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Shi L, Han X, Wang Y, Xu J, Yang H. Significant association between asthma and a lower risk of mortality among COVID-19 patients in Spain: A meta-analysis. Qatar Med J 2024; 2024:34. [PMID: 39040991 PMCID: PMC11262156 DOI: 10.5339/qmj.2024.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 05/12/2024] [Indexed: 07/24/2024] Open
Abstract
Background Various prevalences of asthma in coronavirus disease 2019 (COVID-19) have been reported in different regions, and the association between asthma and COVID-19 subsequent mortality has been in debate. Thus, this study aimed to investigate whether there was a significant association between asthma and COVID-19 mortality in Spain through a meta-analysis. Methods The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were strictly complied with conducting this study. The pooled odds ratio (OR) with a corresponding 95% confidence interval (CI) was calculated by a random-effects model. The I 2 statistics for heterogeneity, sensitivity analysis for robustness, Begg's test, and Egger's test for publication bias, along with subgroup analyses for confounding bias, were also performed to support the foundation of this study. Results The meta-analysis revealed that asthma was significantly associated with a lower risk of mortality among COVID-19 patients in Spain with a random-effects model (pooled OR = 0.78, 95% CI = 0.69-0.88, I 2 = 35%). Further subgroup analyses by male proportion and sample size also indicated that a statistically significant negative correlation did exist between asthma and COVID-19 mortality. Robustness and no publication on-bias were evidenced by sensitivity analysis, Egger's test, and Begg's test, respectively. Conclusion In conclusion, patients with asthma were found to have a lower risk of mortality from COVID-19 in Spain, especially among elderly patients. In addition, asthmatic patients infected with COVID-19 may be at risk of death compared to non-asthmatic patients, which is not a cause for undue concern, thereby reducing the burden of medication.
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Affiliation(s)
- Liqin Shi
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, China *
| | - Xueya Han
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, China *
| | - Yadong Wang
- Department of Toxicology, Henan Center for Disease Control and Prevention, Zhengzhou, China
| | - Jie Xu
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, China *
| | - Haiyan Yang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, China *
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de Diego-Castell MDC, García-López E, González-González J, Álvarez-Gregori JA, Mohedano-Moriano A, Criado-Álvarez JJ. [Factors associated with the risk of hospitalization and death related to SARS-CoV-2 infection.]. Rev Esp Salud Publica 2023; 97:e202306046. [PMID: 37293850 PMCID: PMC10540890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 05/27/2023] [Indexed: 06/10/2023] Open
Abstract
OBJECTIVE COVID-19 has tried out global health causing high mortality. There are some risk factors that associate greater severity and mortality from COVID-19; but their individual impact is unknown yet. There are also no fixed criteria for hospital admission. For this reason, this study aimed to analyze the factors associated with the severity of COVID-19 and create predictive models for the risk of hospitalization and death due to COVID-19. METHODS A descriptive retrospective cohort study was made in Talavera de la Reina (Toledo, Spain). Data were collected through computerized records of Primary Care, Emergencies and Hospitalization. The sample consisted of 275 patients over eighteen years old diagnosed with COVID-19 in a centralized laboratory from March 1st to May 31st, 2020. Analysis was carried on using SPSS, creating two predictive models for the risk of hospitalization and death using linear regression. RESULTS The probability of hospitalization increased independently with polypharmacy (OR 1.086; CI95% 1.009-1.169), the Charlson index (OR 1.613; CI95% 1.158-2.247), the history of acute myocardial infarction (AMI) (OR 4.358; 95% CI 1.114-17.051) and the presence of COVID symptoms (OR 7.001; 95% CI 2.805-17.475). The probability of death was independently associated with age, increasing 8.1% (OD 1.081; 95% CI 1.054- 1.110) for each year of the patient. CONCLUSIONS Comorbidity, polypharmacy, history of AMI and the presence of COVID-19 symptoms predict the risk of hospitalization. The age of individuals predicts the risk of death. Detecting patients at high risk of hospitalization and death allows us to define the target population and define measures to implement.
