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Yoosefian M, Sabaghian H, Kermanshahaninezhad SO. The interplay of COVID-19 and HIV: A comprehensive review of clinical outcomes and demographic associations. J Natl Med Assoc 2024; 116:362-377. [PMID: 39138033 DOI: 10.1016/j.jnma.2024.07.003] [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: 11/16/2023] [Revised: 01/29/2024] [Accepted: 07/02/2024] [Indexed: 08/15/2024]
Abstract
AIM The COVID-19 pandemic posed unprecedented challenges to global healthcare, particularly affecting respiratory systems and impacting individuals with pre-existing conditions, including those with HIV. METHOD HIV's impact on clinical outcomes was assessed in four Statistical Population, synchronized with control groups. The study also explored the influence of SARS-CoV-2 and COVID-19 treatments. Ultimately, a comparison was drawn between patients with and without HIV. RESULTS In the first Statistical Population of COVID-19 patients with HIV, predominantly African-American men with risk factors such as obesity, hypertension, and diabetes were present. Diagnostic results showed no significant differences between the two groups. In the second Statistical Population, half of the patients were asymptomatic, with diagnoses mostly based on clinical symptoms; 6 individuals developed severe respiratory illness. In the third Statistical Population, 81 % of patients were treated at home, and all hospitalized patients had CD4+ lymphocyte counts above 350 cells/mm³. Most patients improved, with fatalities attributed to comorbid conditions. In the fourth Statistical Population, HIV patients were less likely to benefit from antimicrobial drugs, and mortality was higher, though synchronized analysis did not reveal significant differences. CONCLUSION HIV patients are more susceptible to COVID-19, but the direct impact is less significant than other factors. Additional factors contribute to increased risk, while early improvement, accurate diagnosis, and intensive care reduce fatalities.
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Affiliation(s)
- Mehdi Yoosefian
- Department of Chemistry, Graduate University of Advanced Technology, Kerman, Iran; Department of Nanotechnology, Graduate University of Advanced Technology, Kerman, Iran.
| | - Hanieh Sabaghian
- Department of Nanotechnology, Graduate University of Advanced Technology, Kerman, Iran
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Ojukwu E, Pashaei A, Maia JC, Omobhude OF, Tawfik A, Nguyen Y. Repercussions of the COVID-19 pandemic on the HIV care continuum and related factors in economically disadvantaged nations: an integrated analysis using mixed-methods systematic review. Eur J Med Res 2024; 29:346. [PMID: 38926792 PMCID: PMC11202375 DOI: 10.1186/s40001-024-01917-1] [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: 12/13/2023] [Accepted: 06/01/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic affected the self-management and care of people living with HIV, requiring adaptations in the way health services are provided. However, it is unclear how these changes impacted HIV care in low-income countries. METHODS A systematic review including the current evidence related to changes in HIV care continuum during COVID-19 was conducted through a systematic search in the online databases including CINAHL, OVID-Medline, CAB Direct, and OVID-Embase. A two-step screening process was carried out to include eligible papers and reports according to inclusion criteria. RESULTS From the searches we identified 21 total studies published between 2021 and 2024, the studies revealed mostly negative impacts on all stages of the HIV care continuum in low-income countries. There were impacts related to the blocking measures due to COVID-19, fear of contracting the disease, difficulties in providing resources such as income, food and transports, reductions in the provision of care from prevention to viral suppression. CONCLUSION Overall, researchers identified several negative impacts of COVID-19 restrictions on HIV care continuum during pandemic; however, some observations indicated indirect positive impacts on some aspects of HIV care. Decline in HIV care practices during pandemic compared to before pandemic were observed including using preventative methods, counseling and testing, receiving HIV healthcare services, HIV medical appointments, antiretroviral adherence, engagement with treatment, and poor viral suppression. However, in some evidence improvement in ART adherence and PrEP use were observed.
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Affiliation(s)
- Emmanuela Ojukwu
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Ava Pashaei
- School of Nursing, University of British Columbia, Vancouver, BC, Canada.
| | | | | | - Abdulaziz Tawfik
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Yvonne Nguyen
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
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Semnani K, Sohrabi M, Alavijeh PE, SeyedAlinaghi S, Esmaeili S, Halabchi F, Alizadeh Z, Salami A, Khaneshan AS. Prior COVID-19 infection among newly diagnosed tuberculosis patients in a tertiary care center in Tehran: A case-control study. Immun Inflamm Dis 2024; 12:e1275. [PMID: 38804889 PMCID: PMC11131933 DOI: 10.1002/iid3.1275] [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: 12/01/2023] [Revised: 04/14/2024] [Accepted: 05/05/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVE To assess the risk of developing pulmonary tuberculosis (TB) in accordance with prior history of COVID-19 infection. BACKGROUND Since the advent of the COVID-19 pandemic much discussion has been had on the possible role it might play on global efforts to combat TB; most, focusing on the pandemic's impact on health care systems' capabilities to manage TB cases. Mechanisms have also been proposed by which the COVID-19 infection may directly affect individuals' chance of developing TB infection. Cases have been reported with a history of COVID-19 infection preceding a diagnosis of TB, evidencing its possible role as a risk factor for the disease. METHODS A case-control study was conducted enrolling patients diagnosed with pulmonary TB in the absence of major risk factors previous history of TB, (HIV) human immunodeficiency virus infection), end-stage renal disease, organ transplants, and use of immunosuppressive agents) for developing TB. Each patient was age and sex matched with one healthy control. Data regarding prior COVID-19 infection, diabetes, and smoking status as well as the use of corticosteroids and Tocilizumab for the treatment of COVID-19 infection was obtained. Bivariate analysis was conducted and variables with a likely association with TB status were entered in a multivariate model. RESULTS Bivariate analysis demonstrated a significant relationship between prior COVID-19 infection and TB (95% confidence interval = 1.1-22.8, odds ratio [OR] = 5). Among other variables the severity of COVID-19 infection was found to have a likely association with TB status (p = .125). In a multivariate model, prior COVID-19 infection per se, was not found to be significantly associated with TB (p = .12, OR = 4.5). CONCLUSIONS There seems to be an association between prior history of COVID-19 and a future diagnosis of TB partially linked to the severity of disease. The findings of the current study may serve as a basis for further studies to determine the need for and efficacy of measures to follow-up COVID-19 patients at an increased risk for developing TB.
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Affiliation(s)
- Kiavash Semnani
- Tehran University of Medical Sciences School of MedicineTehranIran
| | - Marjan Sohrabi
- Department of Infectious Diseases, Tehran University of Medical SciencesImam Khomeini Hospital Complex, Tohid SqureTehranIran
| | - Parvaneh Ebrahimi Alavijeh
- Department of Infectious Diseases, Tehran University of Medical SciencesArash Women's HospitalTehranIran
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Tehran University of Medical SciencesIranian Institute for Reduction of High Risk BehaviorsTehranIran
| | - Shirin Esmaeili
- Tehran University of Medical Sciences School of MedicineTehranIran
| | - Farzin Halabchi
- Department of Sports and Exercise MedicineTehran University of Medical SciencesTehranIran
| | - Zahra Alizadeh
- Department of Sports and Exercise MedicineTehran University of Medical SciencesTehranIran
| | - Amir Salami
- Student Research CommitteeIran University of Medical Sciences School of Medicine, Hemmat HwyTehranIran
| | - Arezoo Salami Khaneshan
- Department of Infectious Diseases, Tehran University of Medical SciencesImam Khomeini Hospital Complex, Tohid SqureTehranIran
- Iranian Research Center for HIV/AIDS, Tehran University of Medical SciencesIranian Institute for Reduction of High Risk BehaviorsTehranIran
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Lee KS, Go MJ, Choi YY, Kim MK, Seong J, Sung HK, Jeon J, Jang HC, Kim MH. Risk factors for critical COVID-19 illness during Delta- and Omicron-predominant period in Korea; using K-COV-N cohort in the National health insurance service. PLoS One 2024; 19:e0300306. [PMID: 38483919 PMCID: PMC10939205 DOI: 10.1371/journal.pone.0300306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 02/24/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND This study evaluated the clinical characteristics of patients with COVID-19 in Korea, and examined the relationship between severe COVID-19 cases and underlying health conditions during the Delta (September 20, 2021 to December 4, 2021) and the Omicron (February 20, 2022 to March 31, 2022) predominant period. METHODS This study assessed the association between critical COVID-19 illness and various risk factors, including a variety of underlying health conditions, using multiple logistic regression models based on the K-COV-N cohort, a nationwide data of confirmed COVID-19 cases linked with COVID-19 vaccination status and the National Health Insurance claim information. RESULTS We analyzed 137,532 and 8,294,249 cases of COVID-19 infection during the Delta and the Omicron variant dominant periods, respectively. During the Delta as well as the Omicron period, old age (≥80 years) showed the largest effect size among risk factors for critical COVID-19 illness (aOR = 18.08; 95% confidence interval [CI] = 14.71-22.23 for the Delta; aOR = 24.07; 95% CI = 19.03-30.44 for the Omicron period). We found that patients with solid organ transplant (SOT) recipients, unvaccinated, and interstitial lung disease had more than a two-fold increased risk of critical COVID-19 outcomes between the Delta and Omicron periods. However, risk factors such as urban residence, underweight, and underlying medical conditions, including chronic cardiac diseases, immunodeficiency, and mental disorders, had different effects on the development of critical COVID-19 illness between the Delta and Omicron periods. CONCLUSION We found that the severity of COVID-19 infection was much higher for the Delta variant than for the Omicron. Although the Delta and the Omicron variant shared many risk factors for critical illness, several risk factors were found to have different effects on the development of critical COVID-19 illness between those two variants. Close monitoring of a wide range of risk factors for critical illness is warranted as new variants continue to emerge during the pandemic.
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Affiliation(s)
- Kyung-Shin Lee
- Public Health Research Institute, National Medical Center, Seoul, Korea
| | - Min Jin Go
- Division of Clinical Research, National Institute of Infectious Diseases, Korea National Institute of Health, Center for Emerging Virus Research, Cheongju, Republic of Korea
| | - Youn Young Choi
- Department of Pediatrics, National Medical Center, Seoul, Korea
| | - Min-Kyung Kim
- Division of Infectious Diseases, National Medical Center, Seoul, Korea
| | - Jaehyun Seong
- Division of Clinical Research, National Institute of Infectious Diseases, Korea National Institute of Health, Center for Emerging Virus Research, Cheongju, Republic of Korea
| | - Ho Kyung Sung
- National Emergency Medical Center, National Medical Center, Seoul, Korea
| | - Jaehyun Jeon
- Division of Infectious Diseases, National Medical Center, Seoul, Korea
| | - Hee-Chang Jang
- Division of Clinical Research, National Institute of Infectious Diseases, Korea National Institute of Health, Center for Emerging Virus Research, Cheongju, Republic of Korea
| | - Myoung-Hee Kim
- Center for Public Health Data Analytics, National Medical Center, Seoul, Korea
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Huang W, Liu P, Yan B, Zheng F, Yang Y, Xi X, Xia L, Shen Y. Impact of Tuberculosis on Disease Severity and Viral Shedding Duration in COVID-19 Patients. Viruses 2024; 16:260. [PMID: 38400036 PMCID: PMC10893069 DOI: 10.3390/v16020260] [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: 01/22/2024] [Revised: 02/02/2024] [Accepted: 02/04/2024] [Indexed: 02/25/2024] Open
Abstract
Accumulating evidence show a potential association between tuberculosis and COVID-19 disease severity. To further clarify the impact of tuberculosis on COVID-19 disease severity and viral shedding duration, a retrospective study was conducted on 223 COVID-19 patients, including 34 with tuberculosis and 189 without tuberculosis. Clinical information and viral load shedding time were collected. A higher percentage of severe/critical COVID-19 diagnosis and deaths was observed in patients with tuberculosis than in those without tuberculosis (8.8% vs. 3.2%, p = 0.142; 2.9% vs. 1.1%, p = 0.393), and COVID-19 patients with tuberculosis had longer viral shedding than those without tuberculosis (median: 15.0 days vs. 11.0 days; p = 0.0001). Having tuberculosis (HR = 2.21, 95% CI 1.37-3.00; p = 0.000), being of elderly age (HR = 1.02, 95% CI 1.01-1.03; p = 0.001) and being diagnosed with severe or critical COVID-19 (HR = 5.63, 95% CI 2.10-15.05; p = 0.001) were independent factors associated with prolonged virus time of SARS-CoV-2. COVID-19 patients with tuberculosis receiving anti-tuberculosis therapy time (ATT) for <2 months had a significantly longer virus shedding duration than those receiving ATT for ≥ 4 months (17.5 vs. 11.5 days, p = 0.012). Our results demonstrated that COVID-19 patients with tuberculosis tend to have more severe disease and a worse prognosis, and tuberculosis prolonged viral shedding, highlighting special attention and/or care required for COVID-19 patients with tuberculosis receiving ATT for <2 months.
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Affiliation(s)
- Wei Huang
- Department of Tuberculosis, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Ping Liu
- Department of Tuberculosis, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Bo Yan
- Center for Tuberculosis Research, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Fang Zheng
- Department of Medical Affairs, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Yang Yang
- Department of Tuberculosis, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Xiuhong Xi
- Department of Tuberculosis, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Lu Xia
- Department of Tuberculosis, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Yinzhong Shen
- Department of Infection and Immunity, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
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Jassat W, Mudara C, Ozougwu L, Welch R, Arendse T, Masha M, Blumberg L, Kufa T, Puren A, Groome M, Govender N, Pisa P, Govender S, Sanne I, Brahmbhatt H, Parmley L, Wolmarans M, Rousseau P, Selikow A, Burgess M, Hankel L, Parker A, Cohen C. Trends in COVID-19 admissions and deaths among people living with HIV in South Africa: analysis of national surveillance data. Lancet HIV 2024; 11:e96-e105. [PMID: 38296365 DOI: 10.1016/s2352-3018(23)00266-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 10/02/2023] [Accepted: 10/13/2023] [Indexed: 02/08/2024]
Abstract
BACKGROUND In 2021, the HIV prevalence among South African adults was 18% and more than 2 million people had uncontrolled HIV and, therefore, had increased risk of poor outcomes with SARS-CoV-2 infection. We investigated trends in COVID-19 admissions and factors associated with in-hospital COVID-19 mortality among people living with HIV and people without HIV. METHODS In this analysis of national surveillance data, we linked and analysed data collected between March 5, 2020, and May 28, 2022, from the DATCOV South African national COVID-19 hospital surveillance system, the SARS-CoV-2 case line list, and the Electronic Vaccination Data System. All analyses included patients hospitalised with SARS-CoV-2 with known in-hospital outcomes (ie, who were discharged alive or had died) at the time of data extraction. We used descriptive statistics for admissions and mortality trends. Using post-imputation random-effect multivariable logistic regression models, we compared characteristics and the case fatality ratio of people with HIV and people without HIV. Using modified Poisson regression models, we compared factors associated with mortality among all people with COVID-19 admitted to hospital and factors associated with mortality among people with HIV. FINDINGS Among 397 082 people with COVID-19 admitted to hospital, 301 407 (75·9%) were discharged alive, 89 565 (22·6%) died, and 6110 (1·5%) had no recorded outcome. 270 737 (68·2%) people with COVID-19 had documented HIV status (22 858 with HIV and 247 879 without). Comparing characteristics of people without HIV and people with HIV in each COVID-19 wave, people with HIV had increased odds of mortality in the D614G (adjusted odds ratio 1·19, 95% CI 1·09-1·29), beta (1·08, 1·01-1·16), delta (1·10, 1·03-1·18), omicron BA.1 and BA.2 (1·71, 1·54-1·90), and omicron BA.4 and BA.5 (1·81, 1·41-2·33) waves. Among all COVID-19 admissions, mortality was lower among people with previous SARS-CoV-2 infection (adjusted incident rate ratio 0·32, 95% CI 0·29-0·34) and with partial (0·93, 0·90-0·96), full (0·70, 0·67-0·73), or boosted (0·50, 0·41-0·62) COVID-19 vaccination. Compared with people without HIV who were unvaccinated, people without HIV who were vaccinated had lower risk of mortality (0·68, 0·65-0·71) but people with HIV who were vaccinated did not have any difference in mortality risk (1·08, 0·96-1·23). In-hospital mortality was higher for people with HIV with CD4 counts less than 200 cells per μL, irrespective of viral load and vaccination status. INTERPRETATION HIV and immunosuppression might be important risk factors for mortality as COVID-19 becomes endemic. FUNDING South African National Institute for Communicable Diseases, the South African National Government, and the United States Agency for International Development.
