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Obe -A- Ndzem Holenn SE, Mazoba TK, Mukanga DY, Zokere TB, Lungela D, Makulo JR, Ahuka S, Mbongo AT, Molua AA. Interest of Chest CT to Assess the Prognosis of SARS-CoV-2 Pneumonia: An In-Hospital-Based Experience in Sub-Saharan Africa. Pulm Med 2024; 2024:5520174. [PMID: 38699403 PMCID: PMC11065491 DOI: 10.1155/2024/5520174] [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: 01/30/2024] [Revised: 03/24/2024] [Accepted: 04/06/2024] [Indexed: 05/05/2024] Open
Abstract
Methods We included all patients with respiratory symptoms (dyspnea, fever, and cough) and/or respiratory failure admitted to the SOS Médecins de nuit SARL hospital, DR Congo, during the 2nd and 3rd waves of the COVID-19 pandemic. The diagnosis of COVID-19 was established based on RT-PCR anti-SARS-CoV-2 tests (G1 (RT-PCR positive) vs. G2 (RT-PCR negative)), and all patients had a chest CT on the day of admission. We retrieved the digital files of patients, precisely the clinical, biological, and chest CT parameters of the day of admission as well as the vital outcome (survival or death). Chest CT were read by a very high-definition console using Advantage Windows software and exported to the hospital network using the RadiAnt DICOM viewer. To determine the threshold for the percentage of lung lesions associated with all-cause mortality, we used ROC curves. Factors associated with death, including chest CT parameters, were investigated using logistic regression analysis. Results The study included 200 patients (average age 56.2 ± 15.2 years; 19% diabetics and 4.5% obese), and COVID-19 was confirmed among 56% of them (G1). Chest CT showed that ground glass (72.3 vs. 39.8%), crazy paving (69.6 vs. 17.0%), and consolidation (83.9 vs. 22.7%), with bilateral and peripheral locations (68.8 vs. 30.7%), were more frequent in G1 vs. G2 (p < 0.001). No case of pulmonary embolism and fibrosis had been documented. The lung lesions affecting 30% of the parenchyma were informative in predicting death (area under the ROC curve at 0.705, p = 0.017). In multivariate analysis, a percentage of lesions affecting 50% of the lung parenchyma increased the risk of dying by 7.194 (1.656-31.250). Conclusion The chest CT demonstrated certain characteristic lesions more frequently in patients in whom the diagnosis of COVID-19 was confirmed. The extent of lesions affecting at least half of the lung parenchyma from the first day of admission to hospital increases the risk of death by a factor of 7.
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Affiliation(s)
- Serge Emmanuel Obe -A- Ndzem Holenn
- Department of Radiology and Medical Imaging, Hôpital Médecins de nuit SARL, Kinshasa, Democratic Republic of the Congo
- Department of Radiology and Medical Imaging, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of the Congo
- Intensive Care Unit, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Tacite Kpanya Mazoba
- Department of Radiology and Medical Imaging, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of the Congo
- Interdisciplinary Center for Research in Medical Imaging (CIRIMED), University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Désiré Yaya Mukanga
- Department of Radiology and Medical Imaging, Hôpital Médecins de nuit SARL, Kinshasa, Democratic Republic of the Congo
| | - Tyna Bongosepe Zokere
- Department of Radiology and Medical Imaging, Hôpital Médecins de nuit SARL, Kinshasa, Democratic Republic of the Congo
| | - Djo Lungela
- Intensive Care Unit, Hôpital Médecins de nuit SARL, Kinshasa, Democratic Republic of the Congo
| | - Jean-Robert Makulo
- COVID-19 Treatment Center, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Steve Ahuka
- Department of Microbiology, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Angèle Tanzia Mbongo
- Department of Radiology and Medical Imaging, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of the Congo
- Interdisciplinary Center for Research in Medical Imaging (CIRIMED), University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Antoine Aundu Molua
- Department of Radiology and Medical Imaging, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of the Congo
- Interdisciplinary Center for Research in Medical Imaging (CIRIMED), University of Kinshasa, Kinshasa, Democratic Republic of the Congo
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Akilimali PZ, Kayembe DM, Muhindo NM, Tran NT. Predictors of mortality among inpatients in COVID-19 treatment centers in the city of Butembo, North Kivu, Democratic Republic of Congo. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002020. [PMID: 38266008 PMCID: PMC10807785 DOI: 10.1371/journal.pgph.0002020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 12/11/2023] [Indexed: 01/26/2024]
Abstract
Determining the risk factors for severe disease and death among hospitalized Covid-19 patients is critical to optimize health outcomes and health services efficiency, especially in resource-constrained and humanitarian settings. This study aimed to identify the predictors of mortality of Covid-19 patients in North Kivu province in the Democratic Republic of Congo.A retrospective cohort study was conducted in 6 Covid-19 treatment centers in the city of Butembo from 1 January to 31 December 2021. The time to event (death), the outcome variable, was visualized by Kaplan-Meier curves and the log-rank test was used to confirm differences in trends. Cox regression was used for all the predictors in the bivariate analysis and multivariate analysis was done using predictors found statistically significant in the bivariate analysis. The following variables were considered for inclusion to the Cox regression model: Age, Sex, Disease length, Treatment site, History of at least one co-morbidity, Body mass index, Stage according to SpO2 and the NEWS-modified score.Among the 303 participants (mean age of 53 years), the fatality rate was 33.8 deaths per 1000 patient-days. Four predictors were independently associated with inpatient death: age category (≥ 60 years) (adjusted HR: 9.90; 95% CI: 2.68-36.27), presence of at least one comorbidity (adjusted HR: 11.39; 95% CI: 3.19-40.71); duration of illness of > 5 days before hospitalization (adjusted HR:1.70, 95% CI: 1.04-2.79) and peripheral capillary oxygen saturation (SpO2) < 90% (adjusted HR = 14.02, 95% CI: 2.23-88.32). In addition to advanced age, comorbidity, and length of disease before hospitalization, ambient air SpO2 measured by healthcare providers using low-tech, affordable and relatively accessible pulse oximetry could inform the care pathways of Covid-19 inpatients in resource-challenged health systems in humanitarian settings.
