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Bimbo-Szuhai E, Botea MO, Romanescu DD, Beiusanu C, Gavrilas GM, Popa GM, Antal D, Bontea MG, Sachelarie L, Macovei IC. Inflammatory Biomarkers for Assessing In-Hospital Mortality Risk in Severe COVID-19-A Retrospective Study. J Pers Med 2024; 14:503. [PMID: 38793085 PMCID: PMC11122362 DOI: 10.3390/jpm14050503] [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: 04/02/2024] [Revised: 04/21/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024] Open
Abstract
(1) Background: Our study aims to investigate the utility of inflammatory factors as prognostic indicators for disease severity and mortality in COVID-19 patients admitted to the Intensive Care Unit (ICU) Department of Pelican Clinical Hospital Oradea Romania. While elevated white blood cell (WBC) levels are associated with COVID-19 severity and mortality, they may not effectively predict the risk of death; (2) Methods: In our ICU department, we conducted assessments on the 10th and 14th days of COVID-19 patients' hospitalization, measuring the following markers: C-reactive protein (CRP) levels, procalcitonin (PCT) levels, granulocytes/lymphocytes (G/L) ratios, ferritin levels, age, and obesity status. We included a total of 209 eligible COVID-19 patients in the final analysis. Our goal was to identify biomarkers that could quickly identify high-risk patients with a potential for disease progression and mortality; (3) Results: Our study (a retrospective, single-center observational cohort study) demonstrated statistically significant differences in predicting mortality and disease severity based on G/L ratio (p < 0.0001), PCT (p < 0.0002), CRP (p < 0.0001), ferritin (p < 0.0001), age (p < 0.0001), and obesity (p < 0.0001); (4) Conclusions: Having a G/L ratio exceeding 20 units, along with elevated levels of PCR, PCT, and ferritin in older and obese patients on the 3rd day of ICU admission, represents significant risk factors for in-hospital mortality in severe COVID-19 patients.
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Affiliation(s)
- Erika Bimbo-Szuhai
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (E.B.-S.); (G.M.G.); (M.G.B.)
- Pelican Hospital, 410450 Oradea, Romania; (M.O.B.); (D.D.R.); (G.M.P.); (D.A.); (I.C.M.)
| | - Mihai Octavian Botea
- Pelican Hospital, 410450 Oradea, Romania; (M.O.B.); (D.D.R.); (G.M.P.); (D.A.); (I.C.M.)
- Department of Surgery, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Dana Diana Romanescu
- Pelican Hospital, 410450 Oradea, Romania; (M.O.B.); (D.D.R.); (G.M.P.); (D.A.); (I.C.M.)
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Corina Beiusanu
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (E.B.-S.); (G.M.G.); (M.G.B.)
| | - Gabriela Maria Gavrilas
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (E.B.-S.); (G.M.G.); (M.G.B.)
| | - Georgiana Maria Popa
- Pelican Hospital, 410450 Oradea, Romania; (M.O.B.); (D.D.R.); (G.M.P.); (D.A.); (I.C.M.)
- Department of Surgery, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Dania Antal
- Pelican Hospital, 410450 Oradea, Romania; (M.O.B.); (D.D.R.); (G.M.P.); (D.A.); (I.C.M.)
| | - Mihaela Gabriela Bontea
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (E.B.-S.); (G.M.G.); (M.G.B.)
| | - Liliana Sachelarie
- Department of Preclinical Disciplines Apollonia, Faculty of Medicine, University from Iasi, 700511 Iași, Romania
| | - Iulia Codruta Macovei
- Pelican Hospital, 410450 Oradea, Romania; (M.O.B.); (D.D.R.); (G.M.P.); (D.A.); (I.C.M.)
- Department of Surgery, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
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Sultan MA, Kong Y, Story C, Caterson H, Dix C, Gad F, Dhaliwal JS, Dunkley S, Jo H, van Hal S, Passam F. Thrombo-inflammatory response in hospitalised patients with COVID-19: a single institution experience. Intern Med J 2024; 54:43-53. [PMID: 37926861 DOI: 10.1111/imj.16285] [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: 05/17/2023] [Accepted: 10/29/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Severe COVID-19 causes acute inflammation, which is complicated by venous thromboembolism events (VTE). However, it is unclear if VTE risk has evolved over time since the COVID-19 outbreak. AIMS To determine markers of thrombo-inflammation and rates of symptomatic VTE in patients hospitalised for COVID-19 in a metropolitan hospital in Sydney, Australia. METHODS A retrospective, single-centre, cohort study was performed by reviewing electronic medical records of consecutive patients admitted to Royal Prince Alfred Hospital between March 2020 and September 2021. This period included three waves of COVID-19 outbreaks in Australia with the ancestral, alpha and delta variants. Standard coagulation assays and inflammatory markers were recorded over 4 weeks. RESULTS A total of 205 patients were consecutively admitted during the study period. Activated partial thromboplastin time, neutrophil count and C-reactive protein (CRP) were significantly increased in patients hospitalised in the intensive care unit (ICU) compared with non-ICU patients. The use of anti-inflammatory medication increased in 2021 compared with 2020. The mortality rate was 7.3% in our cohort. Ninety-four per cent of patients received anticoagulation with 6.3% of patients developing VTE. CONCLUSION We observed lower rates of VTE compared to the internationally reported rate for the same period. We conclude that in the setting of controlled hospital admission rate and standard anticoagulation guidelines, COVID-19 resulted in similar thrombo-inflammatory response and VTE rates over the first 1.5 years of the pandemic.