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Affiliation(s)
- María Del Carmen de Diego-Castell
- Médico Residente de Medicina Familiar y Comunitaria. Centro de Salud Santa Olalla, Gerencia de Atención Integrada de Talavera de la Reina. Talavera de la Reina (Toledo). España
- Programa de Doctorado en Ciencias de la Salud, Universidad Castilla-La Mancha (UCLM). Talavera de la Reina (Toledo). España
| | - Eduardo García-López
- Médico Residente de Medicina Familiar y Comunitaria. Centro de Salud Presentación Sabio. Móstoles (Madrid). España
| | - Jaime González-González
- Profesor Asociado de la Universidad de Castilla-La Mancha (UCLM). Talavera de la Reina (Toledo). España
- Médico de Medicina Familiar y Comunitaria. Centro de Salud Santa Olalla, Gerencia de Atención Integrada de Talavera de la Reina. Talavera de la Reina (Toledo). España
| | - Joaquín Antonio Álvarez-Gregori
- Médico de Medicina Familiar y Comunitaria. Servicio de Urgencias del Hospital Nuestra Señora del Prado, Gerencia de Atención Integrada de Talavera de la Reina. Talavera de la Reina (Toledo). España
| | - Alicia Mohedano-Moriano
- Profesor Asociado de la Universidad de Castilla-La Mancha (UCLM). Talavera de la Reina (Toledo). España
| | - Juan José Criado-Álvarez
- Profesor Asociado de la Universidad de Castilla-La Mancha (UCLM). Talavera de la Reina (Toledo). España
- Médico de Medicina Familiar y Comunitaria y de Medicina Preventiva y Salud Pública. Director-Gerente del Instituto de Ciencias de la Salud de Castilla-La Mancha. Consejería de Sanidad. Talavera de la Reina (Toledo). España
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Maestre-Muñiz MM, Arias Á, Lucendo AJ. Predicting In-Hospital Mortality in Severe COVID-19: A Systematic Review and External Validation of Clinical Prediction Rules. Biomedicines 2022; 10:biomedicines10102414. [PMID: 36289676 PMCID: PMC9599062 DOI: 10.3390/biomedicines10102414] [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] [Received: 07/17/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 12/03/2022] Open
Abstract
Multiple prediction models for risk of in-hospital mortality from COVID-19 have been developed, but not applied, to patient cohorts different to those from which they were derived. The MEDLINE, EMBASE, Scopus, and Web of Science (WOS) databases were searched. Risk of bias and applicability were assessed with PROBAST. Nomograms, whose variables were available in a well-defined cohort of 444 patients from our site, were externally validated. Overall, 71 studies, which derived a clinical prediction rule for mortality outcome from COVID-19, were identified. Predictive variables consisted of combinations of patients′ age, chronic conditions, dyspnea/taquipnea, radiographic chest alteration, and analytical values (LDH, CRP, lymphocytes, D-dimer); and markers of respiratory, renal, liver, and myocardial damage, which were mayor predictors in several nomograms. Twenty-five models could be externally validated. Areas under receiver operator curve (AUROC) in predicting mortality ranged from 0.71 to 1 in derivation cohorts; C-index values ranged from 0.823 to 0.970. Overall, 37/71 models provided very-good-to-outstanding test performance. Externally validated nomograms provided lower predictive performances for mortality in their respective derivation cohorts, with the AUROC being 0.654 to 0.806 (poor to acceptable performance). We can conclude that available nomograms were limited in predicting mortality when applied to different populations from which they were derived.
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Affiliation(s)
- Modesto M. Maestre-Muñiz
- Department of Internal Medicine, Hospital General de Tomelloso, 13700 Ciudad Real, Spain
- Department of Medicine and Medical Specialties, Universidad de Alcalá, 28801 Alcalá de Henares, Spain
| | - Ángel Arias
- Hospital General La Mancha Centro, Research Unit, Alcázar de San Juan, 13600 Ciudad Real, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, 28006 Madrid, Spain
- Instituto de Investigación Sanitaria La Princesa, 28006 Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), 13700 Tomelloso, Spain
| | - Alfredo J. Lucendo
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, 28006 Madrid, Spain
- Instituto de Investigación Sanitaria La Princesa, 28006 Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), 13700 Tomelloso, Spain
- Department of Gastroenterology, Hospital General de Tomelloso, 13700 Ciudad Real, Spain
- Correspondence: ; Tel.: +34-926-525-927
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Mortality Predictive Value of the C 2HEST Score in Elderly Subjects with COVID-19-A Subanalysis of the COLOS Study. J Clin Med 2022; 11:jcm11040992. [PMID: 35207272 PMCID: PMC8879688 DOI: 10.3390/jcm11040992] [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: 12/17/2021] [Revised: 01/31/2022] [Accepted: 02/10/2022] [Indexed: 01/08/2023] Open
Abstract
Senility has been identified among the strongest risk predictors for unfavorable COVID-19-outcome. However, even in the elderly population, the clinical course of infection in individual patients remains unpredictable. Hence, there is an urgent need for developing a simple tool predicting adverse COVID-19-outcomes. We assumed that the C2HEST-score could predict unfavorable clinical outcomes in the elderly subjects with COVID-19-subjects. Methods: We retrospectively analyzed 1047 medical records of patients at age > 65 years, hospitalized at the medical university center due to COVID-19. Subsequently, patients were divided into three categories depending on their C2HEST-score result. Results: We noticed significant differences in the in-hospital and 3-month and 6-month mortality-which was the highest in high-risk-C2HEST-stratum reaching 35.7%, 54.4%, and 65.9%, respectively. The medium-risk-stratum mortalities reached 24.1% 43.4%, and 57.6% and for low-risk-stratum 14.4%, 25.8%, and 39.2% respectively. In the C2HEST-score model, a change from the low to the medium category increased the probability of death intensity approximately two-times. Subsequently, transfer from the low-risk to the high-risk-stratum raised all-cause-death-intensity 2.7-times. Analysis of the secondary outcomes revealed that the C2HEST-score has predictive value for acute kidney injury, acute heart failure, and cardiogenic shock. Conclusions: C2HEST-score analysis on admission to the hospital may predict the mortality, acute kidney injury, and acute heart failure in elderly subjects with COVID-19.
