total of 40 pediatrics were included in the analysis. Data from pediatric patients with COVID-19 included clinical and epidemiological records, laboratory, imaging studies, COVID-19 diagnostic methods, and medical treatment. Results Of the 40 pediatric patients admitted with cancer with a confirmed diagnosis of COVID-19, 42.5% were solid tumors, 40% leukemias, and 17.5% lymphomas. The clinical parameters associated with mortality were stage IV tumor (p = 0.029) and intubation (p < 0.001). The biochemical factors associated with lower survival were thrombocytopenia under 25,000 cells/mm3 (p < 0.001), D-dimer over 1 μg/ml (p = 0.003), clinical malnutrition (p = 0.023), and disseminated intravascular coagulation (p = 0.03). Conclusion Our findings showed that the fever was the most frequent symptom, and the clinical parameters associated with mortality were stage IV tumor, intubation, saturation percentage, RDW, platelets, creatinine, ALT, D-dimer, ferritin, and FiO2 percentage. The thrombocytopenia, D-dimer, nutritional status, and disseminated intravascular coagulation were significantly associated with lower survival.
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Affiliation(s)
| | - Manuel De Jesús Castillejos-López
- Department of Hospital Epidemiology and Infectology, National Institute of Respiratory Diseases “Ismael Cosío Villegas,”Mexico City, Mexico
| | - Arnoldo Aquino-Gálvez
- Laboratory of Molecular Biology, Pulmonary Fibrosis Department, National Institute of Respiratory Diseases “Ismael Cosío Villegas,”Mexico City, Mexico
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He Y, He Y, Hu Q, Yang S, Li J, Liu Y, Hu J. Association between smoking and COVID-19 severity: A multicentre retrospective observational study. Medicine (Baltimore) 2022; 101:e29438. [PMID: 35866793 PMCID: PMC9302364 DOI: 10.1097/md.0000000000029438] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The relationship between smoking and coronavirus disease 2019 (COVID-19) severity remains unclear. This study aimed to investigate the effect of smoking status (current smoking and a smoking history) on the clinical severity of COVID-19. Data of all enrolled 588 patients, who were referred to 25 hospitals in Jiangsu province between January 10, 2020 and March 14, 2020, were retrospectively reviewed. Univariate and multivariate regression, random forest algorithms, and additive interaction were used to estimate the importance of selective predictor variables in the relationship between smoking and COVID-19 severity. In the univariate analysis, the proportion of patients with a current smoking status in the severe group was significantly higher than that in the non-severe group. In the multivariate analysis, current smoking remained a risk factor for severe COVID-19. Data from the interaction analysis showed a strong interaction between the number of comorbidities in patients with COVID-19 and smoking. However, no significant interaction was found between smoking and specific comorbidities, such as hypertension, diabetes, etc. In the random forest model, smoking history was ranked sixth in mean decrease accuracy. Active smoking may be significantly associated with an enhanced risk of COVID-19 progression towards severe disease. However, additional prospective studies are needed to clarify the complex relationship between smoking and COVID-19 severity.
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Affiliation(s)
- Yue He
- Department of Infectious Diseases, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yangai He
- Department of Infectious Diseases, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qinghui Hu
- Department of Infectious Diseases, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Sheng Yang
- Department of Biostatistics, Nanjing Medical University, Nanjing, China
| | - Jun Li
- Department of Infectious Diseases, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yuan Liu
- Department of Infectious Diseases, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Yuan Liu & Jun Hu, Department of Infectious Diseases, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China (e-mail: )
| | - Jun Hu
- Department of Orthopedics, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Yuan Liu & Jun Hu, Department of Infectious Diseases, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China (e-mail: )
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Vallejo MS, Blümel JE, Bencosme A, Calle A, Dextre M, Díaz K, López M, Miranda C, Ñañez M, Ojeda E, Rey C, Rodrigues MA, Salinas C, Tserotas K, Pérez-López FR. Factors affecting climacteric women with SARS-CoV-2 infection: A multinational Latin America study (REDLINC XI). Maturitas 2022; 165:33-37. [PMID: 35905570 PMCID: PMC9303064 DOI: 10.1016/j.maturitas.2022.07.006] [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: 03/01/2022] [Revised: 07/02/2022] [Accepted: 07/09/2022] [Indexed: 01/08/2023]
Abstract
Objective To evaluate the association between factors, especially those linked to the climacteric, and a history of COVID-19 infection. Methods This was an observational, cross-sectional, and analytical study in which women from ten Latin American countries, aged 40–64, who attended a routine health check-up were invited to participate. A positive history for COVID-19 was based on reverse transcription-polymerase chain reaction reports. We evaluated sociodemographic, clinical, lifestyle, anthropometric variables, and menopausal symptoms using the Menopause Rating Scale (MRS). Results A total of 1238 women were included for analysis, of whom 304 (24.6 %) had a positive history for COVID-19. The median [interquartile range: IQR] age of participants was 53 [IQR 12] years, duration of formal education was 16 [6] years, body mass index 25.6 [5.1] kg/m2, and total MRS score 10 [13]. In a logistic regression model, factors positively associated with COVID-19 included postmenopausal status and having a family history of dementia (OR: 1.53; 95 % CI: 1.13–2.07, and 2.40; 1.65–3.48, respectively), whereas negatively associated were use of menopausal hormone therapy (current or past), being a housewife, and being nulliparous (OR: 0.47; 95 % CI: 0.30–0.73; 0.72; 0.53–0.97 and 0.56; 0.34–0.92, respectively). Smoking, being sexually active, and use of hypnotics were also factors positively associated with COVID-19. Conclusion Postmenopausal status and a family history of dementia were more frequent among women who had had COVID-19, and the infection was less frequent among current or past menopause hormone therapy users and in those with less physical contact.