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Affiliation(s)
- Muhammad Ahmed Sultan
- Department of Haematology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Central Clinical School, Faculty of Medicine Health, University of Sydney, Sydney, New South Wales, Australia
| | - Yvonne Kong
- Department of Haematology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Chloe Story
- Department of Infectious Diseases, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Harriet Caterson
- Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Caroline Dix
- Department of Haematology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Fady Gad
- Department of Pharmacy, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Jagpreet Singh Dhaliwal
- Department of Haematology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Central Clinical School, Faculty of Medicine Health, University of Sydney, Sydney, New South Wales, Australia
| | - Scott Dunkley
- Department of Haematology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Helen Jo
- Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Sebastian van Hal
- Department of Infectious Diseases, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Freda Passam
- Department of Haematology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Central Clinical School, Faculty of Medicine Health, University of Sydney, Sydney, New South Wales, Australia
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Ufongene C, Van Hyfte G, Agarwal P, Goldstein J, Mathew B, Navis A, McCarthy L, Kwon CS, Gururangan K, Balchandani P, Marcuse L, Naasan G, Singh A, Young J, Charney A, Nadkarni G, Jette N, Blank LJ. Older adults with epilepsy and COVID-19: Outcomes in a multi-hospital health system. Seizure 2024; 114:33-39. [PMID: 38039805 PMCID: PMC10841585 DOI: 10.1016/j.seizure.2023.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/26/2023] [Accepted: 11/24/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is associated with high rates of mortality and morbidity in older adults, especially those with pre-existing conditions. There is little work investigating how neurological conditions affect older adults with COVID-19. We aimed to compare in-hospital outcomes, including mortality, in older adults with and without epilepsy. METHODS This retrospective study in a large multicenter New York health system included consecutive older patients (age ≥65 years) either with or without epilepsy who were admitted with COVID-19 between 3/2020-5/2021. Epilepsy was identified using a validated International Classification of Disease (ICD) and antiseizure medicationbased case definition. Univariate comparisons were calculated using Chi-square, Fisher's exact, Mann-Whitney U, or Student's t-tests. Multivariable logistic regression models were generated to examine factors associated with mortality, discharge disposition and length of stay (LOS). RESULTS We identified 5384 older adults admitted with COVID-19 of whom 173 (3.21 %) had epilepsy. Mean age was significantly lower in those with (75.44, standard deviation (SD): 7.23) compared to those without epilepsy (77.98, SD: 8.68, p = 0.007). Older adults with epilepsy were more likely to be ventilated (35.84 % vs. 16.18 %, p < 0.001), less likely to be discharged home (21.39 % vs. 43.12 %, p < 0.001), had longer median LOS (13 days vs. 8 days, p < 0.001), and had higher in-hospital death (35.84 % vs. 28.29 %, p = 0.030) compared to those without epilepsy. Epilepsy in older adults was associated with increased odds of in-hospital death (adjusted odds ratio (aOR), 1.55; 95 % CI 1.12-2.14, p = 0.032), non-routine discharge disposition (aOR, 3.34; 95 % CI 2.21-5.03, p < 0.001), and longer LOS (46.46 % 95 % CI 34 %-59 %, p < 0.001). CONCLUSIONS In models that adjusted for multiple confounders including comorbidity and age, our study found that epilepsy was still associated with higher in-hospital mortality, longer LOS and worse discharge dispositions in older adults with COVID-19 higher in-hospital mortality, longer LOS and worse discharge dispositions in older adults with COVID-19. This work reinforces that epilepsy is a risk factor for worse outcomes in older adults admitted with COVID-19. Timely identification and treatment of COVID-19 in epilepsy may improve outcomes in older people with epilepsy.
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Affiliation(s)
- Claire Ufongene
- Icahn School of Medicine at Mount Sinai (ISMMS), New York, NY, United States
| | - Grace Van Hyfte
- Department of Neurology, ISMMS, New York, NY, United States; Institute for HealthCare Delivery Science, Department of Population Health Science and Policy, ISMMS, New York, NY, United States
| | - Parul Agarwal
- Department of Neurology, ISMMS, New York, NY, United States; Institute for HealthCare Delivery Science, Department of Population Health Science and Policy, ISMMS, New York, NY, United States
| | - Jonathan Goldstein
- Icahn School of Medicine at Mount Sinai (ISMMS), New York, NY, United States
| | - Brian Mathew
- Department of Neurology, ISMMS, New York, NY, United States
| | - Allison Navis
- Department of Neurology, ISMMS, New York, NY, United States
| | | | - Churl-Su Kwon
- Department of Neurology, Epidemiology, Neurosurgery and the Gertrude H. Sergievsky Center, Columbia University, New York, NY, United States
| | | | - Priti Balchandani
- BioMedical Engineering and Imaging Institute, ISMMS, New York, NY, United States
| | - Lara Marcuse
- Department of Neurology, ISMMS, New York, NY, United States
| | - Georges Naasan
- Department of Neurology, ISMMS, New York, NY, United States
| | - Anuradha Singh
- Department of Neurology, ISMMS, New York, NY, United States
| | - James Young
- Department of Neurology, ISMMS, New York, NY, United States
| | | | | | - Nathalie Jette
- Department of Neurology, ISMMS, New York, NY, United States; Institute for HealthCare Delivery Science, Department of Population Health Science and Policy, ISMMS, New York, NY, United States; Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Leah J Blank
- Department of Neurology, ISMMS, New York, NY, United States; Institute for HealthCare Delivery Science, Department of Population Health Science and Policy, ISMMS, New York, NY, United States.
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Jashi L, Kvanchakhadze R, Peshkova T, Dundua K, Nakaidze L, Margalitadze E, Gachechiladze T. The Effect of Metabolic Control on Diabetes Complication Rates and the Need for Medical Care During COVID-19 Social Isolation in Adjara, Georgia. Cureus 2023; 15:e51093. [PMID: 38274943 PMCID: PMC10808950 DOI: 10.7759/cureus.51093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2023] [Indexed: 01/27/2024] Open
Abstract
INTRODUCTION Social isolation or distancing during the COVID-19 pandemic was associated with poor metabolic control in patients with diabetes mellitus. It might have contributed to the high mortality rate of those with diabetes who became infected. This study aims to determine the degree or level of metabolic control in patients with diabetes mellitus, the progression of its complications, and the need for emergency care during social isolation caused by the COVID-19 pandemic. MATERIALS AND METHODS A retrospective study was conducted in Georgia on 752 diabetic patients aged under 65 years old. Results showed that many patients did not control their blood glucose levels, measure their blood pressure, or know their cholesterol and glycated hemoglobin levels before and after the pandemic. Over 35% of patients experienced glycemic profile fluctuations. We compared metabolic rates with complications of diabetes and the need for emergency medical care during isolation. It was found that the testability of glycemia (p = 0.006), fluctuations in glucose (p = 0.001), and glycated hemoglobin levels before (p = 0.001) and after the pandemic (p = 0.004) increased the prevalence of diabetes-related heart disease and multiple micro- and macroangiopathies. Blood pressure (p = 0.001), cholesterol levels (p = 0.001), and glucose control (p = 0.012) affected the condition of patients with diabetes mellitus. It increased the need for medical care due to infarction, hypertension crisis, and hyperglycemia. CONCLUSIONS In a crisis where medical care is limited, the management of diabetes patients requires more attention. Our study proves that active middle-aged patients during isolation had poor metabolic control in terms of self-control of the disease. It is necessary to constantly inform and educate patients about the importance of metabolic parameters in progressing diabetes complications. Proper metabolic control could prevent complications of diabetes and improve a patient's quality of life.
