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Bouton C, Meziere P, Gaultier A, Dupouy J, Rat C. Identification of factors associated with non-adherence to recommended COVID-19 preventive behaviours: a cross-sectional study based on a survey among 1004 French primary care professionals. BMJ Open 2023; 13:e071215. [PMID: 37643842 PMCID: PMC10465903 DOI: 10.1136/bmjopen-2022-071215] [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: 12/20/2022] [Accepted: 07/27/2023] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVES Since the beginning of the COVID-19 pandemic, adherence to preventive behaviours to limit virus spread has been a major issue. The study objective was to identify factors associated with non-adherence to preventive behaviours among general practitioners (GPs) during the COVID-19 pandemic using data from a questionnaire completed during the French National Congress of General Medicine in June 2021. DESIGN This descriptive study relied on data collected with a questionnaire during the national congress on general medicine in Bordeaux, France, from 16-18 June 2021. SETTING The study was conducted in primary care in France. PARTICIPANTS Out of a total of 1004 GPs and GP trainees, 755 completed the questionnaire during conferences and 249 were contacted by mail. RESULTS The questionnaire included questions on sociodemographic characteristics and COVID-19 related preventive behaviours, beliefs and experiences. Answers to questions that explored the Health Belief Model components were selected and then compared among participants who reported appropriate preventive behaviours (wearing face masks and social distancing) and participants who reported non-adherence. Analysis was based on multivariate logistic regression.The responders' mean age was 35.8 years; 61.64% were women, 61.9% were practising GPs and 37.2% were GP trainees. Moreover, 96.6% of participants had completed the COVID-19 vaccination schedule. Non-adherence (reported by 72/1004 participants) was more frequent among smokers (OR=2.57, 95% CI 1.29 to 4.83, p=0.005) and younger participants (OR=0.95, 95% CI 0.92 to 0.98, p=0.005). Complete COVID-19 vaccination or a previous infection was not associated with non-adherence and has been poorly described. CONCLUSION More studies are needed to confirm the factors involved in the adoption of COVID-19 preventive behaviours by healthcare professionals and to explore the beliefs and barriers to the adoption of these behaviours.
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Affiliation(s)
- Céline Bouton
- Department of General Practice, Université de Nantes, Nantes, Pays de la Loire, France
| | - Pauline Meziere
- Department of General Practice, Université de Nantes, Nantes, Pays de la Loire, France
| | - Aurelie Gaultier
- Research Department, Methodology and Biostatistics Platform, University Hospital of Nantes, Universite de Nantes, Nantes, Pays de la Loire, France
| | - Julie Dupouy
- Department of General Practice, University of Toulouse, Toulouse, France
- French National College of General Practioners, CNGE, Paris, Île-de-France, France
| | - Cédric Rat
- Department of General Practice, Université de Nantes, Nantes, Pays de la Loire, France
- French National College of General Practioners, CNGE, Paris, Île-de-France, France
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2
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Rejeki PS, Witarto BS, Witarto AP, Rifdah SN, Wafa IA, Utami DM, Izzatunnisa N, Kencono Wungu CD, Khaerunnisa S, Sakina, Fazleen Mohd Fathil NE. Importance of moderate-to-vigorous physical activity during the COVID-19 pandemic: a systematic review and meta-analysis. J Basic Clin Physiol Pharmacol 2023; 34:311-320. [PMID: 36957989 DOI: 10.1515/jbcpp-2023-0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 03/02/2023] [Indexed: 03/25/2023]
Abstract
Moderate-to-vigorous physical activity (MVPA) has been shown to have a favorable effect on many diseases as a complementary therapy and is a critical component of healthy living. During the pandemic era, physical activity has been promoted for resistance against coronavirus disease 2019 (COVID-19). However, there is scarce evidence on whether MVPA could reduce the infectivity and susceptibility to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The objective of this meta-analysis was to determine the effect of MVPA on morbidity, mortality, and duration of hospitalization in COVID-19 patients. We performed a comprehensive search of five online databases for eligible studies up to September 9, 2021. Meta-analyses were conducted to determine the association between MVPA and COVID-19-related morbidity, hospitalization, and mortality. The odds ratio (OR) was applied as the summary statistic for the primary outcomes. Secondary analyses were conducted to evaluate the difference in the metabolic equivalent of tasks (METs) between the outcome and non-outcome groups with the mean difference as the pooled effect. This meta-analysis included eight observational studies. We found that MVPA significantly reduced the odds of contracting SARS-CoV-2 infection (OR=0.88; 95% confidence interval [CI] = 0.85-0.92), hospitalization (OR=0.56; 95% CI=0.35-0.92), and mortality (OR=0.42; 95% CI=0.21-0.81) due to COVID-19 compared to no physical activity. METs≥500 min/week were linked to decreased morbidity and mortality of COVID-19 (OR=0.94 [95% CI=0.90-0.98]; OR=0.56 [95% CI=0.38-0.83]). COVID-19 patients with MVPA demonstrated a lower risk of COVID-19-related morbidity, hospitalization, and mortality compared to those who were less active, highlighting the importance of an active lifestyle despite the pandemic situation where such activities are limited.
