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Pina Belmonte A, Madrazo M, Piles L, Rubio-Rivas M, de Jorge Huerta L, Gómez Antúnez M, López Caleya JF, Arnalich Fernández F, Gericó-Aseguinolaza M, Pesqueira Fontan PM, Rhyman N, Prieto Dehesa M, Romero Cabrera JL, García García GM, García-Casasola G, Labirua-Iturburu Ruiz A, Carrasco-Sánchez FJ, Martínez Hernández S, Pascual Pérez MDLR, López Castro J, Serrano Carrillo de Albornoz JL, Varona JF, Gómez-Huelgas R, Antón-Santos JM, Lumbreras-Bermejo C. Assessing the impact of long-term inhaled corticosteroid therapy on patients with COVID-19 and coexisting chronic lung disease: A multicenter retrospective cohort study. CANADIAN JOURNAL OF RESPIRATORY THERAPY : CJRT = REVUE CANADIENNE DE LA THERAPIE RESPIRATOIRE : RCTR 2024; 60:86-94. [PMID: 38855380 PMCID: PMC11161176 DOI: 10.29390/001c.118514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 05/23/2024] [Indexed: 06/11/2024]
Abstract
Background Patients with chronic lung disease (CLD), such as asthma or chronic obstructive pulmonary disease, were expected to have an increased risk of clinical manifestations and severity of COVID-19. However, these comorbidities have been reported less frequently than expected. Chronic treatment with inhaled corticosteroids (ICS) may impact the clinical course of COVID-19. The main objective of this study is to know the influence of chronic treatment with ICS on the prognosis of COVID-19 hospitalized patients with CLD. Methods A multicenter retrospective cohort study was designed, including patients hospitalized with COVID-19. Epidemiological and clinical data were collected at admission and at seven days, and clinical outcomes were collected. Patients with CLD with and without chronic treatment with ICS were compared. Results Two thousand five hundred ninety-eight patients were included, of which 1,171 patients had a diagnosis of asthma and 1,427 of COPD (53.37% and 41.41% with ICS, respectively). No differences were found in mortality, transfer to ICU, or development of moderate-severe ARDS. Patients with chronic ICS had a longer hospital stay in both asthma and COPD patients (9 vs. 8 days, p = 0.031 in asthma patients), (11 vs. 9 days, p = 0.018 in COPD patients); although they also had more comorbidity burden. Conclusions Patients with chronic inhaled corticosteroids had longer hospital stays and more chronic comorbidities, measured by the Charlson comorbidity index, but they did not have more severe disease at admission, evaluated with qSOFA and PSI scores. Chronic treatment with inhaled corticosteroids had no influence on the prognosis of patients with chronic lung disease and COVID-19.
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Affiliation(s)
| | | | - Laura Piles
- Medicina InternaHospital Universitario Doctor Peset
| | | | | | | | | | | | | | | | - Nicolás Rhyman
- Medicina InternaHospital de Sant Joan Despí Moisès Broggi
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2
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Shiau BW, Hsu WH, Tsai YW, Wu JY, Liu TH, Huang PY, Chuang MH, Lai CC, Jang LW. Effectiveness of recently-approved oral antiviral medications on the outcome of patients with mild-to-moderate COVID-19 and pre-existing chronic obstructive pulmonary diseases. Expert Rev Anti Infect Ther 2024:1-9. [PMID: 38702925 DOI: 10.1080/14787210.2024.2351571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 04/16/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVES This study assessed the effectiveness of the oral antiviral agents nirmatrelvir - ritonavir (NMV-r) and molnupiravir (MOV) for treating mild-to-moderate coronavirus disease 2019 (COVID-19) in patients with COPD. METHODS This retrospective cohort study extracted data from the TriNetX platform and examined 94,984 COVID-19 patients with preexisting COPD from 1 January 2022, to 1 October 2023. Patients receiving NMV-r or MOV (study group) were compared with those not receiving oral antiviral agents (control group) after propensity score matching (PSM). RESULTS After PSM, 7,944 patients were classified into the study and control groups. The primary composite outcome of all-cause hospitalization, or death in 30 days was reported in 458 (5.7%) patients in the study group and 566 (7.1%) patients in the control cohort, yielding a hazard ratio [HR] of 0.79 (95% confidence interval [CI]: 0.70-0.89; Table 2). Compared with the control group, the study group had a significantly lower risk of all-cause hospitalization (HR, 0.87; 95% CI: 0.76-0.99) and death (HR: 0.21, 95% CI: 0.13-0.35). CONCLUSIONS This study revealed that oral antivirals - NMV-r or MOV might improve clinical outcomes in patients with preexisting COPD and COVID-19. However, only a small proportion of preexisting COPD patients with COVID-19 received oral antiviral treatment.
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Affiliation(s)
- Bo-Wen Shiau
- Division of General Medicine, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Wan-Hsuan Hsu
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Ya-Wen Tsai
- Center for Integrative Medicine, Chi Mei Medical Center, Tainan, Taiwan
- Department of Medical Laboratory Sciences and Biotechnology, Fooyin University, Kaohsiung, Taiwan
| | - Jheng-Yan Wu
- Department of Nutrition, Chi Mei Medical Center, Tainan, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ting-Hui Liu
- Department of Psychiatry, Chi Mei Medical Center, Tainan, Taiwan
| | - Po-Yu Huang
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Min-Hsiang Chuang
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Chih-Cheng Lai
- Division of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Lih-Wen Jang
- Department of Emergency, Chi-Mei Medical Center, Tainan, Taiwan
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Abdulfattah O, Kohli A, White P, Michael C, Alnafoosi Z. Impact of the COVID-19 Pandemic on Hospital Admission Rate, Length of Stay, and Mortality Rate for Patients with Chronic Obstructive Pulmonary Disease Exacerbation: A Retrospective Study. J Community Hosp Intern Med Perspect 2024; 14:1-8. [PMID: 38966505 PMCID: PMC11221434 DOI: 10.55729/2000-9666.1311] [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: 08/12/2023] [Revised: 11/07/2023] [Accepted: 01/02/2024] [Indexed: 07/06/2024] Open
Abstract
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a common cause of hospital admissions. Coronavirus disease 2019 (COVID-19) has large impact on patients with pulmonary diseases. The purpose of the study is to evaluate the impact of COVID-19 on patients with AECOPD. Method Retrospective study with two cohorts, the first period included patients with AECOPD before COVID-19 pandemic; the second period included patients with AECOPD since the beginning of COVID-19 pandemic. The length of stay (LOS), number of patients requiring mechanical ventilation, and allcause mortality were calculated. Results There was a total of 55 (44.72%) patients in the pre-COVID period compared to 68 (55.28%) patients in the COVID period. In the pre-COVID period: 14 (19.44%) had hypertension, 26(36.11%) had diabetes, 27(37.50%) had ischemic heart disease, 3(4.17%) had myocardial infarction; in the COVID period: 20 (29.41%) had hypertension, 24(35.29%) had diabetes, 27(39.71%) had ischemic heart disease, 1(1.47) had myocardial infarction. The LOS was shorter in pre-COVID period compared to COVID period, 6.51(SD 5.02) days vs 8.91(SD7.88) days with P-value of 0.042 respectively. The total number of patients needing mechanical ventilation in pre-COVID period was similar to the COVID period with P-value of 0.555. All-cause mortality number was 2 (3.64%) in the pre-COVID period compared to 6 (8.82%) in COVID period with P-value of 0.217. Conclusion Study results revealed significant difference in length of stay for patients with AECOPD, patient in COVID period had increased LOS compared to pre-COVID period. There was no significant difference in the other parameters.
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Affiliation(s)
- Omar Abdulfattah
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Southern Illinois University,
USA
| | - Akshay Kohli
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Southern Illinois University,
USA
| | - Peter White
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Southern Illinois University,
USA
| | - Cynthia Michael
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Southern Illinois University,
USA
| | - Zainab Alnafoosi
- Division of Infectious Disease, Department of Internal Medicine, Southern Illinois University,
USA
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Montserrat-Capdevila J, Fornells-Barberà I, Roso-Llorach A, Olivares-Sanzo P, Romero-Gracia A, Ichart JX. [Impact of COVID-19 on the mental health of the population: Study in primary care]. Aten Primaria 2024; 56:102813. [PMID: 38039619 PMCID: PMC10711385 DOI: 10.1016/j.aprim.2023.102813] [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: 07/19/2023] [Revised: 10/25/2023] [Accepted: 10/29/2023] [Indexed: 12/03/2023] Open
Abstract
OBJECTIVE To determine the prevalence of COVID-19 and the characteristics of infected patients, as well as the prevalence of mental disorders associated with the infection and the associated risk factors. Secondary: to know the prevalence of the long COVID syndrome and the characteristics of this cohort. DESIGN Incidence study of mental disorder in patients diagnosed with COVID-19 and case-control study of long COVID syndrome in the subsample of patients diagnosed with COVID-19 without a history of mental disorder. SITE: Primary care setting in Lleida. PARTICIPANTS The 46,258 patients diagnosed of COVID-19 without a history of mental disorder were followed for 2 years. MAIN MEASUREMENTS The dependent variable was the mental disorder in the period 03/11/2020 to 03/11/2022; and the independent variables were clinical and social variables. Its association with mental disorder was analyzed by calculating the adjusted hazard ratio using a logistic regression model. RESULTS The average age of 46,258 patients at the beginning of the study was 43±17.9 years. 47% were women. The mental disorder rate for all period was 3.46% (59.20% anxiety). A predictive score was elaborated. The long COVID syndrome was more common in older women, without toxic habits, with obesity and associated comorbidity. CONCLUSIONS COVID-19 has had an impact on the mental health of patients. Knowing the risk factors for developing these mental disorders and the long COVID syndrome would allow the clinician to be able to identify patients at risk in order to establish preventive measures and avoid their appearance.
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Affiliation(s)
- Josep Montserrat-Capdevila
- Unitat Docent Multiprofessional d'Atenció Familiar i Comunitària (UDMAFIC) Lleida, Lleida, España; Fundació d'Investigació en Atenció Primària Jordi Gol, Institut per a la recerca a l'Atenció Primària de Salut (IDIAP), Barcelona, España; Atenció Primària Lleida, Institut Català de la Salut (ICS), Lleida, España; Facultat de Medicina, Universitat de Lleida (UdL), Lleida, España.
| | - Immaculada Fornells-Barberà
- Equip d'Assessorament i d'Orientació Psicopedagògic (EAP) Ll-02 Segrià (Sector B). Departament d'Educació, Generalitat de Catalunya, España
| | - Albert Roso-Llorach
- Fundació d'Investigació en Atenció Primària Jordi Gol, Institut per a la recerca a l'Atenció Primària de Salut (IDIAP), Barcelona, España; Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, España
| | - Pau Olivares-Sanzo
- Unitat Docent Multiprofessional d'Atenció Familiar i Comunitària (UDMAFIC) Lleida, Lleida, España; Fundació d'Investigació en Atenció Primària Jordi Gol, Institut per a la recerca a l'Atenció Primària de Salut (IDIAP), Barcelona, España; Atenció Primària Lleida, Institut Català de la Salut (ICS), Lleida, España
| | - Albert Romero-Gracia
- Fundació d'Investigació en Atenció Primària Jordi Gol, Institut per a la recerca a l'Atenció Primària de Salut (IDIAP), Barcelona, España; Atenció Primària Lleida, Institut Català de la Salut (ICS), Lleida, España
| | - J Xavier Ichart
- Àrea de Gestió Clínica, Direcció d'Atenció Primària Lleida, Institut Català de la Salut (ICS), Lleida, España; Fundació d'Investigació en Atenció Primària Jordi Gol, Institut per a la recerca a l'Atenció Primària de Salut (IDIAP), Barcelona, España
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Chen CH, Wang CY, Chen CY, Wang YH, Chen KH, Lai CC, Wei YF, Fu PK. The influence of prior use of inhaled corticosteroids on COVID-19 outcomes: A systematic review and meta-analysis. PLoS One 2024; 19:e0295366. [PMID: 38241229 PMCID: PMC10798539 DOI: 10.1371/journal.pone.0295366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/21/2023] [Indexed: 01/21/2024] Open
Abstract
The influence of inhaled corticosteroids (ICS) on COVID-19 outcomes remains uncertain. To address this, we conducted a systematic review and meta-analysis, analyzing 30 studies, to investigate the impact of ICS on patients with COVID-19. Our study focused on various outcomes, including mortality risk, hospitalization, admission to the intensive care unit (ICU), mechanical ventilation (MV) utilization, and length of hospital stay. Additionally, we conducted a subgroup analysis to assess the effect of ICS on patients with chronic obstructive pulmonary disease (COPD) and asthma. Our findings suggest that the prior use of ICS did not lead to significant differences in mortality risk, ICU admission, hospitalization, or MV utilization between individuals who had used ICS previously and those who had not. However, in the subgroup analysis of patients with COPD, prior ICS use was associated with a lower risk of mortality compared to non-users (OR, 0.95; 95% CI, 0.90-1.00). Overall, while the use of ICS did not significantly affect COVID-19 outcomes in general, it may have beneficial effects specifically for patients with COPD. Nevertheless, more research is needed to establish a definitive conclusion on the role of ICS in COVID-19 treatment. PROSPERO registration number: CRD42021279429.
