1
|
Babaei M, Heidari B, Ghorbani H, Ahmadnia Z, Rouhi S, Zavareh MSH. Factors Associated with Mortality in Patients with Coronavirus Disease (COVID-19) in Babol, North of Iran. Infect Disord Drug Targets 2024; 24:e090224226818. [PMID: 38343046 DOI: 10.2174/0118715265209731240129042916] [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: 07/11/2022] [Revised: 01/10/2024] [Accepted: 01/10/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND The spectrum of the clinical features of coronavirus disease 2019 (COVID-19) spans from asymptomatic or mild disease to severe respiratory failure, while different factors are related to its mortality rate. This research aimed to determine the clinical and laboratory characteristics and the associated factors of mortality in patients with COVID-19. MATERIALS AND METHODS Data were collected from hospitalized patients (May to June 2020), and COVID-19 was confirmed in patients by real-time polymerase chain reaction (PCR). The patient group was classified into survivor and deceased groups. The chi-square and the independent t-test with Statistical Package for the Social Sciences (SPSS) software program, version 18, were used for analysis. RESULTS Mean age, hemoglobin, serum C-reactive protein (CRP), alkaline phosphatase (ALP), white blood cells, and level of procalcitonin in non-survivors were significantly higher than in survivors. Serum tumour necrosis factor-alpha (TNF-a) had a significant relationship with Ddimer (p = 0.0006). The risk of mortality in patients with serum CRP ≥ 100 mg/dl was significantly higher than those with CRP < 100 mg/dl (odds ratio (OR) = 4.8 (95% CI, 1.33-12.44, p = 0.01). CONCLUSION COVID-19 has different clinical features and can be an asymptomatic, mild, or severe disease. Thus, findings about the disease and the consequent outcomes differ in patients. Further studies are needed to evaluate the clinical features and consequences of COVID-19 infection.
Collapse
Affiliation(s)
- Mansour Babaei
- Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Behzad Heidari
- Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Hossein Ghorbani
- Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Ahmadnia
- Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Samaneh Rouhi
- Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | | |
Collapse
|
2
|
Morís DI, de Moura J, Marcos PJ, Rey EM, Novo J, Ortega M. Comprehensive analysis of clinical data for COVID-19 outcome estimation with machine learning models. Biomed Signal Process Control 2023; 84:104818. [PMID: 36915863 PMCID: PMC9995330 DOI: 10.1016/j.bspc.2023.104818] [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: 06/26/2022] [Revised: 11/22/2022] [Accepted: 03/05/2023] [Indexed: 03/11/2023]
Abstract
COVID-19 is a global threat for the healthcare systems due to the rapid spread of the pathogen that causes it. In such situation, the clinicians must take important decisions, in an environment where medical resources can be insufficient. In this task, the computer-aided diagnosis systems can be very useful not only in the task of supporting the clinical decisions but also to perform relevant analyses, allowing them to understand better the disease and the factors that can identify the high risk patients. For those purposes, in this work, we use several machine learning algorithms to estimate the outcome of COVID-19 patients given their clinical information. Particularly, we perform 2 different studies: the first one estimates whether the patient is at low or at high risk of death whereas the second estimates if the patient needs hospitalization or not. The results of the analyses of this work show the most relevant features for each studied scenario, as well as the classification performance of the considered machine learning models. In particular, the XGBoost algorithm is able to estimate the need for hospitalization of a patient with an AUC-ROC of 0 . 8415 ± 0 . 0217 while it can also estimate the risk of death with an AUC-ROC of 0 . 7992 ± 0 . 0104 . Results have demonstrated the great potential of the proposal to determine those patients that need a greater amount of medical resources for being at a higher risk. This provides the healthcare services with a tool to better manage their resources.
Collapse
Affiliation(s)
- Daniel I Morís
- Centro de Investigación CITIC, Universidade da Coruña, Campus de Elviña, s/n, 15071 A Coruña, Spain.,Grupo VARPA, Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña, Xubias de Arriba, 84, 15006 A Coruña, Spain
| | - Joaquim de Moura
- Centro de Investigación CITIC, Universidade da Coruña, Campus de Elviña, s/n, 15071 A Coruña, Spain.,Grupo VARPA, Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña, Xubias de Arriba, 84, 15006 A Coruña, Spain
| | - Pedro J Marcos
- Dirección Asistencial y Servicio de Neumología, Complejo Hospitalario Universitario de A Coruña (CHUAC), Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña, Sergas, 15006 A Coruña, Spain
| | - Enrique Míguez Rey
- Grupo de Investigación en Virología Clínica, Sección de Enfermedades Infecciosas, Servicio de Medicina Interna, Instituto de Investigación Biomédica de A Coruña (INIBIC), Área Sanitaria A Coruña y CEE (ASCC), SERGAS, 15006 A Coruña, Spain
| | - Jorge Novo
- Centro de Investigación CITIC, Universidade da Coruña, Campus de Elviña, s/n, 15071 A Coruña, Spain.,Grupo VARPA, Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña, Xubias de Arriba, 84, 15006 A Coruña, Spain
| | - Marcos Ortega
- Centro de Investigación CITIC, Universidade da Coruña, Campus de Elviña, s/n, 15071 A Coruña, Spain.,Grupo VARPA, Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña, Xubias de Arriba, 84, 15006 A Coruña, Spain
| |
Collapse
|
3
|
Zhong S, Lee C, Bian J, Towne SD, Lee H, Song Y, Li W, Ory MG. Environmental and Mobility Strategies During Early COVID-19: Insights From an Empirical Study Focusing on Park Visitations in El Paso, TX. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2023; 16:61-82. [PMID: 37138470 DOI: 10.1177/19375867231166080] [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] [Indexed: 05/05/2023]
Abstract
OBJECTIVES We explored the importance of environmental and mobility strategies during early COVID-19 by age and ethnicity and investigated predictors of park visitations considering the COVID-19 impacts. BACKGROUND Parks are safe and accessible venues to stay active and reduce social isolation, which is especially important considering COVID-19 and the associated lockdowns. METHODS We analyzed online survey data from 683 residents (collected July 2020) of El Paso, TX, and objective measures of neighborhood park characteristics. Chi-square tests and mixed-effects logistic regression analyses were performed to examine the environmental/mobility strategies, personal and environmental factors, and park visitations, considering the COVID-19 impacts. RESULTS The percentage of those who visited (1+ times/week) parks or trails/paths in the neighborhood dropped from 41.7% to 19.5% since the start of COVID-19 (OR = 0.015, p < .001). Before COVID-19, middle-aged and older adults were less likely to visit parks than younger adults, while this difference became insignificant during early COVID-19. Hispanic adults were more likely to visit parks than non-Hispanics both before and during early COVID-19. Positive environmental predictors of park visitations included park availability in the neighborhood, proximity to the closest park, seeing people being physically active in the neighborhood, and neighborhood aesthetics. CONCLUSIONS Proximately located parks, trails, and paths well integrated into residential communities, and high aesthetic quality of the neighborhood are the potential features of pandemic-resilient communities and should be considered an important national priority to maintain and promote the health and well-being of the population, especially during pandemics like COVID-19.
Collapse
Affiliation(s)
- Sinan Zhong
- Department of Landscape Architecture and Urban Planning, School of Architecture, Texas A&M University, College Station, TX, USA
| | - Chanam Lee
- Department of Landscape Architecture and Urban Planning, School of Architecture, Texas A&M University, College Station, TX, USA
| | - Jiahe Bian
- Department of Landscape Architecture and Urban Planning, School of Architecture, Texas A&M University, College Station, TX, USA
| | - Samuel D Towne
- School of Global Health Management and Informatics, University of Central Florida, Orlando, FL, USA
- Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL, USA
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Hanwool Lee
- Department of Landscape Architecture and Urban Planning, School of Architecture, Texas A&M University, College Station, TX, USA
| | - Yang Song
- Department of Landscape Architecture and Urban Planning, School of Architecture, Texas A&M University, College Station, TX, USA
| | - Wei Li
- Department of Landscape Architecture and Urban Planning, School of Architecture, Texas A&M University, College Station, TX, USA
| | - Marcia G Ory
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, USA
| |
Collapse
|
4
|
Howe de la Torre S, Parlatini V, Cortese S. Long-term central nervous system (CNS) consequences of COVID-19 in children. Expert Rev Neurother 2023; 23:703-720. [PMID: 37545414 DOI: 10.1080/14737175.2023.2239500] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/18/2023] [Indexed: 08/08/2023]
Abstract
INTRODUCTION Neurological/neuropsychiatric symptoms are commonly reported by children/young people with long COVID, especially headache, fatigue, cognitive deficits, anosmia and ageusia, dizziness, mood symptoms, and sleep problems. However, reported prevalence estimates are highly variable due to study heterogeneity and often small sample size; most studies only considered short-term follow-ups; and, apart from mood and sleep problems, neuropsychiatric conditions have received less attention. Considering the potential debilitating effects of neurological/neuropsychiatric conditions, a comprehensive review of the topic is timely, and needed to support clinical recognition as well as to set the direction for future research. AREAS COVERED The authors discuss neurological/neuropsychiatric manifestations of long COVID in pediatric populations, with a focus on prevalence, associated demographic characteristics, and potential pathogenetic mechanisms. EXPERT OPINION Children/young people may develop persistent neurological/neuropsychiatric symptoms following acute SARS-CoV-2 infection, which may affect daily functioning and well-being. Studies in larger samples with longer follow-ups are needed to clarify prevalence and symptom duration; as well as less investigated risk factors, including genetic predisposition, ethnicity, and comorbidities. Controlled studies may help separate infection-related direct effects from pandemic-related psychosocial stressors. Clarifying pathogenetic mechanisms is paramount to develop more targeted and effective treatments; whilst screening programs and psychoeducation may enhance early recognition.
