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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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Liu TL, Hsiao RC, Chou WJ, Yen CF. Prospective and Cross-Sectional Factors Predicting Caregiver Motivation to Vaccinate Children with Attention-Deficit/Hyperactivity Disorder against COVID-19: A Follow-Up Study. Vaccines (Basel) 2024; 12:450. [PMID: 38793701 PMCID: PMC11125857 DOI: 10.3390/vaccines12050450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 04/16/2024] [Accepted: 04/22/2024] [Indexed: 05/26/2024] Open
Abstract
Adolescents with attention-deficit/hyperactivity disorder (ADHD) have higher risks of contracting COVID-19 and worse outcomes compared with adolescents without ADHD. The most effective method of preventing infection is vaccination. This follow-up study explored the prospective and cross-sectional factors influencing caregiver willingness to vaccinate children with ADHD against COVID-19. Baseline data on caregiver demographics, affiliate stigma, parenting stress, emotional difficulties, beliefs regarding the causes of ADHD, and ADHD symptoms were collected prior to the outbreak of the COVID-19 pandemic in Taiwan. At follow-up, the study assessed caregiver willingness to vaccinate children with ADHD, the challenges caregivers faced in parenting during the pandemic, and ADHD symptoms. The results revealed that caregiver age at baseline was positively associated with a willingness to vaccinate children against COVID-19 at follow-up. By contrast, the belief that ADHD resulted from failures in parental discipline at baseline was negatively associated with caregiver willingness to vaccinate. Parenting challenges were also negatively associated with caregiver willingness to vaccinate. Therefore, the age of caregivers, beliefs about the causes of ADHD, and parenting challenges during the pandemic should be considered when developing interventions to enhance caregiver willingness to vaccinate children with ADHD.
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Affiliation(s)
- Tai-Ling Liu
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80754, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Ray C. Hsiao
- Department of Psychiatry, Seattle Children’s, Seattle, WA 98195, USA
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA 98105, USA
| | - Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung 83341, Taiwan
- School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80754, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
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3
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Hoang HTX, Yeung WF, Truong QTM, Le CT, Bui ATM, Bui QV, Le QTL, Quach LH. Sleep quality among non-hospitalized COVID-19 survivors: a national cross-sectional study. Front Public Health 2024; 11:1281012. [PMID: 38375096 PMCID: PMC10875106 DOI: 10.3389/fpubh.2023.1281012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/28/2023] [Indexed: 02/21/2024] Open
Abstract
Objectives Insomnia is a common symptom after COVID-19 infection; however, its current evidence was among hospitalized COVID-19 patients. This study aimed to assess the prevalence of insomnia and identify its association with depression and anxiety among non-hospitalized COVID-19 recovered population. Methods We conducted a cross-sectional online survey of 1,056 COVID-19 survivors within 6 months of initial COVID-19 infection and retrieved did not require hospitalization. The Insomnia Severity Index, and Depression Anxiety and Stress Scale-14 were used. Multivariate logistic regression was used to examine the associations between depressive and anxiety score, and participants' insomnia level. Results The prevalence of insomnia was 76.1%, and among those, 22.8% of participants scored for severe insomnia. One third of participants reported worse sleep quality, shorter sleep duration, and harder to fall asleep, half reported more awaken nights after COVID-19 infection. Participants with depressive (OR 3.45; 95%CI 1.87-6.34) or anxiety (OR 3.93; 95%CI 2.52-6.13) had significantly higher odds of developing insomnia. Other risk factors of insomnia included pre-existing chronic conditions and higher education level, while COVID-19 symptoms and duration were not significantly associated. Conclusion Our study highlights the substantial burden of insomnia among non-hospitalized COVID-19 survivors and the significant association of depression and anxiety on the development of this long-term effect of COVID-19. These findings underscore the need for comprehensive interventions that address both sychological and sleeping health in this population.
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Affiliation(s)
| | - Wing Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | | | - Cuc Thi Le
- Department of Nursing and Midwifery, Hanoi Medical University, Hanoi, Vietnam
- School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Anh Thi My Bui
- School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | | | | | - Linh Ha Quach
- Center for Ageing Research & Education, Duke-NUS Medical School, Singapore, Singapore
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Al Meslamani AZ. Strategies for reducing chronic disease burden during pandemics. Curr Med Res Opin 2024; 40:193-197. [PMID: 38095584 DOI: 10.1080/03007995.2023.2295410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Ahmad Z Al Meslamani
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates
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Shaheen A, Hamdan K, Allari R, Al-Bashaireh AM, Smadi AA, Amre H, Albqoor MA. Differences in Depression, Anxiety, and Stress in Relation to Changes in Living Conditions, Work Conditions, and Daily Life During the COVID-19 Pandemic in Jordan. SAGE Open Nurs 2024; 10:23779608241254221. [PMID: 38746074 PMCID: PMC11092552 DOI: 10.1177/23779608241254221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 01/20/2024] [Accepted: 04/24/2024] [Indexed: 05/16/2024] Open
Abstract
Introduction The COVID-19 pandemic was associated with numerous changes in daily life conditions that could affect the psychological response of individuals worldwide. Objective The study aimed to describe and examine differences in depression, anxiety, and stress in relation to living conditions during the COVID-19 pandemic. Methods A cross-sectional design was used. Purposive snowball sampling was employed to include 642 participants. Arabic versions of the Depression, Anxiety, and Stress Scales were used to collect data. Descriptive statistics, t-test, ANOVA, and Pearson's correlation were used to analyze the data. Results The total mean scores of depression, anxiety, and stress were 12.26 (SD = 10.53), 9.04 (SD = 9.34), and 13.49 (SD = 10.72), respectively. Of the study sample, 122 (19.5%), 139 (22.2%), and 99 (15.9%) had severe to extremely severe levels of depression, anxiety, and stress, respectively. Significant differences were found in depression, anxiety, and stress in relation to age, chronic diseases, and house size. Conclusion The findings showed an increased prevalence of depression and anxiety during the COVID-19 pandemic. Mental health practitioners need to recognize the impact of pandemics on youth, females, low-income populations, and individuals with chronic diseases. Preventive mental health services among these populations, such as screening and counseling, would help reduce the health risks.
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Affiliation(s)
- Abeer Shaheen
- Department of Community Health Nursing, School of Nursing, University of Jordan, Amman, Jordan
| | - Khaldoun Hamdan
- Department of Acute and Chronic Care Nursing, Faculty of Nursing, Al-Ahliyya Amman University, Amman, Jordan
| | - Rabia Allari
- Department of Acute and Chronic Care Nursing, Faculty of Nursing, Al-Ahliyya Amman University, Amman, Jordan
| | - Ahmad M. Al-Bashaireh
- Faculty of Health Science, Higher Colleges of Technology, Fujairah, United Arab Emirates
| | | | - Huda Amre
- The University of Jordan, Amman, Jordan
| | - Maha Alkaid Albqoor
- Department of Community Health Nursing, School of Nursing, University of Jordan, Amman, Jordan
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Yared S, Abera T, Ali SM, Muhummed AM, Ibrahim M, Hassan A, Hattendorf J, Zinsstag J, Tschopp R. A community based seroprevalence of SARS-CoV-2 antibodies in Somali Region, Eastern Ethiopia. Immun Inflamm Dis 2024; 12:e1148. [PMID: 38270297 PMCID: PMC10777752 DOI: 10.1002/iid3.1148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 12/25/2023] [Accepted: 12/28/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Coronavirus disease 19 (COVID-19) is life-threatening infectious disease caused by SARS-CoV-2 virus that caused a global pandemic. SARS-CoV-2 has been widely transmitted throughout Ethiopia, with over 501,060 cases confirmed and 7574 deaths until November 2023. This study assessed for the first time the seroprevalence SARS-CoV-2 in the general population of the Somali Region during the COVID-19 pandemic. METHODS A cross-sectional study design was conducted from May to June 2021 in 14 districts of Somali Region. Blood samples were collected in 820 participants in addition to administering a questionnaire that included sociodemographic characteristics and history of clinical symptoms of COVID-19. Blood samples were tested for the presence or absence of anti-SARS-CoV-2 using a commercial Enzyme-Linked Immunosorbent Assay (ELISA) kit (Euroimmun). RESULTS Overall, 477 (58.2%) were male and 343 (41.8%) were female. The majority of the participants (N = 581; 70.9%) were between 18 and 34 years old and not vaccinated against COVID-19 (N = 793; 96.7%). The overall seroprevalence of SARS-CoV-2 antibodies was 41.7% (95% CI: 33.3%-47.6%). The highest prevalence was found in Goljano district (70%) and the lowest in Gunagado district (22.5%). Only age was found to be associated with COVID-19 seropositivity. CONCLUSION Prevalence of SARS-CoV-2 antibodies was the highest ever reported in Ethiopia, indicating that a large proportion of the population had been infected 14 months after the start of the outbreak in the country. Such studies are important to swiftly reassess and improve specific COVID-19 preventive and control measures to reduce transmissions within the community in a given setting.
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Affiliation(s)
- Solomon Yared
- Department of Biology, College of Natural and Computational SciencesJigjiga UniversityJigjigaEthiopia
| | - Tsegalem Abera
- Department of Veterinary Microbiology and Public Health, College of Veterinary MedicineJigjiga UniversityJigjigaEthiopia
| | - Seid Mohammed Ali
- Department of Animal and Range Sciences, College of Dryland AgricultureJigjiga UniversityJigjigaEthiopia
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health InstituteUniversity of BaselBaselSwitzerland
| | - Abdifatah Muktar Muhummed
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health InstituteUniversity of BaselBaselSwitzerland
- School of Medicine, College of Medicine and Health SciencesJigjiga UniversityJigjigaEthiopia
| | - Mohammed Ibrahim
- Department of Veterinary Microbiology and Public Health, College of Veterinary MedicineJigjiga UniversityJigjigaEthiopia
| | - Abdullahi Hassan
- School of Medicine, College of Medicine and Health SciencesJigjiga UniversityJigjigaEthiopia
| | - Jan Hattendorf
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health InstituteUniversity of BaselBaselSwitzerland
| | - Jakob Zinsstag
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health InstituteUniversity of BaselBaselSwitzerland
| | - Rea Tschopp
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health InstituteUniversity of BaselBaselSwitzerland
- One Health UnitArmauer Hansen Research InstituteAddis AbabaEthiopia
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Tuan WJ, Kindt HM, Lennon RP. Assessing the risk of COVID-19 reinfection and severe outcomes among individuals with substance use disorders: a retrospective study using real-world electronic health records. BMJ Open 2023; 13:e074993. [PMID: 38072495 PMCID: PMC10729165 DOI: 10.1136/bmjopen-2023-074993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 11/13/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVE Despite advancement in vaccines and treatments for COVID-19 over the past 2 years, many concerns remain about reinfection and waning immunity against COVID-19 and its variants, especially among people with substance use disorder (SUD). The study assessed the risk of COVID-19 reinfection and severe illness among adults with SUD and their vaccination status to inform management in this vulnerable population as the pandemic continues. DESIGN Retrospective cohort study. SETTING Nationwide electronic health records (TriNetX database) in the USA among adults with COVID-19 infection from January 2020 to June 2022. PARTICIPANTS Adults (age ≥18 years) who were infected by COVID-19, excluding those who had cancer or lived in nursing homes or palliative care facilities. OUTCOME MEASURES COVID-19 reinfection was defined as a new diagnosis after 45 days of the initial infection. Logistic regression was applied to assess the OR of COVID-19 reinfection and severe outcomes within 30 day of reinfection for adults with alcohol (AUD), opioid (OUD), cocaine (CUD), stimulant (STUD), cannabis (CAUD) and other use disorders, controlled for demographic and comorbid conditions. RESULTS The SUD cohort was 13%-29% more likely to be reinfected by COVID-19 and had significantly higher 30-day mortality. Adults with AUD, STUD and OUD were at greater risks (adjusted ORs, AORs=1.69-1.86) of emergency department, hospital and intensive care admissions after 30 days of reinfection. Individuals with SUD and multiple vaccines doses were associated with decreased risks of worse COVID-19 outcomes. Lower COVID-19 reinfection rates (AORs=0.67-0.84) were only found among individuals with AUD, CUD or CAUD who had COVID-19 vaccination. CONCLUSIONS Individuals with SUD had greater risks of COVID-19 reinfection and poor outcomes, especially those with OUD, STUD and AUD. Multiple vaccinations are recommended to reduce severe illness after COVID-19 reinfection in the SUD population.
