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Amatya I, Marasini BP, Dhimal M, Koirala J, Pokhrel N, Gyanwali P. COVID-19 mortality and its associated factors in Nepal: A cross-sectional study. IJID REGIONS 2023; 9:120-124. [PMID: 38035052 PMCID: PMC10684362 DOI: 10.1016/j.ijregi.2023.08.002] [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: 04/30/2023] [Revised: 08/02/2023] [Accepted: 08/06/2023] [Indexed: 12/02/2023]
Abstract
Objectives Reports from other countries have indicated that severe forms and fatal cases of COVID-19 in older adults and people with underlying comorbidities. The aim of this study was to assess the risk factors associated with COVID-19 mortality in Nepal. Methods A cross-sectional study was conducted from April 12 to July 23, 2021 to identify the underlying factors associated with COVID-19 deaths. Our sample included all cases diagnosed and registered as COVID-19-related deaths at 30 hospitals of Nepal. Results A total of 1459 COVID-19 hospital-based death records were collected from 30 hospitals. Mean age at death was 60.2 (±15.6) years. One-third of cases were admitted with fever, cough, and shortness of breath. The computerized tomography Severity Score showed that 7.3% of the individuals who underwent high-resolution computerized tomography chest had a severe form of lung involvement, and 3.6% had mild to moderate involvement. The most common comorbidities were hypertension (43.7%) followed by diabetes mellitus (25.8%). Among the deceased, 37.7% were diagnosed as cases of COVID-19 pneumonia. The most common recorded causes of death were respiratory failure followed by cardio-pulmonary arrest. Conclusions Individuals with comorbidities including hypertension and diabetes mellitus were at greater risk of developing complications and had a higher rate of mortality.
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Affiliation(s)
- Isha Amatya
- Research Division, Nepal Health Research Council, Kathmandu, Nepal
| | | | - Meghnath Dhimal
- Research Division, Nepal Health Research Council, Kathmandu, Nepal
| | - Janak Koirala
- Patan Academy of Health Sciences, Department of Medicine, Lalitpur, Nepal
- Southern Illinois University School of Medicine, Division of Infectious Diseases, Springfield, Illinois, USA
| | - Nayanum Pokhrel
- Research Division, Nepal Health Research Council, Kathmandu, Nepal
| | - Pradip Gyanwali
- Research Division, Nepal Health Research Council, Kathmandu, Nepal
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Mainas G, Nibali L, Ide M, Mahmeed WA, Al-Rasadi K, Al-Alawi K, Banach M, Banerjee Y, Ceriello A, Cesur M, Cosentino F, Firenze A, Galia M, Goh SY, Janež A, Kalra S, Kapoor N, Kempler P, Lessan N, Lotufo P, Papanas N, Rizvi AA, Sahebkar A, Santos RD, Stoian AP, Toth PP, Viswanathan V, Rizzo M. Associations between Periodontitis, COVID-19, and Cardiometabolic Complications: Molecular Mechanisms and Clinical Evidence. Metabolites 2022; 13:40. [PMID: 36676965 PMCID: PMC9865290 DOI: 10.3390/metabo13010040] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/11/2022] [Accepted: 12/15/2022] [Indexed: 12/29/2022] Open
Abstract
Periodontitis is a microbially driven, host-mediated disease that leads to loss of periodontal attachment and resorption of bone. It is associated with the elevation of systemic inflammatory markers and with the presence of systemic comorbidities. Coronavirus disease 2019 (COVID-19) is a contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although the majority of patients have mild symptoms, others experience important complications that can lead to death. After the spread of the COVID-19 pandemic, several investigations demonstrating the possible relationship between periodontitis and COVID-19 have been reported. In addition, both periodontal disease and COVID-19 seem to provoke and/or impair several cardiometabolic complications such as cardiovascular disease, type 2 diabetes, metabolic syndrome, dyslipidemia, insulin resistance, obesity, non-alcoholic fatty liver disease, and neurological and neuropsychiatric complications. Therefore, due to the increasing number of investigations focusing on the periodontitis-COVID-19 relationship and considering the severe complications that such an association might cause, this review aims to summarize all existing emerging evidence regarding the link between the periodontitis-COVID-19 axis and consequent cardiometabolic impairments.
