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Haber R, Ghezzawi M, Puzantian H, Haber M, Saad S, Ghandour Y, El Bachour J, Yazbeck A, Hassanieh G, Mehdi C, Ismail D, Abi-Kharma E, El-Zein O, Khamis A, Chakhtoura M, Mantzoros C. Mortality risk in patients with obesity and COVID-19 infection: a systematic review and meta-analysis. Metabolism 2024; 155:155812. [PMID: 38360130 DOI: 10.1016/j.metabol.2024.155812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 01/13/2024] [Accepted: 01/29/2024] [Indexed: 02/17/2024]
Abstract
Obesity is a risk factor for severe respiratory diseases, including COVID-19 infection. Meta-analyses on mortality risk were inconsistent. We systematically searched 3 databases (Medline, Embase, CINAHL) and assessed the quality of studies using the Newcastle-Ottawa tool (CRD42020220140). We included 199 studies from US and Europe, with a mean age of participants 41.8-78.2 years, and a variable prevalence of metabolic co-morbidities of 20-80 %. Exceptionally, one third of the studies had a low prevalence of obesity of <20 %. Compared to patients with normal weight, those with obesity had a 34 % relative increase in the odds of mortality (p-value 0.002), with a dose-dependent relationship. Subgroup analyses showed an interaction with the country income. There was a high heterogeneity in the results, explained by clinical and methodologic variability across studies. We identified one trial only comparing mortality rate in vaccinated compared to unvaccinated patients with obesity; there was a trend for a lower mortality in the former group. Mortality risk in COVID-19 infection increases in parallel to an increase in BMI. BMI should be included in the predictive models and stratification scores used when considering mortality as an outcome in patients with COVID-19 infections. Furthermore, patients with obesity might need to be prioritized for COVID-19 vaccination.
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Affiliation(s)
- Rachelle Haber
- Department of Internal Medicine, Division of Endocrinology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Malak Ghezzawi
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Houry Puzantian
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon; Hariri School of Nursing, American University of Beirut, Beirut, Lebanon.
| | - Marc Haber
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Sacha Saad
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Yara Ghandour
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | | | - Anthony Yazbeck
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | | | - Celine Mehdi
- Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
| | - Dima Ismail
- Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
| | - Elias Abi-Kharma
- Department of Internal Medicine, Division of Endocrinology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ola El-Zein
- Saab Medical Library, American University of Beirut, Beirut, Lebanon
| | - Assem Khamis
- Hull York Medical School, University of Hull, York, United Kingdom
| | - Marlene Chakhtoura
- Department of Internal Medicine, Division of Endocrinology, American University of Beirut Medical Center, Beirut, Lebanon.
| | - Christos Mantzoros
- Beth Israel Deaconess Medical Center and Boston VA Healthcare System, Harvard Medical School, Boston, MA, USA
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Pilipovic Broceta N, Todorovic N, Skrbic R, Acimovic J, Strbac S, Soldatovic I. Clinical and epidemiological risk factors associated with hospitalization and mortality rate of COVID-19 patients in Banja Luka County: A retrospective observational cohort study on 40,000 patients. J Family Med Prim Care 2024; 13:2130-2137. [PMID: 38948596 PMCID: PMC11213400 DOI: 10.4103/jfmpc.jfmpc_1641_23] [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: 10/06/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 07/02/2024] Open
Abstract
Context Since beginning of the coronavirus disease (COVID-19) it became clear that severe forms of this infection have primarily affected patients with chronic conditions. Aims The aim of the study was to explore clinical and epidemiological characteristics associated with COVID 19 outcomes. Settings and Design The retrospective observational study included 40,692 citizens of Banja Luka County, Bosnia and Herzegovina, who were confirmed as reverse transcriptase polymerase chain reaction (RT-PCR) positive on COVID-19 at a primary healthcare centre from March 2020 to September 2022. Methods and Materials Epidemiological data were obtained from Web-Medic medical records of patients. The COVID-19 data were obtained from COVID-19 data sheets comprised of patients' RT-PCR testing forms, surveillance forms for severe acute respiratory syndrome coronavirus-2 status, and a map of their positive and isolated contacts. Statistical Analysis Used Differences regarding the distributions of patients between groups were analysed using the Pearson chi-square test and Mantel-Haenszel chi-square test for trends, while differences in mean values were compared using an independent sample t-test. Results The average age of hospitalised patients was significantly higher compared to the age of non-hospitalised patients (P < 0.001). The average age of patients with lethal outcomes was nearly twice as high in comparison to patients with non-lethal outcomes (P < 0.001). Male patients had a higher hospitalization and mortality rate (P < 0.001). The highest hospitalization rate was in patients with chronic renal failure (CRF), diabetes and cardiovascular diseases (CVDs), while the death rate was the highest among patients with CRF and hearth comorbidities. Patients with fatigue and appetite loss had a higher percentage of lethal outcomes. Vaccinated patients had a significantly lower rate of lethal outcome. Conclusions Clinical symptoms, signs and outcomes, are posing as predictive parameters for further management of COVID-19. Vaccination has an important role in the clinical outcomes of COVID-19.