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Affiliation(s)
- Liana Jashi
- Medicine, David Agmashenebeli University of Georgia, Tbilisi, GEO
- Medicine, Avicenna - Batumi Medical University, Batumi, GEO
| | - Rusudan Kvanchakhadze
- Endocrinology, National Center for Disease Control and Public Health (NCDC), Tbilisi, GEO
| | - Tamar Peshkova
- Medicine, Batumi Shota Rustaveli State University, Batumi, GEO
- Medicine, Avicenna - Batumi Medical University, Batumi, GEO
| | - Ketevan Dundua
- Medicine, David Aghmashenebeli University of Georgia, Tbilisi, GEO
- Medicine, Avicenna - Batumi Medical University, Batumi, GEO
| | - Lela Nakaidze
- Medicine, Batumi Shota Rustaveli State University, Batumi, GEO
| | - Eter Margalitadze
- Medicine, Batumi Shota Rustaveli State University, Batumi, GEO
- Medicine, Avicenna - Batumi Medical University, Batumi, GEO
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Ufongene C, Van Hyfte G, Agarwal P, Blank LJ, Goldstein J, Mathew B, Lin JY, Navis A, McCarthy L, Gururangan K, Peschansky V, Kwon CS, Cohen A, Chan AHW, Dhamoon M, Deng P, Gutzwiller EM, Hao Q, He C, Heredia Nunez WD, Klenofsky B, Lemus HN, Marcuse L, Roberts M, Schorr EM, Singh A, Tantillo G, Young J, Balchandani P, Festa J, Naasan G, Charney A, Nadkarni G, Jetté N. In-hospital outcomes in patients with and without epilepsy diagnosed with COVID-19-A cohort study. Epilepsia 2023; 64:2725-2737. [PMID: 37452760 DOI: 10.1111/epi.17715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 07/07/2023] [Accepted: 07/07/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES Coronavirus disease 2019 (COVID-19) is associated with mortality in persons with comorbidities. The aim of this study was to evaluate in-hospital outcomes in patients with COVID-19 with and without epilepsy. METHODS We conducted a retrospective study of patients with COVID-19 admitted to a multicenter health system between March 15, 2020, and May 17, 2021. Patients with epilepsy were identified using a validated International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)/ICD-10-CM case definition. Logistic regression models and Kaplan-Meier analyses were conducted for mortality and non-routine discharges (i.e., not discharged home). An ordinary least-squares regression model was fitted for length of stay (LOS). RESULTS We identified 9833 people with COVID-19 including 334 with epilepsy. On univariate analysis, people with epilepsy had significantly higher ventilator use (37.70% vs 14.30%, p < .001), intensive care unit (ICU) admissions (39.20% vs 17.70%, p < .001) mortality rate (29.60% vs 19.90%, p < .001), and longer LOS (12 days vs 7 days, p < .001). and fewer were discharged home (29.64% vs 57.37%, p < .001). On multivariate analysis, only non-routine discharge (adjusted odds ratio [aOR] 2.70, 95% confidence interval [CI] 2.00-3.70; p < .001) and LOS (32.50% longer, 95% CI 22.20%-43.60%; p < .001) were significantly different. Factors associated with higher odds of mortality in epilepsy were older age (aOR 1.05, 95% CI 1.03-1.08; p < .001), ventilator support (aOR 7.18, 95% CI 3.12-16.48; p < .001), and higher Charlson comorbidity index (CCI) (aOR 1.18, 95% CI 1.04-1.34; p = .010). In epilepsy, admissions between August and December 2020 or January and May 2021 were associated with a lower odds of non-routine discharge and decreased LOS compared to admissions between March and July 2020, but this difference was not statistically significant. SIGNIFICANCE People with COVID-19 who had epilepsy had a higher odds of non-routine discharge and longer LOS but not higher mortality. Older age (≥65), ventilator use, and higher CCI were associated with COVID-19 mortality in epilepsy. This suggests that older adults with epilepsy and multimorbidity are more vulnerable than those without and should be monitored closely in the setting of COVID-19.
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Affiliation(s)
- Claire Ufongene
- Icahn School of Medicine at Mount Sinai (ISMMS), New York, New York, USA
| | - Grace Van Hyfte
- Institute for HealthCare Delivery Science, Department of Population Health Science and Policy, ISMMS, New York, New York, USA
| | - Parul Agarwal
- Institute for HealthCare Delivery Science, Department of Population Health Science and Policy, ISMMS, New York, New York, USA
- Department of Neurology, ISMMS, New York, New York, USA
| | - Leah J Blank
- Institute for HealthCare Delivery Science, Department of Population Health Science and Policy, ISMMS, New York, New York, USA
- Department of Neurology, ISMMS, New York, New York, USA
| | - Jonathan Goldstein
- Icahn School of Medicine at Mount Sinai (ISMMS), New York, New York, USA
| | - Brian Mathew
- Department of Neurology, ISMMS, New York, New York, USA
| | - Jung-Yi Lin
- Institute for HealthCare Delivery Science, Department of Population Health Science and Policy, ISMMS, New York, New York, USA
| | - Allison Navis
- Department of Neurology, ISMMS, New York, New York, USA
| | | | | | - Veronica Peschansky
- Department of Neurology, ISMMS, New York, New York, USA
- Department of Neurology, Columbia University, New York, New York, USA
| | - Churl-Su Kwon
- Department of Neurology, Columbia University, New York, New York, USA
- Department of Neurosurgery, Epidemiology, and the Gertrude H. Sergievsky Center, Columbia University, New York, New York, USA
| | - Ariella Cohen
- Icahn School of Medicine at Mount Sinai (ISMMS), New York, New York, USA
| | | | | | - Pojen Deng
- Department of Neurology, ISMMS, New York, New York, USA
| | | | - Qing Hao
- Department of Neurology, ISMMS, New York, New York, USA
| | - Celestine He
- Icahn School of Medicine at Mount Sinai (ISMMS), New York, New York, USA
| | | | | | | | - Lara Marcuse
- Department of Neurology, ISMMS, New York, New York, USA
| | | | - Emily M Schorr
- Division of Neuroimmunology and Neuroinfectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Gabriela Tantillo
- Department of Neurology, Baylor College of Medicine, Houston, Texas, USA
| | - James Young
- Department of Neurology, ISMMS, New York, New York, USA
| | - Priti Balchandani
- BioMedical Engineering and Imaging Institute, ISMMS, New York, New York, USA
| | - Joanne Festa
- Department of Neurology, ISMMS, New York, New York, USA
- The Barbara and Maurice Deane Center for Wellness and Cognitive Health, Mount Sinai, New York, New York, USA
| | - Georges Naasan
- Department of Neurology, ISMMS, New York, New York, USA
- The Barbara and Maurice Deane Center for Wellness and Cognitive Health, Mount Sinai, New York, New York, USA
| | - Alexander Charney
- Department of Psychiatry, ISMMS, New York, New York, USA
- Department of Genetics and Genomic Sciences, ISMMS, New York, New York, USA
| | | | - Nathalie Jetté
- Institute for HealthCare Delivery Science, Department of Population Health Science and Policy, ISMMS, New York, New York, USA
- Department of Neurology, ISMMS, New York, New York, USA
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
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Giral-Barajas J, Herrera-Nolasco CI, Herrera-Valdez MA, López SI. A probabilistic approach for the study of epidemiological dynamics of infectious diseases: Basic model and properties. J Theor Biol 2023; 572:111576. [PMID: 37437710 DOI: 10.1016/j.jtbi.2023.111576] [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: 12/31/2022] [Revised: 06/23/2023] [Accepted: 07/03/2023] [Indexed: 07/14/2023]
Abstract
The dynamics of epidemiological phenomena associated to infectious diseases have long been modelled taking different approaches. However, recent pandemic events exposed many areas of opportunity to improve the existing models. We develop a stochastic model based on the idea that transitions between epidemiological stages are alike sampling processes that may involve more than one subset of the population or may be mostly dependent on time intervals defined by pathological or clinical criteria. We apply the model to simulate epidemics, analyse the final distribution of the case fatality ratio, and define a basic reproductive number to determine the existence of a probabilistic phase transition for the dynamics. The resulting modelling scheme is robust, easy to implement, and can readily lend itself for extensions aimed at answering questions that emerge from close examination of data trends, such as those emerging from the COVID-19 pandemic, and other infectious diseases.