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Affiliation(s)
- Pierre Z. Akilimali
- Patrick Kayembe Research Center, Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Congo
- Department of Nutrition, Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Congo
| | - Dynah M. Kayembe
- Department of Nutrition, Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Congo
| | - Norbert M. Muhindo
- Assistant at the Official University of Ruwenzori in Butembo, Butembo, North Kivu, Congo
- Head of Manguredjipa Health Zone, Butembo, Nord Kivu, Congo
| | - Nguyen Toan Tran
- Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
- Faculty of Medicine, University of Geneva, Genève, Switzerland
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Riziki Ghislain M, Muzumbukilwa WT, Magula N. Risk factors for death in hospitalized COVID-19 patients in Africa: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e34405. [PMID: 37657047 PMCID: PMC10476721 DOI: 10.1097/md.0000000000034405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/28/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 has quickly spread worldwide since it first appeared in Wuhan, China, in late 2019. The most affected country in Africa was South Africa. This study aimed to identify the risk factors for death in hospitalized COVID-19 patients in Africa. METHODS We conducted a systematic review following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. We searched articles from the following database: PubMed, Embase, Cochrane Library, Medline, and COVID-19 Research Database. We used Google Scholar for gray literature. The language used in this article was English. The last search was conducted on January 15, 2023. Pooled HRs, or ORs, and 95% confidence intervals, were calculated separately to identify the risk factors for death in hospitalized COVID-19 patients. Heterogeneity was assessed by Cochran's Q statistic and the I2 test. The Egger test was used to assess publication bias. Subgroup analysis was performed to determine the source of heterogeneity. Data analysis was performed using Stata version 17. A P value < .05 was considered significant. RESULTS A total of 16,600 articles were obtained from the database search; finally, 16 articles met the inclusion criteria and were eligible for data extraction. The analysis revealed that the pooled prevalence of mortality in hospitalized COVID-19 patients was 13.9%. Advanced age was a significant risk factor for death in hospitalized COVID-19 patients, with the pooled coronavirus mortality HR and OR being 3.73 (95% CI: 2.27-5.19) and 1.04 (95% CI: 1.02-1.06), respectively. In addition, male gender (pOR 1.23; 95% CI: 1.07-1.40), patients with diabetes mellitus (DM) (pOR 1.26; 95% CI: 1.01-1.51), hypertension (HTN) (pOR 1.56; 95% CI: 1.27-1.85), chronic kidney disease (CKD) (pHR 5.43; 95% CI: 0.18-10.67), severe or critical conditions (pOR 9.04; 95% CI: 3.14-14.94) had a significantly increased risk of coronavirus-related mortality. The main limitations of the present study stem from the predominant use of published studies, which could introduce publication bias. CONCLUSION According to this study, advanced age, male gender, hypertension, diabetes mellitus, chronic kidney disease, and severe or critical condition were clinical risk factors associated with death outcomes in hospitalized COVID-19 patients in Africa.
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Affiliation(s)
- Manimani Riziki Ghislain
- The Department of Internal Medicine, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Willy Tambwe Muzumbukilwa
- The Discipline of Pharmaceutical Sciences, Westville Campus, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Nombulelo Magula
- The Department of Internal Medicine, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
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Karakök T. Splenic Infarction Secondary to COVID-19 and Malaria Co-Infection: A Case Report. IRANIAN JOURNAL OF PARASITOLOGY 2023; 18:400-403. [PMID: 37886245 PMCID: PMC10597879 DOI: 10.18502/ijpa.v18i3.13763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/14/2023] [Indexed: 10/28/2023]
Abstract
Splenic infarction is a rare complication of both malaria and COVID-19. We report a splenic infarction case due to COVID-19 and malaria co-infection. A 35-year-old male with no known chronical disease tested positive for both COVID-19 and malaria in Turkey in 2022. Oral artemether and lumefantrine treatment was started. On the third day of the treatment, he complained about a severe left upper quadrant pain. A repeated abdominal CT showed splenomegaly and 8 cm diameter hypodense areas throughout the spleen consistent with splenic infarction. The patient was discharged with low molecular weight heparin. A rare complication that can be seen in both diseases developed a more rigorous recommendation for anticoagulant therapy is needed for co-infections of COVID-19 with diseases that may present similar thrombotic complications.
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Affiliation(s)
- Taliha Karakök
- Infectious Disease Deparment, Fatsa State Hospital, Ordu, Türkiye
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Co-infection of COVID-19 and parasitic diseases: A systematic review. Parasite Epidemiol Control 2023; 21:e00299. [PMID: 37091061 PMCID: PMC10062795 DOI: 10.1016/j.parepi.2023.e00299] [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: 12/03/2022] [Revised: 02/16/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
Co-infection of COVID-19 with other diseases increases the challenges related to its treatment management. COVID-19 co-infection with parasites is studied with low frequency. Here, we systematically reviewed the cases of parasitic disease co-infection with COVID-19. All articles on COVID-19 co-infected with parasites (protozoa, helminths, and ectoparasites), were screened through defined inclusion/exclusion criteria. Of 2190 records, 35 studies remained for data extraction. The majority of studies were about COVID-19 co-infected with malaria, followed by strongyloidiasis, amoebiasis, chagas, filariasis, giardiasis, leishmaniasis, lophomoniasis, myiasis, and toxoplasmosis. No or low manifestation differences were reported between the co-infected cases and naïve COVID-19 or naïve parasitic disease. Although there was a relatively low number of reports on parasitic diseases-COVID-19 co-infection, COVID-19 and some parasitic diseases have overlapping symptoms and also COVID-19 conditions and treatment regimens may cause some parasites re-emergence, relapse, or re-activation. Therefore, more attention should be paid to the on-time diagnosis of COVID-19 and the co-infected parasites.