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Affiliation(s)
- Natasa Pilipovic Broceta
- Department of Family Medicine, Faculty of Medicine, University of Banja Luka, Banja Luka 78000, The Republic of Srpska, Bosnia and Herzegovina
- Family Medicine Teaching Centre, Primary Health Care Centre Banja Luka, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
| | - Nevena Todorovic
- Department of Family Medicine, Faculty of Medicine, University of Banja Luka, Banja Luka 78000, The Republic of Srpska, Bosnia and Herzegovina
- Family Medicine Teaching Centre, Primary Health Care Centre Banja Luka, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
| | - Ranko Skrbic
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Banja Luka, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
| | - Jela Acimovic
- Department of Epidemiology, Public Health Institute of the Republic of Srpska, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
| | - Savka Strbac
- Department of Epidemiology, Public Health Institute of the Republic of Srpska, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
| | - Ivan Soldatovic
- Institute of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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Rahbeni TA, Satapathy P, Itumalla R, Marzo RR, Mugheed KAL, Khatib MN, Gaidhane S, Zahiruddin QS, Rabaan AA, Alrasheed HA, Al-Subaie MF, Al Kaabil NA, Alissa M, Ibrahim AAAL, Alsaif HA, Naser IH, Rustagi S, Kukreti N, Dziedzic A. COVID-19 Vaccine Hesitancy: Umbrella Review of Systematic Reviews and Meta-Analysis. JMIR Public Health Surveill 2024; 10:e54769. [PMID: 38687992 PMCID: PMC11062401 DOI: 10.2196/54769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/16/2024] [Accepted: 01/22/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND The unprecedented emergence of the COVID-19 pandemic necessitated the development and global distribution of vaccines, making the understanding of global vaccine acceptance and hesitancy crucial to overcoming barriers to vaccination and achieving widespread immunization. OBJECTIVE This umbrella review synthesizes findings from systematic reviews and meta-analyses to provide insights into global perceptions on COVID-19 vaccine acceptance and hesitancy across diverse populations and regions. METHODS We conducted a literature search across major databases to identify systematic reviews and meta-analysis that reported COVID-19 vaccine acceptance and hesitancy. The AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews) criteria were used to assess the methodological quality of included systematic reviews. Meta-analysis was performed using STATA 17 with a random effect model. The data synthesis is presented in a table format and via a narrative. RESULTS Our inclusion criteria were met by 78 meta-analyses published between 2021 and 2023. Our analysis revealed a moderate vaccine acceptance rate of 63% (95% CI 0.60%-0.67%) in the general population, with significant heterogeneity (I2 = 97.59%). Higher acceptance rates were observed among health care workers and individuals with chronic diseases, at 64% (95% CI 0.57%-0.71%) and 69% (95% CI 0.61%-0.76%), respectively. However, lower acceptance was noted among pregnant women, at 48% (95% CI 0.42%-0.53%), and parents consenting for their children, at 61.29% (95% CI 0.56%-0.67%). The pooled vaccine hesitancy rate was 32% (95% CI 0.25%-0.39%) in the general population. The quality assessment revealed 19 high-quality, 38 moderate-quality, 15 low-quality, and 6 critically low-quality meta-analyses. CONCLUSIONS This review revealed the presence of vaccine hesitancy globally, emphasizing the necessity for population-specific, culturally sensitive interventions and clear, credible information dissemination to foster vaccine acceptance. The observed disparities accentuate the need for continuous research to understand evolving vaccine perceptions and to address the unique concerns and needs of diverse populations, thereby aiding in the formulation of effective and inclusive vaccination strategies. TRIAL REGISTRATION PROSPERO CRD42023468363; https://tinyurl.com/2p9kv9cr.
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Affiliation(s)
- Tahani Al Rahbeni
- Molecular Toxicology and Genetics, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Prakasini Satapathy
- Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | | | - Roy Rillera Marzo
- Faculty of Humanities and Health Sciences, Curtin University, Miri Sarawak, Malaysia
| | - Khalid A L Mugheed
- Molecular Toxicology and Genetics, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Mahalaqua Nazli Khatib
- Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India
| | - Shilpa Gaidhane
- One Health Centre (COHERD), Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education, Wardha, India
| | - Quazi Syed Zahiruddin
- South Asia Infant Feeding Research Network, Division of Evidence Synthesis, School of Epidemiology and Public Health and Research, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, India
| | - Ali A Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- Department of Public Health and Nutrition, The University of Haripur, Haripur, Pakistan
| | - Hayam A Alrasheed
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Maha F Al-Subaie
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
- Research Center, Dr Sulaiman Alhabib Medical Group, Riyadh, Saudi Arabia
| | - Nawal A Al Kaabil
- College of Medicine and Health Science, Khalifa University, Abu Dhabi, United Arab Emirates
- Sheikh Khalifa Medical City, Abu Dhabi Health Services Company (SEHA), Abu Dhabi, United Arab Emirates
| | - Mohammed Alissa
- Department of Medical Laboratory, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | | | | | - Israa Habeeb Naser
- Medical Laboratories Techniques Department, AL-Mustaqbal University, Babil, Iraq
| | - Sarvesh Rustagi
- School of Applied and Life Sciences, Uttaranchal University, Dehradun, India
| | - Neelima Kukreti
- School of Pharmacy, Graphic Era Hill University, Dehradun, India
| | - Arkadiusz Dziedzic
- Department of Conservative Dentistry with Endodontics, Medical University of Silesia, Katowice, Poland
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Zhang S, Li J, Xu R, Chen Q, Sun G, Lin Y, Cao Y, Chen Y, Geng C, Teng Y, Nie J, Li X, Xu G, Liu X, Jin F, Fan Z, Luo T, Liu H, Wang FS, Jiang Z. Safety of COVID-19 Vaccination in Patients With Breast Cancer: Cross-Sectional Study in China. JMIR Public Health Surveill 2023; 9:e46009. [PMID: 38060302 PMCID: PMC10739232 DOI: 10.2196/46009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 07/26/2023] [Accepted: 10/31/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND The widespread use of vaccines against the novel coronavirus disease (COVID-19) has become one of the most effective means to establish a population immune barrier. Patients with cancer are vulnerable to COVID-19 infection, adverse events, and high mortality, and should be the focus of epidemic prevention and treatment. However, real-world data on the safety of vaccines for patients with breast cancer are still scarce. OBJECTIVE This study aims to compare the safety of COVID-19 vaccines between patients vaccinated before or after being diagnosed with breast cancer. METHODS Patients with breast cancer who sought medical advice from October 2021 to December 2021 were screened. Those who received COVID-19 vaccines were enrolled in this study to analyze the safety of the vaccines. The primary outcome was patient-reported adverse events (AEs). All events after vaccine injection were retrospectively documented from the patients. RESULTS A total of 15,455 patients with breast cancer from 41 hospitals in 20 provinces in China were screened, and 5766 patients who received COVID-19 vaccines were enrolled. Of those enrolled, 45.1% (n=2599) of patients received vaccines before breast cancer diagnosis, 41.3% (n=2379) were vaccinated after diagnosis, and 13.6% (n=784) did not known the accurate date of vaccination or cancer diagnosis. Among the patients vaccinated after diagnosis, 85.4% (n=2032) were vaccinated 1 year after cancer diagnosis and 95.4% (n=2270) were vaccinated during early-stage cancer. Of all 5766 vaccinated patients, 93.9% (n=5415) received an inactivated vaccine, 3.7% (n=213) received a recombinant subunit vaccine, and 2.4% (n=138) received other vaccines, including adenovirus and mRNA vaccines. In the first injection of vaccines, 24.4% (n=10, 95% CI 11.2-37.5) of patients who received an adenovirus vaccine reported AEs, compared to only 12.5% (n=677, 95% CI 11.6-13.4) of those who received an inactivated vaccine. Patients with metastatic breast cancer reported the highest incidence of AEs (n=18, 16.5%, 95% CI 9.5-23.5). Following the second injection, patients who received an inactivated vaccine (n=464, 8.7%, 95% CI 8.0-9.5) and those who received a recombinant vaccine (n=25, 8.7%, 95% CI 5.5-12.0) reported the same incidence of AEs. No significant differences in patient-reported AEs were found between the healthy population and patients with breast cancer (16.4% vs 16.9%, respectively); the most common AEs were local pain (11.1% vs 9.1%, respectively), fatigue (5.5% vs 6.3%, respectively), and muscle soreness (2.3% vs 3.6%, respectively). The type of vaccine and time window of vaccination had little impact on patient-reported AEs. CONCLUSIONS Compared with patients vaccinated before breast cancer diagnosis, there were no significant differences in patient-reported AEs in the patients vaccinated after diagnosis. Thus, it is safe for patients with breast cancer, especially for those in the early stage, to receive COVID-19 vaccines. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2200055509; https://tinyurl.com/33zzj882.