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Affiliation(s)
- Chao-Hsien Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, Taitung MacKay Memorial Hospital, Taitung, Taiwan
- Department of Medicine, MacKey Medical College, New Taipei City, Taiwan
| | - Cheng-Yi Wang
- Department of Internal Medicine, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Ching-Yi Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Ya-Hui Wang
- Medical Research Center, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Kuang-Hung Chen
- Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chih-Cheng Lai
- Division of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Yu-Feng Wei
- Department of Internal Medicine, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Pin-Kuei Fu
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
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Kwok WC, Tam TCC, Ho JCM, Lam DCL, Ip MSM, Ho PL. Real-World Effectiveness Study of Nirmatrelvir-Ritonavir or Molnupiravir in Hospitalized Unvaccinated Patients with Chronic Respiratory Diseases and Moderate COVID-19 at Presentation. Int J Chron Obstruct Pulmon Dis 2024; 19:77-86. [PMID: 38222320 PMCID: PMC10787548 DOI: 10.2147/copd.s440895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/26/2023] [Indexed: 01/16/2024] Open
Abstract
Introduction Nirmatrelvir-ritonavir (NMV-r) and molnupiravir (MOL) were developed as out-patient anti-viral for mild COVID-19. There was limited data on their role in treating COVID-19 for hospitalized patients, especially among adult patients who are unvaccinated and had chronic respiratory diseases. Methods A territory-wide retrospective study was conducted in Hong Kong to compare the efficacy of NMV-r and MOL against COVID-19 in unvaccinated adult patients with asthma, chronic obstructive pulmonary disease, bronchiectasis and interstitial lung diseases presenting with moderate COVID-19 from 16th February 2022 to 15th March 2023. Results A total of 1354 patients were included, 738 received NMV-r and 616 received MOL. NMV-r was more effective in reducing 90-day mortality with adjusted hazard ratios (aHR) of 0.508 (95% confidence interval [CI] = 0.314-0.822, p = 0.006). Patients who received NMV-r also had significantly shorter length of stay (LOS) than those receiving MOL, with median LOS of 4 (Interquartile range [IQR] = 2-7) for NMV-r and 6 (IQR = 3-10) for MOL (p-value < 0.001). There was no statistically significant difference in the development of respiratory failure and severe respiratory failure in the two groups. Discussion NMV-r was more effective than MOL among unvaccinated adults with chronic respiratory diseases who were hospitalized for moderate COVID-19 without hypoxaemia on admission.
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Affiliation(s)
- Wang Chun Kwok
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People’s Republic of China
| | - Terence Chi Chun Tam
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People’s Republic of China
| | - James Chung Man Ho
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People’s Republic of China
| | - David Chi Leung Lam
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People’s Republic of China
| | - Mary Sau-Man Ip
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People’s Republic of China
| | - Pak Leung Ho
- Department of Microbiology and Carol Yu Centre for Infection, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People’s Republic of China
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7
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Figueira‐Gonçalves JM, García-Bello MÁ, Ramallo‐Fariña Y, Méndez R, Latorre Campos A, González-Jiménez P, Peces-Barba G, Molina-Molina M, España PP, García E, Domínguez-Pazos SDJ, García Clemente M, Panadero C, de la Rosa-Carrillo D, Sibila O, Martínez-Pitarch MD, Toledo-Pons N, López-Ramirez C, Almonte-Batista W, Macías-Paredes A, Badenes-Bonet D, Pérez-Rodas EN, Lázaro J, Quirós Fernández S, Cordovilla R, Cano-Pumarega I, Torres A, Menendez R. Persistent Respiratory Failure and Re-Admission in Patients with Chronic Obstructive Pulmonary Disease Following Hospitalization for COVID-19. Int J Chron Obstruct Pulmon Dis 2023; 18:2473-2481. [PMID: 37955022 PMCID: PMC10638925 DOI: 10.2147/copd.s428316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 10/30/2023] [Indexed: 11/14/2023] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) has been associated with worse clinical evolution/survival during a hospitalization for SARS-CoV2 (COVID-19). The objective of this study was to learn the situation of these patients at discharge as well as the risk of re-admission/mortality in the following 12 months. Methods We carried out a subanalysis of the RECOVID registry. A multicenter, observational study that retrospectively collected data on severe acute COVID-19 episodes and follow-up visits for up to a year in survivors. The data collection protocol includes general demographic data, smoking, comorbidities, pharmacological treatment, infection severity, complications during hospitalization and required treatment. At discharge, resting oxygen saturation (SpO2), dyspnea according to the mMRC (modified Medical Research Council) scale and long-term oxygen therapy prescription were recorded. The follow-up database included the clinical management visits at 6 and 12 months, where re-admission and mortality were recorded. Results A total of 2047 patients were included (5.6% had a COPD diagnosis). At discharge, patients with COPD had greater dyspnea and a greater need for prescription home oxygen. After adjusting for age, sex and Charlson comorbidity index, patients with COPD had a greater risk of hospital re-admission due to respiratory causes (HR 2.57 [1.35-4.89], p = 0.004), with no significant differences in survival. Conclusion Patients with COPD who overcome a serious SARS-CoV2 infection show a worse clinical situation at discharge and a greater risk of re-admission for respiratory causes.
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Affiliation(s)
- Juan Marco Figueira‐Gonçalves
- Pneumology and Thoracic Surgery Service, Unit for Patients with Highly Complex COPD, University Hospital Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
- University Institute of Tropical Disease and Public Health of the Canary Islands, University of La Laguna, Santa Cruz de Tenerife, Spain
| | - Miguel Ángel García-Bello
- Evaluation Unit (SESCS), Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
| | - Yolanda Ramallo‐Fariña
- Evaluation Unit (SESCS), Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Madrid, Spain
| | - Raúl Méndez
- Pneumology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Respiratory InFections, Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Medicine Department, University of Valencia, Valencia, Spain
| | - Ana Latorre Campos
- Pneumology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Respiratory InFections, Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain
| | - Paula González-Jiménez
- Pneumology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Respiratory InFections, Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain
- Medicine Department, University of Valencia, Valencia, Spain
| | | | - María Molina-Molina
- ILD Unit, Respiratory Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain
| | | | - Estela García
- Respiratory Service, Hospital de Cabueñes, Gijón, Spain
| | | | | | | | | | - Oriol Sibila
- Respiratory Service, Hospital Clínic, Barcelona, Spain
| | | | | | - Cecilia López-Ramirez
- Medical Surgical Unit of Respiratory Diseases, Hospital Virgen del Rocío, Sevilla, Spain
| | | | | | | | | | - Javier Lázaro
- Respiratory Service, Hospital Royo Villanova, Zaragoza, Spain
| | | | - Rosa Cordovilla
- Respiratory Service, Hospital de Salamanca, Salamanca, Spain
| | - Irene Cano-Pumarega
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Respiratory Service, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain
| | - Antoni Torres
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Respiratory Service, Hospital Clínic, Barcelona, Spain
| | - Rosario Menendez
- Pneumology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Respiratory InFections, Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Medicine Department, University of Valencia, Valencia, Spain
| | - On behalf of RECOVID
- Pneumology and Thoracic Surgery Service, Unit for Patients with Highly Complex COPD, University Hospital Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
- University Institute of Tropical Disease and Public Health of the Canary Islands, University of La Laguna, Santa Cruz de Tenerife, Spain
- Evaluation Unit (SESCS), Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Madrid, Spain
- Pneumology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Respiratory InFections, Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Medicine Department, University of Valencia, Valencia, Spain
- Pulmonology Department, Hospital Fundación Jiménez Díaz, Madrid, Spain
- ILD Unit, Respiratory Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain
- Respiratory Service, Hospital de Galdakao-Usansolo, Galdakao, Spain
- Respiratory Service, Hospital de Cabueñes, Gijón, Spain
- Respiratory Service, Hospital Universitario de A Coruña, A Coruña, Spain
- Respiratory Service, Hospital Universitario Central de Asturias, Oviedo, Spain
- Respiratory Service, Hospital de Getafe, Getafe, Spain
- Respiratory Service, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Respiratory Service, Hospital Clínic, Barcelona, Spain
- Respiratory Service, Hospital Lluís Alcanyís, Játiva, Spain
- Respiratory Service, Hospital Son Espases, Palma, Spain
- Medical Surgical Unit of Respiratory Diseases, Hospital Virgen del Rocío, Sevilla, Spain
- Respiratory Service, Hospital de Albacete, Albacete, Spain
- Respiratory Service, Hospital de Sant Jaume, Calella, Spain
- Respiratory Service, Hospital del Mar, Barcelona, Spain
- Respiratory Service, Hospital Municipal de Badalona, Badalona, Spain
- Respiratory Service, Hospital Royo Villanova, Zaragoza, Spain
- Respiratory Service, Hospital Basurto, Bilbao, Spain
- Respiratory Service, Hospital de Salamanca, Salamanca, Spain
- Respiratory Service, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain
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Kudo R, Kawaguchi T, Kimura M, Rikitake Y, Iwao C, Rikitake M, Iwao K, Aizawa A, Kariya Y, Matsuda M, Miyauchi S, Takajo I, Sato Y, Asada Y, Miyazaki T, Umekita K. Coronavirus disease 2019 in a patient with pulmonary fibrosis and emphysema: An autopsy report. Heliyon 2023; 9:e22221. [PMID: 38045178 PMCID: PMC10692797 DOI: 10.1016/j.heliyon.2023.e22221] [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: 06/23/2022] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 12/05/2023] Open
Abstract
Various diseases (e.g., hypertension and diabetes) are risk factors for the exacerbation of coronavirus 2019 (COVID-19). Patients with chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) tend to develop severe COVID-19. Patients with severe COVID-19 present with acute respiratory distress syndrome (ARDS), and many COVID-19-related ARDS survivors eventually develop fibrosis. However, the appropriate management of patients with COVID-19 and ILD and post-COVID-19 ILD remains unclear. Thus, a better understanding of the pathology that exacerbates COVID-19 in patients with ILD is needed. We report the autopsy results of a patient with COVID-19 and combined pulmonary fibrosis and emphysema, whose lung organization and fibrosis progressed after the acute phase of infection. Histopathological findings suggest that fatal pulmonary fibrosis persists after the negative conversion of SARS-CoV-2. Elucidating the cause of death by autopsy may help determine therapeutic strategies in patients with COVID-19 and ILD. Vaccination and early administration of anti-inflammatory drugs or antifibrotic agents may be crucial for preventing disease progression and fatal lung fibrosis. This report aims to clarify the histopathological features of COVID-19 in patients with ILD via autopsy and discuss treatment strategies.