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Affiliation(s)
- Waasila Jassat
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; Right to Care, Pretoria, South Africa.
| | - Caroline Mudara
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
| | - Lovelyn Ozougwu
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; Right to Care, Pretoria, South Africa
| | - Richard Welch
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; Right to Care, Pretoria, South Africa
| | - Tracy Arendse
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; Right to Care, Pretoria, South Africa
| | - Maureen Masha
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; Right to Care, Pretoria, South Africa
| | - Lucille Blumberg
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; Right to Care, Pretoria, South Africa
| | - Tendesayi Kufa
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
| | - Adrian Puren
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
| | - Michelle Groome
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
| | - Nevashan Govender
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
| | - Pedro Pisa
- Right to Care, Pretoria, South Africa; Department of Human Nutrition and Dietetics, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | | | - Ian Sanne
- Right to Care, Pretoria, South Africa; School of Pathology (M Groome), Clinical HIV Research Unit, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Heena Brahmbhatt
- United States Agency for International Development, Pretoria, South Africa; Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lauren Parmley
- United States Agency for International Development, Pretoria, South Africa
| | | | | | - Anthony Selikow
- Council for Scientific and Industrial Research, Pretoria, South Africa
| | - Melissa Burgess
- Council for Scientific and Industrial Research, Pretoria, South Africa
| | - Lauren Hankel
- Council for Scientific and Industrial Research, Pretoria, South Africa
| | - Arifa Parker
- Tygerberg Hospital and Division of Infectious Disease, University of Stellenbosch, Cape Town, South Africa
| | - Cheryl Cohen
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Gupta P, Sandhu D, Gupta V, Singhal L. Triple Burden: The Incorrigible Threat of Tuberculosis, HIV, and COVID-19. Infect Disord Drug Targets 2024; 24:1-7. [PMID: 37937570 DOI: 10.2174/0118715265259959231031104820] [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: 04/28/2023] [Revised: 09/12/2023] [Accepted: 09/28/2023] [Indexed: 11/09/2023]
Abstract
The Coronavirus-19 (COVID-19) hasn't seen the dawn since its emergence, however waxing and waning has resulted in the emergence of deadly variants. The effects of pandemic have not been limited to its virulence, but have rather conferred multiple collateral effects, especially in developing countries; thereby, designating it as a SYNDEMIC. The same culminated in neglect of non-COVID-19 conditions like tuberculosis (TB) and human immunodeficiency virus-acquired immunodeficiency syndrome (HIV/AIDS). Besides being the prognostic factor for severe COVID-19, these infections in hidden pockets served as reservoir for emergence of the deadly Omicron. Another significant impact of this juxtaposition was on the delivery of healthcare services for TB and HIV. The unanticipated COVID-19 pandemic turned the path of ongoing progress of elimination programs. Direct consequences of the COVID-19 pandemic were pronounced on diagnosis, treatment, and services for patients with TB and HIV. Essential TB services were reallocated to the COVID-19 rapid response task force. However, despite escalating the tribulations, this triple burden has simultaneously taught lessons to escalate the progress of halted programs. The pandemic has catalyzed an unusual level of collaboration among scientists, which can be exploited for TB and HIV. Fast-track diagnostics, digitalization, contact tracing, and vaccine development have enabled world to envision the same for TB/HIV. .
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Affiliation(s)
| | - Diljot Sandhu
- Department of Microbiology, GMCH-32, Chandigarh, India
| | - Varsha Gupta
- Department of Microbiology, GMCH-32, Chandigarh, India
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Nyasulu PS, Tamuzi JL. Epidemiology, clinical profiles, and prognostic value of COVID-19-related cutaneous manifestations in African populations: a rapid narrative review. Int J Dermatol 2024; 63:10-22. [PMID: 37965793 DOI: 10.1111/ijd.16872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/24/2023] [Accepted: 09/27/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Skin manifestations' true prognostic value, and clinical and epidemiological pictures in SARS-CoV-2 infection in African populations are poorly described and understudied. More familiarity with COVID-19 cutaneous manifestations may aid in early clinical diagnosis or guide prognosis. METHODS In this literature review, we looked for potential studies published from December 2019 to March 2023 on COVID-19 cutaneous lesions in African populations. Our key questions were focused on the prognostic values of cutaneous manifestations related to COVID-19. RESULTS Our findings show that cutaneous manifestations of COVID-19 vary by country and severity of COVID-19, primarily multisystem inflammatory syndrome (MIS). Significant differences were also found between various dermatological lesions, primarily MIS, erythema multiforme-like, livedoid, vesicular, or varicella-like rashes, urticarial, maculopapular or morbilliform rashes, and chilblain-like or pernio-like rashes. There were 47.5% (115/242) of MIS cases reported in nine published African studies. Our findings also revealed that MIS may be diagnosed in 2-7 days due to early onset rash. Advanced age, obesity, diabetes, cardiovascular disease, HIV, tuberculosis, asthma, atopic disease, underweight, malnutrition, and malignancy were found to be associated with COVID-19 cutaneous manifestations in African populations. CONCLUSIONS COVID-19-related skin manifestations in African populations are important as a driving force in COVID-19 prognosis.
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Affiliation(s)
- Peter S Nyasulu
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Division of Epidemiology & Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jacques L Tamuzi
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Silva BPMD, Almeida ASD, Sérgio MGDM, Gatto TC, Carasek VP, Yamamura M. Drug-Resistant Tuberculosis and COVID-19: A Scoping Review on a New Threat to Antimicrobial Resistance. Rev Bras Enferm 2023; 76Suppl 1:e20220803. [PMID: 38055430 DOI: 10.1590/0034-7167-2022-0803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 08/14/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVE To assess the impact of COVID-19 on the morbidity and mortality associated with drug-resistant tuberculosis (DR-TB). METHODS A comprehensive review of articles published in international databases since December 2019 was conducted. The findings are presented in a narrative format, supplemented with tables, diagrams, and a map created using ArcGIS software. RESULTS Thirty-five studies were selected, highlighting the significant consequences of COVID-19 on TB and DR-TB treatment progress. Four main thematic areas were identified: Clinical and epidemiological aspects of the interaction between COVID-19 and DR-TB; Management of physical resources and the team; Challenges and circumstances; Perspectives and possibilities. CONCLUSIONS This study revealed that the COVID-19 pandemic significantly negatively impacted the control of long-standing diseases like TB, particularly in the context of morbidity and mortality related to DR-TB.
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Affiliation(s)
| | | | | | | | | | - Mellina Yamamura
- Universidade Federal de São Carlos. São Carlos, São Paulo, Brazil
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Kazibwe A, Oryokot B, Kyazze AP, Ssekamatte P, Akabwai GP, Seremba E, Mukunya D, Kagimu M, Andia-Biraro I, Kalyesubula R. The Effect of COVID-19 Restrictions on General and HIV Positive Inpatient Admissions and Treatment Outcomes: An Uncontrolled Before-and-after Study at a Ugandan Tertiary Hospital. AIDS Behav 2023; 27:3745-3754. [PMID: 37231190 PMCID: PMC10211272 DOI: 10.1007/s10461-023-04092-2] [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] [Accepted: 05/15/2023] [Indexed: 05/27/2023]
Abstract
Measures to contain the Corona Virus Disease 2019 (COVID-19) pandemic curtailed access to prevention and treatment services for endemic infectious diseases like HIV. We used an uncontrolled before-and-after study design to compare general and HIV positive (HIV+) inpatient outcomes at a tertiary hospital in Uganda, using electronic records of medical inpatients. Data was downloaded, cleaned in Microsoft Excel, and exported to STATA for analysis. We determined the difference in number of admissions and median length of hospital stay using Mann-Whitney U test; and difference in median survival and incidence rates of mortality using Kaplan - Meier statistics, between the pre- and peri-COVID-19 groups. Of 7506 patients admitted to Kiruddu NRH, 50.8% (3812) were female and 18.7% (1,401) were aged 31-40 years, and 18.8% (1,411) were HIV+. Overall, 24.6% (1849) died. Total admissions were lower (2192 vs. 5314 patients), overall mortality rate higher (41.8% vs. 17.6%, p < 0.01), median length of hospital stay longer (6 vs. 4 days, p < 0.01) and median survival shorter (11 vs. 20 days, Chi-square = 252.05, p < 0.01) in the peri- than in pre-COVID-19 period. The adjusted hazard ratio (aHR) of death was 2.08 (95% CI: 1.85-2.23, p < 0.01) in the peri- compared to the pre-COVID-19 period. These differences were more pronounced in HIV + patients. Compared to pre-COVID-19, the peri-COVID-19 period registered lower inpatient admissions but poorer treatment outcomes for general and HIV + inpatients. Emerging epidemic responses should minimize disruption to inpatient care, especially for HIV + individuals.
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Affiliation(s)
- Andrew Kazibwe
- College of Health Sciences, School of Medicine, Department of Medicine, Makerere University, P. O. Box 7072, Kampala, Uganda
- The AIDS Support Organisation (TASO), Programs Directorate, P. O. Box 10443, Kampala, Uganda
| | - Bonniface Oryokot
- The AIDS Support Organisation (TASO), Programs Directorate, P. O. Box 10443, Kampala, Uganda
- University of Suffolk, Ipswich, UK
| | - Andrew Peter Kyazze
- Tuberculosis and Comorbidities (TAC) Research Group, P. O. Box 7072, Kampala, Uganda
| | - Philip Ssekamatte
- Tuberculosis and Comorbidities (TAC) Research Group, P. O. Box 7072, Kampala, Uganda
- College of Health Sciences, School of Biomedical Sciences, Department of Immunology and Molecular Biology, Makerere University, P. O. Box 7072, Kampala, Uganda
| | - George Patrick Akabwai
- Center of Excellence, Baylor College of Medicine, P. O. Box 72025, Kampala, Uganda
- Kiruddu National Referral Hospital, P. O. Box 6558, Kampala, Uganda
| | - Emmanuel Seremba
- Kiruddu National Referral Hospital, P. O. Box 6558, Kampala, Uganda
| | - David Mukunya
- Faculty of Health Sciences, Department of Public Health, Busitema University, P. O. Box 236, Tororo, Uganda
| | - Magid Kagimu
- College of Health Sciences, School of Medicine, Department of Medicine, Makerere University, P. O. Box 7072, Kampala, Uganda
| | - Irene Andia-Biraro
- College of Health Sciences, School of Medicine, Department of Medicine, Makerere University, P. O. Box 7072, Kampala, Uganda
- Tuberculosis and Comorbidities (TAC) Research Group, P. O. Box 7072, Kampala, Uganda
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Robert Kalyesubula
- College of Health Sciences, School of Biomedical Sciences, Department of Physiology, Makerere University, P. O. Box 7072, Kampala, Uganda
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Mnguni AT, Schietekat D, Ebrahim N, Sonday N, Boliter N, Schrueder N, Gabriels S, Cois A, Tamuzi JL, Tembo Y, Davies MA, English R, Nyasulu PS. The interface between SARS-CoV-2 and non-communicable diseases (NCDs) in a high HIV/TB burden district level hospital setting, Cape Town, South Africa. PLoS One 2023; 18:e0277995. [PMID: 37796879 PMCID: PMC10553288 DOI: 10.1371/journal.pone.0277995] [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: 11/05/2022] [Accepted: 12/22/2022] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND COVID-19 experiences on noncommunicable diseases (NCDs) from district-level hospital settings during waves I and II are scarcely documented. The aim of this study is to investigate the NCDs associated with COVID-19 severity and mortality in a district-level hospital with a high HIV/TB burden. METHODS This was a retrospective observational study that compared COVID-19 waves I and II at Khayelitsha District Hospital in Cape Town, South Africa. COVID-19 adult patients with a confirmed SARS-CoV-2 polymerase chain reaction (PCR) or positive antigen test were included. In order to compare the inter wave period, clinical and laboratory parameters on hospital admission of noncommunicable diseases, the Student t-test or Mann-Whitney U for continuous data and the X2 test or Fishers' Exact test for categorical data were used. The role of the NCD subpopulation on COVID-19 mortality was determined using latent class analysis (LCA). FINDINGS Among 560 patients admitted with COVID-19, patients admitted during wave II were significantly older than those admitted during wave I. The most prevalent comorbidity patterns were hypertension (87%), diabetes mellitus (65%), HIV/AIDS (30%), obesity (19%), Chronic Kidney Disease (CKD) (13%), Congestive Cardiac Failure (CCF) (8.8%), Chronic Obstructive Pulmonary Disease (COPD) (3%), cerebrovascular accidents (CVA)/stroke (3%), with similar prevalence in both waves except HIV status [(23% vs 34% waves II and I, respectively), p = 0.022], obesity [(52% vs 2.5%, waves II and I, respectively), p <0.001], previous stroke [(1% vs 4.1%, waves II and I, respectively), p = 0.046]. In terms of clinical and laboratory findings, our study found that wave I patients had higher haemoglobin and HIV viral loads. Wave II, on the other hand, had statistically significant higher chest radiography abnormalities, fraction of inspired oxygen (FiO2), and uraemia. The adjusted odds ratio for death vs discharge between waves I and II was similar (0.94, 95%CI: 0.84-1.05). Wave I had a longer average survival time (8.0 vs 6.1 days) and a shorter average length of stay among patients discharged alive (9.2 vs 10.7 days). LCA revealed that the cardiovascular phenotype had the highest mortality, followed by diabetes and CKD phenotypes. Only Diabetes and hypertension phenotypes had the lowest mortality. CONCLUSION Even though clinical and laboratory characteristics differed significantly between the two waves, mortality remained constant. According to LCA, the cardiovascular, diabetes, and CKD phenotypes had the highest death probability.