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Affiliation(s)
- María S Vallejo
- Clínica Quilín, Facultad de Medicina, Universidad de Chile, Santiago de Chile, Chile
| | - Juan E Blümel
- Departamento de Medicina Interna Sur, Facultad de Medicina, Universidad de Chile, Santiago de Chile, Chile.
| | - Ascanio Bencosme
- Ginecología Obstetricia, Hospital Metropolitano de Santiago, Santiago de los Caballeros, Dominican Republic
| | - Andrés Calle
- Centro Integral de Salud Obstétrica y Femenina-CISOF, Quito, Ecuador
| | - Maribel Dextre
- Ginecología Obstetricia, Clínica Internacional-Clínica Javier Prado, Lima, Peru
| | - Karen Díaz
- Centro Ciudad Mujer, Ministerio de Salud, Asunción, Paraguay
| | - Marcela López
- Clínica Alemana y Hospital Militar, Santiago de Chile, Chile
| | - Carlos Miranda
- Hospital Central FAP-Instituto Médico Miraflores, Lima, Peru
| | - Mónica Ñañez
- II Cátedra de Ginecología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Eliana Ojeda
- Departamento Académico de Medicina Humana, Universidad Andina del Cusco, Cusco, Peru
| | - Claudia Rey
- Medicina Ginecológica Consultorios Médicos, Buenos Aires, Argentina
| | - Marcio A Rodrigues
- Department Gynecology and Obstetrics, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Faustino R Pérez-López
- Instituto Aragonés de Ciencias de la Salud, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, Spain
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Vassilopoulou E, Bumbacea RS, Pappa AK, Papadopoulos AN, Bumbacea D. Obesity and Infection: What Have We Learned From the COVID-19 Pandemic. Front Nutr 2022; 9:931313. [PMID: 35938136 PMCID: PMC9353573 DOI: 10.3389/fnut.2022.931313] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 06/14/2022] [Indexed: 01/14/2023] Open
Abstract
Objective The critical role played by the nutritional status in the complications, duration of hospitalization and mortality in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (COVID-19) has emerged from several research studies in diverse populations. Obesity has been associated with an increased risk of serious complications, as the adipose tissue appears to have significant effects on the immune response. The aim of this narrative review was to investigate the relationship between COVID-19 and obesity. Methods We performed a review of papers in the English language derived from PubMed, Science Direct, and Web of Science. The primary outcomes investigated were the severity of the disease, admission to the intensive care unit (ICU), need for intubation, and mortality. Results and Conclusion Review of 44 eligible studies from 18 countries around the world revealed evidence that obesity increases the risk of severe COVID-19 complications, ICU admission, intubation and mortality. Patients with a higher body mass index (BMI) appear to be more vulnerable to SARS-CoV-2 infection, with more severe illness requiring admission to ICU and intubation, and to have higher mortality. A healthy body weight should be targeted as a long-term prevention measure against acute complications of infection, and in the event of COVID-19, overweight and obese patients should be monitored closely.
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Affiliation(s)
- Emilia Vassilopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Roxana Silvia Bumbacea
- Allergy Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Allergy Department, Nephrology Hospital Dr Carol Davila, Bucharest, Romania
| | | | - Athanasios N. Papadopoulos
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Dragos Bumbacea
- Department of Cardio-Thoracic Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of Pneumology and Acute Respiratory Care, Elias Emergency University Hospital, Bucharest, Romania
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Ocampo Benavides CE, Morales M, Cañón-Muñoz M, Pallares-Gutierrez C, López KD, Fernández-Osorio A. Características clínicas, imagenológicas y de laboratorio de pacientes con COVID-19 según requerimiento de ingreso a UCI en Cali, Colombia. REVISTA DE LA FACULTAD DE MEDICINA 2022. [DOI: 10.15446/revfacmed.v71n2.98696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Introducción. Actualmente, hay pocos estudios en Latinoamérica sobre las características demográficas, clínicas y de laboratorio de pacientes con COVID-19 y con requerimiento de ingreso a unidad de cuidados intensivos (UCI).
Objetivo. Comparar las características sociodemográficas, clínicas, imagenológicas y de laboratorio de pacientes diagnosticados con COVID-19 atendidos en el servicio de urgencias de una clínica en Cali, Colombia, según requerimiento de ingreso a UCI.
Materiales y métodos. Estudio retrospectivo descriptivo de cohorte única realizado en 49 adultos con COVID-19 atendidos en el servicio de urgencias de un hospital de cuarto nivel de atención en Cali, Colombia, en marzo y abril de 2020, los cuales se dividieron en dos grupos: requerimiento de UCI (n=24) y no requerimiento de UCI (n=25). Se realizaron análisis bivariados para determinar las diferencias entre ambos grupos (pruebas de chi-2, exacta de Fisher, t de Student y U de Mann-Whitney), con un nivel de significancia de p<0.05.
Resultados. La edad promedio fue 53 años (DE=13) y 29 pacientes fueron hombres. Se encontraron diferencias significativas entre ambos grupos en las siguientes variables: edad promedio (UCI x̅=58 vs. No UCI x̅=49; p=0.020), presencia de diabetes (8 vs. 1; p=0.010), presencia de dificultad respiratoria (20 vs. 11; p=0.007), presencia uni o bilateral de áreas de consolidación (12 vs. 3; p=0.005), mediana del conteo de leucocitos (Med=7570/mm3 vs. Med=5130/mm3; p=0.0013), de neutrófilos (Med=5980/mm3 vs. Med=3450/mm3; p=0,0001) y linfocitos (Med=865/mm3 vs. Med=1400/mm3; p<0,0001), mediana de proteína C reactiva (Med=141,25mg/L vs. Med=27,95mg/L; p<0,001), ferritina (Med=1038ng/L vs. Med=542,5ng/L; p=0.0073) y lactato-deshidrogenasa (Med=391U/L vs, Med=248,5U/L, p=0,0014). Finalmente, 15 pacientes requirieron ventilación mecánica invasiva, 2 presentaron extubación fallida, y en total, 5 fallecieron.
Conclusiones. Se observaron diferencias significativas en los valores de varios marcadores inflamatorios, daño celular y parámetros del hemograma entre los pacientes que requirieron admisión a la UCI y los que no, por lo que estas variables podrían emplearse para desarrollar herramientas que contribuyan a establecer el pronóstico de esta enfermedad.