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Mmerem JI, Unigwe US, Iroezindu MO, Chukwu KS, Ezenwosu IL, Okorie GO, Chika-Igwenyi NM, Nwatu CB, Onodugo OD. Demographic characteristics, clinical presentation and in-hospital outcome among patients with Covid-19 in a Nigerian tertiary hospital. Malawi Med J 2023; 35:43-57. [PMID: 38124701 PMCID: PMC10645895 DOI: 10.4314/mmj.v35i1.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Background We described the demographic/clinical characteristics and in-hospital outcome of patients with COVID-19 at the University of Nigeria Teaching Hospital (UNTH) during the first wave to inform evidence-based responses during subsequent waves in Africa. Methodology We conducted retrospective cohort analyses of adult patients ≥18 years with PCR or GeneXpert-confirmed SARS-CoV-2 infection. Data was extracted from patients' medical records from 1st May to 30th September 2020. Based on disease severity, patients were either hospitalized (82) or managed at home (90). Logistic regression and cox-proportional hazard models were used to determine predictors of severe COVID-19 disease and in-hospital mortality, respectively. Results Of 172 cases, 113 (65.7%) were males, and the mean age was 45 ± 19 years. The majority were urban dwellers (72.1%), 19.8% had a positive history of contact with a confirmed/suspected case, 15.7% were healthcare workers while 68 (39.5%) had co-morbidities. Symptomatic patients comprised 73.3% of cases. Fever (p=0.02) and breathlessness (p=0.03) were commoner in males while diarrhoea (p<0.01) was predominant in females. On multivariate analysis, severe COVID-19 was predicted by the presence of co-morbidity (AOR= 14.44, 95% C.I= 4.79- 43.58, p <0.001)and prior antibiotic/antimalarial use (AOR= 6.35, 95% C.I= 2.24- 18.05, p =0.001) while being a non-healthcare worker (AOR= 0.18, 95% C.I= 0.04-0.78, p=0.02) was protective. However, none of the variables assessed predicted in-hospital mortality. Conclusion Our findings underscore the contributions of demographic variables in COVID-19 transmission and gender differences in clinical presentation. Underlying comorbidity likewise prior antimicrobial use increased the likelihood of severe COVID-19. The absence of mortality predictors in our study may be related to the relatively small number of deaths. Further studies are recommended to unravel the predominance of severe disease in healthcare workers.
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Affiliation(s)
- Juliet I Mmerem
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
- Department of Internal Medicine, Federal Medical Centre, Owerri, Imo State, Nigeria
| | - Uche S Unigwe
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
- Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - Michael O Iroezindu
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
| | - Kyrian S Chukwu
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
- Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - Ifeyinwa L Ezenwosu
- Department of Community Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
| | - Geofrey O Okorie
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
- Department of Internal Medicine, Enugu State University Teaching Hospital, Parklane, Enugu, Enugu State, Nigeria
| | - Nneka M Chika-Igwenyi
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
- Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - Chidinma B Nwatu
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
| | - Obinna D Onodugo
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
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López-Farfán D, Yerbanga RS, Parres-Mercader M, Torres-Puente M, Gómez-Navarro I, Sanou DMS, Yao AF, Bosco Ouédraogo J, Comas I, Irigoyen N, Gómez-Díaz E. Prevalence of SARS-CoV-2 and co-infection with malaria during the first wave of the pandemic (the Burkina Faso case). Front Public Health 2022; 10:1048404. [PMID: 36579069 PMCID: PMC9791192 DOI: 10.3389/fpubh.2022.1048404] [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: 09/19/2022] [Accepted: 11/24/2022] [Indexed: 12/14/2022] Open
Abstract
Africa accounts for 1.5% of the global coronavirus disease 2019 (COVID-19) cases and 2.7% of deaths, but this low incidence has been partly attributed to the limited testing capacity in most countries. In addition, the population in many African countries is at high risk of infection with endemic infectious diseases such as malaria. Our aim is to determine the prevalence and circulation of SARS-CoV-2 variants, and the frequency of co-infection with the malaria parasite. We conducted serological tests and microscopy examinations on 998 volunteers of different ages and sexes in a random and stratified population sample in Burkina-Faso. In addition, nasopharyngeal samples were taken for RT-qPCR of SARS-CoV-2 and for whole viral genome sequencing. Our results show a 3.2 and a 2.5% of SARS-CoV-2 seroprevalence and PCR positivity; and 22% of malaria incidence, over the sampling period, with marked differences linked to age. Importantly, we found 8 cases of confirmed co-infection and 11 cases of suspected co-infection mostly in children and teenagers. Finally, we report the genome sequences of 13 SARS-CoV-2 isolates circulating in Burkina Faso at the time of analysis, assigned to lineages A.19, A.21, B.1.1.404, B.1.1.118, B.1 and grouped into clades; 19B, 20A, and 20B. This is the first population-based study about SARS-CoV-2 and malaria in Burkina Faso during the first wave of the pandemic, providing a relevant estimation of the real prevalence of SARS-CoV-2 and variants circulating in this Western African country. Besides, it highlights the non-negligible frequency of co-infection with malaria in African communities.