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Affiliation(s)
- Giuseppe Mainas
- Periodontology Unit, Centre for Host-Microbiome Interactions, Dental Institute, King’s College London, London SE1 9RT, UK
| | - Luigi Nibali
- Periodontology Unit, Centre for Host-Microbiome Interactions, Dental Institute, King’s College London, London SE1 9RT, UK
| | - Mark Ide
- Periodontology Unit, Centre for Host-Microbiome Interactions, Dental Institute, King’s College London, London SE1 9RT, UK
| | - Wael Al Mahmeed
- Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi P.O. Box 112412, United Arab Emirates
| | - Khalid Al-Rasadi
- Medical Research Center, Sultan Qaboos University, Muscat 113, Oman
| | - Kamila Al-Alawi
- Department of Training and Studies, Royal Hospital, Ministry of Health, Muscat 113, Oman
| | - Maciej Banach
- Department of Preventive Cardiology and Lipidology, Medical University of Lodz (MUL), 90419 Lodz, Poland
- Polish Mother’s Memorial Hospital Research Institute (PMMHRI), 93338 Lodz, Poland
- Cardiovascular Research Centre, University of Zielona Gora, 65417 Zielona Gora, Poland
| | - Yajnavalka Banerjee
- Department of Biochemistry, Mohamed Bin Rashid University, Dubai 505055, United Arab Emirates
| | | | - Mustafa Cesur
- Clinic of Endocrinology, Ankara Güven Hospital, 06540 Ankara, Turkey
| | - Francesco Cosentino
- Unit of Cardiology, Karolinska Institute and Karolinska University Hospital, University of Stockholm, 17177 Stockholm, Sweden
| | - Alberto Firenze
- Unit of Research and International Cooperation, University Hospital of Palermo, 90133 Palermo, Italy
| | - Massimo Galia
- Department of Biomedicine, Neurosciences and Advanced Diagnostics (Bind), University of Palermo, 90133 Palermo, Italy
| | - Su-Yen Goh
- Department of Endocrinology, Singapore General Hospital, Singapore 169856, Singapore
| | - Andrej Janež
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital & BRIDE, Karnal 132001, India
| | - Nitin Kapoor
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore 632004, India
- Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
| | - Peter Kempler
- Department of Medicine and Oncology, Semmelweis University, 1085 Budapest, Hungary
| | - Nader Lessan
- The Research Institute, Imperial College London Diabetes Centre, Abu Dhabi P.O. Box 48338, United Arab Emirates
| | - Paulo Lotufo
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo 05508-000, Brazil
| | - Nikolaos Papanas
- Diabetes Center, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, 68100 Alexandroupolis, Greece
| | - Ali A. Rizvi
- Department of Medicine, University of Central Florida College of Medicine, Orlando, FL 32827, USA
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad 1313199137, Iran
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad 1313199137, Iran
- Department of Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad 1313199137, Iran
| | - Raul D. Santos
- Heart Institute (InCor) University of Sao Paulo Medical School Hospital, São Paulo 05403-900, Brazil
- Hospital Israelita Albert Einstein, São Paulo 05652-900, Brazil
| | - Anca P. Stoian
- Faculty of Medicine, Diabetes, Nutrition and Metabolic Diseases, Carol Davila University, 050474 Bucharest, Romania
| | - Peter P. Toth
- Cicarrone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | | | - Manfredi Rizzo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (Promise), University of Palermo, 90133 Palermo, Italy
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Mandal SK, Neupane J, Kumar AMV, Davtyan H, Thekkur P, Jayaram A, Chalise BS, Rawal M, Paudel M, Baral B, Shah RK, Maharjan K, Shrestha S, Bhandari L, K.C. N, Gautam N, Sunny AK, Thakur N, Subeedee KC, Mandal SK, Bastola A. Audit of Clinical Care Received by COVID-19 Patients Treated at a Tertiary Care Hospital of Nepal in 2021. Trop Med Infect Dis 2022; 7:381. [PMID: 36422932 PMCID: PMC9698854 DOI: 10.3390/tropicalmed7110381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/10/2022] [Accepted: 11/13/2022] [Indexed: 11/18/2022] Open
Abstract
Like the world over, Nepal was also hard hit by the second wave of COVID-19. We audited the clinical care provided to COVID-19 patients admitted from April to June 2021 in a tertiary care hospital of Nepal. This was a cohort study using routinely collected hospital data. There were 620 patients, and most (458, 74%) had severe illness. The majority (600, 97%) of the patients were eligible for admission as per national guidelines. Laboratory tests helping to predict the outcome of COVID-19, such as D-dimer and C-reactive protein, were missing in about 25% of patients. Nearly all (>95%) patients with severe disease received corticosteroids, anticoagulants and oxygen. The use of remdesivir was low (22%). About 70% of the patients received antibiotics. Hospital exit outcomes of most (>95%) patients with mild and moderate illness were favorable (alive and discharged). Among patients with severe illness, about 25% died and 4% were critically ill, needing further referral. This is the first study from Nepal to audit and document COVID-19 clinical care provision in a tertiary care hospital, thus filling the evidence gap in this area from resource-limited settings. Adherence to admission guidelines was excellent. Laboratory testing, access to essential drugs and data management needs to be improved.