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Passoni R, Lordani TVA, Peres LAB, Carvalho ARDS. Occurrence of acute kidney injury in adult patients hospitalized with COVID-19: A systematic review and meta-analysis. Nefrologia 2022; 42:404-414. [PMID: 36460430 PMCID: PMC9707651 DOI: 10.1016/j.nefroe.2022.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 09/13/2021] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND AND AIM The knowledge about the acute kidney injury (AKI) incidence in patients with coronavirus disease 2019 (COVID-19) can help health teams to carry out a targeted care plan. This study aimed to determine the AKI incidence in patients hospitalized with COVID-19. METHODS The electronic search covered research published until June 20, 2020, and included five databases, PubMed, Embase, Web of Science, Scopus, and Lilacs (Latin American and Caribbean Health Sciences Library). Eligible studies were those including data from AKI occurrence in adult patients hospitalized with COVID-19. The primary outcome was AKI incidence, and the secondary outcome assessed was the AKI mortality. Additionally, the estimated incidence of renal replacement therapy (RRT) need also was verified. Using a standardized form prepared in Microsoft Excel, data were extracted by two independents authors, regarding the description of studies, characteristics of patients and clinical data on the AKI occurrence. RESULTS We included 30 studies in this systematic review, of which 28 were included in the meta-analysis. Data were assessed from 18.043 adult patients with COVID-19. The AKI estimate incidence overall and at the ICU was 9.2% (4.6-13.9) and 32.6% (8.5-56.6), respectively. AKI estimate incidence in the elderly patients and those with acute respiratory disease syndrome was 22.9% (-4.0-49.7) and 4.3% (1.8-6.8), respectively. Patients with secondary infection, AKI estimate incidence was 31.6% (12.3-51.0). The estimate incidence of patients that required RRT was 3.2% (1.1-5.4) and estimate AKI mortality was 50.4% (17.0-83.9). CONCLUSION The occurrence of AKI is frequent among adult patients hospitalized with COVID-19, and affects on average, up to 13.9% of these patients. It is believed that AKI occurs early and in parallel with lung injury.
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Affiliation(s)
- Reginaldo Passoni
- Department of Nursing, Teaching Hospital of Western Paraná State University, Cascavel, Paraná, Brazil.
| | - Tarcísio Vitor Augusto Lordani
- Department of Nursing, Teaching Hospital of Western Paraná State University, Cascavel, Paraná, Brazil; Collegiate of Nursing, Center for Biological and Health Sciences, Western Paraná State University, Cascavel, Paraná, Brazil
| | - Luis Alberto Batista Peres
- Discipline of Nephrology, Undergraduate Course in Medicine, Center for Medical and Pharmaceutical Sciences, Western Paraná State University, Cascavel, Paraná, Brazil; Post-graduate Program in Biosciences and Health, Center for Biological and Health Sciences, Western Paraná State University, Cascavel, Paraná, Brazil
| | - Ariana Rodrigues da Silva Carvalho
- Collegiate of Nursing, Center for Biological and Health Sciences, Western Paraná State University, Cascavel, Paraná, Brazil; Post-graduate Program in Biosciences and Health, Center for Biological and Health Sciences, Western Paraná State University, Cascavel, Paraná, Brazil
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BALCI A, ÇİLEKAR Ş, COŞĞUN İG. Knowledge and Attitude of New Coronavirus Epidemic (COVID-19) Among Health Care Workers. BEZMIALEM SCIENCE 2022. [DOI: 10.14235/bas.galenos.2021.4935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Oliveira ECD, Terças-Trettel ACP, Andrade ACDS, Muraro AP, Santos ESD, Espinosa MM, Musis CRD. [Prevalence of SARS-CoV-2 antibodies in the State of Mato Grosso, Brazil: a population-based survey]. CAD SAUDE PUBLICA 2022; 38:e00093021. [PMID: 35703597 DOI: 10.1590/0102-311xpt093021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 03/10/2022] [Indexed: 12/20/2022] Open
Abstract
Seroprevalence data provide relevant information on the development and progression of the COVID-19 pandemic. The study aimed to estimate the prevalence of SARS-CoV-2 antibodies in Mato Grosso State, Brazil, and its distribution according to sociodemographic and economic characteristics. This population-based serological survey was conducted in September-October 2020 in individuals 18 years or older in ten municipalities (counties) in the state of Mato Grosso. Interviews and collection of biological samples were conducted in the households, and determination of IgG antibodies to SARS-CoV-2 was performed with chemiluminescence. A total of 4,306 individuals were evaluated, and COVID-19 prevalence was estimated at 12.5% (95%CI: 10.5; 14.7), ranging from 7.4% to 24.3% between municipalities. No significant differences were found in prevalence of infection according to race/color, schooling, or family income, but lower prevalence was seen in individuals with a pensioner living in the same household, who did not receive emergency financial aid, and whose family income had not decreased after social distancing measures during the epidemic. Estimated prevalence of SARS-CoV-2 antibodies in this population-based survey is essential to measure the magnitude of the disease and will back measures to confront and control the pandemic.
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Singh R, Rathore SS, Khan H, Karale S, Chawla Y, Iqbal K, Bhurwal A, Tekin A, Jain N, Mehra I, Anand S, Reddy S, Sharma N, Sidhu GS, Panagopoulos A, Pattan V, Kashyap R, Bansal V. Association of Obesity With COVID-19 Severity and Mortality: An Updated Systemic Review, Meta-Analysis, and Meta-Regression. Front Endocrinol (Lausanne) 2022; 13:780872. [PMID: 35721716 PMCID: PMC9205425 DOI: 10.3389/fendo.2022.780872] [Citation(s) in RCA: 75] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 01/10/2022] [Indexed: 12/11/2022] Open
Abstract
Background Obesity affects the course of critical illnesses. We aimed to estimate the association of obesity with the severity and mortality in coronavirus disease 2019 (COVID-19) patients. Data Sources A systematic search was conducted from the inception of the COVID-19 pandemic through to 13 October 2021, on databases including Medline (PubMed), Embase, Science Web, and Cochrane Central Controlled Trials Registry. Preprint servers such as BioRxiv, MedRxiv, ChemRxiv, and SSRN were also scanned. Study Selection and Data Extraction Full-length articles focusing on the association of obesity and outcome in COVID-19 patients were included. Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were used for study selection and data extraction. Our Population of interest were COVID-19 positive patients, obesity is our Intervention/Exposure point, Comparators are Non-obese vs obese patients The chief outcome of the study was the severity of the confirmed COVID-19 positive hospitalized patients in terms of admission to the intensive care unit (ICU) or the requirement of invasive mechanical ventilation/intubation with obesity. All-cause mortality in COVID-19 positive hospitalized patients with obesity was the secondary outcome of the study. Results In total, 3,140,413 patients from 167 studies were included in the study. Obesity was associated with an increased risk of severe disease (RR=1.52, 95% CI 1.41-1.63, p<0.001, I2 = 97%). Similarly, high mortality was observed in obese patients (RR=1.09, 95% CI 1.02-1.16, p=0.006, I2 = 97%). In multivariate meta-regression on severity, the covariate of the female gender, pulmonary disease, diabetes, older age, cardiovascular diseases, and hypertension was found to be significant and explained R2 = 40% of the between-study heterogeneity for severity. The aforementioned covariates were found to be significant for mortality as well, and these covariates collectively explained R2 = 50% of the between-study variability for mortality. Conclusions Our findings suggest that obesity is significantly associated with increased severity and higher mortality among COVID-19 patients. Therefore, the inclusion of obesity or its surrogate body mass index in prognostic scores and improvement of guidelines for patient care management is recommended.
