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Shojaee A, Rafiee R, Hosseinzadeh M, Saboori M. Prognostic value of interleukin-6 serum levels in hospitalized COVID-19 patients: A case-control study in Iran. Health Sci Rep 2024; 7:e2232. [PMID: 38978767 PMCID: PMC11228099 DOI: 10.1002/hsr2.2232] [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: 12/29/2023] [Revised: 06/15/2024] [Accepted: 06/24/2024] [Indexed: 07/10/2024] Open
Abstract
Introduction The coronavirus pandemic (COVID-19) is an infectious disease with a high mortality rate that is challenging to treat. Cytokine storm is a crucial factor leading to acute respiratory distress syndrome in COVID-19 patients. Identifying factors that predict the severity of the disease may be primarily prognostic to guide drug therapy. The objective of this study was to investigate the prognostic role of interleukin 6 (IL-6) in the hospitalized patients infected with COVID-19. Methods This case-control study was conducted from October 2019 to April 2020 at Shahid Faqihi hospital in Iran. Fifty hospitalized COVID-19 patients and 50 healthy individuals were included while controlling demographics and comorbidities. IL-6 serum levels were measured and compared based on demographic characteristics (age, sex) and comorbidities in the case and control groups. Spearman rank correlation coefficient was also used to analyze the correlations between IL-6 levels and lung involvement in COVID-19 patients. Moreover, some laboratory parameters were compared based on the percentage of lung involvement. Results The level of IL-6 in the case group was significantly higher than the control (p ˂ 0.001). We observed a positive and significant correlation between the level of IL-6 and the severity of lung involvement (r = 0.0.79, p < 0.01). The median level of IL-6 in patients who showed more than 75% lung involvement was 573 (IQR = 320-850). Conclusion Available evidence suggests that high levels of IL-6 are associated with the severity of COVID-19. According to the results, it could be proposed that inhibition of IL-6 might be a target for therapeutic managements to reduce mortality in the patients with COVID-19.
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Affiliation(s)
- Asiyeh Shojaee
- Department of Basic Sciences, Faculty of Veterinary Medicine Amol University of Special Modern Technologies Amol Iran
| | - Reza Rafiee
- Department of Pathology Shiraz University of Medical Sciences Shiraz Iran
| | | | - Mohamad Saboori
- Department of Pathology Shiraz University of Medical Sciences Shiraz Iran
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Thakur I, Chatterjee A, Ghosh AK, Chatterjee SS, Saha S, Panja T, Dan U. A comparative study between first three waves of COVID-19 pandemic with respect to risk factors, initial clinic-demographic profile, severity and outcome. J Family Med Prim Care 2024; 13:2455-2461. [PMID: 39027859 PMCID: PMC11254042 DOI: 10.4103/jfmpc.jfmpc_1884_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/30/2023] [Accepted: 02/04/2024] [Indexed: 07/20/2024] Open
Abstract
Introduction During the 2 years and 9 months from March 2020 to December 2022, the SARS-CoV-2 virus raged across the country. Cases occurred in three particular time clusters recognised by World Health Organisation as coronavirus disease 2019 (COVID-19) waves. In this study, we compare the clinical parameters of adult non-obstetric COVID-19 patients admitted to our rural tertiary care hospital during the three distinct waves of the pandemic. Materials and Methods Retrospective chart analysis of 272, 853 and 97 patients admitted with SARS-CoV-2 infection to the only rural medical tertiary care centre in the Sunderbans of West Bengal in the first, second and third waves, respectively, was done after obtaining ethical and scientific clearance. Clinical [vital parameters, oxygen requirement, mental status, risk factor assessment, duration of hospital stay, modified-emergency warning score (m-EWS), quick Sequential Organ Failure Assessment (qSOFA), confusion, uraemia, respiratory rate, blood pressure, age ≥ 65 years (CURB65)], epidemiological variables (age, gender, and vaccination status), laboratory parameters and in-hospital outcome were recorded and analysed statistically. Results Statistically significant (P < 0.05) m-EWS and qSOFA scores were recorded during the second wave of the pandemic. The second wave also recorded the highest mortality (14.89%) compared to the first (12.87%) and third (11.96%) waves, though this was not statistically significant. The highest duration of hospital stay was recorded in the first wave of the pandemic (mean = 9.99 days, P < 0.01). The difference in mortality rates between patients with and without co-morbidity (P < 0.05) was observed during Wave-1, across any pandemic wave, and overall but not in Wave-2 and Wave-3. Conclusion The second wave of the COVID-19 pandemic was the most severe in comparison with the other two waves, while the outcome was poorer in those with co-morbidities, especially in the first wave.