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Affiliation(s)
- Shaohua Zhang
- Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Jianbin Li
- Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
- Beijing Institute of Biotechnology, Academy of Military Medical Sciences, Beijing, China
| | - Ruonan Xu
- Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Qianjun Chen
- Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangdong, China
| | - Gang Sun
- Cancer Hospital Affiliated to Xinjiang Medical University, Xinjiang, China
| | - Ying Lin
- The First Affiliated Hospital of Sun Yat-sen University, Guangdong, China
| | - Yali Cao
- Nanchang Third Hospital, Jiangxi, China
| | - Yiding Chen
- The Second Affiliated Hospital of Medical College of Zhejiang University, Zhejiang, China
| | - Cuizhi Geng
- Fourth Hospital of Hebei Medical University, Hebei, China
| | - Yuee Teng
- The First Hospital of China Medical University, Liaoning, China
| | | | | | | | - Xinlan Liu
- General Hospital of Ningxia Medical University, Ningxia, China
| | - Feng Jin
- The First Hospital of China Medical University, Liaoning, China
| | - Zhimin Fan
- The First Hospital of Jilin University, Jilin, China
| | - Ting Luo
- Sichuan Uniersity Huaxi Campus, Sichuan, China
| | - Hong Liu
- Tumor Hospital of Tianjin Medical University, Tianjin, China
| | - Fu-Sheng Wang
- Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Zefei Jiang
- Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
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Chenchula S, Sharma S, Tripathi M, Chavan M, Misra AK, Rangari G. Prevalence of overweight and obesity and their effect on COVID-19 severity and hospitalization among younger than 50 years versus older than 50 years population: A systematic review and meta-analysis. Obes Rev 2023; 24:e13616. [PMID: 37574901 DOI: 10.1111/obr.13616] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/14/2023] [Indexed: 08/15/2023]
Abstract
Cohort studies have shown that both overweight and obesity have their impact by increasing hospitalization with COVID-19. We conducted a systematic literature search in PubMed, Google Scholar, and MedRxiv databases following the PRISMA guidelines. Statistical analyses were performed using STATA software version 16 MP (Stata Corp, College Station, TX, USA) and Med Calc software version 22.009(Med Calc software Ltd, Ostend, Belgium). The primary outcome was to measure the prevalence of overweight and obesity and their impact on the risk of hospitalization among COVID-19 patients under and above 50 years of age. In total, 184 studies involving 2,365,377 patients were included. The prevalence of overweight was highest among those younger than 50 years of age over those older than 50 years of age, (26.33% vs. 30.46%), but there was no difference in obesity (36.30% vs. 36.02%). Overall, the pooled prevalence of overweight and obesity among hospitalized COVID-19 patients was 31.0% and 36.26%, respectively. Compared with normal weight, the odds of hospitalization with overweight (odds ratio [OR] 2.186, 95% confidence interval [CI] [1.19, 3.99], p < 0.01) and obesity (OR 3.069, 95% CI [1.67, 5.61], p < 0.001) in those younger than 50 years and obesity (OR 3.977, 95% CI [2.75, 5.73], p < 0.001) in the older than 50 years age group were significantly high. The increased prevalence of overweight and obesity among the under 50 years age group and obesity among the older than 50 years age group significantly increased the rate of COVID-19 infections, severity and hospitalization.