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Affiliation(s)
- Romil Singh
- Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA, United States
| | - Sawai Singh Rathore
- Department of Internal Medicine, Dr. Sampurnanand Medical College, Jodhpur, India
| | - Hira Khan
- Department of Neurology, Allegheny General Hospital, Pittsburgh, PA, United States
| | - Smruti Karale
- Department of Internal Medicine, Government Medical College-Kolhapur, Kolhapur, India
| | - Yogesh Chawla
- Department of Immunology, Mayo Clinic, Rochester, MN, United States
| | - Kinza Iqbal
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Abhishek Bhurwal
- Department of Gastroenterology and Hepatology, Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ, United States
| | - Aysun Tekin
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Rochester, MN, United States
| | - Nirpeksh Jain
- Department of Emergency Medicine, Marshfield Clinic, Marshfield, WI, United States
| | - Ishita Mehra
- Department of Internal Medicine, North Alabama Medical Center, Florence, AL, United States
| | - Sohini Anand
- Department of Internal Medicine, Patliputra Medical College and Hospital, Dhanbad, India
| | - Sanjana Reddy
- Department of Internal Medicine, Gandhi Medical College, Secunderabad, India
| | - Nikhil Sharma
- Department of Nephrology, Mayo Clinic, Rochester, MI, United States
| | - Guneet Singh Sidhu
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MI, United States
| | | | - Vishwanath Pattan
- Department of Medicine, Division of Endocrinology and Metabolism, State University of New York (SUNY) Upstate Medical University, Syracuse, NY, United States
| | - Rahul Kashyap
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Rochester, MN, United States
| | - Vikas Bansal
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MI, United States
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Qiu D, Zhang D, Yu Z, Jiang Y, Zhu D. Bioinformatics approach reveals the critical role of the NOD-like receptor signaling pathway in COVID-19-associated multiple sclerosis syndrome. J Neural Transm (Vienna) 2022; 129:1031-1038. [PMID: 35648256 PMCID: PMC9156618 DOI: 10.1007/s00702-022-02518-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 05/14/2022] [Indexed: 01/19/2023]
Abstract
Multiple sclerosis (MS) is a kind of central nervous system (CNS) autoimmune disease, which mainly damages nerves, the brain, and the spinal cord. Recently, several clinical cases reported the relativity between Coronavirus Disease 2019 (COVID-19) and the development of MS, but the mechanism of how COVID-19 affects the occurrence of MS was still not clear. It is bioinformatics technology that we use to explore the potential association at the gene level. The genetic information related to the two diseases was collected from the DisGNET platform for functional protein network analysis and used STRING to identify the complete gene set. The protein–protein interaction (PPI) network was analyzed by STRING. Finally, in the GEO database, we selected peripheral blood mononuclear cell (PBMC) RNA sequencing data (GSE164805, GSE21942) from COVID-19 patients and MS patients to verify the potential cross mechanism between the two diseases. The similar gene set of immune or inflammation existed between the patients with COVID-19 and ones with MS, including L2RA, IFNG, IL1B, NLRP3, and TNF. Interaction network analysis among proteins revealed that IL1B, P2RX7, IFNB1, IFNB1, TNF, and CASP1 enhanced the network connectivity between the combined gene set of COVID-19 and MS associated with NOD-like receptor (NLR) signaling. The involvement of NLR signaling in both diseases was further confirmed by comparing peripheral blood monocyte samples from COVID-19 and MS patients. Activation of NLR signaling was found in both COVID-19 and MS. The PBMC samples analyses also indicated the involvement of the NLR signaling pathway. Taken together, our data analyses revealed that the NLR signaling pathway might play a critical role in the COVID-19-related MS.
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Affiliation(s)
- Dong Qiu
- The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Dongtai Zhang
- The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Zhenyang Yu
- The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Yiwen Jiang
- The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Dan Zhu
- The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
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Lasica R, Djukanovic L, Mrdovic I, Savic L, Ristic A, Zdravkovic M, Simic D, Krljanac G, Popovic D, Simeunovic D, Rajic D, Asanin M. Acute Coronary Syndrome in the COVID-19 Era-Differences and Dilemmas Compared to the Pre-COVID-19 Era. J Clin Med 2022; 11:3024. [PMID: 35683411 PMCID: PMC9181081 DOI: 10.3390/jcm11113024] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/06/2022] [Accepted: 05/17/2022] [Indexed: 01/08/2023] Open
Abstract
The COVID-19 pandemic has led to numerous negative implications for all aspects of society. Although COVID-19 is a predominant lung disease, in 10-30% of cases, it is associated with cardiovascular disease (CVD). The presence of myocardial injury in COVID-19 patients occurs with a frequency between 7-36%. There is growing evidence of the incidence of acute coronary syndrome (ACS) in COVID-19, both due to coronary artery thrombosis and insufficient oxygen supply to the myocardium in conditions of an increased need. The diagnosis and treatment of patients with COVID-19 and acute myocardial infarction (AMI) is a major challenge for physicians. Often the presence of mixed symptoms, due to the combined presence of COVID-19 and ACS, as well as possible other diseases, nonspecific changes in the electrocardiogram (ECG), and often elevated serum troponin (cTn), create dilemmas in diagnosing ACS in COVID-19. Given the often-high ischemic risk, as well as the risk of bleeding, in these patients and analyzing the benefit/risk ratio, the treatment of patients with AMI and COVID-19 is often associated with dilemmas and difficult decisions. Due to delays in the application of the therapeutic regimen, complications of AMI are more common, and the mortality rate is higher.