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Affiliation(s)
- Ayanda Trevor Mnguni
- Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Khayelitsha District Hospital, Cape Town, South Africa
| | | | | | | | | | - Neshaad Schrueder
- Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Shiraaz Gabriels
- Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Annibale Cois
- Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Jacques L. Tamuzi
- Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Yamanya Tembo
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Mary-Ann Davies
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Health Impact Assessment Directorate, Western Cape Government, Cape Town, South Africa
| | - Rene English
- Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Peter S. Nyasulu
- Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Division of Epidemiology & Biostatistics, School of Public Health, Faculty of Medicine and Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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12
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Weng T, Dong Y, Huang N, Zhao C, Zhang L, Cao S, Tang J, Zhang D, Zhang X. Disseminated tuberculosis in a child during the COVID-19 pandemic: a case report and literature review. Front Immunol 2023; 14:1249878. [PMID: 37781385 PMCID: PMC10536161 DOI: 10.3389/fimmu.2023.1249878] [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: 06/29/2023] [Accepted: 08/25/2023] [Indexed: 10/03/2023] Open
Abstract
Background Disseminated tuberculosis is an uncommon but devastating form of tuberculosis, possibly developing with the immune response of patients. COVID-19 infection may produce an immunosuppressive effect with possible implications for tuberculosis dissemination. Case presentation A 17-year-old female patient with a history of tuberculous pleurisy presented to the hospital with a high fever and life-threatening dyspnea after contracting a COVID-19 infection. Her condition deteriorated rapidly with grand mal epilepsy and acute gastrointestinal bleeding with a grossly depressed CD4 T-cell count, which was indicative of her profoundly immunosuppressed state. After identifying Mycobacterium tuberculosis in her cerebrospinal fluid and a subcutaneous abscess in her left lower back, she was diagnosed with disseminated tuberculosis involving both lungs, the central nervous system, the terminal ileum, the liver, bilateral adnexal tissue, and subcutaneous soft tissue in accordance with the chest and abdominal CT. Empirical treatment was initiated with dexamethasone (5 mg/day) and an anti-tuberculosis regimen of isoniazid, rifampicin, pyrazinamide, amikacin, and meropenem, which was replaced with faropenem after she left the hospital. The therapeutic effect was considered satisfied in the second month of follow-up. Conclusion To the best of our knowledge, we report the first case report of disseminated tuberculosis after COVID-19 infection. Tuberculosis may disseminate and progress during the COVID-19 pandemic, requiring more significant studies to provide better diagnosis and treatment options for the co-infection.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Xianming Zhang
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
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13
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Yang X, Huang J, Chen Y, Ying X, Tan Q, Chen X, Zeng X, Lei S, Wang Y, Li S. Development of CRISPR/Cas12b-Based Multiple Cross Displacement Amplification Technique for the Detection of Mycobacterium tuberculosis Complex in Clinical Settings. Microbiol Spectr 2023; 11:e0347522. [PMID: 36975805 PMCID: PMC10100757 DOI: 10.1128/spectrum.03475-22] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 03/02/2023] [Indexed: 03/29/2023] Open
Abstract
Tuberculosis (TB) is a chronic infectious disease with high mortality caused by the Mycobacterium tuberculosis complex (MTC). Its clinical symptoms include a prolonged cough with mucus, pleuritic chest pain, hemoptysis, etc., and predominant complications such as tuberculous meningitis and pleural effusion. Thus, developing rapid, ultrasensitive, and highly specific detection techniques plays an important role in controlling TB. Here, we devised CRISPR/CRISPR-associated 12b nuclease (CRISPR/Cas12b)-based multiple cross displacement amplification technique (CRISPR-MCDA) targeting the IS6110 sequence and used it to detect MTC pathogens. A newly engineered protospacer adjacent motif (PAM) site (TTTC) was modified in the linker region of the CP1 primer. In the CRISPR-MCDA system, the exponentially amplified MCDA amplicons with the PAM sites can guide the Cas12b/gRNA complex to quickly and accurately recognize its target regions, which successfully activates the CRISPR/Cas12b effector and enables ultrafast trans-cleavage of single-stranded DNA reporter molecules. The limit of detection of the CRISPR-MCDA assay was 5 fg/μL of genomic DNA extracted from the MTB reference strain H37Rv. The CRISPR-MCDA assay successfully detected all examined MTC strains and there was no cross-reaction with non-MTC pathogens, confirming that its specificity is 100%. The entire detection process can be completed within 70 min using real-time fluorescence analysis. Moreover, visualization detection (under UV light) was also designed to verify the results, eliminating the use of specialized instruments. In conclusion, the CRISPR-MCDA assay established in this report can be used as a valuable detection technique for MTC infection. IMPORTANCE The Mycobacterium tuberculosis complex pathogen is a crucial infectious agent of tuberculosis. Hence, improving the capability of MTC detection is one of the most urgently required strategies for preventing and controlling TB. In this report, we successfully developed and implemented CRISPR/Cas12b-based multiple cross displacement amplification targeting the IS6110 sequence to detect MTC pathogens. These results demonstrated that the CRISPR-MCDA assay developed in this study was a rapid, ultrasensitive, highly specific, and readily available method which can be used as a valuable diagnostic tool for MTC infection in clinical settings.
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Affiliation(s)
- Xinggui Yang
- Guizhou Provincial Center for Disease Control and Prevention, Guiyang, Guizhou, People’s Republic of China
| | - Junfei Huang
- Guizhou Provincial Center for Disease Control and Prevention, Guiyang, Guizhou, People’s Republic of China
| | - Yijiang Chen
- Guizhou Provincial Center for Disease Control and Prevention, Guiyang, Guizhou, People’s Republic of China
| | - Xia Ying
- Guizhou Provincial Center for Disease Control and Prevention, Guiyang, Guizhou, People’s Republic of China
| | - Qinqin Tan
- Guizhou Provincial Center for Disease Control and Prevention, Guiyang, Guizhou, People’s Republic of China
| | - Xu Chen
- Second Affiliated Hospital, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, People’s Republic of China
| | - Xiaoyan Zeng
- Second Affiliated Hospital, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, People’s Republic of China
| | - Shiguang Lei
- Guizhou Provincial Center for Disease Control and Prevention, Guiyang, Guizhou, People’s Republic of China
| | - Yi Wang
- Experimental Research Center, Capital Institute of Pediatrics, Beijing, People’s Republic of China
| | - Shijun Li
- Guizhou Provincial Center for Disease Control and Prevention, Guiyang, Guizhou, People’s Republic of China
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14
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Mnguni AT, Schietekat D, Ebrahim N, Sonday N, Boliter N, Schrueder N, Gabriels S, Sigwadhi LN, Zemlin AE, Chapanduka ZC, Ngah V, Yalew A, Jalavu T, Abdullah I, Tamuzi JL, Tembo Y, Davies MA, English R, Nyasulu PS. The clinical and epidemiological characteristics of a series of patients living with HIV admitted for COVID-19 in a district hospital. BMC Infect Dis 2023; 23:123. [PMID: 36855103 PMCID: PMC9972337 DOI: 10.1186/s12879-023-08004-6] [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: 06/08/2022] [Accepted: 01/11/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic continues to evolve. Globally, COVID-19 continues to strain even the most resilient healthcare systems, with Omicron being the latest variant. We made a thorough search for literature describing the effects of the COVID-19 in a high human immunodeficiency virus (HIV)/tuberculosis (TB) burden district-level hospital setting. We found scanty literature. METHODS A retrospective observational study was conducted at Khayelitsha District Hospital in Cape Town, South Africa (SA) over the period March 2020-December 2021. We included confirmed COVID-19 cases with HIV infection aged from 18 years and above. Analysis was performed to identify predictors of mortality or hospital discharge among people living with HIV (PLWH). Predictors investigated include CD4 count, antiretroviral therapy (ART), TB, non-communicable diseases, haematological, and biochemical parameters. FINDINGS This cohort of PLWH with SARS-CoV-2 infection had a median (IQR) age of 46 (37-54) years, male sex distribution of 29.1%, and a median (IQR) CD4 count of 267 (141-457) cells/mm3. Of 255 patients, 195 (76%) patients were discharged, 60 (24%) patients died. One hundred and sixty-nine patients (88%) were on ART with 73(28%) patients having acquired immunodeficiency syndrome (AIDS). After multivariable analysis, smoking (risk ratio [RR]: 2.86 (1.75-4.69)), neutrophilia [RR]: 1.024 (1.01-1.03), and glycated haemoglobin A1 (HbA1c) [RR]: 1.01 (1.007-1.01) were associated with mortality. CONCLUSION The district hospital had a high COVID-19 mortality rate among PLWH. Easy-to-access biomarkers such as CRP, neutrophilia, and HbA1c may play a significant role in informing clinical management to prevent high mortality due to COVID-19 in PLWH at the district-level hospitals.
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Affiliation(s)
- Ayanda Trevor Mnguni
- grid.11956.3a0000 0001 2214 904XDepartment of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa ,Khayelitsha District Hospital, Cape Town, South Africa
| | | | | | | | | | - Neshaad Schrueder
- grid.11956.3a0000 0001 2214 904XDepartment of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Shiraaz Gabriels
- grid.11956.3a0000 0001 2214 904XDepartment of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Lovemore N. Sigwadhi
- grid.11956.3a0000 0001 2214 904XDivision of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Annalise E. Zemlin
- grid.11956.3a0000 0001 2214 904XDivision of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and NHLS Tygerberg Hospital, Cape Town, South Africa
| | - Zivanai C. Chapanduka
- grid.11956.3a0000 0001 2214 904XDivision of Haematological Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and NHLS Tygerberg Hospital, Cape Town, South Africa
| | - Veranyuy Ngah
- grid.11956.3a0000 0001 2214 904XDivision of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Anteneh Yalew
- grid.11956.3a0000 0001 2214 904XDivision of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Thumeka Jalavu
- grid.11956.3a0000 0001 2214 904XDivision of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and NHLS Tygerberg Hospital, Cape Town, South Africa
| | - Ibtisam Abdullah
- grid.11956.3a0000 0001 2214 904XDivision of Haematological Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and NHLS Tygerberg Hospital, Cape Town, South Africa ,grid.507908.30000 0000 8750 5335Division of Haematological Pathology, Department of Pathology, Northland District Health Board, Northland, New Zealand
| | - Jacques L. Tamuzi
- grid.11956.3a0000 0001 2214 904XDivision of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Yamanya Tembo
- grid.7836.a0000 0004 1937 1151School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Mary-Ann Davies
- Health Impact Assessment Directorate, Western Cape Government, Cape Town, South Africa ,grid.7836.a0000 0004 1937 1151Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa ,grid.7836.a0000 0004 1937 1151School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Rene English
- grid.11956.3a0000 0001 2214 904XDivision of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Peter S. Nyasulu
- grid.11956.3a0000 0001 2214 904XDivision of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa ,grid.11951.3d0000 0004 1937 1135Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
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15
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Udoakang AJ, Djomkam Zune AL, Tapela K, Nganyewo NN, Olisaka FN, Anyigba CA, Tawiah-Eshun S, Owusu IA, Paemka L, Awandare GA, Quashie PK. The COVID-19, tuberculosis and HIV/AIDS: Ménage à Trois. Front Immunol 2023; 14:1104828. [PMID: 36776887 PMCID: PMC9911459 DOI: 10.3389/fimmu.2023.1104828] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/11/2023] [Indexed: 01/28/2023] Open
Abstract
In December 2019, a novel pneumonic condition, Coronavirus disease 2019 (COVID- 19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), broke out in China and spread globally. The presentation of COVID-19 is more severe in persons with underlying medical conditions such as Tuberculosis (TB), Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) and other pneumonic conditions. All three diseases are of global concern and can significantly affect the lungs with characteristic cytokine storm, immunosuppression, and respiratory failure. Co-infections of SARS-CoV-2 with HIV and Mycobacterium tuberculosis (Mtb) have been reported, which may influence their pathogenesis and disease progression. Pulmonary TB and HIV/AIDS patients could be more susceptible to SARS-CoV-2 infection leading to lethal synergy and disease severity. Therefore, the biological and epidemiological interactions of COVID-19, HIV/AIDS, and TB need to be understood holistically. While data is needed to predict the impact of the COVID-19 pandemic on these existing diseases, it is necessary to review the implications of the evolving COVID-19 management on HIV/AIDS and TB control, including therapy and funding. Also, the impact of long COVID on patients, who may have this co-infection. Thus, this review highlights the implications of COVID-19, HIV/AIDS, and TB co-infection compares disease mechanisms, addresses growing concerns, and suggests a direction for improved diagnosis and general management.
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Affiliation(s)
- Aniefiok John Udoakang
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
- Department of Biosciences and Biotechnology, University of Medical Sciences, Ondo, Nigeria
| | - Alexandra Lindsey Djomkam Zune
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| | - Kesego Tapela
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| | - Nora Nghochuzie Nganyewo
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
- Medical Research Council Unit, The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, Gambia
| | - Frances Ngozi Olisaka
- Environmental and Public Health Microbiology, Department of Biological Science, Benson Idahosa University, Benin City, Edo State, Nigeria
| | - Claudia Adzo Anyigba
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| | | | - Irene Amoakoh Owusu
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| | - Lily Paemka
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| | - Gordon A. Awandare
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| | - Peter Kojo Quashie
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
- Virology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
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16
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Clinical characteristics associated with mortality of COVID-19 patients admitted to an intensive care unit of a tertiary hospital in South Africa. PLoS One 2022; 17:e0279565. [PMID: 36584024 PMCID: PMC9803161 DOI: 10.1371/journal.pone.0279565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 12/11/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Over 130 million people have been diagnosed with Coronavirus disease 2019 (COVID-19), and more than one million fatalities have been reported worldwide. South Africa is unique in having a quadruple disease burden of type 2 diabetes, hypertension, human immunodeficiency virus (HIV) and tuberculosis, making COVID-19-related mortality of particular interest in the country. The aim of this study was to investigate the clinical characteristics and associated mortality of COVID-19 patients admitted to an intensive care unit (ICU) in a South African setting. METHODS AND FINDINGS We performed a prospective observational study of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection admitted to the ICU of a South African tertiary hospital in Cape Town. The mortality and discharge rates were the primary outcomes. Demographic, clinical and laboratory data were analysed, and multivariable robust Poisson regression model was used to identify risk factors for mortality. Furthermore, Cox proportional hazards regression model was performed to assess the association between time to death and the predictor variables. Factors associated with death (time to death) at p-value < 0.05 were considered statistically significant. Of the 402 patients admitted to the ICU, 250 (62%) died, and another 12 (3%) died in the hospital after being discharged from the ICU. The median age of the study population was 54.1 years (IQR: 46.0-61.6). The mortality rate among those who were intubated was significantly higher at 201/221 (91%). After adjusting for confounding, multivariable robust Poisson regression analysis revealed that age more than 48 years, requiring invasive mechanical ventilation, HIV status, procalcitonin (PCT), Troponin T, Aspartate Aminotransferase (AST), and a low pH on admission all significantly predicted mortality. Three main risk factors predictive of mortality were identified in the analysis using Cox regression Cox proportional hazards regression model. HIV positive status, myalgia, and intubated in the ICU were identified as independent prognostic factors. CONCLUSIONS In this study, the mortality rate in COVID-19 patients admitted to the ICU was high. Older age, the need for invasive mechanical ventilation, HIV status, and metabolic acidosis were found to be significant predictors of mortality in patients admitted to the ICU.
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17
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Bereda G. A case report of COVID-19 associated with AIDS-related pulmonary tuberculosis.. [DOI: 10.21203/rs.3.rs-2373106/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
Patients immunocompromised by HIV or with TB lung disease could be more susceptible to severe COVID-19 infection. The COVID-19 pandemic poses a serious hazard to tuberculosis sufferers. A 67-year-old black African house wife with an HIV/AIDS diagnosis arrived at the emergency room on September 28, 2022. The admitted woman had significant complaints included muscle weakness, a loss of weight about 33 pounds during the preceding week, headache, and a cough. Reduced breath sounds were audible on chest auscultation in the right middle and upper lungs. His electrocardiogram showed sinus tachycardia and anterior-lateral lead ST-depression. She had two nasopharyngeal swabs for COVID-19 testing, which were positive. For the first five days of her stay in the hospital, the patient needed continuous oxygen delivered through a nasal cannula at a rate of four liters per minute, and she is still taking her ART regimen. For TB treatment, she took rifampicin 150 mg, isoniazid 75 mg, pyrazinamide 400 mg, and ethambutol 275 mg during a two-month intensive phase of her TB therapy, then rifampicin 150 mg and isoniazid 75 mg for a four-month continuous phase.