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Affiliation(s)
- Santenna Chenchula
- Department of Pharmacology, All India Institute of Medical Sciences, Mangalagiri, India
| | - Sushil Sharma
- Department of Pharmacology, All India Institute of Medical Sciences, Mangalagiri, India
| | - Mukesh Tripathi
- Department of Anaesthesia and Critical care Medicine, All India Institute of Medical Sciences, Mangalagiri, India
| | - Madhavrao Chavan
- Department of Pharmacology, All India Institute of Medical Sciences, Mangalagiri, India
| | - Arup Kumar Misra
- Department of Pharmacology, All India Institute of Medical Sciences, Mangalagiri, India
| | - Gaurav Rangari
- Department of Pharmacology, All India Institute of Medical Sciences, Mangalagiri, India
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Chenchula S, Vidyasagar K, Pathan S, Sharma S, Chavan MR, Bhagavathula AS, Padmavathi R, Manjula M, Chhabra M, Gupta R, Amerneni KC, Ghanta MK, Mudda S. Global prevalence and effect of comorbidities and smoking status on severity and mortality of COVID-19 in association with age and gender: a systematic review, meta-analysis and meta-regression. Sci Rep 2023; 13:6415. [PMID: 37076543 PMCID: PMC10115382 DOI: 10.1038/s41598-023-33314-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 04/11/2023] [Indexed: 04/21/2023] Open
Abstract
A COVID-19 patient often presents with multiple comorbidities and is associated with adverse outcomes. A comprehensive assessment of the prevalence of comorbidities in patients with COVID-19 is essential. This study aimed to assess the prevalence of comorbidities, severity and mortality with regard to geographic region, age, gender and smoking status in patients with COVID-19. A systematic review and multistage meta-analyses were reported using PRISMA guidelines. PubMed/MEDLINE, SCOPUS, Google Scholar and EMBASE were searched from January 2020 to October 2022. Cross-sectional studies, cohort studies, case series studies, and case-control studies on comorbidities reporting among the COVID-19 populations that were published in English were included. The pooled prevalence of various medical conditions in COVID-19 patients was calculated based on regional population size weights. Stratified analyses were performed to understand the variations in the medical conditions based on age, gender, and geographic region. A total of 190 studies comprising 105 million COVID-19 patients were included. Statistical analyses were performed using STATA software, version 16 MP (StataCorp, College Station, TX). Meta-analysis of proportion was performed to obtain pooled values of the prevalence of medical comorbidities: hypertension (39%, 95% CI 36-42, n = 170 studies), obesity (27%, 95% CI 25-30%, n = 169 studies), diabetes (27%, 95% CI 25-30%, n = 175), and asthma (8%, 95% CI 7-9%, n = 112). Moreover, the prevalence of hospitalization was 35% (95% CI 29-41%, n = 61), intensive care admissions 17% (95% CI 14-21, n = 106), and mortality 18% (95% CI 16-21%, n = 145). The prevalence of hypertension was highest in Europe at 44% (95% CI 39-47%, n = 68), obesity and diabetes at 30% (95% CI, 26-34, n = 79) and 27% (95%CI, 24-30, n = 80) in North America, and asthma in Europe at 9% (95% CI 8-11, n = 41). Obesity was high among the ≥ 50 years (30%, n = 112) age group, diabetes among Men (26%, n = 124) and observational studies reported higher mortality than case-control studies (19% vs. 14%). Random effects meta-regression found a significant association between age and diabetes (p < 0.001), hypertension (p < 0.001), asthma (p < 0.05), ICU admission (p < 0.05) and mortality (p < 0.001). Overall, a higher global prevalence of hypertension (39%) and a lower prevalence of asthma (8%), and 18% of mortality were found in patients with COVID-19. Hence, geographical regions with respective chronic medical comorbidities should accelerate regular booster dose vaccination, preferably to those patients with chronic comorbidities, to prevent and lower the severity and mortality of COVID-19 disease with novel SARS-CoV-2 variants of concern (VOC).
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Affiliation(s)
- Santenna Chenchula
- Department of Pharmacology, All India Institute of Medical Sciences (AIIMS), Mangalagiri, Andhra Pradesh, 522503, India.
| | - Kota Vidyasagar
- Department of Pharmaceutical Sciences, University College of Pharmaceutical Sciences (UCPSc), Hanmakonda, Telangana, India
| | - Saman Pathan
- Department of Pharmacology, All India Institute of Medical Sciences, Bhopal, India
| | - Sushil Sharma
- Department of Pharmacology, All India Institute of Medical Sciences (AIIMS), Mangalagiri, Andhra Pradesh, 522503, India
| | - Madhav Rao Chavan
- Department of Pharmacology, All India Institute of Medical Sciences (AIIMS), Mangalagiri, Andhra Pradesh, 522503, India
| | | | - R Padmavathi
- SVS Medical College and Hospital, Mahbubnagar, Telangana, India
| | - M Manjula
- Balaji College of Nursing, Tirupathi, Andhra Pradesh, India
| | - Manik Chhabra
- Department of Pharmacy Practice, Indo-Soviet Friendship College of Pharmacy, Moga, India
| | - Rupesh Gupta
- Department of Internal Medicine, GMC, Shahdol, Madhya Pradesh, India
| | | | | | - Sofia Mudda
- Department of AYUSH, All India Institute of Medical Sciences, Bhopal, India
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Massó M, Granés L, Cayuelas L, Gené-Badia J, Sequeira E, Catalán M. Predictive factors for hospitalization in a cohort of primary healthcare patients with suspected COVID-19. ATENCIÓN PRIMARIA PRÁCTICA 2023. [PMCID: PMC9841078 DOI: 10.1016/j.appr.2023.100168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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8
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Oliván-Blázquez B, Bartolomé-Moreno C, Gericó-Aseguinolaza J, Méndez-López F, Lerma-Irureta D, Lamiquiz-Moneo I, Fernández-Martínez S, Magallón-Botaya R. Relationship between initial symptoms and the prognosis, sex, and demographic area of patients with COVID-19. Front Med (Lausanne) 2022; 9:1040062. [PMID: 36590935 PMCID: PMC9795186 DOI: 10.3389/fmed.2022.1040062] [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: 09/08/2022] [Accepted: 11/21/2022] [Indexed: 12/15/2022] Open
Abstract
Background A method of determining the initial symptoms and main prognostic identifiers for COVID-19 can be a key tool for physicians, especially primary care physicians. Therefore, the objective of this study was to examine the prognosis of patients with COVID-19 from two different demographic regions according to baseline and main symptoms, age, and sex. Methods All individuals selected from both urban and rural health centers were over 18 years of age, had COVID-19 before 2 March 2021, and were followed up with a primary care physician. All patients included in this study were recruited in terms of sex, age at the time of infection, type of contact, baseline symptoms, primary and secondary symptomatology, emergency assistance, hospitalization, intensive care unit (ICU) admission, and death. Results A total of 219 and 214 subjects were recruited from rural and urban health centers, respectively. Subjects with COVID-19 from rural areas were significantly older in age, with a higher proportion of men, and had significantly lower baseline and main symptoms than those from urban areas. In addition, the presence of both fever and dyspnea as the initial or main symptom is significantly associated with emergency assistance, hospitalization, and death, regardless of sex, age, and demographic area. This type of illness was reported to be significantly less frequent in the rural population than in the urban population. Conclusion The presence of both fever and dyspnea as both initial and main symptoms is a poor prognostic factor for COVID-19, regardless of age, sex, and demographic areas. In addition, women reported lower levels of fever and dyspnea, requiring minimal emergency assistance and fewer hospitalization, and a lower rate of mortality than men. During a COVID-19 infection follow-up, subjects in rural areas seem to have less access to medical care than those in urban areas.