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Affiliation(s)
- José Giral-Barajas
- Departamento de Matemáticas, Facultad de Ciencias, Universidad Nacional Autónoma de México, Mexico
| | - Carlos Ignacio Herrera-Nolasco
- Departamento de Matemáticas, Facultad de Ciencias, Universidad Nacional Autónoma de México, Mexico; Laboratorio de Dinámica, Biofísica, y Fisiología de Sistemas, Facultad de Ciencias, Universidad Nacional Autónoma de México, Mexico
| | - Marco Arieli Herrera-Valdez
- Departamento de Matemáticas, Facultad de Ciencias, Universidad Nacional Autónoma de México, Mexico; Laboratorio de Dinámica, Biofísica, y Fisiología de Sistemas, Facultad de Ciencias, Universidad Nacional Autónoma de México, Mexico.
| | - Sergio I López
- Departamento de Matemáticas, Facultad de Ciencias, Universidad Nacional Autónoma de México, Mexico.
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7
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Bekbossynova M, Tauekelova A, Sailybayeva A, Kozhakhmetov S, Mussabay K, Chulenbayeva L, Kossumov A, Khassenbekova Z, Vinogradova E, Kushugulova A. Unraveling Acute and Post-COVID Cytokine Patterns to Anticipate Future Challenges. J Clin Med 2023; 12:5224. [PMID: 37629267 PMCID: PMC10455949 DOI: 10.3390/jcm12165224] [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: 07/03/2023] [Revised: 07/25/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023] Open
Abstract
The aims of this study were to analyze cytokine profiles in patients with COVID-19, gain insights into the immune response during acute infection, identify cytokines associated with disease severity and post-COVID complications, and explore potential biomarkers for prognosis and therapeutic targets. Using a multiplex analysis, we studied the cytokine pattern in 294 acute COVID-19 and post-COVID patients with varying severities of infection. Our findings revealed that disease severity was associated with elevated levels of IL-15, IL-8, and fractalkine. Severe/extremely severe forms in comparison with mild/moderate disease were associated with MCP-1, IFNa2, IL-7, IL-15, EGF, IP-10, IL-8, Eotaxin, FGF-2, GROa, sCD40L, and IL-10. The key cytokines of post-COVID are FGF-2, VEGF-A, EGF, IL-12(p70), IL-13, and IL-6. By the sixth month after recovering from a coronavirus infection, regardless of disease severity, some patients may develop complications such as arterial hypertension, type 2 diabetes mellitus, glucose intolerance, thyrotoxicosis, atherosclerosis, and rapid progression of previously diagnosed conditions. Each complication is characterized by distinct cytokine profiles. Importantly, these complications can also be predicted during the acute phase of the coronavirus infection. Understanding cytokine patterns can aid in predicting disease progression, identifying high-risk patients, and developing targeted interventions to improve the outcomes of COVID-19.
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Affiliation(s)
- Makhabbat Bekbossynova
- National Research Cardiac Surgery Center, Astana 020000, Kazakhstan; (M.B.); (A.T.); (A.S.)
| | - Ainur Tauekelova
- National Research Cardiac Surgery Center, Astana 020000, Kazakhstan; (M.B.); (A.T.); (A.S.)
| | - Aliya Sailybayeva
- National Research Cardiac Surgery Center, Astana 020000, Kazakhstan; (M.B.); (A.T.); (A.S.)
| | - Samat Kozhakhmetov
- Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Astana 010000, Kazakhstan; (S.K.); (L.C.); (A.K.); (E.V.)
| | - Karakoz Mussabay
- Department of Microbiology and Virology Named after Sh.I.Sarbasova, Astana Medical University, Astana 010000, Kazakhstan;
| | - Laura Chulenbayeva
- Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Astana 010000, Kazakhstan; (S.K.); (L.C.); (A.K.); (E.V.)
| | - Alibek Kossumov
- Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Astana 010000, Kazakhstan; (S.K.); (L.C.); (A.K.); (E.V.)
| | - Zhanagul Khassenbekova
- Department of General Pharmacology, Astana Medical University, Astana 010000, Kazakhstan;
| | - Elizaveta Vinogradova
- Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Astana 010000, Kazakhstan; (S.K.); (L.C.); (A.K.); (E.V.)
| | - Almagul Kushugulova
- National Research Cardiac Surgery Center, Astana 020000, Kazakhstan; (M.B.); (A.T.); (A.S.)
- Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Astana 010000, Kazakhstan; (S.K.); (L.C.); (A.K.); (E.V.)
