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Seif M, Sharafi M, Ghaem H, Kasraei F. Factors associated with survival of Iranian patients with COVID-19: comparison of Cox regression and mixture cure model. Trop Dis Travel Med Vaccines 2022; 8:4. [PMID: 35227332 PMCID: PMC8885138 DOI: 10.1186/s40794-022-00162-w] [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: 05/25/2021] [Accepted: 01/02/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUNDS SARS-CoV-2 is almost the most problematic virus of this century. It has caused extensive damage to various economic, social, and health aspects worldwide. Nowadays, coronavirus disease 2019 (COVID-19) is the most dangerous threat to human survival. Therefore, this study aimed to investigate factors associated with the survival of Iranian patients with SARS-CoV-2. METHODS This retrospective hospital-based cohort study was conducted on 870 COVID-19 patients with blood oxygen levels of less than 93%. Cox regression and mixture cure model were used and compared to analyze the patients' survival. It is worth noting that no similar study has been previously conducted using mixture cure regression to model the survival of Iranian patients with COVID-19. RESULT The cure rate and median survival time were respectively 81.5% and 20 days. Cox regression identified that respiratory distress, history of heart disease and hypertension, and older age were shown to increase the hazard. The Incidence and Latency parts of the mixture cure model respectively revealed that respiratory distress, history of hypertension, diabetes and cardiovascular diseases (CVDs), cough, fever, and older age reduced the cure odds; also, respiratory distress, history of hypertension, and CVDs, and older age increased the hazard. CONCLUSION The findings of our study revealed that priority should be given to older patients with a history of diabetes, hypertension, and CVDs in receiving intensive care and immunization. Also, the lower cure odds for patients with respiratory distress, fever, and cough favor early hospitalization before the appearance of severe symptoms.
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Affiliation(s)
- Mozhgan Seif
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehdi Sharafi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Haleh Ghaem
- Research Center for Health Sciences, Institute of Health, Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farzaneh Kasraei
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
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Lekpa FK, Ngahane BHM, Njonnou SRS, Fouda H, Halle MP, Njankouo YM, Dzudie A, Choukem SP, Luma HN. Hydroxychloroquine and COVID-19: can we learn from the use of rituximab in systemic lupus erythematosus? Pan Afr Med J 2021; 38:372. [PMID: 34367451 PMCID: PMC8308936 DOI: 10.11604/pamj.2021.38.372.29087] [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: 03/29/2021] [Accepted: 04/08/2021] [Indexed: 11/11/2022] Open
Abstract
Rituximab (RTX), a chimeric monoclonal anti-CD20 antibody has become part of the standard therapy for patients with CD20-expressing B-cell lymphoma and rheumatoid arthritis. After encouraging results with open studies in systemic lupus erythematosus (SLE), RTX has not shown its effectiveness in randomized controlled trials. However, its efficacy has been validated in renal, hematological, and neuropsychiatric disorders. Understanding the history of RTX in SLE would be instructive in the hydroxychloroquine (HCQ) saga in COVID-19. Three steps would be necessary and sufficient before definitively closing the debate: 1) determine the effective and safe dose of HCQ, as well as the minimum duration of treatment in COVID-19; 2) define the profile of patients in whom HCQ would be more likely to be effective (especially in asymptomatic patients and/or at the onset of the first signs of the disease) and 3) conduct one or more multicentre RCT to evaluate the efficacy and safety of HCQ in COVID-19 in SSA.
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Affiliation(s)
- Fernando Kemta Lekpa
- Internal Medicine Department, Douala General Hospital, Douala, Cameroon.,Department of Internal Medicine and Specialties, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon.,The University of Dschang Taskforce for the Elimination of COVID-19 (UNITED#COVID-19), Dschang, Cameroon
| | | | - Sylvain Raoul Simeni Njonnou
- Department of Internal Medicine and Specialties, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon.,The University of Dschang Taskforce for the Elimination of COVID-19 (UNITED#COVID-19), Dschang, Cameroon
| | - Hermine Fouda
- Internal Medicine Department, Douala General Hospital, Douala, Cameroon
| | | | | | - Anastase Dzudie
- Internal Medicine Department, Douala General Hospital, Douala, Cameroon.,The University of Dschang Taskforce for the Elimination of COVID-19 (UNITED#COVID-19), Dschang, Cameroon
| | - Simeon Pierre Choukem
- Internal Medicine Department, Douala General Hospital, Douala, Cameroon.,Department of Internal Medicine and Specialties, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon.,The University of Dschang Taskforce for the Elimination of COVID-19 (UNITED#COVID-19), Dschang, Cameroon.,Health and Human Development (2HD) Research Network, Douala, Cameroon
| | - Henry Namme Luma
- Internal Medicine Department, Douala General Hospital, Douala, Cameroon
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Terry PD, Heidel RE, Dhand R. Asthma in Adult Patients with COVID-19. Prevalence and Risk of Severe Disease. Am J Respir Crit Care Med 2021; 203:893-905. [PMID: 33493416 PMCID: PMC8017581 DOI: 10.1164/rccm.202008-3266oc] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 01/25/2021] [Indexed: 12/15/2022] Open
Abstract
Rationale: Health outcomes of people with coronavirus disease (COVID-19) range from no symptoms to severe illness and death. Asthma, a common chronic lung disease, has been considered likely to increase the severity of COVID-19, although data addressing this hypothesis have been scarce until very recently.Objectives: To review the epidemiologic literature related to asthma's potential role in COVID-19 severity.Methods: Studies were identified through the PubMed (MEDLINE) and medRxiv (preprint) databases using the search terms "asthma," "SARS-CoV-2" (severe acute respiratory syndrome coronavirus 2), and "COVID-19," and by cross-referencing citations in identified studies that were available in print or online before December 22, 2020.Measurements and Main Results: Asthma prevalence data were obtained from studies of people with COVID-19 and regional health statistics. We identified 150 studies worldwide that allowed us to compare the prevalence of asthma in patients with COVID-19 by region, disease severity, and mortality. The results of our analyses do not provide clear evidence of increased risk of COVID-19 diagnosis, hospitalization, severity, or mortality due to asthma.Conclusions: These findings could provide some reassurance to people with asthma regarding its potential to increase their risk of severe morbidity from COVID-19.