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18
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Collins PY, Kline S. A historic moment for mental health integration in HIV and tuberculosis programmes. Lancet Psychiatry 2022; 9:936-937. [PMID: 36206778 DOI: 10.1016/s2215-0366(22)00343-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 09/20/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Pamela Y Collins
- Department of Psychiatry and Behavioral Sciences, and International Training and Education Center for Health (I-TECH), Department of Global Health, University of Washington, Seattle, WA 98195, USA.
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Mertaniasih NM, Soedarsono S, Pakasi TT, Nuha Z, Ato M. Proposed Algorithm for Integrated Management of TB-SARS-CoV-2 Co-Infection in a TB-Endemic Country. Trop Med Infect Dis 2022; 7:367. [PMID: 36355911 PMCID: PMC9694243 DOI: 10.3390/tropicalmed7110367] [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: 10/06/2022] [Revised: 11/04/2022] [Accepted: 11/07/2022] [Indexed: 11/12/2022] Open
Abstract
Tuberculosis (TB) and COVID-19 have become significant health problems globally, especially in countries with high prevalence. Therefore, this research aims to examine all possibilities and predict the impact of TB-SARS-CoV-2 co-infection to anticipate the cascade effect of both diseases in all sectors. The conceptual strategy of the algorithm in TB-COVID-19 is needed to create an integrated management system. It includes the stages of early detection with accurate and effective methods, as well as the synchronization of TB-COVID-19 health services, starting from primary health facilities to secondary and tertiary referral centers. The algorithm in TB-COVID-19 is crucial to prepare future strategies for PTB co-infection viral respiratory infections other than SARS-CoV-2, ILI, ARI, and SARI. Since the implementation involves all health services, there is a need to integrate the governance of TB-COVID-19 and other comorbidities in good health services based on research and multicentre design.
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Affiliation(s)
- Ni Made Mertaniasih
- Department of Medical Microbiology, Faculty of Medicine, Universitas Airlangga, Surabaya 60131, Indonesia
- Sub-Pulmonology Department of Internal Medicine, Faculty of Medicine, Hang Tuah University, Surabaya 57600, Indonesia
| | - Soedarsono Soedarsono
- Sub-Pulmonology Department of Internal Medicine, Faculty of Medicine, Hang Tuah University, Surabaya 57600, Indonesia
- Tuberculosis Laboratory, Institute of Tropical Disease, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Tiffany Tiara Pakasi
- National TB Program, Directorate of Communicable Disease Prevention and Control, Ministry of Health Indonesia, Jakarta 10710, Indonesia
| | - Zakiyathun Nuha
- Tuberculosis Laboratory, Institute of Tropical Disease, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Manabu Ato
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo 162-0052, Japan
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20
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Chanda-Kapata P, Ntoumi F, Kapata N, Lungu P, Mucheleng'anga LA, Chakaya J, Tembo J, Himwaze C, Ansumana R, Asogun D, Mfinanga S, Nyasulu P, Mwaba P, Yeboah-Manu D, Zumla A, Nachega JB. Tuberculosis, HIV/AIDS and Malaria Health Services in sub-Saharan Africa - A Situation Analysis of the Disruptions and Impact of the COVID-19 Pandemic. Int J Infect Dis 2022; 124 Suppl 1:S41-S46. [PMID: 35341998 PMCID: PMC8949686 DOI: 10.1016/j.ijid.2022.03.033] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The unprecedented and ongoing COVID-19 pandemic has exposed weaknesses in African countries' health systems. The impact of shifted focus on COVID-19 for the past 2 years on routine health services, especially those for the epidemics of Tuberculosis, HIV/AIDS and Malaria, have been dramatic in both quantity and quality. METHODS In this article, we reflect on the COVID-19 related disruptions on the Tuberculosis, HIV/AIDS and Malaria routine health services across Africa. RESULTS The COVID-19 pandemic resulted in disruptions of routine health services and diversion of already limited available resources in sub-Saharan Africa. As a result, disease programs like TB, malaria and HIV have recorded gaps in prevention and treatment with the prospects of reversing gains made towards meeting global targets. The extent of the disruption is yet to be fully quantified at country level as most data available is from modelling estimates before and during the pandemic. CONCLUSIONS Accurate country-level data is required to convince donors and governments to invest more into revamping these health services and help prepare for managing future pandemics without disruption of routine services. Increasing government expenditure on health is a critical part of Africa's economic policy. Strengthening health systems at various levels to overcome the negative impacts of COVID-19, and preparing for future epidemics will require strong visionary political leadership. Innovations in service delivery and technological adaptations are required as countries aim to limit disruptions to routine services.
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Affiliation(s)
| | - Francine Ntoumi
- Fondation Congolaise pour la Recherche Médicale (FCRM), Brazzaville, Republic of Congo; Institute for Tropical Medicine, University of Tübingen, Germany.
| | - Nathan Kapata
- National Public Health Institute, Ministry of Health, and UNZA-UCLMS Research and Training Program, Lusaka, Zambia.
| | - Patrick Lungu
- University of Zambia, School of Medicine, Department Internal Medicine, Lusaka, Zambia.
| | - Luchenga Adam Mucheleng'anga
- Ministry of Home Affairs, Office of the State Forensic Pathologist, and UNZA-UCLMS Research and Training Program, University Teaching Hospital, Lusaka, Zambia.
| | - Jeremiah Chakaya
- Department of Medicine, Therapeutics, Dermatology and Psychiatry, Kenyatta University, Nairobi, Kenya.
| | - John Tembo
- HERPEZ and UNZA-UCLMS Research and Training Program, University Teaching Hospital, Lusaka, Zambia.
| | - Cordelia Himwaze
- University Teaching Hospital, Department of Pathology and Microbiology; and UNZA-UCLMS Research and Training Program, University Teaching Hospital, Lusaka, Zambia.
| | - Rashid Ansumana
- Mercy Hospital Research Laboratory, Bo, Freetown, Sierra Leone.
| | - Danny Asogun
- Ambrose Alli University, Ekpoma and Irrua Specialist Teaching Hospital, Nigeria.
| | - Sayoki Mfinanga
- Muhimbili Medical Research Centre National Institute for Medical Research, Dar es Salaam, Tanzania.
| | - Peter Nyasulu
- Division of Epidemiology & Biostatistics, Faculty of Medicine; Health Sciences, Stellenbosch University, Cape Town, South Africa.
| | - Peter Mwaba
- Lusaka Apex Medical University, Faculty of Medicine, and UNZA-UCLMS Research and Training Project, Lusaka, Zambia.
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.
| | - Alimuddin Zumla
- Center for Clinical Microbiology, Division of Infection and Immunity, University College London, and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, United Kingdom; UNZA-UCLMS Research and Training Program Program, Lusaka, Zambia.
| | - Jean B Nachega
- Department of Medicine and Division of Infectious Diseases, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa; Depts of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Depts of Epidemiology, Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA.
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21
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Granozzi B, Bisognin F, Tadolini M, Lombardi G, Zangoli E, Salvi D, Dormi A, Dal Monte P. IGRA test for TB in COVID-19: role of corticosteroids. Int J Tuberc Lung Dis 2022; 26:1088-1091. [PMID: 36281053 PMCID: PMC9621302 DOI: 10.5588/ijtld.22.0283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 06/07/2022] [Indexed: 11/10/2022] Open
Affiliation(s)
- B Granozzi
- Infectious Diseases Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero, Universitaria di Bologna, Bologna, Italy, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - F Bisognin
- Microbiology Unit, IRCCS Azienda Ospedaliero, Universitaria di Bologna, Bologna, Italy, Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - M Tadolini
- Infectious Diseases Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero, Universitaria di Bologna, Bologna, Italy, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - G Lombardi
- Microbiology Unit, IRCCS Azienda Ospedaliero, Universitaria di Bologna, Bologna, Italy
| | - E Zangoli
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy, Respiratory and Critical care Unit, IRCCS Azienda Ospedaliero, Universitaria di Bologna, Bologna, Italy
| | - D Salvi
- Digestive Endoscopy Unit and Gastroenterology, Fondazione Poliambulanza, Brescia, Italy, Digestive Endoscopy Unit, Catholic University of the Sacred Heart, Rome, Italy
| | - A Dormi
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - P Dal Monte
- Microbiology Unit, IRCCS Azienda Ospedaliero, Universitaria di Bologna, Bologna, Italy, Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy
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22
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Jhaveri TA, Fung C, LaHood AN, Lindeborg A, Zeng C, Rahman R, Bain PA, Velásquez GE, Mitnick CD. Clinical Outcomes of Individuals with COVID-19 and Tuberculosis during the Pre-Vaccination Period of the Pandemic: A Systematic Review. J Clin Med 2022; 11:5656. [PMID: 36233523 PMCID: PMC9570663 DOI: 10.3390/jcm11195656] [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: 07/31/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Tuberculosis, like COVID-19, is most often a pulmonary disease. The COVID-19 pandemic has severely disrupted tuberculosis services in myriad ways: health facility closures, lockdowns, travel bans, overwhelmed healthcare systems, restricted export of antituberculous drugs, etc. The effects of the shared risk on outcomes of the two diseases is not known, particularly for the first year of the pandemic, during the period before COVID-19 vaccines became widely available. OBJECTIVE We embarked on a systematic review to elucidate the consequences of tuberculosis on COVID-19 outcomes and of COVID-19 on tuberculosis outcomes during the pre-vaccination period of the pandemic. METHODS The systematic review protocol is registered in PROSPERO. We conducted an initial search of PubMed, Embase, Web of Science, WHO coronavirus database, medRxiv, bioRxiv, preprints.org, and Google Scholar using terms relating to COVID-19 and tuberculosis. We selected cohort and case-control studies for extraction and assessed quality with the Newcastle-Ottawa scale. RESULTS AND CONCLUSION We identified 2108 unique abstracts published between December 2019 and January 2021. We extracted data from 18 studies from 8 countries. A total of 650,317 persons had a diagnosis of COVID-19, and 4179 had a diagnosis of current or prior tuberculosis. We explored links between tuberculosis and COVID-19 incidence, mortality, and other adverse outcomes. Nine studies reported on mortality and 13 on other adverse outcomes; results on the association between tuberculosis and COVID-19 mortality/adverse outcomes were heterogenous. Tuberculosis outcomes were not fully available in any studies, due to short follow-up (maximum of 3 months after COVID-19 diagnosis), so the effects of COVID-19 on tuberculosis outcomes could not be assessed. Much of the rapid influx of literature on tuberculosis and COVID-19 during this period was published on preprint servers, and therefore not peer-reviewed. It offered limited examination of the effect of tuberculosis on COVID-19 outcomes and even less on the effect of COVID-19 on tuberculosis treatment outcomes.
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Affiliation(s)
- Tulip A. Jhaveri
- Division of Infectious Diseases, Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
- Division of Medical Microbiology, Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Celia Fung
- Department of Neurology, Yale New Haven Hospital, New Haven, CT 06510, USA
| | - Allison N. LaHood
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Andrew Lindeborg
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Chengbo Zeng
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Rifat Rahman
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Paul A. Bain
- Francis A. Countway Library of Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Gustavo E. Velásquez
- UCSF Center for Tuberculosis, University of California San Francisco, San Francisco, CA 94110, USA
- Division of HIV, Infectious Diseases, and Global Medicine, University of California San Francisco, San Francisco, CA 94110, USA
- Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Carole D. Mitnick
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA
- Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
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23
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El Tantawi M, Folayan MO, Nguyen AL, Aly NM, Ezechi O, Uzochukwu BSC, Alaba OA, Brown B. Validation of a COVID-19 mental health and wellness survey questionnaire. BMC Public Health 2022; 22:1509. [PMID: 35941580 PMCID: PMC9358641 DOI: 10.1186/s12889-022-13825-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 07/18/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND AND AIM COVID-19 affected mental health and wellbeing. Research is needed to assess its impact using validated tools. The study assessed the content validity, reliability and dimensionality of a multidimensional tool for assessing the mental health and wellbeing of adults. METHODS An online questionnaire collected data in the second half of 2020 from adults in different countries. The questionnaire included nine sections assessing: COVID-19 experience and sociodemographic profile; health and memory; pandemic stress (pandemic stress index, PSI); financial and lifestyle impact; social support; post-traumatic stress disorder (PTSD); coping strategies; self-care and HIV profile over 57 questions. Content validity was assessed (content validity index, CVI) and participants evaluated the test-retest reliability (Kappa statistic and intra-class correlation coefficient, ICC). Internal consistency of scales was assessed (Cronbach α). The dimensionality of the PSI sections and self-care strategies was assessed by multiple correspondence analysis (MCA) using all responses and SPSS. For qualitative validation, we used a semi-structured interview and NVivo was used for coding and thematic analysis. RESULTS The overall CVI = 0.83 with lower values for the memory items. Cronbach α for the memory items = 0.94 and ICC = 0.71. Cronbach α for PTSD items was 0.93 and ICC = 0.89. Test-retest scores varied by section. The 2-dimensions solution of MCA for the PSI behavior section explained 33.6% (precautionary measures dimension), 11.4% (response to impact dimension) and overall variance = 45%. The 2-dimensions of the PSI psychosocial impact explained 23.5% (psychosocial impact of the pandemic dimension), 8.3% (psychosocial impact of the precautionary measures of the pandemic dimension) and overall variance = 31.8%. The 2-dimensions of self-care explained 32.9% (dimension of self-care strategies by people who prefer to stay at home and avoid others), 9% (dimension of self-care strategies by outward-going people) and overall variance = 41.9%. Qualitative analysis showed that participants agreed that the multidimensional assessment assessed the effect of the pandemic and that it was better suited to the well-educated. CONCLUSION The questionnaire has good content validity and can be used to assess the impact of the pandemic in cross-sectional studies especially as individual items. The PSI and self-care strategies need revision to ensure the inclusion of items with strong discrimination.
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Affiliation(s)
- Maha El Tantawi
- grid.7155.60000 0001 2260 6941Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champolion St., Azarita, Alexandria, 21521 Egypt
| | - Morenike Oluwatoyin Folayan
- grid.10824.3f0000 0001 2183 9444Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Annie Lu Nguyen
- grid.42505.360000 0001 2156 6853Department of Family Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA USA
| | - Nourhan M. Aly
- grid.7155.60000 0001 2260 6941Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champolion St., Azarita, Alexandria, 21521 Egypt
| | - Oliver Ezechi
- grid.416197.c0000 0001 0247 1197Clinical Sciences Department, Nigerian Institute of Medical Research, Yaba Lagos, Nigeria
| | - Benjamin S. C. Uzochukwu
- grid.10757.340000 0001 2108 8257Department of Community Medicine, University of Nigeria, Nsukka, Nigeria
| | - Oluwatoyin Adedoyin Alaba
- grid.10824.3f0000 0001 2183 9444Institute of Public Health, Obafemi Awolowo University, Ile-Ife, Nigeria ,grid.257427.10000000088740847Department of Employment and Labor Relations, Indiana University of Pennsylvania, Indiana, PA USA
| | - Brandon Brown
- grid.266097.c0000 0001 2222 1582Center for Healthy Communities, Department of Social Medicine, Population and Public Health, University of California, Riverside School of Medicine, Riverside, USA
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24
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Carlos SJ, Ladislav M, Dagmar D. Impact of the COVID-19 pandemic on HIV epidemic and testing in the Czech Republic in 2020. Curr HIV Res 2022; 20:CHR-EPUB-125257. [PMID: 35927917 DOI: 10.2174/1570162x20666220801142503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/18/2022] [Accepted: 05/10/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND The COVID-19 pandemic determines the functioning of the healthcare system. The epidemic of HIV infection depends heavily on the effectiveness of the health system and its ability to test and deliver prevention and treatment.This study aims to determine the consequences of this pandemic on the development of HIV infection testing in the Czech Republic. METHODS A descriptive cross-sectional study analyzed data for two infectious diseases, HIV (2020 and 2015-2019) and COVID-19 (2020), in the Czech Republic. For the statistical comparison of 2020 with the earlier period, the incidence rate ratio (IRR) and Poisson regression methods were used. Monthly HIV and COVID-19 indicators for 2020 were analyzed using correlation analysis. RESULTS AND DISCUSSION A significant difference was observed only in April (IRR = 0.81; p = 0.046) and July (IRR = 1.27; p = 0.023) between the number of HIV tests performed in each month in 2020 and the control period (average for the same months of the period 2015-2019).Significant differences between the observed periods were further identified for testing reasons. Correlation analysis of the number of tests performed on HIV and COVID-19 after 2020 showed a negative relationship (r = -0.261, p = 0.412). CONCLUSION The study did not confirm statistically significant differences between the number of HIV tests performed in the pandemic year 2020 compared to the previous period, except for two months. The incidence and number of newly diagnosed cases did not differ statistically significantly from previous years (2015-2019).
