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Hermányi Z, Menyhárt A, Körei AE, Istenes I, Lao-Kan GA, Csiki V, Benhamida A, Kozlovszky M, Berey A, Markovich P, Kempler P. A comprehensive analysis of diabetic patient data before and during the COVID-19 pandemic - Lessons from the MÉRY diabetes database (MDD). J Diabetes Complications 2024; 38:108799. [PMID: 38897066 DOI: 10.1016/j.jdiacomp.2024.108799] [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: 04/22/2024] [Revised: 06/13/2024] [Accepted: 06/13/2024] [Indexed: 06/21/2024]
Abstract
AIMS Our study examined changes in average blood glucose levels (ABG), measurement frequency (MF), and data uploading (DU) before and during the COVID-19 pandemic in 882-day spans, which were divided into further 20-week intervals to highlight the pandemic's impact. METHODS T-Tests assessed the statistical significance of blood glucose data from 26,655/20,936 patients and 19.5/16.6 million records during pre-COVID/COVID. RESULTS During COVID, patients had significantly lower ABG levels (9.1/8.9 mmol/L, p < 0.001). Weekly DU decreased (155,945/128,445, p < 0.05), while daily MF increased (0.83/0.87, p < 0.001). Comparing the last 20 weeks pre-COVID to the first 20 weeks during COVID, ABG levels were lower (9.0 /8.9, p < 0.01), MF increased (0.83 /0.99, p < 0.001), and DU decreased (153,133/145,381, p < 0.05). In the initial 20 weeks of COVID compared to the second 20 weeks of COVID, ABG increased (8.9/9.1, p < 0.01), MF decreased (0.99/0.95, p < 0.001), and DU decreased (145,381/140,166, p < 0.05). Our most striking observation was the temporary dramatic fall in glucose uploads during the first few weeks of COVID. The changes of ABG and MF values were statistically significant, but were not deemed clinically relevant. CONCLUSIONS Despite COVID's prolonged impact, diabetic patients showed improved attitudes. A significant drop in data uploads occurred during the first 20 weeks of COVID; home office and lockdowns apparently disrupted patient routines.
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Affiliation(s)
- Zsolt Hermányi
- Bajcsy-Zsilinszky Hospital and Clinic, 1106 Budapest, Maglódi út 89-91, Hungary.
| | - Adrienn Menyhárt
- Semmelweis University, Department of Internal Medicine and Oncology, 1083 Budapest, Korányi Sándor u. 2/a, Hungary
| | - Anna Erzsébet Körei
- Semmelweis University, Department of Internal Medicine and Oncology, 1083 Budapest, Korányi Sándor u. 2/a, Hungary
| | - Ildikó Istenes
- Semmelweis University, Department of Internal Medicine and Oncology, 1083 Budapest, Korányi Sándor u. 2/a, Hungary
| | - Genevieve Arany Lao-Kan
- Semmelweis University, Department of Internal Medicine and Oncology, 1083 Budapest, Korányi Sándor u. 2/a, Hungary
| | - Vanda Csiki
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Üllői út 78/A, Hungary
| | - Abdallah Benhamida
- BioTech Research Center, Obuda University, Bécsi út 96/b. 1034, Hungary.
| | - Miklos Kozlovszky
- BioTech Research Center, Obuda University, Bécsi út 96/b. 1034, Hungary; Di-Care Zrt., 1119 Budapest, Mérnök utca 12-14, Hungary.
| | - Attila Berey
- Medical Device Research Group, LPDS, MTA-SZTAKI, 1111 Budapest, Lágymányosi út 11, Hungary.
| | - Peter Markovich
- Medical Device Research Group, LPDS, MTA-SZTAKI, 1111 Budapest, Lágymányosi út 11, Hungary.
| | - Péter Kempler
- Semmelweis University, Department of Internal Medicine and Oncology, 1083 Budapest, Korányi Sándor u. 2/a, Hungary.
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Ramphul K, Sombans S, Verma R, Lohana P, Dhillon BK, Gonzalez Mejias S, Sanikommu S, Ramphul Y, Pekyi-Boateng PK. Characteristics and Outcomes of 7620 Multiple Sclerosis Patients Admitted With COVID-19 in the United States. Neurohospitalist 2024; 14:237-241. [PMID: 38895008 PMCID: PMC11181971 DOI: 10.1177/19418744241230728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024] Open
Abstract
Background At the start of the COVID-19 pandemic, several experts raised concerns about its impact on Multiple Sclerosis (MS) patients. This study aims to provide a perspective using the biggest inpatient database from the United States. Method We screened for COVID-19 cases between April to December 2020, via the 2020 National Inpatient Sample (NIS). Various outcomes were analyzed. Results We identified 1,628,110 hospitalizations with COVID-19, including 7620 (.5%) MS patients. 8.9% of MS patients with COVID-19 died, and it was lower than non-MS cases (12.9%). Less MS patients with COVID-19 needed non-invasive ventilation (4.5% vs 6.4%) and mechanical ventilation (9.0% vs 11.2%). Furthermore, MS patients with COVID-19 reported higher odds of non-invasive ventilation if they were ≥60 years, had chronic pulmonary disease (CPD), obesity, or diabetes. Private insurance beneficiaries showed reduced risk, vs Medicare. Similarly, for mechanical ventilation, those ≥60 years, with alcohol abuse, obesity, diabetes, hypertension, or dialysis had higher odds, while females, smokers, and those with depression or hyperlipidemia showed reduced odds. The study revealed higher odds of mortality among those aged ≥60, who had CPD, obesity, CKD, or a history of old MI while females, smokers, as well as those with depression, and hyperlipidemia showed better outcomes. Blacks had lower odds, whereas Hispanics had higher odds of death, vs Whites. Medicaid and Privately insured patients had lower odds of dying vs Medicare. Conclusion We found several differences in patient characteristics and outcomes among MS and non-MS patients with COVID-19.