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Sheikh D, Tripathi N, Chandler TR, Furmanek S, Bordon J, Ramirez JA, Cavallazzi R. Clinical outcomes in patients with COPD hospitalized with SARS-CoV-2 versus non- SARS-CoV-2 community-acquired pneumonia. Respir Med 2021; 191:106714. [PMID: 34915396 PMCID: PMC8654722 DOI: 10.1016/j.rmed.2021.106714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 12/06/2021] [Accepted: 12/07/2021] [Indexed: 12/13/2022]
Abstract
Background Patients with chronic obstructive pulmonary disease (COPD) have poor outcomes in the setting of community-acquired pneumonia (CAP) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The primary objective is to compare outcomes of SARS-CoV-2 CAP and non-SARS-CoV-2 CAP in patients with COPD. The secondary objective is to compare outcomes of SARS-CoV-2 CAP with and without COPD. Methods In this analysis of two observational studies, three cohorts were analyzed: (1) patients with COPD and SARS-CoV-2 CAP; (2) patients with COPD and non-SARS-CoV-2 CAP; and (3) patients with SARS-CoV-2 CAP without COPD. Outcomes included length of stay, ICU admission, cardiac events, and in-hospital mortality. Results Ninety-six patients with COPD and SARS-CoV-2 CAP were compared to 1129 patients with COPD and non-SARS-CoV-2 CAP. 536 patients without COPD and SARS-CoV-2 CAP were analyzed for the secondary objective. Patients with COPD and SARS-CoV-2 CAP had longer hospital stay (15 vs 5 days, p < 0.001), 4.98 higher odds of cardiac events (95% CI: 3.74–6.69), and 7.31 higher odds of death (95% CI: 5.36–10.12) in comparison to patients with COPD and non-SARS-CoV-2 CAP. In patients with SARS-CoV-2 CAP, presence of COPD was associated with 1.74 (95% CI: 1.39–2.19) higher odds of ICU admission and 1.47 (95% CI: 1.05–2.05) higher odds of death. Conclusion In patients with COPD and CAP, presence of SARS-CoV-2 as an etiologic agent is associated with more cardiovascular events, longer hospital stay, and seven-fold increase in mortality. In patients with SARS-CoV-2 CAP, presence of COPD is associated with 1.5-fold increase in mortality.
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Affiliation(s)
- Daniya Sheikh
- Division of Infectious Diseases, University of Louisville, Louisville, KY, USA.