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Affiliation(s)
- Ratko Lasica
- Department of Cardiology, Emergency Center, Clinical Center of Serbia, 11000 Belgrade, Serbia; (L.D.); (I.M.); (L.S.); (G.K.); (D.R.); (M.A.)
| | - Lazar Djukanovic
- Department of Cardiology, Emergency Center, Clinical Center of Serbia, 11000 Belgrade, Serbia; (L.D.); (I.M.); (L.S.); (G.K.); (D.R.); (M.A.)
| | - Igor Mrdovic
- Department of Cardiology, Emergency Center, Clinical Center of Serbia, 11000 Belgrade, Serbia; (L.D.); (I.M.); (L.S.); (G.K.); (D.R.); (M.A.)
| | - Lidija Savic
- Department of Cardiology, Emergency Center, Clinical Center of Serbia, 11000 Belgrade, Serbia; (L.D.); (I.M.); (L.S.); (G.K.); (D.R.); (M.A.)
| | - Arsen Ristic
- Department of Cardiology, Clinical Center of Serbia, 11000 Belgrade, Serbia; (A.R.); (D.S.); (D.P.); (D.S.)
| | | | - Dragan Simic
- Department of Cardiology, Clinical Center of Serbia, 11000 Belgrade, Serbia; (A.R.); (D.S.); (D.P.); (D.S.)
| | - Gordana Krljanac
- Department of Cardiology, Emergency Center, Clinical Center of Serbia, 11000 Belgrade, Serbia; (L.D.); (I.M.); (L.S.); (G.K.); (D.R.); (M.A.)
| | - Dejana Popovic
- Department of Cardiology, Clinical Center of Serbia, 11000 Belgrade, Serbia; (A.R.); (D.S.); (D.P.); (D.S.)
| | - Dejan Simeunovic
- Department of Cardiology, Clinical Center of Serbia, 11000 Belgrade, Serbia; (A.R.); (D.S.); (D.P.); (D.S.)
| | - Dubravka Rajic
- Department of Cardiology, Emergency Center, Clinical Center of Serbia, 11000 Belgrade, Serbia; (L.D.); (I.M.); (L.S.); (G.K.); (D.R.); (M.A.)
| | - Milika Asanin
- Department of Cardiology, Emergency Center, Clinical Center of Serbia, 11000 Belgrade, Serbia; (L.D.); (I.M.); (L.S.); (G.K.); (D.R.); (M.A.)
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Almutairi MS, Assiri AM, Almohammed OA. Predictors of Poor Outcome among Critically Ill COVID-19 Patients: A Nationally Representative Sample of the Saudi Arabian Population. J Clin Med 2022; 11:jcm11102818. [PMID: 35628942 PMCID: PMC9147701 DOI: 10.3390/jcm11102818] [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: 04/02/2022] [Revised: 05/11/2022] [Accepted: 05/13/2022] [Indexed: 01/08/2023] Open
Abstract
The outbreak and continuing impact of COVID-19 have significantly increased the rates of hospitalization and admissions to intensive care units (ICU). This study evaluates clinical outcomes in critically ill patients and investigates variables tied to poor prognosis. A secondary database analysis was conducted to investigate the predictors of poor outcome among critically ill COVID-19 patients in Saudi Arabia. Multivariable logistic regression analysis was used to assess the association between various demographic characteristics, comorbidities, and COVID-19 symptoms and patients’ poor prognosis, as a composite outcome. A total of 2257 critically ill patients were identified (male (71.8%), and elderly (37.3%)). The mortality rate was 50.0%, and the composite poor outcome was 68.4%. The predictors of poor outcome were being elderly (OR = 4.79, 95%CI 3.19−7.18), obesity (OR = 1.43, 95%CI 1.1−1.87), having a severe or critical case at admission (OR = 6.46, 95%CI 2.34−17.8; OR = 22.3, 95%CI 11.0−45, respectively), and some signs and symptoms of COVID-19 such as shortness of breath, feeling fatigued or headache, respiratory rate ≥ 30/min, PaO2/FiO2 ratio < 300, and altered consciousness. In conclusion, identifying high-risk populations that are expected to have a poor prognosis based on their criteria upon admission helps policymakers and practitioners better triage patients when faced with limited healthcare resources.
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Affiliation(s)
- Masaad Saeed Almutairi
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim 51452, Saudi Arabia;
| | - Ahmed M. Assiri
- Health Volunteering Center, Ministry of Health, Riyadh 11176, Saudi Arabia;
| | - Omar A. Almohammed
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
- Pharmacoeconomics Research Unit, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
- Correspondence: ; Tel.: +966-555-10-4065
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Survival analysis of COVID-19 patients in Ethiopia: A hospital-based study. PLoS One 2022; 17:e0268280. [PMID: 35533178 PMCID: PMC9084518 DOI: 10.1371/journal.pone.0268280] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 04/26/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND COVID-19 is a global public health problem causing high mortality worldwide. This study aimed to assess time to death and predictors of mortality among patients hospitalized for COVID-19 in the Arsi zone treatment center. METHOD We performed a retrospective observational cohort study using medical records of laboratory-confirmed COVID-19 cases hospitalized at Bokoji Hospital COVID-19 treatment center from 1st July 2020 to 5th March 2021. We extracted data on the patients' sociodemographic and clinical characteristics from medical records of hospitalized patients retrospectively. We carried out Kaplan Meier and Cox regression analysis to estimate survival probability and investigate predictors of COVID-19 death 5% level of significance. The Adjusted Hazard Ratio (aHR) with 95% Confidence Interval (CI) was estimated and interpreted for predictors of time to death in the final cox model. RESULT A total of 422 COVID-19 patients treated were analyzed, of these more than one tenth (11.14%) deaths, with a mortality rate of 6.35 cases per 1000 person-days. The majority (87.2%) of deaths occurred within the first 14 days of admission, with a median time-to-death of nine (IQR: 8-12) days. We found patients that age between 31 and 45 years (aHR = 2.55; 95% CI: (1.03, 6.34), older than 46 years (aHR = 2.59 (1.27, 5.30), chronic obstructive pulmonary disease (aHR = 4.60, 95%CI: (2.37, 8.91), Chronic kidney disease (aHR = 5.58, 95%CI: (1.70, 18.37), HIV/AIDS (aHR = 3.66, 95%CI: (1.20, 11.10), admission to the Intensive care unit(aHR = 7.44, 95%CI: (1.82, 30.42), and being on intranasal oxygen care (aHR = 6.27, 95%CI: (2.75, 4.30) were independent risk factors increasing risk of death from COVID-19 disease than their counterparts. CONCLUSION The risk of dying due to COVID-19 disease was higher among patients with HIV/AIDS, chronic obstructive pulmonary disease, and chronic kidney diseases. We also found that older people, those admitted to ICU, and patients who received intranasal oxygen care had a higher risk of dying due to COVID-19 disease. Therefore, close monitoring hospitalized patients that are old aged and those with comorbidities after hospitalization is crucial within the first ten days of admission.