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Affiliation(s)
| | - Shaheen Sombans
- Department of Neurology, Bharati Vidyapeeth University Medical College and Hospital, Hyderabad, India
| | - Renuka Verma
- Department of Neurology, Raj Multispecialty Hospital, Punjab, India
| | - Petras Lohana
- Department of Nephrology, Jacobi Medical Centre, Bronx, NY, USA
| | | | | | - Sailaja Sanikommu
- Department of Neurology, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India
| | - Yogeshwaree Ramphul
- Department of Medicine, Sir Seewoosagur Ramgoolam National Hospital, Pamplemousses, Mauritius
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3
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Ramphul K, Singh Dhaliwal J, Sombans S, Passi JK, Aggarwal S, Kumar N, Sakthivel H, Ahmed R, Verma R. Trends in admissions for COVID-19 in the United States between April 2020 and December 2021 and cardiovascular events. Arch Med Sci Atheroscler Dis 2024; 9:e60-e65. [PMID: 38846059 PMCID: PMC11155464 DOI: 10.5114/amsad/185410] [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: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 06/09/2024] Open
Abstract
Introduction Coronavirus disease 2019 (COVID-19) can lead to cardiovascular complications. We aimed to understand the trends in admission for COVID-19 and the incidence of various cardiovascular events. Material and methods The 2020 and 2021 National Inpatient Sample (NIS) was studied for cases of COVID-19 between April 2020 and December 2021 in the United States. Linear-by-linear association helped us understand the trends of various events. Results The number of cases of COVID-19 was highest in January 2021 (261,469 patients). The incidence of acute pulmonary embolism rose from 2.08% in April 2020 to 4.82% in November 2021, while deep vein thrombosis cases rose from 1.74% in April 2020 to 2.63% in December 2021. The incidence of cardiac arrest varied, with a maximum of 3.00% in August 2021. Similarly, acute ischemic stroke cases experienced their highest incidence in January 2021 (0.91%). The incidence of myocarditis was highest in April and May 2020 (0.42% each). Peak takotsubo cases were seen between October and December 2021. The highest overall all-cause mortality among COVID-19 cases was seen in April 2020 (16.74%). Conclusions Throughout the 21 months of our analysis, various trends in COVID-19 cases and incidence of cardiac events were noticed. This could relate to the different variants of COVID-19, their direct and indirect impact on coagulation pathways and the myocardial tissues, and the protective roles of the vaccines.
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Affiliation(s)
| | | | | | - Jatin Kumar Passi
- Department of Internal Medicine, Guru Gobind Singh Medical College, Faridkot, India
| | - Shruti Aggarwal
- Department of Internal Medicine, Guru Gobind Singh Medical College, Faridkot, India
| | - Nomesh Kumar
- Department of Internal Medicine, Detroit Medical Center Sinai Grace-Wayne State University, Michigan, US
| | | | - Raheel Ahmed
- Royal Brompton Hospital, part of Guy’s and St. Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Renuka Verma
- Department of Internal Medicine, University of Nevada, Las Vegas(UNLV), Las Vegas, US
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Burhan E, Mubarak F, Adilah SASU, Sari CYI, Ismail E, Astuti P, Hanifah Y, Wiyarta E, Suryana NM. Association between cardiovascular diseases and COVID-19 pneumonia outcome in Indonesia: a multi-center cohort study. Front Med (Lausanne) 2023; 10:1190148. [PMID: 37457562 PMCID: PMC10339801 DOI: 10.3389/fmed.2023.1190148] [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: 03/20/2023] [Accepted: 06/13/2023] [Indexed: 07/18/2023] Open
Abstract
Background COVID-19 is a pandemic affecting 185 countries, including Indonesia. Cardiovascular diseases (CVD) in COVID-19 patients were linked to worse clinical outcomes. However, the association remained inconclusive due to limited data in Indonesia. This study aimed to determine the association between CVD in COVID-19 pneumonia patients with its clinical outcomes. Methods This retrospective cohort study was conducted in four Indonesian hospitals, enrolling 584 adult COVID-19 pneumonia patients from September 2020 to July 2021. Patients were categorized into two groups: non-CVD and CVD [hypertension, coronary artery disease (CAD), chronic heart failure (CHF), hypertensive heart disease (HHD), arrhythmia, cardiomegaly, left ventricular hypertrophy (LVH), mitral regurgitation (MR), and myocardial injury (MI)]. Clinical outcomes include in-hospital mortality, intensive care unit admission, ventilator use, earlier death, and prolonged hospital stay. Mann-Whitney test was used for analysis. Results The most common CVD was hypertension (48.1%), followed by MI (10.6%), CAD (9.2%), CHF (6.8%), HHD (3.1%), arrhythmia (1.7%), and others (0.7%). The in-hospital mortality rate was 24%, and patients were hospitalized for a median of 12 days. MI was the only CVD that increased in-hospital mortality (RR 2.105). It was also significantly increased in patients with diabetes mellitus (RR 1.475) and chronic kidney disease (RR 2.079). Meanwhile, prolonged hospital stay was associated with any CVD (RR 1.553), hypertension (RR 1.511), MI (RR 1.969), CHF (RR 1.595), diabetes mellitus (RR 1.359), and cerebrovascular disease (RR 2.203). Conclusion COVID-19 pneumonia in patients with CVD, specifically MI and hypertension, worsens the COVID-19 clinical outcomes.