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Affiliation(s)
| | | | - Rajiv Dhand
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Graduate School of Medicine, University of Tennessee Medical Center, Knoxville, Tennessee
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Bright B, Babalola CP, Sam-Agudu NA, Onyeaghala AA, Olatunji A, Aduh U, Sobande PO, Crowell TA, Tebeje YK, Phillip S, Ndembi N, Folayan MO. COVID-19 preparedness: capacity to manufacture vaccines, therapeutics and diagnostics in sub-Saharan Africa. Global Health 2021; 17:24. [PMID: 33658050 PMCID: PMC7927760 DOI: 10.1186/s12992-021-00668-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 02/04/2021] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE The COVID-19 pandemic is a biosecurity threat, and many resource-rich countries are stockpiling and/or making plans to secure supplies of vaccine, therapeutics, and diagnostics for their citizens. We review the products that are being investigated for the prevention, diagnosis, and treatment of COVID-19; discuss the challenges that countries in sub-Saharan Africa may face with access to COVID-19 vaccine, therapeutics, and diagnostics due to the limited capacity to manufacture them in Africa; and make recommendations on actions to mitigate these challenges and ensure health security in sub-Saharan Africa during this unprecedented pandemic and future public-health crises. MAIN BODY Sub-Saharan Africa will not be self-reliant for COVID-19 vaccines when they are developed. It can, however, take advantage of existing initiatives aimed at supporting COVID-19 vaccine access to resource-limited settings such as partnership with AstraZeneca, the Coalition for Epidemic Preparedness and Innovation, the Global Alliance for Vaccine and Immunisation, the Serum Institute of India, and the World Health Organization's COVID-19 Technology Access Pool. Accessing effective COVID-19 therapeutics will also be a major challenge for countries in sub-Saharan Africa, as production of therapeutics is frequently geared towards profitable Western markets and is ill-adapted to sub-Saharan Africa realities. The region can benefit from pooled procurement of COVID-19 therapy by the Africa Centres for Disease Control and Prevention in partnership with the African Union. If the use of convalescent plasma for the treatment of patients who are severely ill is found to be effective, access to the product will be minimally challenging since the region has a pool of recovered patients and human resources that can man supportive laboratories. The region also needs to drive the local development of rapid-test kits and other diagnostics for COVID-19. CONCLUSION Access to vaccines, therapeutics, and diagnostics for COVID-19 will be a challenge for sub-Saharan Africans. This challenge should be confronted by collaborating with vaccine developers; pooled procurement of COVID-19 therapeutics; and local development of testing and diagnostic materials. The COVID-19 pandemic should be a wake-up call for sub-Saharan Africa to build vaccines, therapeutics, and diagnostics manufacturing capacity as one of the resources needed to address public-health crises.
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Affiliation(s)
- Bisi Bright
- , COVID-19 Think Tank, Nigeria
- Live Well Initiative Academy Nigeria, Lagos, Nigeria
| | - Chinedum Peace Babalola
- , COVID-19 Think Tank, Nigeria
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
- Centre for Drug Discovery, Development & Production, University of Ibadan, Ibadan, Nigeria
- Genetics & Bioethics Unit, Institute of Advanced Medical Research & Training, College of Medicine, Ibadan, Nigeria
- College of Basic Medical Sciences, Chrisland University, Abeokuta, Ogun State, Nigeria
| | - Nadia Adjoa Sam-Agudu
- , COVID-19 Think Tank, Nigeria
- Institute of Human Virology Nigeria, Abuja, Nigeria
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, USA
- Department of Paediatrics, University of Cape Coast School of Medical Sciences, Cape Coast, Ghana
| | - Augustine Anayochukwu Onyeaghala
- , COVID-19 Think Tank, Nigeria
- Unit of Clinical Chemistry, Department of Medical Laboratory Science, University College Hospital, Ibadan, Nigeria
- Unit of Clinical Chemistry, Department of Medical Laboratory Science, Lead City University, Ibadan, Nigeria
| | - Adebola Olatunji
- , COVID-19 Think Tank, Nigeria
- Fort Worth Internal Medicine, Fort Worth, TX, USA
| | - Ufuoma Aduh
- , COVID-19 Think Tank, Nigeria
- World Health Organisation, Asaba, Delta State, Nigeria
| | - Patrick O Sobande
- , COVID-19 Think Tank, Nigeria
- Stephen's Pedi & Pulmonary Medicine, Fort Worth, TX, USA
| | - Trevor A Crowell
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Yenew Kebede Tebeje
- Africa Center for Disease Control and Prevention, African Union Commission, Addis Ababa, Ethiopia
| | - Sunny Phillip
- , COVID-19 Think Tank, Nigeria
- Institute of Human Virology Nigeria, Abuja, Nigeria
| | - Nicaise Ndembi
- , COVID-19 Think Tank, Nigeria
- Institute of Human Virology Nigeria, Abuja, Nigeria
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, USA
- Africa Center for Disease Control and Prevention, African Union Commission, Addis Ababa, Ethiopia
- Kanazawa University, Graduate School of Medical Sciences, Kanazawa, Japan
| | - Morenike Oluwatoyin Folayan
- , COVID-19 Think Tank, Nigeria.
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
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