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Affiliation(s)
- Risa Kudo
- Division of Respirology, Rheumatology, Infectious Diseases, and Neurology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Takeshi Kawaguchi
- Division of Respirology, Rheumatology, Infectious Diseases, and Neurology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Masatoshi Kimura
- Division of Respirology, Rheumatology, Infectious Diseases, and Neurology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Yuuki Rikitake
- Division of Respirology, Rheumatology, Infectious Diseases, and Neurology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Chihiro Iwao
- Division of Respirology, Rheumatology, Infectious Diseases, and Neurology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Mao Rikitake
- Division of Respirology, Rheumatology, Infectious Diseases, and Neurology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Kosho Iwao
- Division of Respirology, Rheumatology, Infectious Diseases, and Neurology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Ayako Aizawa
- Division of Respirology, Rheumatology, Infectious Diseases, and Neurology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Yumi Kariya
- Division of Respirology, Rheumatology, Infectious Diseases, and Neurology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Motohiro Matsuda
- Division of Respirology, Rheumatology, Infectious Diseases, and Neurology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Shunichi Miyauchi
- Division of Respirology, Rheumatology, Infectious Diseases, and Neurology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Ichiro Takajo
- Division of Respirology, Rheumatology, Infectious Diseases, and Neurology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Yuichiro Sato
- Department of Diagnostic Pathology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Yujiro Asada
- Department of Diagnostic Pathology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Taiga Miyazaki
- Division of Respirology, Rheumatology, Infectious Diseases, and Neurology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Kunihiko Umekita
- Division of Respirology, Rheumatology, Infectious Diseases, and Neurology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
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Motoc NȘ, Făgărășan I, Urda-Cîmpean AE, Todea DA. Prognosis Predictive Markers in Patients with Chronic Obstructive Pulmonary Disease and COVID-19. Diagnostics (Basel) 2023; 13:2597. [PMID: 37568963 PMCID: PMC10416888 DOI: 10.3390/diagnostics13152597] [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: 05/31/2023] [Revised: 07/28/2023] [Accepted: 07/30/2023] [Indexed: 08/13/2023] Open
Abstract
Some studies have reported that chronic respiratory illnesses in patients with COVID-19 result in an increase in hospitalization and death rates, while other studies reported to the contrary. The present research aims to determine if a predictive model (developed by combing different clinical, imaging, or blood markers) could be established for patients with both chronic obstructive pulmonary disease (COPD) and COVID-19, in order to be able to foresee the outcomes of these patients. A prospective observational cohort of 165 patients with both diseases was analyzed in terms of clinical characteristics, blood tests, and chest computed tomography results. The beta-coefficients from the logistic regression were used to create a score based on the significant identified markers for poor outcomes (transfers to an intensive care unit (ICU) for mechanical ventilation, or death). The severity of COVID-19, renal failure, diabetes, smoking status (current or previous), the requirement for oxygen therapy upon admission, high lactate dehydrogenase (LDH) and C-reactive protein level (CRP readings), and low eosinophil and lymphocyte counts were all identified as being indicators of a poor prognosis. Higher mortality was linked to the occurrence of renal failure, the number of affected lobes, the need for oxygen therapy upon hospital admission, high LDH, and low lymphocyte levels. Patients had an 86.4% chance of dying if their mortality scores were -2.80 or lower, based on the predictive model. The factors that were linked to a poor prognosis in patients who had both COPD and COVID-19 were the same as those that were linked to a poor prognosis in patients who had only COVID-19.
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Affiliation(s)
- Nicoleta Ștefania Motoc
- Department of Medical Sciences-Pulmonology, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, 8 Victor Babeș Street, 400012 Cluj-Napoca, Romania
| | - Iulia Făgărășan
- Department of Medical Sciences-Pulmonology, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, 8 Victor Babeș Street, 400012 Cluj-Napoca, Romania
| | - Andrada Elena Urda-Cîmpean
- Department of Medical Informatics and Biostatistics, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, Louis Pasteur Str. No. 6, 400349 Cluj-Napoca, Romania
| | - Doina Adina Todea
- Department of Medical Sciences-Pulmonology, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, 8 Victor Babeș Street, 400012 Cluj-Napoca, Romania
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10
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Smadi M, Kaburis M, Schnapper Y, Reina G, Molero P, Molendijk ML. SARS-CoV-2 susceptibility and COVID-19 illness course and outcome in people with pre-existing neurodegenerative disorders: systematic review with frequentist and Bayesian meta-analyses. Br J Psychiatry 2023:1-14. [PMID: 37183681 DOI: 10.1192/bjp.2023.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND People with neurodegenerative disease and mild cognitive impairment (MCI) may have an elevated risk of acquiring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and may be disproportionally affected by coronavirus disease 2019 (COVID-19) once infected. AIMS To review all eligible studies and quantify the strength of associations between various pre-existing neurodegenerative disorders and both SARS-CoV-2 susceptibility and COVID-19 illness course and outcome. METHOD Pre-registered systematic review with frequentist and Bayesian meta-analyses. Systematic searches were executed in PubMed, Web of Science and preprint servers. The final search date was 9 January 2023. Odds ratios (ORs) were used as measures of effect. RESULTS In total, 136 primary studies (total sample size n = 97 643 494), reporting on 268 effect-size estimates, met the inclusion criteria. The odds for a positive SARS-CoV-2 test result were increased for people with pre-existing dementia (OR = 1.83, 95% CI 1.16-2.87), Alzheimer's disease (OR = 2.86, 95% CI 1.44-5.66) and Parkinson's disease (OR = 1.65, 95% CI 1.34-2.04). People with pre-existing dementia were more likely to experience a relatively severe COVID-19 course, once infected (OR = 1.43, 95% CI 1.00-2.03). People with pre-existing dementia or Alzheimer's disease were at increased risk for COVID-19-related hospital admission (pooled OR range: 1.60-3.72). Intensive care unit admission rates were relatively low for people with dementia (OR = 0.54, 95% CI 0.40-0.74). All neurodegenerative disorders, including MCI, were at higher risk for COVID-19-related mortality (pooled OR range: 1.56-2.27). CONCLUSIONS Our findings confirm that, in general, people with neurodegenerative disease and MCI are at a disproportionally high risk of contracting COVID-19 and have a poor outcome once infected.
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Affiliation(s)
- Muhannad Smadi
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Melina Kaburis
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Youval Schnapper
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Gabriel Reina
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; and Clínica Universidad de Navarra, Department of Microbiology, Pamplona, Spain
| | - Patricio Molero
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; and Clínica Universidad de Navarra, Department of Psychiatry and Medical Psychology, Pamplona, Spain
| | - Marc L Molendijk
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands; and Leiden Institute for Brain and Cognition, Leiden University Medical Centre, Leiden, The Netherlands
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11
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Gómez-Antúnez M, Muiño-Míguez A, Bacete-Cebrián M, Rubio-Rivas M, de Cossío S, Peris-García J, López-Caleya JF, García-García GM, Casas-Rojo JM, Núñez-Cortés JM. Patients with COPD hospitalized due to COVID-19 in Spain: a comparison between the first and second wave. Rev Clin Esp 2023; 223:298-309. [PMID: 37028707 PMCID: PMC10074726 DOI: 10.1016/j.rceng.2023.04.002] [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: 10/10/2022] [Accepted: 02/28/2023] [Indexed: 04/09/2023]
Abstract
OBJECTIVE This work aimed to compare the characteristics, progress, and prognosis of patients with COPD hospitalized due to COVID-19 in Spain in the first wave with those of the second wave. MATERIAL AND METHODS This is an observational study of patients hospitalized in Spain with a diagnosis of COPD included in the SEMI-COVID-19 registry. The medical history, symptoms, analytical and radiological results, treatment, and progress of patients with COPD hospitalized in the first wave (from March to June 2020) versus those hospitalized in the second wave (from July to December 2020) were compared. Factors associated with poor prognosis, defined as all-cause mortality and a composite endpoint that included mortality, high-flow oxygen therapy, mechanical ventilation, and ICU admission, were analyzed. RESULTS Of the 21,642 patients in the SEMI-COVID-19 Registry, 6.9% were diagnosed with COPD: 1,128 (6.8%) in WAVE1 and 374 (7.7%) in WAVE2 (p = 0.04). WAVE2 patients presented less dry cough, fever and dyspnea, hypoxemia (43% vs 36%, p < 0.05), and radiological condensation (46% vs 31%, p < 0.05) than WAVE1 patients. Mortality was lower in WAVE2 (35% vs 28.6%, p = 0.01). In the total sample, mortality and the composite outcome of poor prognosis were lower among patients who received inhalation therapy. CONCLUSIONS Patients with COPD admitted to the hospital due to COVID-19 in the second wave had less respiratory failure and less radiological involvement as well as a better prognosis. These patients should receive bronchodilator treatment if there is no contraindication for it.
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Affiliation(s)
- M Gómez-Antúnez
- Hospital General Universitario Gregorio Marañón, Madrid, Spain; Hospital Costa del Sol. Marbella, Málaga, Spain.
| | - A Muiño-Míguez
- Hospital General Universitario Gregorio Marañón, Madrid, Spain; Hospital Costa del Sol. Marbella, Málaga, Spain
| | - M Bacete-Cebrián
- Hospital General Universitario Gregorio Marañón, Madrid, Spain; Hospital Costa del Sol. Marbella, Málaga, Spain
| | - M Rubio-Rivas
- Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Costa del Sol. Marbella, Málaga, Spain
| | - S de Cossío
- Hospital Costa del Sol. Marbella, Málaga, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain
| | - J Peris-García
- Hospital Costa del Sol. Marbella, Málaga, Spain; Hospital Clínico Universitario San Juan, San Juan de Alicante, Alicante, Spain
| | - J F López-Caleya
- Hospital Costa del Sol. Marbella, Málaga, Spain; Hospital Universitario de Cabueñes, Gijón, Asturias, Spain
| | - G M García-García
- Hospital Costa del Sol. Marbella, Málaga, Spain; Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain
| | - J M Casas-Rojo
- Hospital Costa del Sol. Marbella, Málaga, Spain; Hospital Universitario Infanta Cristina, Parla, Madrid, Spain
| | - J M Núñez-Cortés
- Hospital General Universitario Gregorio Marañón, Madrid, Spain; Hospital Costa del Sol. Marbella, Málaga, Spain
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12
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Hosseninia S, Ghobadi H, Garjani K, Hosseini SAH, Aslani MR. Aggregate index of systemic inflammation (AISI) in admission as a reliable predictor of mortality in COPD patients with COVID-19. BMC Pulm Med 2023; 23:107. [PMID: 37003999 PMCID: PMC10063934 DOI: 10.1186/s12890-023-02397-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 03/23/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND The role of leukocytes and systemic inflammation indicators in predicting the severity and mortality of inflammatory diseases has been well reported, such as the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR), neutrophil/lymphocyte*platelet ratio (NLPR), derived neutrophil/lymphocyte ratio (dNLR), aggregate index of systemic inflammation (AISI), as well as systemic inflammation response index (SIRI) and systemic inflammation index (SII). The purpose of the present study was to investigate the prognostic role of systemic inflammatory indicators in the mortality of chronic obstructive pulmonary disease (COPD) patients with COVID-19. METHODS This retrospective study included 169 COPD patients hospitalized with COVID-19. Demographic, clinical, and laboratory data were obtained from the patients' electronic records. The ability of systemic inflammation indeces to distinguish the severity of COVID-19 was determined by receiver operating characteristic (ROC) analysis, and survival probability was determined by the mean of Kaplan-Meier curves, with the endpoint being death. RESULTS ROC curves showed that the AUD level was significant for WBC, MLR, SIRI, and AISI. Interestingly, Kaplan-Meier survival curves revealed that survival was lower with higher MLR (HR = 2.022, 95% CI = 1.030 to 3.968, P < 0.05) and AISI (HR = 2.010, 95% CI = 1.048 to 3.855, P < 0.05) values. However, the multivariate Cox regression model showed that only AISI was significantly associated with survival. CONCLUSION AISI in COPD patients with COVID-19 was a reliable predictor of mortality.
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Affiliation(s)
- Saeed Hosseninia
- Lung Diseases Research Center, Ardabil University of Medical Sciences, Ardabil, 5615780011, Iran
| | - Hassan Ghobadi
- Lung Diseases Research Center, Ardabil University of Medical Sciences, Ardabil, 5615780011, Iran
| | - Kara Garjani
- Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | | | - Mohammad Reza Aslani
- Lung Diseases Research Center, Ardabil University of Medical Sciences, Ardabil, 5615780011, Iran.