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Affiliation(s)
- Erlina Burhan
- Department of Pulmonology and Respiratory Medicine, Persahabatan Central General Hospital, Universitas Indonesia, Jakarta, Indonesia
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Farhan Mubarak
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | | | - Cut Yulia Indah Sari
- Department of Pulmonology, Jakarta Islam Hospital Cempaka Putih, Jakarta, Indonesia
| | - Efriadi Ismail
- Department of Pulmonology, Yarsi Hospital, Jakarta, Indonesia
| | - Puji Astuti
- Department of Pulmonology, Cengkareng District General Hospital, Jakarta, Indonesia
| | - Yasmina Hanifah
- Department of Cardiology and Vascular Medicine, Persahabatan Central General Hospital, Jakarta, Indonesia
| | - Elvan Wiyarta
- Department of Medical Science, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Nana Maya Suryana
- Department of Cardiology and Vascular Medicine, Persahabatan Central General Hospital, Jakarta, Indonesia
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Demeneck H, Luiz Parmegiani de Oliveira A, do Carmo Machado Kneipp Lopes J, Ryoiti Matsunago L, Cavalca Grupenmacher L, Roberto Curcio Pereira M, Benício Stocco R, Ali El Chab Parolin S, Olandoski M, Pellegrino Baena C. Clinical characteristics and outcomes of hospitalized patients with COVID-19 in a city of South Brazil: Have they changed through the first year of the pandemic? PLoS One 2023; 18:e0286589. [PMID: 37262056 DOI: 10.1371/journal.pone.0286589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/18/2023] [Indexed: 06/03/2023] Open
Abstract
The Coronavirus Disease 2019 (COVID-19) pandemic posed various challenges to the healthcare system and disease management. This study aimed to describe changes in the clinical characteristics and outcomes of hospitalized patients during the first year of the COVID-19 pandemic in a city in southern Brazil. This prospective study was carried out in two tertiary care private hospitals in Curitiba. A total of 1151 patients hospitalized between March 2020 and March 2021 were included. We identified three epidemiological critical periods of the pandemic and compared patients' characteristics and the frequencies of oral intubation, intensive care unit (ICU) admission and mortality. Continuous variables were analyzed by variance analysis model (ANOVA) or the Kruskal-Wallis nonparametric test and categorical variables by the chi-square or Fisher's exact test. Models for univariate and multivariate logistic regression analysis were adjusted to identify the factors associated with mortality. All p-values were two-tailed and p<0.05 was considered statistically significant. The average age of the patients was 58 years and 60.9% (n = 701) were males. The most prevalent comorbidities were systemic arterial hypertension, diabetes and obesity. There were no significant variations in the demographic characteristics and previous comorbidities of the patients for the different periods of analysis. Mortality was positively associated with the age ≥65 years and the presence of one or more cardiometabolic comorbidities (p<0.001). March 2021 was the most important critical period of the pandemic since there were higher frequencies of patients admitted later in the course of the disease, with desaturation and more symptoms at hospital admission (p<0.001). There was also an increase in the duration of hospital stay (p<0.001) and the frequencies of all critical outcomes for this period: oral intubation (p<0.001), ICU admission (p = 0.606) and mortality (p = 0.001). Our key findings revealed that, although there were no statistically significant differences between the subgroups of hospitalized patients over time in terms of demographic characteristics and comorbidities, the course of COVID-19 was significantly more severe for patients admitted to the hospital at the end of the first year of the pandemic in Brazil.
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Affiliation(s)
- Henrique Demeneck
- Postgraduate Program in Health Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | | | | | - Leonardo Ryoiti Matsunago
- Postgraduate Program in Health Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | | | | | - Rebecca Benício Stocco
- Postgraduate Program in Health Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Salma Ali El Chab Parolin
- Postgraduate Program in Health Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Marcia Olandoski
- Postgraduate Program in Health Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Cristina Pellegrino Baena
- Postgraduate Program in Health Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
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Mphekgwana PM, Sono-Setati ME, Mokgophi TV, Kifle YG, Madiba S, Modjadji P. Retrospective Analysis of the Outcome of Hospitalized COVID-19 Patients with Coexisting Metabolic Syndrome and HIV Using Multinomial Logistic Regression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105799. [PMID: 37239527 DOI: 10.3390/ijerph20105799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/05/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023]
Abstract
Globally, the coexistence of metabolic syndrome (MetS) and HIV has become an important public health problem, putting coronavirus disease 19 (COVID-19) hospitalized patients at risk for severe manifestations and higher mortality. A retrospective cross-sectional analysis was conducted to identify factors and determine their relationships with hospitalization outcomes for COVID-19 patients using secondary data from the Department of Health in Limpopo Province, South Africa. The study included 15,151 patient clinical records of laboratory-confirmed COVID-19 cases. Data on MetS was extracted in the form of a cluster of metabolic factors. These included abdominal obesity, high blood pressure, and impaired fasting glucose captured on an information sheet. Spatial distribution of mortality among patients was observed; overall (21-33%), hypertension (32-43%), diabetes (34-47%), and HIV (31-45%). A multinomial logistic regression model was applied to identify factors and determine their relationships with hospitalization outcomes for COVID-19 patients. Mortality among COVID-19 patients was associated with being older (≥50+ years), male, and HIV positive. Having hypertension and diabetes reduced the duration from admission to death. Being transferred from a primary health facility (PHC) to a referral hospital among COVID-19 patients was associated with ventilation and less chance of being transferred to another health facility when having HIV plus MetS. Patients with MetS had a higher mortality rate within seven days of hospitalization, followed by those with obesity as an individual component. MetS and its components such as hypertension, diabetes, and obesity should be considered a composite predictor of COVID-19 fatal outcomes, mostly, increased risk of mortality. The study increases our understanding of the common contributing variables to severe manifestations and a greater mortality risk among COVID-19 hospitalized patients by investigating the influence of MetS, its components, and HIV coexistence. Prevention remains the mainstay for both communicable and non-communicable diseases. The findings underscore the need for improvement of critical care resources across South Africa.