- Almagul Kushugulova, Laboratory of Microbiome, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Kabanbay Batyr Ave., 53, Block S1, Office 303, Astana 010000, Kazakhstan
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8
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Rauzi MR, Ridgeway KJ, Wilson MP, Jolley SE, Nordon-Craft A, Stevens-Lapsley JE, Erlandson KM. Rehabilitation Therapy Allocation and Changes in Physical Function Among Patients Hospitalized Due to COVID-19: A Retrospective Cohort Analysis. Phys Ther 2023; 103:pzad007. [PMID: 37172130 PMCID: PMC10071586 DOI: 10.1093/ptj/pzad007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 06/03/2022] [Accepted: 12/28/2022] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Limited staffing and initial transmission concerns have limited rehabilitation services during the COVID-19 pandemic. The purpose of this analysis was to determine the associations between Activity Measure for Post-Acute Care (AM-PAC) mobility categories and allocation of rehabilitation, and in-hospital AM-PAC score change and receipt of rehabilitation services for patients with COVID-19. METHODS This was a retrospective cohort study of electronic health record data from 1 urban hospital, including adults with a COVID-19 diagnosis, admitted August 2020 to April 2021. Patients were stratified by level of medical care (intensive care unit [ICU] and floor). Therapy allocation (referral for rehabilitation, receipt of rehabilitation, and visit frequency) was the primary outcome; change in AM-PAC score was secondary. AM-PAC Basic Mobility categories (None [21-24], Minimum [18-21], Moderate [10-17], and Maximum [6-9]) were the main predictor variable. Primary analysis included logistic and linear regression, adjusted for covariates. RESULTS A total of 1397 patients (ICU: n = 360; floor: n = 1037) were included. AM-PAC mobility category was associated with therapy allocation outcomes for floor but not patients in the ICU: the Moderate category had greater adjusted odds of referral (adjusted odds ratio [aOR] = 10.88; 95% CI = 5.71-21.91), receipt of at least 1 visit (aOR = 3.45; 95% CI = 1.51-8.55), and visit frequency (percentage mean difference) (aOR = 42.14; 95% CI = 12.45-79.67). The secondary outcome of AM-PAC score improvement was highest for patients in the ICU who were given at least 1 rehabilitation therapy visit (aOR = 5.31; 95% CI = 1.90-15.52). CONCLUSION AM-PAC mobility categories were associated with rehabilitation allocation outcomes for floor patients. AM-PAC score improvement was highest among patients requiring ICU-level care with at least 1 rehabilitation therapy visit. IMPACT Use of AM-PAC Basic Mobility categories may help improve decisions for rehabilitation therapy allocation among patients who do not require critical care, particularly during times of limited resources.
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Affiliation(s)
- Michelle R Rauzi
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, Colorado USA
| | - Kyle J Ridgeway
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, Colorado USA
- Inpatient Rehabilitation Therapy Department, University of Colorado Hospital, University of Colorado Health, Aurora, Colorado, USA
| | - Melissa P Wilson
- Department of Biomedical Informatics, University of Colorado, Aurora, Colorado, USA
| | - Sarah E Jolley
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Colorado, Aurora, Colorado, USA
| | - Amy Nordon-Craft
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, Colorado USA
| | - Jennifer E Stevens-Lapsley
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, Colorado USA
- VA Eastern Colorado Geriatric Research, Education, and Clinical Center (GRECC), VA Eastern Colorado Health Care System, Aurora, Colorado, USA
| | - Kristine M Erlandson
- Division of Infectious Diseases, Department of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, Colorado, USA
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9
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Kandil S, Tharwat AI, Mohsen SM, Eldeeb M, Abdallah W, Hilal A, Sweed H, Mortada M, Arif E, Ahmed T, Elshafie A, Youssef T, Zaki M, El-Gendy Y, Ebied E, Hamad S, Habil I, Dabbous H, El-Said A, Mostafa Y, Girgis S, Mansour O, El-Anwar A, Omar A, Saleh A, El-Meteini M. Developing a mortality risk prediction model using data of 3663 hospitalized COVID-19 patients: a retrospective cohort study in an Egyptian University Hospital. BMC Pulm Med 2023; 23:57. [PMID: 36750802 PMCID: PMC9903412 DOI: 10.1186/s12890-023-02345-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 01/31/2023] [Indexed: 02/09/2023] Open
Abstract
PURPOSE Since the declaration of COVID-19 as a pandemic, a wide between-country variation was observed regarding in-hospital mortality and its predictors. Given the scarcity of local research and the need to prioritize the provision of care, this study was conducted aiming to measure the incidence of in-hospital COVID-19 mortality and to develop a simple and clinically applicable model for its prediction. METHODS COVID-19-confirmed patients admitted to the designated isolation areas of Ain-Shams University Hospitals (April 2020-February 2021) were included in this retrospective cohort study (n = 3663). Data were retrieved from patients' records. Kaplan-Meier survival and Cox proportional hazard regression were used. Binary logistic regression was used for creating mortality prediction models. RESULTS Patients were 53.6% males, 4.6% current smokers, and their median age was 58 (IQR 41-68) years. Admission to intensive care units was 41.1% and mortality was 26.5% (972/3663, 95% CI 25.1-28.0%). Independent mortality predictors-with rapid mortality onset-were age ≥ 75 years, patients' admission in critical condition, and being symptomatic. Current smoking and presence of comorbidities particularly, obesity, malignancy, and chronic haematological disorders predicted mortality too. Some biomarkers were also recognized. Two prediction models exhibited the best performance: a basic model including age, presence/absence of comorbidities, and the severity level of the condition on admission (Area Under Receiver Operating Characteristic Curve (AUC) = 0.832, 95% CI 0.816-0.847) and another model with added International Normalized Ratio (INR) value (AUC = 0.842, 95% CI 0.812-0.873). CONCLUSION Patients with the identified mortality risk factors are to be prioritized for preventive and rapid treatment measures. With the provided prediction models, clinicians can calculate mortality probability for their patients. Presenting multiple and very generic models can enable clinicians to choose the one containing the parameters available in their specific clinical setting, and also to test the applicability of such models in a non-COVID-19 respiratory infection.
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Affiliation(s)
- Sahar Kandil
- Department of Community, Environmental, and Occupational Medicine, Faculty of Medicine, Ain Shams University, 38 Ramses St., Abbassia Square, Cairo, 1156, Egypt.