Collapse
Affiliation(s)
| | - Valeria Parlatini
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Samuele Cortese
- School of Psychology, University of Southampton, Southampton, UK
- Horizon Centre, CAMHS West, William Macleod Way, Solent NHS Trust, Southampton, UK
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
- Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, New York, USA
| |
Collapse
|
5
|
Abedinzadeh M, Vahidi S, Rahavian A, Lojje H, Abouei S. Effect of COVID-19 On the Sexual Activity of Men. Am J Mens Health 2023; 17:15579883231193913. [PMID: 37599378 PMCID: PMC10467192 DOI: 10.1177/15579883231193913] [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: 05/13/2023] [Revised: 07/22/2023] [Accepted: 07/25/2023] [Indexed: 08/22/2023] Open
Abstract
In December 2019, severe acute respiratory syndrome COVID-19 was found in China. This virus can affect different organs depending on the coronavirus receptors on the cell surface, which allows the organ to be attacked by the coronavirus. Psychological distress and impaired pulmonary hemodynamics seem to be the cause of decreasing libido or sexual dysfunction after contracting COVID-19. This study was performed to assess the effect of coronavirus on the sexual activity of men. We enrolled 200 men with COVID-19, confirmed by an oropharyngeal sample, who had recovered from the coronavirus for 3 months. These men filled out the International Index of Erectile Function 5 (IIEF-5) questionnaire for their current and previous sexual status. Then, according to their IIEF-5 score, sexual activity before and after corona infection was compared. The mean age of the participants was 31.5 ±3.2 years. This study showed a significant difference between the IIEF-5 mean scores before and after COVID-19, which were 20.4 and 18.6, respectively (p = .000). The condition of 56.1% of the patients did not change; however, coronavirus did have a negative effect on 39.6% of the patients. 4.1% of patients reported improvement in sexual performance. 45% of the patients reported no erectile dysfunction (ED) before contracting the coronavirus; while only 27.7% reported no ED after getting COVID-19. Our findings show that COVID-19 could influence the sexual activity of infected men, who also showed a higher ED prevalence after COVID-19 infection; however, hormonal assessment should be observed in the follow-up.
Collapse
Affiliation(s)
- Mehdi Abedinzadeh
- Department of Urology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Serajoddin Vahidi
- Andrology Research Center, Yazd Reproductive Science Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amirhossein Rahavian
- Andrology Research Center, Yazd Reproductive Science Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hossein Lojje
- Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Saied Abouei
- Andrology Research Center, Yazd Reproductive Science Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| |
Collapse
|
6
|
Aditianingsih D, Soenarto RF, Puiantana AM, Pranata R, Lim MA, Raharja PAR, Birowo P, Meyer M. Dose response relationship between D-dimer level and mortality in critically ill COVID-19 patients: a retrospective observational study. F1000Res 2023; 11:269. [PMID: 38665691 PMCID: PMC11043662 DOI: 10.12688/f1000research.108972.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/19/2022] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is a global pandemic. Coagulopathy is one of the most common complications characterized by increased D-dimer level. We aimed to investigate the dose-response relationship between elevated D-dimer level and mortality in critically ill COVID-19 patients. METHODS This was a retrospective observational study in 259 critically ill COVID-19 patients requiring intensive care unit admission between March and December 2020. We compared the mortality rate between patients with and without elevated D-dimer. Receiver operating characteristic (ROC) curve analysis, Fagan's nomogram, and dose-response relationship were performed to determine the association between D-dimer level and mortality. RESULTS Overall mortality rate was 40.9% (106 patients). Median D-dimer level was higher in non-survivor group (10,170 ng/mL vs 4,050 ng/mL, p=0.028). The association remained significant after multivariate logistic regression analysis (p=0.046). The optimal cut-off for D-dimer level to predict mortality from ROC curve analysis was 9,020 ng/mL (OR (odds ratio) 3.73 [95% CI (confidence interval) 1.91 - 7.28], p<0.001). D-dimer level >9,020 ng/mL confers 67% posterior probability of mortality and D-dimer level <9,020 ng/mL had 35% probability of mortality. CONCLUSIONS There was a non-linear dose-response relationship between D-dimer level and mortality with P nonlinearity of 0.004. D-dimer level was associated with mortality in critically ill COVID-19 patients in the non-linear dose-response relationship.
Collapse
Affiliation(s)
- Dita Aditianingsih
- Division of Critical Care, Universitas Indonesia Hospita, Depok, Jawa Barat, Indonesia
- Department of Anesthesia and Intensive Care, Dr. Cipto Mangunkusumo Hospital – Universitas Indonesia Hospital, Jakarta, DKI Jakarta, Indonesia
| | - Ratna Farida Soenarto
- Department of Anesthesia and Intensive Care, Dr. Cipto Mangunkusumo Hospital – Universitas Indonesia Hospital, Jakarta, DKI Jakarta, Indonesia
| | - Artheta Mutiara Puiantana
- Department of Anesthesia and Intensive Care, Dr. Cipto Mangunkusumo Hospital – Universitas Indonesia Hospital, Jakarta, DKI Jakarta, Indonesia
| | - Raymond Pranata
- Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia
| | | | - Putu Angga Risky Raharja
- Department of Urology, Dr. Cipto Mangunkusumo Hospital – Universitas Indonesia Hospital, Jakarta, DKI Jakarta, Indonesia
| | - Ponco Birowo
- Department of Urology, Dr. Cipto Mangunkusumo Hospital – Universitas Indonesia Hospital, Jakarta, DKI Jakarta, Indonesia
| | - Markus Meyer
- Faculty of Medicine, Universitas Indonesia, Jakarta, DKI Jakarta, Indonesia
| |
Collapse
|
7
|
Hartman WR. An Executed Plan to Combat COVID-19 in the United States. Adv Anesth 2022; 40:45-62. [PMID: 36333051 PMCID: PMC9276922 DOI: 10.1016/j.aan.2022.07.002] [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] [Indexed: 01/29/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in late 2019. To date, this coronavirus is responsible for greater than 90 million cases in the United States and more than 1 million confirmed deaths. When this virus came to the United States, testing was unorganized, no effective treatments were known, and no vaccines had been discovered. A plan to correct these deficiencies through cooperative science and efficient clinical trials was implemented to combat this novel virus. This plan developed efficient and inexpensive tests, highly effective medicines to treat and prevent disease progression, and vaccines to immunize the population.
Collapse
Affiliation(s)
- William R Hartman
- Department of Anesthesiology, Office of Clinical Research, University of Wisconsin-Madison, Madison, WI, USA.
| |
Collapse
|
8
|
Burden of COVID-19 infection and lockdown measures on individuals with chronic diseases in Saudi Arabia: A national population-based study. J Infect Public Health 2022; 15:1531-1539. [PMID: 36434997 PMCID: PMC9674401 DOI: 10.1016/j.jiph.2022.11.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 10/15/2022] [Accepted: 11/15/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The recent COVID-19 crisis has placed a huge strain on the global health and economy. The toll of the damage on the human society exceeds the morbidity and mortality of the pandemic and the associated burden, considering the multidimensional impact on all aspects of life. OBJECTIVES The present study assessed the specific impact of COVID-19 on individuals with chronic diseases including the Years Lost for Disability (YLD) burden of COVID-19 infection, and multidimensional impact on the disease management, adaptive lifestyle, and socioeconomic dimensions. METHOD A national, population-based cross-sectional study was conducted among adult Saudi population. An internet-based questionnaire was used to collect sociodemographic characteristics, medical history, impact of COVID-19 lockdown on the management of the chronic disease, adaptive lifestyle, and impact of COVID-19 on family members. Additionally, data regarding eventual COVID-19 infection, severity and management were collected. YLD was estimated and normalized per 100,000 persons. RESULT Having a chronic disease was not associated with a greater risk of COVID-19 (relative risk [RR]=0.83, p = 0.153); however, it was associated with higher risk of declined physical activity (RR=1.30, p < 0.0001), deteriorated eating habit (RR=1.20, p = 0.002), sleep quality (RR=1.25, p < 0.0001), and overall health perception (RR=1.61, p < 0.0001), loss of family members due to COVID-19 (RR=1.96, p = 0.0001), and impacted household income (RR=1.11, p = 0.010). In case of COVID-19 infection, having a chronic disease was associated with increased risk of hospitalization (RR=5.04, p = 0.005) and having a moderate-to-severe form of COVID-19 (RR=6.00, p = 0.013). The overall YLD was estimated to be 17.7 per 100,000 individuals, and there was no significant difference between individuals with chronic diseases and those without. CONCLUSION COVID-19 entailed a substantial burden on the Saudi society in 2020, and individuals with preexisting chronic diseases suffered more important multidimensional impact, which need further research to assess the real impact of the pandemic and draw the pertinent lessons from the experience for future possible epidemics.
Collapse
|
9
|
Safaie N, Kaveie M, Mardanian S, Mohammadi M, Abdol Mohamadi R, Nasri SA. Investigation of Factors Affecting COVID-19 and Sixth Wave Management Using a System Dynamics Approach. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:4079685. [PMID: 36471726 PMCID: PMC9719431 DOI: 10.1155/2022/4079685] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/12/2022] [Accepted: 07/29/2022] [Indexed: 11/04/2023]
Abstract
The COVID-19 pandemic has plunged the world into a health and economic crisis never seen before since the Spanish flu pandemic in 1918. The closure of schools and universities, the banning of rallies, and other social distancing in countries have been done to disrupt the transmission of the virus. Governments have planned to reduce restrictions on corona management by implementing vaccination programs. This research aims to better understand the Coronavirus disease's behavior, identify the prevalent factors, and adopt effective policies to control the pandemic. This study examines the different scenarios of releasing the constraints and returning to normal conditions before Corona to analyze the results of different scenarios to prevent the occurrence of subsequent peaks. The system dynamics approach is an effective means of studying COVID-19's behavioral characteristics. The factors that affect Coronavirus disease outbreak and control by expanding the basic SEIR model, interventions, and policies, such as vaccination, were investigated in this research. Based on the obtained results, the most critical factor in reducing the prevalence of the disease is reducing the behavioral risks of people and increasing the vaccination process. Observance of hygienic principles leads to disruption of the transmission chain, and vaccination increases the immunity of individuals against the acute type of infection. In addition, the closure of businesses and educational centers, along with government support for incomes, effectively controls and reduces the pandemic, which requires cooperation between the people and the government. In a situation where a new type of corona has spread, if the implementation of the policy of reducing restrictions and reopening schools and universities is done without planning, it will cause a lot of people to suffer.