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Degarege A, Naveed Z, Kabayundo J, Brett-Major D. Heterogeneity and Risk of Bias in Studies Examining Risk Factors for Severe Illness and Death in COVID-19: A Systematic Review and Meta-Analysis. Pathogens 2022; 11:563. [PMID: 35631084 PMCID: PMC9147100 DOI: 10.3390/pathogens11050563] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/02/2022] [Accepted: 05/05/2022] [Indexed: 02/07/2023] Open
Abstract
This systematic review and meta-analysis synthesized the evidence on the impacts of demographics and comorbidities on the clinical outcomes of COVID-19, as well as the sources of the heterogeneity and publication bias of the relevant studies. Two authors independently searched the literature from PubMed, Embase, Cochrane library, and CINAHL on 18 May 2021; removed duplicates; screened the titles, abstracts, and full texts by using criteria; and extracted data from the eligible articles. The variations among the studies were examined by using Cochrane, Q.; I2, and meta-regression. Out of 11,975 articles that were obtained from the databases and screened, 559 studies were abstracted, and then, where appropriate, were analyzed by meta-analysis (n = 542). COVID-19-related severe illness, admission to the ICU, and death were significantly correlated with comorbidities, male sex, and an age older than 60 or 65 years, although high heterogeneity was present in the pooled estimates. The study design, the study country, the sample size, and the year of publication contributed to this. There was publication bias among the studies that compared the odds of COVID-19-related deaths, severe illness, and admission to the ICU on the basis of the comorbidity status. While an older age and chronic diseases were shown to increase the risk of developing severe illness, admission to the ICU, and death among the COVID-19 patients in our analysis, a marked heterogeneity was present when linking the specific risks with the outcomes.
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Affiliation(s)
- Abraham Degarege
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA; (Z.N.); (J.K.); (D.B.-M.)
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Leretter M, Vulcanescu D, Horhat F, Matichescu A, Rivis M, Rusu LC, Roi A, Racea R, Badea I, Dehelean C, Mocanu A, Horhat D. COVID‑19: Main findings after a year and half of unease and the proper scientific progress (Review). Exp Ther Med 2022; 23:424. [PMID: 35601072 PMCID: PMC9117952 DOI: 10.3892/etm.2022.11350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 11/17/2021] [Indexed: 11/21/2022] Open
Abstract
Since the emergence of the disease in late December 2019, numerous studies have been published to date regarding clinical, laboratory and treatment aspects associated with COVID-19. The present study attempts to compare and unify the clinical, para-clinical and therapeutic aspects that have come to light regarding coronavirus disease-19 (COVID 19), mainly in adults. Between April 2020 and September 2021, a comprehensive systematic literature review was performed, which we added to from our own medical experiences. The search was performed on the PubMed, Scopus and Google Scholar databases, comprising studies with analyzable data that were identified alongside studies and documents containing general scientific data. All published studies were written in English, and were from different countries. A 95% confidence interval (CI95) was also calculated for almost each study using the Wilson formula. When compared with preliminary reports between December 2019 and January 2020, the most frequent symptoms were still identified as being fever (68.6%; CI95: 67.5-69.7) and cough (72.7%; CI95: 71.7-73.8). Nevertheless, asymptomatic cases also increased (by 21.4%; CI95: 16.6-27.1). Severe and critical cases accounted for 10.4% (CI95: 9.6-11.1) of all cases. The mean fatality rate was found to be 4% (CI95: 3.6-4.5). The primary co-morbidity found was hypertension (28.9%; CI95: 27-30.8), followed by other underlying cardiovascular diseases (15.4%; CI95: 13.9-16.9) and diabetes (14.5%; CI95: 13.1-16.1). The majority of studies showed lower white blood cell numbers with neutropenia and lymphopenia, and lower platelet levels. The levels of the biomarkers C-reaction protein and erythrocyte sedimentation rate were positive in all studied cases alongside other lab tests, such as examining the D-dimer levels and those of other hepatic, cardiac and renal injury markers. The procalcitonin level was also found to be elevated in many cases, resulting in high usage of antibiotics (83.7%; CI95: 81.2-85.9). Approximately 31.6% (CI95: 29.1-34.1) of the patients required non-invasive ventilation, whereas 9.9% (CI95: 8.1-12.1) of the patients were intubated or placed on extracorporeal membrane oxygenation. The most used antivirals were ribavirin (67.3%; CI95: 63.4-70.9), oseltamivir (52.5%; CI95: 49.4-55.5) and Arbidol™ (34.5%; CI95: 32-37.1). General admittance to the intensive care unit was ~7.2% (CI95: 6.5-7.9) of patients.
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Affiliation(s)
- Marius Leretter
- Department of Prosthodontics, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, ‘Victor Babeș’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Dan Vulcanescu
- Department of Microbiology, Multidisciplinary Research Center on Antimicrobial Resistance (MULTI‑REZ), ‘Victor Babeș’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Florin Horhat
- Department of Microbiology, Multidisciplinary Research Center on Antimicrobial Resistance (MULTI‑REZ), ‘Victor Babeș’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Anamaria Matichescu
- Department of Preventive Dentistry, Community and Oral Health, ‘Victor Babeș’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Mircea Rivis
- Department of Anesthesiology and Oral Surgery, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, ‘Victor Babeș’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Laura-Cristina Rusu
- Department of Oral Pathology, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, ‘Victor Babeș’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Alexandra Roi
- Department of Oral Pathology, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, ‘Victor Babeș’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Robert Racea
- Department of Oral Pathology, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, ‘Victor Babeș’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ioana Badea
- Department of Oral Pathology, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, ‘Victor Babeș’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Cristina Dehelean
- Department of Toxicology, Research Center for Pharmaco‑Toxicological Evaluation, ‘Victor Babeș’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Alexandra Mocanu
- Department XIII, Discipline of Infectious Diseases, ‘Victor Babeș’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Delia Horhat
- Department of Otorhinolaryngology, ‘Victor Babeș’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
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Abstract
Cardiometabolic disease describes a combination of metabolic abnormalities that increases the risk of type 2 diabetes and cardiovascular diseases, including pathological changes such as insulin resistance, hyperglycemia, dyslipidemia, abdominal obesity, and hypertension, and environmental risk factors such as smoking, sedentary lifestyle, poor diet, and poverty. As the number of coronavirus disease 2019 (COVID-19) patients continues to rise, type 2 diabetes, cardiovascular disease, hypertension, and obesity, all components of, or sequelae of cardiometabolic disease, were identified among others as key risk factors associated with increased mortality in these patients. Numerous studies have been done to further elucidate this relationship between COVID-19 and cardiometabolic disease. Cardiometabolic disease is associated with both increased susceptibility to COVID-19 and worse outcomes of COVID-19, including intensive care, mechanical ventilation, and death. The proinflammatory state of cardiometabolic disease specifically obesity, has been associated with a worse prognosis in COVID-19 patients. There has been no evidence to suggest that antihypertensives and antidiabetic medications should be discontinued in COVID-19 patients but these patients should be closely monitored to ensure that their blood pressure and blood glucose levels are stable. Assessment of vaccination efficacy in cardiometabolic disease patients is also discussed.