| | - Ayman I. Tharwat
- grid.7269.a0000 0004 0621 1570Department of Anaesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Sherief M. Mohsen
- grid.7269.a0000 0004 0621 1570Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mai Eldeeb
- grid.7269.a0000 0004 0621 1570Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Waleed Abdallah
- grid.7269.a0000 0004 0621 1570Department of Anaesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Amr Hilal
- grid.7269.a0000 0004 0621 1570Department of Anaesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Hala Sweed
- grid.7269.a0000 0004 0621 1570Department of Geriatric Medicine and Gerontology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed Mortada
- grid.7269.a0000 0004 0621 1570Department of Geriatric Medicine and Gerontology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Elham Arif
- grid.7269.a0000 0004 0621 1570Department of Geriatric Medicine and Gerontology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Tarek Ahmed
- grid.7269.a0000 0004 0621 1570Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ahmed Elshafie
- grid.7269.a0000 0004 0621 1570Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Tarek Youssef
- grid.7269.a0000 0004 0621 1570Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed Zaki
- grid.7269.a0000 0004 0621 1570Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Yasmin El-Gendy
- grid.7269.a0000 0004 0621 1570Department of Paediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Essam Ebied
- grid.7269.a0000 0004 0621 1570Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Safwat Hamad
- grid.7269.a0000 0004 0621 1570Department of Scientific Computing, Faculty of Computer and Information Sciences, Ain Shams University, Cairo, Egypt
| | - Ihab Habil
- grid.7269.a0000 0004 0621 1570Department of Community, Environmental, and Occupational Medicine, Faculty of Medicine, Ain Shams University, 38 Ramses St., Abbassia Square, Cairo, 1156 Egypt
| | - Hany Dabbous
- grid.7269.a0000 0004 0621 1570Department of Hepatology and Infectious Diseases, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Amr El-Said
- grid.7269.a0000 0004 0621 1570Department of Anaesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Yasser Mostafa
- grid.7269.a0000 0004 0621 1570Department of Chest Diseases, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Samia Girgis
- grid.7269.a0000 0004 0621 1570Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ossama Mansour
- grid.7269.a0000 0004 0621 1570Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ali El-Anwar
- grid.7269.a0000 0004 0621 1570Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ashraf Omar
- grid.7269.a0000 0004 0621 1570Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ayman Saleh
- grid.7269.a0000 0004 0621 1570Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mahmoud El-Meteini
- grid.7269.a0000 0004 0621 1570Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt ,grid.7269.a0000 0004 0621 1570Department of Hepatobiliary Surgery and Liver Transplantation, Faculty of Medicine, Ain Shams Centre for Organ Transplantation (ASCOT),, Ain Shams University, Cairo, Egypt
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10
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Clinical Characteristics and Predictors of Mortality in Elderly Patients Hospitalized with COVID-19 in Bangladesh: A Multicenter, Retrospective Study. Interdiscip Perspect Infect Dis 2022; 2022:5904332. [PMID: 35698592 PMCID: PMC9188299 DOI: 10.1155/2022/5904332] [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: 03/11/2022] [Accepted: 05/24/2022] [Indexed: 01/08/2023] Open
Abstract
Purpose Elderly patients are at high risk of fatality from COVID-19. The present work aims to describe the clinical characteristics of elderly inpatients with COVID-19 and identify the predictors of in-hospital mortality at admission. Materials and Methods In this retrospective, multicenter cohort study, we included elderly COVID-19 inpatients (n = 245) from four hospitals in Sylhet, Bangladesh, who had been discharged between October 2020 and February 2021. Demographic, clinical, and laboratory data were extracted from hospital records and compared between survivors and nonsurvivors. We used univariable and multivariable logistic regression analysis to explore the risk factors associated with in-hospital death. Principal Results. Of the included patients, 202 (82.44%) were discharged and 43 (17.55%) died in hospital. Except hypertension, other comorbidities like diabetes, chronic kidney disease, ischemic heart disease, and chronic obstructive pulmonary disease were more prevalent in nonsurvivors. Nonsurvivors had a higher prevalence of leukocytosis (51.2 versus 30.7; p=0.01), lymphopenia (72.1 versus 55; p=0.05), and thrombocytopenia (20.9 versus 9.9; p=0.07). Multivariable regression analysis showed an increasing odds ratio of in-hospital death associated with older age (odds ratio 1.05, 95% CI 1.01–1.10, per year increase; p=0.009), thrombocytopenia (OR = 3.56; 95% CI 1.22–10.33, p=0.019), and admission SpO2 (OR 0.91, 95% CI 0.88–0.95; p=0.001). Conclusions Higher age, thrombocytopenia, and lower initial level of SpO2 at admission are predictors of in-hospital mortality in elderly patients with COVID-19.
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11
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Cocoş R, Mahler B, Turcu-Stiolica A, Stoichiță A, Ghinet A, Shelby ES, Bohîlțea LC. Risk of Death in Comorbidity Subgroups of Hospitalized COVID-19 Patients Inferred by Routine Laboratory Markers of Systemic Inflammation on Admission: A Retrospective Study. Viruses 2022; 14:v14061201. [PMID: 35746672 PMCID: PMC9228480 DOI: 10.3390/v14061201] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 05/27/2022] [Accepted: 05/28/2022] [Indexed: 12/21/2022] Open
Abstract
Our study objective was to construct models using 20 routine laboratory parameters on admission to predict disease severity and mortality risk in a group of 254 hospitalized COVID-19 patients. Considering the influence of confounding factors in this single-center study, we also retrospectively assessed the correlations between the risk of death and the routine laboratory parameters within individual comorbidity subgroups. In multivariate regression models and by ROC curve analysis, a model of three routine laboratory parameters (AUC 0.85; 95% CI: 0.79–0.91) and a model of six laboratory factors (AUC 0.86; 95% CI: 0.81–0.91) were able to predict severity and mortality of COVID-19, respectively, compared with any other individual parameter. Hierarchical cluster analysis showed that inflammatory laboratory markers grouped together in three distinct clusters including positive correlations: WBC with NEU, NEU with neutrophil-to-lymphocyte ratio (NLR), NEU with systemic immune-inflammation index (SII), NLR with SII and platelet-to-lymphocyte ratio (PLR) with SII. When analyzing the routine laboratory parameters in the subgroups of comorbidities, the risk of death was associated with a common set of laboratory markers of systemic inflammation. Our results have shown that a panel of several routine laboratory parameters recorded on admission could be helpful for early evaluation of the risk of disease severity and mortality in COVID-19 patients. Inflammatory markers for mortality risk were similar in the subgroups of comorbidities, suggesting the limited effect of confounding factors in predicting COVID-19 mortality at admission.
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Affiliation(s)
- Relu Cocoş
- Institute of Pneumophtisiology “Marius Nasta”, 050159 Bucharest, Romania; (B.M.); (A.S.); (A.G.)
- Department of Medical Genetics, University of Medicine and Pharmacy “Carol Davila”, 020032 Bucharest, Romania;
- Correspondence: (R.C.); (A.T.-S.)
| | - Beatrice Mahler
- Institute of Pneumophtisiology “Marius Nasta”, 050159 Bucharest, Romania; (B.M.); (A.S.); (A.G.)
- Pneumology Department (II), University of Medicine and Pharmacy “Carol Davila”, 020021 Bucharest, Romania
| | - Adina Turcu-Stiolica
- Department of Pharmacoeconomics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Correspondence: (R.C.); (A.T.-S.)
| | - Alexandru Stoichiță
- Institute of Pneumophtisiology “Marius Nasta”, 050159 Bucharest, Romania; (B.M.); (A.S.); (A.G.)