Collapse
Affiliation(s)
- Nasser Safaie
- Department of Industrial Engineering, K. N. Toosi University of Technology, Tehran, Iran
| | - Maryam Kaveie
- Department of Industrial Engineering, K. N. Toosi University of Technology, Tehran, Iran
| | - Siroos Mardanian
- Department of Industrial Engineering, K. N. Toosi University of Technology, Tehran, Iran
| | - Mina Mohammadi
- Department of Industrial Engineering, K. N. Toosi University of Technology, Tehran, Iran
| | - Rasoul Abdol Mohamadi
- Department of Industrial Engineering, K. N. Toosi University of Technology, Tehran, Iran
| | - Seyed Amir Nasri
- Department of Industrial Engineering, K. N. Toosi University of Technology, Tehran, Iran
| |
Collapse
|
10
|
Galanis P, Vraka I, Katsiroumpa A, Siskou O, Konstantakopoulou O, Katsoulas T, Mariolis-Sapsakos T, Kaitelidou D. COVID-19 Vaccine Uptake among Healthcare Workers: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2022; 10:1637. [PMID: 36298502 PMCID: PMC9610263 DOI: 10.3390/vaccines10101637] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 09/24/2022] [Accepted: 09/26/2022] [Indexed: 11/17/2022] Open
Abstract
The vaccine-induced immunity of healthcare workers (HCWs) is crucial to controlling the COVID-19 pandemic. Therefore, we conducted a systematic review and meta-analysis to assess the COVID-19 vaccine uptake among HCWs worldwide and to identify predictors of vaccination. We searched Scopus, Web of Science, Medline, PubMed, ProQuest, CINAHL, and medRxiv up to 25 August 2022. We applied the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We found 25 studies including 491,624 vaccinated HCWs, while the full sample included 555,561 HCWs. The overall proportion of vaccinated HCWs was 77.3%. Vaccine uptake for studies that were conducted in North America (85.6%) was higher than the proportion for studies that were conducted in Asia (79.5%), Europe (72.8%), and Africa (65.6%). The overall prevalence of COVID-19 vaccine uptake was 83.6% and 77.4% for physicians and nurses, respectively. Older age, white race, physicians' profession, seasonal influenza vaccine, direct COVID-19 patient care, and confidence in COVID-19 vaccine safety and effectiveness were positive predictors of vaccine uptake, while history of SARS-CoV-2 infection was a negative predictor. Deep understanding of the factors that influence HCWs' decisions to receive a COVID-19 vaccine is critical to implementing tailored communication strategies for HCWs who are at risk for not getting vaccinated.
Collapse
Affiliation(s)
- Petros Galanis
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Irene Vraka
- Department of Radiology, P. & A. Kyriakou Children’s Hospital, 11527 Athens, Greece
| | - Aglaia Katsiroumpa
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Olga Siskou
- Department of Tourism Studies, University of Piraeus, 18534 Piraeus, Greece
| | - Olympia Konstantakopoulou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Theodoros Katsoulas
- Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | | | - Daphne Kaitelidou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| |
Collapse
|
11
|
Behboodikhah H, Shorafa E, Karimzadeh I, Moghadami M, Shahmohammadi J, Bayati M, Keshavarz K, Negahdaripour M. Evaluation of the Costs and Outcomes of COVID-19 Therapeutic Regimens in Hospitalized Patients in Shiraz. IRANIAN JOURNAL OF SCIENCE AND TECHNOLOGY. TRANSACTION A, SCIENCE 2022; 46:1339-1347. [PMID: 36128189 PMCID: PMC9477173 DOI: 10.1007/s40995-022-01351-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
COVID-19 patients in critical conditions are hospitalized and treated with various protocols including antiviral drugs, which have been updated repeatedly. This study was aimed to analyze the demographics, costs, and outcomes of drug regimens in COVID-19 patients hospitalized in "Ali Asghar" hospital, affiliated with Shiraz University of Medical Sciences, from March 2019 to December 2020 as a retrospective study, approved by the ethics committee of Shiraz University of Medical Sciences (IR.SUMS.REC.1399.1003) on Dec. 28, 2020. Using hospital information system (HIS) data, 2174 patients receiving favipiravir, remdesivir, interferon-β, and Kaletra® were analyzed. Descriptive, univariate, and regression analyses were used. The costs and consequences of different drug regimens were significantly different (P value < 0.05); the highest and lowest costs belonged to remdesivir and Kaletra®, respectively. The highest and lowest mean length of stay and mortality were related to remdesivir and favipiravir, respectively. Mortality did not differ significantly with various regimens. Length of stay was significantly shorter with favipiravir and Kaletra® than interferon-β. Remdesivir had significantly the highest cost. Age presented a significantly positive relationship with mortality and length of stay. Besides, ICU admission significantly increased mortality, length of stay, and costs. Underlying diseases and low blood oxygen saturation contributed to mortality. COVID-19 correlation with age and underlying diseases is accordant with the published data. Given the highest costs and broad usage of remdesivir, besides controversies regarding its outcomes and side effects, a stricter evaluation of remdesivir benefits seems essential. Totally, COVID-19 therapeutic protocols should be selected carefully to optimize costs and outcomes.
Collapse
Affiliation(s)
- Hooman Behboodikhah
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Shiraz University of Medical Sciences, P.O. Box 71345-1583, Shiraz, Iran
| | - Eslam Shorafa
- Division of Intensive Care Unit, Department of Pediatrics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Iman Karimzadeh
- Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Moghadami
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Javad Shahmohammadi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Bayati
- Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Khosro Keshavarz
- Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Emergency Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Manica Negahdaripour
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Shiraz University of Medical Sciences, P.O. Box 71345-1583, Shiraz, Iran
| |
Collapse
|
12
|
Kamali K, Hoseinzade Z, Hajimiri K, Hoveidamanesh S, Zahraei SM, Gouya MM, Bavandpouri SM, Mohamadi T, Mohamadi S, Bigdeli Z, Maleki A, Shirzad M, Heidari Z, Farsadegi M, Shoghli A. Determinants of COVID-19 vaccine acceptance in healthcare workers in Iran: National Survey. BMC Infect Dis 2022; 22:703. [PMID: 35996088 PMCID: PMC9395894 DOI: 10.1186/s12879-022-07675-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 08/09/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND AIM It seems that acceptance of COVID-19 vaccination is the most effective way to tackle the COVID-19 pandemic now. Health care workers (HCWs) are one of the most important groups who are at risk for COVID-19 infection. This study aimed to assess the COVID-19 vaccine acceptance among HCWs in Iran and its determinants. METHODS A cross-sectional survey was carried out among 3600 HCWs in Iran. Data were collected through a self-administered questionnaire by a trained team from February to March 2021. Multi-stage cluster sampling method was used for selecting respondents of the study. Multivariate logistic regression analysis was used to determine the key factors of COVID-19 vaccine acceptance among participants. P-value < 0.05 was considered statistically significant. RESULTS Out of the 3536 respondents, 2191 (62.1%) intended to uptake the COVID-19 vaccine. Only about 10 percent of respondents said they did not trust any vaccine (domestic or foreign). Willing to accept a COVID-19 vaccine was relatively high among males, doctors, and those who had a history of hospitalization due to COVID-19 infection. The multivariate regression analysis showed respondents who were 40-50 years (aOR: 1.56; 95% CI: 1.47-1.66), had a history of COVID-19 infection (aOR: 0.85; 95% CI: 0.83-0.88), and hospitalized due to COVID-19 infection (aOR: 2.18; 95% CI: 1.97-2.39), were significantly associated with vaccine acceptance (p < 0.05). CONCLUSION Our study showed moderate acceptance of COVID-19 vaccination in the HCWs in the Islamic Republic of Iran. The most important factor in the acceptance of the COVID-19 vaccine by the health staff is having a history of hospitalization. Further training and justification of health personnel is needed to increase the acceptance of COVID 19 vaccine.
Collapse
Affiliation(s)
- Koorosh Kamali
- School of Public Health, Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Zarrintaj Hoseinzade
- Social Medicine, School of Medicine, Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Khadijeh Hajimiri
- Health Education and Promotion, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Soodabeh Hoveidamanesh
- Community Medicine, Burn Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohsen Zahraei
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Mohammad Mehdi Gouya
- Infectious Disease, School of Medicine, Iran University of Medical Sciences, Teheran, Iran
| | | | - Tahereh Mohamadi
- Business Administration, Health Insurance Organization, Zanjan, Iran
| | - Soraya Mohamadi
- Biostatistics, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Zohre Bigdeli
- Biostatistics, Social Determinant of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Azam Maleki
- Reproductive Health, Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mahboubeh Shirzad
- Health Education and Promotion, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Zahra Heidari
- Social Determinant of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mahya Farsadegi
- School of Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Alireza Shoghli
- Social Medicine, School of Medicine, Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran.
| |
Collapse
|
13
|
First COVID-19 Booster Dose in the General Population: A Systematic Review and Meta-Analysis of Willingness and Its Predictors. Vaccines (Basel) 2022; 10:vaccines10071097. [PMID: 35891260 PMCID: PMC9323526 DOI: 10.3390/vaccines10071097] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 02/01/2023] Open
Abstract
The emergence of breakthrough infections and new highly contagious variants of SARS-CoV-2 threaten the immunization in individuals who had completed the primary COVID-19 vaccination. This systematic review and meta-analysis investigated, for the first time, acceptance of the first COVID-19 booster dose and its associated factors among fully vaccinated individuals. We followed the PRISMA guidelines. We searched Scopus, Web of Science, Medline, PubMed, ProQuest, CINAHL and medrxiv from inception to 21 May 2022. We found 14 studies including 104,047 fully vaccinated individuals. The prevalence of individuals who intend to accept a booster was 79.0%, while the prevalence of unsure individuals was 12.6%, and the prevalence of individuals that intend to refuse a booster was 14.3%. The main predictors of willingness were older age, flu vaccination in the previous season, and confidence in COVID-19 vaccination. The most important reasons for decline were adverse reactions and discomfort experienced after previous COVID-19 vaccine doses and concerns for serious adverse reactions to COVID-19 booster doses. Considering the burden of COVID-19, a high acceptance rate of booster doses could be critical in controlling the pandemic. Our findings are innovative and could help policymakers to design and implement specific COVID-19 vaccination programs in order to decrease booster vaccine hesitancy.
Collapse
|
14
|
Taghinezhad F, Kaffashian M, Kalvandi G, Shafiei E. Explanation of COVID-19 Mortality Using Artificial Neural Network Based on Underlying and Laboratory Risk Factors in Ilam, Iran. ARCHIVES OF RAZI INSTITUTE 2022; 77:1327-1332. [PMID: 36618315 PMCID: PMC9759234 DOI: 10.22092/ari.2021.355438.1684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 10/10/2021] [Indexed: 01/10/2023]
Abstract
The spread of new waves of coronavirus outbreaks, high mortality rates, and time-consuming and numerous challenges in achieving collective safety through vaccination and the need to prioritize the allocation of vaccines to the general population have led to the continued identification of risk factors associated with mortality in patients through innovative strategies and new statistical models. In this study, an artificial neural network (ANN) model was used to predict morbidity in patients with coronavirus disease 2019 (COVID-19). Data of 2,206 patients were extracted from the registry program of Shahid Mostafa Khomeini Hospital in Ilam, Iran, and were randomly analyzed in two training (1,544) and testing (662) groups. By fitting different models of a three-layer neural network, 12 variables could explain more than 77% of the mortality variance in COVID-19 patients. These findings could be used to better mortality management, vaccination prioritization, public education, and quarantine, and allocation of intensive care beds to reduce COVID-19 mortality. The results also confirmed the power of a better explanation of ANN models to predict the mortality of patients.