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Affiliation(s)
- Wen-Jan Tuan
- Family and Community Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Hailey M Kindt
- Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Robert P Lennon
- Family and Community Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
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Wolff D, Drewitz KP, Ulrich A, Siegels D, Deckert S, Sprenger AA, Kuper PR, Schmitt J, Munblit D, Apfelbacher C. Allergic diseases as risk factors for Long-COVID symptoms: Systematic review of prospective cohort studies. Clin Exp Allergy 2023; 53:1162-1176. [PMID: 37936547 DOI: 10.1111/cea.14391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 11/09/2023]
Abstract
OBJECTIVE The role of allergy as a risk factor for Long-COVID (LC) is unclear and has not been thoroughly examined yet. We aimed to systematically review and appraise the epidemiological evidence on allergic diseases as risk factors for LC. DESIGN This is an initial systematic review. Two reviewers independently performed the study selection and data extraction using Covidence. Risk of bias (RoB) and certainty of evidence (GRADE) were assessed. Random effects meta-analyses were used to pool unadjusted ORs within homogeneous data subsets. DATA SOURCES We retrieved articles published between January 1st, 2020 and January 19th, 2023 from MEDLINE via PubMed, Scopus, the WHO-COVID-19 database and the LOVE platform (Epistemonikos Foundation). In addition, citations and reference lists were searched. ELIGIBILITY CRITERIA We included prospective cohort studies recruiting individuals of all ages with confirmed SARS-CoV-2 infection that were followed up for at least 12 months for LC symptoms where information on pre-existing allergic diseases was available. We excluded all study designs that were not prospective cohort studies and all publication types that were not original articles. RESULTS We identified 13 studies (9967 participants, range 39-1950 per study), all assessed as high RoB, due to population selection and methods used to ascertain the exposures and the outcome. Four studies did not provide sufficient data to calculate Odds Ratios. The evidence supported a possible relationship between LC and allergy, but was very uncertain. For example, pre-existing asthma measured in hospital-based populations (6 studies, 4019 participants) may be associated with increased risk of LC (Odds Ratio 1.94, 95% CI 1.08, 3.50) and findings were similar for pre-existing rhinitis (3 studies, 1141 participants; Odds Ratio 1.96, 95% CI 1.61, 2.39), both very low certainty evidence. CONCLUSIONS Pre-existing asthma or rhinitis may increase the risk of LC.
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Affiliation(s)
- Doreen Wolff
- Institute of Social Medicine and Health Systems Research, University of Magdeburg, Magdeburg, Germany
| | - Karl Philipp Drewitz
- Institute of Social Medicine and Health Systems Research, University of Magdeburg, Magdeburg, Germany
| | - Angela Ulrich
- Institute of Social Medicine and Health Systems Research, University of Magdeburg, Magdeburg, Germany
| | - Doreen Siegels
- Center for Evidence-Based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Stefanie Deckert
- Center for Evidence-Based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Antonia Anabella Sprenger
- Institute of Social Medicine and Health Systems Research, University of Magdeburg, Magdeburg, Germany
| | - Paula Ricarda Kuper
- Institute of Social Medicine and Health Systems Research, University of Magdeburg, Magdeburg, Germany
| | - Jochen Schmitt
- Center for Evidence-Based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Daniel Munblit
- Care for Long Term Conditions Division, King's College London, London, UK
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research, University of Magdeburg, Magdeburg, Germany
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore City, Singapore
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Wu XC, Yu Q, Yi Y, Maniscalco LS, Hsieh MC, Gruber D, Mendoza L, Subbiah S, Sokol T, Shrestha P, Chen VW, Mederos ET, Ochoa A. Effect of chronic disease on racial difference in COVID-19-associated hospitalization among cancer patients. J Natl Cancer Inst 2023; 115:1204-1212. [PMID: 37697664 PMCID: PMC10560601 DOI: 10.1093/jnci/djad150] [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: 04/24/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Research indicates that Black cancer patients have higher rates of COVID-19 hospitalization than their White counterparts. However, the extent to which chronic diseases contribute to racial disparities remains uncertain. We aimed to quantify the effect of chronic diseases on racial disparity in COVID-19-associated hospitalization among cancer patients. METHODS We linked Louisiana Tumor Registry's data with statewide COVID-19 data and hospital in-patient discharge data to identify patients diagnosed with cancer in 2015-2019 who tested positive for COVID-19 in 2020 and those with COVID-19-associated hospitalization. Multivariable logistic regression and mediation methods based on linear structural equations were employed to assess the effects of the number of chronic diseases (0, 1-2, ≥3) and individual chronic diseases. RESULTS Of 6381 cancer patients who tested positive for COVID-19, 31.6% were non-Hispanic Black cancer patients. Compared with non-Hispanic White cancer patients, non-Hispanic Black cancer patients had a higher prevalence of chronic diseases (79.5% vs 66.0%) and higher COVID-19-associated hospitalization (27.2% vs 17.2%). The odds of COVID-19-associated hospitalization were 80% higher for non-Hispanic Black cancer patients than non-Hispanic White cancer patients (odds ratio = 1.80, 95% confidence interval = 1.59 to 2.04). After adjusting for age, sex, insurance, poverty, obesity, and cancer type, number of chronic diseases explained 37.8% of the racial disparity in COVID-19-associated hospitalization, and hypertension, diabetes, and chronic renal disease were the top 3 chronic diseases explaining 9.6%, 8.9%, and 7.3% of the racial disparity, respectively. CONCLUSION Chronic diseases played a substantial role in the racial disparity in COVID-19-associated hospitalization among cancer patients, especially hypertension, diabetes, and renal disease. Understanding and addressing the root causes are crucial for targeted interventions, policies, and health-care strategies to reduce racial disparity.
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Affiliation(s)
- Xiao-Cheng Wu
- Louisiana Tumor Registry, Epidemiology Program, School of Public Health, Louisiana State University (LSU) Health, New Orleans, LA, USA
| | - Qingzhao Yu
- Biostatistics Program, School of Public Health, LSU Health, New Orleans, LA, USA
| | - Yong Yi
- Louisiana Tumor Registry, Epidemiology Program, School of Public Health, Louisiana State University (LSU) Health, New Orleans, LA, USA
| | - Lauren S Maniscalco
- Louisiana Tumor Registry, Epidemiology Program, School of Public Health, Louisiana State University (LSU) Health, New Orleans, LA, USA
| | - Mei-Chin Hsieh
- Louisiana Tumor Registry, Epidemiology Program, School of Public Health, Louisiana State University (LSU) Health, New Orleans, LA, USA
| | - DeAnn Gruber
- Bureau of Infectious Diseases, Office of Public Health, Louisiana Department of Health, New Orleans, LA, USA
| | - Lee Mendoza
- Bureau of Health Informatics, Office of Public Health, Louisiana Department of Health, New Orleans, LA, USA
| | - Suki Subbiah
- Section of Hematology-Oncology, School of Medicine, LSU Health, New Orleans, LA, USA
| | - Theresa Sokol
- Bureau of Infectious Diseases, Office of Public Health, Louisiana Department of Health, New Orleans, LA, USA
| | - Pratibha Shrestha
- Louisiana Tumor Registry, Epidemiology Program, School of Public Health, Louisiana State University (LSU) Health, New Orleans, LA, USA
| | - Vivien W Chen
- Louisiana Tumor Registry, Epidemiology Program, School of Public Health, Louisiana State University (LSU) Health, New Orleans, LA, USA
| | - Eileen T Mederos
- LSU-LCMC Health Cancer Center, Department of Interdisciplinary Oncology, LSU Health, New Orleans, LA, USA
| | - Augusto Ochoa
- LSU-LCMC Health Cancer Center, Department of Interdisciplinary Oncology, LSU Health, New Orleans, LA, USA
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Santiago González N, García-Hernández MDL, Cruz-Bello P, Chaparro-Díaz L, Rico-González MDL, Hernández-Ortega Y. Modified Early Warning Score: Clinical Deterioration of Mexican Patients Hospitalized with COVID-19 and Chronic Disease. Healthcare (Basel) 2023; 11:2654. [PMID: 37830691 PMCID: PMC10572652 DOI: 10.3390/healthcare11192654] [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: 08/25/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 10/14/2023] Open
Abstract
The objective was to evaluate the Modified Early Warning Score in patients hospitalized for COVID-19 plus chronic disease. METHODS Retrospective observational study, 430 hospitalized patients with COVID-19 and chronic disease. Instrument, Modified Early Warning Score (MEWS). Data analysis, with Cox and logistic regression, to predict survival and risk. RESULTS Of 430 patients, 58.6% survived, and 41.4% did not. The risk was: low 53.5%, medium 23.7%, and high 22.8%. The MEWS score was similar between survivors 3.02, p 0.373 (95% CI: -0.225-0.597) and non-survivors 3.20 (95% CI: -0.224-0.597). There is a linear relationship between MEWS and mortality risk R 0.920, ANOVA 0.000, constant 4.713, and coefficient 4.406. The Cox Regression p 0.011, with a risk of deterioration of 0.325, with a positive coefficient, the higher the risk, the higher the mortality, while the invasive mechanical ventilation coefficient was negative -0.757. By providing oxygen and ventilation, mortality is lower. CONCLUSIONS The predictive value of the modified early warning score in patients hospitalized for COVID-19 and chronic disease is not predictive with the MEWS scale. Additional assessment is required to prevent complications, especially when patients are assessed as low-risk.
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Affiliation(s)
- Nicolás Santiago González
- Hospital Regional de Alta Especialidad Ixtapaluca (HRAEI), Universidad Autónoma del Estado de México (UAEMex), Ixtapaluca 56530, Mexico;
| | - María de Lourdes García-Hernández
- Facultad de Enfermería y Obstetricia, Universidad Autónoma del Estado de México (UAEMéx), Toluca 50000, Mexico; (P.C.-B.); (M.d.L.R.-G.); (Y.H.-O.)
| | - Patricia Cruz-Bello
- Facultad de Enfermería y Obstetricia, Universidad Autónoma del Estado de México (UAEMéx), Toluca 50000, Mexico; (P.C.-B.); (M.d.L.R.-G.); (Y.H.-O.)
| | - Lorena Chaparro-Díaz
- Nursing Department, Faculty of Nursing, Universidad Nacional de Colombia, Sede Bogotá, Bogotá 111321, Colombia;
| | - María de Lourdes Rico-González
- Facultad de Enfermería y Obstetricia, Universidad Autónoma del Estado de México (UAEMéx), Toluca 50000, Mexico; (P.C.-B.); (M.d.L.R.-G.); (Y.H.-O.)
| | - Yolanda Hernández-Ortega
- Facultad de Enfermería y Obstetricia, Universidad Autónoma del Estado de México (UAEMéx), Toluca 50000, Mexico; (P.C.-B.); (M.d.L.R.-G.); (Y.H.-O.)
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11
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Ogbonna O, Bull F, Spinks B, Williams D, Lewis R, Edwards A. The Impact of Being Homeless on the Clinical Outcomes of COVID-19: Systematic Review. Int J Public Health 2023; 68:1605893. [PMID: 37780134 PMCID: PMC10540688 DOI: 10.3389/ijph.2023.1605893] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 08/22/2023] [Indexed: 10/03/2023] Open
Abstract
Objective: The homeless population experiences inequality in health compared with the general population, which may have widened during the COVID-19 pandemic. However, the impact of being homeless on the outcomes of COVID-19 is uncertain. This systematic review aimed to analyse the impact of experiencing homelessness on the clinical outcomes of COVID-19, including the effects on health inequalities. Methods: A review protocol was developed and registered in PROSPERO (PROSPERO registration 2022 CRD42022304941). Nine databases were searched in November 2022 to identify studies on homeless populations which contained primary research on the following outcomes of COVID-19: incidence, hospitalisation, mortality, long COVID, mental wellbeing, and evidence of inequalities. Included studies were summarised with narrative synthesis. Results: The searches yielded 8,233 initial hits; after screening, 41 studies were included. Overall, evidence showed that those in crowded living settings had a higher risk of COVID-19 infection compared to rough sleepers and the general population. The homeless population had higher rates of hospitalisation and mortality than the general population, lower vaccination rates, and suffered negative mental health impacts. Conclusion: This systematic review shows the homeless population is more susceptible to COVID-19 outcomes. Further research is needed to determine the actual impact of the pandemic on this population, and of interventions to mitigate overall risk, given the low certainty of findings from some of the low-quality evidence available. In addition, further research is required to ascertain the impact of long COVID on those experiencing homelessness, since the present review yielded no studies on this topic.
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Affiliation(s)
- Obianuju Ogbonna
- Health and Care Research Wales Evidence Centre, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Francesca Bull
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Bethany Spinks
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Denitza Williams
- Health and Care Research Wales Evidence Centre, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Ruth Lewis
- North Wales Centre for Primary Care Research, School of Medical and Health Sciences, Bangor University, Bangor, United Kingdom
| | - Adrian Edwards
- Health and Care Research Wales Evidence Centre, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
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12
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Paul KI, Hollederer A. Unemployment and Job Search Behavior among People with Disabilities during the First Year of the COVID-19 Pandemic in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6036. [PMID: 37297640 PMCID: PMC10252648 DOI: 10.3390/ijerph20116036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/25/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023]
Abstract
Not much is known about how the COVID-19 pandemic affected the labor market experiences of people with disabilities. Since they constitute a generally disadvantaged group in the labor market, it is important to scrutinize whether their position has worsened during these difficult times and how they reacted with regard to their job search behavior. We therefore used data for the year 2020 from a large German panel (Panel Arbeitsmarkt und Soziale Sicherung, PASS), in order to scrutinize the prevalence of unemployment among people with disabilities (N = 739) during the first year of the COVID-19 pandemic. The factors that affected their unemployment status were also analyzed. The study found that people with legally recognized disabilities were more often unemployed than non-disabled people, even when controlling for possible confounding factors such as age, gender, or education. This effect was significant for severe disabilities and marginally significant for minor disabilities. Additionally, the type of disability affected the probability of being unemployed, with cardiovascular diseases, mental illnesses, and musculoskeletal disorders carrying a higher risk. In terms of job-seeking behavior, unemployed people with disabilities reported using some job search methods more frequently than their non-disabled counterparts. However, the intensity of the job search did not differ significantly between the two groups. Further differences were found when analyzing the reasons for abstinence from searching for a job, with unemployed people with disabilities primarily citing health-related factors (with a frequency of over 90%). In summary, health played a pivotal role in determining disabled people's labor market experiences during the COVID-19 pandemic.