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Affiliation(s)
- Purwo Sri Rejeki
- Department of Medical Physiology and Biochemistry, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Bendix Samarta Witarto
- Medical Program, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Andro Pramana Witarto
- Medical Program, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | | | - Ifan Ali Wafa
- Medical Program, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Dita Mega Utami
- Medical Program, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Nabilah Izzatunnisa
- Medical Program, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Citrawati Dyah Kencono Wungu
- Department of Medical Physiology and Biochemistry, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Siti Khaerunnisa
- Department of Medical Physiology and Biochemistry, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Sakina
- Department of Anatomy, Histology and Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
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3
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Ahlström B, Frithiof R, Larsson IM, Strandberg G, Lipcsey M, Hultström M. A comparison of impact of comorbidities and demographics on 60-day mortality in ICU patients with COVID-19, sepsis and acute respiratory distress syndrome. Sci Rep 2022; 12:15703. [PMID: 36127433 PMCID: PMC9487845 DOI: 10.1038/s41598-022-19539-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 08/30/2022] [Indexed: 11/17/2022] Open
Abstract
Severe Coronavirus disease 2019 (COVID-19) is associated with several pre-existing comorbidities and demographic factors. Similar factors are linked to critical sepsis and acute respiratory distress syndrome (ARDS). We hypothesized that age and comorbidities are more generically linked to critical illness mortality than a specific disease state. We used national databases to identify ICU patients and to retrieve comorbidities. The relative importance of risk factors for 60-day mortality was evaluated using the interaction with disease group (Sepsis, ARDS or COVID-19) in logistic regression models. We included 32,501 adult ICU patients. In the model on 60-day mortality in sepsis and COVID-19 there were significant interactions with disease group for age, sex and asthma. In the model on 60-day mortality in ARDS and COVID-19 significant interactions with cohort were found for acute disease severity, age and chronic renal failure. In conclusion, age and sex play particular roles in COVID-19 mortality during intensive care but the burden of comorbidity was similar between sepsis and COVID-19 and ARDS and COVID-19.
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Affiliation(s)
- Björn Ahlström
- Anesthesiology and Intensive Care, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden. .,Region Dalarna, Centre for Clinical Research Dalarna, Falun Hospital, Nissers väg 3, 79182, Falun, Sweden.
| | - Robert Frithiof
- Anesthesiology and Intensive Care, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Ing-Marie Larsson
- Anesthesiology and Intensive Care, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Gunnar Strandberg
- Anesthesiology and Intensive Care, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Miklos Lipcsey
- Anesthesiology and Intensive Care, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.,Hedenstierna Laboratory, CIRRUS, Anesthesiology and Intensive Care, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Michael Hultström
- Anesthesiology and Intensive Care, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.,Integrative Physiology, Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
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4
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Azghar A, Bensalah M, Berhili A, Slaoui M, Mouhoub B, El Mezgueldi I, Nassiri O, El Malki J, Maleb A, Seddik R. Value of hematological parameters for predicting patients with severe coronavirus disease 2019: a real-world cohort from Morocco. J Int Med Res 2022; 50:3000605221109381. [PMID: 35854474 PMCID: PMC9340338 DOI: 10.1177/03000605221109381] [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] [Indexed: 11/16/2022] Open
Abstract
Objective Coronavirus disease 2019 (COVID-19) is a viral disease caused by severe acute
respiratory syndrome coronavirus 2. The clinical manifestations and the
evolution of patients with COVID-19 are variable. In addition to respiratory
involvement, COVID-19 leads to systemic involvement and can affect the
hematopoietic system. This study aimed to evaluate the prognostic value of
hematological and hemocytometric parameters in predicting the severity of
patients with COVID-19. Methods We performed a retrospective study at Mohammed VI university Hospital from 1
March to 11 November 2020. We collected demographic characteristics and
hematological findings of incident COVID-19 cases. Results A total of 245 patients were included in our study. We found that the rate of
lymphopenia was significantly reduced in patients who were severely affected
by COVID-19. Additionally, the rate of neutrophilia, the neutrophil side
fluorescence light signal, monocyte fluorescent intensity, monocyte size,
the neutrophil-to-lymphocyte ratio, the platelet-to-lymphocyte ratio, and
the lymphocyte-to-monocyte ratio were significantly elevated in patients who
were severely affected by COVID-19. Conclusions These results are consistent with the literature regarding the predictive
value of these markers. A prospective validation in a large population with
a longer follow-up is required.
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Affiliation(s)
- Ali Azghar
- Hematology Laboratory, Mohammed VI University Hospital Center, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Mohammed Bensalah
- Hematology Laboratory, Mohammed VI University Hospital Center, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Abdelilah Berhili
- Hematology Laboratory, Mohammed VI University Hospital Center, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Mounia Slaoui
- Hematology Laboratory, Mohammed VI University Hospital Center, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Boutaina Mouhoub
- Hematology Laboratory, Mohammed VI University Hospital Center, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Imane El Mezgueldi
- Hematology Laboratory, Mohammed VI University Hospital Center, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Oumaima Nassiri
- Hematology Laboratory, Mohammed VI University Hospital Center, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Jalila El Malki
- Hematology Laboratory, Mohammed VI University Hospital Center, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Adil Maleb
- Microbiology Laboratory, Mohammed VI University Hospital Center, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Rachid Seddik
- Hematology Laboratory, Mohammed VI University Hospital Center, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
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5
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Fugazzaro S, Denti M, Mainini C, Accogli MA, Bedogni G, Ghizzoni D, Bertolini A, Esseroukh O, Gualdi C, Schiavi M, Braglia L, Costi S. Sex differences and rehabilitation needs after hospital discharge for COVID-19: an Italian cross-sectional study. BMJ Open 2022; 12:e055308. [PMID: 35584875 PMCID: PMC9118361 DOI: 10.1136/bmjopen-2021-055308] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES COVID-19 can result in persistent symptoms leaving potential rehabilitation needs unmet. This study aims to describe persistent symptoms and health status of individuals hospitalised for COVID-19 according to the International Classification of Functioning, Disability and Health domains of impairments, limitations in activity, and participation restrictions. DESIGN Cross-sectional study consisting in a telephone interview 3 months after hospital discharge. SETTING This study was conducted during the first peak of the COVID-19 pandemic by the Local Health Authority of Reggio Emilia (Italy). PARTICIPANTS Adult individuals discharged from hospital between April and June 2020 after COVID-19. EXCLUSION CRITERIA hospitalisation for reasons other than COVID-19, inability to participate in the study, concomitant acute or chronic conditions causing disability. PRIMARY AND SECONDARY OUTCOME MEASURES We assessed: dyspnoea (Medical Research Council), fatigue (Fatigue Severity Scale), mood disturbances (Hospital Anxiety and Depression Scale), limitations in activity (Barthel Index) and participation restrictions (Reintegration to Normal Living Index). We also collected data on sociodemographic characteristics, health status prior to COVID-19, COVID-related clinical manifestations and hospital care pathway up to discharge, rehabilitation interventions, accidental falls and emergency room access. RESULTS 149 participants (men, 62%; average age 62 (±11) years) were enrolled, 35 of which (23%) were admitted to the intensive care unit (ICU) while hospitalised. Three months after hospital discharge, nearly half of the participants still suffered from dyspnoea (44%) or fatigue (39%). Almost all individuals (91.2%) recovered a good level of independence in activity of daily living, but 76% still suffered participation restrictions. Female sex was significantly associated with worse outcomes for all symptoms. CONCLUSIONS Individuals who had moderate or severe COVID-19 may perceive persistent symptoms which may result in reduced social participation. Sex differences should be monitored, as women may recover more slowly than men. TRIAL REGISTRATION NUMBER NCT04438239.
