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Farah R, Al-Hawari H, Albtoush A, Nofal A, Hyasat TB, Abu Jabeh RAH, Suboh LT, Toubasi AA, Eqrai TF, Abufaraj M. Prevalence and risk factors of COVID-19 infection, mortality, and post-infection lung fibrosis in patients with type 2 diabetes: a cross-sectional study. J Int Med Res 2023; 51:3000605231198413. [PMID: 37728611 PMCID: PMC10515529 DOI: 10.1177/03000605231198413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/14/2023] [Indexed: 09/21/2023] Open
Abstract
OBJECTIVES The clinical course of coronavirus disease 2019 (COVID-19) infection is often aggressive, with unfavorable outcomes for those with comorbidities such as type 2 diabetes mellitus (T2DM). We aimed to assess the prevalence and risk factors of COVID-19 infection, mortality, and post-infection lung fibrosis in patients with COVID-19 infection who had T2DM. METHODS In this cross-sectional study, we included adult patients with T2DM who attended an endocrinology clinic and underwent testing for COVID-19 infection. RESULTS Among 1039 included patients, the mean age was 59.5 ± 11.0 years and 429 (41.3%) were men. Overall, 87.1% of patients had received COVID-19 vaccination and 32.3% had confirmed COVID-19 infection. The COVID-19-related mortality was 3.0% and rate of post-COVID-19 lung fibrosis was 19.1%. Vaccination was associated with lower COVID-19-related mortality (odds ratio [OR]: 0.03, 95% confidence interval [CI]: 0.0-0.3) and post-COVID-19 lung fibrosis risk (OR: 0.3, 95% CI: 0.1-0.9). CONCLUSION Patients with T2DM exhibited a high prevalence of COVID-19 infection and associated mortality. However, COVID-19 vaccines were beneficial in reducing the risks of COVID-19-related mortality and post-infection lung fibrosis in these patients. COVID-19 vaccines and boosters are recommended for patients with T2DM. Further studies involving larger study populations are necessary to validate these findings.
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Affiliation(s)
- Randa Farah
- Nephrology Division, Department of Internal Medicine, School of Medicine, University of Jordan, Amman, Jordan
| | - Hussam Al-Hawari
- Endocrinology Division, Department of Internal Medicine, School of Medicine, University of Jordan, Amman, Jordan
| | - Asma Albtoush
- Pulmonary Division, Department of Internal Medicine, School of Medicine, University of Jordan, Amman, Jordan
| | - Amani Nofal
- School of Medicine, University of Jordan, Amman, Jordan
| | | | | | | | - Ahmad A. Toubasi
- Pulmonary Division, Department of Internal Medicine, School of Medicine, University of Jordan, Amman, Jordan
| | - Tareq Fatah Eqrai
- Department of Internal Medicine, The University of Jordan, Amman, Jordan
| | - Mohammad Abufaraj
- Department of Special Surgery, School of Medicine, University of Jordan, Amman, Jordan
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Sweis NWG, Zayed AA, Jaberi MA, AlQirem L, Hyasat TB, Khraisat FA, Maaita W, Naser AM, Nimer A, Qatamin M, Sweis JJG, Sweis N, Al-Ani AT, Alghrabli AM, Haghighi A. Geographic variation in the association between Hashimoto's thyroiditis and Papillary thyroid carcinoma, a meta-analysis. Endocrine 2023; 81:432-449. [PMID: 37129757 DOI: 10.1007/s12020-023-03378-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/15/2023] [Indexed: 05/03/2023]
Abstract
PURPOSE The association between papillary thyroid cancer (PTC) and Hashimoto's thyroiditis (HT) remains a matter of debate. Several genetic and environmental factors have been found to influence this association. Because of the variation in these factors among different populations, we conducted a country- and region-based meta-analysis to examine whether the geographic area influences this association. METHODS We searched PubMed and Web of Science databases for original articles that investigated the association between HT and PTC from February 1955 to February 28, 2023. The included studies were stratified according to their country and region of origin. Various subgroup analyses were conducted. The primary outcome was the pooled relative risk (RR) and its 95% confidence interval (CI) for each region and country. RESULTS Forty-six studies including a total of 93,970 participants met our inclusion criteria. They originated from 16 countries distributed in five regions. Significant variation was found among countries but not among regions. Upon analysis of all 46 included studies, countries were classified based on their RR and its 95% CI. Excluding countries with pooled sample sizes <500, Sri Lanka (RR 4.23, 95% CI 2.91-6.14), Poland (RR 3.16, 95% CI 2.79-3.57) and Japan (2.68, 2.14-3.36) showed the strongest association between HT and PTC while Greece (RR 1.06, 95% CI 1.00-1.13), Spain (RR 0.70, 95% CI 0.23-2.11), and Jordan (0.62, 0.32-1.32) showed no significant association. CONCLUSION Our findings revealed a variation in the association between HT and PTC among countries but not among regions. The country-to-country variation could be due to certain genetic and/or environmental factors subject to geographic variation that influence this association. These findings may help guide health policies aiming to mitigate the risk of PTC in the HT population by helping identify high-risk and low-risk countries.