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Affiliation(s)
- Karsten Ingmar Paul
- School of Business, Economics, and Society, Friedrich-Alexander Universität Erlangen-Nürnberg, 90403 Nürnberg, Germany
| | - Alfons Hollederer
- Department of Social Work and Social Welfare, The Faculty of Human Sciences (FB 01), University of Kassel, 34127 Kassel, Germany;
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13
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Zhu D, Zhao R, Yuan H, Xie Y, Jiang Y, Xu K, Zhang T, Chen X, Suo C. Host Genetic Factors, Comorbidities and the Risk of Severe COVID-19. J Epidemiol Glob Health 2023; 13:279-291. [PMID: 37160831 PMCID: PMC10169198 DOI: 10.1007/s44197-023-00106-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 04/17/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was varied in disease symptoms. We aim to explore the effect of host genetic factors and comorbidities on severe COVID-19 risk. METHODS A total of 20,320 COVID-19 patients in the UK Biobank cohort were included. Genome-wide association analysis (GWAS) was used to identify host genetic factors in the progression of COVID-19 and a polygenic risk score (PRS) consisted of 86 SNPs was constructed to summarize genetic susceptibility. Colocalization analysis and Logistic regression model were used to assess the association of host genetic factors and comorbidities with COVID-19 severity. All cases were randomly split into training and validation set (1:1). Four algorithms were used to develop predictive models and predict COVID-19 severity. Demographic characteristics, comorbidities and PRS were included in the model to predict the risk of severe COVID-19. The area under the receiver operating characteristic curve (AUROC) was applied to assess the models' performance. RESULTS We detected an association with rs73064425 at locus 3p21.31 reached the genome-wide level in GWAS (odds ratio: 1.55, 95% confidence interval: 1.36-1.78). Colocalization analysis found that two genes (SLC6A20 and LZTFL1) may affect the progression of COVID-19. In the predictive model, logistic regression models were selected due to simplicity and high performance. Predictive model consisting of demographic characteristics, comorbidities and genetic factors could precisely predict the patient's progression (AUROC = 82.1%, 95% CI 80.6-83.7%). Nearly 20% of severe COVID-19 events could be attributed to genetic risk. CONCLUSION In this study, we identified two 3p21.31 genes as genetic susceptibility loci in patients with severe COVID-19. The predictive model includes demographic characteristics, comorbidities and genetic factors is useful to identify individuals who are predisposed to develop subsequent critical conditions among COVID-19 patients.
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Affiliation(s)
- Dongliang Zhu
- Department of Epidemiology & Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
| | - Renjia Zhao
- State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, Human Phenome Institute, Fudan University, Shanghai, China
| | - Huangbo Yuan
- State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, Human Phenome Institute, Fudan University, Shanghai, China
| | - Yijing Xie
- Department of Epidemiology & Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
| | - Yanfeng Jiang
- State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, Human Phenome Institute, Fudan University, Shanghai, China
- Fudan University Taizhou Institute of Health Sciences, Yaocheng Road 799, Taizhou, Jiangsu, China
| | - Kelin Xu
- Fudan University Taizhou Institute of Health Sciences, Yaocheng Road 799, Taizhou, Jiangsu, China
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
| | - Tiejun Zhang
- Department of Epidemiology & Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
- Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China
- Fudan University Taizhou Institute of Health Sciences, Yaocheng Road 799, Taizhou, Jiangsu, China
| | - Xingdong Chen
- State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, Human Phenome Institute, Fudan University, Shanghai, China
- Fudan University Taizhou Institute of Health Sciences, Yaocheng Road 799, Taizhou, Jiangsu, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
- Yiwu Research Institute of Fudan University, Yiwu, Zhejiang, China
| | - Chen Suo
- Department of Epidemiology & Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China.
- Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China.
- Fudan University Taizhou Institute of Health Sciences, Yaocheng Road 799, Taizhou, Jiangsu, China.
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14
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Premuzic V, Stevanovic R, Vilibic-Cavlek T, Sirovica M, Stalman S, Bogdanic M, Zilic D, Nakic D, Santini Dusevic D, Vojkovic M, Barbic J, Durlen I, Grdan Z, Pavlovic D, Kudumija B, Sefer S, Griparic D, Rogic D, Bubas M, Capak K, Jelakovic B. Serological Response to SARS-CoV-2 Vaccine in Hemodialyzed Patients and the Association with Later COVID-19 Positivity. Antibodies (Basel) 2023; 12:37. [PMID: 37366653 DOI: 10.3390/antib12020037] [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: 03/29/2023] [Revised: 05/13/2023] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND The effectiveness of the COVID-19 vaccine may differ in hemodialysis patients. The aim of this prospective multicenter study was to determine the degree of serological response to the SARS-CoV-2 vaccine in the population of dialysis patients and its association with later SARS-CoV-2 infections. METHODS A blood sample was taken for the determination of COVID-19 serological status (IgG antibodies) in 706 dialysis patients 16 weeks after vaccination with the second dose (Pfizer-BioNTech). RESULTS Only 314 (44.5%) hemodialyzed patients had a satisfactory response to the COVID-19 vaccine. Eighty-two patients (11.6%) had a borderline response, while 310 patients (43.9%) had an unsatisfactory (negative) post-vaccinal antibody titer. A longer dialysis vintage had an increased odds ratio (OR) of 1.01 for the occurrence of COVID-19 positivity after vaccination. In the group of subsequently positive patients, 28 patients (13.6%) died from complications of COVID-19. We have found differences in mean survival time between patients with and without appropriate responses to vaccination in favor of patients with a satisfactory serological response. CONCLUSIONS The results showed that the dialysis population will not have the same serological response to the vaccine as the general population. The majority of dialysis patients did not develop a severe clinical picture or die at the time of positivity for COVID-19.
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Affiliation(s)
- Vedran Premuzic
- Department of Nephrology, Hypertension, Dialysis and Transplantation, University Hospital Center Zagreb, 10000 Zagreb, Croatia
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | | | - Tatjana Vilibic-Cavlek
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Croatian Institute of Public Health, 10000 Zagreb, Croatia
| | - Maja Sirovica
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Sara Stalman
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Maja Bogdanic
- Croatian Institute of Public Health, 10000 Zagreb, Croatia
| | | | - Dario Nakic
- Department of Nephrology and Dialysis, General Hospital Zadar, 23000 Zadar, Croatia
| | | | - Marina Vojkovic
- Department of Nephrology and Dialysis, General Hospital Zadar, 23000 Zadar, Croatia
| | - Jerko Barbic
- Department of Nephrology, Dialysis and Transplantation, Clinical Hospital Center Osijek, 31000 Osijek, Croatia
| | - Ivan Durlen
- Department of Nephrology and Dialysis, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Zeljka Grdan
- Department of Nephrology, Clinical Hospital Varazdin, 42000 Varazdin, Croatia
| | - Drasko Pavlovic
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Policlinic for Internal Medicine and Dialysis B. Braun Avitum, 10000 Zagreb, Croatia
| | - Boris Kudumija
- Policlinic for Internal Medicine and Dialysis B. Braun Avitum, 10000 Zagreb, Croatia
| | - Sinisa Sefer
- Department of Nephrology and Dialysis, University Clinical Hospital Centre "Sestre Milosrdnice", 10000 Zagreb, Croatia
| | - Davor Griparic
- Policlinic for Dialysis Fresenius Sveti Duh 2, 10000 Zagreb, Croatia
| | - Dunja Rogic
- Clinical Institute for Laboratory Diagnostics, University Hospital Center Zagreb, 10000 Zagreb, Croatia
| | - Marija Bubas
- Croatian Institute of Public Health, 10000 Zagreb, Croatia
| | | | - Bojan Jelakovic
- Department of Nephrology, Hypertension, Dialysis and Transplantation, University Hospital Center Zagreb, 10000 Zagreb, Croatia
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
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15
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Birtolo MF, Vena W, Pizzocaro A, Lavezzi E, Brunetti A, Jaafar S, Betella N, Bossi AC, Mazziotti G, Lania AG. Serum testosterone mirrors inflammation parameters in females hospitalized with COVID-19. J Endocrinol Invest 2023; 46:939-945. [PMID: 36370325 PMCID: PMC9660177 DOI: 10.1007/s40618-022-01957-6] [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: 06/15/2022] [Accepted: 10/31/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND While low testosterone (T) was described as a predictor of unfavorable coronavirus-disease 19 (COVID-19) outcome in men, data concerning the role of T in women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are scant and limited to small cohorts. This study investigated the relationship between serum T values and outcomes of COVID-19 in a large female hospitalized cohort. METHODS One-hundred-sixty-eight adult women (median age 77, range 18-100 years; 154 in post-menopause) hospitalized for COVID-19 were assessed for PaO2/Fio2 ratio, serum T and inflammatory parameters. RESULTS Median duration for hospital stay was 14.2 days (range 1-115) with overall mortality of 26% (n = 44). Subjects who died were significantly older (p < 0.001), had significantly more comorbidities (p = 0.015) and higher serum T (p = 0.040), white blood cells (p = 0.007), c-reactive protein (CRP; p < 0.001), interleukin-6 (IL-6; p < 0.001), procalcitonin (PCT; p < 0.001), lactate dehydrogenase (LDH; p = 0.001), D-dimer (p = 0.035), fibrinogen (p = 0.038) and lower serum free-triiodothyronine (FT3; p < 0.001) and luteinizing hormone (LH; p = 0.024) values. In post-menopausal women, significant associations were observed between T levels and serum CRP (rho: 0.23; p = 0.002), IL-6 (rho: 0.41; p < 0.001), LDH (rho: 0.34; p < 0.001), D-Dimer (rho: 0.21; p = 0.008), PCT (rho: 0.26; p = 0.001) and HDL cholesterol (rho: - 0,22, p = 0.008). In multivariate regression analyses, serum T maintained the significant association with mortality after correction for age, coexistent comorbidities and serum LH and FT3, whereas it was lost after correction for inflammatory parameters. CONCLUSION In females, high serum T levels might be a mirror of inflammatory phenotype and worse COVID-19 course.
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Affiliation(s)
- M F Birtolo
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy
- Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - W Vena
- Diabetes Center, Humanitas Gavazzeni Institute, Via M. Gavazzeni 21, 24100, Bergamo, Italy.
| | - A Pizzocaro
- Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - E Lavezzi
- Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - A Brunetti
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy
- Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - S Jaafar
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy
- Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - N Betella
- Diabetes Center, Humanitas Gavazzeni Institute, Via M. Gavazzeni 21, 24100, Bergamo, Italy
| | - A C Bossi
- Diabetes Center, Humanitas Gavazzeni Institute, Via M. Gavazzeni 21, 24100, Bergamo, Italy
| | - G Mazziotti
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy
- Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - A G Lania
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy
- Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Milan, Rozzano, Italy
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16
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de Oliveira MPB, de Castro AEF, Miri AL, Lima CR, Truax BD, Probst VS, Smaili SM. The impact of the COVID-19 pandemic on neuropsychiatric and sleep disorders, and quality of life in individuals with neurodegenerative and demyelinating diseases: a systematic review and meta-analysis of observational studies. BMC Neurol 2023; 23:150. [PMID: 37046209 PMCID: PMC10091330 DOI: 10.1186/s12883-023-03176-9] [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: 08/22/2022] [Accepted: 03/21/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has affected the mental health, sleep and quality of life, especially in individuals with chronic disease. Therefore, the purpose of this systematic review and meta-analysis was to investigate the impact of the COVID-19 pandemic on neuropsychiatric disorders (depression, anxiety, stress), sleep disorders (sleep quality, insomnia) and quality of life in individuals with Parkinson's disease (PD), Multiple Sclerosis (MS) and Alzheimer's disease (AD) compared to healthy controls. METHODS Seven databases (Medline, Embase, ScienceDirect, Web of Science, The Cochrane Library, Scielo and Lilacs) were searched between March 2020 and December 2022. Observational studies (i.e., cross-sectional, case-control, cohort) were included. GRADE approach was used to assess the quality of evidence and strength of the recommendation. Effect size was calculated using standardized mean differences (SMD; random effects model). A customized Downs and Black checklist was used to assess the risk of bias. RESULTS Eighteen studies (PD = 7, MS = 11) were included. A total of 627 individuals with PD (healthy controls = 857) and 3923 individuals with MS (healthy controls = 2432) were analyzed. Twelve studies (PD = 4, MS = 8) were included in the meta-analysis. Individuals with PD had significantly elevated levels of depression (very low evidence, SMD = 0.40, p = 0.04) and stress (very low evidence, SMD = 0.60, p < 0.0001). There was no difference in anxiety (p = 0.08). Individuals with MS had significantly higher levels of depression (very low evidence, SMD = 0.73, p = 0.007) and stress (low evidence, SMD = 0.69, p = 0.03) and low quality of life (very low evidence, SMD = 0.77, p = 0.006). There was no difference in anxiety (p = 0.05) and sleep quality (p = 0.13). It was not possible to synthesize evidence in individuals with AD and sleep disorder (insomnia). CONCLUSION In general, the COVID-19 pandemic negatively impacted individuals with PD and MS. Individuals with PD showed significantly higher levels of depression and stress; and individuals with MS presented significantly higher depression and stress levels, as well as significantly lower quality of life when compared to healthy controls. Further studies are needed to investigate the impact of the COVID-19 pandemic in individuals with AD.