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Affiliation(s)
- Stefania Fugazzaro
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy
| | - Monica Denti
- Physical Medicine and Rehabilitation Unit, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Carlotta Mainini
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy
| | - Monia Allisen Accogli
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy
| | - Ginevra Bedogni
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy
| | - Daniele Ghizzoni
- Physiotherapy Service, Private Hospital Villa Verde Srl, Reggio Emilia, Italy
| | - Anna Bertolini
- Department of Medical and Sugical Sciences;University of Modena e Reggio, Bachelor' degree in OT, Modena e Reggio Emilia, Italy
| | - Otmen Esseroukh
- Department of Surgery, Medicine, DentristY and Morphological Sciences; University of Modena e Reggio Emilia, Bachelor's degree PT, Modena e Reggio Emilia, Italy
| | - Cecilia Gualdi
- Department of Surgery, Medicine, DentristY and Morphological Sciences; University of Modena e Reggio Emilia, Bachelor's degree PT, Modena e Reggio Emilia, Italy
| | - Margherita Schiavi
- Department of Health Professions, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Luca Braglia
- Research and Statistic Infrastructure, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefania Costi
- Department of Medical and Sugical Sciences;University of Modena e Reggio, Bachelor' degree in OT, Modena e Reggio Emilia, Italy
- Scientific Directorate, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
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6
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Ebner B, Volz Y, Mumm JN, Stief CG, Magistro G. The COVID-19 pandemic - what have urologists learned? Nat Rev Urol 2022; 19:344-356. [PMID: 35418709 PMCID: PMC9007269 DOI: 10.1038/s41585-022-00586-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2022] [Indexed: 12/18/2022]
Abstract
On 11 March 2020, the WHO declared the coronavirus disease 2019 (COVID-19) outbreak a pandemic and COVID-19 emerged as one of the biggest challenges in public health and economy in the twenty-first century. The respiratory tract has been the centre of attention, but COVID-19-associated complications affecting the genitourinary tract are reported frequently, raising concerns about possible long-term damage in these organs. The angiotensin-converting enzyme 2 (ACE2) receptor, which has a central role in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) invasion, is highly expressed in the genitourinary tract, indicating that these organs could be at a high risk of cell damage. The detection of SARS-CoV-2 in urine and semen is very rare; however, COVID-19 can manifest through urological symptoms and complications, including acute kidney injury (AKI), which is associated with poor survival, severe structural changes in testes and impairment of spermatogenesis, and hormonal imbalances (mostly secondary hypogonadism). The effect of altered total testosterone levels or androgen deprivation therapy on survival of patients with COVID-19 was intensively debated at the beginning of the pandemic; however, androgen inhibition did not show any effect in preventing or treating COVID-19 in a clinical study. Thus, urologists have a crucial role in detecting and managing damage of the genitourinary tract caused by COVID-19.
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Affiliation(s)
- Benedikt Ebner
- Department of Urology, Ludwig-Maximilians-University, Munich, Germany
| | - Yannic Volz
- Department of Urology, Ludwig-Maximilians-University, Munich, Germany
| | - Jan-Niclas Mumm
- Department of Urology, Ludwig-Maximilians-University, Munich, Germany
| | - Christian G Stief
- Department of Urology, Ludwig-Maximilians-University, Munich, Germany
| | - Giuseppe Magistro
- Department of Urology, Ludwig-Maximilians-University, Munich, Germany.
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7
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Zhuang C, Liu X, Chen Q, Sun Y, Su Y, Huang S, Wu T, Xia N. Protection Duration of COVID-19 Vaccines: Waning Effectiveness and Future Perspective. Front Microbiol 2022; 13:828806. [PMID: 35273584 PMCID: PMC8902038 DOI: 10.3389/fmicb.2022.828806] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 01/13/2022] [Indexed: 12/31/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) vaccines have very successfully decreased the disease risk as we know; some key information remains unknown due to the short development history and the lack of long-term follow-up studies in vaccinated populations. One of the unanswered issues is the protection duration conferred after COVID-19 vaccination, which appears to play a pivotal role in the future impact of pathogens and is critical to inform the public health response and policy decisions. Here, we review current information on the long-term effectiveness of different COVID-19 vaccines, persistence of immunogenicity, and gaps in knowledge. Meanwhile, we also discuss the influencing factors and future study prospects on this topic.