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Affiliation(s)
| | - Machala Ladislav
- Department of Infectious and Tropical Diseases Charles University
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25
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Kaforou M, Broderick C, Vito O, Levin M, Scriba TJ, Seddon JA. Transcriptomics for child and adolescent tuberculosis. Immunol Rev 2022; 309:97-122. [PMID: 35818983 PMCID: PMC9540430 DOI: 10.1111/imr.13116] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Tuberculosis (TB) in humans is caused by Mycobacterium tuberculosis (Mtb). It is estimated that 70 million children (<15 years) are currently infected with Mtb, with 1.2 million each year progressing to disease. Of these, a quarter die. The risk of progression from Mtb infection to disease and from disease to death is dependent on multiple pathogen and host factors. Age is a central component in all these transitions. The natural history of TB in children and adolescents is different to adults, leading to unique challenges in the development of diagnostics, therapeutics, and vaccines. The quantification of RNA transcripts in specific cells or in the peripheral blood, using high-throughput methods, such as microarray analysis or RNA-Sequencing, can shed light into the host immune response to Mtb during infection and disease, as well as understanding treatment response, disease severity, and vaccination, in a global hypothesis-free manner. Additionally, gene expression profiling can be used for biomarker discovery, to diagnose disease, predict future disease progression and to monitor response to treatment. Here, we review the role of transcriptomics in children and adolescents, focused mainly on work done in blood, to understand disease biology, and to discriminate disease states to assist clinical decision-making. In recent years, studies with a specific pediatric and adolescent focus have identified blood gene expression markers with diagnostic or prognostic potential that meet or exceed the current sensitivity and specificity targets for diagnostic tools. Diagnostic and prognostic gene expression signatures identified through high-throughput methods are currently being translated into diagnostic tests.
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Affiliation(s)
- Myrsini Kaforou
- Department of Infectious DiseaseImperial College LondonLondonUK
| | | | - Ortensia Vito
- Department of Infectious DiseaseImperial College LondonLondonUK
| | - Michael Levin
- Department of Infectious DiseaseImperial College LondonLondonUK
| | - Thomas J. Scriba
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of PathologyUniversity of Cape TownCape TownSouth Africa
| | - James A. Seddon
- Department of Infectious DiseaseImperial College LondonLondonUK
- Desmond Tutu TB Centre, Department of Paediatrics and Child HealthStellenbosch UniversityCape TownSouth Africa
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26
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Tuberculosis and HIV responses threatened by nCOVID-19: A situation prompting an in silico investigation of reported MbtA inhibitors for combined inhibition of SARS-CoV-2 and HIV-TB co-infection. Struct Chem 2022. [DOI: 10.1007/s11224-022-02013-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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27
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Rwezaura H, Diagne ML, Omame A, de Espindola AL, Tchuenche JM. Mathematical modeling and optimal control of SARS-CoV-2 and tuberculosis co-infection: a case study of Indonesia. MODELING EARTH SYSTEMS AND ENVIRONMENT 2022; 8:5493-5520. [PMID: 35814616 PMCID: PMC9251044 DOI: 10.1007/s40808-022-01430-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 05/16/2022] [Indexed: 01/08/2023]
Abstract
A new mathematical model incorporating epidemiological features of the co-dynamics of tuberculosis (TB) and SARS-CoV-2 is analyzed. Local asymptotic stability of the disease-free and endemic equilibria are shown for the sub-models when the respective reproduction numbers are below unity. Bifurcation analysis is carried out for the TB only sub-model, where it was shown that the sub-model undergoes forward bifurcation. The model is fitted to the cumulative confirmed daily SARS-CoV-2 cases for Indonesia from February 11, 2021 to August 26, 2021. The fitting was carried out using the fmincon optimization toolbox in MATLAB. Relevant parameters in the model are estimated from the fitting. The necessary conditions for the existence of optimal control and the optimality system for the co-infection model is established through the application of Pontryagin’s Principle. Different control strategies: face-mask usage and SARS-CoV-2 vaccination, TB prevention as well as treatment controls for both diseases are considered. Simulations results show that: (1) the strategy against incident SARS-CoV-2 infection averts about 27,878,840 new TB cases; (2) also, TB prevention and treatment controls could avert 5,397,795 new SARS-CoV-2 cases. (3) In addition, either SARS-CoV-2 or TB only control strategy greatly mitigates a significant number of new co-infection cases.
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28
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Devlin SA, Johnson AK, McNulty MC, Joseph OL, Hall A, Ridgway JP. "Even if I'm undetectable, I just feel like I would die": a qualitative study to understand the psychological and socioeconomic impacts of the COVID-19 pandemic on women living with HIV (WLWH) in Chicago, IL. BMC Womens Health 2022; 22:218. [PMID: 35689277 PMCID: PMC9185710 DOI: 10.1186/s12905-022-01812-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/31/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has affected the health and well-being of people worldwide, yet few studies have qualitatively examined its cumulative effects on ciswomen living with HIV (WLWH). We aimed to explore how the pandemic has impacted WLWH, including challenges related to HIV care, employment, finances, and childcare. We also investigated how HIV status and different psychosocial stressors affected their mental health. METHODS We performed 25 semi-structured qualitative interviews with WLWH regarding the ways in which COVID-19 impacted their social determinants of health and physical well-being during the pandemic. 19 WLWH who received care at the University of Chicago Medicine (UCM) and 6 women who received care at Howard Brown Health, a federally qualified health center (FQHC) in Chicago, were interviewed remotely from June 2020 to April 2021. All interviews were audio recorded and transcribed. Interviews were thematically analyzed for commonalities regarding HIV-specific and general experiences of WLWH during the pandemic. RESULTS The majority of participants reported COVID-19 impacted their HIV care, such as appointment cancellations and difficulties adhering to antiretroviral therapy. In addition to HIV care obstacles, almost all participants described perceived heightened vulnerability to or fear of COVID-19. The pandemic also affected the socioeconomic well-being of participants, with reported financial strains and employment disruptions. Some mothers took on additional childcare responsibilities, such as homeschooling. Increased mental health concerns and negative psychological effects from the social isolation associated with the pandemic were also experienced by most participants. CONCLUSIONS We gained invaluable insight into how WLWH were challenged by and adapted to the COVID-19 pandemic, including its destabilizing effects on their HIV care and mental health. Women described how they undertook additional childcare responsibilities during the pandemic and how their HIV status compounded their concerns (e.g., perceived heightened vulnerability to COVID-19). Strategies to better support WLWH in maintaining their overall health throughout the pandemic include childcare assistance, access to affordable mental health services, support groups, and education from HIV care providers. These findings have significant implications for examining future health crises through the perspective of potential gender inequalities.
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Affiliation(s)
- Samantha A. Devlin
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, L-038, Chicago, IL 60637 USA
| | - Amy K. Johnson
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL USA
- Feinberg School of Medicine, Northwestern University, Chicago, IL USA
| | - Moira C. McNulty
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, L-038, Chicago, IL 60637 USA
| | - Olivier L. Joseph
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, L-038, Chicago, IL 60637 USA
| | - André Hall
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, L-038, Chicago, IL 60637 USA
| | - Jessica P. Ridgway
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, L-038, Chicago, IL 60637 USA
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Shanaube K, Schaap A, Klinkenberg E, Floyd S, Bwalya J, Cheeba M, de Haas P, Kosloff B, Ruperez M, Hayes R, Ayles H. SARS-CoV-2 seroprevalence and associated risk factors in periurban Zambia: a population-based study. Int J Infect Dis 2022; 118:256-263. [PMID: 35306205 PMCID: PMC8925090 DOI: 10.1016/j.ijid.2022.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/10/2022] [Accepted: 03/12/2022] [Indexed: 10/29/2022] Open
Abstract
BACKGROUND We nested a seroprevalence survey within the TREATS (Tuberculosis Reduction through Expanded Antiretroviral Treatment and Screening) project. We aimed to measure the seroprevalence of SARS-CoV-2 infection and investigate associated risk factors in one community (population ∼27,000) with high prevalence of TB/HIV in Zambia. METHODS The study design was cross-sectional. A random sample of 3592 individuals aged ≥15 years enrolled in the TREATS TB-prevalence survey were selected for antibody testing. Randomly selected blocks of residence were visited between October 2020 and March 2021. Antibodies against SARS-CoV-2 were detected using Abbott- ARCHITECT SARS-CoV-2 IgG assay. RESULTS A total of 3035/3526 (86.1%) individuals had a blood sample taken. Antibody testing results were available for 2917/3035 (96.1%) participants. Overall, 401/2977 (13.5%) individuals tested positive for IgG antibodies. Seroprevalence was similar by sex (12.7% men vs 14.0% women) and was lowest in the youngest age group 15-19 years (9.7%) and similar in ages 20 years and older (∼15%). We found no evidence of an association between seroprevalence and HIV-status or TB. There was strong evidence (p <0.001) of variation by time of enrollment, with prevalence varying from 2.8% (95% CI 0.8-4.9) among those recruited in December 2020 to 33.7% (95% CI 27.7-39.7) among those recruited in mid-February 2021. CONCLUSION Seroprevalence was 13.5% but there was substantial variation over time, with a sharp increase to approximately 35% toward the end of the second epidemic wave.
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Affiliation(s)
| | - A Schaap
- Zambart, Lusaka, Zambia; London School of Hygiene and Tropical Medicine
| | | | - S Floyd
- London School of Hygiene and Tropical Medicine
| | | | | | - P de Haas
- KNCV Tuberculosis Foundation, Netherlands
| | - B Kosloff
- Zambart, Lusaka, Zambia; London School of Hygiene and Tropical Medicine
| | - M Ruperez
- London School of Hygiene and Tropical Medicine
| | - R Hayes
- London School of Hygiene and Tropical Medicine
| | - H Ayles
- Zambart, Lusaka, Zambia; London School of Hygiene and Tropical Medicine
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Srivastava S, Jaggi N. TB positive cases go up in ongoing COVID-19 pandemic despite lower testing of TB: An observational study from a hospital from Northern India. Indian J Tuberc 2022; 69:157-160. [PMID: 35379395 PMCID: PMC8098039 DOI: 10.1016/j.ijtb.2021.04.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/05/2021] [Indexed: 05/23/2023]
Abstract
The whole world is wrestling against SARS-CoV-2 infection (COVID-19). COVID-19-TB co-infection is also reported but there are limited number of studies which analyze the impact of COVID-19 pandemic in TB diagnosis and management. In this retrospective study, we observed that the TB diagnosis was reduced in pandemic time. Before COVID-19 pandemic (March-December 2019), there were 644 TB tests out of which 127 were TB positive. In ongoing COVID-19 pandemic (January-October 2020), 484 TB tests were performed and 146 patients were TB positive. Male accounted for 64%/57% of TB cases in 2019/2020 whereas female patients were 35%/42% in 2019/2020. Increase in female TB positive cases was a noticeable feature. The newly diagnosed with TB cases in 2019/2020 were 112/130 respectively. Though, we have seen only 7 COVID-TB co-infection cases, we could not establish the causal relationship in COVID-TB co-infection. The increase in the number of TB positive cases during COVID-19 pandemic clearly showed how adversely COVID-19 has affected TB diagnosis and management. Anticipating the increase in TB cases in future, we emphasize the need to ensure continuous TB testing and treatment despite the pandemic burden. Further study on the COVID-TB co-infection in high TB-burden countries like India, is required to enable analyses of interactions, risk factors in COVID-19-TB co-infection.
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Affiliation(s)
- Shruti Srivastava
- Education & Research, Artemis Hospitals, Gurugram, Haryana, 122001, India.
| | - Namita Jaggi
- Laboratory Services & Infection Control, Education & Research - Lab Medicine, Artemis Hospitals, Gurugram, Haryana, 122001, India.
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Maslove DM, Sibley S, Boyd JG, Goligher EC, Munshi L, Bogoch II, Rochwerg B. Complications of Critical COVID-19: Diagnostic and Therapeutic Considerations for the Mechanically Ventilated Patient. Chest 2022; 161:989-998. [PMID: 34655568 PMCID: PMC8511547 DOI: 10.1016/j.chest.2021.10.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/04/2021] [Accepted: 10/06/2021] [Indexed: 01/31/2023] Open
Abstract
Patients admitted to the ICU with critical COVID-19 often require prolonged periods of mechanical ventilation. Difficulty weaning, lack of progress, and clinical deterioration are commonly encountered. These conditions should prompt a thorough evaluation for persistent or untreated manifestations of COVID-19, as well as complications from COVID-19 and its various treatments. Inflammation may persist and lead to fibroproliferative changes in the lungs. Infectious complications may arise including bacterial superinfection in the earlier stages of disease. Use of immunosuppressants may lead to the dissemination of latent infections, and to opportunistic infections. Venous thromboembolic disease is common, as are certain neurologic manifestations of COVID-19 including delirium and stroke. High levels of ventilatory support may lead to ventilator-induced injury to the lungs and diaphragm. We present diagnostic and therapeutic considerations for the mechanically ventilated patient with COVID-19 who shows persistent or worsening signs of critical illness, and we offer an approach to treating this complex but common scenario.