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Affiliation(s)
- Indranil Thakur
- General Medicine, DHGMCH, Diamond Harbour, West Bengal, India
| | - Arabinda Chatterjee
- Department of Forensic Medicine and Toxicology, JGMCH, Jhargram, West Bengal, India (Formerly Department of Forensic Medicine and Toxicology, DHGMCH, Diamond Harbour, West Bengal, India)
| | - Ashis Kumar Ghosh
- Department of Otorhinolaryngology, DHGMCH, Diamond Harbour, West Bengal, India
| | - Shiv Sekhar Chatterjee
- Department of Microbiology, AIIMS, Kalyani, West Bengal, India (Formerly Department of Microbiology, DHGMCH, Diamond Harbour, West Bengal, India)
| | - Santanu Saha
- General Medicine, DHGMCH, Diamond Harbour, West Bengal, India
| | | | - Utpal Dan
- Principal and Anatomy, DHGMCH, Diamond Harbour, West Bengal, India
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Grunnill M, Arino J, McCarthy Z, Bragazzi NL, Coudeville L, Thommes EW, Amiche A, Ghasemi A, Bourouiba L, Tofighi M, Asgary A, Baky-Haskuee M, Wu J. Modelling disease mitigation at mass gatherings: A case study of COVID-19 at the 2022 FIFA World Cup. PLoS Comput Biol 2024; 20:e1011018. [PMID: 38236838 PMCID: PMC10796029 DOI: 10.1371/journal.pcbi.1011018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 11/20/2023] [Indexed: 01/22/2024] Open
Abstract
The 2022 FIFA World Cup was the first major multi-continental sporting Mass Gathering Event (MGE) of the post COVID-19 era to allow foreign spectators. Such large-scale MGEs can potentially lead to outbreaks of infectious disease and contribute to the global dissemination of such pathogens. Here we adapt previous work and create a generalisable model framework for assessing the use of disease control strategies at such events, in terms of reducing infections and hospitalisations. This framework utilises a combination of meta-populations based on clusters of people and their vaccination status, Ordinary Differential Equation integration between fixed time events, and Latin Hypercube sampling. We use the FIFA 2022 World Cup as a case study for this framework (modelling each match as independent 7 day MGEs). Pre-travel screenings of visitors were found to have little effect in reducing COVID-19 infections and hospitalisations. With pre-match screenings of spectators and match staff being more effective. Rapid Antigen (RA) screenings 0.5 days before match day performed similarly to RT-PCR screenings 1.5 days before match day. Combinations of pre-travel and pre-match testing led to improvements. However, a policy of ensuring that all visitors had a COVID-19 vaccination (second or booster dose) within a few months before departure proved to be much more efficacious. The State of Qatar abandoned all COVID-19 related travel testing and vaccination requirements over the period of the World Cup. Our work suggests that the State of Qatar may have been correct in abandoning the pre-travel testing of visitors. However, there was a spike in COVID-19 cases and hospitalisations within Qatar over the World Cup. Given our findings and the spike in cases, we suggest a policy requiring visitors to have had a recent COVID-19 vaccination should have been in place to reduce cases and hospitalisations.