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Affiliation(s)
- Chunlan Zhuang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, China
| | - Xiaohui Liu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, China
| | - Qi Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, China
| | - Yuxin Sun
- School of Life Sciences, Sun Yat-sen University, Guangzhou, China
| | - Yingying Su
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, China
| | - Shoujie Huang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, China
| | - Ting Wu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, China
| | - Ningshao Xia
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, China
- Research Unit of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Beijing, China
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8
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Karasneh RA, Khassawneh BY, Al-Azzam S, Al-Mistarehi AH, Lattyak WJ, Aldiab M, Kabbaha S, Hasan SS, Conway BR, Aldeyab MA. Risk Factors Associated with Mortality in COVID-19 Hospitalized Patients: Data from the Middle East. Int J Clin Pract 2022; 2022:9617319. [PMID: 36072822 PMCID: PMC9398873 DOI: 10.1155/2022/9617319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 07/23/2022] [Indexed: 11/24/2022] Open
Abstract
This study aimed to assess the risk factors for COVID-19 mortality among hospitalized patients in Jordan. All COVID-19 patients admitted to a tertiary hospital in Jordan from September 20, 2020, to August 8, 2021, were included in this study. Demographics, clinical characteristics, comorbidities, and laboratory results were extracted from the patients' electronic records. Multivariable logistic and machine learning (ML) methods were used to study variable importance. Out of 1,613 COVID-19 patients, 1,004 (62.2%) were discharged from the hospital (survived), while 609 (37.8%) died. Patients who were of elderly age (>65 years) (OR, 2.01; 95% CI, 1.28-3.16), current smokers (OR, 1.61; 95%CI, 1.17-2.23), and had severe or critical illness at admission ((OR, 1.56; 95%CI, 1.05-2.32) (OR, 2.94; 95%CI, 2.02-4.27); respectively), were at higher risk of mortality. Comorbidities including chronic kidney disease (OR, 2.90; 95% CI, 1.90-4.43), deep venous thrombosis (OR, 2.62; 95% CI, 1.08-6.35), malignancy (OR, 2.22; 95% CI, 1.46-3.38), diabetes (OR, 1.31; 95% CI, 1.04-1.65), and heart failure (OR, 1.51; 95% CI, 1.02-2.23) were significantly associated with increased risk of mortality. Laboratory abnormalities associated with mortality included hypernatremia (OR, 11.37; 95% CI, 4.33-29.81), elevated aspartate aminotransferase (OR, 1.81; 95% CI, 1.42-2.31), hypoalbuminemia (OR, 1.75; 95% CI, 1.37-2.25), and low platelets level (OR, 1.43; 95% CI, 1.05-1.95). Several demographic, clinical, and laboratory risk factors for COVID-19 mortality were identified. This study is the first to examine the risk factors associated with mortality using ML methods in the Middle East. This will contribute to a better understanding of the impact of the disease and improve the outcome of the pandemic worldwide.
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Affiliation(s)
- Reema A. Karasneh
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Basheer Y. Khassawneh
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Sayer Al-Azzam
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Abdel-Hameed Al-Mistarehi
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Motasem Aldiab
- Department of Computing, British Columbia Institute of Technology, Vancouver, Canada
| | - Suad Kabbaha
- Department of Health Research Methods, Evidence & Impact (HEI), McMaster University, Hamilton, Canada
| | - Syed Shahzad Hasan
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK
| | - Barbara R. Conway
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK
- Institute of Skin Integrity and Infection Prevention, University of Huddersfield, Huddersfield, UK
| | - Mamoon A. Aldeyab
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK
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9
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Wei R, Zhou B, Li S, Zhong D, Li B, Qin J, Zhao L, Qin L, Hu J, Wang J, Yang S, Zhao J, Meng S. Plasma gp96 is a Novel Predictive Biomarker for Severe COVID-19. Microbiol Spectr 2021; 9:e0059721. [PMID: 34817280 PMCID: PMC8612155 DOI: 10.1128/spectrum.00597-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 10/27/2021] [Indexed: 11/25/2022] Open
Abstract
Early and effective identification of severe coronavirus disease 2019 (COVID-19) may allow us to improve the outcomes of associated severe acute respiratory illness with fever and respiratory symptoms. This study analyzed plasma concentrations of heat shock protein gp96 in nonsevere (including mild and typical) and severe (including severe and critical) patients with COVID-19 to evaluate its potential as a predictive and prognostic biomarker for disease severity. Plasma gp96 levels that were positively correlated with interleukin-6 (IL-6) levels were significantly elevated in COVID-19 patients admitted to the hospital but not in non-COVID-19 patients with less severe respiratory impairment. Meanwhile, significantly higher gp96 levels were observed in severe than nonsevere patients. Moreover, the continuous decline of plasma gp96 levels predicted disease remission and recovery, whereas its persistently high levels indicated poor prognosis in COVID-19 patients during hospitalization. Finally, monocytes were identified as the major IL-6 producers under exogenous gp96 stimulation. Our results demonstrate that plasma gp96 may be a useful predictive and prognostic biomarker for disease severity and outcome of COVID-19. IMPORTANCE Early and effective identification of severe COVID-19 may allow us to improve the outcomes of associated severe acute respiratory illness with fever and respiratory symptoms. Some heat shock proteins (Hsps) are released during oxidative stress, cytotoxic injury, and viral infection and behave as danger-associated molecular patterns (DAMPs). This study analyzed plasma concentrations of Hsp gp96 in nonsevere and severe patients with COVID-19. Significantly higher plasma gp96 levels were observed in severe than those in nonsevere patients, and its persistently high levels indicated poor prognosis in COVID-19 patients. The results demonstrate that plasma gp96 may be a useful predictive and prognostic biomarker for disease severity and outcome of COVID-19.