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Affiliation(s)
- Diana López-Farfán
- Instituto de Parasitología y Biomedicina López-Neyra, Consejo Superior de Investigaciones Científicas (IPBLN, CSIC), Granada, Spain
| | - R Serge Yerbanga
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo-Dioulasso, Burkina Faso.,Institut des Sciences et Techniques (INSTech), Bobo-Dioulasso, Burkina Faso
| | - Marina Parres-Mercader
- Instituto de Parasitología y Biomedicina López-Neyra, Consejo Superior de Investigaciones Científicas (IPBLN, CSIC), Granada, Spain
| | - Manuela Torres-Puente
- Instituto de Biomedicina de Valencia, Consejo Superior de Investigaciones Científicas (IBV, CSIC), Valencia, Spain
| | - Inmaculada Gómez-Navarro
- Instituto de Biomedicina de Valencia, Consejo Superior de Investigaciones Científicas (IBV, CSIC), Valencia, Spain
| | | | - Adama Franck Yao
- Institut de Recherche en Sciences de la Santé (IRSS), Bobo-Dioulasso, Burkina Faso
| | | | - Iñaki Comas
- Instituto de Biomedicina de Valencia, Consejo Superior de Investigaciones Científicas (IBV, CSIC), Valencia, Spain.,Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBER), Madrid, Spain
| | - Nerea Irigoyen
- Division of Virology, Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Elena Gómez-Díaz
- Instituto de Parasitología y Biomedicina López-Neyra, Consejo Superior de Investigaciones Científicas (IPBLN, CSIC), Granada, Spain
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Bepouka B, Mayasi N, Mandina M, Longokolo M, Odio O, Mangala D, Mbula M, Kayembe JM, Situakibanza H. Risk factors for mortality in COVID-19 patients in sub-Saharan Africa: A systematic review and meta-analysis. PLoS One 2022; 17:e0276008. [PMID: 36251715 PMCID: PMC9576083 DOI: 10.1371/journal.pone.0276008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 09/27/2022] [Indexed: 11/05/2022] Open
Abstract
Aim Mortality rates of coronavirus-2019 (COVID-19) disease continue to increase worldwide and in Africa. In this study, we aimed to summarize the available results on the association between sociodemographic, clinical, biological, and comorbidity factors and the risk of mortality due to COVID-19 in sub-Saharan Africa. Methods We followed the PRISMA checklist (S1 Checklist). We searched PubMed, Google Scholar, and European PMC between January 1, 2020, and September 23, 2021. We included observational studies with Subjects had to be laboratory-confirmed COVID-19 patients; had to report risk factors or predictors of mortality in COVID-19 patients, Studies had to be published in English, include multivariate analysis, and be conducted in the sub-Saharan region. Exclusion criteria included case reports, review articles, commentaries, errata, protocols, abstracts, reports, letters to the editor, and repeat studies. The methodological quality of the studies included in this meta-analysis was assessed using the methodological items for nonrandomized studies (MINORS). Pooled hazard ratios (HR) or odds ratios (OR) and 95% confidence intervals (CI) were calculated separately to identify mortality risk. In addition, publication bias and subgroup analysis were assessed. Results and discussion Twelve studies with a total of 43598 patients met the inclusion criteria. The outcomes of interest were mortality. The results of the analysis showed that the pooled prevalence of mortality in COVID-19 patients was 4.8%. Older people showed an increased risk of mortality from SARS-Cov-2. The pooled hazard ratio (pHR) and odds ratio (pOR) were 9.01 (95% CI; 6.30–11.71) and 1.04 (95% CI; 1.02–1.06), respectively. A significant association was found between COVID-19 mortality and men (pOR = 1.52; 95% CI 1.04–2). In addition, the risk of mortality in patients hospitalized with COVID-19 infection was strongly influenced by chronic kidney disease (CKD), hypertension, severe or critical infection on admission, cough, and dyspnea. The major limitations of the present study are that the data in the meta-analysis came mainly from studies that were published, which may lead to publication bias, and that the causal relationship between risk factors and poor outcome in patients with COVID-19 cannot be confirmed because of the inherent limitations of the observational study. Conclusions Advanced age, male sex, CKD, hypertension, severe or critical condition on admission, cough, and dyspnea are clinical risk factors for fatal outcomes associated with coronavirus. These findings could be used for research, control, and prevention of the disease and could help providers take appropriate measures and improve clinical outcomes in these patients.
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Affiliation(s)
- Ben Bepouka
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
- * E-mail:
| | - Nadine Mayasi
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Madone Mandina
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Murielle Longokolo
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Ossam Odio
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Donat Mangala
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Marcel Mbula
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Jean Marie Kayembe
- Pneumology Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Hippolyte Situakibanza
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
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El-Kady AM, Aldakheel FM, Allemailem KS, Almatroudi A, Dbas Alharbi R, Al Hamed H, Alsulami M, Alshehri WA, El-Ashram S, Kreys E, Mohamed K, Al-Megrin WAI, Elshabrawy HA. Clinical Characteristics, Outcomes and Prognostic Factors for Critical Illness in Hospitalized COVID-19 Patients in Saudi Arabia: A Retrospective Cohort Study. Int J Gen Med 2022; 15:6945-6963. [PMID: 36068791 PMCID: PMC9441173 DOI: 10.2147/ijgm.s374090] [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: 05/11/2022] [Accepted: 08/04/2022] [Indexed: 01/08/2023] Open
Abstract
Background A good understanding of the possible risk factors for coronavirus disease 19 (COVID‐19) severity could help clinicians in identifying patients who need prioritized treatment to prevent disease progression and adverse outcome. In the present study, we aimed to correlate clinical and laboratory characteristics of hospitalized COVID-19 patients to disease outcome in Saudi Arabia. Materials and Methods The present study included 199 COVID-19 patients admitted to King Fahd Specialist Hospital, Buraydah, Qassim, Saudi Arabia, from April to December 2020. Patients were followed-up until discharge either for recovery or death. Demographic data, clinical data and laboratory results were retrieved from electronic patient records. Results Critical COVID-19 cases showed higher mean of age and higher prevalence of co-morbid conditions. Fifty-five patients died during the observation period. Risk factors for in hospital death for COVID 19 patients were leukocytosis (OR 1.89, 95% CI 1.008–3.548, p = 0.081), lymphocytopenia (OR 2.152, 95% CI 1.079–4.295, p = 0.020), neutrophilia (OR 1.839, 95% CI 0.951–3.55, p = 0.047), thrombocytopenia (OR 2.152, 95% CI 0.852–5.430, p = 0.085), liver injury (OR 2.689, 95% CI 1.373–4.944, p = 0.003), acute kidney injury (OR 1.248, 95% CI 0.631–2.467 p = 0.319), pancreatic injury (OR 1.973, 95% CI 0.939–4.144, p = 0.056) and high D dimer (OR 2.635, 95% CI 0.747–9.287, p = 0.091). Conclusion Clinical and laboratory data of COVID-19 patients may help understanding the pathogenesis of the disease and subsequently improve of the outcome of patients by determination of the associated risk factors and recognition of high risk group who are more liable for complications and in hospital death. The present study put an eye on some parameters (laboratory and clinical) that should be alarming signs that the patient is at high risk bad prognosis.