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Affiliation(s)
- Chan W. Kim
- From the Cardiology Division, Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY
| | - Wilbert S. Aronow
- From the Cardiology Division, Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY
| | - William H. Frishman
- From the Cardiology Division, Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY
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Kastora S, Patel M, Carter B, Delibegovic M, Myint PK. Impact of diabetes on COVID-19 mortality and hospital outcomes from a global perspective: An umbrella systematic review and meta-analysis. Endocrinol Diabetes Metab 2022; 5:e00338. [PMID: 35441801 PMCID: PMC9094465 DOI: 10.1002/edm2.338] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/25/2022] [Accepted: 03/28/2022] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION To date, COVID-19 has claimed 4.9 million lives. Diabetes has been identified as an independent risk factor of serious outcomes in people with COVID-19 infection. Whether that holds true across world regions uniformly has not been previously assessed. METHODS This study offers the first umbrella systematic review and meta-analysis to analyse the collective and geographically stratified mortality, ICU admission, ventilation requirement, illness severity and discharge rate amongst patients with diabetes. Five databases (EMBASE, MEDLINE, CAB Abstracts, PsychInfo and Web of Science) and 3 additional sources (SSRN's eLibrary, Research Square and MedRxiv) were searched from inception to 30 August 2021. Prospective and retrospective cohort studies, reporting the association between diabetes and one or more COVID-19 hospitalization outcomes, were included. This meta-analysis was registered on PROSPERO, CRD42021278579. Abbreviated MeSH terms used for search were as follows: (Diabetes) AND (2019 Novel Coronavirus Disease), adapted per database requirements. Exclusion criteria exclusion criteria were as follows: (1) none of the primary or secondary outcomes of meta-analysis reported, (2) no confirmed COVID-19 infection (laboratory or clinical) and (3) no unexposed population (solely patients with diabetes included). Quality of the included studies were assessed using the Newcastle-Ottawa Scale (NOS) whilst quality of evidence by the GRADE framework. Studies that were clinically homogeneous were pooled. Summative data and heterogeneity were generated by the Cochrane platform RevMan (V. 5.4). RESULTS Overall, 158 observational studies were included, with a total of 270,212 of participants, median age 59 [53-65 IQR] of who 56.5% were male. A total of 22 studies originated from EU, 90 from Far East, 16 from Middle East and 30 from America. Data were synthesized with mixed heterogeneity across outcomes. Pooled results highlighted those patients with diabetes were at a higher risk of COVID-19-related mortality, OR 1.87 [95%CI 1.61, 2.17]. ICU admissions increased across all studies for patients with diabetes, OR 1.59 [95%CI 1.15, 2.18], a result that was mainly skewed by Far East-originating studies, OR 1.94 [95%CI 1.51, 2.49]. Ventilation requirements were also increased amongst patients with diabetes worldwide, OR 1.44 [95%CI 1.20, 1.73] as well as their presentation with severe or critical condition, OR 2.88 [95%CI 2.29, 3.63]. HbA1C levels under <70 mmol and metformin use constituted protective factors in view of COVID-19 mortality, whilst the inverse was true for concurrent insulin use. CONCLUSIONS Whilst diabetes constitutes a poor prognosticator for various COVID-19 infection outcomes, variability across world regions is significant and may skew overall trends.
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Affiliation(s)
- Stavroula Kastora
- School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Manisha Patel
- School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Ben Carter
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Mirela Delibegovic
- Aberdeen Cardiovascular and Diabetes Centre (ACDC), Institute of Medical Sciences (IMS), University of Aberdeen, Aberdeen, UK
| | - Phyo Kyaw Myint
- Aberdeen Cardiovascular and Diabetes Centre (ACDC), Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
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Guaní-Guerra E, Torres-Murillo B, Muñoz-Corona C, Rodríguez-Jiménez JC, Macías AE, Scavo-Montes DA, Alvarez JA. Diagnostic Accuracy of the RDW for Predicting Death in COVID-19. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58050613. [PMID: 35630030 PMCID: PMC9144906 DOI: 10.3390/medicina58050613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/15/2022] [Accepted: 04/17/2022] [Indexed: 01/10/2023]
Abstract
Background and Objectives: An association between high red blood cell distribution width (RDW) and mortality has been found in several diseases, including infection and sepsis. Some studies have aimed at determining the association of elevated RDW with adverse prognosis in COVID-19, but its usefulness has not been well established. The objective of this study was to determine the accuracy of the RDW, measured at hospital admission and discharge, for predicting death in patients with COVID-19. Materials andMethods: An observational, retrospective, longitudinal, and analytical study was conducted in two different COVID-19 reference centers in the state of Guanajuato, Mexico. A total of 323 patients hospitalized by COVID-19 were included. Results: We found higher RDW levels at the time of hospital admission in the non-survivors group compared to levels in survivors (median = 13.6 vs. 13.0, p < 0.001). Final RDW levels were even higher in the deceased group when compared with those of survivors (median = 14.6 [IQR, 12.67−15.6] vs. 12.9 [IQR, 12.2−13.5], p < 0.001). For patients who died, an RDW > 14.5% was more common at the time of death than for patients who survived at the time of discharge (81 vs. 13 patients, p < 0.001; RR = 2.3, 95% CI 1.89−2.81). Conclusions: The RDW is an accessible and economical parameter that, together with other characteristics of the presentation and evolution of patients with COVID-19, can be helpful in determining the prognosis. An RDW that increases during hospitalization could be a more important mortality predictor than the RDW at hospital admission.