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Affiliation(s)
- Rongguo Wei
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Center for Biosafety Mega-Science, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
- Department of Clinical Laboratory, The Fifth Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Biyan Zhou
- Department of Clinical Laboratory, The Fifth Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Shaohua Li
- Department of Pathology and Hepatology, The 5th Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Debin Zhong
- Department of Clinical Laboratory, The Fifth Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Boan Li
- Department of Clinical Laboratory, The 5th Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Jianqiu Qin
- Nanning Municipal Center for Disease Control and Prevention, Nanning, China
| | - Liping Zhao
- Department of Clinical Laboratory, The Fifth Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Lixian Qin
- Department of Clinical Laboratory, The Fifth Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jun Hu
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Center for Biosafety Mega-Science, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Jiuru Wang
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Center for Biosafety Mega-Science, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Shixiong Yang
- Nanning Municipal Center for Disease Control and Prevention, Nanning, China
| | - Jingming Zhao
- Department of Pathology and Hepatology, The 5th Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Songdong Meng
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Center for Biosafety Mega-Science, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
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10
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Case-control study of the association of chronic acid suppression and social determinants of health with COVID-19 infection. Sci Rep 2021; 11:20987. [PMID: 34697319 PMCID: PMC8545937 DOI: 10.1038/s41598-021-00367-7] [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: 03/27/2021] [Accepted: 09/28/2021] [Indexed: 11/23/2022] Open
Abstract
Acid suppressants are widely-used classes of medications linked to increased risks of aerodigestive infections. Prior studies of these medications as potentially reversible risk factors for COVID-19 have been conflicting. We aimed to determine the impact of chronic acid suppression use on COVID-19 infection risk while simultaneously evaluating the influence of social determinants of health to validate known and discover novel risk factors. We assessed the association of chronic acid suppression with incident COVID-19 in a 1:1 case–control study of 900 patients tested across three academic medical centers in California, USA. Medical comorbidities and history of chronic acid suppression use were manually extracted from health records by physicians following a pre-specified protocol. Socio-behavioral factors by geomapping publicly-available data to patient zip codes were incorporated. We identified no evidence to support an association between chronic acid suppression and COVID-19 (adjusted odds ratio 1.04, 95% CI 0.92–1.17, P = 0.515). However, several medical and social features were positive (Latinx ethnicity, BMI ≥ 30, dementia, public transportation use, month of the pandemic) and negative (female sex, concurrent solid tumor, alcohol use disorder) predictors of new infection. These findings demonstrate the value of integrating publicly-available databases with medical data to identify critical features of communicable diseases.
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11
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Akhtar H, Khalid S, Ur Rahman F, Umar M, Ali S, Afridi M, Hassan F, Saleh Khader Y, Akhtar N, Mujeeb Khan M, Ikram A. Presenting characteristics, comorbidities, and outcomes among COVID-19 patients hospitalized in twin cities of Pakistan. JMIR Public Health Surveill 2021; 7:e32203. [PMID: 34710053 PMCID: PMC8673715 DOI: 10.2196/32203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/04/2021] [Accepted: 10/25/2021] [Indexed: 02/05/2023] Open
Abstract
Background COVID-19 became a pandemic rapidly after its emergence in December 2019. It belongs to the coronavirus family of viruses, which have struck a few times before in history. Data based on previous research regarding etiology and epidemiology of other viruses from this family helped played a vital role in formulating prevention and precaution strategies during the initial stages of this pandemic. Data related to COVID-19 in Pakistan were not initially documented on a large scale. In addition, due to a weak health care system and low economic conditions, Pakistan’s population, in general, already suffers from many comorbidities, which can severely affect the outcome of patients infected with COVID-19. Objective COVID-19 infections are coupled with a manifestation of various notable outcomes that can be documented and characterized clinically. The aim of this study was to examine these clinical manifestations, which can serve as indicators for early detection as well as severity prognosis for COVID-19 infections, especially in high-risk groups. Methods A retrospective observational study involving abstraction of demographic features, presenting symptoms, and adverse clinical outcomes for 1812 patients with COVID-19 was conducted. Patients were admitted to the four major hospitals in the Rawalpindi-Islamabad region of Pakistan, and the study was conducted from February to August 2020. Multivariate regression analysis was carried out to identify significant indicators of COVID-19 severity, intensive care unit (ICU) admission, ventilator aid, and mortality. The study not only relates COVID-19 infection with comorbidities, but also examines other related factors, such as age and gender. Results This study identified fever (1592/1812, 87.9%), cough (1433/1812, 79.1%), and shortness of breath (998/1812, 55.1%) at the time of hospital admission as the most prevalent symptoms for patients with COVID-19. These symptoms were common but not conclusive of the outcome of infection. Out of 1812 patients, 24.4% (n=443) required ICU admission and 21.5% (n=390) required ventilator aid at some point of disease progression during their stay at the hospital; 25.9% (n=469) of the patients died. Further analysis revealed the relationship of the presented symptoms and comorbidities with the progression of disease severity in these patients. Older adult patients with comorbidities, such as hypertension, diabetes, chronic kidney disease, and asthma, were significantly affected in higher proportions, resulting in requirement of ICU admission and ventilator aid in some cases and, in many cases, even mortality. Conclusions Older adult patients with comorbidities, such as hypertension, diabetes, asthma, chronic obstructive pulmonary disorder, and chronic kidney disease, are at increased risk of developing severe COVID-19 infections, with an increased likelihood of adverse clinical outcomes.