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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13
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Kwok WC, Leung SHI, Tam TCC, Ho JCM, Lam DCL, Ip MSM, Ho PL. Efficacy of mRNA and Inactivated Whole Virus Vaccines Against COVID-19 in Patients with Chronic Respiratory Diseases. Int J Chron Obstruct Pulmon Dis 2023; 18:47-56. [PMID: 36698687 PMCID: PMC9869785 DOI: 10.2147/copd.s394101] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/11/2023] [Indexed: 01/20/2023] Open
Abstract
Background While different COVID-19 vaccines have been developed, there has been lack of data on the efficacy comparison between mRNA and inactivated whole virus vaccine among patients with chronic respiratory diseases, including asthma, chronic obstructive pulmonary disease (COPD), and bronchiectasis. Methods This was a retrospective case control study on the efficacy of BNT162b2 (mRNA vaccine) and CoronaVac (inactivated whole virus vaccine) against COVID-19 in patients with chronic respiratory diseases. A total of 327 patients were included, with 109 patients infected with COVID-19 matched with 218 patients without COVID-19. The co-primary outcomes were vaccine effectiveness against symptomatic COVID-19, COVID-19-related hospitalization and COVID-19-related respiratory failure. Vaccine effectiveness was calculated using the formula (1-adjusted odds ratio) x 100. Results Patients who received at least 2 doses of CoronaVac had lower risk of being hospitalized for COVID-19 and developing respiratory failure than those who did not have vaccination, with adjusted odds ratio (OR) of 0.189 (95% CI = 0.050-0.714, p = 0.014) and 0.128 (95% CI = 0.026-0.638, p = 0.012) respectively. Patients who received at least 2 doses of BNT162b2 had lower risk of being hospitalized for COVID-19 and developing respiratory failure than those who did not have vaccination with adjusted OR of 0.207 (95% CI = 0.043-0.962, p = 0.050) and 0.093 (95% CI = 0.011-0.827, p = 0.033) respectively. There was no statistically significant difference in the risks of being hospitalized for COVID-19 and developing respiratory failure between patients who received at least 2 doses of CoronaVac or BNT162b2. Conclusion BNT162b2 and CoronaVac vaccines are effective in preventing hospitalization for COVID-19 and respiratory failure complicating COVID-19 among patients with chronic respiratory diseases. Patients with chronic respiratory diseases should be encouraged to have COVID-19 vaccination.
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Affiliation(s)
- Wang Chun Kwok
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region, People’s Republic of China
| | - Sze Him Isaac Leung
- Department of Statistics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of China
| | - Terence Chi Chun Tam
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region, People’s Republic of China
| | - James Chung Man Ho
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region, People’s Republic of China
| | - David Chi-Leung Lam
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region, People’s Republic of China
| | - Mary Sau Man Ip
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region, People’s Republic of China
| | - Pak Leung Ho
- Department of Microbiology and Carol Yu Centre for Infection, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region, People’s Republic of China,Correspondence: Pak Leung Ho, Department of Microbiology, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Pok Fu Lam, Hong Kong Special Administrative Region, People’s Republic of China, Tel +852 2255 2584, Fax +852 2855 1241, Email
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14
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Uruma Y, Manabe T, Fujikura Y, Iikura M, Hojo M, Kudo K. Effect of asthma, COPD, and ACO on COVID-19: A systematic review and meta-analysis. PLoS One 2022; 17:e0276774. [PMID: 36318528 PMCID: PMC9624422 DOI: 10.1371/journal.pone.0276774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 10/13/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction The prevalence of asthma, chronic obstructive pulmonary disease (COPD), and asthma-COPD overlap (ACO) in patients with COVID-19 varies, as well as their risks of mortality. The present study aimed to assess the prevalence of asthma, COPD, and ACO as comorbidities, and to determine their risks of mortality in patients with COVID-19 using a systematic review and meta-analysis. Methods We systematically reviewed clinical studies that reported the comorbidities of asthma, COPD, and ACO in patients with COVID-19. We searched various databases including PubMed (from inception to 27 September 2021) for eligible studies written in English. A meta-analysis was performed using the random-effect model for measuring the prevalence of asthma, COPD, and ACO as comorbidities, and the mortality risk of asthma, COPD, and ACO in patients with COVID-19 was estimated. A stratified analysis was conducted according to country. Results One hundred one studies were eligible, and 1,229,434 patients with COVID-19 were identified. Among them, the estimated prevalence of asthma, COPD, and ACO using a meta-analysis was 10.04% (95% confidence interval [CI], 8.79–11.30), 8.18% (95% CI, 7.01–9.35), and 3.70% (95% CI, 2.40–5.00), respectively. The odds ratio for mortality of pre-existing asthma in COVID-19 patients was 0.89 (95% CI, 0.55–1.4; p = 0.630), while that in pre-existing COPD in COVID-19 patients was 3.79 (95% CI, 2.74–5.24; p<0.001). France showed the highest prevalence of asthma followed by the UK, while that of COPD was highest in the Netherlands followed by India. Conclusion Pre-existing asthma and COPD are associated with the incidence of COVID-19. Having COPD significantly increases the risk of mortality in patients with COVID-19. These differences appear to be influenced by the difference of locations of disease pathophysiology and by the daily diagnosis and treatment policy of each country.
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Affiliation(s)
- Yuka Uruma
- Nagoya City University Medical School, Aichi, Japan
| | - Toshie Manabe
- Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
- Nagoya City University West Medical Center, Aichi, Japan
- * E-mail:
| | - Yuji Fujikura
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, Saitama, Japan
- Department of Medical Risk Management and Infection Control, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Motoyasu Iikura
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masayuki Hojo
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Koichiro Kudo
- Yurin Hospital, Tokyo, Japan
- Waseda University, Institute for Asia Human Community, Tokyo, Japan
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15
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Johansen MD, Mahbub RM, Idrees S, Nguyen DH, Miemczyk S, Pathinayake P, Nichol K, Hansbro NG, Gearing LJ, Hertzog PJ, Gallego-Ortega D, Britton WJ, Saunders BM, Wark PA, Faiz A, Hansbro PM. Increased SARS-CoV-2 Infection, Protease, and Inflammatory Responses in Chronic Obstructive Pulmonary Disease Primary Bronchial Epithelial Cells Defined with Single-Cell RNA Sequencing. Am J Respir Crit Care Med 2022; 206:712-729. [PMID: 35549656 PMCID: PMC9799113 DOI: 10.1164/rccm.202108-1901oc] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Rationale: Patients with chronic obstructive pulmonary disease (COPD) develop more severe coronavirus disease (COVID-19); however, it is unclear whether they are more susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and what mechanisms are responsible for severe disease. Objectives: To determine whether SARS-CoV-2 inoculated primary bronchial epithelial cells (pBECs) from patients with COPD support greater infection and elucidate the effects and mechanisms involved. Methods: We performed single-cell RNA sequencing analysis on differentiated pBECs from healthy subjects and patients with COPD 7 days after SARS-CoV-2 inoculation. We correlated changes with viral titers, proinflammatory responses, and IFN production. Measurements and Main Results: Single-cell RNA sequencing revealed that COPD pBECs had 24-fold greater infection than healthy cells, which was supported by plaque assays. Club/goblet and basal cells were the predominant populations infected and expressed mRNAs involved in viral replication. Proteases involved in SARS-CoV-2 entry/infection (TMPRSS2 and CTSB) were increased, and protease inhibitors (serpins) were downregulated more so in COPD. Inflammatory cytokines linked to COPD exacerbations and severe COVID-19 were increased, whereas IFN responses were blunted. Coexpression analysis revealed a prominent population of club/goblet cells with high type 1/2 IFN responses that were important drivers of immune responses to infection in both healthy and COPD pBECs. Therapeutic inhibition of proteases and inflammatory imbalances reduced viral titers and cytokine responses, particularly in COPD pBECs. Conclusions: COPD pBECs are more susceptible to SARS-CoV-2 infection because of increases in coreceptor expression and protease imbalances and have greater inflammatory responses. A prominent cluster of IFN-responsive club/goblet cells emerges during infection, which may be important drivers of immunity. Therapeutic interventions suppress SARS-CoV-2 replication and consequent inflammation.
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Affiliation(s)
- Matt D. Johansen
- Faculty of Science, School of Life Sciences, Centre for Inflammation, Centenary Institute, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Rashad M. Mahbub
- Faculty of Science, School of Life Sciences, Centre for Inflammation, Centenary Institute, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Sobia Idrees
- Faculty of Science, School of Life Sciences, Centre for Inflammation, Centenary Institute, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Duc H. Nguyen
- Faculty of Science, School of Life Sciences, Centre for Inflammation, Centenary Institute, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Stefan Miemczyk
- Faculty of Science, School of Life Sciences, Centre for Inflammation, Centenary Institute, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Prabuddha Pathinayake
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia
| | - Kristy Nichol
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia
| | - Nicole G. Hansbro
- Faculty of Science, School of Life Sciences, Centre for Inflammation, Centenary Institute, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Linden J. Gearing
- Department of Molecular and Translational Sciences, School of Clinical Sciences at Monash Health, Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research, Monash University, Clayton, Victoria, Australia
| | - Paul J. Hertzog
- Department of Molecular and Translational Sciences, School of Clinical Sciences at Monash Health, Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research, Monash University, Clayton, Victoria, Australia
| | - David Gallego-Ortega
- Faculty of Engineering and Information Technology, School of Biomedical Engineering, Centre for Single Cell Technology, University of Technology Sydney, Ultimo, New South Wales, Australia;,Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia;,St. Vincent’s Clinical School, Faculty of Medicine, University of New South Wales Sydney, Kensington, New South Wales, Australia; and
| | - Warwick J. Britton
- Centenary Institute, University of Sydney and Department of Clinical Immunology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Bernadette M. Saunders
- Faculty of Science, School of Life Sciences, Centre for Inflammation, Centenary Institute, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Peter A. Wark
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia
| | - Alen Faiz
- Faculty of Science, School of Life Sciences, Centre for Inflammation, Centenary Institute, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Philip M. Hansbro
- Faculty of Science, School of Life Sciences, Centre for Inflammation, Centenary Institute, University of Technology Sydney, Sydney, New South Wales, Australia;,Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia
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16
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Navas Alcántara MS, Montero Rivas L, Guisado Espartero ME, Rubio-Rivas M, Ayuso García B, Moreno Martinez F, Ausín García C, Taboada Martínez ML, Arnalich Fernández F, Martínez Murgui R, Molinos Castro S, Ramos Muñoz ME, Fernández-Garcés M, Carreño Hernandez MC, García García GM, Vázquez Piqueras N, Abadía-Otero J, Lajara Villar L, Salazar Monteiro C, Pascual Pérez MDLR, Perez-Martin S, Collado-Aliaga J, Antón-Santos JM, Lumbreras-Bermejo C. Influence of smoking history on the evolution of hospitalized in COVID-19 positive patients: results from the SEMI-COVID-19 registry. Med Clin (Barc) 2022; 159:214-223. [PMID: 34895891 PMCID: PMC8590935 DOI: 10.1016/j.medcli.2021.10.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 10/05/2021] [Accepted: 10/14/2021] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Smoking can play a key role in SARS-CoV-2 infection and in the course of the disease. Previous studies have conflicting or inconclusive results on the prevalence of smoking and the severity of the coronavirus disease (COVID-19). METHODS Observational, multicenter, retrospective cohort study of 14,260 patients admitted for COVID-19 in Spanish hospitals between February and September 2020. Their clinical characteristics were recorded and the patients were classified into a smoking group (active or former smokers) or a non-smoking group (never smokers). The patients were followed up to one month after discharge. Differences between groups were analyzed. A multivariate logistic regression and Kapplan Meier curves analyzed the relationship between smoking and in-hospital mortality. RESULTS The median age was 68.6 (55.8-79.1) years, with 57.7% of males. Smoking patients were older (69.9 [59.6-78.0 years]), more frequently male (80.3%) and with higher Charlson index (4 [2-6]) than non-smoking patients. Smoking patients presented a worse evolution, with a higher rate of admission to the intensive care unit (ICU) (10.4 vs 8.1%), higher in-hospital mortality (22.5 vs. 16.4%) and readmission at one month (5.8 vs. 4.0%) than in non-smoking patients. After multivariate analysis, smoking remained associated with these events. CONCLUSIONS Active or past smoking is an independent predictor of poor prognosis in patients with COVID-19. It is associated with higher ICU admissions and in-hospital mortality.