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Affiliation(s)
- Martin Grunnill
- Laboratory of Industrial and Applied Mathematics (LIAM), York University, Toronto, Ontario, Canada
| | - Julien Arino
- Department of Mathematics, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Zachary McCarthy
- Laboratory of Industrial and Applied Mathematics (LIAM), York University, Toronto, Ontario, Canada
| | - Nicola Luigi Bragazzi
- Laboratory of Industrial and Applied Mathematics (LIAM), York University, Toronto, Ontario, Canada
| | | | - Edward W. Thommes
- Modeling, Epidemiology and Data Science (MEDS), Sanofi, Lyon, France
- Department of Mathematics and Statistics, University of Guelph, Guelph, Ontario, Canada
| | | | - Abbas Ghasemi
- The Fluid Dynamics of Disease Transmission Laboratory, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
- Mechanical and Industrial Engineering Department, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Lydia Bourouiba
- The Fluid Dynamics of Disease Transmission Laboratory, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | - Mohammadali Tofighi
- Dahdaleh Institute for Global Health Research, York University, Toronto, Canada
- Disaster & Emergency Management, York University, Toronto, Canada
| | - Ali Asgary
- Disaster & Emergency Management, York University, Toronto, Canada
- York Emergency Mitigation, Response, Engagement and Governance Institute, York University, Toronto, Ontario, Canada
| | | | - Jianhong Wu
- Laboratory of Industrial and Applied Mathematics (LIAM), York University, Toronto, Ontario, Canada
- York Emergency Mitigation, Response, Engagement and Governance Institute, York University, Toronto, Ontario, Canada
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Clinical Characteristics and Outcomes of Patients with Acute Respiratory Failure Due to SARS-CoV-2 Interstitial Pneumonia Treated with CPAP in a Medical Intermediate Care Setting: A Retrospective Observational Study on Comparison of Four Waves. J Clin Med 2023; 12:jcm12041562. [PMID: 36836094 PMCID: PMC9959438 DOI: 10.3390/jcm12041562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND In COVID-19 patients non-invasive-positive-pressure-ventilation (NIPPV) has held a challenging role to reduce mortality and the need for invasive mechanical ventilation (IMV). The aim of this study was to compare the characteristics of patients admitted to a Medical Intermediate Care Unit for acute respiratory failure due to SARS-CoV-2 pneumonia throughout four pandemic waves. METHODS The clinical data of 300 COVID-19 patients treated with continuous positive airway pressure (CPAP) were retrospectively analysed, from March-2020 to April-2022. RESULTS Non-survivors were older and more comorbid, whereas patients transferred to ICU were younger and had fewer pathologies. Patients were older (from 65 (29-91) years in I wave to 77 (32-94) in IV, p < 0.001) and with more comorbidities (from Charlson's Comorbidity Index = 3 (0-12) in I to 6 (1-12) in IV, p < 0.001). No statistical difference was found for in-hospital mortality (33.0%, 35.8%, 29.6% and 45.9% in I, II, III and IV, p = 0.216), although ICU-transfers rate decreased from 22.0% to 1.4%. CONCLUSIONS COVID-19 patients have become progressively older and with more comorbidities even in critical care area; from risk class analyses by age and comorbidity burden, in-hospital mortality rates remain high and are thus consistent over four waves while ICU-transfers have significantly reduced. Epidemiological changes need to be considered to improve the appropriateness of care.