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Affiliation(s)
- Eduardo Guaní-Guerra
- Department of Research, Hospital Regional de Alta Especialidad del Bajío, San Carlos La Roncha, León P.C. 37660, Guanajuato, Mexico;
- Department of Medicine, University of Guanajuato, San Carlos La Roncha, León P.C. 37660, Guanajuato, Mexico;
| | - Brenda Torres-Murillo
- Department of Medicine, University of Guanajuato, San Carlos La Roncha, León P.C. 37660, Guanajuato, Mexico;
| | - Carolina Muñoz-Corona
- General Directorate of Quality and Health Education, Ministry of Health, Mexico City P.C. 11410, Mexico;
| | - José Carlos Rodríguez-Jiménez
- Department of Internal Medicine, Hospital Regional de Alta Especialidad del Bajío, San Carlos La Roncha, León P.C. 37660, Guanajuato, Mexico;
| | - Alejandro E. Macías
- Microbiology Laboratory, Department of Medicine and Nutrition, University of Guanajuato, León P.C. 37000, Guanajuato, Mexico;
| | | | - Jose A. Alvarez
- Department of Research, Hospital Regional de Alta Especialidad del Bajío, San Carlos La Roncha, León P.C. 37660, Guanajuato, Mexico;
- Microbiology Laboratory, Department of Medicine and Nutrition, University of Guanajuato, León P.C. 37000, Guanajuato, Mexico;
- Correspondence:
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Raeisi T, Mozaffari H, Sepehri N, Darand M, Razi B, Garousi N, Alizadeh M, Alizadeh S. The negative impact of obesity on the occurrence and prognosis of the 2019 novel coronavirus (COVID-19) disease: a systematic review and meta-analysis. Eat Weight Disord 2022; 27:893-911. [PMID: 34247342 PMCID: PMC8272688 DOI: 10.1007/s40519-021-01269-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 07/07/2021] [Indexed: 02/07/2023] Open
Abstract
PURPOSE The 2019 novel coronavirus (COVID-19) is an emerging pandemic, with a disease course varying from asymptomatic infection to critical disease resulting to death. Recognition of prognostic factors is essential because of its growing prevalence and high clinical costs. This meta-analysis aimed to evaluate the global prevalence of obesity in COVID-19 patients and to investigate whether obesity is a risk factor for the COVID-19, COVID-19 severity, and its poor clinical outcomes including hospitalization, intensive care unit (ICU) admission, need for mechanical ventilation, and mortality. METHODS The study protocol was registered in PROSPERO (CRD42020203386). A systematic search of Scopus, Medline, and Web of Sciences was conducted from 31 December 2019 to 1 June 2020 to find pertinent studies. After selection, 54 studies from 10 different countries were included in the quantitative analyses. Pooled odds ratios (OR) with 95% confidence intervals (CIs) were calculated to assess the associations. RESULTS The prevalence of obesity was 33% (95% CI 30.0%-35.0%) among patients with COVID-19. Obesity was significantly associated with susceptibility to COVID-19 (OR = 2.42, 95% CI 1.58-3.70; moderate certainty) and COVID-19 severity (OR = 1.62, 95% CI 1.48-1.76; low certainty). Furthermore, obesity was a significant risk factor for hospitalization (OR = 1.75, 95% CI 1.47-2.09; very low certainty), mechanical ventilation (OR = 2.24, 95% CI 1.70-2.94; low certainty), intensive care unit (ICU) admission (OR = 1.75, 95% CI 1.38-2.22; low certainty), and death (OR = 1.23, 95% CI 1.06-1.41; low certainty) in COVID-19 patients. In the subgroup analyses, these associations were supported by the majority of subgroups. CONCLUSION Obesity is associated with COVID-19, need for hospitalization, mechanical ventilation, ICU admission, and death due to COVID-19. LEVEL OF EVIDENCE Level I, systematic reviews and meta-analyses.
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Affiliation(s)
- Tahereh Raeisi
- Department of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Hadis Mozaffari
- Faculty of Land and Food Systems, University of British Columbia, Vancouver, Canada
| | | | - Mina Darand
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahman Razi
- Department of Hematology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Nazila Garousi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Alizadeh
- Department of Medical Surgical Nursing, Nasibeh Nursing and Midwifery School, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shahab Alizadeh
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
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50
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Lee JY, Nam BH, Kim M, Hwang J, Kim JY, Hyun M, Kim HA, Cho CH. A risk scoring system to predict progression to severe pneumonia in patients with Covid-19. Sci Rep 2022; 12:5390. [PMID: 35354828 PMCID: PMC8966605 DOI: 10.1038/s41598-022-07610-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 04/29/2021] [Indexed: 01/10/2023] Open
Abstract
Rapid outbreak of coronavirus disease 2019 (Covid-19) raised major concern regarding medical resource constraints. We constructed and validated a scoring system for early prediction of progression to severe pneumonia in patients with Covid-19. A total of 561 patients from a Covid-19 designated hospital in Daegu, South Korea were randomly divided into two cohorts: development cohort (N = 421) and validation cohort (N = 140). We used multivariate logistic regression to identify four independent risk predictors for progression to severe pneumonia and constructed a risk scoring system by giving each factor a number of scores corresponding to its regression coefficient. We calculated risk scores for each patient and defined two groups: low risk (0 to 8 points) and high risk (9 to 20 points). In the development cohort, the sensitivity and specificity were 83.8% and 78.9%. In the validation cohort, the sensitivity and specificity were 70.8% and 79.3%, respectively. The C-statistics was 0.884 (95% CI 0.833–0.934) in the development cohort and 0.828 (95% CI 0.733–0.923) in the validation cohort. This risk scoring system is useful to identify high-risk group for progression to severe pneumonia in Covid-19 patients and can prevent unnecessary overuse of medical care in limited-resource settings.
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Affiliation(s)
- Ji Yeon Lee
- Department of Infectious Diseases, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Republic of Korea.,Covid-19 Task Force Team of Keimyung University Daegu Dongsan Hospital, Daegu, Republic of Korea
| | - Byung-Ho Nam
- HERINGS, Institute of Advanced Clinical and Biomedical Research, Seoul, Republic of Korea
| | - Mhinjine Kim
- Covid-19 Task Force Team of Keimyung University Daegu Dongsan Hospital, Daegu, Republic of Korea.,Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, USA
| | - Jongmin Hwang
- Department of Cardiology, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Jin Young Kim
- Department of Radiology, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Miri Hyun
- Department of Infectious Diseases, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Republic of Korea.,Covid-19 Task Force Team of Keimyung University Daegu Dongsan Hospital, Daegu, Republic of Korea
| | - Hyun Ah Kim
- Department of Infectious Diseases, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Republic of Korea.,Covid-19 Task Force Team of Keimyung University Daegu Dongsan Hospital, Daegu, Republic of Korea
| | - Chi-Heum Cho
- Covid-19 Task Force Team of Keimyung University Daegu Dongsan Hospital, Daegu, Republic of Korea. .,Department of Obstetrics and Gynecology, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, 1035, Dalgubeol-daero, Dalseo-gu, Daegu, 42601, Republic of Korea.
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