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Affiliation(s)
- Peter M Mphekgwana
- Research Administration and Development, University of Limpopo, Polokwane 0727, South Africa
| | - Musa E Sono-Setati
- Department of Public Health Medicine, University of Limpopo, Private Bag X1106, Sovenga, Polokwane 0727, South Africa
| | - Tania V Mokgophi
- Department of Statistics and Operations Research, University of Limpopo, Polokwane 0727, South Africa
| | - Yehenew G Kifle
- Department of Mathematics and Statistics, University of Maryland Baltimore County, Baltimore, MD 21250, USA
| | - Sphiwe Madiba
- Faculty of Health Sciences, University of Limpopo, Polokwane 0727, South Africa
| | - Perpetua Modjadji
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town 7505, South Africa
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7
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Liu Y, Zhou S, Wang L, Xu M, Huang X, Li Z, Hajdu A, Zhang L. Machine learning approach combined with causal relationship inferring unlocks the shared pathomechanism between COVID-19 and acute myocardial infarction. Front Microbiol 2023; 14:1153106. [PMID: 37065165 PMCID: PMC10090501 DOI: 10.3389/fmicb.2023.1153106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 02/27/2023] [Indexed: 04/03/2023] Open
Abstract
BackgroundIncreasing evidence suggests that people with Coronavirus Disease 2019 (COVID-19) have a much higher prevalence of Acute Myocardial Infarction (AMI) than the general population. However, the underlying mechanism is not yet comprehended. Therefore, our study aims to explore the potential secret behind this complication.Materials and methodsThe gene expression profiles of COVID-19 and AMI were acquired from the Gene Expression Omnibus (GEO) database. After identifying the differentially expressed genes (DEGs) shared by COVID-19 and AMI, we conducted a series of bioinformatics analytics to enhance our understanding of this issue.ResultsOverall, 61 common DEGs were filtered out, based on which we established a powerful diagnostic predictor through 20 mainstream machine-learning algorithms, by utilizing which we could estimate if there is any risk in a specific COVID-19 patient to develop AMI. Moreover, we explored their shared implications of immunology. Most remarkably, through the Bayesian network, we inferred the causal relationships of the essential biological processes through which the underlying mechanism of co-pathogenesis between COVID-19 and AMI was identified.ConclusionFor the first time, the approach of causal relationship inferring was applied to analyzing shared pathomechanism between two relevant diseases, COVID-19 and AMI. Our findings showcase a novel mechanistic insight into COVID-19 and AMI, which may benefit future preventive, personalized, and precision medicine.Graphical abstract
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Affiliation(s)
- Ying Liu
- Department of Cardiology, Sixth Medical Center, PLA General Hospital, Beijing, China
| | - Shujing Zhou
- Department of Data Science and Visualization, Faculty of Informatics, University of Debrecen, Debrecen, Hungary
- Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Longbin Wang
- Department of Clinical Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Ming Xu
- Department of Clinical Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Xufeng Huang
- Department of Data Science and Visualization, Faculty of Informatics, University of Debrecen, Debrecen, Hungary
- Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Zhengrui Li
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
| | - Andras Hajdu
- Department of Data Science and Visualization, Faculty of Informatics, University of Debrecen, Debrecen, Hungary
- *Correspondence: Andras Hajdu,
| | - Ling Zhang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
- Ling Zhang,
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Miranda C, Garlatti E, Da Porto A, Rinaldo E, Grazioli S, Zanette G, Tonizzo M. Liver injury in COVID-19 patients with non-alcoholic fatty liver disease: an update. Arch Med Sci Atheroscler Dis 2023; 8:e1-e10. [PMID: 37153375 PMCID: PMC10161789 DOI: 10.5114/amsad/160950] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 02/06/2023] [Indexed: 05/09/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has revolutionized the priorities of the medical society worldwide. Although most patients infected with SARS-CoV-2 exhibit respiratory symptoms, other organs may also be involved, including the liver, often resulting in liver injury. Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the world, and its prevalence is expected to increase together with the epidemics of type 2 diabetes and obesity. Data about liver injury during COVID-19 are numerous, while overviews of this infection in patients with NAFLD, both in terms of respiratory and liver, are emerging. In this review, we summarise the current research focusing on COVID-19 in NAFLD patients and discuss the association between liver injury in COVID-19 subjects and non-alcoholic fatty liver disease.