Collapse
Affiliation(s)
- F Taghinezhad
- Clinical Research Development Unit, Mostafa Khomeini Hospital, Ilam University of Medical Sciences, Ilam, Iran
| | - M Kaffashian
- Department of Physiology, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Gh Kalvandi
- Department of Pediatrics, School of Medicine, Besat Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
| | - E Shafiei
- Non-Communicable Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran
| |
Collapse
|
15
|
Picchio M, Santolini R. The COVID-19 pandemic's effects on voter turnout. EUROPEAN JOURNAL OF POLITICAL ECONOMY 2022; 73:102161. [PMID: 34975184 PMCID: PMC8715663 DOI: 10.1016/j.ejpoleco.2021.102161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 10/30/2021] [Accepted: 12/04/2021] [Indexed: 05/07/2023]
Abstract
The COVID-19 pandemic has increased the risk of participating in public events, among them elections. We assess whether the voter turnout in the 2020 local government elections in Italy was affected by the COVID-19 pandemic. We do so by exploiting the variation among municipalities in the intensity of the COVID-19 outbreak as measured by the mortality rate among the elderly. We find that a 1 percentage point increase in the elderly mortality rate decreased the voter turnout by 0.5 percentage points, with no gender differences in the behavioural response. The effect was especially strong in densely populated municipalities. We do not detect statistically significant differences in voter turnout among different levels of autonomy from the central government.
Collapse
Affiliation(s)
- Matteo Picchio
- Department of Economics and Social Sciences, Marche Polytechnic University, Italy
- Department of Economics, Ghent University, Belgium
- IZA - Institute of Labor Economics, Bonn, Germany
- GLO - Global Labor Organization
| | - Raffaella Santolini
- Department of Economics and Social Sciences, Marche Polytechnic University, Italy
| |
Collapse
|
16
|
Uptake of COVID-19 Vaccines among Pregnant Women: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2022; 10:vaccines10050766. [PMID: 35632521 PMCID: PMC9145279 DOI: 10.3390/vaccines10050766] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 01/27/2023] Open
Abstract
Mass vaccination against COVID-19 is essential to control the pandemic. COVID-19 vaccines are now recommended during pregnancy to prevent adverse outcomes. With this review, we aimed to evaluate the evidence in the literature regarding the uptake of COVID-19 vaccinations among pregnant women. A comprehensive search was performed in PubMed, Medline, Scopus, ProQuest, Web of Science, CINAHL, and medRxiv from inception to 23 March 2022. We performed a meta-analysis to estimate the overall proportion of pregnant women vaccinated against COVID-19. We found 11 studies including 703,004 pregnant women. The overall proportion of pregnant women vaccinated against COVID-19 was 27.5% (95% CI: 18.8–37.0%). Predictors of COVID-19 vaccination uptake were older age, ethnicity, race, trust in COVID-19 vaccines, and fear of COVID-19 during pregnancy. Mistrust in the government, diagnosis of COVID-19 during pregnancy, and fears about the safety and side effects of COVID-19 vaccines were reasons for declining vaccination. The global COVID-19 vaccination prevalence in pregnant women is low. A large gap exists in the literature on the factors influencing the decision of pregnant women to be vaccinated against COVID-19. Targeted information campaigns are essential to increase vaccine literacy among pregnant women.
Collapse
|
17
|
Awang H, Yaacob EL, Ahmad Daud A, Ahmad N, Ishak MS, Alias NA, Ghazali NH, Ismail NF, Abd Khalim MA, Mohamed Yusof SA, Samsury SF, Abd Rahman MA, Embong K. Risk Factors for Mortality among COVID-19 Patients in Besut Region, Terengganu, Malaysia. EUROPEAN JOURNAL OF MEDICAL AND HEALTH SCIENCES 2022; 4:1-6. [DOI: 10.24018/ejmed.2022.4.3.1307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Background: COVID-19 mortality is a public health issue in Malaysia and its contributing factors need to be addressed thoroughly. This study aimed to determine the risk factors for COVID-19 mortality in Besut region of Malaysia.
Materials and Methods: A 1:5 case-control study between deceased and survived groups among COVID-19 patients was conducted in Besut district, Terengganu state from 1st October 2020 until 16th September 2021 based on retrospective record review. The inclusion criteria for cases were individuals with laboratory RT-PCR confirmed positive test for COVID-19 and died during COVID-19 care period. Descriptive statistics, simple and multiple logistic regression analyses were employed for statistical analysis.
Result: There were 6464 COVID-19 cases in Besut district during the studied period. The proportion of COVID-19 mortality was 0.84%. Among the deceased group, majority of them were male (51.9%), symptomatic (87.0%), unvaccinated (94.4%); had COVID-19 of category 5 (31.5%) and comorbidity (81.5%). Multiple logistic regression revealed older age, stage 4 COVID-19, stage 5 COVID-19, symptomatic, cases with comorbidity and unvaccinated cases as the significant associated factors for COVID-19 mortality with adjusted odds ratio (AOR) of 1.07 (95%CI: 1.01, 1.10), p<0.001; AOR 92.61 (95%CI: 7.07, 1212.02), p=0.001; AOR 274.97 (95%CI: 25.27, 2991.74), p<0.001; AOR 8.83 (95%CI: 3.21, 24.28), p<0.001; AOR 46.72 (95%CI: 15.29, 142.70), p<0.001; and AOR 16.94 (95%CI: 6.34, 121.22), p=0.001, respectively.
Conclusion: Advanced age, severe stages of COVID-19, symptomatic cases, cases with comorbidity and unvaccinated cases were the risk factors for COVID-19 mortality. Emphasis should be given to these factors to ensure timely control and treatment strategies.
Collapse
|
18
|
Kouhpayeh H. Clinical features predicting COVID-19 mortality risk. Eur J Transl Myol 2022; 32. [PMID: 35421918 PMCID: PMC9295175 DOI: 10.4081/ejtm.2022.10268] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 11/23/2021] [Indexed: 12/15/2022] Open
Abstract
Currently, the world is involved by a pandemic of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2), which has been responsible for the deaths of hundreds of thousands of people so far. The consequences of infection with SARS-CoV-2 vary widely from asymptomatic to severe. Considering the increasing prevalence of different types of virus and acute infection with this disease, strategies to prevent mortality from COVID-19 should be seriously analyzed. In this study, the epidemiological, clinical and laboratory characteristics of patients with COVID-19 were investigated in order to identify risk factors for mortality. Chronic diseases such as chronic kidney disease (CKD), COPD, diabetes, hypertension, cardiovascular disease (CVD), cancer, increased D-dimer, male gender, old age, smoking and obesity are among the deadly risk factors associated COVID-19. Furthermore, lymphopenia and neutrophilia are often present in patients with SARS-CoV-2, and the ratio of absolute neutrophils to lymphocytes (NLR) was significantly increased in patients without bacterial infection. These findings could be used in the future to control and prevent disease, because timely identification of patients with risk of COVID-19 is important to provide better treatment strategies for reduction of mortality.
Collapse
|
19
|
Akbari A, Razmi M, Sedaghat A, Alavi Dana SMM, Amiri M, Halvani AM, Yazdani S, Sahab-Negah S. Comparative effectiveness of pharmacological interventions on mortality and the average length of hospital stay of patients with COVID-19: a systematic review and meta-analysis of randomized controlled trials. Expert Rev Anti Infect Ther 2022; 20:585-609. [PMID: 34694949 PMCID: PMC8787838 DOI: 10.1080/14787210.2022.1997587] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 10/22/2021] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Up to now, numerous randomized controlled trials (RCTs) have examined various drugs as possible treatments for Coronavirus Disease 2019 (COVID-19), but the results were diverse and occasionally even inconsistent with each other. To this point,we performed a systematic review and meta-analysis to assess the comparative effectiveness of pharmacological agents in published RCTs. AREAS COVERED A literature search was performed using PubMed, SCOPUS, EMBASE, and Web of Science databases. RCTs evaluating mortality and the average length of hospital stay to standard of care (SOC)/placebo/control were included. RCTs mainly were classified into five categories of drugs, including anti-inflammatory, antiviral, antiparasitic, antibody and antibiotics. Meta-analysis was done on 5 drugs classes and sub-group meta-analysis was done on single drugs and moderate or severe stage of disease. EXPERT OPINION Mortality and the average length of hospital stay of COVID-19 patients were significantly reduced with anti-inflammatory drugs (odds ratio [OR]: 0.77, 95% confidence interval [CI]: 0.69 to 0.85, P<0.00001, and mean difference [MD]: -1.41, CI:-1.75 to -1.07, P<0.00001, respectively) compared to SOC/control/placebo. Furthermore, antiparasitic was associated with reduced length of hospital stay (MD: -0.65, CI: -1.26 to -0.03, P<0.05) in comparison to SOC/placebo/control. However, no effectiveness was found in other pharmacological interventions.