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Affiliation(s)
- Bárbara Oliván-Blázquez
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain,Group B21-20R, Health Research Institute of Aragon (IISA), Zaragoza, Spain,Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS) RD21/0016/0001, Zaragoza, Spain
| | - Cruz Bartolomé-Moreno
- Group B21-20R, Health Research Institute of Aragon (IISA), Zaragoza, Spain,Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS) RD21/0016/0001, Zaragoza, Spain,Aragonese Healthcare Service, Zaragoza, Spain,Aragonese Healthcare Service, Department of Family and Community Care Teaching- Sector I, Zaragoza, Spain,*Correspondence: Cruz Bartolomé-Moreno
| | | | - Fátima Méndez-López
- Group B21-20R, Health Research Institute of Aragon (IISA), Zaragoza, Spain,Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS) RD21/0016/0001, Zaragoza, Spain,Department of Medicine, Psychiatry and Dermatology, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain
| | - David Lerma-Irureta
- Department of Medicine, Psychiatry and Dermatology, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain
| | - Itziar Lamiquiz-Moneo
- Miguel Servet University Hospital, Health Research Institute of Aragon (IISA), Zaragoza, Spain,Department of Human Anatomy and Histology, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain
| | | | - Rosa Magallón-Botaya
- Group B21-20R, Health Research Institute of Aragon (IISA), Zaragoza, Spain,Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS) RD21/0016/0001, Zaragoza, Spain,Aragonese Healthcare Service, Zaragoza, Spain,Department of Medicine, Psychiatry and Dermatology, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain
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9
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Loader J, Taylor FC, Lampa E, Sundström J. Renin-Angiotensin Aldosterone System Inhibitors and COVID-19: A Systematic Review and Meta-Analysis Revealing Critical Bias Across a Body of Observational Research. J Am Heart Assoc 2022; 11:e025289. [PMID: 35624081 PMCID: PMC9238740 DOI: 10.1161/jaha.122.025289] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background Renin‐angiotensin aldosterone system (RAAS) inhibitor—COVID‐19 studies, observational in design, appear to use biased methods that can distort the interaction between RAAS inhibitor use and COVID‐19 risk. This study assessed the extent of bias in that research and reevaluated RAAS inhibitor—COVID‐19 associations in studies without critical risk of bias. Methods and Results Searches were performed in MEDLINE, EMBASE, and CINAHL databases (December 1, 2019 to October 21, 2021) identifying studies that compared the risk of infection and/or severe COVID‐19 outcomes between those using or not using RAAS inhibitors (ie, angiotensin‐converting enzyme inhibitors or angiotensin II type‐I receptor blockers). Weighted hazard ratios (HR) and 95% CIs were extracted and pooled in fixed‐effects meta‐analyses, only from studies without critical risk of bias that assessed severe COVID‐19 outcomes. Of 169 relevant studies, 164 had critical risks of bias and were excluded. Ultimately, only two studies presented data relevant to the meta‐analysis. In 1 351 633 people with uncomplicated hypertension using a RAAS inhibitor, calcium channel blocker, or thiazide diuretic in monotherapy, the risk of hospitalization (angiotensin‐converting enzyme inhibitor: HR, 0.76; 95% CI, 0.66–0.87; P<0.001; angiotensin II type‐I receptor blockers: HR, 0.86; 95% CI, 0.77–0.97; P=0.015) and intubation or death (angiotensin‐converting enzyme inhibitor: HR, 0.64; 95% CI, 0.48–0.85; P=0.002; angiotensin II type‐I receptor blockers: HR, 0.74; 95% CI, 0.58–0.95; P=0.019) with COVID‐19 was lower in those using a RAAS inhibitor. However, these protective effects are probably not clinically relevant. Conclusions This study reveals the critical risk of bias that exists across almost an entire body of COVID‐19 research, raising an important question: Were research methods and/or peer‐review processes temporarily weakened during the surge of COVID‐19 research or is this lack of rigor a systemic problem that also exists outside pandemic‐based research? Registration URL: www.crd.york.ac.uk/prospero/; Unique identifier: CRD42021237859.
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Affiliation(s)
- Jordan Loader
- Department of Medical Sciences Uppsala University Uppsala Sweden.,Inserm U1300 - HP2 CHU Grenoble Alpes Grenoble France
| | - Frances C Taylor
- Baker Heart and Diabetes Institute Melbourne Victoria Australia.,Mary MacKillop Institute for Health Research, Australian Catholic University Melbourne Victoria Australia
| | - Erik Lampa
- Department of Medical Sciences Uppsala University Uppsala Sweden
| | - Johan Sundström
- Department of Medical Sciences Uppsala University Uppsala Sweden.,The George Institute for Global Health University of New South Wales Sydney Australia
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10
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Degarege A, Naveed Z, Kabayundo J, Brett-Major D. Heterogeneity and Risk of Bias in Studies Examining Risk Factors for Severe Illness and Death in COVID-19: A Systematic Review and Meta-Analysis. Pathogens 2022; 11:563. [PMID: 35631084 PMCID: PMC9147100 DOI: 10.3390/pathogens11050563] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/02/2022] [Accepted: 05/05/2022] [Indexed: 02/07/2023] Open
Abstract
This systematic review and meta-analysis synthesized the evidence on the impacts of demographics and comorbidities on the clinical outcomes of COVID-19, as well as the sources of the heterogeneity and publication bias of the relevant studies. Two authors independently searched the literature from PubMed, Embase, Cochrane library, and CINAHL on 18 May 2021; removed duplicates; screened the titles, abstracts, and full texts by using criteria; and extracted data from the eligible articles. The variations among the studies were examined by using Cochrane, Q.; I2, and meta-regression. Out of 11,975 articles that were obtained from the databases and screened, 559 studies were abstracted, and then, where appropriate, were analyzed by meta-analysis (n = 542). COVID-19-related severe illness, admission to the ICU, and death were significantly correlated with comorbidities, male sex, and an age older than 60 or 65 years, although high heterogeneity was present in the pooled estimates. The study design, the study country, the sample size, and the year of publication contributed to this. There was publication bias among the studies that compared the odds of COVID-19-related deaths, severe illness, and admission to the ICU on the basis of the comorbidity status. While an older age and chronic diseases were shown to increase the risk of developing severe illness, admission to the ICU, and death among the COVID-19 patients in our analysis, a marked heterogeneity was present when linking the specific risks with the outcomes.