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Ticinesi A, Parise A, Nouvenne A, Cerundolo N, Prati B, Guerra A, Tuttolomondo D, Gaibazzi N, Meschi T. Insights from comparison of the clinical presentation and outcomes of patients hospitalized with COVID-19 in an Italian internal medicine ward during first and third wave. Front Med (Lausanne) 2023; 10:1112728. [PMID: 36817786 PMCID: PMC9928966 DOI: 10.3389/fmed.2023.1112728] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/11/2023] [Indexed: 02/04/2023] Open
Abstract
Background The reasons of variability of clinical presentation of coronavirus disease-19 (COVID-19) across different pandemic waves are not fully understood, and may include individual risk profile, SARS-CoV-2 lineage and seasonal variations of viral spread. The objective of this retrospective study was to compare the characteristics and outcomes of patients admitted with confirmed coronavirus disease-19 (COVID-19) in the same season during the first (March 2020) and the third pandemic wave (March 2021, dominance of SARS-CoV-2 B.1.1.7 lineage) in an internal medicine ward of a large teaching hospital in Italy. Materials and methods Data of 769 unvaccinated patients (399 from the first and 370 from the third wave) were collected from clinical records, including symptom type and duration, extension of lung abnormalities on chest computed tomography (CT) and PaO2/FiO2 ratio on admission arterial blood gas analysis. Results Third wave patients were in average younger (median 65, interquartile range [IQR] 55-75, vs. 72, IQR 61-81 years old, p < 0.001), with less comorbidities and better pulmonary (CT visual score median 25, IQR 15-40, vs. 30, IQR 15-50, age- and sex-adjusted p = 0.017) and respiratory involvement (PaO2/FiO2 median 288, IQR 237-338, vs. 233, IQR 121-326 mmHg, age- and sex-adjusted p < 0.001) than first wave patients. Hospital mortality was lower (19% vs. 36%, p < 0.001), but not for subjects over 75 years old (46 vs. 49%). Age, number of chronic illnesses, PCT levels, CT visual score [Odds Ratio (OR) 1.022, 95% confidence interval (CI) 1.009-1.036, p < 0.001] and PaO2/FiO2 (OR 0.991, 95% CI 0.988-0.994, p < 0.001), but not the pandemic wave, were associated with mortality on stepwise multivariate logistic regression analysis. Conclusion Despite the higher virulence of B.1.1.7 lineage, we detected milder clinical presentation and improved mortality in patients hospitalized during the third COVID-19 wave, with involvement of younger subjects. The reasons of this discrepancy are unclear, but could involve the population effect of vaccination campaigns, that were being conducted primarily in older frail subjects during the third wave.
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Affiliation(s)
- Andrea Ticinesi
- Department of Medicine and Surgery, University of Parma, Parma, Italy,Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy,*Correspondence: Andrea Ticinesi, ✉
| | - Alberto Parise
- Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Antonio Nouvenne
- Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Nicoletta Cerundolo
- Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Beatrice Prati
- Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Angela Guerra
- Department of Medicine and Surgery, University of Parma, Parma, Italy,Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Domenico Tuttolomondo
- Department of Medicine and Surgery, University of Parma, Parma, Italy,Cardiology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Nicola Gaibazzi
- Cardiology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Tiziana Meschi
- Department of Medicine and Surgery, University of Parma, Parma, Italy,Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
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Kyu K, Ko TK, Lwin ZM, Soe MK, Maw KW, Thant AM, Shin K, Kyaw Myint M. Clinical Profile of COVID-19 Patients Admitted at a Private Hospital During Three Surges in Mandalay, Myanmar. Cureus 2023; 15:e35167. [PMID: 36960252 PMCID: PMC10030156 DOI: 10.7759/cureus.35167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2023] [Indexed: 02/21/2023] Open
Abstract
Introduction During the coronavirus disease 2019 (COVID-19) pandemic, private hospitals in Mandalay started to manage COVID-19 infections according to national treatment guidelines since February 2021. Variations of clinical characteristics and their outcomes in different surges could be evaluated in the private hospital. This study aimed to assess the clinical profile and outcomes of COVID-19 patients admitted at a private hospital during three surges in Mandalay. Methods This study is a retrospective record review of the case series of COVID-19 patients admitted at City Hospital, Mandalay. The study was conducted from January to December 2022. All of the hospital records of COVID-19 patients admitted during the second wave from February 2020 to 26 May 2021, the third wave from 27 May 2021 to 27 January 2022, and the fourth wave from 28 January to April 2022 were included in the study. Results A total of 1606 admitted cases were included in the study. The mean with standard deviation (SD) of age was 55.7±18.5, and males were 778 (48.4%). The mean duration of hospital stay in days was 10.8±5.94, 10.6±6.11, and 7.3±2.88 in second, third, and fourth waves, respectively. The mean duration of hospital stay was shortened in the fourth wave. Comorbid conditions with hypertension and/or diabetes diseases were mostly observed in three waves of COVID-19 infection. Fever was the most presented symptom in three waves. Cough, sore throat, and rhinorrhea were observed more in the fourth wave compared with previous waves. Complication with pneumonia (71.3%), liver dysfunction (21.0%), acute respiratory distress syndrome (10.0%), thrombocytopenia (6.2%), acute kidney injury (5.5%), bleeding (3.9%), and pulmonary embolism (2.9%) were investigated. Antiviral treatment such as remdesivir or molnupiravir was used more in the patients of third and fourth waves than those of the second wave. Oxygen therapy (59.9%), prone position (35.5%), non-invasive ventilation (9.5%), invasive ventilation (0.5%), inotropes (4.6%), and renal replacement therapy (1.1%) were recorded in serious cases. Only 7.9% and 9.4% died in the hospital in second and third waves. No mortality was observed in the fourth wave. Conclusions The study recommended that COVID-19 patients with comorbid conditions of hypertension or diabetes and ages 65 and older should be taken with intensive care support at the hospital. This study also concluded that a private hospital in Mandalay could tackle with COVID-19 severe cases in line with national treatment guidelines since the second wave and could provide better management in the fourth wave. Antiviral treatment should be used in severe COVID-19 cases for further emergency management. In conclusion, private hospital involvement in the COVID-19 pandemic is supportive of the healthcare provision in Myanmar in an emergency situation.