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Affiliation(s)
- Cesare Miranda
- Clinic of Endocrinology and Metabolism Diseases, Pordenone Hospital, Pordenone, Italy
| | - Elena Garlatti
- Internal Medicine, Santa Maria degli Angeli Hospital, Pordenone, Italy
| | - Andrea Da Porto
- Department of Medicine, Clinica Medica, University of Udine, Udine, Italy
| | - Elena Rinaldo
- Clinic of Endocrinology and Metabolism Diseases, Pordenone Hospital, Pordenone, Italy
| | - Silvia Grazioli
- Internal Medicine, Santa Maria degli Angeli Hospital, Pordenone, Italy
| | - Giorgio Zanette
- Clinic of Endocrinology and Metabolism Diseases, Pordenone Hospital, Pordenone, Italy
| | - Maurizio Tonizzo
- Internal Medicine, Santa Maria degli Angeli Hospital, Pordenone, Italy
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Zsichla L, Müller V. Risk Factors of Severe COVID-19: A Review of Host, Viral and Environmental Factors. Viruses 2023; 15:175. [PMID: 36680215 PMCID: PMC9863423 DOI: 10.3390/v15010175] [Citation(s) in RCA: 32] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/04/2023] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
The clinical course and outcome of COVID-19 are highly variable, ranging from asymptomatic infections to severe disease and death. Understanding the risk factors of severe COVID-19 is relevant both in the clinical setting and at the epidemiological level. Here, we provide an overview of host, viral and environmental factors that have been shown or (in some cases) hypothesized to be associated with severe clinical outcomes. The factors considered in detail include the age and frailty, genetic polymorphisms, biological sex (and pregnancy), co- and superinfections, non-communicable comorbidities, immunological history, microbiota, and lifestyle of the patient; viral genetic variation and infecting dose; socioeconomic factors; and air pollution. For each category, we compile (sometimes conflicting) evidence for the association of the factor with COVID-19 outcomes (including the strength of the effect) and outline possible action mechanisms. We also discuss the complex interactions between the various risk factors.
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Affiliation(s)
- Levente Zsichla
- Institute of Biology, Eötvös Loránd University, 1117 Budapest, Hungary
- National Laboratory for Health Security, Eötvös Loránd University, 1117 Budapest, Hungary
| | - Viktor Müller
- Institute of Biology, Eötvös Loránd University, 1117 Budapest, Hungary
- National Laboratory for Health Security, Eötvös Loránd University, 1117 Budapest, Hungary
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10
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Guo Q, Yang L, Peng R, Gao T, Chu X, Jiang D, Ke D, Ren H. Safety and immunogenicity of inactivated COVID-19 vaccine in patients with metabolic syndrome: A cross-sectional observational study. Front Public Health 2022; 10:1067342. [PMID: 36620297 PMCID: PMC9817001 DOI: 10.3389/fpubh.2022.1067342] [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: 10/11/2022] [Accepted: 11/30/2022] [Indexed: 12/25/2022] Open
Abstract
Background and aims The prevalence of metabolic syndrome (MS), wich mainly including hypertension, hyperglycemia, hyperlipidemia, remains high, and the safety and antibody response of inactivated coronavirus disease 2019 (COVID-19) vaccination in patients with metabolic syndrome (MS) is still inconsistency, therefore it is necessary to explore the safety and antibody responses of inactivated COVID-19 vaccination in MS patients in clinical practice. Methods 157 adults patients who were suffering from MS and 117 health controls (HC) at an interval of at least 21 days after full-course (2nd dose) vaccination were enrolled. The safety of inactivated COVID-19 vaccination was evaluated through collected adverse events (AEs) by questionnaire. The immunogenicity of included participant to inactivated COVID-19 vaccination was represented by serum seropositivity rate of anti-receptor binding domain (RBD) IgG, SARS-CoV-2 neutralizing antibodies (CoV-2 Nab) and titers of anti-RBD IgG, CoV-2 Nab. The B cells, mainly including RBD-specific B cells, RBD-specific memory B cell (MBC), RBD+ resting MBC cells, RBD+ activated MBC cells, RBD+ atypical MBC cells (atyMBCs), and RBD+ intermediate MBC cells, were also analyzed. Results In terms of safety, all AEs in MS patients were mild and self-limiting, and the incidence was comparable to that of HC participants, with overall AEs within seven days reported in 9.6% (15/157) of 3H and 11.1% (13/117) of HC. Both groups experienced no serious adverse events. As for immunogenicity of MS patients to inactivated COVID-19 vaccination, compared with health controls, the seroprevalence of anti-RBD IgG and CoV-2 Nab was significantly decreased in MS patients (p = 0.000, p = 0.003, respectively), while the titers of anti-RBD IgG (AU/ml) and CoV-2 Nab (μg/ml) were also significant lower in MS patients (p = 0.014, p = 0.002, respectively). As for frequencies of B cells, MS patients had lower frequencies of RBD-specific B cells, RBD+ resting MBCs, and RBD+ intermediate MBCs (p = 0.003, p = 0.000, p = 0.000, respectively), but had a higher frequencies of RBD+ atypical MBCs (p = 0.000) than HC. In comorbidity number subgroups analysis of MS, except frequencies of RBD+ resting MBC cells, RBD+ activated MBC cells and RBD+ intermediate MBC cells had significant difference among three groups (p = 0.035, p = 0.042, p = 0.046, respectively), antibody response had no significant difference among 1H, 2H, and 3H groups (p > 0.05). And took 70 years old as a boundary, also no statistically significant differences (p > 0.05) were found in age subgroups. Lastly, comprehensive analysis in MS patients indicated that interval time after 2nd dose vaccine was the statistical significant factor which impacting antibody response in MS individuals. Conclusions Inactivated COVID-19 vaccines were well-tolerated, but induced a poorer antibody response against SARS-CoV-2 in MS patients comparing to HC participants. Patients with MS should therefore be more proactive in receiving inactivated COVID-19 vaccine, and a booster vaccination may be considered necessary. Clinical trial registration https://clinicaltrials.gov/, identifier: NCT05043246.