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Affiliation(s)
- Hashaam Akhtar
- Yusra Institute of Pharmaceutical Sciences (YIPs), Zaraj Housing Society, Opposite DHA Phase 2 Gate III, Main G.T. Road, Islamabad, PK
| | - Sundas Khalid
- School Of Chemical And Materials Engineering, National University Of Science And Technology, Islamabad, PK
| | - Fazal Ur Rahman
- HEAD OF DEPARTMENT OF MEDICINE BENAZIR BHUTTO HOSPITAL, Rawalpindi, PK
| | - Muhammad Umar
- Vice Chancellor, Rawalpindi Medical University (RMU), Rawalpindi, PK
| | - Sabahat Ali
- Department Of Gynecology And Obstetrics, Paf Hospital, Islamabad, PK
| | - Maham Afridi
- Department Of Biotechnology, Quaid I Azam University, Islamabad, PK
| | - Faheem Hassan
- CT Angio-Department, Armed Forces Institute of Cardiology (AFIC), Rawalpindi, PK
| | - Yousef Saleh Khader
- Medical Education And Biostatistics Department Of Community Medicine, Public Health And Family Medicine/ Faculty Of Medicine.Jordan University Of Science & Technology, Irbid, JO
| | - Nasim Akhtar
- Department of Infectious Diseases, Pakistan Institute Of Medical Sciences (PIMS), Islamabad, PK
| | - Muhammad Mujeeb Khan
- Department of Infectious Diseases, Rawalpindi Medical University (RMU), Rawalpindi, PK
| | - Aamer Ikram
- Executive Director, National Institute Of Health, Islamabad, PK
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12
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Deng H, Yan X, Yuan L. Human genetic basis of coronavirus disease 2019. Signal Transduct Target Ther 2021; 6:344. [PMID: 34545062 PMCID: PMC8450706 DOI: 10.1038/s41392-021-00736-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 07/28/2021] [Accepted: 08/08/2021] [Indexed: 02/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in considerable morbidity and mortality worldwide. COVID-19 incidence, severity, and mortality rates differ greatly between populations, genders, ABO blood groups, human leukocyte antigen (HLA) genotypes, ethnic groups, and geographic backgrounds. This highly heterogeneous SARS-CoV-2 infection is multifactorial. Host genetic factors such as variants in the angiotensin-converting enzyme gene (ACE), the angiotensin-converting enzyme 2 gene (ACE2), the transmembrane protease serine 2 gene (TMPRSS2), along with HLA genotype, and ABO blood group help to explain individual susceptibility, severity, and outcomes of COVID-19. This review is focused on COVID-19 clinical and viral characteristics, pathogenesis, and genetic findings, with particular attention on genetic diversity and variants. The human genetic basis could provide scientific bases for disease prediction and targeted therapy to address the COVID-19 scourge.
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Affiliation(s)
- Hao Deng
- grid.216417.70000 0001 0379 7164Health Management Center, the Third Xiangya Hospital, Central South University, Changsha, China ,grid.216417.70000 0001 0379 7164Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha, China ,grid.216417.70000 0001 0379 7164Disease Genome Research Center, Central South University, Changsha, China ,grid.216417.70000 0001 0379 7164Department of Neurology, the Third Xiangya Hospital, Central South University, Changsha, China
| | - Xue Yan
- grid.216417.70000 0001 0379 7164Health Management Center, the Third Xiangya Hospital, Central South University, Changsha, China ,grid.216417.70000 0001 0379 7164Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha, China ,grid.216417.70000 0001 0379 7164Disease Genome Research Center, Central South University, Changsha, China
| | - Lamei Yuan
- grid.216417.70000 0001 0379 7164Health Management Center, the Third Xiangya Hospital, Central South University, Changsha, China ,grid.216417.70000 0001 0379 7164Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha, China ,grid.216417.70000 0001 0379 7164Disease Genome Research Center, Central South University, Changsha, China ,grid.216417.70000 0001 0379 7164Department of Neurology, the Third Xiangya Hospital, Central South University, Changsha, China
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13
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Fernández-Martínez NF, Ortiz-González-Serna R, Serrano-Ortiz Á, Rivera-Izquierdo M, Ruiz-Montero R, Pérez-Contreras M, Guerrero-Fernández de Alba I, Romero-Duarte Á, Salcedo-Leal I. Sex Differences and Predictors of In-Hospital Mortality among Patients with COVID-19: Results from the ANCOHVID Multicentre Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9018. [PMID: 34501608 PMCID: PMC8431708 DOI: 10.3390/ijerph18179018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/06/2021] [Accepted: 08/17/2021] [Indexed: 12/16/2022]
Abstract
Spain is one of the countries most affected by the COVID-19 pandemic. Although risk factors for severe disease are published, sex differences have been widely neglected. In this multicentre study, we aimed to identify predictors of in-hospital mortality in men and women hospitalised with COVID-19. An observational longitudinal study was conducted in the cohort of patients admitted to four hospitals in Andalusia, Spain, from 1 March 2020 to 15 April 2020. Sociodemographic and clinical data were collected from hospital records. The Kaplan-Meier method was used to estimate 30-day survival and multiple Cox regression models were applied. All analyses were stratified by sex. A total of 968 patients were included (54.8% men, median age 67.0 years). In-hospital mortality reached 19.1% in men and 16.0% in women. Factors independently associated with an increased hazard of death were advanced age, higher CURB-65 score and not receiving azithromycin treatment, in both sexes; active cancer and autoimmune disease, in men; cardiovascular disease and chronic lung disease, in women. Disease outcomes and predictors of death differed between sexes. In-hospital mortality was higher in men, but the long-term effects of COVID-19 merit further research. The sex-differential impact of the pandemic should be addressed in public health policies.
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Affiliation(s)
- Nicolás Francisco Fernández-Martínez
- Unidad de Gestión Clínica Interniveles de Prevención, Promoción y Vigilancia de la Salud, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain; (N.F.F.-M.); (R.O.-G.-S.); (Á.S.-O.); (I.S.-L.)
- Preventive Medicine and Public Health Research Group, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), 14004 Córdoba, Spain
| | - Rocío Ortiz-González-Serna
- Unidad de Gestión Clínica Interniveles de Prevención, Promoción y Vigilancia de la Salud, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain; (N.F.F.-M.); (R.O.-G.-S.); (Á.S.-O.); (I.S.-L.)
- Preventive Medicine and Public Health Research Group, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), 14004 Córdoba, Spain
| | - Álvaro Serrano-Ortiz
- Unidad de Gestión Clínica Interniveles de Prevención, Promoción y Vigilancia de la Salud, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain; (N.F.F.-M.); (R.O.-G.-S.); (Á.S.-O.); (I.S.-L.)
- Preventive Medicine and Public Health Research Group, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), 14004 Córdoba, Spain
| | - Mario Rivera-Izquierdo
- Service of Preventive Medicine and Public Health, Hospital Universitario Clínico San Cecilio, 18016 Granada, Spain; (M.R.-I.); (I.G.-F.d.A.)