Collapse
Affiliation(s)
- Abolfazl Akbari
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahya Razmi
- Student Research Committee, Faculty of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Sedaghat
- Lung Disease Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mahdi Amiri
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Mohammad Halvani
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Soroush Yazdani
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sajad Sahab-Negah
- Neuroscience Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Neuroscience, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Shefa Neuroscience Research Center, Khatam Alanbia Hospital, Tehran, Iran
| |
Collapse
|
20
|
Zhang K, Chan PSF, Chen S, Fang Y, Cao H, Chen H, Hu T, Chen Y, Zhou X, Wang Z. Factors Predicting COVID-19 Vaccination Uptake Among Men Who Have Sex With Men in China: An Observational Prospective Cohort Study. Front Med (Lausanne) 2022; 9:838973. [PMID: 35360721 PMCID: PMC8963419 DOI: 10.3389/fmed.2022.838973] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 02/17/2022] [Indexed: 01/15/2023] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected sexual minorities including men who have sex with men (MSM). This study investigated factors associated with the uptake of COVID-19 vaccination among MSM in China. Methods Inclusion criteria were: (1) born biologically male, (2) had oral or anal sex with men in the past year, (3) aged at least 18 years, and (4) lived in Shenzhen, China. Prospective participants were recruited through outreach in gay bars and saunas, online recruitment, and peer referrals. Participants completed a baseline online survey between August and September 2020 and a follow-up online survey between April and May 2021. Logistic regression models were fitted for data analysis. Results Among 420 participants who completed the baseline survey, 303 completed the follow-up survey. Among participants being followed up, 113 (37%) received at least one dose of COVID-19 vaccination during the study period. After adjusting for significant sociodemographic characteristics, five baseline predisposing factors predicted COVID-19 vaccination uptake during the follow-up period, including asking whether their partners had COVID-19 symptoms [adjusted odds ratio (AOR): 1.17, 95% confidence interval (CI): 1.00-1.38], washing hands before and after sex (AOR: 1.23, 95% CI: 1.03-1.46), sanitizing before and after sex (AOR: 1.17, 95% CI: 1.00-1.37), perceived higher risk of COVID-19 transmission through sexual behaviors (AOR: 1.28, 95% CI: 1.04-1.58), and panic about COVID-19 (AOR: 1.48, 95% CI: 1.16-1.89). Regarding enabling factors, receiving testing for sexually transmitted infections (STI) (AOR: 2.19, 95% CI: 1.25-3.85) and other prevention measures for human immunodeficiency virus (HIV)/STI (AOR: 2.61, 95% CI: 1.56-4.37) 6 months prior to the baseline survey were associated with higher uptake of COVID-19 vaccination. Conclusion MSM's uptake rate of COVID-19 vaccination was comparable to that of the general population in Shenzhen, China. This study offered an overview for us to identify tapping points that can encourage COVID-19 vaccination uptake among Chinese MSM.
Collapse
Affiliation(s)
- Kechun Zhang
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Paul Shing-fong Chan
- Jockey Club (JC) School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Siyu Chen
- Jockey Club (JC) School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - He Cao
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Hongbiao Chen
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Tian Hu
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Yaqi Chen
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Xiaofeng Zhou
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Zixin Wang
- Jockey Club (JC) School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| |
Collapse
|
21
|
Masoudi M, Maasoumi R, Bragazzi NL. Effects of the COVID-19 pandemic on sexual functioning and activity: a systematic review and meta-analysis. BMC Public Health 2022; 22:189. [PMID: 35086497 PMCID: PMC8794736 DOI: 10.1186/s12889-021-12390-4] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 12/07/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Since December 2019, when it was first reported in Wuhan, province of Hubei, China, the new virus SARS-CoV-2 has spread rapidly around the world and has become a global pandemic. During the COVID-19 pandemic, due to the public health measures implemented, people's sexual activity has also been affected. Restrictions on people's activities, reduced sports activities, economic issues, increased psychological stress, and reduced entertainment have, indeed, dramatically impacted sexual activity and functioning. The purpose of this study was tosystematically identify, collect and summarize the existing body of evidence from published studies on the effects of COVID-19 pandemic on sexual activity and functioning. METHODS Several scholarly databases, namely MEDLINE (via PubMed interface), Web of Science (WOS), Embase, CINAHL, the Cochrane Library, Scopus, and PsycINFO databases, were mined from December 2019 to the end of January 2021. We utilized a random-effect meta-analytical model to analyze all the data. More in detail, the Standardized Mean Difference (SMD) was used in order to estimate and evaluate the effects of the COVID-19 pandemic on sexual activity and functioning. RESULTS Twenty-one studies were included in the present study. In total, 2454 women and 3765 men were evaluated. In the present meta-analysis, sexual functioning and activity were assessed by means of two standardized and reliable tools, namely the "Female Sexual Function Index" (FSFI) and the "International Index of Erectile Function-5 items" (IIEF-5). A total of 5 studies reported the FSFI score before and after the COVID-19 pandemic in female participants. Based on the random-effect model, the SMD was computed to be - 4.26 [95% confidence interval or CI: - 7.26, - 1.25], being statistically significant. A total of 3 studies reported the IIEF-5 score before and after the COVID-19 pandemic in male participants. Based on the random-effect model, the SMD was computed to be - 0.66 [CI 95%: - 0.99, - 0.33], being statistically significant. In the majority of these studies, participants reported a reduction in the number of sexual relations and an increase in the frequency of solo sex activity, especially masturbation, compared to the time prior to the COVID-19 pandemic. CONCLUSION The results of the present study showed that COVID-19 related restrictions were correlated with higher rates of sexual dysfunction and reduced sexual activity; however, results of the current meta-analytical study show that this change in sexual functioning was greater in women compared to men. Sex is one of the dimensions of every person's life; therefore, researchers should identify the factors that lead to sexual dysfunction due to COVID-19 pandemic in their community. In this regard, sexologists should design and implement effective programs to reduce the heterogeneous causes affecting sexual functioning, given the psychological strain that the COVID-19 pandemic puts on individuals.
Collapse
Affiliation(s)
- Mojgan Masoudi
- grid.411705.60000 0001 0166 0922Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Raziyeh Maasoumi
- grid.411705.60000 0001 0166 0922Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran ,grid.411705.60000 0001 0166 0922Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Nicola Luigi Bragazzi
- grid.21100.320000 0004 1936 9430Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON Canada ,grid.5606.50000 0001 2151 3065Department of Health Sciences (DISSAL), Postgraduate School of Public Health, University of Genoa, Genoa, Italy
| |
Collapse
|
22
|
Jdiaa SS, Mansour R, El Alayli A, Gautam A, Thomas P, Mustafa RA. COVID-19 and chronic kidney disease: an updated overview of reviews. J Nephrol 2022; 35:69-85. [PMID: 35013985 PMCID: PMC8747880 DOI: 10.1007/s40620-021-01206-8] [Citation(s) in RCA: 65] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 11/08/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Coronavirus disease (COVID-19) has resulted in the death of more than 3.5 million people worldwide. While COVID-19 mostly affects the lungs, different comorbidities can have an impact on its outcomes. We performed an overview of reviews to assess the effect of Chronic Kidney Disease (CKD) on contracting COVID-19, hospitalization, mortality, and disease severity. METHODS We searched published and preprint databases. We updated the reviews by searching for primary studies published after August 2020, and prioritized reviews that are most updated and of higher quality using the AMSTAR tool. RESULTS We included 69 systematic reviews and 66 primary studies. Twenty-eight reviews reported on the prevalence of CKD among patients with COVID-19, which ranged from 0.4 to 49.0%. One systematic review showed an increased risk of hospitalization in patients with CKD and COVID-19 (RR = 1.63, 95% CI 1.03-2.58) (Moderate certainty). Primary studies also showed a statistically significant increase of hospitalization in such patients. Thirty-seven systematic reviews assessed mortality risk in patients with CKD and COVID-19. The pooled estimates from primary studies for mortality in patients with CKD and COVID-19 showed a HR of 1.48 (95% CI 1.33-1.65) (Moderate certainty), an OR of 1.77 (95% CI 1.54-2.02) (Moderate certainty) and a RR of 1.6 (95% CI 0.88-2.92) (Low certainty). CONCLUSIONS Our review highlights the impact of CKD on the poor outcomes of COVID-19, underscoring the importance of identifying strategies to prevent COVID-19 infection among patients with CKD.
Collapse
Affiliation(s)
- Sara S Jdiaa
- Division of Nephrology, University of Toronto, Toronto, ON, Canada
| | - Razan Mansour
- Division of Nephrology and Hypertension, Department of Internal Medicine, Medical Center, University of Kansas, Kansas City, KS, USA
| | - Abdallah El Alayli
- Division of Nephrology and Hypertension, Department of Internal Medicine, Medical Center, University of Kansas, Kansas City, KS, USA
| | - Archana Gautam
- Division of Nephrology and Hypertension, Department of Internal Medicine, Medical Center, University of Kansas, Kansas City, KS, USA
| | - Preston Thomas
- School of Medicine, University of Kansas, Kansas City, KS, USA
| | - Reem A Mustafa
- Division of Nephrology and Hypertension, Department of Internal Medicine, Medical Center, University of Kansas, Kansas City, KS, USA.
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
| |
Collapse
|
23
|
Nasseri Atashani F, Nasseri E, Zeinali E, Zamani R, Salahshouri A, Ghourchibeigi M, Heidari P, Koushan A, Naseri Atashani N, Heidari B. Clinical, demographic, and laboratory characteristics of COVID -19 infection and risk of in-hospital mortality. A single center 4. CASPIAN JOURNAL OF INTERNAL MEDICINE 2022; 13:221-227. [PMID: 35872689 PMCID: PMC9272956 DOI: 10.22088/cjim.13.0.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 12/01/2021] [Accepted: 12/06/2021] [Indexed: 11/15/2022]
Abstract
Background: Frequent waves of corona virus disease (COVID-19) and lack of specific drugs against that, warrant studies to reduce the morbidity and mortality of this pandemic disease. In this study, we investigated the association between influenza vaccination and the severity and outcome of COVID-19 disease in Iranian patients living in the North. Methods: This retrospective case-control study was performed on186 patients with COVID-19 infection between March and April, 2020. Patients with positive PCR were divided into two groups of case and control; Patients with moderate to severe and normal to mild lung involvement, respectively. The lung opacities in all of the 5 lobes were evaluated on chest CT images using a CT severity scoring system. The history of influenza vaccination during the fall of 2019-2020 was determined by a phone call. Statistical analysis was done using the chi-square test, student’s t-test, and logistic regression. The significance level was p<0.05. Results: The mean age of patients was 54.67±15.05years. Most patients had pulmonary manifestations including ground-glass opacity (57%), consolidation (80%) and pleural effusion (3.2%). Adjusting for age, gender, and history of underlying disease, vaccination is an effective factor in the severity of pulmonary involvement (AOR=0.39; 95%CI: (0.21, 0.73); P=0.003). Furthermore, the chance of ICU admission decreased via influenza vaccination (OR=0.21, P=0.001). Conclusion: The results showed that the severity of COVID-19 pulmonary involvement and outcome as ICU admission, and severe symptoms in patients with history of influenza vaccination were significantly lower than those without history of vaccination. This strategy can be used to prevent and reduce the complications of COVID-19.