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, 020021 Bucharest, Romania
| | - Andreea Ghinet
- Institute of Pneumophtisiology “Marius Nasta”, 050159 Bucharest, Romania; (B.M.); (A.S.); (A.G.)
| | - Elena-Silvia Shelby
- Scientific Research Nucleus, Dr. Nicolae Robanescu National Clinical Centre for Children’s Neurorecovery, 041408 Bucharest, Romania;
| | - Laurențiu Camil Bohîlțea
- Department of Medical Genetics, University of Medicine and Pharmacy “Carol Davila”, 020032 Bucharest, Romania;
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12
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Gupta A, Marzook H, Ahmad F. Comorbidities and clinical complications associated with SARS-CoV-2 infection: an overview. Clin Exp Med 2022; 23:313-331. [PMID: 35362771 PMCID: PMC8972750 DOI: 10.1007/s10238-022-00821-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 03/12/2022] [Indexed: 01/08/2023]
Abstract
The novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causes major challenges to the healthcare system. SARS-CoV-2 infection leads to millions of deaths worldwide and the mortality rate is found to be greatly associated with pre-existing clinical conditions. The existing dataset strongly suggests that cardiometabolic diseases including hypertension, coronary artery disease, diabetes and obesity serve as strong comorbidities in coronavirus disease (COVID-19). Studies have also shown the poor outcome of COVID-19 in patients associated with angiotensin-converting enzyme-2 polymorphism, cancer chemotherapy, chronic kidney disease, thyroid disorder, or coagulation dysfunction. A severe complication of COVID-19 is mostly seen in people with compromised medical history. SARS-CoV-2 appears to attack the respiratory system causing pneumonia, acute respiratory distress syndrome, which lead to induction of severe systemic inflammation, multi-organ dysfunction, and death mostly in the patients who are associated with pre-existing comorbidity factors. In this article, we highlighted the key comorbidities and a variety of clinical complications associated with COVID-19 for a better understanding of the etiopathogenesis of COVID-19.
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Affiliation(s)
- Anamika Gupta
- Cardiovascular Research Group, Sharjah Institute for Medical Research, University of Sharjah, Sharjah, 27272, UAE
| | - Hezlin Marzook
- Cardiovascular Research Group, Sharjah Institute for Medical Research, University of Sharjah, Sharjah, 27272, UAE
| | - Firdos Ahmad
- Cardiovascular Research Group, Sharjah Institute for Medical Research, University of Sharjah, Sharjah, 27272, UAE. .,Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, 27272, UAE.
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13
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Bisserier M, Sun XQ, Fazal S, Turnbull IC, Bonnet S, Hadri L. Novel Insights into the Therapeutic Potential of Lung-Targeted Gene Transfer in the Most Common Respiratory Diseases. Cells 2022; 11:984. [PMID: 35326434 PMCID: PMC8947048 DOI: 10.3390/cells11060984] [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] [Received: 02/04/2022] [Revised: 03/08/2022] [Accepted: 03/10/2022] [Indexed: 12/10/2022] Open
Abstract
Over the past decades, a better understanding of the genetic and molecular alterations underlying several respiratory diseases has encouraged the development of new therapeutic strategies. Gene therapy offers new therapeutic alternatives for inherited and acquired diseases by delivering exogenous genetic materials into cells or tissues to restore physiological protein expression and/or activity. In this review, we review (1) different types of viral and non-viral vectors as well as gene-editing techniques; and (2) the application of gene therapy for the treatment of respiratory diseases and disorders, including pulmonary arterial hypertension, idiopathic pulmonary fibrosis, cystic fibrosis, asthma, alpha-1 antitrypsin deficiency, chronic obstructive pulmonary disease, non-small-cell lung cancer, and COVID-19. Further, we also provide specific examples of lung-targeted therapies and discuss the major limitations of gene therapy.
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Affiliation(s)
- Malik Bisserier
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Avenue, New York, NY 10029, USA; (M.B.); (S.F.); (I.C.T.)
| | - Xiao-Qing Sun
- Department of Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands;
| | - Shahood Fazal
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Avenue, New York, NY 10029, USA; (M.B.); (S.F.); (I.C.T.)
| | - Irene C. Turnbull
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Avenue, New York, NY 10029, USA; (M.B.); (S.F.); (I.C.T.)
| | - Sébastien Bonnet
- Pulmonary Hypertension Research Group, Québec Heart and Lung Institute Research Centre, Québec, QC G1V4G5, Canada;
- Department of Medicine, Laval University, Québec, QC G1V4G5, Canada
| | - Lahouaria Hadri
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Avenue, New York, NY 10029, USA; (M.B.); (S.F.); (I.C.T.)
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14
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Chang Villacreses MM, Karnchanasorn R, Ou HY, Samoa R, Chuang LM, Chiu KC. The impact of glucose tolerance state on seropositivity rate after hepatitis B vaccination. Sci Rep 2022; 12:3087. [PMID: 35197568 PMCID: PMC8866475 DOI: 10.1038/s41598-022-07163-x] [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] [Received: 10/11/2021] [Accepted: 02/14/2022] [Indexed: 11/24/2022] Open
Abstract
Immunization is recommended for people with diabetes mellitus (DM), but little information is available on their seropositivity rates. To determine the impact of glucose tolerance state on seropositivity rate after hepatitis B vaccination, we included 7645 adult participants from the National Health and Nutrition Examination Survey 2005-2016 who reported three doses of hepatitis B vaccine and were seropositive for anti-hepatitis B surface antibody (≥ 12.0 mIU/mL), after exclusion of those positive for anti-hepatitis B core antibody and/or hepatitis B surface antigen. We classified the states of glucose tolerance as normal glucose tolerance (NGT, 61.68%), abnormal glucose tolerance (AGT, 26.02%), or DM (13.30%). We observed a stepwise decline in hepatitis B seropositivity rate from NGT (53.64%) to AGT (45.52%) to DM (28.84%) (P < 0.0001). We confirmed these results after standardization for age and BMI (P < 0.0001 for all subgroup analyses) and in subgroup analyses by gender and racial/ethnic group. Dysregulated glucose metabolism is associated with a decreased seropositivity rate after hepatitis B vaccination. Our observations suggest that regular follow-up screening for anti-hepatitis B surface antibody, with additional booster vaccination as necessary, is especially important in patients with DM. Whether a similar phenomenon exits for other vaccines, especially COVID-19, remains to be investigated.
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Affiliation(s)
- Maria Mercedes Chang Villacreses
- Department of Clinical Diabetes, Endocrinology, and Metabolism, City of Hope National Medical Center, Duarte, CA, USA
- Division of Endocrinology, Metabolism and Nutrition, Department of Internal Medicine, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Rudruidee Karnchanasorn
- Division of Endocrinology, Department of Medicine, University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - Horng-Yih Ou
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Cheng-Kung University Medical College and Hospital, Tainan, Taiwan
| | - Raynald Samoa
- Department of Clinical Diabetes, Endocrinology, and Metabolism, City of Hope National Medical Center, Duarte, CA, USA
- Division of Endocrinology, Metabolism and Nutrition, Department of Internal Medicine, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Lee-Ming Chuang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ken C Chiu
- Division of Endocrinology, Metabolism and Nutrition, Department of Internal Medicine, Harbor-UCLA Medical Center, Torrance, CA, USA.