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Affiliation(s)
- David M. Maslove
- Department of Critical Care Medicine, Queen’s University, Kingston, ON, Canada,Kingston Health Sciences Centre, Kingston, ON, Canada,CORRESPONDENCE TO: David M. Maslove, MD
| | - Stephanie Sibley
- Department of Critical Care Medicine, Queen’s University, Kingston, ON, Canada,Kingston Health Sciences Centre, Kingston, ON, Canada
| | - J. Gordon Boyd
- Department of Critical Care Medicine, Queen’s University, Kingston, ON, Canada,Kingston Health Sciences Centre, Kingston, ON, Canada
| | - Ewan C. Goligher
- Interdepartmental Division of Critical Care, University of Toronto, Toronto, ON, Canada,University Health Network, Toronto, ON, Canada
| | - Laveena Munshi
- Interdepartmental Division of Critical Care, University of Toronto, Toronto, ON, Canada,Sinai Health System, Toronto, ON, Canada
| | - Isaac I. Bogoch
- University Health Network, Toronto, ON, Canada,Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Bram Rochwerg
- Department of Medicine, McMaster University, Hamilton, ON, Canada,Juravinski Hospital, Hamilton, ON, Canada
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Kassie SY, Melese T, Handebo S, Sebastian Y, Ngusie HS. Information seeking about COVID-19 and associated factors among chronic patients in Bahir Dar city public hospitals, Northwest Ethiopia: a cross-sectional study. BMC Infect Dis 2022; 22:325. [PMID: 35365126 PMCID: PMC8972753 DOI: 10.1186/s12879-022-07315-4] [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: 11/17/2021] [Accepted: 03/28/2022] [Indexed: 11/11/2022] Open
Abstract
Background The health impacts of COVID-19 are not evenly distributed in societies. Chronic patients are highly affected and develop dangerous symptoms of COVID-19. Understanding their information seeking about COVID-19 may help to improve the effectiveness of public health strategies in the future, the adoption of safety measures, and minimize the spread of the pandemic. However, there is little evidence on information seeking specifically on COVID-19 in this study setting. Therefore, this study aimed to assess information seeking about COVID-19 and associated factors among chronic patients. Method An institutional-based cross-sectional study supplemented with qualitative data was conducted at Bahir Dar city public hospitals in Northwest Ethiopia from April 8 to June 15, 2021. A total of 423 chronic patients were selected using systematic random sampling techniques with an interval of 5. Bi-variable and multivariable logistic regression analysis was fitted to identify factors associated with information seeking about COVID-19. A p-value < 0.05 was used to declare statistical significance. Qualitative data were analyzed using a thematic approach. Finally, it was triangulated with quantitative findings. Result The proportion of information seeking about COVID-19 among chronic patients was 44.0% (95% CI = 39.0, 49.0). Being living in urban [AOR = 4.4, 95% CI (2.01, 9.58)], having high perceived susceptibility to COVID-19 [AOR = 3.4, 95%CI (1.98, 5.70)], having high perceived severity to COVID-19 [AOR = 1.7, 95%CI (1.04, 2.91)], having high self-efficacy to COVID-19 [AOR = 4.3, 95%CI (2.52, 7.34)], and having adequate health literacy [AOR = 1.8, 95%CI (1.10, 3.03)] were significant factors associated with information-seeking about COVID-19. Conclusion The overall proportion of information seeking about COVID-19 among chronic patients was low. Thus, health promotion programs should emphasize the chronic patients living in a rural area; enhance perceived risk and severity of COVID-19, enhancing self-efficacy and health literacy interventions to improve information seeking. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07315-4.
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Affiliation(s)
- Sisay Yitayih Kassie
- Department of Health Informatics, College of Health Sciences, Mettu University, P. O. Box: 318, Mettu, Ethiopia.
| | - Tesfahun Melese
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Simegnew Handebo
- Department of Health Education and Behavioural Sciences, School of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Yakub Sebastian
- College of Engineering, IT and Environment, Charles Darwin University, Casuarina, Australia
| | - Habtamu Setegn Ngusie
- Department of Health Informatics, College of Health Sciences, Mettu University, P. O. Box: 318, Mettu, Ethiopia
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Chilot D, Woldeamanuel Y, Manyazewal T. COVID-19 Burden on HIV Patients Attending Antiretroviral Therapy in Addis Ababa, Ethiopia: A Multicenter Cross-Sectional Study. Front Med (Lausanne) 2022; 9:741862. [PMID: 35308528 PMCID: PMC8924523 DOI: 10.3389/fmed.2022.741862] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 01/07/2022] [Indexed: 12/18/2022] Open
Abstract
Background There has been promising progress toward screening, testing, and retaining patients with HIV in care in Ethiopia. Concern exists that possible disruptions in HIV programs due to coronavirus disease 2019 (COVID-19) could result in a more HIV-related mortality and new HIV infections. This study aimed to investigate the real-time burden of COVID-19 on patients with HIV attending antiretroviral therapy. Methods We conducted a facility-based, multicenter, and cross-sectional study among patients with HIV attending antiretroviral therapy in 10 healthcare facilities in Addis Ababa, Ethiopia, in the COVID-19 pandemic period. Data were collected using adapted, interviewer-based questionnaires, and entered into EpiInfo version 7 and exported to SPSS version 26 for analysis. Result A total of 212 patients with HIV were included. The participants who missed visits for refill were 58 (27.4%). When the effects of other independent variables on appointments/visits for refill were controlled, the following characteristics were found to be the most important predictors of missed appointments (p< 0.05): age ≥ 55 [adjusted odds ratio (AOR) = 6.73, 95% CI (1.495-30.310)], fear of COVID-19 [AOR = 24.93, 95% CI (2.798-222.279)], transport disruption [AOR = 4.90, 95% CI (1.031-23.174)], reduced income for traveling to a health facility [AOR = 5.64, 95% CI (1.234-25.812)], limited access to masks [AOR = 7.67, 95% CI (1.303-45.174)], sanitizer [AOR = 0.07, 95% CI (0.007-0.729)], and non-medical support [AOR = 2.32, 95% CI (1.547-12.596)]. The participants were well aware of the COVID-19 preventive measures. The most costly COVID-19 preventive measures that cause financial burden to the patients were the costs for buying face masks (63.7%), disinfectants (55.2%), and soap for handwashing (22.2%). The participants who missed follow-up diagnostic tests were 56 (26.4%). Variables, which were found to be statistically significant, include the following: age ≥ 55 [AOR = 0.22, 95% CI (0.076-0.621)], partial lockdown [AOR = 0.10, 95% CI (0.011-0.833)], limited access to health services [AOR = 0.15, 95% CI (0.045-0.475)], reduced income for traveling to health facility [AOR = 0.18, 95% CI (0.039-0.784)], and unable to get masks [AOR = 0.12, 95% CI (0.026-0.543)]. The participants who missed counseling services were 55 (25.9%). In multivariate logistic regression, the following were statistically significant: age ≥ 55 [AOR = 0.21, 95% CI (0.078-0.570)], fear of COVID-19 [AOR = 0.11, 95% CI (0.013-0.912)], reduced income [AOR = 0.17, 95% CI (0.041-0.699)], unable to get face masks [AOR = 0.19, 95% CI (0.039-0.959)], and partial lockdown [AOR = 0.08, 95% CI (0.008-0.790)]. Conclusions The COVID-19 had a significant burden on patients with HIV to attend their routine clinical care and treatment, which may lead to treatment failure and drug resistance. The impact was on their appointments for medication refills and clinical and laboratory follow-ups. Targeted initiatives are needed to sustain HIV clinical care and treatment services and improve the well-being of people living with HIV.
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Affiliation(s)
- Dagmawi Chilot
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yimtubezinash Woldeamanuel
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tsegahun Manyazewal
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Rosas Mejia O, Gloag ES, Li J, Ruane-Foster M, Claeys TA, Farkas D, Wang SH, Farkas L, Xin G, Robinson RT. Mice infected with Mycobacterium tuberculosis are resistant to acute disease caused by secondary infection with SARS-CoV-2. PLoS Pathog 2022; 18:e1010093. [PMID: 35325013 PMCID: PMC8946739 DOI: 10.1371/journal.ppat.1010093] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 02/23/2022] [Indexed: 12/22/2022] Open
Abstract
Mycobacterium tuberculosis (Mtb) and SARS-CoV-2 (CoV2) are the leading causes of death due to infectious disease. Although Mtb and CoV2 both cause serious and sometimes fatal respiratory infections, the effect of Mtb infection and its associated immune response on secondary infection with CoV2 is unknown. To address this question we applied two mouse models of COVID19, using mice which were chronically infected with Mtb. In both model systems, Mtb-infected mice were resistant to the pathological consequences of secondary CoV2 infection, and CoV2 infection did not affect Mtb burdens. Single cell RNA sequencing of coinfected and monoinfected lungs demonstrated the resistance of Mtb-infected mice is associated with expansion of T and B cell subsets upon viral challenge. Collectively, these data demonstrate that Mtb infection conditions the lung environment in a manner that is not conducive to CoV2 survival. Mycobacterium tuberculosis (Mtb) and SARS-CoV-2 (CoV2) are distinct organisms which both cause lung disease. We report the surprising observation that Mtb-infected mice are resistant to secondary infection with CoV2, with no impact on Mtb burden and resistance associating with lung T and B cell expansion.
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Affiliation(s)
| | | | | | | | | | - Daniela Farkas
- Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Davis Heart and Lung Research Institute
| | - Shu-Hua Wang
- Department of Infectious Disease, The Ohio State University, Columbus, Ohio, United States of America
| | - Laszlo Farkas
- Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Davis Heart and Lung Research Institute
| | - Gang Xin
- Department of Microbial Infection and Immunity
- Pelotonia Institute for Immuno-Oncology
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35
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Molecular and Cellular Mechanisms of M. tuberculosis and SARS-CoV-2 Infections—Unexpected Similarities of Pathogenesis and What to Expect from Co-Infection. Int J Mol Sci 2022; 23:ijms23042235. [PMID: 35216349 PMCID: PMC8878934 DOI: 10.3390/ijms23042235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/07/2022] [Accepted: 02/14/2022] [Indexed: 11/16/2022] Open
Abstract
Tuberculosis is still an important medical and social problem. In recent years, great strides have been made in the fight against M. tuberculosis, especially in the Russian Federation. However, the emergence of a new coronavirus infection (COVID-19) has led to the long-term isolation of the population on the one hand and to the relevance of using personal protective equipment on the other. Our knowledge regarding SARS-CoV-2-induced inflammation and tissue destruction is rapidly expanding, while our understanding of the pathology of human pulmonary tuberculosis gained through more the 100 years of research is still limited. This paper reviews the main molecular and cellular differences and similarities caused by M. tuberculosis and SARS-CoV-2 infections, as well as their critical immunological and pathomorphological features. Immune suppression caused by the SARS-CoV-2 virus may result in certain difficulties in the diagnosis and treatment of tuberculosis. Furthermore, long-term lymphopenia, hyperinflammation, lung tissue injury and imbalance in CD4+ T cell subsets associated with COVID-19 could propagate M. tuberculosis infection and disease progression.
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Garcia PJ, Cabrera DM, Cárcamo PM, Diaz MM. HIV and COVID-19 in Latin America and the Caribbean. Curr HIV/AIDS Rep 2022; 19:37-45. [PMID: 35092570 PMCID: PMC8799981 DOI: 10.1007/s11904-021-00589-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE OF REVIEW Latin America and the Caribbean (LAC) has been hit hard by COVID-19 due to political instability, flawed health systems, and structural inequalities. The repercussion of the pandemic on vulnerable populations, like people living with HIV (PLWH), is complex. This review aims to explore the interactions between the HIV and COVID-19 pandemics in this region. RECENT FINDINGS Data regarding the interactions of HIV and COVID-19 in LAC is scarce. Only case reports or small case series have been published regarding the clinical course of COVID-19 in PLWH and regarding the clinical course of COVID-19 in PLWH, which appears to be similar to the general population. The pandemic has disrupted prevention and treatment of PLWH. However, there have been country efforts to counteract those effects. There are some lessons from the HIV response which have been effectively applied in the region to address COVID-19. COVID-19 has had an unprecedented impact on the cascade-of-care among PLWH in LAC. There is a need for longitudinal studies that assess clinic implication of these pandemic interactions in LAC.
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Affiliation(s)
- Patricia J. Garcia
- School of Public Health, Cayetano Heredia University, Av. Honorio Delgado 430, San Martin de Porres, Lima 31 Peru
| | - Diego M. Cabrera
- School of Public Health, Cayetano Heredia University, Av. Honorio Delgado 430, San Martin de Porres, Lima 31 Peru
- Section of Rheumatology, Allergy and Immunology, Yale School of Medicine, 330 Cedar Street, New Haven, CT 06510 USA
| | - Paloma M. Cárcamo
- School of Public Health, Cayetano Heredia University, Av. Honorio Delgado 430, San Martin de Porres, Lima 31 Peru
| | - Monica M. Diaz
- School of Public Health, Cayetano Heredia University, Av. Honorio Delgado 430, San Martin de Porres, Lima 31 Peru
- Department of Neurology, University of North Carolina at Chapel Hill, 170 Manning Drive, Campus Box 7025, Chapel Hill, NC, 27599 USA
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Lommatzsch M, Rabe KF, Taube C, Joest M, Kreuter M, Wirtz H, Blum TG, Kolditz M, Geerdes-Fenge H, Otto-Knapp R, Häcker B, Schaberg T, Ringshausen FC, Vogelmeier CF, Reinmuth N, Reck M, Gottlieb J, Konstantinides S, Meyer J, Worth H, Windisch W, Welte T, Bauer T. Risk Assessment for Patients with Chronic Respiratory Conditions in the Context of the SARS-CoV-2 Pandemic Statement of the German Respiratory Society with the Support of the German Association of Chest Physicians. Respiration 2022; 101:307-320. [PMID: 35231915 PMCID: PMC8985038 DOI: 10.1159/000518896] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 03/10/2021] [Indexed: 12/23/2022] Open
Abstract
Assessing the risk for specific patient groups to suffer from severe courses of COVID-19 is of major importance in the current SARS-CoV-2 pandemic. This review focusses on the risk for specific patient groups with chronic respiratory conditions, such as patients with asthma, chronic obstructive pulmonary disease, cystic fibrosis (CF), sarcoidosis, interstitial lung diseases, lung cancer, sleep apnea, tuberculosis, neuromuscular diseases, a history of pulmonary embolism, and patients with lung transplants. Evidence and recommendations are detailed in exemplary cases. While some patient groups with chronic respiratory conditions have an increased risk for severe courses of COVID-19, an increasing number of studies confirm that asthma is not a risk factor for severe COVID-19. However, other risk factors such as higher age, obesity, male gender, diabetes, cardiovascular diseases, chronic kidney or liver disease, cerebrovascular and neurological disease, and various immunodeficiencies or treatments with immunosuppressants need to be taken into account when assessing the risk for severe COVID-19 in patients with chronic respiratory diseases.