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Affiliation(s)
- Qiao Guo
- Department of General Practice, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Lei Yang
- Department of Respiratory Medicine, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Ran Peng
- Department of General Practice, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Tao Gao
- Department of General Practice, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Xinglin Chu
- Department of General Practice, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Depeng Jiang
- Department of Respiratory Medicine, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China,*Correspondence: Depeng Jiang ✉
| | - Dazhi Ke
- Department of General Practice, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China,Dazhi Ke ✉
| | - Hong Ren
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Department of Infectious Diseases, Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China,Hong Ren ✉
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11
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Ying CQ, Lin XQ, Lv L, Chen Y, Jiang JJ, Zhang Y, Tung TH, Zhu JS. Intentions of Patients with Hypertension to Receive a Booster Dose of the COVID-19 Vaccine: A Cross-Sectional Survey in Taizhou, China. Vaccines (Basel) 2022; 10:vaccines10101635. [PMID: 36298500 PMCID: PMC9608070 DOI: 10.3390/vaccines10101635] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/10/2022] [Accepted: 09/20/2022] [Indexed: 11/18/2022] Open
Abstract
COVID-19 patients with hypertension have increased hospital complications and mortality rates. Moreover, these patients also have lower antibody titers after receiving the coronavirus disease (COVID-19) vaccine. Therefore, patients with hypertension should receive a COVID-19 vaccine booster. To promote the uptake of COVID-19 vaccine booster among hypertensive patients, this study investigated patients’ willingness and factors that influence patients with hypertension to receive the COVID-19 vaccine booster. From July 2021 to August, 410 patients with hypertension were surveyed. Overall, 76.8% of patients were willing to receive the COVID-19 vaccine booster, as 82.7% of patients without comorbidities and 72.7% of patients with comorbidities were willing to receive the vaccine booster. The main factors that influenced the willingness of patients with hypertension to receive a booster dose were the preventive effect of the vaccine (χ2 = 52.827, p < 0.05), vaccine safety (χ2 = 42.423, p < 0.05), vaccine knowledge (χ2 = 7.831, p < 0.05), presence of comorbidities (χ2 = 4.862, p < 0.05), disease control (χ2 = 5.039, p < 0.05), and antihypertensive treatments (χ2 = 12.565, p < 0.05). This study’s findings highlight the need to promote knowledge about booster vaccination among patients and health management. These measures would improve patients’ willingness and knowledge about the vaccine and their health status, which are the main factors that influence patients’ intention to receive booster vaccines.
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Affiliation(s)
- Chen-Qian Ying
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai 317000, China
| | - Xiao-Qing Lin
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai 317000, China
| | - Li Lv
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province, Zhejiang University, Linhai 317000, China
| | - Yan Chen
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai 317000, China
| | - Jian-Jun Jiang
- Department of Cardiovascular Diseases, Taizhou Hospital of Zhejiang Province, Zhejiang University, Linhai 317000, China
| | - Yun Zhang
- Department of Cardiovascular Diseases, Taizhou Hospital of Zhejiang Province, Zhejiang University, Linhai 317000, China
| | - Tao-Hsin Tung
- Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai 317000, China
- Correspondence: (T.-H.T.); (J.-S.Z.)
| | - Jian-Sheng Zhu
- Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai 317000, China
- Correspondence: (T.-H.T.); (J.-S.Z.)
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12
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Wu G, Zhang M, Xie X, Zhu Y, Tang H, Zhu X, Liang Y, Chen T, Zhu K, Zhang D, Jiang S, Jiang Z, Ke S. A survey on the safety of the SARS-CoV-2 vaccine among a population with stroke risk in China. Front Med (Lausanne) 2022; 9:859682. [PMID: 36213663 PMCID: PMC9532547 DOI: 10.3389/fmed.2022.859682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 08/09/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe safety of the COVID-19 vaccine in patients at stroke risk is poorly understood.MethodsA survey was conducted on risk factors related to stroke and adverse reactions to vaccines. The participants were divided into low-, medium-, and high-risk groups, according to the stroke risk scorecard recommended by the Stroke Prevention and Control Engineering Committee of the National Health and Family Planning Commission. Factors associated with adverse reactions were analyzed. Reasons for non-vaccination and the aggravation of underlying diseases after vaccination were investigated.Results1747 participants participated (138 unvaccinated) and 36.8, 22.1, 41.1% of the vaccinated participants had low, medium, high risk of stroke, respectively. The incidence of adverse reactions after the first and second injection was 16.6, 13.7%, respectively. There was no difference in the incidence of adverse reactions among different risk groups. Sex, vaccine type, sleep quality, worry of adverse reactions, age, and education level were significantly related to adverse reactions to vaccination. The most popular reason for non-vaccination for medium- or high risk-participants was the aggravation of the existing disease. Only 0.3% of vaccinated participants reported slight changes in blood pressure, sugar levels, and lipid levels. No aggravation of stroke sequelae, atrial fibrillation, or transient ischemic attack was reported.ConclusionsVaccination against COVID-19 (inactive virus) is safe for people at risk of stroke when the existing disease condition is stable. It is suggested to strengthen vaccine knowledge and ensure good sleep before vaccination.