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Affiliation(s)
| | - Lorena Montero Rivas
- Servicio de Medicina Interna, Hospital Infanta Margarita, Cabra, Córdoba, España
| | | | - Manuel Rubio-Rivas
- Servicio de Medicina Interna, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat (Barcelona), Barcelona, España
| | - Blanca Ayuso García
- Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, Madrid, España
| | | | | | | | | | | | - Sonia Molinos Castro
- Servicio de Medicina Interna, Hospital Clínico de Santiago de Compostela, A Coruña, España
| | | | | | - Mari Cruz Carreño Hernandez
- Unidad de Riesgo Vascular, Servicio de Neumología, Hospital Madrid Norte Sanchinarro, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España
| | | | - Nuria Vázquez Piqueras
- Servicio de Medicina Interna, Hospital Moisès Broggi, Sant Joan Despí, Barcelona, España
| | - Jesica Abadía-Otero
- Consulta de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital Universitario Río Hortega, Valladolid, España
| | - Lourdes Lajara Villar
- Servicio de Medicina Interna, Hospital Universitario San Juan de Alicante, Alicante, España
| | - Cristina Salazar Monteiro
- Servicio de Medicina Interna, Hospital Nuestra Señora del Prado,Talavera de la Reina, Toledo, España
| | | | | | - Javier Collado-Aliaga
- Servicio de Medicina Interna, Complejo Asistencial Universitario de Salamanca, España
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17
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Navas Alcántara MS, Montero Rivas L, Guisado Espartero ME, Rubio-Rivas M, Ayuso García B, Moreno Martinez F, Ausín García C, Taboada Martínez ML, Arnalich Fernández F, Martínez Murgui R, Molinos Castro S, Ramos Muñoz ME, Fernández-Garcés M, Carreño Hernandez MC, García García GM, Vázquez Piqueras N, Abadía-Otero J, Lajara Villar L, Salazar Monteiro C, Pascual Pérez MDLR, Perez-Martin S, Collado-Aliaga J, Antón-Santos JM, Lumbreras-Bermejo C. Influence of smoking history on the evolution of hospitalized in COVID-19 positive patients: Results from the SEMI-COVID-19 registry. MEDICINA CLÍNICA (ENGLISH EDITION) 2022; 159:214-223. [PMID: 35935808 PMCID: PMC9339973 DOI: 10.1016/j.medcle.2022.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 10/14/2021] [Indexed: 11/03/2022]
Abstract
Introduction Methods Results Conclusions
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18
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Tang Q, Gao L, Tong Z, Li W. Hyperlipidemia, COVID-19 and acute pancreatitis: A tale of three entities. Am J Med Sci 2022; 364:257-263. [PMID: 35381217 PMCID: PMC8977370 DOI: 10.1016/j.amjms.2022.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 01/04/2022] [Accepted: 03/30/2022] [Indexed: 01/09/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the ongoing pandemic of coronavirus disease 2019 (COVID-19), which presented as not only respiratory symptoms, but various digestive manifestations including pancreatic injury and acute pancreatitis (AP). The underlying mechanism is still unclear. Hypertriglyceridemia has become one of the leading causes of AP in recent years and hyperlipidemia is highly reported in COVID-19 cases. The current narrative review aimed to explore the associations between AP, COVID-19 and hyperlipidemia. Substantial cases of COVID-19 patients complicated with AP were reported, while the incidence of AP in the COVID-19 population was relatively low. Hyperlipidemia was common in COVID-19 patients with a pooled incidence of 32.98%. Hyperlipidemia could be a mediating factor in the pathogenesis of AP in COVID-19 patients. Further studies are warranted to clarify the relationship among AP, lipid metabolism disorders and COVID-19.
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Affiliation(s)
- Qiuyi Tang
- Medical School, Southeast University, Nanjing, Jiangsu, China; Center of Severe Acute Pancreatitis (CSAP), Department of Intensive Care Unit, Jinling Hospital, Nanjing, Jiangsu, China
| | - Lin Gao
- Center of Severe Acute Pancreatitis (CSAP), Department of Intensive Care Unit, Jinling Hospital, Nanjing, Jiangsu, China
| | - Zhihui Tong
- Center of Severe Acute Pancreatitis (CSAP), Department of Intensive Care Unit, Jinling Hospital, Nanjing, Jiangsu, China.
| | - Weiqin Li
- Medical School, Southeast University, Nanjing, Jiangsu, China; Center of Severe Acute Pancreatitis (CSAP), Department of Intensive Care Unit, Jinling Hospital, Nanjing, Jiangsu, China.
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19
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Omer S, Gondal MF, Usman M, Sarwar MB, Roman M, Khan A, Afzal N, Qaiser TA, Yasir M, Shahzad F, Tahir R, Ayub S, Akram J, Faizan RM, Naveed MA, Jahan S. Epidemiology, Clinico-Pathological Characteristics, and Comorbidities of SARS-CoV-2-Infected Pakistani Patients. Front Cell Infect Microbiol 2022; 12:800511. [PMID: 35755851 PMCID: PMC9226825 DOI: 10.3389/fcimb.2022.800511] [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: 10/23/2021] [Accepted: 04/15/2022] [Indexed: 11/25/2022] Open
Abstract
SARS-CoV-2 is a causative agent for COVID-19 disease, initially reported from Wuhan, China. The infected patients experienced mild to severe symptoms, resulting in several fatalities due to a weak understanding of its pathogenesis, which is the same even to date. This cross-sectional study has been designed on 452 symptomatic mild-to-moderate and severe/critical patients to understand the epidemiology and clinical characteristics of COVID-19 patients with their comorbidities and response to treatment. The mean age of the studied patients was 58 ± 14.42 years, and the overall male to female ratio was 61.7 to 38.2%, respectively. In total, 27.3% of the patients had a history of exposure, and 11.9% had a travel history, while for 60% of patients, the source of infection was unknown. The most prevalent signs and symptoms in ICU patients were dry cough, myalgia, shortness of breath, gastrointestinal discomfort, and abnormal chest X-ray (p < 0.001), along with a high percentage of hypertension (p = 0.007) and chronic obstructive pulmonary disease (p = 0.029) as leading comorbidities. The complete blood count indicators were significantly disturbed in severe patients, while the coagulation profile and D-dimer values were significantly higher in mild-to-moderate (non-ICU) patients (p < 0.001). The serum creatinine (1.22 μmol L-1; p = 0.016) and lactate dehydrogenase (619 μmol L-1; p < 0.001) indicators were significantly high in non-ICU patients, while raised values of total bilirubin (0.91 μmol L-1; p = 0.054), C-reactive protein (84.68 mg L-1; p = 0.001), and ferritin (996.81 mg L-1; p < 0.001) were found in ICU patients. The drug dexamethasone was the leading prescribed and administrated medicine to COVID-19 patients, followed by remdesivir, meropenem, heparin, and tocilizumab, respectively. A characteristic pattern of ground glass opacities, consolidation, and interlobular septal thickening was prominent in severely infected patients. These findings could be used for future research, control, and prevention of SARS-CoV-2-infected patients.
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Affiliation(s)
- Saadia Omer
- Department of Immunology, University of Health Sciences, Lahore, Pakistan.,Institute of Public Health, Health Department, Government of Punjab, Lahore, Pakistan.,Department of Community Medicine, Fatima Jinnah Medical University, Lahore, Pakistan
| | | | - Muhammad Usman
- Allama Iqbal Medical College, Jinnah Hospital, Lahore, Pakistan
| | | | - Muhammad Roman
- Department of Immunology, University of Health Sciences, Lahore, Pakistan
| | - Alam Khan
- Department of Immunology, University of Health Sciences, Lahore, Pakistan
| | - Nadeem Afzal
- Department of Immunology, University of Health Sciences, Lahore, Pakistan
| | - Tanveer Ahmed Qaiser
- Department of Molecular Biology, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan
| | - Muhammad Yasir
- Quadram Institute Bioscience, Norwich Research Park, Norwich, United Kingdom
| | - Faheem Shahzad
- Department of Immunology, University of Health Sciences, Lahore, Pakistan
| | - Romeeza Tahir
- Department of Immunology, University of Health Sciences, Lahore, Pakistan
| | - Saima Ayub
- Institute of Public Health, Health Department, Government of Punjab, Lahore, Pakistan
| | - Javed Akram
- Department of Immunology, University of Health Sciences, Lahore, Pakistan
| | | | | | - Shah Jahan
- Department of Immunology, University of Health Sciences, Lahore, Pakistan
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20
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Bioinformatics Approach Predicts Candidate Targets for SARS-CoV-2 Infections to COPD Patients. BIOMED RESEARCH INTERNATIONAL 2022; 2022:1806427. [PMID: 35747501 PMCID: PMC9211381 DOI: 10.1155/2022/1806427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 06/05/2022] [Accepted: 06/09/2022] [Indexed: 01/08/2023]
Abstract
COVID-19 is still prevalent in more world regions and poses a severe threat to human health due to its high pathogenicity. The incidence of COPD patients is gradually increasing, especially in patients over 45 years old. COPD patients are susceptible to COVID-19 due to the specific lung receptor ACE2 of SARS-CoV-2. We attempt to reveal the genetic basis by analyzing the expression of common DEGs of the two diseases through bioinformatics approaches and find potential therapeutic agents based on the target genes. Thus, we search the GEO database for COVID-19 and COPD transcriptomic gene expression. We also study the enrichment of signaling regulatory pathways and hub genes for potential therapeutic treatments. There are 34 common DEGs in the two datasets. The signaling pathways are mainly enriched in intercellular junctions between virus and cytokine regulation. In the PPI network of common DEGs, we extract 5 hub genes. We find that artesunate CTD 00001840, dexverapamil MCF7 UP, and STOCK1N-35696 PC3 DOWN could be therapeutic agents for both diseases. We also analyze the regulatory network of differential genes with transcription factors and miRNAs. Therefore, we conclude that artesunate CTD 00001840, dexverapamil MCF7 UP, and STOCK1N-35696 PC3 DOWN can be therapeutic candidates in COPD combined with COVID-19.
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21
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Sex Differences in COVID-19 Hospitalization and Hospital Mortality among Patients with COPD in Spain: A Retrospective Cohort Study. Viruses 2022; 14:v14061238. [PMID: 35746709 PMCID: PMC9229343 DOI: 10.3390/v14061238] [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: 03/18/2022] [Revised: 05/30/2022] [Accepted: 06/06/2022] [Indexed: 12/10/2022] Open
Abstract
(1) Background: We aimed to assess the effect of COPD in the incidence of hospital admissions for COVID-19 and on the in-hospital mortality (IHM) according to sex. (2) Methods: We used national hospital discharge data to select persons aged ≥40 years admitted to a hospital with a diagnosis of COVID-19 in 2020 in Spain. (3) Results: The study population included 218,301 patients. Age-adjusted incidence rates of COVID-19 hospitalizations for men with and without COPD were 10.66 and 9.27 per 1000 persons, respectively (IRR 1.14; 95% CI 1.08−1.20; p < 0.001). The IHM was higher in men than in women regardless of the history of COPD. The COPD was associated with higher IHM among women (OR 1.09; 95% CI 1.01−1.22) but not among men. The COPD men had a 25% higher risk of dying in the hospital with COVID-19 than women with COPD (OR 1.25, 95% CI 1.1−1.42). (4) Conclusions: Sex differences seem to exist in the effect of COPD among patients suffering COVID-19. The history of COPD increased the risk of hospitalization among men but not among women, and COPD was only identified as a risk factor for IHM among women. In any case, we observed that COPD men had a higher mortality than COPD women. Understanding the mechanisms underlying these sex differences could help predict the patient outcomes and inform clinical decision making to facilitate early treatment and disposition decisions.