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Affiliation(s)
- Marek Lommatzsch
- Department of Pneumology, University of Rostock, Rostock, Germany
| | | | - Christian Taube
- Klinik für Pneumologie, University of Essen, Duisburg, Germany
| | | | | | - Hubert Wirtz
- Department of Pneumology, University of Leipzig, Leipzig, Germany
| | | | - Martin Kolditz
- Department of Pneumology, University of Dresden, Dresden, Germany
| | | | - Ralf Otto-Knapp
- German Central Committee against Tuberculosis, DZK, Berlin, Germany
| | - Brit Häcker
- German Central Committee against Tuberculosis, DZK, Berlin, Germany
| | | | | | - Claus F. Vogelmeier
- Department of Medicine, Pulmonary and Critical Care Medicine, University of Marburg, Marburg, Germany
| | | | - Martin Reck
- LungenClinic Großhansdorf, Großhansdorf, Germany
| | - Jens Gottlieb
- Department of Respiratory Medicine, University of Hannover, Hanover, Germany
| | | | - Joachim Meyer
- Lung Center Bogenhausen and Harlaching, Hospital Munich, Munich, Germany
| | | | | | - Tobias Welte
- Department of Respiratory Medicine, University of Hannover, Hanover, Germany
| | - Torsten Bauer
- Lung Hospital Heckeshorn, Helios Klinikum Emil von Behring, Berlin, Germany
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Jindal R, Gupta M, Khan F, Chaudhry G. Prevalence of co-morbidities and its association with mortality in Indian patients with COVID-19: A meta-analysis. Indian J Anaesth 2022; 66:399-418. [PMID: 35903589 PMCID: PMC9316668 DOI: 10.4103/ija.ija_845_21] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 11/21/2022] Open
Abstract
Background and Aims: Coronavirus disease 2019 (COVID 19) has spread to every corner of the world and has led to significant health consequences, especially in patients with co morbidities. This study aimed to estimate the prevalence of co morbidities among COVID 19 patients in the Indian population and their association with mortality. Methods: PubMed, Google Scholar, and World Health Organization website were searched for Indian studies on COVID 19 published from February 2020 up to 20 May 2021. English language publications from India, studies reporting epidemiological characteristics, prevalence of co morbidities and in hospital mortality were included in the meta analysis. Results: 34 studies were identified with a total of 23,034 patients. The pooled prevalence for co morbidities in COVID 19 patients was 18.1% [95% confidence interval (CI), 13.3 to 24.3%] for hypertension, 17.7% (95% CI, 12.2 to 25.1%) for diabetes, 7.9% (95% CI, 4.6 to 13.4%) for hypothyroidism and 7.7%(95% CI, 4.8 to 12. 1%) for cardiovascular diseases. For chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), cerebrovascular diseases, asthma, chronic liver disease, tuberculosis and cancer, the pooled prevalence was less than 4%. Additionally, the mortality risk was increased significantly in patients with CKD [odds ratio (OR) = 4.1], COPD (OR = 3.9), diabetes (OR = 3.7), cardiovascular diseases (OR = 4.07), tuberculosis (OR = 6.11), chronic liver disease (OR = 8.5), malignancy (OR = 1.89) and hypertension (OR = 2.9). Cerebrovascular diseases, hypothyroidism and asthma were not associated with increased mortality. Conclusion: Co-morbidities are more prevalent in COVID 19 hospitalised patients and the presence of co morbidities is associated with increased risk of mortality in Indian COVID 19 patients.
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Optimal control analysis of a COVID-19 and tuberculosis co-dynamics model. INFORMATICS IN MEDICINE UNLOCKED 2022; 28:100849. [PMID: 35071729 PMCID: PMC8759807 DOI: 10.1016/j.imu.2022.100849] [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: 12/09/2021] [Revised: 01/02/2022] [Accepted: 01/02/2022] [Indexed: 01/08/2023] Open
Abstract
Tuberculosis and COVID-19 are among the diseases with major global public health concern and great socio-economic impact. Co-infection of these two diseases is inevitable due to their geographical overlap, a potential double blow as their clinical similarities could hamper strategies to mitigate their spread and transmission dynamics. To theoretically investigate the impact of control measures on their long-term dynamics, we formulate and analyze a mathematical model for the co-infection of COVID-19 and tuberculosis. Basic properties of the tuberculosis only and COVID-19 only sub-models are investigated as well as bifurcation analysis (possibility of the co-existence of the disease-free and endemic equilibria). The disease-free and endemic equilibria are globally asymptotically stable. The model is extended into an optimal control system by incorporating five control measures. These are: tuberculosis awareness campaign, prevention against COVID-19 (e.g., face mask, physical distancing), control against co-infection, tuberculosis and COVID-19 treatment. Five strategies which are combinations of the control measures are investigated. Strategy B which focuses on COVID-19 prevention, treatment and control of co-infection yields a better outcome in terms of the number of COVID-19 cases prevented at a lower percentage of the total cost of this strategy.
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Mejia OR, Gloag ES, Li J, Ruane-Foster M, Claeys TA, Farkas D, Farkas L, Xin G, Robinson RT. Mice infected with Mycobacterium tuberculosis are resistant to secondary infection with SARS-CoV-2. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2021:2021.11.09.467862. [PMID: 34790981 PMCID: PMC8597884 DOI: 10.1101/2021.11.09.467862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
UNLABELLED Mycobacterium tuberculosis (Mtb) and SARS-CoV-2 (CoV2) are the leading causes of death due to infectious disease. Although Mtb and CoV2 both cause serious and sometimes fatal respiratory infections, the effect of Mtb infection and its associated immune response on secondary infection with CoV2 is unknown. To address this question we applied two mouse models of COVID19, using mice which were chronically infected with Mtb. In both model systems, Mtb-infected mice were resistant to secondary CoV2 infection and its pathological consequences, and CoV2 infection did not affect Mtb burdens. Single cell RNA sequencing of coinfected and monoinfected lungs demonstrated the resistance of Mtb-infected mice is associated with expansion of T and B cell subsets upon viral challenge. Collectively, these data demonstrate that Mtb infection conditions the lung environment in a manner that is not conducive to CoV2 survival. AUTHOR SUMMARY Mycobacterium tuberculosis (Mtb) and SARS-CoV-2 (CoV2) are distinct organisms which both cause lung disease. We report the surprising observation that Mtb-infected mice are resistant to secondary infection with CoV2, with no impact on Mtb burden and resistance associating with lung T and B cell expansion.
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Affiliation(s)
- Oscar Rosas Mejia
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH, USA
| | - Erin S Gloag
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH, USA
| | - Jianying Li
- Pelotonia Institute for Immuno-Oncology, The Ohio State University, Columbus, OH, USA
| | - Marisa Ruane-Foster
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH, USA
| | - Tiffany A Claeys
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH, USA
| | - Daniela Farkas
- Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Davis Heart and Lung Research Institute, The Ohio State University, Columbus, OH, USA
| | - Laszlo Farkas
- Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Davis Heart and Lung Research Institute, The Ohio State University, Columbus, OH, USA
| | - Gang Xin
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH, USA
- Pelotonia Institute for Immuno-Oncology, The Ohio State University, Columbus, OH, USA
| | - Richard T Robinson
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH, USA
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Zhang F, Karamagi H, Nsenga N, Nanyunja M, Karinja M, Amanfo S, Chase-Topping M, Calder-Gerver G, McGibbon M, Huber A, Wagner-Gamble T, Guo CG, Haynes S, Morrison A, Ferguson M, Awandare GA, Mutapi F, Yoti Z, Cabore J, Moeti MR, Woolhouse MEJ. Predictors of COVID-19 epidemics in countries of the World Health Organization African Region. Nat Med 2021; 27:2041-2047. [PMID: 34480125 PMCID: PMC8604723 DOI: 10.1038/s41591-021-01491-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/05/2021] [Indexed: 11/20/2022]
Abstract
Countries of the World Health Organization (WHO) African Region have experienced a wide range of coronavirus disease 2019 (COVID-19) epidemics. This study aimed to identify predictors of the timing of the first COVID-19 case and the per capita mortality in WHO African Region countries during the first and second pandemic waves and to test for associations with the preparedness of health systems and government pandemic responses. Using a region-wide, country-based observational study, we found that the first case was detected earlier in countries with more urban populations, higher international connectivity and greater COVID-19 test capacity but later in island nations. Predictors of a high first wave per capita mortality rate included a more urban population, higher pre-pandemic international connectivity and a higher prevalence of HIV. Countries rated as better prepared and having more resilient health systems were worst affected by the disease, the imposition of restrictions or both, making any benefit of more stringent countermeasures difficult to detect. Predictors for the second wave were similar to the first. Second wave per capita mortality could be predicted from that of the first wave. The COVID-19 pandemic highlights unanticipated vulnerabilities to infectious disease in Africa that should be taken into account in future pandemic preparedness planning.
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Affiliation(s)
- Feifei Zhang
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom.
| | | | - Ngoy Nsenga
- WHO Regional Office for Africa, Brazzaville, Republic of Congo
| | - Miriam Nanyunja
- WHO Regional Office for Africa, Brazzaville, Republic of Congo
| | - Miriam Karinja
- University of Nairobi Institute of Tropical and Infectious Diseases, Nairobi, Kenya
| | - Seth Amanfo
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Margo Chase-Topping
- School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Miles McGibbon
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Alexandra Huber
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Chuan-Guo Guo
- Department of Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Samuel Haynes
- School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Miranda Ferguson
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Gordon A Awandare
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Accra, Ghana
| | - Francisca Mutapi
- School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Zabulon Yoti
- WHO Regional Office for Africa, Brazzaville, Republic of Congo
| | - Joseph Cabore
- WHO Regional Office for Africa, Brazzaville, Republic of Congo
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Chetty VV, Chetty M. Potential benefit of vitamin D supplementation in people with respiratory illnesses, during the COVID-19 pandemic. Clin Transl Sci 2021; 14:2111-2116. [PMID: 34057814 PMCID: PMC8239894 DOI: 10.1111/cts.13044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/24/2021] [Accepted: 02/27/2021] [Indexed: 11/30/2022] Open
Abstract
This review describes the evidence for the potential benefit of vitamin D supplementation in people with respiratory diseases who may have a higher susceptibility to coronavirus disease 2019 (COVID-19) infection and its consequences. Clinical evidence indicates that vitamin D may reduce the risk of both upper and lower respiratory tract infections and offers benefit particularly in people with vitamin D deficiency. Some evidence exists for a higher incidence of active tuberculosis (TB) in patients who are deficient in vitamin D. An association between low levels of 25(OH)D (the active form of vitamin D) and COVID-19 severity of illness and mortality has also been reported. In addition, low 25(OH)D levels are associated with poor outcomes in acute respiratory distress syndrome (ARDS). The cytokine storm experienced in severe COVID-19 infections results from excessive release of pro-inflammatory cytokines. Due to its immunomodulatory effects, adequate vitamin D levels may cause a decrease in the pro-inflammatory cytokines and an increase in the anti-inflammatory cytokines during COVID-19 infections. Vitamin D deficiency was found in 82.2% of hospitalized COVID-19 cases and 47.2% of population-based controls (p < 0.0001). The available evidence warrants an evaluation of vitamin D supplementation in susceptible populations with respiratory diseases, such as TB, and particularly in those who are deficient in vitamin D. This may mitigate against serious complications of COVID-19 infections or reduce the impact of ARDS in those who have been infected.
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Affiliation(s)
| | - Manoranjenni Chetty
- Discipline of Pharmaceutical SciencesCollege of Health SciencesUniversity of KwaZulu NatalDurbanSouth Africa
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Aggarwal AN, Agarwal R, Dhooria S, Prasad KT, Sehgal IS, Muthu V. Active pulmonary tuberculosis and coronavirus disease 2019: A systematic review and meta-analysis. PLoS One 2021; 16:e0259006. [PMID: 34673822 PMCID: PMC8530351 DOI: 10.1371/journal.pone.0259006] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 10/08/2021] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE The proportion of COVID-19 patients having active pulmonary tuberculosis, and its impact on COVID-19 related patient outcomes, is not clear. We conducted this systematic review to evaluate the proportion of patients with active pulmonary tuberculosis among COVID-19 patients, and to assess if comorbid pulmonary tuberculosis worsens clinical outcomes in these patients. METHODS We queried the PubMed and Embase databases for studies providing data on (a) proportion of COVID-19 patients with active pulmonary tuberculosis or (b) severe disease, hospitalization, or mortality among COVID-19 patients with and without active pulmonary tuberculosis. We calculated the proportion of tuberculosis patients, and the relative risk (RR) for each reported outcome of interest. We used random-effects models to summarize our data. RESULTS We retrieved 3,375 citations, and included 43 studies, in our review. The pooled estimate for proportion of active pulmonary tuberculosis was 1.07% (95% CI 0.81%-1.36%). COVID-19 patients with tuberculosis had a higher risk of mortality (summary RR 1.93, 95% CI 1.56-2.39, from 17 studies) and for severe COVID-19 disease (summary RR 1.46, 95% CI 1.05-2.02, from 20 studies), but not for hospitalization (summary RR 1.86, 95% CI 0.91-3.81, from four studies), as compared to COVID-19 patients without tuberculosis. CONCLUSION Active pulmonary tuberculosis is relatively common among COVID-19 patients and increases the risk of severe COVID-19 and COVID-19-related mortality.
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Affiliation(s)
- Ashutosh Nath Aggarwal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ritesh Agarwal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sahajal Dhooria
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Kuruswamy Thurai Prasad
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Inderpaul Singh Sehgal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Valliappan Muthu
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Global, regional, and national sex-specific burden and control of the HIV epidemic, 1990-2019, for 204 countries and territories: the Global Burden of Diseases Study 2019. Lancet HIV 2021. [PMID: 34592142 PMCID: PMC8491452 DOI: 10.1016/s2352-3018(21)00152-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The sustainable development goals (SDGs) aim to end HIV/AIDS as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. This study assesses the current sex-specific HIV burden in 204 countries and territories and measures progress in the control of the epidemic. METHODS To estimate age-specific and sex-specific trends in 48 of 204 countries, we extended the Estimation and Projection Package Age-Sex Model to also implement the spectrum paediatric model. We used this model in cases where age and sex specific HIV-seroprevalence surveys and antenatal care-clinic sentinel surveillance data were available. For the remaining 156 of 204 locations, we developed a cohort-incidence bias adjustment to derive incidence as a function of cause-of-death data from vital registration systems. The incidence was input to a custom Spectrum model. To assess progress, we measured the percentage change in incident cases and deaths between 2010 and 2019 (threshold >75% decline), the ratio of incident cases to number of people living with HIV (incidence-to-prevalence ratio threshold <0·03), and the ratio of incident cases to deaths (incidence-to-mortality ratio threshold <1·0). FINDINGS In 2019, there were 36·8 million (95% uncertainty interval [UI] 35·1-38·9) people living with HIV worldwide. There were 0·84 males (95% UI 0·78-0·91) per female living with HIV in 2019, 0·99 male infections (0·91-1·10) for every female infection, and 1·02 male deaths (0·95-1·10) per female death. Global progress in incident cases and deaths between 2010 and 2019 was driven by sub-Saharan Africa (with a 28·52% decrease in incident cases, 95% UI 19·58-35·43, and a 39·66% decrease in deaths, 36·49-42·36). Elsewhere, the incidence remained stable or increased, whereas deaths generally decreased. In 2019, the global incidence-to-prevalence ratio was 0·05 (95% UI 0·05-0·06) and the global incidence-to-mortality ratio was 1·94 (1·76-2·12). No regions met suggested thresholds for progress. INTERPRETATION Sub-Saharan Africa had both the highest HIV burden and the greatest progress between 1990 and 2019. The number of incident cases and deaths in males and females approached parity in 2019, although there remained more females with HIV than males with HIV. Globally, the HIV epidemic is far from the UNAIDS benchmarks on progress metrics. FUNDING The Bill & Melinda Gates Foundation, the National Institute of Mental Health of the US National Institutes of Health (NIH), and the National Institute on Aging of the NIH.
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Tolossa T, Tsegaye R, Shiferaw S, Wakuma B, Ayala D, Bekele B, Shibiru T. Survival from a Triple Co-Infection of COVID-19, HIV, and Tuberculosis: A Case Report. Int Med Case Rep J 2021; 14:611-615. [PMID: 34512043 PMCID: PMC8421329 DOI: 10.2147/imcrj.s326383] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/24/2021] [Indexed: 12/24/2022] Open
Abstract
Introduction The triple burden of COVID-19, human immune virus (HIV), and TB co-infection is one of the contemporary challenges to this globe. People living with chronic medical diseases such as HIV and TB are more likely to experience poor outcomes from COVID-19. This study aimed to report survival from triple co-infection with PTB, HIV, and COVID-19 in Wollega University referral hospital (WURH), western Ethiopia. Case Presentation A 55-year-old male known HIV patient on HAART for the last 3 years presented to WURH on May 26, 2021, with chief complaints of shortness of breath of 5 days' duration associated with productive cough, history of high-grade fever, and severe headache. He had produced a lot of bloody sputum one month prior to the current complaints. On 1st day of his presentation, a Gene Expert test was done from sputum, and he was positive for pulmonary TB. On the same day, a nasopharyngeal sample for COVID-19 using polymerase chain reaction (PCR) was positive. On his 2nd day of admission, he was transferred to the COVID-19 treatment center with the diagnosis of severe COVID-19, PTB, and WHO stage-3 RVI. During his stay in the hospital, he was provided with oxygen via a nasal cannula. Intensive phase anti-TB treatment was initiated on the 3rd day of admission. HAART was continued with the same regimen he was taking prior to his presentation. On June 6, 2021, the patient was recovered and discharged from the hospital after 10 days of hospital stay. Conclusion This case report suggests, after 10 days of admission with triple infections, there is a good clinical prognosis and survival from COVID-19. On admission, further diagnosis and investigations of TB co-infection should be performed for all patients admitted with COVID-19 due to their similar and non-specific clinical manifestations.