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Affiliation(s)
- Marcos Paulo Braz de Oliveira
- Healthy Aging Research Laboratory, Department of Physical Therapy, Federal University of São Carlos, Washington Luis Highway, Km 235, São Carlos, São Paulo, Brazil.
| | - Ana Emilia Fonseca de Castro
- Physical Therapy Laboratory, Department of Physical Therapy, State University of Campinas, São Paulo, Campinas, Brazil
| | - Andressa Leticia Miri
- Neurofunctional Physical Therapy Research Group, Department of Physical Therapy, State University of Londrina, Londrina, Paraná, Brazil
| | - Carla Rigo Lima
- Mechanisms of Spinal Manual Therapy Laboratory, Department of Physical Therapy, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Brendon David Truax
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Vanessa Suziane Probst
- Neurofunctional Physical Therapy Research Group, Department of Physical Therapy, State University of Londrina, Londrina, Paraná, Brazil
| | - Suhaila Mahmoud Smaili
- Neurofunctional Physical Therapy Research Group, Department of Physical Therapy, State University of Londrina, Londrina, Paraná, Brazil
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Al Maqbali M. Impact of insomnia on mental status among chronic disease patients during Covid-19 pandemic. ETHICS, MEDICINE, AND PUBLIC HEALTH 2023; 27:100879. [PMID: 36846861 PMCID: PMC9943730 DOI: 10.1016/j.jemep.2023.100879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 02/15/2023] [Indexed: 02/24/2023]
Abstract
Background The Coronavirus disease (Covid-19) 2019 pandemic had a serious impact on the mental health of individuals globally. A lack of psychological well-being on the part of individuals with chronic diseases might increase the risk of developing symptoms such as insomnia, depression, and anxiety. Objectives The aim of this study is to evaluate the prevalence of insomnia, depression, and anxiety among patients with chronic disease during the Covid-19 pandemic in Oman. Methods This is a web-based cross-sectional study conducted between June 2021 and September 2021. Insomnia was assessed by using the Insomnia Severity Index (ISI), while depression and anxiety were measured using the Hospital Anxiety and Depression Scale (HADS). Results Of the 922 chronic disease patients who participated, 77% (n = 710) reported insomnia, while the mean score for the ISI was11.38 (SD 5.82). Depression and anxiety were prevalent among the participants with 47% and 63% respectively. The participants' mean with regard to the sleep duration items was 7.04 (SD = 1.59) hours per night, whereas the mean in terms of sleep latency was 38.18 minutes (SD = 31.81). Logistic regression analysis revealed that insomnia was positively associated with depression and anxiety. Conclusions This study demonstrated that chronic disease patients had a high prevalence of insomnia during the Covid-19 pandemic. Psychological support is recommended in order to help such patients reduce the level of insomnia. Furthermore, a routine assessment of levels of insomnia, depression and anxiety is essential, in order to help identify appropriate intervention and management measures.
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Affiliation(s)
- M Al Maqbali
- Department of Nursing, Fatima College of Health Sciences, Al Ain, United Arab Emirates
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18
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Najjar M, Albuaini S, Fadel M, Aljbawi A, AlAwad Y, Mohsen F. Impact of comorbidities on hospitalised Syrian patients with COVID-19: a retrospective study. BMJ Open 2023; 13:e068849. [PMID: 36940947 PMCID: PMC10030286 DOI: 10.1136/bmjopen-2022-068849] [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] [Indexed: 03/23/2023] Open
Abstract
OBJECTIVES This study aims to compare the clinical manifestations, laboratory findings, outcomes and overall survival time of patients with COVID-19 with and without comorbidities. DESIGN Retrospective design. SETTING This study was undertaken at two hospitals in Damascus. PARTICIPANTS A total of 515 Syrian patients met the inclusion criterion, laboratory-confirmed COVID-19 infection following the Centers for Disease Control and Prevention. Exclusion criteria were suspected and probable cases that were not confirmed with a positive reverse transcription-PCR assay, and patients who self-discharged from the hospital against medical advice. PRIMARY AND SECONDARY OUTCOME MEASURES First, assess the impacts of comorbidities on COVID-19 infection in four areas (clinical manifestations, laboratory findings, severity and outcomes). Second, calculate the overall survival time for patients with COVID-19 with comorbidities. RESULTS Of 515 patients included, 316 (61.4%) were male and 347 (67.4%) had at least one coexisting chronic disease. Patients with comorbidities compared with no comorbidities were more vulnerable to poor outcomes such as severe infection (32.0% vs 9.5%, p<0.001), severe complications (34.6% vs 9.5%, p<0.001), the need for mechanical ventilation (28.8% vs 7.7%, p<0.001) and death (32.0% vs 8.3%, p<0.001). Multiple logistic regression showed that age ≥65 years old, positive smoking history, having ≥2 comorbidities and chronic obstructive pulmonary disease were risk factors linked to severe COVID-19 infection in patients with comorbidities. Overall survival time was lower among patients with comorbidities (vs no comorbidities), patients with ≥2 comorbidities (vs one comorbidity), and patients with hypertension, chronic obstructive pulmonary disease, malignancy or obesity (vs other comorbidities) (p<0.05). CONCLUSION This study revealed that COVID-19 infection had poor outcomes among those with comorbidities. Severe complications, mechanical ventilation usage and death were more prevalent among patients with comorbidities compared with those with no comorbidities.
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Affiliation(s)
- Michel Najjar
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
| | - Sara Albuaini
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
| | - Mohammad Fadel
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
| | - Ahmad Aljbawi
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
| | - Yara AlAwad
- Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic
| | - Fatema Mohsen
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
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19
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PulDi-COVID: Chronic obstructive pulmonary (lung) diseases with COVID-19 classification using ensemble deep convolutional neural network from chest X-ray images to minimize severity and mortality rates. Biomed Signal Process Control 2023; 81:104445. [PMID: 36466567 PMCID: PMC9708623 DOI: 10.1016/j.bspc.2022.104445] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 10/10/2022] [Accepted: 11/20/2022] [Indexed: 12/05/2022]
Abstract
Background and Objective In the current COVID-19 outbreak, efficient testing of COVID-19 individuals has proven vital to limiting and arresting the disease's accelerated spread globally. It has been observed that the severity and mortality ratio of COVID-19 affected patients is at greater risk because of chronic pulmonary diseases. This study looks at radiographic examinations exploiting chest X-ray images (CXI), which have become one of the utmost feasible assessment approaches for pulmonary disorders, including COVID-19. Deep Learning(DL) remains an excellent image classification method and framework; research has been conducted to predict pulmonary diseases with COVID-19 instances by developing DL classifiers with nine class CXI. However, a few claim to have strong prediction results; because of noisy and small data, their recommended DL strategies may suffer from significant deviation and generality failures. Methods Therefore, a unique CNN model(PulDi-COVID) for detecting nine diseases (atelectasis, bacterial-pneumonia, cardiomegaly, covid19, effusion, infiltration, no-finding, pneumothorax, viral-Pneumonia) using CXI has been proposed using the SSE algorithm. Several transfer-learning models: VGG16, ResNet50, VGG19, DenseNet201, MobileNetV2, NASNetMobile, ResNet152V2, DenseNet169 are trained on CXI of chronic lung diseases and COVID-19 instances. Given that the proposed thirteen SSE ensemble models solved DL's constraints by making predictions with different classifiers rather than a single, we present PulDi-COVID, an ensemble DL model that combines DL with ensemble learning. The PulDi-COVID framework is created by incorporating various snapshots of DL models, which have spearheaded chronic lung diseases with COVID-19 cases identification process with a deep neural network produced CXI by applying a suggested SSE method. That is familiar with the idea of various DL perceptions on different classes. Results PulDi-COVID findings were compared to thirteen existing studies for nine-class classification using COVID-19. Test results reveal that PulDi-COVID offers impressive outcomes for chronic diseases with COVID-19 identification with a 99.70% accuracy, 98.68% precision, 98.67% recall, 98.67% F1 score, lowest 12 CXIs zero-one loss, 99.24% AUC-ROC score, and lowest 1.33% error rate. Overall test results are superior to the existing Convolutional Neural Network(CNN). To the best of our knowledge, the observed results for nine-class classification are significantly superior to the state-of-the-art approaches employed for COVID-19 detection. Furthermore, the CXI that we used to assess our algorithm is one of the larger datasets for COVID detection with pulmonary diseases. Conclusion The empirical findings of our suggested approach PulDi-COVID show that it outperforms previously developed methods. The suggested SSE method with PulDi-COVID can effectively fulfill the COVID-19 speedy detection needs with different lung diseases for physicians to minimize patient severity and mortality.
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Muehlenbein M, Gassen J, Nowak T, Henderson A, Morris B, Weaver S, Baker E. Age-Dependent Relationships Between Disease Risk and Testosterone Levels: Relevance to COVID-19 Disease. Am J Mens Health 2023; 17:15579883221130195. [PMID: 36935555 PMCID: PMC10028446 DOI: 10.1177/15579883221130195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023] Open
Abstract
Testosterone levels in men appear to be prognostic of a number of disease outcomes, including severe COVID-19 disease. Testosterone levels naturally decline with age and are lower in individuals with a number of comorbidities and chronic conditions. Low testosterone may therefore be both a cause and a consequence of illness, including COVID-19 disease. The present project examines whether preexisting conditions for severe COVID-19 disease were themselves related to serum-free testosterone levels in men who had not been infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. A clinical risk score for severe COVID-19 disease was computed based on the results of previously published meta-analyses and cohort studies, and relationships between this score and testosterone levels were tested in 142 men ages 19 to 82 years. Greater burden of preexisting conditions for severe COVID-19 disease was related to lower testosterone levels among men younger than 40 years of age. In older men, the decrease in testosterone that accompanies aging attenuated the effect of the clinical risk score on free testosterone levels. Given that older age itself is a predictor of COVID-19 disease severity, these results together suggest that the presence of preexisting conditions may confound the relationship between testosterone levels and COVID-19 disease outcomes in men. Future research examining relationships among testosterone and outcomes related to infectious and chronic diseases should consider potential confounds, such as the role of preexisting conditions.
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The Effect of COVID-19 Vaccine Acceptance, Intention, and/or Hesitancy and Its Association with Our Health and/or Important Areas of Functioning. Vaccines (Basel) 2023; 11:vaccines11020368. [PMID: 36851246 PMCID: PMC9963362 DOI: 10.3390/vaccines11020368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 02/08/2023] Open
Abstract
The emergence of coronavirus 2019 (COVID-19) has had a significant negative impact on the world, with its effect noted in various areas, such as commerce [...].
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Orey FAH, Sodal AM, Mohamoud JH, Garba B, Mohamed IH, Adam MH, Dahie HA, Nur MAS, Dirie NI. Investigation of severe acute respiratory syndrome coronavirus 2 antibodies among the paediatric population in Mogadishu, Somalia. Trans R Soc Trop Med Hyg 2023; 117:139-146. [PMID: 36107977 PMCID: PMC9494475 DOI: 10.1093/trstmh/trac088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 08/15/2022] [Accepted: 09/01/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND We undertook this cross-sectional study to determine the level of circulating anti-severe acute respiratory syndrome coronavirus 2 immunoglobulins (IgM and IgG) in children, as well as to evaluate other potential risk factors. METHODS Children attending the outpatient department of the SOS and Benadir Hospitals in Mogadishu from 26 July to 8 August 2021 were selected following parental consent. The children (aged <18 y) were screened using the coronavirus disease 2019 (COVID-19) rapid test lateral flow immune-assay kit. RESULTS Of the 500 children screened for COVID-19, 32 (6.4%) tested positive, out of which 26 (5.2%) had IgG antibodies, while five (1%) had IgM, with the other child (0.2%) having both circulating IgG and IgM antibodies. Also, 46.9% of the COVID-19-positive children were asymptomatic without any clinical signs of the disease. Children aged >6 y and those attending school were the most affected (p=0.002). The most common clinical features among positive children were fever (22.6%), cough (22.2%), shortness of breath (5.8%) and loss of smell (2.6%) and taste (2.2%). Similarly, not wearing a facemask as a preventive measure was found to be a significant risk factor (p=0.007). CONCLUSIONS This study shows that children are at risk of contracting COVID-19 infection. Our study also shows evidence of a high rate of IgG antibodies in school-aged children having close contact with infected adults, in those not wearing facemasks, as well as in those with a family history of comorbidities.