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Affiliation(s)
- Gang Wu
- Department of Pharmacy, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
- Department of Neurology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Meixian Zhang
- Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Xiaomei Xie
- Department of Neurology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Yanwu Zhu
- Department of Pharmacy, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Hongxia Tang
- Department of Pharmacy, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Xinmiao Zhu
- Department of Neurology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Yifan Liang
- Department of Pharmacy, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Tao Chen
- Department of Pharmacy, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Kuangyao Zhu
- Department of Pharmacy, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Danfeng Zhang
- Department of Neurology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Sujun Jiang
- Department of Prevention and Health Care, Health Service Center of Gucheng Community, Linhai, China
| | - Zhengli Jiang
- Department of Pharmacy, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
- Zhengli Jiang
| | - Shaofa Ke
- Department of Neurology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
- *Correspondence: Shaofa Ke
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McCulloch L, Mouat IC, South K, McColl BW, Allan SM, Smith CJ. Stroke-induced changes to immune function and their relevance to increased risk of severe COVID-19 disease. DISCOVERY IMMUNOLOGY 2022; 1:kyac004. [PMID: 38566903 PMCID: PMC10917238 DOI: 10.1093/discim/kyac004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 07/07/2022] [Accepted: 08/01/2022] [Indexed: 04/04/2024]
Abstract
As the COVID-19 pandemic moves towards endemic disease, it remains of key importance to identify groups of individuals vulnerable to severe infection and understand the biological factors that mediate this risk. Stroke patients are at increased risk of developing severe COVID-19, likely due to stroke-induced alterations to systemic immune function. Furthermore, immune responses associated with severe COVID-19 in patients without a history of stroke parallel many of the immune alterations induced by stroke, possibly resulting in a compounding effect that contributes to worsened disease severity. In this review, we discuss the changes to systemic immune function that likely contribute to augmented COVID-19 severity in patients with a history of stroke and the effects of COVID-19 on the immune system that may exacerbate these effects.
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Affiliation(s)
- Laura McCulloch
- Centre for Inflammation Research, University of Edinburgh, Edinburgh, UK
| | - Isobel C Mouat
- Centre for Inflammation Research, University of Edinburgh, Edinburgh, UK
| | - Kieron South
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Lydia Becker Institute of Immunology and Inflammation, Division of Immunology, Immunity to Infection and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance NHS Foundation Trust, University of Manchester, Manchester, UK
| | - Barry W McColl
- UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK
| | - Stuart M Allan
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Lydia Becker Institute of Immunology and Inflammation, Division of Immunology, Immunity to Infection and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance NHS Foundation Trust, University of Manchester, Manchester, UK
| | - Craig J Smith
- Lydia Becker Institute of Immunology and Inflammation, Division of Immunology, Immunity to Infection and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance NHS Foundation Trust, University of Manchester, Manchester, UK
- Greater Manchester Comprehensive Stroke Centre, Manchester Centre for Clinical Neurosciences, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Salford, UK
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Huang H, Chen J, Fang S, Chen X, Pan X, Lei H, Zhang Y, Lin H, Yuan Q, Xia P, Liu N, Du H. Association Between Previous Stroke and Severe COVID-19: A Retrospective Cohort Study and an Overall Review of Meta-Analysis. Front Neurol 2022; 13:922936. [PMID: 35911884 PMCID: PMC9327441 DOI: 10.3389/fneur.2022.922936] [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: 04/18/2022] [Accepted: 06/14/2022] [Indexed: 01/08/2023] Open
Abstract
Objective The objective of this study was to investigate the association between previous stroke and the risk of severe coronavirus disease 2019 (COVID-19). Methods We included 164 (61.8 ± 13.6 years) patients with COVID-19 in a retrospective study. We evaluated the unadjusted and adjusted associations between previous stroke and severe COVID-19, using a Cox regression model. We conducted an overall review of systematic review and meta-analysis to investigate the relationship of previous stroke with the unfavorable COVID-19 outcomes. Results The rate of severe COVID-19 in patients with previous stroke was 28.37 per 1,000 patient days (95% confidence interval [CI]: 10.65–75.59), compared to 3.94 per 1,000 patient days (95% CI: 2.66–5.82) in those without previous stroke (p < 0.001). Previous stroke was significantly associated with severe COVID-19 using a Cox regression model (unadjusted [hazard ratio, HR]: 6.98, 95% CI: 2.42–20.16, p < 0.001; adjusted HR [per additional 10 years]: 4.62, 95% CI: 1.52–14.04, p = 0.007). An overall review of systematic review and meta-analysis showed that previous stroke was significantly associated with severe COVID-19, mortality, need for intensive care unit admission, use of mechanical ventilation, and an unfavorable composite outcome. Conclusion Previous stroke seems to influence the course of COVID-19 infection; such patients are at high risk of severe COVID-19 and might benefit from early hospital treatment measures and preventive strategies.