- Instituto de Investigación Biosanitaria, ibs. Granada, 18012 Granada, Spain
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain
| | - Rafael Ruiz-Montero
- Unidad de Gestión Clínica Interniveles de Prevención, Promoción y Vigilancia de la Salud, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain; (N.F.F.-M.); (R.O.-G.-S.); (Á.S.-O.); (I.S.-L.)
- Preventive Medicine and Public Health Research Group, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), 14004 Córdoba, Spain
- Facultad de Medicina y Enfermería, Universidad de Córdoba, 14004 Córdoba, Spain
| | - Marina Pérez-Contreras
- Service of Preventive Medicine and Public Health, Hospital Universitario de Puerto Real, 11510 Puerto Real, Spain;
| | - Inmaculada Guerrero-Fernández de Alba
- Service of Preventive Medicine and Public Health, Hospital Universitario Clínico San Cecilio, 18016 Granada, Spain; (M.R.-I.); (I.G.-F.d.A.)
- Service of Preventive Medicine and Public Health, Complejo Hospitalario de Jaén, 23007 Jaén, Spain
| | | | - Inmaculada Salcedo-Leal
- Unidad de Gestión Clínica Interniveles de Prevención, Promoción y Vigilancia de la Salud, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain; (N.F.F.-M.); (R.O.-G.-S.); (Á.S.-O.); (I.S.-L.)
- Preventive Medicine and Public Health Research Group, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), 14004 Córdoba, Spain
- Facultad de Medicina y Enfermería, Universidad de Córdoba, 14004 Córdoba, Spain
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Bennett KE, Mullooly M, O'Loughlin M, Fitzgerald M, O'Donnell J, O'Connor L, Oza A, Cuddihy J. Underlying conditions and risk of hospitalisation, ICU admission and mortality among those with COVID-19 in Ireland: A national surveillance study. LANCET REGIONAL HEALTH-EUROPE 2021; 5:100097. [PMID: 33880459 PMCID: PMC8049357 DOI: 10.1016/j.lanepe.2021.100097] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background To date, over 2 million people worldwide have died with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. To describe the experience in Ireland, this study examined associations between underlying conditions and the following outcomes: mortality, admission to hospital or admission to the intensive care unit (ICU) among those infected with COVID-19. Methods This study used data from the Health Protection Surveillance Centre in Ireland and included confirmed cases of COVID-19 from the first wave of the pandemic between March and July 2020. Two cohorts were included: all cases (community and hospital) and hospital admissions only. For all cases, health outcome data included mortality and hospitalisation. For hospitalised cases, outcome data included mortality and ICU admission. Logistic regression was used to examine associations between underlying conditions and outcomes across both cohorts. Results are presented as adjusted odds ratios (OR) and 95% confidence intervals (CIs). Findings There were 19,789 cases included in analysis, which encompassed 1,476 (7.5%) deaths, 2,811 (14.2%) hospitalisations, and 438 (2.2%) ICU admissions of whom 90 (20.5%) died. Significantly higher risk of mortality, hospitalisation and ICU admission was associated with having chronic heart disease, a BMI ≥40kg/m2 and male sex. Additionally, diagnosis of a chronic neurological condition (OR 1.41; 95%CI:1.17, 1.69), chronic kidney disease (OR 1.74; 95%CI:1.35, 2.24) and cancer (OR 2.77; 95%CI:2.21, 3.47) were significantly associated with higher risk of mortality among all cases, with similar patterns of association observed for mortality among hospitalised cases. Interpretation The identification of underlying conditions among COVID-19 cases may help identify those at highest risk of the worst health outcomes and inform preventive strategies to improve outcomes. Funding This study was supported by the Health Service Executive, Health Protection Surveillance Centre. KEB and MM are funded by the Health Research Board (RL-15-1579 and EIA-2019-012 respectively).
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Affiliation(s)
- Kathleen E Bennett
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.,Data Science Centre, Royal College of Surgeons in Ireland, Beaux Lane House, Mercer Street Lower, Dublin, Ireland
| | - Maeve Mullooly
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Mark O'Loughlin
- Health Service Executive, Health Protection Surveillance Centre, Dublin, Ireland
| | - Margaret Fitzgerald
- Health Service Executive, Health Protection Surveillance Centre, Dublin, Ireland
| | - Joan O'Donnell
- Health Service Executive, Health Protection Surveillance Centre, Dublin, Ireland
| | - Lois O'Connor
- Health Service Executive, Health Protection Surveillance Centre, Dublin, Ireland
| | - Ajay Oza
- Health Service Executive, Health Protection Surveillance Centre, Dublin, Ireland
| | - John Cuddihy
- Health Service Executive, Health Protection Surveillance Centre, Dublin, Ireland
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15
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Geng MJ, Wang LP, Ren X, Yu JX, Chang ZR, Zheng CJ, An ZJ, Li Y, Yang XK, Zhao HT, Li ZJ, He GX, Feng ZJ. Risk factors for developing severe COVID-19 in China: an analysis of disease surveillance data. Infect Dis Poverty 2021; 10:48. [PMID: 33845915 PMCID: PMC8040359 DOI: 10.1186/s40249-021-00820-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 03/05/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND COVID-19 has posed an enormous threat to public health around the world. Some severe and critical cases have bad prognoses and high case fatality rates, unraveling risk factors for severe COVID-19 are of significance for predicting and preventing illness progression, and reducing case fatality rates. Our study focused on analyzing characteristics of COVID-19 cases and exploring risk factors for developing severe COVID-19. METHODS The data for this study was disease surveillance data on symptomatic cases of COVID-19 reported from 30 provinces in China between January 19 and March 9, 2020, which included demographics, dates of symptom onset, clinical manifestations at the time of diagnosis, laboratory findings, radiographic findings, underlying disease history, and exposure history. We grouped mild and moderate cases together as non-severe cases and categorized severe and critical cases together as severe cases. We compared characteristics of severe cases and non-severe cases of COVID-19 and explored risk factors for severity. RESULTS The total number of cases were 12 647 with