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Affiliation(s)
- Fartun Abdullahi H Orey
- Department of Pediatrics and Child Health, Dr Sumait Hospital, Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu 00000, Somalia
| | - Ali Mohamed Sodal
- Department of Pediatrics and Child Health, Jazeera University Hospital, Jazeera University, Mogadishu 00000, Somalia
| | - Jamal Hassan Mohamoud
- Department of Public Health, Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu 00000, Somalia
| | - Bashiru Garba
- Institute for Medical Research, SIMAD University, Mogadishu 00000, Somalia.,Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, Usmanu Danfodiyo University Sokoto, Sokoto 840212, Nigeria
| | | | - Mohamed Hussein Adam
- Department of Public Health, Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu 00000, Somalia
| | - Hassan Abdullahi Dahie
- Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu 00000, Somalia
| | - Maryan Abdullahi Sh Nur
- Department of Obstetrics and Gynecology, Dr Sumait Hospital, Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu 00000, Somalia
| | - Najib Isse Dirie
- Department of Urology, Dr Sumait Hospital, Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu 00000, Somalia
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Silva FM, Lima J, Teixeira PP, Grezzana GB, Figueiro M, Colombo T, Souto K, Stein AT. Risk of bias and certainty of evidence on the association between obesity and mortality in patients with SARS-COV-2: An umbrella review of meta-analyses. Clin Nutr ESPEN 2023; 53:13-25. [PMID: 36657904 PMCID: PMC9381948 DOI: 10.1016/j.clnesp.2022.08.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 08/07/2022] [Accepted: 08/08/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND & AIMS This umbrella review of systematic reviews with meta-analysis (SR-MAs) aimed to evaluate the risk of bias and the certainty of the evidence of SR-MAs on the association between obesity and mortality in patients with SARS-CoV-2. METHODS We conducted a comprehensive literature search until April 22, 2022, in several databases and assessed the risk of bias of SR-MAs according to AMSTAR-2 and the certainty of evidence using the GRADE approach. The degree of overlap between meta-analyses was based on the corrected covered area (CCA) index. The results of each MA [relative risk (RR), hazard ratio (HR), or odds ratio (OR)] were extracted to evaluate the magnitude of the association between obesity and mortality. RESULTS A total of 24 SR-MAs were eligible, and the association between obesity and mortality was not statistically significant in eight (33.3%) of them, while the OR/HR/RR ranged from 1.14 to 3.52 in the other SR-MAs. The overlap was slight (CCA = 4.82%). The majority of SR-MAs presented critically low quality according to AMSTAR-2 (66.7%), and the certainty of the evidence for most of them (83.4%) was "very low". CONCLUSIONS Obesity was associated with an increased risk of death in patients with SARS-CoV-2 infection in most SR-MAs; however, a critical appraisal pointed to a high risk of bias, and the certainty of their evidence was not well graded. The dissemination of poor SR-MAs may limit the interpretation of findings, and we should always aspire to trustworthy scientific evidence. PROSPERO PROSPERO 2021 CRD42021253142.
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Affiliation(s)
- Flávia M Silva
- Nutrition Department, Federal University of Health Science of Porto Alegre, Sarmento Leite street, 245, Porto Alegre, Rio Grande do Sul, 90050-170, Brazil; Graduate Program of Nutrition Science, Federal University of Health Science of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Julia Lima
- Graduate Program of Nutrition Science, Federal University of Health Science of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Paula P Teixeira
- Graduate Program on Medical Science, Endocrinology, Federal University of Rio Grande do Sul, Brazil
| | | | - Mabel Figueiro
- Health Knowledge Implementation Laboratory of Heart Hospital (HCor), São Paulo, SP, Brazil
| | - Talita Colombo
- Graduate Program of Health Science, Federal University of Health Science of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Katia Souto
- Grupo Hospitalar Conceição, Porto Alegre, Rio Grande do Sul, Brazil
| | - Airton T Stein
- Graduate Program of Health Science, Federal University of Health Science of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; Grupo Hospitalar Conceição, Porto Alegre, Rio Grande do Sul, Brazil; Public Health Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
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Alsaleh FM, Elzain M, Alsairafi ZK, Naser AY. Perceived Knowledge, Attitude, and Practices (KAP) and Fear toward COVID-19 among Patients with Diabetes Attending Primary Healthcare Centers in Kuwait. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20032369. [PMID: 36767736 PMCID: PMC9916070 DOI: 10.3390/ijerph20032369] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/22/2023] [Accepted: 01/23/2023] [Indexed: 06/01/2023]
Abstract
OBJECTIVES To assess perceived fear and to evaluate the level of knowledge, attitude, and prevention practices (KAP) regarding COVID-19 infection among patients with diabetes mellitus (DM) attending primary healthcare centers (PHCs) in Kuwait. This will help evaluate gaps and provide appropriate support to limit the spread of COVID-19 infection in high-risk patients. METHODS A descriptive cross-sectional study was carried out using a self-administered questionnaire. All patients aged 18 years or older attending for follow-up or newly diagnosed with type 1 or type 2 diabetes were eligible to participate in the study. Patients waiting for their regular follow-up appointments at the PHCs were invited verbally to take part in the study. The study excluded patients under the age of 18 and those with significant cognitive or physical impairment that might interfere with independent self-care behavior. The questionnaire included 57 items. The data were analyzed using descriptive statistics. RESULTS A total of 294 questionnaires were distributed to patients at PHCs in three health districts (Hawally, Capital, and Farwaniya) in Kuwait; 251 patients agreed to participate in the study, yielding a response rate of 85.4%. The study showed that most patients had moderate knowledge (71.1%) of COVID-19. The majority of correctly responded questions were about the mode of COVID-19 transmission, the most common clinical presentations, and at-risk people. On the other hand, 83.7% (n = 210) identified common cold symptoms (stuffy nose, runny nose, and sneezing) as COVID-19 symptoms. More than half of the patients (n = 146, 58.2%) were unable to identify uncommon COVID-19 symptoms, such as diarrhea and skin rash or discoloration. Most patients had a positive attitude (90.9%) and good prevention practices (83.6%). The overall fear score of the participating patients was 21.6 ± 6.5 (61.7%). CONCLUSIONS Regardless of the positive attitude and good preventive practices of the patients, they had moderate knowledge levels about COVID-19. This indicates that there are significant knowledge gaps that still need to be filled. Different strategies can be used for this purpose, such as social media and public information campaigns. Supporting psychological well-being is vital for at-risk patients during a pandemic.
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Affiliation(s)
- Fatemah M. Alsaleh
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait City 12037, Kuwait
| | - Muna Elzain
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait City 12037, Kuwait
| | - Zahra K. Alsairafi
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait City 12037, Kuwait
| | - Abdallah Y. Naser
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman 11622, Jordan
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Zewdie A, Mose A, Sahle T, Kasahun AW, Melaku E, Zemene MA. COVID 19 prevention practice of patients with known chronic illness in Ethiopia: A systemic review and meta-analysis. JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2023; 13:26335565231176166. [PMID: 37197196 PMCID: PMC10184217 DOI: 10.1177/26335565231176166] [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: 07/04/2022] [Accepted: 04/28/2023] [Indexed: 05/19/2023]
Abstract
Introduction There were different studies done and found a highly variable level of COVID 19 prevention practice; however, there was no summarized evidence on the prevention practice of chronic disease patients in Ethiopia. This systematic review and meta-analysis aims to assess the pooled prevalence of COVID 19 prevention practice and associated factors among chronic disease patients in Ethiopia. Method Systematic review and meta-analysis were conducted using PRISMA guidelines. Comprehensive literature was searched in international databases. A weighted inverse variance random effect model was used to estimate pooled prevalence. Cochrane Q-test and I2 statistics were computed to assess heterogeneity among studies. Funnel plot and Eggers test were done to assess publication bias. Review manager software was used to identify determinants of COVID 19 prevention practice. Result Overall, 437 articles were retrieved and finally 8 articles were included in this review. The pooled prevalence of good COVID 19 prevention practices was 44.02% (95%CI (35.98%-52.06%). Being rurally reside (AOR = 2.39, 95% CI (1.30-4.41)), having educational status of cannot read and write (AOR = 2.32, 95% CI (1.22-4.40)), and poor knowledge (AOR = 2.43, 95% CI (1.64-3.60)) positively associated with poor practice. Conclusion Good COVID 19 prevention practices of chronic disease patients in Ethiopia was low. Rural residence, educational status of cannot read and write and poor knowledge was positively associated with poor practice. Therefore, policymakers and program planners should target those high-risk groups in improving their awareness to enhance their practice specifically focusing on those who are rural reside and with low educational status.
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Affiliation(s)
- Amare Zewdie
- Department of Public Health, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Ayenew Mose
- Department of Midwifery, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Tadesse Sahle
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Abebaw Wasie Kasahun
- Department of Public Health, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Elyas Melaku
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Melkamu Aderajew Zemene
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Zakaria D, Aziz S, Bartholomew S, Park SB, Robitaille C, Weeks M. Associations between chronic conditions and death in hospital among adults (aged 20+ years) during first acute care hospitalizations with a confirmed or suspected COVID-19 diagnosis in Canada. PLoS One 2023; 18:e0280050. [PMID: 36598923 DOI: 10.1371/journal.pone.0280050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 12/20/2022] [Indexed: 01/05/2023] Open
Abstract
PURPOSE We aimed to quantify life course-specific associations between death in hospital and 30 chronic conditions, and comorbidity among them, in adults (aged 20+ years) during their first acute care hospitalization with a confirmed or suspected COVID-19 diagnosis in Canada. METHODS We identified 35,519 first acute care hospitalizations with a confirmed or suspected COVID-19 diagnosis in the Discharge Abstract Database as of March 31, 2021. For each of five life-course age groups (20-34, 35-49, 50-64, 65-79, and 80+ years), we used multivariable logistic regression to examine associations between death in hospital and 30 chronic conditions, comorbidity, period of admission, and pregnant status, after adjusting for sex and age. RESULTS About 20.9% of hospitalized patients with COVID-19 died in hospital. Conditions most strongly associated with in-hospital death varied across the life course. Chronic liver disease, other nervous system disorders, and obesity were statistically significantly associated (α = 0.05) with in-hospital death in the 20-34 to 65-79 year age groups, but the magnitude of the associations decreased as age increased. Stroke (aOR = 5.24, 95% CI: 2.63, 9.83) and other inflammatory rheumatic diseases (aOR = 4.37, 95% CI: 1.64, 10.26) were significantly associated with in-hospital death among 35 to 49 year olds only. Among 50+ year olds, more chronic conditions were significantly associated with in-hospital death, but the magnitude of the associations were generally weaker except for Down syndrome in the 50 to 64 (aOR = 8.49, 95% CI: 4.28, 16.28) and 65 to 79 year age groups (aOR = 5.19, 95% CI: 1.44, 20.91). Associations between comorbidity and death also attenuated with age. Among 20 to 34 year olds, the likelihood of death was 19 times greater (aOR = 18.69, 95% CI: 7.69, 48.24) in patients with three or more conditions compared to patients with none of the conditions, while for 80+ year olds the likelihood of death was two times greater (aOR = 2.04, 95% CI: 1.70, 2.45) for patients with six or more conditions compared to patients with none of the conditions. CONCLUSION Conditions most strongly associated with in-hospital death among hospitalized adults with COVID-19 vary across the life course, and the impact of chronic conditions and comorbidity attenuate with age.
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Affiliation(s)
- Dianne Zakaria
- Centre for Surveillance and Applied Research, Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Samina Aziz
- Centre for Surveillance and Applied Research, Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Sharon Bartholomew
- Centre for Surveillance and Applied Research, Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Su-Bin Park
- Centre for Surveillance and Applied Research, Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Cynthia Robitaille
- Centre for Surveillance and Applied Research, Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Murray Weeks
- Centre for Surveillance and Applied Research, Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Ottawa, Ontario, Canada
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Räuber S, Willison A, Korsen M, Kölsche T, Golombeck KS, Plaack B, Schüller J, Huntemann N, Rolfes L, Schroeter CB, Nelke C, Regner-Nelke L, Förster M, Ringelstein M, Barnett MH, Hartung HP, Aktas O, Albrecht P, Ruck T, Melzer N, Meuth SG, Kremer D. Vaccine-based clinical protection against SARS-CoV-2 infection and the humoral immune response: A 1-year follow-up study of patients with multiple sclerosis receiving ocrelizumab. Front Immunol 2022; 13:1037214. [PMID: 36618356 PMCID: PMC9822773 DOI: 10.3389/fimmu.2022.1037214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 12/12/2022] [Indexed: 12/25/2022] Open
Abstract
Introduction Given the varying severity of coronavirus disease 2019 (COVID-19) and the rapid spread of Severe-Acute-Respiratory-Syndrome-Corona-Virus-2 (SARS-CoV-2), vaccine-mediated protection of particularly vulnerable individuals has gained increasing attention during the course of the pandemic. Methods We performed a 1-year follow-up study of 51 ocrelizumab-treated patients with multiple sclerosis (OCR-pwMS) who received COVID-19 vaccination in 2021. We retrospectively identified 37 additional OCR-pwMS, 42 pwMS receiving natalizumab, 27 pwMS receiving sphingosine 1-phosphate receptor modulators, 59 pwMS without a disease-modifying therapy, and 61 controls without MS (HC). In OCR-pwMS, anti-SARS-CoV-2(S)-antibody titers were measured prior to the first and after the second, third, and fourth vaccine doses (pv2/3/4). The SARS-CoV-2-specific T cell response was analyzed pv2. SARS-CoV-2 infection status, COVID-19 disease severity, and vaccination-related adverse events were assessed in all pwMS and HC. Results We found a pronounced and increasing anti-SARS-CoV-2(S)-antibody response after COVID-19 booster vaccinations in OCR-pwMS (pv2: 30.4%, pv3: 56.5%, and pv4 90.0% were antibody positive). More than one third of OCR-pwMS without detectable antibodies pv2 developed positive antibodies pv3. 23.5% of OCR-pwMS had a confirmed SARS-CoV-2 infection, of which 84.2% were symptomatic. Infection rates were comparable between OCR-pwMS and control groups. None of the pwMS had severe COVID-19. An attenuated humoral immune response was not associated with a higher risk of SARS-CoV-2 infection. Discussion Additional COVID-19 vaccinations can boost the humoral immune response in OCR-pwMS and improve clinical protection against COVID-19. Vaccines effectively protect even OCR-pwMS without a detectable COVID-19 specific humoral immune response, indicating compensatory, e.g., T cell-mediated immunological mechanisms.