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Affiliation(s)
- Asmaa M El-Kady
- Department of Medical Parasitology, Faculty of Medicine, South Valley University, Qena, 83523, Egypt
- Correspondence: Asmaa M El-Kady; Hatem A Elshabrawy, Email ;
| | - Fahad M Aldakheel
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, 11433, Saudi Arabia
| | - Khaled S Allemailem
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah, 51452, Saudi Arabia
| | - Ahmad Almatroudi
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah, 51452, Saudi Arabia
| | - Reem Dbas Alharbi
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah, 51452, Saudi Arabia
| | - Hamad Al Hamed
- Department of Laboratory and Blood Bank, King Fahd Specialist Hospital, Buraydah, 52211, Saudi Arabia
| | - Muslimah Alsulami
- Department of Biology, College of Science, University of Jeddah, Jeddah, 21959, Saudi Arabia
| | - Wafa A Alshehri
- Department of Biology, College of Science, University of Jeddah, Jeddah, 21959, Saudi Arabia
| | - Saeed El-Ashram
- Faculty of Science, Kafrelsheikh University, Kafr El-Sheikh, 33516, Egypt
| | - Eugene Kreys
- Department of Clinical & Administrative Sciences, College of Pharmacy, California Northstate University, Elk Grove, CA, 95757, USA
| | - Khalil Mohamed
- Department of Epidemiology, Faculty of Public Health and Health Informatics, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Wafa Abdullah I Al-Megrin
- Department of Biology, College of Science, Princess Nourah bint Abdulrahman University, Riyadh, Riyadh, 11671, Saudi Arabia
| | - Hatem A Elshabrawy
- Department of Molecular and Cellular Biology, College of Osteopathic Medicine, Sam Houston State University, Conroe, TX, 77304, USA
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Bepouka B, Odio O, Mangala D, Mayasi N, Mandina M, Longokolo M, Makulo JR, Mbula M, Kayembe JM, Situakibanza H. Diabetes Mellitus is Associated With Higher COVID-19 Mortality Rates in Sub-Saharan Africa: A Systematic Review and Meta-analysis. Cureus 2022; 14:e26877. [PMID: 35978734 PMCID: PMC9375835 DOI: 10.7759/cureus.26877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 11/08/2022] Open
Abstract
The rate of COVID-19-related mortality among patients with diabetes mellitus in Sub-Saharan Africa (SSA) is unknown. The current study aimed to determine the mortality rate of COVID-19 among diabetes patients in SSA. We performed a systematic review of research articles until July 1, 2021. A literature review was conducted in accordance with the PRISMA guidelines to gather relevant data. A random effects model was used to calculate odds ratios and 95% confidence intervals (CIs). We used Egger's tests and Begg's funnel plot to examine publication bias. The mortality rate of 7778 COVID-19 patients was analyzed using data from seven studies. The I2 test was used to determine the heterogeneity between studies. The meta-analysis revealed that diabetes mellitus was linked to a 1.39-fold increase in the risk of death among COVID-19 inpatients (95% CI: 1.02-1.76). According to our findings, there was no significant heterogeneity between studies, and there was no publication bias. The present review describes an association between diabetes mellitus and the risk of COVID-19 mortality in SSA.
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11
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Santosh KC, Rasmussen N, Mamun M, Aryal S. A systematic review on cough sound analysis for Covid-19 diagnosis and screening: is my cough sound COVID-19? PeerJ Comput Sci 2022; 8:e958. [PMID: 35634112 PMCID: PMC9138020 DOI: 10.7717/peerj-cs.958] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/04/2022] [Indexed: 06/15/2023]
Abstract
For COVID-19, the need for robust, inexpensive, and accessible screening becomes critical. Even though symptoms present differently, cough is still taken as one of the primary symptoms in severe and non-severe infections alike. For mass screening in resource-constrained regions, artificial intelligence (AI)-guided tools have progressively contributed to detect/screen COVID-19 infections using cough sounds. Therefore, in this article, we review state-of-the-art works in both years 2020 and 2021 by considering AI-guided tools to analyze cough sound for COVID-19 screening primarily based on machine learning algorithms. In our study, we used PubMed central repository and Web of Science with key words: (Cough OR Cough Sounds OR Speech) AND (Machine learning OR Deep learning OR Artificial intelligence) AND (COVID-19 OR Coronavirus). For better meta-analysis, we screened for appropriate dataset (size and source), algorithmic factors (both shallow learning and deep learning models) and corresponding performance scores. Further, in order not to miss up-to-date experimental research-based articles, we also included articles outside of PubMed and Web of Science, but pre-print articles were strictly avoided as they are not peer-reviewed.
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Affiliation(s)
- KC Santosh
- 2AI: Applied Artificial Intelligence Lab, Computer Science, University of South Dakota, Vermiillion, South Dakota, United States
| | - Nicholas Rasmussen
- 2AI: Applied Artificial Intelligence Lab, Computer Science, University of South Dakota, Vermiillion, South Dakota, United States
| | - Muntasir Mamun
- 2AI: Applied Artificial Intelligence Lab, Computer Science, University of South Dakota, Vermiillion, South Dakota, United States
| | - Sunil Aryal
- School of Information Technology, Deakin University, Victoria, Australia
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12
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Bepouka B, Mandina M, Longokolo M, Mayasi N, Odio O, Mangala D, Mafuta Y, Makulo JR, Mbula M, Kayembe JM, Situakibanza H. Factors associated with death in COVID-19 patients over 60 years of age at Kinshasa University Hospital, Democratic Republic of Congo (DRC). Pan Afr Med J 2022; 41:330. [PMID: 35865854 PMCID: PMC9268318 DOI: 10.11604/pamj.2022.41.330.32602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 03/30/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction the objectives of the present study were to determine the mortality rate in patients over 60 years of age with COVID-19 and to identify risk factors. Methods the present historical cohort study took place at the Kinshasa University Hospital (KUH), DRC. Older patients admitted from March 2020 to May 2021 and diagnosed COVID-19 positive at the laboratory were selected. The relationship between clinical and biological risk factors, treatment, and in-hospital mortality was modeled using Cox regression. Results of two hundred and twenty-two patients at least 60 years old, 97 died, for a mortality rate of 43.69%. The median age was 70 years (64-74) with extremes of 60 to 88 years. Low oxygen saturation of < 90% (aHR 1.69; 95% CI [1.03-2.77]; p=0.038) was an independent predictor of mortality. The risk of death was reduced with corticosteroid use (aHR 0.54; 95% CI [0.40-0.75]; p=0.01) and anticoagulant treatment (aHR 0.53; 95% CI [0.38-0.73]; p=0.01). Conclusion mortality was high in seniors during COVID-19 and low oxygen saturation on admission was a risk factor for mortality. Corticosteroid therapy and anticoagulation were protective factors. These should be considered in management to reduce mortality.