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Affiliation(s)
- Nabil W G Sweis
- The University of Jordan School of Medicine, Amman, 11942, Jordan
| | - Ayman A Zayed
- Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, The University of Jordan School of Medicine, Amman, 11942, Jordan.
| | - Mira Al Jaberi
- The University of Jordan School of Medicine, Amman, 11942, Jordan
| | - Lina AlQirem
- The University of Jordan School of Medicine, Amman, 11942, Jordan
| | | | - Farah A Khraisat
- The University of Jordan School of Medicine, Amman, 11942, Jordan
| | - Ward Maaita
- The University of Jordan School of Medicine, Amman, 11942, Jordan
| | - Ahmad Moayad Naser
- Department of Internal Medicine, Jordan University Hospital, Amman, 11942, Jordan
| | - Abdullah Nimer
- The University of Jordan School of Medicine, Amman, 11942, Jordan
| | - Mamoon Qatamin
- The University of Jordan School of Medicine, Amman, 11942, Jordan
| | - Jaleel J G Sweis
- The University of Jordan School of Medicine, Amman, 11942, Jordan
| | - Nadia Sweis
- The University of Jordan School of Medicine, Amman, 11942, Jordan
| | - Abdallah T Al-Ani
- Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman, 11941, Jordan
| | - Ahmad M Alghrabli
- Department of Internal Medicine, Jordan University Hospital, Amman, 11942, Jordan
| | - Alireza Haghighi
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Genetics, Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
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Farah R, Alhajahjeh A, Nofal A, Hyasat TB, Abu Jabeh RAH, Suboh LT, Alhawari H, Momani MS, Jaber HJ, AlAwwa I. Clinical outcomes in patients with type 2 diabetes mellitus-related kidney disease: A Jordanian population cohort study. J Diabetes Complications 2023; 37:108478. [PMID: 37084653 DOI: 10.1016/j.jdiacomp.2023.108478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/12/2023] [Accepted: 04/12/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND Diabetic kidney disease (DKD) increases the risk of cardiovascular (CV) complications, kidney disease progression, and mortality. We aimed to determine the incidence and risk of these outcomes according to DKD phenotype among the Jordanian population. METHODS A total of 1172 type 2 diabetes mellitus patients with estimated glomerular filtration rates (eGFRs) of >30 ml/min/1.73 m2 were followed-up from 2019 to 2022. At baseline, patients were classified according to the presence of albuminuria (>30 mg/g creatinine) and reduced eGFR (<60 ml/min/1.73 m2) into four phenotypes: non-DKD (reference category), albuminuric DKD without decreased eGFR, non-albuminuric DKD with decreased eGFR, and albuminuric DKD with decreased eGFR. RESULTS Mean follow-up was 2.9 ± 0.4 years. Overall, 147 patients (12.5 %) experienced CV events, while 61 (5.2 %) demonstrated kidney disease progression (eGFR: <30 ml/min/1.73 m2). The mortality rate was 4.0 %. Multivariable-adjusted risk for CV events and mortality was greatest for the albuminuric DKD with decreased eGFR group (hazard ratio [HR]: 1.45, 95 % confidence interval [CI]: 1.02-2.33 and HR: 6.36, 95 % CI: 2.98-13.59, respectively), with the risk increasing when adjusted for prior CV history (HR: 1.47, 95 % CI: 1.06-3.42 and HR: 6.70, 95 % CI: 2.70-16.60, respectively). Risk of a ≥40 % decline in eGFR was greatest for the albuminuric DKD with decreased eGFR group (HR: 3.45, 95 % CI: 1.74-6.85), followed by the albuminuric DKD without decreased eGFR group (HR: 1.6, 95 % CI: 1.06-2.75). CONCLUSION Thus, patients with albuminuric DKD and decreased eGFR were at greater risk for poor CV, renal, and mortality outcomes compared to other phenotypes.
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Affiliation(s)
- Randa Farah
- Nephrology Division, Department of Internal Medicine, School of Medicine, University of Jordan, Amman, Jordan.
| | | | - Amani Nofal
- School of Medicine, University of Jordan, Amman, Jordan
| | | | | | | | - Hussam Alhawari
- Endocrinology Division, Department of Internal Medicine, School of Medicine, University of Jordan, Amman, Jordan
| | - Munther S Momani
- Endocrinology Division, Department of Internal Medicine, School of Medicine, University of Jordan, Amman, Jordan
| | - Hazem Jamal Jaber
- Department of Internal Medicine, School of Medicine, University of Jordan, Amman, Jordan
| | - Izzat AlAwwa
- Nephrology Division, Department of Internal Medicine, School of Medicine, University of Jordan, Amman, Jordan
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