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Affiliation(s)
- Huayao Huang
- Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China
| | - Junnian Chen
- Department of Critical Care Medicine, Fujian Medical University Union Hospital, Fuzhou, China
| | - Shuangfang Fang
- Department of Neurology, Stroke Research Center, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xiaoling Chen
- Department of Infectious Disease, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xiaobin Pan
- Department of Critical Care Medicine, Fujian Provincial Hospital South Branch, Fuzhou, China
| | - Hanhan Lei
- Department of Neurology, Stroke Research Center, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yixian Zhang
- Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China
| | - Hailong Lin
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Qilin Yuan
- Department of Neurology, Stroke Research Center, Fujian Medical University Union Hospital, Fuzhou, China
| | - Pincang Xia
- Fujian Center for Disease Control and Prevention, Fuzhou, China
| | - Nan Liu
- Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China
- Department of Neurology, Stroke Research Center, Fujian Medical University Union Hospital, Fuzhou, China
| | - Houwei Du
- Department of Neurology, Stroke Research Center, Fujian Medical University Union Hospital, Fuzhou, China
- *Correspondence: Houwei Du
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Kumar N, Verma R, Lohana P, Lohana A, Ramphul K. Acute myocardial infarction in COVID-19 patients. A review of cases in the literature. Arch Med Sci Atheroscler Dis 2021; 6:e169-e175. [PMID: 34703946 PMCID: PMC8525248 DOI: 10.5114/amsad.2021.109287] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 08/31/2021] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION COVID-19 is an ongoing pandemic that has lasted more than a year. Patients with multiple comorbidities such as diabetes, hypertension, and smoking have been shown to be at increased risk of a more severe course and lethal outcome. Since the disease can also lead to a hypercoagulable state, several cases of acute myocardial infarction (AMI) have also been recorded. MATERIAL AND METHODS We searched PubMed/Medline for case reports of AMI occurring in COVID-19 positive patients using "acute myocardial infarction", "COVID-19", and "SARS-CoV-2" as keywords. RESULTS Thirty-three articles covering 37 patients were identified, among which 30 (81.1%) were male, and 7 (18.9%) were females. The mean age of these 37 patients was 52.8 ±15.6 years. Most cases were from the United States (17 cases, 45.9%). Several comorbidities such as hypertension (16 cases, 43.2%), diabetes (14 cases, 37.8%), smoking (8 cases, 21.6%), obesity (3 cases, 8.1%), morbid obesity (1 case, 2.7%), and elevated lipid levels (4 cases, 10.8%) were also identified. The most common symptom of AMI was chest tightness (22 cases, 59.5%), while the most common symptoms for COVID-19 were dyspnoea (25 cases, 67.6%) and fever (22 cases, 59.5%). The mortality rate was 35.1%. CONCLUSIONS Given the high mortality rate, physicians are encouraged to properly check for signs of cardiac dysfunction and possible AMI while treating COVID-19 positive patients with several comorbidities or previous history of AMI.
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Affiliation(s)
- Nomesh Kumar
- Department of Internal Medicine, Liaquat University of Medical and Health Sciences Hospital, Jamshoro, Pakistan
| | - Renuka Verma
- Department of Internal Medicine, Guru Gobind Singh Medical College and Hospital, Punjab, India
| | - Petras Lohana
- Department of Internal Medicine, Liaquat University of Medical and Health Sciences Hospital, Jamshoro, Pakistan
| | - Arti Lohana
- Department of Internal Medicine, Liaquat University of Medical and Health Sciences Hospital, Jamshoro, Pakistan
| | - Kamleshun Ramphul
- Department of Pediatrics, Shanghai Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Ramphul K, Verma R, Kumar N, Ramphul Y, Mejias S, Lohana P. Rising concerns of Mucormycosis (Zygomycosis) among COVID-19 patients; an analysis and review based on case reports in literature. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021271. [PMID: 34487063 PMCID: PMC8477096 DOI: 10.23750/abm.v92i4.11787] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 05/20/2021] [Indexed: 01/12/2023]
Abstract
As the world continues to struggle with the pandemic of COVID-19 (coronavirus disease 2019), several cases of mucormycosis have been reported in these patients with a high mortality rate. We conducted a review of literature and found 19 articles with 20 patients who developed mucormycosis during their COVID-19 infection.14 (70%) were males, and 6(30%) were females. While their mean age was 52.2 ± 17.3 years, affected men were older than females. Ten (50%) patients also had diabetes. Common clinical findings included ophthalmologic complaints, fever, shortness of breath, and facial pain. Amphotericin B was the most common antifungal used and around 40% of cases needed surgical management of the infection. Steroid use was reported in around 12 cases (60%). Unfortunately, the mortality rate was 65% in this group of patients. Several changes in care should be brought for a consistent prevention, early diagnosis, and strong management of mucormycosis in COVID-19 patients.
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Affiliation(s)
- Kamleshun Ramphul
- Department of Pediatrics, Shanghai Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine.
| | - Renuka Verma
- Guru Gobind Singh Medical College, Punjab, India.
| | - Nomesh Kumar
- Liaquat University of Medicine and Health Sciences, Jamshroo, Pakistan.
| | | | | | - Petras Lohana
- Liaquat University of Medicine and Health Sciences, Jamshroo, Pakistan.
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