Collapse
Affiliation(s)
| | - Elham Nasseri
- Emergency Clinic, Shahriyar Hospital, Shahriyar, Karaj, Iran
| | - Esmaeil Zeinali
- Department of Internal Medicine, Shahriyar Hospital, Karaj, Iran
| | - Roya Zamani
- Department of Internal Medicine, Shahriyar Hospital, Karaj, Iran
| | | | | | | | | | | | - Behzad Heidari
- Mobility Impairment Research Center, Babol University of Medical Sciences, Babol, Iran
| |
Collapse
|
24
|
Damayanthi HDWT, Prabani KIP, Weerasekara I. Factors Associated for Mortality of Older People With COVID 19: A Systematic Review and Meta-analysis. Gerontol Geriatr Med 2021; 7:23337214211057392. [PMID: 34888405 PMCID: PMC8649451 DOI: 10.1177/23337214211057392] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 09/28/2021] [Indexed: 01/12/2023] Open
Abstract
Background Whilst people of all ages are affected in some way by COVID-19 virus, older people are at a high mortality risk. This study aimed to systematically review the numerous factors associated with mortality among COVID-19 infected older people. Method PubMed and Science Direct were searched from inception to the April 15, 2021. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement and Joanna Briggs Institute critical appraisal tool to assess the methodological quality of the included studies. Results Of the 4957 studies identified, 20 were included in the qualitative analysis, while 10 were included in the quantitative analysis. Male sex (OR = 2.22, 95% CI = 1.23-3.99), age (over 75 years old) (OR = 3.36, 95% CI = 2.30-4.90), Dementia (OR = 3.69, 95% CI = 1.99-6.83) and Dyspnoea (OR = 3.16, 95% CI = 2.61-3.82), were found to be significantly associated with mortality. There is no significant association between Diabetes, or Hypertension. Conclusion Older age, male gender, dyspnoea and dementia were associated with a greater risk of death of older people from COVID-19 infection. These findings may help health care professionals to identify high-risk groups, facilitate appropriate remedial measures, and control mortality among older people.
Collapse
Affiliation(s)
- H D W T Damayanthi
- Department of Nursing, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - K I P Prabani
- Department of Nursing, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Ishanka Weerasekara
- Department of Physiotherapy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka.,Adjunct Associate Lecturer, College of Health Medicine and Wellbeing, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NTL, Australia
| |
Collapse
|
25
|
Akhtar H, Khalid S, Rahman FU, Ali S, Afridi M, Khader YS, Hassan F, Akhtar N, Khan MM, Ikram A. Delayed admissions and efficacy of steroid use in patients with critical and severe COVID-19: an apprehensive approach. J Public Health (Oxf) 2021; 43:iii43-iii48. [PMID: 34580731 PMCID: PMC8500079 DOI: 10.1093/pubmed/fdab239] [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] [Received: 06/04/2021] [Revised: 06/04/2021] [Accepted: 06/07/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Inadvertent delays in access to appropriate therapeutic interventions in high-risk group coronavirus disease 2019 (COVID-19) patients contribute to mortality in patients with severe/critical disease presentation. OBJECTIVES The aim of this study was to determine the effect of timely admission to the hospital on mortality of patients with severe/critical COVID-19. Another secondary aspect of this study was to observe the efficacy of time-dependent use of corticosteroids on mortality of critical/severe COVID-19 patients. METHODS Clinical data of 659 patients with severe/critical COVID-19, admitted to four major tertiary care hospitals from the Islamabad-Rawalpindi region of Pakistan was retrospectively collected from a period February-August 2020. Multivariate logistic regression analysis was carried out to determine the predictors of mortality in severe/critical COVID-19 patients. RESULTS Out of a total of 659 patients, 469 (71.2%) patients died. Age > 60 years, presence of hypertension, heart disease and kidney disease along with late admission (>5 days) were significant predictors of mortality in patients with severe/critical COVID-19. CONCLUSIONS The study highlights the importance of well-timed provision of appropriate medical interventions control COVID-19-associated mortality.
Collapse
Affiliation(s)
- Hashaam Akhtar
- Yusra Institute of Pharmaceutical Sciences, Yusra Medical and Dental College, Islamabad 44000, Pakistan
| | - Sundas Khalid
- Department of Materials Engineering, School of Chemical and Materials Engineering, National University of Science and Technology, Islamabad 44000, Pakistan
| | - Fazal-ur- Rahman
- Department of Medicine, Benazir Bhutto Hospital, Rawalpindi 44000, Pakistan
| | - Sabahat Ali
- Department of Gynecology and Obstetrics, Pakistan Air Force Hospital, Islamabad 44000, Pakistan
| | - Maham Afridi
- Department of Biotechnology, Quaid-i-Azam University, Islamabad 44000, Pakistan
| | - Yousef S Khader
- Department of Community Medicine, Public Health and Family Medicine/Faculty of Medicine, Jordan University of Science & Technology, Irbid 22110, Jordan
| | - Faheem Hassan
- CT Angio Department, Armed Forces Institute of Cardiology and National Institute of Heart Diseases (AFIC/NIHD),, Rawalpindi 44000, Pakistan
| | - Nasim Akhtar
- Department of General Medicine, Pakistan Institute of Medical Sciences, Islamabad 44000, Pakistan
| | - Muhammad Mujeeb Khan
- Department of Infectious Diseases, Rawalpindi Medical University, Rawalpindi 44000, Pakistan
| | - Aamer Ikram
- National Institute of Health, Islamabad 44000, Pakistan
| |
Collapse
|
26
|
Alharbi AA, Alqassim AY, Muaddi MA, Alghamdi SS. Regional Differences in COVID-19 Mortality Rates in the Kingdom of Saudi Arabia: A Simulation of the New Model of Care. Cureus 2021; 13:e20797. [PMID: 34987945 PMCID: PMC8716006 DOI: 10.7759/cureus.20797] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2021] [Indexed: 12/23/2022] Open
Abstract
Background This study aimed to assess regional COVID-19 mortality rates and compare the five proposed business units (BUs). Methods A cross-sectional study was conducted in the Ministry of Health (MOH) hospitals in the Kingdom of Saudi Arabia (KSA). We included 1743 adults (≥ 18 years of age) with COVID-19 admitted to any of 30 MOH hospitals. Results The inpatients had confirmed mild to severe COVID-19 between March and mid-July 2020. The central BU (Riyadh) was used as the reference. MOH electronic health record data were reviewed and utilized, including variables reflecting hospital course (mortality and discharge status). The primary outcome was COVID-19-related inpatient death. Covariates included patient demographics, pre-existing chronic diseases, and COVID-19-related complications. The data were analysed using univariate and multivariate logistic regression. KSA inpatient mortality was 30%. Univariate and multivariate logistic regression analysis suggested that COVID-19-related mortality was significantly higher in the northern and western BUs and significantly lower in the southern and eastern BUs than in the central BU. On controlling for other variables, adjusted odds ratios (AORs) for essential COVID-19 mortality predictors during admission, using the central BU as a reference, were as 9.90 [95% CI, 4.53-21.61] and 1.55 [95% CI, 1.04-2.13] times higher in the northern and western BUs, respectively, and 0.60 [95% CI, 0.36-0.99] and 0.23 [95% CI, 0.14-0.038] times lower in the southern and eastern BUs, respectively. Conclusion The five BUs differed in COVID-19 mortality rates after adjusting for patient and disease characteristics, with the differences consistent with those in the regions comprising the BUs. These outcome differences apparently relate to differences in healthcare resources and quality.
Collapse
Affiliation(s)
- Abdullah A Alharbi
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Ahmad Y Alqassim
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Mohammed A Muaddi
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Saleh S Alghamdi
- Clinical Audit General Directorate, Ministry of Health, Riyadh, SAU
| |
Collapse
|
27
|
Yan D, Ra OH, Yan B. The nucleoside antiviral prodrug remdesivir in treating COVID-19 and beyond with interspecies significance. ANIMAL DISEASES 2021; 1:15. [PMID: 34778881 PMCID: PMC8422062 DOI: 10.1186/s44149-021-00017-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 07/25/2021] [Indexed: 01/18/2023] Open
Abstract
Infectious pandemics result in hundreds and millions of deaths, notable examples of the Spanish Flu, the Black Death and smallpox. The current pandemic, caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), is unprecedented even in the historical term of pandemics. The unprecedentedness is featured by multiple surges, rapid identification of therapeutic options and accelerated development of vaccines. Remdesivir, originally developed for Ebola viral disease, is the first treatment of COVID-19 (Coronavirus disease 2019) approved by the United States Food and Drug Administration. As demonstrated by in vitro and preclinical studies, this therapeutic agent is highly potent with a broad spectrum activity against viruses from as many as seven families even cross species. However, randomized controlled trials have failed to confirm the efficacy and safety. Remdesivir improves some clinical signs but not critical parameters such as mortality. This antiviral agent is an ester/phosphorylation prodrug and excessive hydrolysis which increases cellular toxicity. Remdesivir is given intravenously, leading to concentration spikes and likely increasing the potential of hydrolysis-based toxicity. This review has proposed a conceptual framework for improving its efficacy and minimizing toxicity not only for the COVID-19 pandemic but also for future ones caused by remdesivir-sensitive viruses.
Collapse
Affiliation(s)
- Daisy Yan
- Sidney Kimmel Medical College, Thomas Jefferson University, 1025 Walnut St, Philadelphia, PA 19107 USA
| | - One Hyuk Ra
- Department of Anesthesiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115 USA
| | - Bingfang Yan
- Division of Pharmaceutical Sciences, James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH 45229 USA
| |
Collapse
|
28
|
Akhtar H, Khalid S, Ur Rahman F, Umar M, Ali S, Afridi M, Hassan F, Saleh Khader Y, Akhtar N, Mujeeb Khan M, Ikram A. Presenting characteristics, comorbidities, and outcomes among COVID-19 patients hospitalized in twin cities of Pakistan. JMIR Public Health Surveill 2021; 7:e32203. [PMID: 34710053 PMCID: PMC8673715 DOI: 10.2196/32203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/04/2021] [Accepted: 10/25/2021] [Indexed: 02/05/2023] Open
Abstract
Background COVID-19 became a pandemic rapidly after its emergence in December 2019. It belongs to the coronavirus family of viruses, which have struck a few times before in history. Data based on previous research regarding etiology and epidemiology of other viruses from this family helped played a vital role in formulating prevention and precaution strategies during the initial stages of this pandemic. Data related to COVID-19 in Pakistan were not initially documented on a large scale. In addition, due to a weak health care system and low economic conditions, Pakistan’s population, in general, already suffers from many comorbidities, which can severely affect the outcome of patients infected with COVID-19. Objective COVID-19 infections are coupled with a manifestation of various notable outcomes that can be documented and characterized clinically. The aim of this study was to examine these clinical manifestations, which can serve as indicators for early detection as well as severity prognosis for COVID-19 infections, especially in high-risk groups. Methods A retrospective observational study involving abstraction of demographic features, presenting symptoms, and adverse clinical outcomes for 1812 patients with COVID-19 was conducted. Patients were admitted to the four major hospitals in the Rawalpindi-Islamabad region of Pakistan, and the study was conducted from February to August 2020. Multivariate regression analysis was carried out to identify significant indicators of COVID-19 severity, intensive care unit (ICU) admission, ventilator aid, and mortality. The study not only relates COVID-19 infection with comorbidities, but also examines other related factors, such as age and gender. Results This study identified fever (1592/1812, 87.9%), cough (1433/1812, 79.1%), and shortness of breath (998/1812, 55.1%) at the time of hospital admission as the most prevalent symptoms for patients with COVID-19. These symptoms were common but not conclusive of the outcome of infection. Out of 1812 patients, 24.4% (n=443) required ICU admission and 21.5% (n=390) required ventilator aid at some point of disease progression during their stay at the hospital; 25.9% (n=469) of the patients died. Further analysis revealed the relationship of the presented symptoms and comorbidities with the progression of disease severity in these patients. Older adult patients with comorbidities, such as hypertension, diabetes, chronic kidney disease, and asthma, were significantly affected in higher proportions, resulting in requirement of ICU admission and ventilator aid in some cases and, in many cases, even mortality. Conclusions Older adult patients with comorbidities, such as hypertension, diabetes, asthma, chronic obstructive pulmonary disorder, and chronic kidney disease, are at increased risk of developing severe COVID-19 infections, with an increased likelihood of adverse clinical outcomes.