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Affiliation(s)
- Abraham Degarege
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA; (Z.N.); (J.K.); (D.B.-M.)
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11
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Alves-Cabratosa L, Comas-Cufí M, Blanch J, Martí-Lluch R, Ponjoan A, Castro-Guardiola A, Hurtado-Ganoza A, Pérez-Jaén A, Rexach-Fumaña M, Faixedas-Brunsoms D, Gispert-Ametller MA, Guell-Cargol A, Rodriguez-Batista M, Santaularia-Font F, Orriols R, Bonnin-Vilaplana M, Calderón López JC, Sabater-Talaverano G, Queralt Moles FX, Rodriguez-Requejo S, Avellana-Revuelta E, Balló E, Fages-Masmiquel E, Sirvent JM, Lorencio C, Morales-Pedrosa JM, Ortiz-Ballujera P, Ramos R. Individuals With SARS-CoV-2 Infection During the First and Second Waves in Catalonia, Spain: Retrospective Observational Study Using Daily Updated Data. JMIR Public Health Surveill 2022; 8:e30006. [PMID: 34797774 PMCID: PMC8734611 DOI: 10.2196/30006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 11/16/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND A description of individuals with SARS-CoV-2 infection comparing the first and second waves could help adapt health services to manage this highly transmissible infection. OBJECTIVE We aimed to describe the epidemiology of individuals with suspected SARS-CoV-2 infection, and the characteristics of patients with a positive test comparing the first and second waves in Catalonia, Spain. METHODS This study had 2 stages. First, we analyzed daily updated data on SARS-CoV-2 infection in individuals from Girona (Catalonia). Second, we compared 2 retrospective cohorts of patients with a positive reverse-transcription polymerase chain reaction or rapid antigen test for SARS-CoV-2. The severity of patients with a positive test was defined by their admission to hospital, admission to intermediate respiratory care, admission to the intensive care unit, or death. The first wave was from March 1, 2020, to June 24, 2020, and the second wave was from June 25, 2020, to December 8, 2020. RESULTS The numbers of tests and cases were lower in the first wave than in the second wave (26,096 tests and 3140 cases in the first wave versus 140,332 tests and 11,800 cases in the second wave), but the percentage of positive results was higher in the first wave than in the second wave (12.0% versus 8.4%). Among individuals with a positive diagnostic test, 818 needed hospitalization in the first wave and 680 in the second; however, the percentage of hospitalized individuals was higher in the first wave than in the second wave (26.1% versus 5.8%). The group that was not admitted to hospital included older people and those with a higher percentage of comorbidities in the first wave, whereas the characteristics of the groups admitted to hospital were more alike. CONCLUSIONS Screening systems for SARS-CoV-2 infection were scarce during the first wave, but were more adequate during the second wave, reflecting the usefulness of surveillance systems to detect a high number of asymptomatic infected individuals and their contacts, to help control this pandemic. The characteristics of individuals with SARS-CoV-2 infection in the first and second waves differed substantially; individuals in the first wave were older and had a worse health condition.
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Affiliation(s)
- Lia Alves-Cabratosa
- Vascular Health Research Group of Girona, Institut Universitari per a la Recerca en Atenció Primària Jordi Gol i Gurina, Girona, Spain
| | - Marc Comas-Cufí
- Vascular Health Research Group of Girona, Institut Universitari per a la Recerca en Atenció Primària Jordi Gol i Gurina, Girona, Spain
| | - Jordi Blanch
- Vascular Health Research Group of Girona, Institut Universitari per a la Recerca en Atenció Primària Jordi Gol i Gurina, Girona, Spain
| | - Ruth Martí-Lluch
- Vascular Health Research Group of Girona, Institut Universitari per a la Recerca en Atenció Primària Jordi Gol i Gurina, Girona, Spain
- Institut d'Investigació Biomèdica de Girona, Girona, Spain
| | - Anna Ponjoan
- Vascular Health Research Group of Girona, Institut Universitari per a la Recerca en Atenció Primària Jordi Gol i Gurina, Girona, Spain
- Institut d'Investigació Biomèdica de Girona, Girona, Spain
| | - Antoni Castro-Guardiola
- Institut d'Investigació Biomèdica de Girona, Girona, Spain
- Internal Medicine Department, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
- Department of Medical Sciences, University of Girona, Girona, Spain
| | - Abelardo Hurtado-Ganoza
- Institut d'Investigació Biomèdica de Girona, Girona, Spain
- Internal Medicine Department, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
| | - Ana Pérez-Jaén
- Internal Medicine Department, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
| | - Maria Rexach-Fumaña
- Institut d'Investigació Biomèdica de Girona, Girona, Spain
- Internal Medicine Department, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
| | - Delfi Faixedas-Brunsoms
- Technical Secretariat, Institut Assistència Sanitària, Girona, Spain
- Technical Secretariat, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
| | - Maria Angels Gispert-Ametller
- Department of Medical Sciences, University of Girona, Girona, Spain
- Emergency Department, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
| | - Anna Guell-Cargol
- Emergency Department, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
| | | | | | - Ramon Orriols
- Institut d'Investigació Biomèdica de Girona, Girona, Spain
- Department of Medical Sciences, University of Girona, Girona, Spain
- Pneumology Department, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
- Pneumology Department, Hospital Santa Caterina de Salt, Salt, Spain
- CIBER of Respiratory Diseases, Barcelona, Spain
| | - Marc Bonnin-Vilaplana
- Institut d'Investigació Biomèdica de Girona, Girona, Spain
- Department of Medical Sciences, University of Girona, Girona, Spain
- Pneumology Department, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
- Pneumology Department, Hospital Santa Caterina de Salt, Salt, Spain
| | - Juan Carlos Calderón López
- Institut d'Investigació Biomèdica de Girona, Girona, Spain
- Department of Medical Sciences, University of Girona, Girona, Spain
- Pneumology Department, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
- Pneumology Department, Hospital Santa Caterina de Salt, Salt, Spain
| | - Gladis Sabater-Talaverano
- Institut d'Investigació Biomèdica de Girona, Girona, Spain
- Department of Medical Sciences, University of Girona, Girona, Spain
- Pneumology Department, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