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Affiliation(s)
- Kyu Kyu
- Internal Medicine, City Hospital, Mandalay, MMR
| | - Tin Ko Ko
- Internal Medicine, City Hospital, Mandalay, MMR
| | | | - May Kyi Soe
- Internal Medicine, City Hospital, Mandalay, MMR
| | | | | | - Kyi Shin
- Hospital Medicine, City Hospital, Mandalay, MMR
| | - Moe Kyaw Myint
- Health Systems Research, Department of Medical Research, Myanmar Health Ministry, Pyin Oo Lwin, MMR
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Luna-Vilchez M, Mejia JR, Ortiz-Benique ZN, Santiago-Abal M, Taype-Rondan A. Medication use in pediatric patients with covid-19 hospitalized in a referral hospital in Lima, Peru, 2020 - 2022. Rev Peru Med Exp Salud Publica 2023; 40:73-78. [PMID: 37377240 PMCID: PMC10959514 DOI: 10.17843/rpmesp.2023.401.12326] [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: 11/03/2022] [Accepted: 03/29/2023] [Indexed: 06/29/2023] Open
Abstract
Motivation for the study. Therapeutic guidelines for COVID-19 in children changed constantly during the pandemic. In Peru, the variation of the treatment during the different waves of the pandemic has not been studied. Main findings. During the third wave, there was a greater number of patients with COVID-19; however, these patients had less severe symptoms. The use of ceftriaxone and azithromycin was less frequent during the third wave. The use of immunoglobulin was only found in patients with pediatric inflammatory multisystemic syndrome. Implications. Determining the patterns of medication use during the COVID-19 pandemic in the pediatric population will allow us to evaluate how the therapeutic decision-making process evolved in this population.
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Affiliation(s)
- Medalit Luna-Vilchez
- Instituto Nacional de Salud del Niño San Borja, Lima, Peru.Instituto Nacional de Salud del Niño San BorjaLimaPeru
| | - Jhonatan R. Mejia
- Universidad Científica del Sur, Lima, Peru.Universidad Científica del SurUniversidad Científica del SurLimaPeru
- EviSalud - Evidencias en Salud, Lima, Peru.EviSalud - Evidencias en SaludLimaPeru
| | - Zhamanda N. Ortiz-Benique
- Faculty of medicine, Universidad Nacional de San Agustín de Arequipa, Arequipa, Peru.Universidad Nacional de San AgustínFaculty of medicineUniversidad Nacional de San Agustín de ArequipaArequipaPeru
| | - Mitsi Santiago-Abal
- Instituto Nacional de Salud del Niño San Borja, Lima, Peru.Instituto Nacional de Salud del Niño San BorjaLimaPeru
| | - Alvaro Taype-Rondan
- EviSalud - Evidencias en Salud, Lima, Peru.EviSalud - Evidencias en SaludLimaPeru
- Research Unit for Health Evidence Generation and Synthesis, Universidad San Ignacio de Loyola, Lima, Peru.Universidad San Ignacio de LoyolaResearch Unit for Health Evidence Generation and SynthesisUniversidad San Ignacio de LoyolaLimaPeru
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