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Affiliation(s)
- Saskia Räuber
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Alice Willison
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Melanie Korsen
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Tristan Kölsche
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Kristin S. Golombeck
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Benedikt Plaack
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Julia Schüller
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Niklas Huntemann
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Leoni Rolfes
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Christina B. Schroeter
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Christopher Nelke
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Liesa Regner-Nelke
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Moritz Förster
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Marius Ringelstein
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany,Department of Neurology, Center for Neurology and Neuropsychiatry, LVR-Klinikum, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | | | - Hans-Peter Hartung
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany,Brain and Mind Center, University of Sydney, Sydney, NSW, Australia,Department of Neurology, Medical University of Vienna, Vienna, Austria,Department of Neurology, Palacky University, Olomouc, Czechia
| | - Orhan Aktas
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Philipp Albrecht
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Tobias Ruck
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Nico Melzer
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Sven G. Meuth
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - David Kremer
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany,*Correspondence: David Kremer,
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Vekaria PH, Syed A, Anderson J, Cornett B, Bourbia A, Flynn MG, Kashyap R, Shah AR. Association of dementia and patient outcomes among COVID-19 patients: A multi-center retrospective case-control study. Front Med (Lausanne) 2022; 9:1050747. [PMID: 36419792 PMCID: PMC9676493 DOI: 10.3389/fmed.2022.1050747] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 10/20/2022] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND We conducted a retrospective cohort study on COVID-19 patients with and without dementia by extracting data from the HCA Healthcare Enterprise Data Warehouse between January-September 2020. AIMS To describe the role of patients' baseline characteristics specifically dementia in determining overall health outcomes in COVID-19 patients. METHODS We grouped in-patients who had ICD-10 codes for dementia (DM) with age and gender-matched (1:2) patients without dementia (ND). Our primary outcome variables were in-hospital mortality, length of stay, Intensive Care Unit (ICU) admission, ICU-free days, mechanical ventilation (MV) use, MV-free days and 90-day re-admission. RESULTS Matching provided similar age and sex in DM and ND groups. BMI (median, 25.8 vs. 27.6) and proportion of patients who had smoked (23.3 vs. 31.3%) were lower in DM than in ND patients. The median (IQR) Elixhauser Comorbidity Index was higher in dementia patients 7 (5-10) vs. 5 (3-7, p < 0.01). Higher mortality was observed in DM group (30.8%) vs. ND group (26.4%, p < 0.01) as an unadjusted univariate analysis. The 90-day readmission was not different (32.1 vs. 31.8%, p = 0.8). In logistic regression analysis, the odds of dying were not different between patients in DM and ND groups (OR = 1.0; 95% CI 0.86-1.17), but the odds of ICU admissions were significantly lower for dementia patients (OR = 0.58, 95% CI 0.51-0.66). CONCLUSIONS Our data showed that COVID-19 patients with dementia did not fare substantially worse, but in fact, fared better when certain metrics were considered.
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Affiliation(s)
- Pratikkumar H. Vekaria
- Prisma Health-Upstate, Greenville, SC, United States
- Redmond Regional Medical Center, Advent Health, Rome, GA, United States
| | - Areej Syed
- Redmond Regional Medical Center, Advent Health, Rome, GA, United States
| | | | | | - Amine Bourbia
- Redmond Regional Medical Center, Advent Health, Rome, GA, United States
| | | | - Rahul Kashyap
- HCA Healthcare, Nashville, TN, United States
- Mayo Clinic, Rochester, MN, United States
| | - Asif R. Shah
- Redmond Regional Medical Center, Advent Health, Rome, GA, United States
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Chen Z, Peng Y, Wu X, Pang B, Yang F, Zheng W, Liu C, Zhang J. Comorbidities and complications of COVID-19 associated with disease severity, progression, and mortality in China with centralized isolation and hospitalization: A systematic review and meta-analysis. Front Public Health 2022; 10:923485. [PMID: 36052001 PMCID: PMC9424916 DOI: 10.3389/fpubh.2022.923485] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/25/2022] [Indexed: 01/22/2023] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) causes life-threatening with the high-fatality rates and spreads with high-infectious disease worldwide. We aimed to systematically review the comorbidities and complications of COVID-19 that are associated with various disease severity, progression, and mortality in China, to provide contemporary and reliable estimates in settings with centralized isolation and hospitalization. Methods In this systematic review and meta-analysis, we searched four main English language databases, and four main Chinese language databases for observational studies published from inception to January 2022, to identify all the related comorbidities and complications of COVID-19, in the China region with centralized isolation and hospitalization, with disease severity, progression, and mortality. Literature search, data extraction, and quality assessment were independently conducted by two reviewers. We used the generalized linear mixed model to estimate pooled effect sizes for any comorbidities and complications, and subgroup in gender ratio was done to further address the potential heterogeneity. Results Overall, 187 studies describing 77,013 patients, namely, 54 different comorbidities and 46 various complications of COVID-19, were identified who met our inclusion criteria. The most prevalent comorbidities were hypertension [20.37% 95% CI (15.28-26.63), 19.29% (16.17-22.85), 34.72% (31.48-38.10), and 43.94% (38.94-49.06)] and diabetes [7.84% (5.78-10.54), 8.59% (7.25-10.16), 17.99% (16.29-19.84), and 22.68% (19.93-25.69)] in mild, moderate, severe, and critical cases. The most prevalent complications were liver injury [10.00% (1.39-46.72), 23.04% (14.20-35.13), and 43.48% (39.88-47.15)] in mild, moderate, and severe cases, and acute respiratory distress syndrome [ARDS; 94.17% (20.78-99.90)] and respiratory failure [90.69% (28.08-99.59)] in critical cases. Renal insufficiency [odds ratio (OR) 17.43 (6.69-45.43)] in comorbidities and respiratory failure [OR 105.12 (49.48-223.33)] in complications were strongly associated in severe/critical than in mild/moderate cases. The highest estimated risk in intensive care unit (ICU) admission, progression, and mortality was an autoimmune disease, nervous system disease, and stroke in comorbidities, shock, and ARDS in complications. Conclusion Comorbidities and complications in inpatients with COVID-19 were positively associated with increased risk in severe and critical cases, ICU admission, exacerbation, and death during centralized isolation and hospitalization. Prompt identification of comorbidities and complications in inpatients with COVID-19 can enhance the prevention of disease progression and death and improve the precision of risk predictions.
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Affiliation(s)
- Zhe Chen
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yingying Peng
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Xiaolei Wu
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Bo Pang
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Fengwen Yang
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Wenke Zheng
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Chunxiang Liu
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China,*Correspondence: Chunxiang Liu
| | - Junhua Zhang
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China,Junhua Zhang
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Kramarič J, Ješe R, Tomšič M, Rotar Ž, Hočevar A. COVID-19 among patients with giant cell arteritis: a single-centre observational study from Slovenia. Clin Rheumatol 2022; 41:2449-2456. [PMID: 35366735 PMCID: PMC8976457 DOI: 10.1007/s10067-022-06157-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/28/2022] [Accepted: 03/28/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Patients with giant cell arteritis (GCA) represent a fragile population with an increased infection risk. In a recent study, older age, a higher number of comorbidities, higher disease activity and prednisolone ≥ 10 mg/day were associated with worse COVID-19 outcome. We aimed to evaluate the frequency and severity of COVID-19 in a well-defined GCA cohort. METHODS We reviewed medical records of histologically and/or by imaging-proven GCA patients diagnosed between September 2011 and February 2020 at our secondary/tertiary centre and followed during the COVID-19 pandemic between March 2020 and February 2022 (24 months). Descriptive statistics were used to explore the studied population. RESULTS Of 314 patients with GCA diagnosed for the first time during a 102-month period, 49 patients died before March 2020. Of the remaining 265 patients, 55 (20.8%) patients suffered from a total of 57 SARS-CoV-2 infections. We observed 44 (77.2%) mild and 13 (22.8%) severe COVID-19 episodes (the latter defined as needing hospitalization, death or thrombotic complication). Patients with severe COVID-19 were more likely to have arterial hypertension (12 [92.3%] vs. 25 [56.8%]; p = 0.022), cardiovascular disease (7 [53.8%] vs. 10 [22.7%]; p = 0.043) or obesity (5 [38.5%] vs. 5 [11.4%]; p = 0.038). Neither prednisolone dose 1-5 mg/day (p = 0.483) nor leflunomide use (p = 1.000) was associated with COVID-19 course. There were no significant differences in sex, age, GCA type, GCA disease duration and other comorbidities in patients with mild and severe COVID-19 in our cohort. CONCLUSION More than a fifth of our GCA patients had severe COVID-19. Treatment with leflunomide or low doses of glucocorticoids were not associated with severe course in our cohort. Key Points • Treatment with leflunomide or low doses of glucocorticoids were not associated with worse COVID-19 outcome. • Outcomes of COVID-19 improved as the COVID-19 pandemic, prevention and treatment options evolved. • Arterial hypertension, cardiovascular disease or obesity were associated with severe COVID-19.
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Affiliation(s)
- Jelka Kramarič
- Department of Rheumatology, University Medical Centre Ljubljana, Vodnikova 62, 1000, Ljubljana, Slovenia.
| | - Rok Ješe
- Department of Rheumatology, University Medical Centre Ljubljana, Vodnikova 62, 1000, Ljubljana, Slovenia
| | - Matija Tomšič
- Department of Rheumatology, University Medical Centre Ljubljana, Vodnikova 62, 1000, Ljubljana, Slovenia
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Žiga Rotar
- Department of Rheumatology, University Medical Centre Ljubljana, Vodnikova 62, 1000, Ljubljana, Slovenia
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Alojzija Hočevar
- Department of Rheumatology, University Medical Centre Ljubljana, Vodnikova 62, 1000, Ljubljana, Slovenia
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
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The Impact of SARS-CoV-2 Pandemic on Patients with Malignant Melanoma at a Romanian Academic Center: A Four-Year Retrospective Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148499. [PMID: 35886351 PMCID: PMC9317187 DOI: 10.3390/ijerph19148499] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 11/17/2022]
Abstract
Considering cancer patients may be at an increased risk of severe COVID-19 disease, their oncologic treatment cannot be delayed without risking their oncologic outcomes. Considering this, a comprehensive evaluation is required for the management of malignant diseases such as melanoma. The current study aimed to assess the impact of the COVID-19 pandemic on the delivery of cancer care services for patients diagnosed with malignant melanoma in Romania; to document the difference in patients’ addressability and melanoma staging between the pandemic and pre-pandemic periods; as well as to determine the risk factors responsible for disease progression during the pandemic. We developed a retrospective analysis using a monocentric hospital database to compare the final 24 months of the pre-pandemic era to the first 24 months of the COVID-19 pandemic. All outpatients and inpatients with a diagnosis of malignant melanoma were screened during the study period and included in the analysis if matching the inclusion criteria. A total of 301 patients were included in the study, with 163 cases identified in the 24 months before the COVID-19 pandemic and 138 patients during the first 24 months of the pandemic. It was observed during the first two lockdown periods from March to May 2020, and, respectively, from October to December 2020, that significantly fewer patients with malignant melanoma presented for specialized medical care, while there was a statistically significantly lower proportion of outpatients due to COVID-19 restrictions (18.1% vs. 42.9%). The average Breslow depth was 1.1 mm before the pandemic, compared with 1.8 mm during the pandemic (p-value < 0.001). Third-stage patients were the most prevalent during both study periods, although with a statistically significant difference during the pandemic, with an increase from 90 (55.2%) patients to 94 (68.1%) (p-value < 0.001). The significant risk factors for disease progression were advanced AJCC stage (HR = 3.48), high Breslow index (HR = 3.19), postponed treatment (HR = 2.46), missed appointments (HR = 2.31), anemia at presentation (HR = 1.60), and patient’s age (HR = 1.57). After the pandemic limitations are brought to an end, a broad skin-cancer-screening campaign is warranted to detect the missed cases during COVID-19.