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Affiliation(s)
- Ben Bepouka
- Infectious and Tropical Diseases Unit, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo,,Corresponding author: Ben Bepouka, Infectious and Tropical Diseases Unit, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo.
| | - Madone Mandina
- Infectious and Tropical Diseases Unit, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo
| | - Murielle Longokolo
- Infectious and Tropical Diseases Unit, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo
| | - Nadine Mayasi
- Infectious and Tropical Diseases Unit, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo
| | - Ossam Odio
- Infectious and Tropical Diseases Unit, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo
| | - Donat Mangala
- Infectious and Tropical Diseases Unit, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo
| | - Yves Mafuta
- Infectious and Tropical Diseases Unit, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo
| | - Jean Robert Makulo
- Nephrology Unit, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo
| | - Marcel Mbula
- Infectious and Tropical Diseases Unit, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo
| | - Jean Marie Kayembe
- Pneumology Unit, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo
| | - Hippolyte Situakibanza
- Infectious and Tropical Diseases Unit, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo
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13
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Bepouka B, Situakibanza H, Sangare M, Mandina M, Mayasi N, Longokolo M, Odio O, Mangala D, Isekusu F, Kayembe JM, Nachega J, Mbula M. Mortality associated with COVID-19 and hypertension in sub-Saharan Africa. A systematic review and meta-analysis. J Clin Hypertens (Greenwich) 2022; 24:99-105. [PMID: 35083847 PMCID: PMC8845466 DOI: 10.1111/jch.14417] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/04/2021] [Accepted: 12/10/2021] [Indexed: 01/08/2023]
Abstract
Hypertension is a common comorbidity in COVID-19 patients. However, little data is available on mortality in COVID-19 patients with hypertension in sub-Saharan Africa (SSA). Herein, the authors conducted a systematic review of research articles published from January 1, 2020 to July 1, 2021. Our aim was to evaluate the magnitude of COVID-19 mortality in patients with hypertension in SSA. Following the PRISMA guidelines, two independent investigators conducted the literature review to collect relevant data. The authors used a random effect model to estimate the odds ratio, or hazard ratio, with a 95% confidence interval (CI). Furthermore, the authors used Egger's tests to check for publication bias. For mortality analysis, the authors included data on 29 945 COVID-19 patients from seven publications. The authors assessed the heterogeneity across studies with the I2 test. Finally, the pooled analysis revealed that hypertension was associated with an increased odds of mortality among COVID-19 inpatients (OR 1.32; 95% CI, 1.13-1.50). Our analysis revealed neither substantial heterogeneity across studies nor a publication bias. Therefore, our prespecified results provided new evidence that hypertension could increase the risk of mortality from COVID-19 in SSA.
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Affiliation(s)
- Ben Bepouka
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Democratic Republic of Congo, Kinshasa, USA
| | - Hippolyte Situakibanza
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Democratic Republic of Congo, Kinshasa, USA
| | - Modibo Sangare
- Faculty of Medicine and Odontostomatology (FMOS), University of Sciences, Techniques & Technologies of Bamako (USTTB), Bamako, Mali
| | - Madone Mandina
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Democratic Republic of Congo, Kinshasa, USA
| | - Nadine Mayasi
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Democratic Republic of Congo, Kinshasa, USA
| | - Murielle Longokolo
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Democratic Republic of Congo, Kinshasa, USA
| | - Ossam Odio
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Democratic Republic of Congo, Kinshasa, USA
| | - Donatien Mangala
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Democratic Republic of Congo, Kinshasa, USA
| | - Fiston Isekusu
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Democratic Republic of Congo, Kinshasa, USA
| | - Jean Marie Kayembe
- Pneumology Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, DRC, Kinshasa, USA
| | - Jean Nachega
- Department of Medicine, Centre for Infectious Diseases, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; and Department of Epidemiology, Infectious Diseases and Microbiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Marcel Mbula
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Democratic Republic of Congo, Kinshasa, USA
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14
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Mosadegh Khah A, Sadidi M, Zare A, Nasrollahzadehsabet M, Dastan F, Jafari Asheyani M. The roles of dipeptidyl peptidase-4 inhibitors in prognosis of COVID-19 infection in patients with type 2 diabetes mellitus. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2022; 27:62. [PMID: 36353337 PMCID: PMC9639723 DOI: 10.4103/jrms.jrms_71_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 03/02/2022] [Accepted: 03/08/2022] [Indexed: 01/09/2023]
Abstract
Background: COVID-19 is responsible for the latest pandemic. Dipeptidyl peptidase-4 (DPP-4) is one of the cellular receptors of interest for coronavirus. The aim of this study was to assess the roles of DPP-4 inhibitors in prognosis of COVID-19 infection in patients with type 2 diabetes mellitus. Materials and Methods: retrospective cohort study was performed in 2020 in military medical centers affiliated to AJA University of Medical Sciences in Tehran on 220 patients with type 2 diabetes mellitus who were admitted in medical centers with COVID-19 infection. We collected demographic data of patients including age, gender, drug history, usage of DPP-4 inhibitors, clinical presentations at the time of the first visit, and the disease outcome including hospitalization duration and need for respiratory assist. Results: The study population consisted of 133 males (60.5%) and 87 females (39.5%), with a mean age of 66.13 ± 12.3 years. Forty-four patients (20%) consumed DPP-4 inhibitors (sitagliptin and linagliptin). Patients who were treated with DPP-4 inhibitors required less oxygen (O2) therapies compared to other cases (76.7% vs. 88.6%, P = 0.04). Patients who were treated with DPP-4 inhibitors had significantly lower hospitalization duration compared to other cases (6.57 ± 2.3 days vs. 8.03 ± 4.4 days, respectively, P = 0.01). There were no significant differences between the two groups of patients regarding survival rates (P = 0.55). Age was a predictive factor for survival (odds ratio, 1.13; 95% confidence interval, 1.04–1.23; P = 0.004). Conclusion: DPP-4 inhibitors could significantly decrease hospitalization days in patients with type 2 diabetes mellitus who were hospitalized for COVID-19. However, DPP-4 inhibitor usage showed no statistically significant impact on survival. Age was the important prognostic factor.