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Affiliation(s)
- Tadesse Tolossa
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Reta Tsegaye
- Department of Nursing, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Siraj Shiferaw
- School of Medicine, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Bizuneh Wakuma
- Department of Nursing, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Diriba Ayala
- Department of Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Belay Bekele
- Wollega University Referral Hospital, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Tesfaye Shibiru
- School of Medicine, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
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Thomas L, Birangal SR, Ray R, Sekhar Miraj S, Munisamy M, Varma M, S V CS, Banerjee M, Shenoy GG, Rao M. Prediction of potential drug interactions between repurposed COVID-19 and antitubercular drugs: an integrational approach of drug information software and computational techniques data. Ther Adv Drug Saf 2021; 12:20420986211041277. [PMID: 34471515 PMCID: PMC8404633 DOI: 10.1177/20420986211041277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 07/24/2021] [Indexed: 01/02/2023] Open
Abstract
Introduction: Tuberculosis is a major respiratory disease globally with a higher prevalence in Asian and African countries than rest of the world. With a larger population of tuberculosis patients anticipated to be co-infected with COVID-19 infection, an ongoing pandemic, identifying, preventing and managing drug–drug interactions is inevitable for maximizing patient benefits for the current repurposed COVID-19 and antitubercular drugs. Methods: We assessed the potential drug–drug interactions between repurposed COVID-19 drugs and antitubercular drugs using the drug interaction checker of IBM Micromedex®. Extensive computational studies were performed at a molecular level to validate and understand the drug–drug interactions found from the Micromedex drug interaction checker database at a molecular level. The integrated knowledge derived from Micromedex and computational data was collated and curated for predicting potential drug–drug interactions between repurposed COVID-19 and antitubercular drugs. Results: A total of 91 potential drug–drug interactions along with their severity and level of documentation were identified from Micromedex between repurposed COVID-19 drugs and antitubercular drugs. We identified 47 pharmacodynamic, 42 pharmacokinetic and 2 unknown DDIs. The majority of our molecular modelling results were in line with drug–drug interaction data obtained from the drug information software. QT prolongation was identified as the most common type of pharmacodynamic drug–drug interaction, whereas drug–drug interactions associated with cytochrome P450 3A4 (CYP3A4) and P-glycoprotein (P-gp) inhibition and induction were identified as the frequent pharmacokinetic drug–drug interactions. The results suggest antitubercular drugs, particularly rifampin and second-line agents, warrant high alert and monitoring while prescribing with the repurposed COVID-19 drugs. Conclusion: Predicting these potential drug–drug interactions, particularly related to CYP3A4, P-gp and the human Ether-à-go-go-Related Gene proteins, could be used in clinical settings for screening and management of drug–drug interactions for delivering safer chemotherapeutic tuberculosis and COVID-19 care. The current study provides an initial propulsion for further well-designed pharmacokinetic-pharmacodynamic-based drug–drug interaction studies. Plain Language Summary
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Affiliation(s)
- Levin Thomas
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Sumit Raosaheb Birangal
- Department of Pharmaceutical Chemistry, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Rajdeep Ray
- Department of Pharmaceutical Chemistry, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Sonal Sekhar Miraj
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Murali Munisamy
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Muralidhar Varma
- Department of Infectious Diseases, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | | | - Mithu Banerjee
- Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Gautham G Shenoy
- Department of Pharmaceutical Chemistry, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Mahadev Rao
- Professor and Head, Department of Pharmacy Practice, Coordinator, Centre for Translational Research, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education (MAHE), Manipal 576104, Karnataka, India
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Treskova-Schwarzbach M, Haas L, Reda S, Pilic A, Borodova A, Karimi K, Koch J, Nygren T, Scholz S, Schönfeld V, Vygen-Bonnet S, Wichmann O, Harder T. Pre-existing health conditions and severe COVID-19 outcomes: an umbrella review approach and meta-analysis of global evidence. BMC Med 2021; 19:212. [PMID: 34446016 PMCID: PMC8390115 DOI: 10.1186/s12916-021-02058-6] [Citation(s) in RCA: 102] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 07/08/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND This study applies an umbrella review approach to summarise the global evidence on the risk of severe COVID-19 outcomes in patients with pre-existing health conditions. METHODS Systematic reviews (SRs) were identified in PubMed, Embase/Medline and seven pre-print servers until December 11, 2020. Due to the absence of age-adjusted risk effects stratified by geographical regions, a re-analysis of the evidence was conducted. Primary studies were extracted from SRs and evaluated for inclusion in the re-analysis. Studies were included if they reported risk estimates (odds ratio (OR), hazard ratio (HR), relative risk (RR)) for hospitalisation, intensive care unit admission, intubation or death. Estimated associations were extracted from the primary studies for reported pre-existing conditions. Meta-analyses were performed stratified for each outcome by regions of the World Health Organization. The evidence certainty was assessed using GRADE. Registration number CRD42020215846. RESULTS In total, 160 primary studies from 120 SRs contributed 464 estimates for 42 pre-existing conditions. Most studies were conducted in North America, European, and Western Pacific regions. Evidence from Africa, South/Latin America, and the Eastern Mediterranean region was scarce. No evidence was available from the South-East Asia region. Diabetes (HR range 1.2-2.0 (CI range 1.1-2.8)), obesity (OR range 1.5-1.75 (CI range 1.1-2.3)), heart failure (HR range 1.3-3.3 (CI range 0.9-8.2)), COPD (HR range 1.12-2.2 (CI range 1.1-3.2)) and dementia (HR range 1.4-7.7 (CI range 1.2-39.6)) were associated with fatal COVID-19 in different regions, although the estimates varied. Evidence from Europe and North America showed that liver cirrhosis (OR range 3.2-5.9 (CI range 0.9-27.7)) and active cancer (OR range 1.6-4.7 (CI range 0.5-14.9)) were also associated with increased risk of death. Association between HIV and undesirable COVID-19 outcomes showed regional heterogeneity, with an increased risk of death in Africa (HR 1.7 (CI 1.3-2.2)). GRADE certainty was moderate to high for most associations. CONCLUSION Risk of undesirable COVID-19 health outcomes is consistently increased in certain patient subgroups across geographical regions, showing high variability in others. The results can be used to inform COVID-19 vaccine prioritisation or other intervention strategies.
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Affiliation(s)
| | - Laura Haas
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Sarah Reda
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Antonia Pilic
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Anna Borodova
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Kasra Karimi
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Judith Koch
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Teresa Nygren
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Stefan Scholz
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Viktoria Schönfeld
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Sabine Vygen-Bonnet
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Ole Wichmann
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Thomas Harder
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
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Chilot D, Woldeamanuel Y, Manyazewal T. COVID-19 Burden on HIV Patients Attending Antiretroviral Therapy in Addis Ababa, Ethiopia: A Multicenter Cross-Sectional Study. RESEARCH SQUARE 2021. [PMID: 34341785 PMCID: PMC8328071 DOI: 10.21203/rs.3.rs-699963/v1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background There has been promising progress towards screening, testing, and retaining HIV patients in care in Ethiopia. Concern exists that possible disruptions in HIV programs due to COVID-19 could result in more HIV-related mortality and new HIV infections. This study aimed to investigate the real-time burden of COVID-19 on HIV patients attending antiretroviral therapy. Methods We conducted a facility-based, multicentre, cross-sectional study among HIV patients attending antiretroviral therapy in 10 healthcare facilities in Addis Ababa, Ethiopia, in the COVID-19 pandemic period. Data was collected using adapted, interviewer-based questionnaires, and entered into Epi Info version 7 and exported to SPSS version 26 for analysis. Result A total of 212 patients with HIV were included. Participants who missed visits for refill were 58 (27.4%). When the effects of other independent variables on appointments/visits for refill were controlled, the following characteristics were found to be the most important pridictors of missed appointments (P < 0.05): age ≥ 55 [AOR = 6.73, 95% CI (1.495–30.310)], fear of COVID-19 [AOR = 24.93, 95% CI (2.798-222.279)], transport disruption [AOR = 4.90, 95% CI (1.031–23.174)], reduced income for traveling to health facility [AOR = 5.64, 95% CI (1.234–25.812)], and limited access to mask [AOR = 7.67, 95% CI (1.303–45.174)], sanitizer [AOR = 0.07, 95% CI (0.007–0.729)] and non-medical support [AOR = 2.32, 95% CI (1.547–12.596)]. The participants were well aware of the COVID-19 preventive measures. The most costly COVID-19 preventive measures that cause financial burden to the patients were costs for buying facemasks (63.7%), disinfectants (55.2) and sops for handwashing (22.2). Participants who missed follow-up diagnostic tests were 56 (26.4%). Variables which were found to be statistically significant include the following: age ≥ 55 [AOR = 0.22, 95% CI (0.076–0.621)], partial lockdown [AOR = 0.10, 95% CI (0.011–0.833)], limited access to health services [AOR = 0.15, 95% CI (0.045–0.475)], reduced income for traveling to health facility [AOR = 0.18, 95% CI (0.039–0.784)], and unable to get mask [AOR = 0.12, 95% CI (0.026–0.543)]. Participants who missed counseling services were 55 (25.9%). In multivariate logistic regression the following were statisticaly significant: age ≥ 55 [AOR = 0.21, 95% CI (0.078–0.570)], fear of COVID-19 [AOR = 0.11, 95% CI (0.013–0.912)], reduced income [AOR = 0.17, 95% CI (0.041–0.699)], unable to get face mask [AOR = 0.19, 95%CI (0.039–0.959)], and partial lockdown [AOR = 0.08, 95% CI (0.008–0.790)]. Conclusions COVID-19 had a significant burden on HIV patients to attend their routine clinical care and treatment, which may lead to treatment failure and drug resistance. The impact was on their appointments for medication refills and clinical and laboratory follow-ups. Targeted initiatives are needed to sustain HIV clinical care and treatment services and improve the wellbeing of people living with HIV.
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van Wyngaard A, Whiteside A. AIDS and COVID-19 in southern Africa. AJAR-AFRICAN JOURNAL OF AIDS RESEARCH 2021; 20:117-124. [PMID: 34264162 DOI: 10.2989/16085906.2021.1948877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
By the end of the first year of the COVID-19 pandemic, in February 2021, the numbers of cases and deaths in southern Africa were low in absolute and relative numbers. The BBC ran a story (which was later retracted) headlined "Coronavirus in Africa: Could poverty explain mystery of low death rate?". A heading in the New York Post said: "Scientists can't explain puzzling lack of coronavirus outbreaks in Africa". Journalist Karen Attiah concluded: "It's almost as if they are disappointed that Africans aren't dying en masse and countries are not collapsing". We wondered if the knowledge that southern African countries have acquired in their struggle against AIDS has contributed to a more effective approach against COVID-19. The viral origins of the diseases through zoonotic events are similar; neither has a cure, yet. In both diseases, behaviour change is an important prevention tool, and there are specific groups that are more vulnerable to infection. Equally, there are important differences: most people with COVID-19 will recover relatively quickly, while people living with HIV will need lifelong treatment. COVID-19 is extremely infectious, while HIV is less easily transmitted.
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Affiliation(s)
- Arnau van Wyngaard
- Shiselweni Home-Based Care, Department of Science of Religion and Missiology, University of Pretoria, Piet Retief, South Africa
| | - Alan Whiteside
- Balsillie School of International Affairs, Waterloo, Canada
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Hoque MN, Akter S, Mishu ID, Islam MR, Rahman MS, Akhter M, Islam I, Hasan MM, Rahaman MM, Sultana M, Islam T, Hossain MA. Microbial co-infections in COVID-19: Associated microbiota and underlying mechanisms of pathogenesis. Microb Pathog 2021; 156:104941. [PMID: 33962007 PMCID: PMC8095020 DOI: 10.1016/j.micpath.2021.104941] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 04/08/2021] [Accepted: 04/08/2021] [Indexed: 01/08/2023]
Abstract
The novel coronavirus infectious disease-2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has traumatized the whole world with the ongoing devastating pandemic. A plethora of microbial domains including viruses (other than SARS-CoV-2), bacteria, archaea and fungi have evolved together, and interact in complex molecular pathogenesis along with SARS-CoV-2. However, the involvement of other microbial co-pathogens and underlying molecular mechanisms leading to extortionate ailment in critically ill COVID-19 patients has yet not been extensively reviewed. Although, the incidence of co-infections could be up to 94.2% in laboratory-confirmed COVID-19 cases, the fate of co-infections among SARS-CoV-2 infected hosts often depends on the balance between the host's protective immunity and immunopathology. Predominantly identified co-pathogens of SARS-CoV-2 are bacteria such as Streptococcus pneumoniae, Staphylococcus aureus, Klebsiella pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, Acinetobacter baumannii, Legionella pneumophila and Clamydia pneumoniae followed by viruses including influenza, coronavirus, rhinovirus/enterovirus, parainfluenza, metapneumovirus, influenza B virus, and human immunodeficiency virus. The cross-talk between co-pathogens (especially lung microbiomes), SARS-CoV-2 and host is an important factor that ultimately increases the difficulty of diagnosis, treatment, and prognosis of COVID-19. Simultaneously, co-infecting microbiotas may use new strategies to escape host defense mechanisms by altering both innate and adaptive immune responses to further aggravate SARS-CoV-2 pathogenesis. Better understanding of co-infections in COVID-19 is critical for the effective patient management, treatment and containment of SARS-CoV-2. This review therefore necessitates the comprehensive investigation of commonly reported microbial co-pathogens amid COVID-19, their transmission pattern along with the possible mechanism of co-infections and outcomes. Thus, identifying the possible co-pathogens and their underlying molecular mechanisms during SARS-CoV-2 pathogenesis may shed light in developing diagnostics, appropriate curative and preventive interventions for suspected SARS-CoV-2 respiratory infections in the current pandemic.
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Affiliation(s)
- M Nazmul Hoque
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh; Department of Gynecology, Obstetrics and Reproductive Health, Bangabandhu Sheikh Mujibur Rahman Agricultural University (BSMRAU), Gazipur, 1706, Bangladesh
| | - Salma Akter
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh; Department of Microbiology, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | | | - M Rafiul Islam
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - M Shaminur Rahman
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Masuda Akhter
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Israt Islam
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Mehedi Mahmudul Hasan
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh; Department of Fisheries and Marine Science, Noakhali Science and Technology University, Noakhali, 3814, Bangladesh
| | - Md Mizanur Rahaman
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Munawar Sultana
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Tofazzal Islam
- Institute of Biotechnology and Genetic Engineering (IBGE), BSMRAU, Gazipur, 1706, Bangladesh
| | - M Anwar Hossain
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh; Jashore University of Science and Technology, Jashore, 7408, Bangladesh.
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