Collapse
Affiliation(s)
- Hashaam Akhtar
- Yusra Institute of Pharmaceutical Sciences (YIPs), Zaraj Housing Society, Opposite DHA Phase 2 Gate III, Main G.T. Road, Islamabad, PK
| | - Sundas Khalid
- School Of Chemical And Materials Engineering, National University Of Science And Technology, Islamabad, PK
| | - Fazal Ur Rahman
- HEAD OF DEPARTMENT OF MEDICINE BENAZIR BHUTTO HOSPITAL, Rawalpindi, PK
| | - Muhammad Umar
- Vice Chancellor, Rawalpindi Medical University (RMU), Rawalpindi, PK
| | - Sabahat Ali
- Department Of Gynecology And Obstetrics, Paf Hospital, Islamabad, PK
| | - Maham Afridi
- Department Of Biotechnology, Quaid I Azam University, Islamabad, PK
| | - Faheem Hassan
- CT Angio-Department, Armed Forces Institute of Cardiology (AFIC), Rawalpindi, PK
| | - Yousef Saleh Khader
- Medical Education And Biostatistics Department Of Community Medicine, Public Health And Family Medicine/ Faculty Of Medicine.Jordan University Of Science & Technology, Irbid, JO
| | - Nasim Akhtar
- Department of Infectious Diseases, Pakistan Institute Of Medical Sciences (PIMS), Islamabad, PK
| | - Muhammad Mujeeb Khan
- Department of Infectious Diseases, Rawalpindi Medical University (RMU), Rawalpindi, PK
| | - Aamer Ikram
- Executive Director, National Institute Of Health, Islamabad, PK
| |
Collapse
|
29
|
AKHAVIZADEGAN HAMED, HOSAMIRUDSARI HADISEH, ALIZADEH MAHBOOBEH, ALIMOHAMADI YOUSEF, KARBAKHSH DAVARI MOJGAN, AKBARPOUR SAMANEH, NAKHOSTIN-ANSARI AMIN, FOROUGHI ALIREZA, MANSURI FARIBA, FARAJI NEDA, NASIRI ZOHREH. Can laboratory tests at the time of admission guide us to the prognosis of patients with COVID-19? JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E321-E325. [PMID: 34604572 PMCID: PMC8451338 DOI: 10.15167/2421-4248/jpmh2021.62.2.1700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 05/19/2021] [Indexed: 11/25/2022]
Abstract
Introduction To enhance the COVID-19 patients’ care and to optimize utilizing medical resources during the pandemic, relevant biomarkers are needed for prediction of the disease’s progression. The current study was aimed to determine the factors that affect the mortality of COVID-19 patients admitted in Baharloo hospital in Iran. Methods in the current retrospective study, 56 survived patients and 56 patients who were died (a total of 112 cases) because of COVID-19 infection were randomly selected from those who were admitted to Baharloo hospital. Each patient who was diagnosed with COVID-19 and had recovered from it matched with each non-survived patient in the term of age. Laboratory tests of all these patients at the time of admission were recorded and compared. All analyses performed using spss version 22 by considering α = 0.05 as a significant level. Results There was no statistical difference in the age and gender distribution between the two groups (p > 0.05). The prevalence of diabetes among survived patients was 37.5% and among non-survived patients was 26.8% and there was no statistical difference between two groups regarding this comorbidity (p = 0.22). Also, there was no statistical difference in the prevalence of hypertension and coronary heart diseases between two groups (p > 0.05). Lymphocyte percentage, blood oxygen level, and platelet (PLT) count was significantly higher in patients who had recovered (P < 0.05). Conclusions LDH level, Lymphocyte percentage, PLT count, and blood Oxygen saturation have associations with severe forms of COVID-19 infection and can be used as predictors to assess the patients who are suspected of infection with COVID-19 at the time of admission.
Collapse
Affiliation(s)
| | - HADISEH HOSAMIRUDSARI
- Infectious disease department, Tehran University of Medical Sciences, Tehran, Iran
- Correspondence: Hadiseh Hosamirudsari, Infectious Disease Department, Tehran University of Medical Sciences, Tehran, Iran - E-mail:
| | - MAHBOOBEH ALIZADEH
- Infectious disease department, Baharloo hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - YOUSEF ALIMOHAMADI
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran
| | | | - SAMANEH AKBARPOUR
- Department of Epidemiology & Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - ALIREZA FOROUGHI
- Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran
| | - FARIBA MANSURI
- Department of Pulmonology and respiratory diseases, Tehran University of Medical Sciences, Tehran, Iran
| | - NEDA FARAJI
- Department of Internal medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - ZOHREH NASIRI
- Medical physiology and nursing office, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
30
|
Treskova-Schwarzbach M, Haas L, Reda S, Pilic A, Borodova A, Karimi K, Koch J, Nygren T, Scholz S, Schönfeld V, Vygen-Bonnet S, Wichmann O, Harder T. Pre-existing health conditions and severe COVID-19 outcomes: an umbrella review approach and meta-analysis of global evidence. BMC Med 2021; 19:212. [PMID: 34446016 PMCID: PMC8390115 DOI: 10.1186/s12916-021-02058-6] [Citation(s) in RCA: 102] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 07/08/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND This study applies an umbrella review approach to summarise the global evidence on the risk of severe COVID-19 outcomes in patients with pre-existing health conditions. METHODS Systematic reviews (SRs) were identified in PubMed, Embase/Medline and seven pre-print servers until December 11, 2020. Due to the absence of age-adjusted risk effects stratified by geographical regions, a re-analysis of the evidence was conducted. Primary studies were extracted from SRs and evaluated for inclusion in the re-analysis. Studies were included if they reported risk estimates (odds ratio (OR), hazard ratio (HR), relative risk (RR)) for hospitalisation, intensive care unit admission, intubation or death. Estimated associations were extracted from the primary studies for reported pre-existing conditions. Meta-analyses were performed stratified for each outcome by regions of the World Health Organization. The evidence certainty was assessed using GRADE. Registration number CRD42020215846. RESULTS In total, 160 primary studies from 120 SRs contributed 464 estimates for 42 pre-existing conditions. Most studies were conducted in North America, European, and Western Pacific regions. Evidence from Africa, South/Latin America, and the Eastern Mediterranean region was scarce. No evidence was available from the South-East Asia region. Diabetes (HR range 1.2-2.0 (CI range 1.1-2.8)), obesity (OR range 1.5-1.75 (CI range 1.1-2.3)), heart failure (HR range 1.3-3.3 (CI range 0.9-8.2)), COPD (HR range 1.12-2.2 (CI range 1.1-3.2)) and dementia (HR range 1.4-7.7 (CI range 1.2-39.6)) were associated with fatal COVID-19 in different regions, although the estimates varied. Evidence from Europe and North America showed that liver cirrhosis (OR range 3.2-5.9 (CI range 0.9-27.7)) and active cancer (OR range 1.6-4.7 (CI range 0.5-14.9)) were also associated with increased risk of death. Association between HIV and undesirable COVID-19 outcomes showed regional heterogeneity, with an increased risk of death in Africa (HR 1.7 (CI 1.3-2.2)). GRADE certainty was moderate to high for most associations. CONCLUSION Risk of undesirable COVID-19 health outcomes is consistently increased in certain patient subgroups across geographical regions, showing high variability in others. The results can be used to inform COVID-19 vaccine prioritisation or other intervention strategies.
Collapse
Affiliation(s)
| | - Laura Haas
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Sarah Reda
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Antonia Pilic
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Anna Borodova
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Kasra Karimi
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Judith Koch
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Teresa Nygren
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Stefan Scholz
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Viktoria Schönfeld
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Sabine Vygen-Bonnet
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Ole Wichmann
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| | - Thomas Harder
- Immunisation Unit, The Robert Koch Institute, Seestrasse 10, 13353, Berlin, Germany
| |
Collapse
|
31
|
Nikoloski Z, Alqunaibet AM, Alfawaz RA, Almudarra SS, Herbst CH, El-Saharty S, Alsukait R, Algwizani A. Covid-19 and non-communicable diseases: evidence from a systematic literature review. BMC Public Health 2021; 21:1068. [PMID: 34090396 PMCID: PMC8178653 DOI: 10.1186/s12889-021-11116-w] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/21/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Since early 2020, the Covid-19 pandemic has engulfed the world. Amidst the growing number of infections and deaths, there has been an emphasis of patients with non-communicable diseases as they are particularly susceptible to the virus. The objective of this literature review is to systematize the available evidence on the link between non-communicable diseases and Covid-19. METHODS We have conducted a systematic review of the literature on Covid-19 and non-communicable diseases from December, 2019 until 15th of November, 2020. The search was done in PubMed and in doing so we used a variety of searching terms in order to isolate the final set of papers. At the end of the selection process, 45 papers were selected for inclusion in the literature review. RESULTS The results from the review indicate that patients with certain chronic illnesses such as diabetes, hypertension (and other cardiovascular diseases), chronic respiratory illnesses, chronic kidney and liver conditions are more likely to be affected by Covid-19. More importantly, once they do get infected by the virus, patients with chronic illnesses have a much higher likelihood of having worse clinical outcomes (developing a more severe form of the disease or dying) than an average patient. There are two hypothesized channels that explain this strong link between the chronic illnesses enumerated above and Covid 19: (i) increased ACE2 (angiotensin-converting enzyme 2) receptor expressions, which facilitates the entry of the virus into the host body; and (ii) hyperinflammatory response, referred to as "cytokine storm". Finally, the literature review does not find any evidence that diabetes or hypertension related medications exacerbate the overall Covid-19 condition in chronic illness patients. CONCLUSIONS Thus, the evidence points out to 'business as usual' disease management model, although with greater supervision. However, given the ongoing Covid-19 vulnerabilities among people with NCDs, prioritizing them for the vaccination process should also figure high on the agenda on health authorities.