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22
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Uranga A, Villanueva A, Lafuente I, González N, Legarreta MJ, Aguirre U, España PP, Quintana JM, García-Gutiérrez S. [Risk factors for clinical deterioration in patients admitted for COVID-19: A case-control study]. Rev Clin Esp 2022; 222:22-30. [PMID: 34054133 PMCID: PMC8141782 DOI: 10.1016/j.rce.2021.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 04/25/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION There is controversy regarding the best predictors of clinical deterioration in COVID-19. OBJECTIVE This work aims to identify predictors of risk factors for deterioration in patients hospitalized due to COVID-19. METHODS DESIGN Nested case-control study within a cohort. Setting: 13 acute care centers of the Osakidetza-Basque Health Service. Participants: Patients hospitalized for COVID-19 with clinical deterioration-defined as onset of severe ARDS, ICU admission, or death-were considered cases. Two controls were matched to each case based on age. Sociodemographic data; comorbidities; baseline treatment; symptoms; date of onset; previous consultations; and clinical, analytical, and radiological variables were collected. An explanatory model of clinical deterioration was created by means of conditional logistic regression. RESULTS A total of 99 cases and 198 controls were included. According to the logistic regression analysis, the independent variables associated with clinical deterioration were: emergency department O2 saturation ≤90% (OR 16.6; 95%CI 4-68), pathological chest X-ray (OR 5.6; 95%CI 1.7-18.4), CRP >100 mg/dL (OR 3.62; 95%CI 1.62-8), thrombocytopenia with < 150,000 platelets (OR 4; 95%CI 1.84-8.6); and a medical history of acute myocardial infarction (OR 15.7; 95%CI, 3.29-75.09), COPD (OR 3.05; 95%CI 1.43-6.5), or HT (OR 2.21; 95%CI 1.11-4.4). The model's AUC was 0.86. On the univariate analysis, female sex and presence of dry cough and sore throat were associated with better clinical progress, but were not found to be significant on the multivariate analysis. CONCLUSION The variables identified could be useful in clinical practice for the detection of patients at high risk of poor outcomes.
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Affiliation(s)
- A Uranga
- Servicio de Respiratorio, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, España
| | - A Villanueva
- Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, España
| | - I Lafuente
- Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, España
| | - N González
- Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, España
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, España
| | - M J Legarreta
- Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, España
| | - U Aguirre
- Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, España
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, España
| | - P P España
- Servicio de Respiratorio, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, España
| | - J M Quintana
- Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, España
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, España
| | - S García-Gutiérrez
- Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, España
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, España
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23
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Fitero A, Bungau SG, Tit DM, Endres L, Khan SA, Bungau AF, Romanul I, Vesa CM, Radu AF, Tarce AG, Bogdan MA, Nechifor AC, Negrut N. Comorbidities, Associated Diseases, and Risk Assessment in COVID-19-A Systematic Review. Int J Clin Pract 2022; 2022:1571826. [PMID: 36406478 PMCID: PMC9640235 DOI: 10.1155/2022/1571826] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 10/12/2022] [Indexed: 11/05/2022] Open
Abstract
It is considered that COVID-19's pandemic expansion is responsible for the particular increase in deaths, especially among the population with comorbidities. The health system is often overwhelmed by the large number of cases of patients addressing it, by the regional limitation of funds, and by the gravity of cases at subjects suffering from this pathology. Several associated conditions including diabetes, cardiovascular illnesses, obesity, persistent lung condition, neurodegenerative diseases, etc., increase the mortality risk and hospitalization of subjects suffering from COVID-19. The rapid identification of patients with increased risk of death from the SARS-CoV-2 virus, the stratification in accordance with the risk and the allocation of human, financial, and logistical resources in proportion must be a priority for health systems worldwide.
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Affiliation(s)
- Andreea Fitero
- Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410073, Romania
| | - Simona Gabriela Bungau
- Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410073, Romania
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410028, Romania
| | - Delia Mirela Tit
- Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410073, Romania
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410028, Romania
| | - Laura Endres
- Department of Psycho-Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410073, Romania
| | - Shamim Ahmad Khan
- Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410073, Romania
| | | | - Ioana Romanul
- Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410073, Romania
| | - Cosmin Mihai Vesa
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410073, Romania
| | - Andrei-Flavius Radu
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410028, Romania
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410073, Romania
| | | | - Mihaela Alexandra Bogdan
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410028, Romania
| | - Aurelia Cristina Nechifor
- Analytical Chemistry and Environmental Engineering Department, Polytechnic University of Bucharest, Bucharest 011061, Romania
| | - Nicoleta Negrut
- Department of Psycho-Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410073, Romania
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24
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Uranga A, Villanueva A, Lafuente I, González N, Legarreta MJ, Aguirre U, España PP, Quintana JM, García-Gutiérrez S. Risk factors for clinical deterioration in patients admitted for COVID-19: A case-control study. Rev Clin Esp 2022; 222:22-30. [PMID: 34556435 PMCID: PMC8426292 DOI: 10.1016/j.rceng.2021.04.009] [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: 11/30/2020] [Accepted: 04/25/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION There is controversy regarding the best predictors of clinical deterioration in COVID-19. OBJECTIVE This work aims to identify predictors of risk factors for deterioration in patients hospitalized due to COVID-19. METHODS DESIGN Nested case-control study within a cohort. SETTING 13 acute care centers of the Osakidetza-Basque Health Service. PARTICIPANTS patients hospitalized for COVID-19 with clinical deterioration-defined as onset of severe ARDS, ICU admission, or death-were considered cases. Two controls were matched to each case based on age. Sociodemographic data; comorbidities; baseline treatment; symptoms; date of onset; previous consultations; and clinical, analytical, and radiological variables were collected. An explanatory model of clinical deterioration was created by means of conditional logistic regression. RESULTS A total of 99 cases and 198 controls were included. According to the logistic regression analysis, the independent variables associated with clinical deterioration were: emergency department O2 saturation ≤90% (OR 16.6; 95%CI 4-68), pathological chest X-ray (OR 5.6; 95%CI 1.7-18.4), CRP > 100 mg/dL (OR 3.62; 95%CI 1.62-8), thrombocytopenia with <150,000 platelets (OR 4; 95%CI 1.84-8.6); and a medical history of acute myocardial infarction (OR 15.7; 95%CI, 3.29-75.09), COPD (OR 3.05; 95%CI 1.43-6.5), or HT (OR 2.21; 95%CI 1.11-4.4). The model's AUC was 0.86. On the univariate analysis, female sex and presence of dry cough and sore throat were associated with better clinical progress, but were not found to be significant on the multivariate analysis. CONCLUSION The variables identified could be useful in clinical practice for the detection of patients at high risk of poor outcomes.
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Affiliation(s)
- A Uranga
- Servicio de Respiratorio, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain
| | - A Villanueva
- Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain
| | - I Lafuente
- Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain
| | - N González
- Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain; Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, Spain
| | - M J Legarreta
- Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain
| | - U Aguirre
- Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain; Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, Spain
| | - P P España
- Servicio de Respiratorio, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain
| | - J M Quintana
- Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain; Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, Spain
| | - S García-Gutiérrez
- Unidad de Investigación Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain; Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, Spain.
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25
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Sheikh D, Tripathi N, Chandler TR, Furmanek S, Bordon J, Ramirez JA, Cavallazzi R. Clinical outcomes in patients with COPD hospitalized with SARS-CoV-2 versus non- SARS-CoV-2 community-acquired pneumonia. Respir Med 2021; 191:106714. [PMID: 34915396 PMCID: PMC8654722 DOI: 10.1016/j.rmed.2021.106714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 12/06/2021] [Accepted: 12/07/2021] [Indexed: 12/13/2022]
Abstract
Background Patients with chronic obstructive pulmonary disease (COPD) have poor outcomes in the setting of community-acquired pneumonia (CAP) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The primary objective is to compare outcomes of SARS-CoV-2 CAP and non-SARS-CoV-2 CAP in patients with COPD. The secondary objective is to compare outcomes of SARS-CoV-2 CAP with and without COPD. Methods In this analysis of two observational studies, three cohorts were analyzed: (1) patients with COPD and SARS-CoV-2 CAP; (2) patients with COPD and non-SARS-CoV-2 CAP; and (3) patients with SARS-CoV-2 CAP without COPD. Outcomes included length of stay, ICU admission, cardiac events, and in-hospital mortality. Results Ninety-six patients with COPD and SARS-CoV-2 CAP were compared to 1129 patients with COPD and non-SARS-CoV-2 CAP. 536 patients without COPD and SARS-CoV-2 CAP were analyzed for the secondary objective. Patients with COPD and SARS-CoV-2 CAP had longer hospital stay (15 vs 5 days, p < 0.001), 4.98 higher odds of cardiac events (95% CI: 3.74–6.69), and 7.31 higher odds of death (95% CI: 5.36–10.12) in comparison to patients with COPD and non-SARS-CoV-2 CAP. In patients with SARS-CoV-2 CAP, presence of COPD was associated with 1.74 (95% CI: 1.39–2.19) higher odds of ICU admission and 1.47 (95% CI: 1.05–2.05) higher odds of death. Conclusion In patients with COPD and CAP, presence of SARS-CoV-2 as an etiologic agent is associated with more cardiovascular events, longer hospital stay, and seven-fold increase in mortality. In patients with SARS-CoV-2 CAP, presence of COPD is associated with 1.5-fold increase in mortality.
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Affiliation(s)
- Daniya Sheikh
- Division of Infectious Diseases, University of Louisville, Louisville, KY, USA.
| | - Nishita Tripathi
- Division of Infectious Diseases, University of Louisville, Louisville, KY, USA
| | - Thomas R Chandler
- Division of Infectious Diseases, University of Louisville, Louisville, KY, USA
| | - Stephen Furmanek
- Division of Infectious Diseases, University of Louisville, Louisville, KY, USA
| | - Jose Bordon
- Washington Health Institute, George Washington University, Washington, DC, USA
| | - Julio A Ramirez
- Division of Infectious Diseases, University of Louisville, Louisville, KY, USA
| | - Rodrigo Cavallazzi
- Division of Pulmonary, Critical Care Medicine and Sleep Disorders, University of Louisville, Louisville, KY, USA
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Machado-Alba JE, Valladales-Restrepo LF, Machado-Duque ME, Gaviria-Mendoza A, Sánchez-Ramírez N, Usma-Valencia AF, Rodríguez-Martínez E, Rengifo-Franco E, Forero-Supelano VH, Gómez-Ramirez DM, Sabogal-Ortiz A. Factors associated with admission to the intensive care unit and mortality in patients with COVID-19, Colombia. PLoS One 2021; 16:e0260169. [PMID: 34797857 PMCID: PMC8604321 DOI: 10.1371/journal.pone.0260169] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 11/03/2021] [Indexed: 12/15/2022] Open
Abstract
Introduction Coronavirus disease 2019 (COVID-19) has affected millions of people worldwide, and several sociodemographic variables, comorbidities and care variables have been associated with complications and mortality. Objective To identify the factors associated with admission to intensive care units (ICUs) and mortality in patients with COVID-19 from 4 clinics in Colombia. Methods This was a follow-up study of a cohort of patients diagnosed with COVID-19 between March and August 2020. Sociodemographic, clinical (Charlson comorbidity index and NEWS 2 score) and pharmacological variables were identified. Multivariate analyses were performed to identify variables associated with the risk of admission to the ICU and death (p<0.05). Results A total of 780 patients were analyzed, with a median age of 57.0 years; 61.2% were male. On admission, 54.9% were classified as severely ill, 65.3% were diagnosed with acute respiratory distress syndrome, 32.4% were admitted to the ICU, and 26.0% died. The factors associated with a greater likelihood of ICU admission were severe pneumonia (OR: 9.86; 95%CI:5.99–16.23), each 1-point increase in the NEWS 2 score (OR:1.09; 95%CI:1.002–1.19), history of ischemic heart disease (OR:3.24; 95%CI:1.16–9.00), and chronic obstructive pulmonary disease (OR:2.07; 95%CI:1.09–3.90). The risk of dying increased in those older than 65 years (OR:3.08; 95%CI:1.66–5.71), in patients with acute renal failure (OR:6.96; 95%CI:4.41–11.78), admitted to the ICU (OR:6.31; 95%CI:3.63–10.95), and for each 1-point increase in the Charlson comorbidity index (OR:1.16; 95%CI:1.002–1.35). Conclusions Factors related to increasing the probability of requiring ICU care or dying in patients with COVID-19 were identified, facilitating the development of anticipatory intervention measures that favor comprehensive care and improve patient prognosis.