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Muccioli L, Zenesini C, Taruffi L, Licchetta L, Mostacci B, Di Vito L, Pasini E, Volpi L, Riguzzi P, Ferri L, Baccari F, Nonino F, Michelucci R, Tinuper P, Vignatelli L, Bisulli F. Risk of hospitalization and death for COVID-19 in persons with epilepsy over a 20-month period: the EpiLink Bologna cohort, Italy. Epilepsia 2022; 63:2279-2289. [PMID: 35778963 PMCID: PMC9349826 DOI: 10.1111/epi.17356] [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: 04/19/2022] [Revised: 06/30/2022] [Accepted: 06/30/2022] [Indexed: 11/28/2022]
Abstract
Objective Data on COVID‐19 outcomes in persons with epilepsy (PWE) are scarce and inconclusive. We aimed to study the risk of hospitalization and death for COVID‐19 in a large cohort of PWE from March 1, 2020 to October 31, 2021. Methods The historical cohort design (EpiLink Bologna) compared adult PWE grouped into people with focal epilepsy (PFE), idiopathic generalized epilepsy (PIGE), and developmental and/or epileptic encephalopathy (PDEE), and a population cohort matched (ratio 1:10) for age, sex, residence, and comorbidity (assessed with the multisource comorbidity score), living in the local health trust of Bologna (approximately 800 000 residents). Clinical data were linked to health administrative data. Results In both cohorts (EpiLink: n = 1575 subjects, 1128 PFE, 267 PIGE, 148 PDEE, 32 other; controls: n = 15 326 subjects), 52% were females, and the mean age was 50 years (SD = 18). Hospital admissions for COVID‐19 in the whole period were 49 (3.1%) in PWE and 225 (1.5%) in controls. The adjusted hazard ratio (aHR) in PWE was 1.9 (95% confidence interval [CI] = 1.4–2.7). The subgroups at higher risk were PFE (aHR = 1.9, 95% CI = 1.3–2.8) and PDEE (aHR = 3.9, 95% CI = 1.7–8.7), whereas PIGE had a risk comparable to the controls (aHR = 1.1, 95% CI = .3–3.5). Stratified analyses of the two main epidemic waves (March–May 2020, October 2020–May 2021) disclosed a higher risk of COVID‐19‐related hospitalization during the first epidemic wave (March–May 2020; aHR = 3.8, 95% CI = 2.2–6.7). Polytherapy with antiseizure medications contributed to a higher risk of hospital admission. Thirty‐day risk of death after hospitalization was 14% in both PWE and controls. Significance During the first 20 months since the outbreak of COVID‐19 in Bologna, PWE had a doubled risk of COVID‐19 hospital admission compared to a matched control population. Conversely, epilepsy did not represent a risk factor for COVID‐19‐related death.
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Affiliation(s)
- Lorenzo Muccioli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Corrado Zenesini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Lisa Taruffi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Laura Licchetta
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Barbara Mostacci
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Lidia Di Vito
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Elena Pasini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Lilia Volpi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Patrizia Riguzzi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Lorenzo Ferri
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Flavia Baccari
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Francesco Nonino
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | | | - Paolo Tinuper
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Luca Vignatelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Francesca Bisulli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
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Abdulah DM, Mirza AMS. Receiving COVID-19 vaccine, hospitalization, and outcomes of patients with COVID-19: A prospective study. Monaldi Arch Chest Dis 2022; 93. [PMID: 35754392 DOI: 10.4081/monaldi.2022.2194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 06/04/2022] [Indexed: 11/23/2022] Open
Abstract
Despite Iraq having started the COVID-19 vaccine in January 2020, there is no official data on vaccination and hospitalization across the country. We aimed to explore the role of the COVID-19 vaccine on the hospitalization and outcomes of patients with COVID-19 in Iraqi Kurdistan. In this prospective study, patients who were admitted to two COVID-19 hospitals in Iraqi Kurdistan in 2021 were followed-up by the discharge time between August and November 2021. The mean age of the patients was 57.6 (27-98 years) of both genders. Most of the patients were illiterate (69.3%) or had a lower level of education (20.5%). A small percentage of patients had previous thrombotic disorders (4.7%) and close to half of the patients had chronic diseases (44.9%). The patients had mild to moderate (44.9%), moderate-severe (36.2%), and critical (18.9%) status. The median hospitalization day was 9 days (1-45 days). The study found that 91.3% of the COVID-19 hospitalized patients did not receive the vaccine and 26.8% of patients died. We did not find a significant association between receiving vaccination and patients' outcomes or disease severity. No patients with previous thrombotic disorders received the COVID-19 vaccine. The male patients were more likely to receive the COVID-19 vaccine compared to female patients; 14.55% vs. 4.17%, p=0.0394. This study showed that most patients with COVID-19 who were admitted to the hospitals have not received the COVID-19 vaccine. A high percentage of the COVID-19 hospitalized patients died of the disease in this region.
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Affiliation(s)
- Deldar Morad Abdulah
- Community Health Unit, College of Nursing, University of Duhok, Iraqi Kurdistan, Duhok.
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Seid AA, Woday Tadesse A, Hasen AA. Severity and mortality of COVID-19 among people with disabilities: protocol for a systematic review and meta-analysis. BMJ Open 2022; 12:e061438. [PMID: 35701069 PMCID: PMC9198383 DOI: 10.1136/bmjopen-2022-061438] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION As the COVID-19 pandemic and the subsequent global healthcare crisis continue, people with disabilities may face greater health risks than their non-disabled peers. This systematic review and meta-analysis aims to determine the severity and mortality of COVID-19 among people with different types of disabilities. METHODS AND ANALYSIS We will search PubMed, HINARI, ScienceDirect, PEDro and Cochrane Library databases. Grey literature search will also be conducted on MedRxiv and Google Scholar. Searches will be without date restrictions. Cohort, case-control and cross-sectional studies assessing the severity and mortality of COVID-19 among people with disabilities will be included. Only full-text studies in the English language will be included. The outcomes of interest include the risk of COVID-19 infection, rate of hospitalisation, severity, hospital stay, mortality and others variables where data are available. Two reviewers will extract data and perform risk of bias assessment independently. The Newcastle-Ottawa Scale will be used to assess risk of bias. Review Manager V.5.4 and Stata V.16.0 software will be used for statistical analysis. Heterogeneity will be analysed using I² statistics. Pooled OR with 95% CI will be used to calculate the pooled results for outcome variables. ETHICS AND DISSEMINATION Ethical approval and informed consent are not required as this is a systematic review of existing publications. The final results will be published in a peer reviewed journal and presented at national and international conferences. PROSPERO REGISTRATION NUMBER CRD42022306361.
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Affiliation(s)
- Abubeker Alebachew Seid
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Afar, Ethiopia
| | - Abay Woday Tadesse
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Afar, Ethiopia
| | - Aragaw Asfaw Hasen
- Department of Statistics, College of Natural and Computational Sciences, Samara University, Samara, Afar, Ethiopia
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Raia L, Urbina T, Gabarre P, Bonny V, Hariri G, Ehrminger S, Bigé N, Baudel JL, Guidet B, Maury E, Joffre J, Ait-Oufella H. Impaired skin microvascular endothelial reactivity in critically ill COVID-19 patients. Ann Intensive Care 2022; 12:51. [PMID: 35696007 PMCID: PMC9188908 DOI: 10.1186/s13613-022-01027-3] [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: 03/13/2022] [Accepted: 06/01/2022] [Indexed: 11/25/2022] Open
Abstract
Background Some clinical and histological studies have reported that SARS-CoV-2 infection may damage the endothelium. However, the impact of this virus on endothelial function in vivo remains poorly characterized. In this single-center pilot observational study, we performed iontophoresis of acetylcholine coupled with Laser doppler to investigate microvascular endothelial reactivity in COVID-19 patients compared to patients with non-COVID-19 bacterial pneumonia (NCBP) patients. Results During three consecutive months, 32 COVID-19 patients and 11 control NCBP patients with acute respiratory failure were included. The median age was 59 [50–68] and 69 [57–75] years in COVID-19 and NCBP groups, respectively (P = 0.11). There was no significant difference in comorbidities or medications between the two groups, except for body mass index, which was higher in COVID-19 patients. NCBP patients had a higher SAPS II score compared to COVID-19 patients (P < 0.0001), but SOFA score was not different between groups (P = 0.51). Global hemodynamic and peripheral tissue perfusion parameters were not different between groups. COVID-19 patients had significantly lower skin microvascular basal blood flow than NCBP patients (P = 0.02). In addition, endothelium-dependent microvascular reactivity was threefold lower in COVID-19 patients than NCBP patients (P = 0.008). Conclusions Both baseline skin microvascular blood flow and skin endothelial-dependent microvascular reactivity were impaired in critically ill COVID-19 patients compared to NCBP patients, despite a lower disease severity score supporting a specific pathogenic role of SARS-CoV-2 on the endothelium. Supplementary Information The online version contains supplementary material available at 10.1186/s13613-022-01027-3.
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Affiliation(s)
- Lisa Raia
- Medical Intensive Care Unit, Saint Antoine University Hospital, APHP, Sorbonne University, 75012, Paris, France
| | - Tomas Urbina
- Medical Intensive Care Unit, Saint Antoine University Hospital, APHP, Sorbonne University, 75012, Paris, France
| | - Paul Gabarre
- Medical Intensive Care Unit, Saint Antoine University Hospital, APHP, Sorbonne University, 75012, Paris, France
| | - Vincent Bonny
- Medical Intensive Care Unit, Saint Antoine University Hospital, APHP, Sorbonne University, 75012, Paris, France
| | - Geoffroy Hariri
- Medical Intensive Care Unit, Saint Antoine University Hospital, APHP, Sorbonne University, 75012, Paris, France
| | - Sebastien Ehrminger
- Medical Intensive Care Unit, Saint Antoine University Hospital, APHP, Sorbonne University, 75012, Paris, France
| | - Naïke Bigé
- Medical Intensive Care Unit, Saint Antoine University Hospital, APHP, Sorbonne University, 75012, Paris, France
| | - Jean-Luc Baudel
- Medical Intensive Care Unit, Saint Antoine University Hospital, APHP, Sorbonne University, 75012, Paris, France
| | - Bertrand Guidet
- Medical Intensive Care Unit, Saint Antoine University Hospital, APHP, Sorbonne University, 75012, Paris, France.,Pierre Louis Institute of Epidemiology and Public Health, Sorbonne University, Inserm U1136, Paris, France
| | - Eric Maury
- Medical Intensive Care Unit, Saint Antoine University Hospital, APHP, Sorbonne University, 75012, Paris, France.,Pierre Louis Institute of Epidemiology and Public Health, Sorbonne University, Inserm U1136, Paris, France.,Centre de Recherche Saint-Antoine, Sorbonne University, Inserm U938, 75012, Paris, France
| | - Jeremie Joffre
- Medical Intensive Care Unit, Saint Antoine University Hospital, APHP, Sorbonne University, 75012, Paris, France.,Centre de Recherche Saint-Antoine, Sorbonne University, Inserm U938, 75012, Paris, France
| | - Hafid Ait-Oufella
- Medical Intensive Care Unit, Saint Antoine University Hospital, APHP, Sorbonne University, 75012, Paris, France. .,Paris Cardiovascular Research Center, Paris University, Inserm U970, Paris, France.
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Huy LD, Shih CL, Chang YM, Nguyen NTH, Phuc PT, Ou TY, Huang CC. Comparison of COVID-19 Resilience Index and Its Associated Factors across 29 Countries during the Delta and Omicron Variant Periods. Vaccines (Basel) 2022; 10:vaccines10060940. [PMID: 35746548 PMCID: PMC9228202 DOI: 10.3390/vaccines10060940] [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: 04/21/2022] [Revised: 05/21/2022] [Accepted: 06/07/2022] [Indexed: 11/16/2022] Open
Abstract
Our study aims to compare the pandemic resilience index and explore the associated factors during the Delta and Omicron variant periods. In addition, the study aims to identify the characteristics of countries that had good performances. We analyzed observation data among 29 countries over the first eight weeks during the two periods of Delta and Omicron variant dominance. Data were extracted from open public databases. The Omicron variant caused a lowered mortality rate per 100,000 COVID-19 patients; however, it is still imposing a colossal burden on health care systems. We found the percentage of the population fully vaccinated and high government indices were significantly associated with a better resilience index in both the Delta and Omicron periods. In contrast, the higher death rate of cancers and greater years lived with disability (YLD) caused by low bone density were linked with poor resilience index in the Omicron periods. Over two periods of Delta and Omicron, countries with good performance had a lower death rate from chronic diseases and lower YLD caused by nutrition deficiency and PM2.5. Our findings suggest that governments need to keep enhancing the vaccine coverage rates, developing interventions for populations with chronic diseases and nutrition deficiency to mitigate COVID-19 impacts on these targeted vulnerable cohorts.
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Affiliation(s)
- Le Duc Huy
- Health Personnel Training Institute, University of Medicine and Pharmacy, Hue University, Hue 49120, Vietnam; (L.D.H.); (N.T.H.N.)
- School of Health Care Administration, College of Management, Taipei Medical University, Taipei 10675, Taiwan; (Y.-M.C.); (P.T.P.)
| | | | - Yao-Mao Chang
- School of Health Care Administration, College of Management, Taipei Medical University, Taipei 10675, Taiwan; (Y.-M.C.); (P.T.P.)
- Research Center of Health and Welfare Policy, Taipei Medical University, Taipei 11031, Taiwan
| | - Nhi Thi Hong Nguyen
- Health Personnel Training Institute, University of Medicine and Pharmacy, Hue University, Hue 49120, Vietnam; (L.D.H.); (N.T.H.N.)
- School of Health Care Administration, College of Management, Taipei Medical University, Taipei 10675, Taiwan; (Y.-M.C.); (P.T.P.)
| | - Phan Thanh Phuc
- School of Health Care Administration, College of Management, Taipei Medical University, Taipei 10675, Taiwan; (Y.-M.C.); (P.T.P.)
- International Ph.D. Program in Biotech and Healthcare Management, College of Management, Taipei Medical University, Taipei 10675, Taiwan
- Department of Social Work, University Medical Center, Ho Chi Minh City 70000, Vietnam
| | - Tsong-Yih Ou
- Division of Infectious Diseases, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan;
- Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, New Taipei 23143, Taiwan
| | - Chung-Chien Huang
- School of Health Care Administration, College of Management, Taipei Medical University, Taipei 10675, Taiwan; (Y.-M.C.); (P.T.P.)