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Affiliation(s)
- Shrawan Kumar Mandal
- Sukraraj Tropical and Infectious Disease Hospital, Ministry of Health and Population, Government of Nepal, Kathmandu 44600, Nepal
| | - Jenish Neupane
- Sukraraj Tropical and Infectious Disease Hospital, Ministry of Health and Population, Government of Nepal, Kathmandu 44600, Nepal
| | - Ajay M. V. Kumar
- International Union Against Tuberculosis and Lung Disease, 2 Rue Jean Lantier, 75001 Paris, France
- International Union Against Tuberculosis and Lung Disease, South-East Asia Office, C-6 Qutub Institutional Area, New Delhi 110016, The National Capital Territory of Delhi, India
- Yenepoya Medical College, Yenepoya (Deemed to be University), University Road, Deralakatte, Mangaluru 575018, Karnataka, India
| | - Hayk Davtyan
- Tuberculosis Research and Prevention Center, NGO, Yerevan 0014, Armenia
| | - Pruthu Thekkur
- International Union Against Tuberculosis and Lung Disease, 2 Rue Jean Lantier, 75001 Paris, France
- International Union Against Tuberculosis and Lung Disease, South-East Asia Office, C-6 Qutub Institutional Area, New Delhi 110016, The National Capital Territory of Delhi, India
| | - Anup Jayaram
- Manipal Institute of Virology, Manipal, Academy of Higher Education, Manipal, Udupi 576104, Karnataka, India
| | - Bimal Sharma Chalise
- Sukraraj Tropical and Infectious Disease Hospital, Ministry of Health and Population, Government of Nepal, Kathmandu 44600, Nepal
| | - Manisha Rawal
- Sukraraj Tropical and Infectious Disease Hospital, Ministry of Health and Population, Government of Nepal, Kathmandu 44600, Nepal
| | - Manu Paudel
- Sukraraj Tropical and Infectious Disease Hospital, Ministry of Health and Population, Government of Nepal, Kathmandu 44600, Nepal
| | - Bishwodip Baral
- Sukraraj Tropical and Infectious Disease Hospital, Ministry of Health and Population, Government of Nepal, Kathmandu 44600, Nepal
| | - Rajesh Kumar Shah
- Sukraraj Tropical and Infectious Disease Hospital, Ministry of Health and Population, Government of Nepal, Kathmandu 44600, Nepal
| | - Kijan Maharjan
- Sukraraj Tropical and Infectious Disease Hospital, Ministry of Health and Population, Government of Nepal, Kathmandu 44600, Nepal
| | - Sanjay Shrestha
- Sukraraj Tropical and Infectious Disease Hospital, Ministry of Health and Population, Government of Nepal, Kathmandu 44600, Nepal
| | - Lilanath Bhandari
- Sukraraj Tropical and Infectious Disease Hospital, Ministry of Health and Population, Government of Nepal, Kathmandu 44600, Nepal
| | - Nisha K.C.