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Affiliation(s)
- Jorge Enrique Machado-Alba
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A, Pereira, Risaralda, Colombia
| | - Luis Fernando Valladales-Restrepo
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A, Pereira, Risaralda, Colombia.,Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia
| | - Manuel Enrique Machado-Duque
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A, Pereira, Risaralda, Colombia.,Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia
| | - Andrés Gaviria-Mendoza
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A, Pereira, Risaralda, Colombia.,Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia
| | - Nicolás Sánchez-Ramírez
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A, Pereira, Risaralda, Colombia
| | - Andrés Felipe Usma-Valencia
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A, Pereira, Risaralda, Colombia
| | - Esteban Rodríguez-Martínez
- Semillero de Investigación en Farmacología Geriátrica, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia
| | - Eliana Rengifo-Franco
- Semillero de Investigación en Farmacología Geriátrica, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia
| | | | - Diego Mauricio Gómez-Ramirez
- Grupo Ospedale, Grupo Operador Clínico Hospitalario por Outsourcing S.A.S - G-Ocho S.A.S, Área de Salud, Cali, Valle del Cauca, Colombia
| | - Alejandra Sabogal-Ortiz
- Grupo Ospedale, Grupo Operador Clínico Hospitalario por Outsourcing S.A.S - G-Ocho S.A.S, Área de Salud, Cali, Valle del Cauca, Colombia
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Zuin M, Rigatelli G, Bilato C, Cervellati C, Zuliani G, Roncon L. Dyslipidaemia and mortality in COVID-19 patients: a meta-analysis. QJM 2021; 114:390-397. [PMID: 33822215 PMCID: PMC8083520 DOI: 10.1093/qjmed/hcab071] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 03/29/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The prevalence and prognostic implications of pre-existing dyslipidaemia in patients infected by the SARS-CoV-2 remain unclear. AIM To assess the prevalence and mortality risk in COVID-19 patients with pre-existing dyslipidaemia. DESIGN Systematic review and meta-analysis. METHODS Preferred reporting items for systematic reviews and meta-analyses guidelines were followed in abstracting data and assessing validity. We searched MEDLINE and Scopus to locate all the articles published up to 31 January 2021, reporting data on dyslipidaemia among COVID-19 survivors and non-survivors. The pooled prevalence of dyslipidaemia was calculated using a random-effects model and presenting the related 95% confidence interval (CI), while the mortality risk was estimated using the Mantel-Haenszel random-effect models with odds ratio (OR) and related 95% CI. Statistical heterogeneity was measured using the Higgins I2 statistic. RESULTS Of about 18 studies, enrolling 74 132 COVID-19 patients (mean age 70.6 years), met the inclusion criteria and were included in the final analysis. The pooled prevalence of dyslipidaemia was 17.5% of cases (95% CI: 12.3-24.3%, P < 0.0001), with high heterogeneity (I2 = 98.7%). Pre-existing dyslipidaemia was significantly associated with higher risk of short-term death (OR: 1.69, 95% CI: 1.19-2.41, P = 0.003), with high heterogeneity (I2 = 88.7%). Due to publication bias, according to the Trim-and-Fill method, the corrected random-effect ORs resulted 1.61, 95% CI 1.13-2.28, P < 0.0001 (one studies trimmed). CONCLUSION Dyslipidaemia represents a major comorbidity in about 18% of COVID-19 patients but it is associated with a 60% increase of short-term mortality risk.
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Affiliation(s)
- Marco Zuin
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
- Department of Cardiology, Santa Maria della Misericordia Hospital, Rovigo, Italy
| | - Gianluca Rigatelli
- Department of Cardiology, Santa Maria della Misericordia Hospital, Rovigo, Italy
| | - Claudio Bilato
- Division of Cardiology, West Vicenza General Hospitals, Arzignano, Vicenza, Italy
| | - Carlo Cervellati
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Giovanni Zuliani
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Loris Roncon
- Department of Cardiology, Santa Maria della Misericordia Hospital, Rovigo, Italy
- Corresponding author: Prof. Loris Roncon MD, Department of Cardiology, Rovigo General Hospital, Viale tre Martiri, Rovigo 45100, Italy. Tel.+390425393286; Fax: +390425393597,
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Rodríguez González-Moro JM, Izquierdo Alonso JL. [Oral antibiotic treatment of exacerbation of COPD. Beyond COVID-19]. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2021; 34:429-440. [PMID: 34533020 PMCID: PMC8638829 DOI: 10.37201/req/125.2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 09/10/2021] [Indexed: 11/12/2022]
Abstract
COPD (chronic obstructive pulmonary disease) includes patients with chronic bronchitis and / or emphysema who have in common the presence of a chronic and progressive airflow obstruction, with symptoms of dyspnea and whose natural history is modified by acute episodes of exacerbations. Exacerbation (EACOPD) is defined as an acute episode of clinical instability characterized by a sustained worsening of respiratory symptoms. It is necessary to distinguish a new EACOPD from a previous treatment failure or a relapse. EACOPD become more frequent and intense over time, deteriorating lung function and quality of life. The diagnosis of EACOPD consists of 3 essential steps: a) differential diagnosis; b) establish the severity, and c) identify its etiology. The main cause of exacerbations is infection, both bacterial and viral. Antibiotics are especially indicated in severe EACOPD and the presence of purulent sputum. Beta-lactams (amoxicillin-clavulanate and cefditoren) and fluoroquinolones (levofloxacin) are the most widely used antimicrobials. This review updates the problem of acute exacerbation with infectious origin from the perspective of etiology, antimicrobial resistance, microbiological studies, risk stratification, and antimicrobial management. The risk, prognosis and characteristics of COPD patients who develop COVID19 are analyzed.
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Affiliation(s)
- J M Rodríguez González-Moro
- José Miguel Rodríguez González-Moro, Servicio de neumología. Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain.
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Impact of smoking, COPD and comorbidities on the mortality of COVID-19 patients. Sci Rep 2021; 11:19251. [PMID: 34584165 PMCID: PMC8478875 DOI: 10.1038/s41598-021-98749-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 08/23/2021] [Indexed: 01/08/2023] Open
Abstract
The prognosis of the coronavirus disease 2019 (COVID-19) patients is variable and depends on several factors. Current data about the impact of chronic obstructive pulmonary disease (COPD) and smoking on the clinical course of COVID-19 are still controversial. This study evaluated the prevalence and the prognosis of COPD patients and smokers in a cohort of 521 patients admitted to four intermediate Respiratory Intensive Care Units (Puglia, Italy) with respiratory failure due to COVID-19 pneumonia. The prevalence of COPD and current smokers was 14% and 13%, respectively. COPD patients had a higher 30-day all-cause mortality than non-COPD patients. Former smokers compared to never smokers and current smokers had higher 30-day all-cause mortality. COPD patients and former smokers had more comorbidities. This study described the prevalence and the outcomes of COPD patients and smokers in a homogenous cohort of COVID-19 patients. The study showed that the prevalence of COPD and current smokers was not high, suggesting that they were not at increased risk of getting the infection. However, when SARS-CoV-2 infection occurred, COPD patients and former smokers were those with the highest all-cause mortality, which seemed to be mainly related to the presence of comorbidities and not to COPD and smoking itself.
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Giossi R, Menichelli D, Pani A, Tratta E, Romandini A, Roncato R, Nani A, Schenardi P, Diani E, Fittipaldo VA, Farcomeni A, Scaglione F, Pastori D. A Systematic Review and a Meta-Analysis Comparing Prophylactic and Therapeutic Low Molecular Weight Heparins for Mortality Reduction in 32,688 COVID-19 Patients. Front Pharmacol 2021; 12:698008. [PMID: 34539396 PMCID: PMC8443784 DOI: 10.3389/fphar.2021.698008] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 08/05/2021] [Indexed: 12/13/2022] Open
Abstract
Background: Antithrombotic treatment, including low molecular weight heparin (LMWH) or unfractionated heparin (UFH), has been proposed as a potential therapy for coronavirus disease 2019 (COVID-19) to lower diffuse intravascular clotting activation. However, it is unclear whether prophylactic or therapeutic doses have similar efficacy in reducing mortality. Methods: We performed a systematic review (PROSPERO registration CRD42020179955) and meta-analysis including observational cohort studies and randomized controlled trials (RCT) evaluating the effectiveness of heparins (either LMWH, UFH, or fondaparinux) in COVID-19 patients. Heparin treatment was compared to no anticoagulation. A subgroup analysis on prophylactic or therapeutic doses compared to no anticoagulation was performed. Prophylactic dose was also compared to full dose anticoagulation. Primary endpoint was all-cause mortality. Secondary endpoints were major bleeding and length of hospital stay (LOS). Results: 33 studies (31 observational, 2 RCT) were included for a total overall population of 32,688 patients. Of these, 21,723 (66.5%) were on heparins. 31 studies reported data on all-cause mortality, showing that both prophylactic and full dose reduced mortality (pooled Hazard Ratio [HR] 0.63, 95% confidence interval [CI] 0.57-0.69 and HR 0.56, 95% CI 0.47-0.66, respectively). However, the full dose was associated with a higher risk of major bleeding (Odds Ratio [OR] 2.01, 95% CI 1.14-3.53) compared to prophylactic dose. Finally, LOS was evaluated in 3 studies; no difference was observed between patients with and without heparins (0.98, -3.87, 5.83 days). Conclusion: Heparin at both full and prophylactic dose is effective in reducing mortality in hospitalized COVID-19 patients, compared to no treatment. However, full dose was associated with an increased risk of bleeding. Systematic Review Registration: https://clinicaltrials.gov/, identifier CRD42020179955.
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Affiliation(s)
- Riccardo Giossi
- Postgraduate School of Clinical Pharmacology, Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Danilo Menichelli
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Arianna Pani
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Elena Tratta
- Postgraduate School of Clinical Pharmacology, Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Central Pharmacy, ASST Spedali Civili, Brescia, Italy
| | - Alessandra Romandini
- Postgraduate School of Clinical Pharmacology, Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Rossana Roncato
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Alessandro Nani
- Postgraduate School of Clinical Pharmacology, Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Paolo Schenardi
- Postgraduate School of Clinical Pharmacology, Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Erika Diani
- Postgraduate School of Clinical Pharmacology, Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Pharmacy Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | - Alessio Farcomeni
- Department of Economics and Finance, University of Rome “Tor Vergata”, Rome, Italy
| | - Francesco Scaglione
- Postgraduate School of Clinical Pharmacology, Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Department of Laboratory Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Daniele Pastori
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
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32
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Yong SJ. Diseased lungs may hinder COVID-19 development: A possible reason for the low prevalence of COPD in COVID-19 patients. Med Hypotheses 2021; 153:110628. [PMID: 34139599 PMCID: PMC8188770 DOI: 10.1016/j.mehy.2021.110628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 05/28/2021] [Accepted: 06/07/2021] [Indexed: 11/29/2022]
Abstract
Presently, it remains unclear why the prevalence of lung diseases, namely chronic obstructive pulmonary disease (COPD), is much lower than other medical comorbidities and the general population among patients with coronavirus disease 2019 (COVID-19). If COVID-19 is a respiratory disease, why is COPD not the leading risk factor for contracting COVID-19? The same odd phenomenon was also observed with other pathogenic human coronaviruses causing severe acute respiratory distress syndrome (SARS) and Middle East respiratory syndrome (MERS), but not other respiratory viral infections such as influenza and respiratory syncytial viruses. One commonly proposed reason for the low COPD rates among COVID-19 patients is the usage of inhaled corticosteroids or bronchodilators that may protect against COVID-19. However, another possible reason not discussed elsewhere is that lungs in a diseased state may not be conducive for the severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) to establish COVID-19. For one, COPD causes mucous plugging in large and small airways, which may hinder SARS-CoV-2 from reaching deeper parts of the lungs (i.e., alveoli). Thus, SARS-CoV-2 may only localize to the upper respiratory tract of persons with COPD, causing mild or asymptomatic infections requiring no hospital attention. Even if SARS-CoV-2 reaches the alveoli, cells therein are probably under a heavy burden of endoplasmic reticulum (ER) stress and extensively damaged where it may not support efficient viral replication. As a result, limited SARS-CoV-2 virions would be produced in diseased lungs, preventing the development of COVID-19.
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Affiliation(s)
- Shin Jie Yong
- Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, Selangor, Malaysia.