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15
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Puri A, He L, Giri M, Wu C, Zhao Q. Comparison of comorbidities among severe and non-severe COVID-19 patients in Asian versus non-Asian populations: A systematic review and meta-analysis. Nurs Open 2021; 9:733-751. [PMID: 34761532 PMCID: PMC8661719 DOI: 10.1002/nop2.1126] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 09/25/2021] [Accepted: 10/14/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES This study aimed to evaluate the comorbidities among severe and non-severe COVID-19 patients in Asian versus non-Asian populations. DESIGN Systemic review and Meta-analysis. METHODS A systematic literature search was conducted using PubMed, Embase, Scopus and the web of science Database up to 24 March 2021. Odds ratios were calculated using a random-effects model. RESULTS We identified 66 studies including 39 Asian and 27 non-Asian studies. This study demonstrated that the proportion of hypertension was significantly higher in severe group than in non-severe group for Asian (OR = 2.46) and non-Asian (OR = 1.60, 95% CI: 1.37-1.86, I2 = 84%; p < .00001) patients. Similarly, the proportion of diabetes, cardiovascular disease and chronic kidney disease was significantly higher in severe group than in non-severe group for both Asian and non-Asian studies. We found no statistically significant difference between the severe versus non-severe group for cancer (OR = 1.26) and chronic obstructive pulmonary disease (OR = 1.32) among non-Asian patients.
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Affiliation(s)
- Anju Puri
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lin He
- Department of Respiratory and Critical Care Medicine, Fuling Central Hospital of Chongqing City, Chongqing, China
| | - Mohan Giri
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chengfei Wu
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qinghua Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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16
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Lawson ATDD, Dieng M, Faye FA, Diaw PA, Kempf C, Berthe A, Diop MM, Martinot M, Diop SA. Demographics and outcomes of laboratory-confirmed COVID-19 cases during the first epidemic wave in Senegal. Infect Dis Now 2021; 52:44-46. [PMID: 34634483 PMCID: PMC8500691 DOI: 10.1016/j.idnow.2021.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/12/2021] [Accepted: 10/05/2021] [Indexed: 10/31/2022]
Abstract
BACKGROUND Few studies have focused on the effects of COVID-19 on African populations. During the first epidemic wave in Senegal (May 1 to July 31, 2020), COVID-19 cases were isolated in treatment centers of epidemics (TCEs). We described the demographics and outcomes of COVID-19 cases in TCEs. PATIENTS AND METHODS All cases with laboratory-confirmed COVID-19 in Thiès medical region of Senegal were included. RESULTS COVID-19 was confirmed in 600 cases. Median age of cases (men: 357, 59.5%; women: 243, 40.5%) was 34.0years. The incidence was 12 per 100,000 inhabitants per month. Overall, 46 (7.7%) cases had a severe or critical form of the disease, and nine of them died. Of 455 cases quarantined in non-hospital TCEs, 340 (74.7%) had no symptom and 115 (25.3%) had mild or moderate symptoms. CONCLUSION In this African retrospective cohort, COVID-19 cases were young and mostly asymptomatic with a low case fatality rate.
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Affiliation(s)
- A T D-D Lawson
- UFR of Health Sciences, University of Thiès, Thiès, Senegal
| | - M Dieng
- UFR of Health Sciences, University of Thiès, Thiès, Senegal
| | - F A Faye
- UFR of Health Sciences, University of Bambey, Bambey, Senegal
| | - P A Diaw
- Institute for Research in Health Sciences and formation (IRESSEF), Rufisque, Senegal
| | - C Kempf
- Colmar Civil Hospitals, Colmar, France
| | - A Berthe
- UFR of Health Sciences, University of Thiès, Thiès, Senegal
| | - M M Diop
- UFR of Health Sciences, University of Thiès, Thiès, Senegal
| | | | - S A Diop
- UFR of Health Sciences, University of Thiès, Thiès, Senegal
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17
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Wilairatana P, Masangkay FR, Kotepui KU, Milanez GDJ, Kotepui M. Prevalence and characteristics of malaria among COVID-19 individuals: A systematic review, meta-analysis, and analysis of case reports. PLoS Negl Trop Dis 2021; 15:e0009766. [PMID: 34597315 PMCID: PMC8486116 DOI: 10.1371/journal.pntd.0009766] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 08/26/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The world population is currently at a very high risk of Coronavirus disease-2019 (COVID-19), caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). People who live in malaria-endemic areas and get infected by SARS-CoV-2 may be at increased risk of severe COVID-19 or unfavorable disease outcomes if they ignore their malaria status. Therefore, the present study aimed to synthesize, qualitatively and quantitatively, information on the prevalence and characteristics of malaria infection among COVID-19-infected individuals. The findings will help us better understand this particular comorbidity during the COVID-19 pandemic. METHODS The systematic review protocol was registered at the International Prospective Register of Systematic Reviews (PROSPERO) with the identification number: CRD42021247521. We searched for studies reporting on the coinfection of COVID-19 and malaria in PubMed, Web of Science, and Scopus from inception to March 27, 2021 using Medical Subject Headings (MeSH) terms. The study's methodological quality in the search output was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Tools for cross-sectional study. The pooled prevalence of Plasmodium spp. infection among patients infected with COVID-19 was estimated using the random effect model and then graphically presented as forest plots. The heterogeneity among the included studies was assessed using Cochrane Q and I2 statistics. The characteristics of patients co-infected with COVID-19 and malaria were derived from case reports and series and were formally analyzed using simple statistics. RESULTS Twelve of 1,207 studies reporting the coinfection of COVID-19 and malaria were selected for further analysis. Results of quantitative synthesis show that the pooled prevalence of Plasmodium spp. infection (364 cases) among COVID-19 individuals (1,126 cases) is 11%, with a high degree of heterogeneity (95% CI: 4%-18%, I2: 97.07%, 5 studies). Most of the coinfections were reported in Nigeria (336 cases), India (27 cases), and the Democratic Republic of Congo (1 case). Results of qualitative synthesis indicate that patients with coinfection are typically symptomatic at presentation with mild or moderate parasitemia. An analysis of case reports and series indicates that co-infected individuals often display thrombocytopenia, lymphopenia, and elevated bilirubin levels. Among four patients (30%) who required treatment with intravenous artesunate, one experienced worsened clinical status after administering the drug. One serious outcome of coinfection involved a pregnant woman who experienced fetal abortion due to the initial misdiagnosis of malaria. CONCLUSIONS All individuals in malaria-endemic regions who are febrile or display symptoms of COVID-19 should be evaluated for malaria to avoid serious complications. Further prospective studies are required to investigate the burden and outcomes of COVID-19 in malaria-endemic regions. Prompt management is required to prevent serious outcomes in individuals co-infected with COVID-19 and malaria.