- Sukraraj Tropical and Infectious Disease Hospital, Ministry of Health and Population, Government of Nepal, Kathmandu 44600, Nepal
| | - Nabaraj Gautam
- Sukraraj Tropical and Infectious Disease Hospital, Ministry of Health and Population, Government of Nepal, Kathmandu 44600, Nepal
| | | | - Nishant Thakur
- Epidemiology and Disease Control Division, Kathmandu 44600, Nepal
| | | | | | - Anup Bastola
- Sukraraj Tropical and Infectious Disease Hospital, Ministry of Health and Population, Government of Nepal, Kathmandu 44600, Nepal
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Marshall GC, Skeva R, Jay C, Silva MEP, Fyles M, House T, Davis EL, Pi L, Medley GF, Quilty BJ, Dyson L, Yardley L, Fearon E. Public perceptions and interactions with UK COVID-19 Test, Trace and Isolate policies, and implications for pandemic infectious disease modelling. F1000Res 2022. [DOI: 10.12688/f1000research.124627.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Background The efforts to contain SARS-CoV-2 and reduce the impact of the COVID-19 pandemic have been supported by Test, Trace and Isolate (TTI) systems in many settings, including the United Kingdom. Mathematical models of transmission and TTI interventions, used to inform design and policy choices, make assumptions about the public’s behaviour in the context of a rapidly unfolding and changeable emergency. This study investigates public perceptions and interactions with UK TTI policy in July 2021, assesses them against how TTI processes are conceptualised and represented in models, and then interprets the findings with modellers who have been contributing evidence to TTI policy. Methods 20 members of the public recruited via social media were interviewed for one hour about their perceptions and interactions with the UK TTI system. Thematic analysis identified key themes, which were then presented back to a workshop of pandemic infectious disease modellers who assessed these findings against assumptions made in TTI intervention modelling. Workshop members co-drafted this report. Results Themes included education about SARS-CoV-2, perceived risks, trust, mental health and practical concerns. Findings covered testing practices, including the uses of and trust in different types of testing, and the challenges of testing and isolating faced by different demographic groups. This information was judged as consequential to the modelling process, from guiding the selection of research questions, influencing choice of model structure, informing parameter ranges and validating or challenging assumptions, to highlighting where model assumptions are reasonable or where their poor reflection of practice might lead to uninformative results. Conclusions We conclude that deeper engagement with members of the public should be integrated at regular stages of public health intervention modelling.
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Kouhpayeh H. Clinical features predicting COVID-19 mortality risk. Eur J Transl Myol 2022; 32:10268. [PMID: 35421918 PMCID: PMC9295175 DOI: 10.4081/ejtm.2022.10268] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 11/23/2021] [Indexed: 12/15/2022] Open
Abstract
Currently, the world is involved by a pandemic of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2), which has been responsible for the deaths of hundreds of thousands of people so far. The consequences of infection with SARS-CoV-2 vary widely from asymptomatic to severe. Considering the increasing prevalence of different types of virus and acute infection with this disease, strategies to prevent mortality from COVID-19 should be seriously analyzed. In this study, the epidemiological, clinical and laboratory characteristics of patients with COVID-19 were investigated in order to identify risk factors for mortality. Chronic diseases such as chronic kidney disease (CKD), COPD, diabetes, hypertension, cardiovascular disease (CVD), cancer, increased D-dimer, male gender, old age, smoking and obesity are among the deadly risk factors associated COVID-19. Furthermore, lymphopenia and neutrophilia are often present in patients with SARS-CoV-2, and the ratio of absolute neutrophils to lymphocytes (NLR) was significantly increased in patients without bacterial infection. These findings could be used in the future to control and prevent disease, because timely identification of patients with risk of COVID-19 is important to provide better treatment strategies for reduction of mortality.
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Affiliation(s)
- Hamidreza Kouhpayeh
- Tropical and Infectious Diseases Department, Zahedan University of Medical Sciences, Zahedan, Iran; Zahedan University of Medical Sciences Research Center, Emam Ali Hospital, Zahedan.
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Leggat PA, Frean J, Blumberg L. COVID-19: Current Challenges and Future Perspectives. Trop Med Infect Dis 2022; 7:tropicalmed7020016. [PMID: 35202212 PMCID: PMC8879616 DOI: 10.3390/tropicalmed7020016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 01/19/2022] [Indexed: 12/04/2022] Open
Affiliation(s)
- Peter A. Leggat
- World Health Organization Collaborating Centre for Vector-borne and Neglected Tropical Diseases, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa
- Correspondence: ; Tel.: +61-7-4781-6108
| | - John Frean
- Centre for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases, Johannesburg 2131, South Africa; (J.F.); (L.B.)
| | - Lucille Blumberg
- Centre for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases, Johannesburg 2131, South Africa; (J.F.); (L.B.)
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