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33
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Cosio BG, Shafiek H, Toledo-Pons N, Iglesias A, Barcelo M, Represas-Represas C, Comeche L, Catalan P, Fernandez-Villar A, Lopez-Campos JL, Echave-Sustaeta J, Soler-Cataluna JJ. Characterization of COPD Admissions During the First COVID-19 Outbreak. Int J Chron Obstruct Pulmon Dis 2021; 16:1549-1554. [PMID: 34113088 PMCID: PMC8184145 DOI: 10.2147/copd.s312493] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/10/2021] [Indexed: 01/14/2023] Open
Abstract
Purpose Exacerbations of COPD (ECOPD) are a frequent cause of hospitalization that seemed to ameliorate during the COVID outbreak. We aimed to evaluate the clinical characteristics of COPD-related hospital admissions and mortality in relation to the presence of COVID-19. Patients and Methods We conducted a case-control study of patients admitted in four teaching hospitals throughout Spain between March 15 and April 30, 2020. Hospital admissions of respiratory cause with and without PCR-proven SARS-CoV-2 infection in patients with COPD were evaluated. Baseline and episode-related clinical characteristics were analyzed. Logistic regression analysis was performed to evaluate the risk for mortality. Results During the study period, 2101 patients were admitted for respiratory worsening, 1200 (57.1%) with COVID-19. A total of 228 (10.8%) were admitted due to COPD worsening, of whom 52 (22.8%) tested positive for COVID-19. COPD patients with COVID-19, when compared to those without COVID-19, were more frequently males with better lung function (FEV1 postbronchodilator 71% vs 46% respectively, p<0.001) and had higher mortality (44.9% vs 13.6% respectively, p<0.001) despite similar age, comorbidities, total days of hospitalization and admission to intensive care unit. COVID-19 and eosinopenia were the strongest risk factors for mortality in the multivariate analysis in the overall COPD population. Inhaled corticosteroid use was not associated to mortality. Conclusion Hospitalizations for ECOPD without COVID-19 were more frequent than COPD with COVID-19 during the first outbreak, but the latter were associated with higher mortality and low eosinophil counts that warrant further analysis.
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Affiliation(s)
- Borja G Cosio
- Respiratory Medicine, Hospital Universitario Son Espases-IdISBa, Palma de Mallorca, Spain.,CIBERES-IDISBa, Palma de Mallorca, Spain
| | - Hanaa Shafiek
- Respiratory Medicine, Hospital Universitario Son Espases-IdISBa, Palma de Mallorca, Spain.,Chest Diseases Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Nuria Toledo-Pons
- Respiratory Medicine, Hospital Universitario Son Espases-IdISBa, Palma de Mallorca, Spain.,CIBERES-IDISBa, Palma de Mallorca, Spain
| | - Amanda Iglesias
- Respiratory Medicine, Hospital Universitario Son Espases-IdISBa, Palma de Mallorca, Spain.,CIBERES-IDISBa, Palma de Mallorca, Spain
| | - Margalida Barcelo
- Respiratory Medicine, Hospital Universitario Son Espases-IdISBa, Palma de Mallorca, Spain
| | | | - Lorena Comeche
- Respiratory Medicine, Hospital Universitario Quironsalud Madrid, Madrid, Spain
| | - Pablo Catalan
- Respiratory Medicine, Hospital General de Castellón, Castellón, Spain
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Molecular Interactions of SARS-CoV-2 in Lung Tissue of Patients with Chronic Obstructive Pulmonary Disease. Ann Am Thorac Soc 2021; 18:1922-1924. [PMID: 33950792 PMCID: PMC8641835 DOI: 10.1513/annalsats.202006-619rl] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Can Prophylactic High Flow of Humidified and Warmed Filtered Air Improve Survival from Bacterial Pneumonia and SARS-CoV-2 in Elderly Individuals? The Role of Surfactant Protein A. Antioxidants (Basel) 2021; 10:antiox10050640. [PMID: 33922049 PMCID: PMC8143458 DOI: 10.3390/antiox10050640] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 12/12/2022] Open
Abstract
In this opinion article, we discuss a serendipitous observation we made in a study investigating survival in aged mice after bacterial infection. This observation involved a non-invasive ventilation approach that led to variable and higher survival in male and female mice with different genetic backgrounds for the innate immune molecule, surfactant protein A (SP-A). We suggest that employing the best ventilatory modality, whether that be HFNC or another method, may augment the role of other factors such as SP-A genetics and sex in a personalized approach, and may ultimately improve the outcome.
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Pre-existing atrial fibrillation is associated with increased mortality in COVID-19 Patients. J Interv Card Electrophysiol 2021; 62:231-238. [PMID: 33855639 PMCID: PMC8046494 DOI: 10.1007/s10840-021-00992-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 04/05/2021] [Indexed: 12/19/2022]
Abstract
Purpose The impacts of pre-existing atrial fibrillation (AF) on COVID-19-associated outcomes are unclear. We conducted a systematic review and meta-analysis to investigate the pooled prevalence of pre-existing AF and its short-term mortality risk in COVID-19 patients. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed in abstracting data and assessing validity. We searched MEDLINE and Scopus to locate all the articles published up to January 31, 2021, reporting data on pre-existing AF among COVID-19 survivors and non-survivors. The pooled prevalence of pre-existing AF was calculated using a random effects model and presenting the related 95% confidence interval (CI), while the mortality risk was estimated using the Mantel-Haenszel random effects models with odds ratio (OR) and related 95% CI. Statistical heterogeneity was measured using the Higgins I2 statistic. Results Twelve studies, enrolling 15.562 COVID-19 patients (mean age 71.6 years), met the inclusion criteria and were included in the final analysis. The pooled prevalence of pre-existing AF was 11.0% of cases (95% CI: 7.8–15.2%, p < 0.0001) with high heterogeneity (I2 = 95.2%). Pre-existing AF was associated with higher risk of short-term death (OR 2.22, 95% CI 1.47–3.36, p < 0.0001), with high heterogeneity (I2 = 79.1%). Conclusion Pre-existing AF is present in about 11% of COVID-19 cases but results associated with an increased risk of short-term mortality. Supplementary Information The online version contains supplementary material available at 10.1007/s10840-021-00992-2.
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Solaro RJ, Rosas PC, Langa P, Warren CM, Wolska BM, Goldspink PH. Mechanisms of troponin release into serum in cardiac injury associated with COVID-19 patients. INTERNATIONAL JOURNAL OF CARDIOLOGY AND CARDIOVASCULAR DISEASES 2021; 1:41-47. [PMID: 34734211 PMCID: PMC8562719 DOI: 10.46439/cardiology.1.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Serum levels of thin filament proteins, cardiac troponin T (cTnT) and cardiac troponin I (cTnI) employing high sensitivity antibodies provide a state-of-the art determination of cardiac myocyte injury in COVID-19 patients. Although there is now sufficient evidence of the value of these determinations in patients infected with SARS-CoV-2, mechanisms of their release have not been considered in depth. We summarize the importance of these mechanisms with emphasis on their relation to prognosis, stratification, and treatment of COVID-19 patients. Apart from frank necrotic cell death, there are other mechanisms of myocyte injury leading to membrane fragility that provoke release of cTnT and cTnI. We discuss a rationale for understanding these mechanisms in COVID-19 patients with co-morbidities associated with myocyte injury such as heart failure, hypertension, arrythmias, diabetes, and inflammation. We describe how understanding these significant aspects of these mechanisms in the promotion of angiotensin signaling by SARS-CoV-2 can affect treatment options in the context of individualized therapies. Moreover, with likely omic data related to serum troponins and with the identification of elevations of serum troponins now more broadly detected employing high sensitivity antibodies, we think it is important to consider molecular mechanisms of elevations in serum troponin as an element in clinical decisions and as a critical aspect of development of new therapies.
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Affiliation(s)
- R. John Solaro
- Department of Physiology and Biophysics, University of Illinois at Chicago, Chicago, IL, USA
- Center for Cardiovascular Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Paola C. Rosas
- Department of Physiology and Biophysics, University of Illinois at Chicago, Chicago, IL, USA
- Center for Cardiovascular Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Paulina Langa
- Department of Physiology and Biophysics, University of Illinois at Chicago, Chicago, IL, USA
- Center for Cardiovascular Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Chad M. Warren
- Department of Physiology and Biophysics, University of Illinois at Chicago, Chicago, IL, USA
- Center for Cardiovascular Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Beata M. Wolska
- Department of Physiology and Biophysics, University of Illinois at Chicago, Chicago, IL, USA
- Center for Cardiovascular Research, University of Illinois at Chicago, Chicago, IL, USA
- Division of Cardiology, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Paul H. Goldspink
- Department of Physiology and Biophysics, University of Illinois at Chicago, Chicago, IL, USA
- Center for Cardiovascular Research, University of Illinois at Chicago, Chicago, IL, USA
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Yin T, Li Y, Ying Y, Luo Z. Prevalence of comorbidity in Chinese patients with COVID-19: systematic review and meta-analysis of risk factors. BMC Infect Dis 2021; 21:200. [PMID: 33618678 PMCID: PMC7897883 DOI: 10.1186/s12879-021-05915-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 02/09/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is an infectious disease characterized by cough, fever, and fatigue and 20% of cases will develop into severe conditions resulting from acute lung injury with the manifestation of the acute respiratory distress syndrome (ARDS) that accounts for more than 50% of mortality. Currently, it has been reported that some comorbidities are linked with an increased rate of severity and mortality among COVID-19 patients. To assess the role of comorbidity in COVID-19 progression, we performed a systematic review with a meta-analysis on the relationship of COVID-19 severity with 8 different underlying diseases. METHODS PubMed, Web of Science, and CNKI were searched for articles investigating the prevalence of comorbidities in severe and non-severe COVID-19 patients. A total of 41 studies comprising 12,526 patients were included. RESULTS Prevalence of some commodities was lower than that in general population such as hypertension (19% vs 23.2%), diabetes (9% vs 10.9%), chronic kidney disease (CKD) (2% vs 9.5%), chronic liver diseases (CLD) (3% vs 24.8%) and chronic obstructive pulmonary disease (COPD) (3% vs 8.6%), while some others including cancer (1% vs 0.6%), cardiovascular disease (6% vs 1.8%) and cerebrovascular disease (2% vs 0.9%) exhibited greater percentage in COVID-19. Cerebrovascular disease (OR = 3.70, 95%CI 2.51-5.45) was found to be the strongest risk factor in disease exacerbation, followed by CKD (OR = 3.60, 95%CI 2.18-5.94), COPD (OR = 3.14, 95% CI 2.35-4.19), cardiovascular disease (OR = 2.76, 95% CI 2.18-3.49), malignancy (OR = 2.63, 95% CI 1.75-3.95), diabetes (OR = 2.49, 95% CI 2.10-2.96) and hypertension (OR = 2.13, 95% CI 1.81-2.51). We found no correlation between CLD and increased disease severity (OR = 1.32, 95% CI 0.96-1.82). CONCLUSION The impact of all eight underlying diseases on COVID-19 deterioration seemed to be higher in patients outside Hubei. Based on different comorbidities, COVID-19 patients tend to be at risk of developing poor outcomes to a varying degree. Thus, tailored infection prevention and monitoring and treatment strategies targeting these high-risk subgroups might improve prognosis during the COVID-19 pandemic.
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Affiliation(s)
- Tingxuan Yin
- Queen Mary School, Nanchang University, Nanchang, Jiangxi, China
| | - Yuanjun Li
- Jiangxi Province Key Laboratory of Tumor Pathogenesis and Molecular Pathology and Department of Pathophysiology, School of Basic Medical Sciences, Nanchang University, Nanchang, Jiangxi, China
| | - Ying Ying
- Jiangxi Province Key Laboratory of Tumor Pathogenesis and Molecular Pathology and Department of Pathophysiology, School of Basic Medical Sciences, Nanchang University, Nanchang, Jiangxi, China
| | - Zhijun Luo
- Queen Mary School, Nanchang University, Nanchang, Jiangxi, China. .,Jiangxi Province Key Laboratory of Tumor Pathogenesis and Molecular Pathology and Department of Pathophysiology, School of Basic Medical Sciences, Nanchang University, Nanchang, Jiangxi, China.
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