- Pneumology Department, Hospital Santa Caterina de Salt, Salt, Spain
| | | | - Sara Rodriguez-Requejo
- Atenció Primària, Institut Català de la Salut, Girona, Spain
- Atenció Primària, Institut d'Assistència Sanitària, Girona, Spain
| | - Esteve Avellana-Revuelta
- Atenció Primària, Institut Català de la Salut, Girona, Spain
- Atenció Primària, Institut d'Assistència Sanitària, Girona, Spain
| | - Elisabet Balló
- Department of Medical Sciences, University of Girona, Girona, Spain
- Atenció Primària, Institut Català de la Salut, Girona, Spain
| | | | - Josep-Maria Sirvent
- Intensive Care Department, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
| | - Carol Lorencio
- Intensive Care Department, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
| | | | | | - Rafel Ramos
- Vascular Health Research Group of Girona, Institut Universitari per a la Recerca en Atenció Primària Jordi Gol i Gurina, Girona, Spain
- Institut d'Investigació Biomèdica de Girona, Girona, Spain
- Department of Medical Sciences, University of Girona, Girona, Spain
- Atenció Primària, Institut Català de la Salut, Girona, Spain
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12
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Burgaña Agoües A, Serra Gallego M, Hernández Resa R, Joven Llorente B, Lloret Arabi M, Ortiz Rodriguez J, Puig Acebal H, Campos Hernández M, Caballero Ayala I, Pavón Calero P, Losilla Calle M, Bueno Nieto R, Oliver Messeguer L, Madridejos Mora R, Abellana Sangrà R, Perez-Porcuna TM. Risk Factors for COVID-19 Morbidity and Mortality in Institutionalised Elderly People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10221. [PMID: 34639522 PMCID: PMC8507792 DOI: 10.3390/ijerph181910221] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/13/2021] [Accepted: 09/22/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND SARS-CoV-2 has caused a high mortality in institutionalised individuals. There are very few studies on the involvement and the real impact of COVID-19 in nursing homes. This study analysed factors related to morbidity and mortality of COVID-19 in institutionalised elderly people. METHODS This cohort study included 842 individuals from 12 nursing homes in Sant Cugat del Vallès (Spain) from 15 March to 15 May 2020. We evaluated individual factors (demographic, dependence, clinical, and therapeutic) and those related to the nursing homes (size and staff) associated with infection and mortality by SARS-CoV-2. Infection was diagnosed by molecular biology test. RESULTS Of the 842 residents included in the analysis, 784 underwent a Polymerase Chain Reaction (PCR) test; 74.2% were women, the mean age was 87.1 years, and 11.1% died. The PCR test was positive in 44%. A total of 33.4% of the residents presented symptoms compatible with COVID-19 and of these, 80.9% were PCR-positive for SARS-CoV-2. Infection by SARS-CoV-2 among residents was associated with the rate of staff infected in the homes. Mortality by SARS-CoV-2 was related to male sex and a greater grade of dependence measured with the Barthel index. CONCLUSIONS SARS-Cov-2 infection in institutionalised people is associated with the infection rate in nursing home workers and mortality by SARS-Cov-2 with sex and greater dependency according to the Barthel index. Adequate management of nursing home staff and special attention to measures of infection control, especially of individuals with greater dependence, are keys for successful management of future pandemic situations.
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Affiliation(s)
- Ander Burgaña Agoües
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| | - Marta Serra Gallego
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| | - Raquel Hernández Resa
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| | - Beatriz Joven Llorente
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| | - Maria Lloret Arabi
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| | - Jessica Ortiz Rodriguez
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| | - Helena Puig Acebal
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| | - Mireia Campos Hernández
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| | - Itziar Caballero Ayala
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| | - Pedro Pavón Calero
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| | - Montserrat Losilla Calle
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| | - Rosario Bueno Nieto
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| | - Laura Oliver Messeguer
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| | - Rosa Madridejos Mora
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| | | | - Tomás M. Perez-Porcuna
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
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13
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Sars-Cov-2 Infection in Patients on Long-Term Treatment with Macrolides in Spain: A National Cross-Sectional Study. Antibiotics (Basel) 2021; 10:antibiotics10091039. [PMID: 34572621 PMCID: PMC8468207 DOI: 10.3390/antibiotics10091039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 08/12/2021] [Accepted: 08/20/2021] [Indexed: 12/27/2022] Open
Abstract
The aim of this study was to know the prevalence and severity of COVID-19 in patients treated with long-term macrolides and to describe the factors associated with worse outcomes. A cross-sectional study was conducted in Primary Care setting. Patients with macrolides dispensed continuously from 1 October 2019 to 31 March 2020, were considered. Main outcome: diagnosis of coronavirus disease-19 (COVID-19). Secondary outcomes: symptoms, severity, characteristics of patients, comorbidities, concomitant treatments. A total of 3057 patients met the inclusion criteria. Median age: 73 (64–81) years; 55% were men; 62% smokers/ex-smokers; 56% obese/overweight. Overall, 95% of patients had chronic respiratory diseases and four comorbidities as a median. Prevalence of COVID-19: 4.8%. This was in accordance with official data during the first wave of the pandemic. The most common symptoms were respiratory: shortness of breath, cough, and pneumonia. Additionally, 53% percent of patients had mild/moderate symptoms, 28% required hospital admission, and 19% died with COVID-19. The percentage of patients hospitalized and deaths were 2.6 and 5.8 times higher, respectively, in the COVID-19 group (p < 0.001). There was no evidence of a beneficial effect of long-term courses of macrolides in preventing SARS-CoV-2 infection or the progression to worse outcomes in old patients with underlying chronic respiratory diseases and a high burden of comorbidity.