| | - Nishita Tripathi
- Division of Infectious Diseases, University of Louisville, Louisville, KY, USA
| | - Thomas R Chandler
- Division of Infectious Diseases, University of Louisville, Louisville, KY, USA
| | - Stephen Furmanek
- Division of Infectious Diseases, University of Louisville, Louisville, KY, USA
| | - Jose Bordon
- Washington Health Institute, George Washington University, Washington, DC, USA
| | - Julio A Ramirez
- Division of Infectious Diseases, University of Louisville, Louisville, KY, USA
| | - Rodrigo Cavallazzi
- Division of Pulmonary, Critical Care Medicine and Sleep Disorders, University of Louisville, Louisville, KY, USA
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Long-Term Outcomes of Patients with Coronavirus Disease 2019 at One Year after Hospital Discharge. J Clin Med 2021; 10:jcm10132945. [PMID: 34209085 PMCID: PMC8269002 DOI: 10.3390/jcm10132945] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 06/26/2021] [Accepted: 06/27/2021] [Indexed: 12/29/2022] Open
Abstract
Background: The long-term effects of COVID-19 remain largely unclear. This study aims to investigate post-acute health consequences and mortality one year after hospital discharge. Methods: All surviving adult patients who were discharged after hospital admission due to acute COVID-19 in the first wave of the pandemic underwent a comprehensive interview. Functional assessment was performed in patients aged over 65. Clinical and hospital records were reviewed and mortality causes assessed. Results: A total of 587 patients with COVID-19 were discharged from hospital, including 266 after hospital admission and 321 from the emergency room. Mortality within the following year occurred in 34/266 (12.8%) and 10/321 (3.1%), respectively, due to causes directly or possibly related to COVID-19 in 20.5% and 25% of patients. Post-COVID-19 syndrome was assessed in 543 patients at one year from discharge. Any clinical complaint was reported by 90.1% of patients who needed hospitalization and 80.4% of those discharged from the emergency room (p = 0.002), with breathlessness (41.6%), tiredness (35.4%), ageusia (30.2%), and anosmia (26.3%) being the most common complaints. Ongoing symptoms attributed to COVID-19 were reported by 66.8% and 49.5% of patients, respectively (p < 0.001). Newly developed COPD, asthma, diabetes, heart failure, and arthritis—as well as worsening of preexisting comorbidities—were found. Conclusions: One-year mortality among survivors of acute COVID-19 was 7.5%. A significant proportion of COVID-19 patients experienced ongoing symptoms at 1 year from onset of the disease.
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Grassi A, Andriolo L, Golinelli D, Tedesco D, Rosa S, Gramegna P, Ciaffi J, Meliconi R, Landini MP, Filardo G, Fantini MP, Zaffagnini S. Higher 90-Day Mortality after Surgery for Hip Fractures in Patients with COVID-19: A Case-Control Study from a Single Center in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5205. [PMID: 34068405 PMCID: PMC8153577 DOI: 10.3390/ijerph18105205] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/07/2021] [Accepted: 05/11/2021] [Indexed: 12/23/2022]
Abstract
The mortality of hip fracture (HF) patients is increased by concomitant COVID-19; however, evidence is limited to only short follow-up. A retrospective matched case-control study was designed with the aim to report the 90-day mortality and determine the hazard ratio (HR) of concomitant HF and COVID-19 infection. Cases were patients hospitalized for HF and diagnosed with COVID-19. Controls were patients hospitalized for HF not meeting the criteria for COVID-19 diagnosis and were individually matched with each case through a case-control (1:3) matching algorithm. A total of 89 HF patients were treated during the study period, and 14 of them were diagnosed as COVID-19 positive (overall 15.7%). Patients' demographic, clinical, and surgical characteristics were similar between case and control groups. At 90 days after surgery, 5 deaths were registered among the 14 COVID-19 cases (35.7%) and 4 among the 42 HF controls (9.5%). COVID-19-positive cases had a higher risk of mortality at 30 days (HR = 4.51; p = 0.0490) and 90 days (HR = 4.50; p = 0.025) with respect to controls. Patients with concomitant HF and COVID-19 exhibit high perioperative mortality, which reaches a plateau of nearly 30-35% after 30 to 45 days and is stable up to 90 days. The mortality risk is more than four-fold higher in patients with COVID-19.
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Affiliation(s)
- Alberto Grassi
- II Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy; (A.G.); (S.Z.)
| | - Luca Andriolo
- II Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy; (A.G.); (S.Z.)
| | - Davide Golinelli
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum—University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy; (D.G.); (S.R.); (M.P.F.)
| | - Dario Tedesco
- IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy; (D.T.); (M.P.L.)
| | - Simona Rosa
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum—University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy; (D.G.); (S.R.); (M.P.F.)
| | - Pasquale Gramegna
- Medicina e Reumatologia, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy; (P.G.); (J.C.); (R.M.)
| | - Jacopo Ciaffi
- Medicina e Reumatologia, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy; (P.G.); (J.C.); (R.M.)
| | - Riccardo Meliconi
- Medicina e Reumatologia, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy; (P.G.); (J.C.); (R.M.)
| | - Maria Paola Landini
- IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy; (D.T.); (M.P.L.)
| | - Giuseppe Filardo
- Applied and Translational Research (ATR) Center, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy;
| | - Maria Pia Fantini
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum—University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy; (D.G.); (S.R.); (M.P.F.)
| | - Stefano Zaffagnini
- II Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy; (A.G.); (S.Z.)
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