age from less than 1 year old to 99 years old. The severe cases were 1662 (13.1%), the median age of severe cases was 57 years [Inter-quartile range(IQR): 46-68] and the median age of non-severe cases was 43 years (IQR: 32-54). The risk factors for severe COVID-19 were being male [adjusted odds ratio (aOR) = 1.3, 95% CI: 1.2-1.5]; fever (aOR = 2.3, 95% CI: 2.0-2.7), cough (aOR = 1.4, 95% CI: 1.2-1.6), fatigue (aOR = 1.3, 95% CI: 1.2-1.5), and chronic kidney disease (aOR = 2.5, 95% CI: 1.4-4.6), hypertension (aOR = 1.5, 95% CI: 1.2-1.8) and diabetes (aOR = 1.96, 95% CI: 1.6-2.4). With the increase of age, risk for the severity was gradually higher [20-39 years (aOR = 3.9, 95% CI: 1.8-8.4), 40-59 years (aOR = 7.6, 95% CI: 3.6-16.3), ≥ 60 years (aOR = 20.4, 95% CI: 9.5-43.7)], and longer time from symtem onset to diagnosis [3-5 days (aOR = 1.4, 95% CI: 1.2-1.7), 6-8 days (aOR = 1.8, 95% CI: 1.5-2.1), ≥ 9 days(aOR = 1.9, 95% CI: 1.6-2.3)]. CONCLUSIONS Our study showed the risk factors for developing severe COVID-19 with large sample size, which included being male, older age, fever, cough, fatigue, delayed diagnosis, hypertension, diabetes, chronic kidney diasease, early case identification and prompt medical care. Based on these factors, the severity of COVID-19 cases can be predicted. So cases with these risk factors should be paid more attention to prevent severity.
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Affiliation(s)
- Meng-Jie Geng
- Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Li-Ping Wang
- Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiang Ren
- Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jian-Xing Yu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhao-Rui Chang
- Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Can-Jun Zheng
- Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhi-Jie An
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yu Li
- Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiao-Kun Yang
- Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hong-Ting Zhao
- Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhong-Jie Li
- Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Guang-Xue He
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Zi-Jian Feng
- Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China.
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16
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Booth A, Reed AB, Ponzo S, Yassaee A, Aral M, Plans D, Labrique A, Mohan D. Population risk factors for severe disease and mortality in COVID-19: A global systematic review and meta-analysis. PLoS One 2021; 16:e0247461. [PMID: 33661992 PMCID: PMC7932512 DOI: 10.1371/journal.pone.0247461] [Citation(s) in RCA: 303] [Impact Index Per Article: 101.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 02/06/2021] [Indexed: 02/06/2023] Open
Abstract
AIM COVID-19 clinical presentation is heterogeneous, ranging from asymptomatic to severe cases. While there are a number of early publications relating to risk factors for COVID-19 infection, low sample size and heterogeneity in study design impacted consolidation of early findings. There is a pressing need to identify the factors which predispose patients to severe cases of COVID-19. For rapid and widespread risk stratification, these factors should be easily obtainable, inexpensive, and avoid invasive clinical procedures. The aim of our study is to fill this knowledge gap by systematically mapping all the available evidence on the association of various clinical, demographic, and lifestyle variables with the risk of specific adverse outcomes in patients with COVID-19. METHODS The systematic review was conducted using standardized methodology, searching two electronic databases (PubMed and SCOPUS) for relevant literature published between 1st January 2020 and 9th July 2020. Included studies reported characteristics of patients with COVID-19 while reporting outcomes relating to disease severity. In the case of sufficient comparable data, meta-analyses were conducted to estimate risk of each variable. RESULTS Seventy-six studies were identified, with a total of 17,860,001 patients across 14 countries. The studies were highly heterogeneous in terms of the sample under study, outcomes, and risk measures reported. A large number of risk factors were presented for COVID-19. Commonly reported variables for adverse outcome from COVID-19 comprised patient characteristics, including age >75 (OR: 2.65, 95% CI: 1.81-3.90), male sex (OR: 2.05, 95% CI: 1.39-3.04) and severe obesity (OR: 2.57, 95% CI: 1.31-5.05). Active cancer (OR: 1.46, 95% CI: 1.04-2.04) was associated with increased risk of severe outcome. A number of common symptoms and vital measures (respiratory rate and SpO2) also suggested elevated risk profiles. CONCLUSIONS Based on the findings of this study, a range of easily assessed parameters are valuable to predict elevated risk of severe illness and mortality as a result of COVID-19, including patient characteristics and detailed comorbidities, alongside the novel inclusion of real-time symptoms and vital measurements.
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Affiliation(s)
- Adam Booth
- Huma Therapeutics Limited, London, United Kingdom
| | | | - Sonia Ponzo
- Huma Therapeutics Limited, London, United Kingdom
| | | | - Mert Aral
- Huma Therapeutics Limited, London, United Kingdom
| | - David Plans
- Huma Therapeutics Limited, London, United Kingdom
- INDEX Group, Department of Science, Innovation, Technology, and Entrepreneurship, University of Exeter, Exeter, United Kingdom
- * E-mail:
| | - Alain Labrique
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Diwakar Mohan
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
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Meléndez K, Vilcarromero A, Pillaca-Pullo O. [The stratification of information by gender in COVID-19: an important link in the identification of risks]. GACETA SANITARIA 2021; 36:91-92. [PMID: 33549343 PMCID: PMC7831459 DOI: 10.1016/j.gaceta.2020.12.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/27/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Karina Meléndez
- Facultad de Ciencias de la Salud, Universidad Privada San Juan Bautista, Lima, Perú
| | - André Vilcarromero
- Facultad de Ciencias de la Salud, Universidad Privada San Juan Bautista, Lima, Perú.
| | - Omar Pillaca-Pullo
- Facultad de Ciencias de la Salud, Universidad Privada San Juan Bautista, Lima, Perú
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