Collapse
Affiliation(s)
| | | | | | | | - Christopher H Herbst
- Health, Nutrition and Population Global Practice, World Bank Group, Riyadh, Saudi Arabia
| | - Sameh El-Saharty
- Health, Nutrition and Population Global Practice, World Bank Group, Kuwait City, Kuwait
| | - Reem Alsukait
- Health, Nutrition and Population Global Practice, World Bank Group, Riyadh, Saudi Arabia
| | | |
Collapse
|
32
|
Adham D, Habibzadeh S, Ghobadi H, Jajin SA, Abbasi-Ghahramanloo A, Moradi-Asl E. Epidemiological characteristics and mortality risk factors among COVID-19 patients in Ardabil, Northwest of Iran. BMC Emerg Med 2021; 21:67. [PMID: 34078273 PMCID: PMC8170426 DOI: 10.1186/s12873-021-00463-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 05/25/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Coronavirus disease highly contagious, is prevalent in all age and sex groups infecting the respiratory system. The present study seeks to investigate the epidemiology and effective factors in mortality of patients with COVID-19 in Ardabil province, northwestern Iran. METHODS In a retrospective study, the hospitalized patients with laboratory-diagnosed COVID-19 between February to August 2020 were enrolled. The data registration portal was designated according to Iranian Ministry of Health and Medical Education guidelines. In this portal, demographic information, clinical presentation, laboratory and imaging data were registered for patients in all hospitals in the same format. The Hosmer-Lemeshow strategy was used for variable selection in a multiple model. RESULTS Of the patients involved 2812(50.3%) were male and 150 (2.7%) had contact with a confirmed case of COVID-19 in the last 14 days. Pre-existing comorbidity was reported in 1310 (23.4%) patients. Of all patients, 477(8.5%) died due to COVID-19. the result of the multiple logistic regression model indicated that after adjusting for other factors, higher age (OR = 3.11), fever or chills (OR = 1.61), shortness of breath (OR = 1.82), fatigue (OR = 0.71), headache (OR = 0.64), runny nose (OR = 1.54), Skeletal muscle pain (OR = 1.53), hospitalization (OR = 5.66), and hospitalization in ICU (OR = 5.12) were associated with death. CONCLUSIONS Hospitalization had the strongest effect on mortality followed by hospitalization in ICU, and higher age. This study showed that having some extra-pulmonary symptoms in contrast with pulmonary symptoms can predict as good prognostic factors.
Collapse
Affiliation(s)
- Davoud Adham
- Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Shahram Habibzadeh
- Department of Infection Diseases, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Hassan Ghobadi
- Department of Internal Medicine, Pulmonary Division, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Shabnam Asghari Jajin
- Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Abbas Abbasi-Ghahramanloo
- Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran.
| | - Eslam Moradi-Asl
- Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran.
| |
Collapse
|
33
|
Moradzadeh R, Jamalian SM, Nazari J, Kamali A, Sadeghi B, Hosseinkhani Z, Sofian M, Zamanian M. Age-standardized mortality rate and predictors of mortality among COVID-19 patients in Iran. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:169. [PMID: 34250103 PMCID: PMC8249980 DOI: 10.4103/jehp.jehp_946_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 09/29/2020] [Indexed: 05/09/2023]
Abstract
BACKGROUND To have a thorough understanding of epidemic surveillance, it is essential to broaden our knowledge of death tolls worldwide. This study aimed to determine the age-standardized mortality rate (ASMR) and predictors of mortality among coronavirus disease 2019 (COVID-19) patients. MATERIALS AND METHODS In this cross-sectional design, all COVID-19 patients with a positive polymerase chain reaction test in the population covered by Arak University of Medical Sciences (AUMS) were entered to the study. Data collection was conducted by phone interview. The study variables comprised age, sex, coronary heart diseases, diabetes, and some symptoms at admission. The adjusted odds ratio (OR) and 95% confidence intervals (CIs) were obtained by logistic regression. The direct method was applied to calculate ASMR (per 100,000) of COVID-19. The analysis was applied by STATA software 12.0. RESULTS A total of 208 cases of COVID-19 (out of 3050 total infected cases) were dead and 2500 cases were recovered. The mean age of dead patients was 70 years. The COVID-19 fatality rate in the population equaled 6.8%; in those patients who were 70 years old or more, however, the case fatality rate was 16.4%. The ASMR of COVID-19 was 12.9 (CI 95%: 11.2, 14.8). The odds of COVID-19-related death in the age over 60 were 10.87 (CI 95%: 6.30, 18.75) times than lower 45 years old. Moreover, it was observed that COVID-19 significantly increased the odds of COVID-19-related death in diabetes patients (OR = 1.45, CI 95%: 1.02, 2.06, P = 0.036). CONCLUSION The ASMR of COVID-19 was relatively higher in males than females. In general, the COVID-19 fatality rate was relatively high. We found that older age and diabetes can have impact on the death of COVID-19, but the headache was found to have a negative association with the COVID-19-related death.
Collapse
Affiliation(s)
- Rahmatollah Moradzadeh
- Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
| | - Seyed Mohammad Jamalian
- Department of Forensic Medicine and Poisoning, Arak University of Medical Sciences, Arak, Iran
| | - Javad Nazari
- Department of Pediatrics, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Alireza Kamali
- Department of Anesthesiology and Critical Care, Arak University of Medical Sciences, Arak, Iran
| | - Bahman Sadeghi
- Department of Social Medicine, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Zahra Hosseinkhani
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Masoomeh Sofian
- Infectious Disease Research Center, Arak University of Medical Sciences, Arak, Iran
| | - Maryam Zamanian
- Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
| |
Collapse
|
34
|
Sherwal BL, Makkar N, Jain A, Dogra V, Prasad S, Sachan A, Jain R, Gupta A, Gulati S, Bhattar S, Bargotya M. Trends and clinico-epidemiological profile of COVID-19 patients at a designated COVID-19 hospital in Delhi, North India. J Family Med Prim Care 2020; 9:6261-6266. [PMID: 33681074 PMCID: PMC7928146 DOI: 10.4103/jfmpc.jfmpc_1267_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/13/2020] [Accepted: 10/14/2020] [Indexed: 01/08/2023] Open
Abstract
Background: The coronavirus disease (COVID-19) presents across a spectrum of signs and symptoms and shows clinico-epidemiological predilections (elderly, those with comorbidities). Delhi is among the highest burden states in India. Objectives: To report the case detection trends and clinico-epidemiological profile of patients tested positive at a designated COVID-19 hospital in Delhi in Northern India. Methods: Using an observational (descriptive design) we analyzed data from the electronic medical records of the hospital. All individuals testing positive for SARS-CoV-2 RNA using reverse transcription polymerase chain reaction (RT-PCR) between 17th March and 07th May 2020 (both dates inclusive) were included. Case detection trend (7-day moving averages) was plotted. Clinico-epidemiological profile of patients was summarized statistically. Results: Total 308 positive cases were enrolled in this study. The median age of participants was 48 years (09–95 years) men (47.9 ± 16.4 years) and women (43.5 ± 14.0 years). Men to women ratio was 3.4:1 with a statistically significant difference (P < 0.001). During the study timeframe, 166 (54.0%) patients had an outcome: 11 (6.6%; 95% CI: 3.4–11.6) expired and 155 recovered (recovery rate: 93.4%; 95% CI: 88.5–96.7). Chance of death was significantly associated with the higher age group (P = 0.005). The commonest clinical symptoms noted were fever (38.9%) and cough (38.6%). Majority (56.6%) had mild to moderate symptoms, 12.6% had severe symptoms and the remaining were asymptomatic (30.8%). 31 patients (26.05%) needed ICU care. Total 119 patients (38.6%) had various preexisting comorbidities, most commonly diabetes mellitus (35.0%) and hypertension (34.0%). However, the comorbidities were not associated with age (P = 1.000). Conclusion: Triangulation of data and careful analysis of trends in designated COVID-19 hospitals and other institutional settings may help inform surge preparedness and care provisioning. Stringent containment strategies must continue as the pandemic is intensifying.
Collapse
Affiliation(s)
- Banke Lal Sherwal
- Director, Rajiv Gandhi Super Speciality Hospital, Tahirpur, Delhi, India
| | - Namrata Makkar
- Deputy Medical Superintendent, Rajiv Gandhi Super Speciality Hospital, Tahirpur, Delhi, India
| | - Ajeet Jain
- Department of CTVS, Rajiv Gandhi Super Speciality Hospital, Tahirpur, Delhi, India
| | - Vikas Dogra
- Department of Pulmonology, Rajiv Gandhi Super Speciality Hospital, Tahirpur, Delhi, India
| | - Shaleen Prasad
- Department of CTVS, Rajiv Gandhi Super Speciality Hospital, Tahirpur, Delhi, India
| | - Ashish Sachan
- Department of GI Surgery, Rajiv Gandhi Super Speciality Hospital, Tahirpur, Delhi, India
| | - Ragi Jain
- Department of Anaesthesia, Rajiv Gandhi Super Speciality Hospital, Tahirpur, Delhi, India
| | - Aarti Gupta
- Department of Critical Care, Rajiv Gandhi Super Speciality Hospital, Tahirpur, Delhi, India
| | - Smita Gulati
- Department of Anaesthesia, Rajiv Gandhi Super Speciality Hospital, Tahirpur, Delhi, India
| | - Sonali Bhattar
- Department of Microbiology, Rajiv Gandhi Super Speciality Hospital, Tahirpur, Delhi, India
| | - Mona Bargotya
- Department of Pathology, Rajiv Gandhi Super Speciality Hospital, Tahirpur, Delhi, India
| |
Collapse
|