- International Ph.D. Program in Biotech and Healthcare Management, College of Management, Taipei Medical University, Taipei 10675, Taiwan
- Department of Long-Term Care and School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan
- Department and School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei 11031, Taiwan
- Department of Medical Quality, Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan
- Correspondence:
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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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Müller I, Mancinetti M, Renner A, Bridevaux PO, Brutsche MH, Clarenbach C, Garzoni C, Lenoir A, Naccini B, Ott S, Piquilloud L, Prella M, Que YA, Soccal PM, von Garnier C, Geiser TK, Funke-Chambour M, Guler S. Frailty assessment for COVID-19 follow-up: a prospective cohort study. BMJ Open Respir Res 2022; 9:9/1/e001227. [PMID: 35459694 PMCID: PMC9035838 DOI: 10.1136/bmjresp-2022-001227] [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: 02/10/2022] [Accepted: 04/08/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The Clinical Frailty Scale (CFS) is increasingly used for clinical decision making in acute care but little is known about frailty after COVID-19. OBJECTIVES To investigate frailty and the CFS for post-COVID-19 follow-up. METHODS This prospective multicentre cohort study included COVID-19 survivors aged ≥50 years presenting for a follow-up visit ≥3 months after the acute illness. Nine centres retrospectively collected pre-COVID-19 CFS and prospectively CFS at follow-up. Three centres completed the Frailty Index (FI), the short physical performance battery (SPPB), 30 s sit-to-stand test and handgrip strength measurements. Mixed effect logistic regression models accounting for repeated measurements and potential confounders were used to investigate factors associated with post-COVID-19 CFS. Criterion and construct validity were determined by correlating the CFS to other concurrently assessed frailty measurements and measures of respiratory impairment, respectively. RESULTS Of the 288 participants 65% were men, mean (SD) age was 65.1 (9) years. Median (IQR) CFS at follow-up was 3 (2-3), 21% were vulnerable or frail (CFS ≥4). The CFS was responsive to change, correlated with the FI (r=0.69, p<0.001), the SPPB score (r=-0.48, p<0.001) (criterion validity) and with the St George's Respiratory Questionnaire score (r=0.59, p<0.001), forced vital capacity %-predicted (r=-0.25, p<0.001), 6 min walk distance (r=-0.39, p<0.001) and modified Medical Research Council (mMRC) (r=0.59, p<0.001). Dyspnoea was significantly associated with a higher odds for vulnerability/frailty (per one mMRC adjusted OR 2.01 (95% CI 1.13 to 3.58), p=0.02). CONCLUSIONS The CFS significantly increases with COVID-19, and dyspnoea is an important risk factor for post-COVID-19 frailty and should be addressed thoroughly.
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Affiliation(s)
- Ilena Müller
- Department of Pulmonary Medicine, Inselspital University Hospital Bern, Bern, Switzerland
| | - Marco Mancinetti
- Department of Internal Medicine, Hopital cantonal de Fribourg, Fribourg, Switzerland
| | - Anja Renner
- Department of Pulmonary Medicine, Inselspital University Hospital Bern, Bern, Switzerland
| | | | | | | | - Christian Garzoni
- Clinic of Internal Medicine and Infectious Diseases, Clinica Luganese Moncucco, Lugano, Switzerland.,Department of Infectious Diseases, Inselspital University Hospital Bern, Bern, Switzerland
| | - Alexandra Lenoir
- Division of Pulmonary Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Bruno Naccini
- Department of Pulmonary Medicine, Clinica Luganese Moncucco, Lugano, Ticino, Switzerland
| | - Sebastian Ott
- Department of Pulmonary Medicine, Inselspital University Hospital Bern, Bern, Switzerland.,Department of Pulmonary Medicine, Sankt Claraspital AG, Basel, Switzerland
| | - Lise Piquilloud
- Adult Intensive Care Unit, Lausanne University Hospital, Lausanne, Switzerland
| | - Maura Prella
- Division of Pulmonary Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Yok-Ai Que
- Department of Intensive Care Medicine, Inselspital University Hospital Bern, Bern, Switzerland
| | - Paola Marina Soccal
- Division of Pulmonary Medicine, Geneva University Hospitals, Geneve, Switzerland
| | | | - Thomas K Geiser
- Department of Pulmonary Medicine, Inselspital University Hospital Bern, Bern, Switzerland.,Department for BioMedical Research DBMR, University of Bern, Bern, Switzerland
| | - Manuela Funke-Chambour
- Department of Pulmonary Medicine, Inselspital University Hospital Bern, Bern, Switzerland.,Department for BioMedical Research DBMR, University of Bern, Bern, Switzerland
| | - Sabina Guler
- Department of Pulmonary Medicine, Inselspital University Hospital Bern, Bern, Switzerland .,Department for BioMedical Research DBMR, University of Bern, Bern, Switzerland
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39
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Infection, cases due to SARS-CoV-2 in rural areas during early COVID-19 vaccination: Findings from sero-survey study in a rural cohort of eastern India. Epidemiol Infect 2022; 150:e58. [PMID: 35287778 PMCID: PMC8937583 DOI: 10.1017/s0950268822000346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
COVID-19 serosurvey provides a better estimation of people who have developed antibody against the infection. But limited information on such serosurveys in rural areas poses many hurdles to understand the epidemiology of the virus and to implement proper control strategies. This study was carried out in the rural catchment area of Model Rural Health Research Unit in Odisha, India during March–April 2021, the initial phase of COVID vaccination. A total of 60 village clusters from four study blocks were identified using probability proportionate to size sampling. From each cluster, 60 households and one eligible participant from each household (60 per cluster) were selected for the collection of blood sample and socio-demographic data. The presence of SARS-CoV-2 antibody was tested using the Elecsys Anti-SARS-CoV-2 immunoassay. The overall seroprevalence after adjusting for test performance was 54.21% with an infection to case ratio of 96.89 along with 4.25% partial and 6.79% full immunisation coverage. Highest seroprevalence was observed in the age group of 19–44 years and females had both higher seroprevalence as well as vaccine coverage. People of other backward caste also had higher seropositivity than other caste categories. The study emphasises on continuing surveillance for COVID-19 cases and prioritizing COVID-19 vaccination for susceptible groups for better disease management.
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40
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Pongiglione B, Ploubidis GB, Dowd JB. Older Adults in the United States Have Worse Cardiometabolic Health Compared to England. J Gerontol B Psychol Sci Soc Sci 2022; 77:S167-S176. [PMID: 35217868 PMCID: PMC9154237 DOI: 10.1093/geronb/gbac023] [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: 06/10/2021] [Indexed: 01/09/2023] Open
Abstract
Explanations for lagging life expectancy in the United States compared to other high-income countries have focused largely on "deaths of despair," but attention has also shifted to the role of stalling improvements in cardiovascular disease and the obesity epidemic. Using harmonized data from the U.S. Health and Retirement Study and English Longitudinal Study of Ageing, we assess differences in self-reported and objective measures of health, among older adults in the United States and England and explore whether the differences in body mass index (BMI) documented between the United States and England explain the U.S. disadvantage. Older adults in the United States have a much higher prevalence of diabetes, low high-density lipoprotein cholesterol, and high inflammation (C-reactive protein) compared to English adults. While the distribution of BMI is shifted to the right in the United States with more people falling into extreme obesity categories, these differences do not explain the cross-country differences in measured biological risk. We conclude by considering how country differences in health may have affected the burden of coronavirus disease 2019 mortality in both countries.
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Affiliation(s)
- Benedetta Pongiglione
- Address correspondence to: Benedetta Pongiglione, PhD, Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Via Sarfatti 10, 20136 Milano, Italy. E-mail:
| | | | - Jennifer B Dowd
- Leverhulme Centre for Demographic Science, University of Oxford, Oxford, UK
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41
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Rosário Ferreira ME, Santos de Andrade AV, Ferreira Queiroz AA, Martins-Filho PR, de Aquino Neves EL, Oliveira de Carvalho F, de Souza Araujo AA, Ramos Silva É, Santos Nunes P. COVID-19 and obesity: a systematic review and meta-analysis on the pre-existing clinical conditions, COVID-19 symptoms, laboratory findings and clinical outcomes. EXCLI JOURNAL 2022; 20:1610-1614. [PMID: 35024019 PMCID: PMC8743833 DOI: 10.17179/excli2021-4226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 11/22/2021] [Indexed: 12/22/2022]
Affiliation(s)
| | | | | | | | | | - Fernanda Oliveira de Carvalho
- Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, Brazil.,Federal University of Sergipe, University Hospital (HU-UFS/EBSERH), Aracaju, Sergipe, Brazil
| | | | - Érika Ramos Silva
- Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Paula Santos Nunes
- Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, Brazil
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Collischon M, Patzina A. COVID-19 and Gender Differences in Social Trust: Causal Evidence from the First Wave of the Pandemic. SOCIUS: SOCIOLOGICAL RESEARCH FOR A DYNAMIC WORLD 2022; 8:23780231221117910. [PMID: 35991907 PMCID: PMC9378828 DOI: 10.1177/23780231221117910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although research provides causal evidence on the effects of COVID-19 lockdown measures on trust, causal effects of infection risks are missing. To contribute to increasing research on the societal consequences of the COVID-19 pandemic, we estimate whether high incidence rates net of lockdown measures induce causal changes in social trust. We use representative household panel data from Germany and employ a difference-in-difference design. Although social trust increased during the first phase of the pandemic, the difference-in-difference analysis reveals that high incidences have a negative effect on social trust. We show that females drive this effect. The negative effect is especially large among highly educated women and women with poor pre-COVID-19 health. Overall, our results suggest that increasing incidences signal noncompliance of unknown others. Consequently, the overall positive trend might reverse in the medium and long run, leading to declines in social cohesion over the course of the pandemic.
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Affiliation(s)
| | - Alexander Patzina
- Institute for Employment Research, Nuremberg, Germany
- University of Bamberg, Bamberg, Germany
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Alshukairi A, Aldabbagh Y, Sayes N, Al Gethamy M, Alghamdi M, Rahbeeni Z, Dada A. A COVID-19 family cluster with retinitis pigmentosa and hypogammaglobulinemia. Ann Thorac Med 2022; 17:66-69. [PMID: 35198051 PMCID: PMC8809126 DOI: 10.4103/atm.atm_520_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 11/30/2021] [Indexed: 11/04/2022] Open
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44
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Manolis AS, Manolis AA, Manolis TA, Apostolaki NE, Melita H. COVID-19 infection and body weight: A deleterious liaison in a J-curve relationship. Obes Res Clin Pract 2021; 15:523-535. [PMID: 34799284 PMCID: PMC8563353 DOI: 10.1016/j.orcp.2021.10.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 10/10/2021] [Accepted: 10/29/2021] [Indexed: 02/07/2023]
Abstract
During the course of the COVID-19 pandemic, obesity has been shown to be an independent risk factor for high morbidity and mortality. Obesity confers poor outcomes in younger (<60 years) patients, an age-group considered low-risk for complications, a privilege that is negated by obesity. Findings are consistent, the higher the body mass index (BMI) the worse the outcomes. Ectopic (visceral) obesity also promotes proinflammatory, prothrombotic, and vasoconstrictive states, thus enhancing the deleterious effects of COVID-19 disease. Less, albeit robust, evidence also exists for a higher risk of COVID-19 infection incurred with underweight. Thus, the relationship of COVID-19 and BMI has a J-curve pattern, where patients with both overweight/obesity and underweight are more susceptible to the ailments of COVID-19. The pathophysiology underlying this link is multifactorial, mostly relating to the inflammatory state characterizing obesity, the impaired immune response to infectious agents coupled with increased viral load, the overexpression in adipose tissue of the receptors and proteases for viral entry, an increased sympathetic activity, limited cardiorespiratory reserve, a prothrombotic milieu, and the associated comorbidities. All these issues are herein reviewed, the results of large studies and meta-analyses are tabulated and the pathogenetic mechanisms and the BMI relationship with COVID-19 are pictorially illustrated.
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Ademe M, Girma F. The Influence of Helminth Immune Regulation on COVID-19 Clinical Outcomes: Is it Beneficial or Detrimental? Infect Drug Resist 2021; 14:4421-4426. [PMID: 34737582 PMCID: PMC8558425 DOI: 10.2147/idr.s335447] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/19/2021] [Indexed: 12/28/2022] Open
Abstract
Immunologically, chronic worm infections prevent themselves from strong immune responses by skewing the host response towards a T helper 2 (Th2) type. The regulatory response initiated by helminth infections is supposed to temper responses to non-helminth antigens including viral infections which will, in turn, alter the clinical outcomes of infections. In view of this, recent reports highlighted the possible negative associations of severe COVID-19 and helminth co-infections in helminth-endemic regions. As the pathology of COVID-19 is primarily mediated by an excessive immune response and subsequent cytokine storm, which contributes to the poor prognosis of COVID-19, helminth-driven immune modulation will hypothetically contribute to the less severe outcomes of COVID-19. Nevertheless, emerging reports also stated that COVID-19 and helminth co-infections may have more hidden outcomes than predictable ones. Herein, the current knowledge on the interaction of COVID-19 and helminth co-infections will be discussed.
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Affiliation(s)
- Muluneh Ademe
- Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Friehiwot Girma
- Department of Pediatrics and Child Health Nursing, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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