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Loader J, Lampa E, Gustafsson S, Cars T, Sundström J. Renin-Angiotensin Aldosterone System Inhibitors in Primary Prevention and COVID-19. J Am Heart Assoc 2021; 10:e021154. [PMID: 34320843 PMCID: PMC8475700 DOI: 10.1161/jaha.120.021154] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Considering the widespread risk of collider bias and confounding by indication in previous research, the associations between renin‐angiotensin aldosterone system (RAAS) inhibitor use and COVID‐19 remain unknown. Accordingly, this study tested the hypothesis that RAAS inhibitors influence the summation effect of COVID‐19 and its progression to severe outcomes. Methods and Results This nationwide cohort study compared all residents of Sweden, without prior cardiovascular disease, in monotherapy (as of January 1, 2020) with a RAAS inhibitor to those using a calcium channel blocker or a thiazide diuretic. Comparative cohorts were balanced using machine‐learning‐derived propensity score methods. Of 165 355 people in the analysis (51% women), 367 were hospitalized or died with COVID‐19 (246 using a RAAS inhibitor versus 121 using a calcium channel blocker or thiazide diuretic; Cox proportional hazard ratio [HR], 0.97; 95% CI, 0.74–1.27). When each outcome was assessed separately, 335 people were hospitalized with COVID‐19 (HR, 0.92; 95% CI, 0.70–1.22), and 64 died with COVID‐19 (HR, 1.22; 95% CI, 0.68–2.19). The severity of COVID‐19 outcomes did not differ between those using a RAAS inhibitor and those using a calcium channel blocker or thiazide diuretic (ordered logistic regression odds ratio, 1.01; 95% CI, 0.89–1.14). Conclusions Despite potential limitations, this study is among the best available evidence that RAAS inhibitor use in primary prevention does not increase the risk of severe COVID‐19 outcomes; presenting strong data from which scientists and policy makers alike can base, with greater confidence, their current position on the safety of using RAAS inhibitors during the COVID‐19 pandemic.
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Affiliation(s)
- Jordan Loader
- Department of Medical Sciences Uppsala University Uppsala Sweden
| | - Erik Lampa
- Department of Medical Sciences Uppsala University Uppsala Sweden
| | | | - Thomas Cars
- Department of Medical Sciences Uppsala University Uppsala Sweden
| | - Johan Sundström
- Department of Medical Sciences Uppsala University Uppsala Sweden.,The George Institute for Global HealthUniversity of New South Wales Sydney NSW Australia
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15
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Yang H, Hou H, Liang X, Xu J, Wang Y. Lack of significant association between dyslipidemia and COVID-19 mortality. J Infect 2021; 82:276-316. [PMID: 33684401 PMCID: PMC7934672 DOI: 10.1016/j.jinf.2021.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 03/03/2021] [Indexed: 01/22/2023]
Affiliation(s)
- Haiyan Yang
- Department of Epidemiology, School of Public Health, Zhengzhou University, No. 100 of Science Avenue, Zhengzhou 450001, China.
| | - Hongjie Hou
- Department of Epidemiology, School of Public Health, Zhengzhou University, No. 100 of Science Avenue, Zhengzhou 450001, China
| | - Xuan Liang
- Department of Epidemiology, School of Public Health, Zhengzhou University, No. 100 of Science Avenue, Zhengzhou 450001, China
| | - Jie Xu
- Department of Epidemiology, School of Public Health, Zhengzhou University, No. 100 of Science Avenue, Zhengzhou 450001, China
| | - Yadong Wang
- Department of Toxicology, Henan Center for Disease Control and Prevention, Zhengzhou 450016, China
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Seidelman J, Fleece M, Bloom A, Lydon E, Yang W, Arnold C, Weber DJ, Okeke NL. Endogenous Candida endophthalmitis: Who is really at risk? J Infect 2021; 82:276-281. [PMID: 33412206 DOI: 10.1016/j.jinf.2020.12.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 12/26/2020] [Accepted: 12/31/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The Infectious Disease Society of America recommends that all patients with candidemia undergo a dilated retinal exam to exclude endogenous Candida endophthalmitis. Our objective was to determine if there are significant risk factors in candidemic patients for developing endogenous Candida endophthalmitis METHODS: We conducted a retrospective study of all candidemic patients at three academic medical centers between 2012 and 2017. We extracted risk factors for Candida endophthalmitis based on prior literature and compared them between patients with and without endophthalmitis. We then built a multivariate logistic regression model to assess which ones were significant. RESULTS We found 771 patients with candidemia. 120 (15.6%) of these patients were diagnosed with Candida endophthalmitis. In our logistic regression analysis, central venous catheter presence (OR 8.35), intravenous drug use (OR 4.76), immunosuppression (OR 2.40), total parenteral nutrition recipient (OR 2.28), race (OR 1.65), age (OR 1.02), and gender (OR 0.57) were risk factors for developing Candida endophthalmitis. Additionally, Candida albicans was more likely to result in Candida endophthalmitis (OR 1.86). CONCLUSIONS This cohort represents the largest study of risk factors for candidemic patients who developed endogenous Candida endophthalmitis. Based on our findings, clinicians should develop targeted and cost-effective strategies for endophthalmitis screening.
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Affiliation(s)
- Jessica Seidelman
- Duke University School of Medicine, Department of Infectious Disease, Box 102359, Durham, NC 27710, United States; Duke Center for Antimicrobial Stewardship and Infection Prevention, United States.
| | - Molly Fleece
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, United States
| | | | - Emily Lydon
- Duke University School of Medicine, United States
| | - Wesley Yang
- University of Virginia School of Medicine, United States
| | - Christopher Arnold
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, United States
| | - David J Weber
- Department of Epidemiology, University of North Carolina at Chapel Hill, United States; Department of Hospital Epidemiology, University of North Carolina Medical Center, United States
| | - Nwora Lance Okeke
- Duke University School of Medicine, Department of Infectious Disease, Box 102359, Durham, NC 27710, United States.
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