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Affiliation(s)
- Polrat Wilairatana
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Frederick Ramirez Masangkay
- Department of Medical Technology, Institute of Arts and Sciences, Far Eastern University-Manila, Manila, Philippines
| | - Kwuntida Uthaisar Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
| | - Giovanni De Jesus Milanez
- Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas, Manila, Philippines
| | - Manas Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
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18
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Bahloul M, Kharrat S, Chtara K, Hafdhi M, Turki O, Baccouche N, Ammar R, Kallel N, Hsairi M, Chakroun-Walha O, Hamida CB, Chelly H, Mahfoudh KB, Karoui A, Karray H, Rekik N, Bouaziz M. Clinical characteristics and outcomes of critically ill COVID-19 patients in Sfax, Tunisia. Acute Crit Care 2021; 37:84-93. [PMID: 34380191 PMCID: PMC8918704 DOI: 10.4266/acc.2021.00129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 04/11/2021] [Indexed: 12/15/2022] Open
Abstract
Background Africa, like the rest of the world, has been impacted by the coronavirus disease 2019 (COVID-19) pandemic. However, only a few studies covering this subject in Africa have been published. Methods We conducted a retrospective study of critically ill adult COVID-19 patients—all of whom had a confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection—admitted to the intensive care unit (ICU) of Habib Bourguiba University Hospital (Sfax, Tunisia). Results A total of 96 patients were admitted into our ICU for respiratory distress due to COVID-19 infection. Mean age was 62.4±12.8 years and median age was 64 years. Mean arterial oxygen tension (PaO2)/fractional inspired oxygen (FiO2) ratio was 105±60 and ≤300 in all cases but one. Oxygen support was required for all patients (100%) and invasive mechanical ventilation for 38 (40%). Prone positioning was applied in 67 patients (70%). Within the study period, 47 of the 96 patients died (49%). Multivariate analysis showed that the factors associated with poor outcome were the development of acute renal failure (odds ratio [OR], 6.7; 95% confidence interval [CI], 1.75–25.9), the use of mechanical ventilation (OR, 5.8; 95% CI, 1.54–22.0), and serum cholinesterase (SChE) activity lower than 5,000 UI/L (OR, 5.0; 95% CI, 1.34–19). Conclusions In this retrospective cohort study of critically ill patients admitted to the ICU in Sfax, Tunisia, for acute respiratory failure following COVID-19 infection, the mortality rate was high. The development of acute renal failure, the use of mechanical ventilation, and SChE activity lower than 5,000 UI/L were associated with a poor outcome.
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Affiliation(s)
- Mabrouk Bahloul
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Sana Kharrat
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Kamilia Chtara
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Malek Hafdhi
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Olfa Turki
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Najeh Baccouche
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Rania Ammar
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Nozha Kallel
- Department of Radiology, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Majdi Hsairi
- Department of Anesthesiology, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Olfa Chakroun-Walha
- Department of Emergency Medicine, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Chokri Ben Hamida
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Hedi Chelly
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | | | - Abelhamid Karoui
- Department of Anesthesiology, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Hela Karray
- Department of Microbiology, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Noureddine Rekik
- Department of Emergency Medicine, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Mounir Bouaziz
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
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Shang YF, Liu T, Yu JN, Xu XR, Zahid KR, Wei YC, Wang XH, Zhou FL. Half-year follow-up of patients recovering from severe COVID-19: Analysis of symptoms and their risk factors. J Intern Med 2021; 290:444-450. [PMID: 33904618 PMCID: PMC8242565 DOI: 10.1111/joim.13284] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/10/2021] [Accepted: 03/10/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To understand the sequelae of COVID-19. METHODS We followed up 1174 patients with severe coronavirus disease 2019 (COVID-19)who were recovered and discharged for 6 months. RESULTS There were 175 cases with clear IgG results 6 months after discharge, of which 82 (46.9%) were IgG (+) and 16 (9.1%) were IgG (dim+). Four hundred and forty-one participants (55.4%) had some kind of sequelae. The most common symptoms were fatigue (25.3%), sleep disorder (23.2%) and shortness of breath (20.4%). In those who had sequelae, 262 (59.4%) had more than one symptom. Critical cases were more likely to have cough (20.5% vs 11.6%, p = 0.023) and hypomnesis (15.1% vs 8.0%, p = 0.041) than severe cases. Furthermore, univariate and multivariate logistic regression analyses revealed that women are more likely to have multiple symptoms (p = 0.002), fatigue (p = 0.009) and sleep disorder (p = 0.008), whereas critical illness was found as independent risk factor for hypomnesis (p = 0.045). CONCLUSION Our study demonstrated the duration of antibody and sequelae of COVID-19 and compared the differences amongst different populations.
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Affiliation(s)
- Y F Shang
- Department of Hematology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - T Liu
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - J N Yu
- Department of Hematology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - X R Xu
- Department of Hematology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - K R Zahid
- Shenzhen Key Laboratory of Microbial Genetic Engineering, College of Life Science and Oceanography, Carson International Cancer Center, Shenzhen University, Shenzhen, China
| | - Y C Wei
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - X H Wang
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - F L Zhou
- Department of Hematology, Zhongnan Hospital of Wuhan University, Wuhan, China
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