- The Lundquest Institute, Torrance, CA, USA.
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15
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Biasco L, Klersy C, Beretta GS, Valgimigli M, Valotta A, Gabutti L, Bruna RD, Pagnamenta A, Tersalvi G, Ruinelli L, Artero A, Senatore G, Jüni P, Pedrazzini GB. Comparative frequency and prognostic impact of myocardial injury in hospitalized patients with COVID-19 and Influenza. EUROPEAN HEART JOURNAL OPEN 2021; 1:oeab025. [PMID: 35915652 PMCID: PMC8499788 DOI: 10.1093/ehjopen/oeab025] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/23/2021] [Accepted: 08/26/2021] [Indexed: 04/22/2023]
Abstract
AIMS Myocardial injury (MINJ) in Coronavirus disease 2019 (COVID-19) identifies individuals at high mortality risk but its clinical relevance is less well established for Influenza and no comparative analyses evaluating frequency and clinical implications of MINJ among hospitalized patients with Influenza or COVID-19 are available. METHODS AND RESULTS Hospitalized adults with laboratory confirmed Influenza A or B or COVID-19 underwent highly sensitive cardiac T Troponin (hs-cTnT) measurement at admission in four regional hospitals in Canton Ticino, Switzerland. MINJ was defined as hs-cTnT >14 ng/L. Clinical, laboratory and outcome data were retrospectively collected. The primary outcome was mortality up to 28 days. Cox regression models were used to assess correlations between admission diagnosis, MINJ, and mortality. Clinical correlates of MINJ in both viral diseases were also identified. MINJ occurred in 94 (65.5%) out of 145 patients hospitalized for Influenza and 216 (47.8%) out of 452 patients hospitalized for COVID-19. Advanced age and renal impairment were factors associated with MINJ in both diseases. At 28 days, 7 (4.8%) deaths occurred among Influenza and 76 deaths (16.8%) among COVID-19 patients with a hazard ratio (HR) of 3.69 [95% confidence interval (CI) 1.70-8.00]. Adjusted Cox regression models showed admission diagnosis of COVID-19 [HR 6.41 (95% CI 4.05-10.14)] and MINJ [HR 8.01 (95% CI 4.64-13.82)] to be associated with mortality. CONCLUSIONS Myocardial injury is frequent among both viral diseases and increases the risk of death in both COVID-19 and Influenza. The absolute risk of death is considerably higher in patients admitted for COVID-19 when compared with Influenza.
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Affiliation(s)
- Luigi Biasco
- Department of Biomedical Sciences, Università della Svizzera Italiana, Via Buffi 13, 6900, Lugano, Switzerland
- Department of Cardiology, Azienda Sanitaria Locale Torino 4, Via Battitore 7, 10070, Ciriè, Italy
| | - Catherine Klersy
- Service of Clinical Epidemiology & Biometry, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi, 19, 27100, Pavia, Italy
| | - Giulia S Beretta
- Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Via Tesserete 48, 6900 Lugano, Switzerland
| | - Marco Valgimigli
- Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Via Tesserete 48, 6900 Lugano, Switzerland
- University of Berne, Hochschulstrasse 6, 3012, Berne, Switzerland
| | - Amabile Valotta
- Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Via Tesserete 48, 6900 Lugano, Switzerland
| | - Luca Gabutti
- Department of Internal Medicine, Ente Ospedaliero Cantonale, Via Tesserete 46, 6900, Lugano, Switzerland
| | - Roberto Della Bruna
- Department of Clinical Chemistry, Ente Ospedaliero Cantonale, Via Tesserete 46, 6900, Lugano, Switzerland
| | - Alberto Pagnamenta
- Department of Intensive Medicine, Ente Ospedaliero Cantonale, Via Alfonso Turconi 23, 6850, Mendrisio, Switzerland
| | - Gregorio Tersalvi
- Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Via Tesserete 48, 6900 Lugano, Switzerland
| | - Lorenzo Ruinelli
- Service of Information and Technology, Ente Ospedaliero Cantonale, Via Ospedale 12, 6500, Bellinzona, Switzerland
| | - Andrea Artero
- Department of Justice, Law & Criminology, American University, Ward Circle Building, 4400 Massachusetts Ave, 20016, Washington, DC, USA
| | - Gaetano Senatore
- Department of Cardiology, Azienda Sanitaria Locale Torino 4, Via Battitore 7, 10070, Ciriè, Italy
| | - Peter Jüni
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St 4th Floor, Toronto, ON M5T 3M6, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Giovanni B Pedrazzini
- Department of Biomedical Sciences, Università della Svizzera Italiana, Via Buffi 13, 6900, Lugano, Switzerland
- Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Via Tesserete 48, 6900 Lugano, Switzerland
- Corresponding author. Tel: +41 91 8053170,
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The Effects of Previous Thyroid Disease on the Susceptibility to, Morbidity of, and Mortality Due to COVID-19: A Nationwide Cohort Study in South Korea. J Clin Med 2021; 10:jcm10163522. [PMID: 34441818 PMCID: PMC8396860 DOI: 10.3390/jcm10163522] [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: 07/27/2021] [Revised: 08/10/2021] [Accepted: 08/10/2021] [Indexed: 01/22/2023] Open
Abstract
This study aimed to investigate the associations of the susceptibility to, morbidity of, and mortality due to coronavirus disease 2019 (COVID-19) with thyroid diseases. Korea National Health Insurance Database Coronavirus disease 2019 (NHID-COVID-19) medical claim code data from 2015 to 2020 were analyzed. A total of 8070 COVID-19 patients and 32,280 matched control participants were evaluated for histories of hypothyroidism, hyperthyroidism, Graves’ disease, thyroiditis, and autoimmune thyroiditis. The relationships of susceptibility to, morbidity of, and mortality due to COVID-19 with hypothyroidism, hyperthyroidism, Graves’ disease, thyroiditis, and autoimmune thyroiditis were analyzed using a conditional logistic regression. Hypothyroidism, hyperthyroidism, Graves’ disease, thyroiditis, and autoimmune thyroiditis were not associated with susceptibility to, morbidity of, or mortality due to COVID-19. Graves’ disease was related to higher odds of mortality due to COVID-19 in the adjusted model but the confidence interval (CI) was wide, probably due to the small number of deaths among patients with Graves’ disease (aOR = 11.43, 95% CI = 1.29–101.22, p = 0.029). Previous histories of hypothyroidism, hyperthyroidism, Graves’ disease, thyroiditis, and autoimmune thyroiditis were not related to susceptibility to COVID-19. In addition, prior histories of thyroid diseases were not related to increased risks of COVID-19-related morbidity and mortality.
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