201
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Kulaga SS, Miller CWT. Viral respiratory infections and psychosis: A review of the literature and the implications of COVID-19. Neurosci Biobehav Rev 2021; 127:520-530. [PMID: 33992695 PMCID: PMC9616688 DOI: 10.1016/j.neubiorev.2021.05.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 05/08/2021] [Accepted: 05/09/2021] [Indexed: 01/08/2023]
Abstract
The historical association between respiratory infections and neuropsychiatric symptoms dates back centuries, with more recent literature highlighting a link between viral infections and schizophrenia. Maternal influenza infection during pregnancy has been associated with the development of schizophrenia in offspring. Viral infections in neonates, children, and adolescents have also been associated with later development of schizophrenia. Neuroinvasive and/or systemic infections are thought to increase risk for psychopathology via inflammatory mechanisms, particularly when exposure occurs during critical neurodevelopmental windows. Several human coronaviruses (HCoVs) have been associated with psychotic disorders and increasing reports of the neuropsychiatric manifestations of COVID-19 suggest it has neuroinvasive properties similar to those of other HCoVs. These properties, in conjunction with its ability to generate a massive inflammatory response, suggest that COVID-19 may also contribute to future psychopathology. This review will summarize the psychopathogenic mechanisms of viral infections and discuss the neuroinvasive and inflammatory properties of COVID-19 that could contribute to the development of psychotic disorders, with a focus on in utero, neonatal, and childhood exposure.
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Affiliation(s)
- Stephanie S Kulaga
- University of Maryland School of Medicine, 701 W. Pratt St., 4th Floor, Baltimore, MD 21201, United States.
| | - Christopher W T Miller
- University of Maryland School of Medicine, 701 W. Pratt St., 4th Floor, Baltimore, MD 21201, United States
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202
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Eskian M, Rezaei N. Clinical Manifestations of COVID-19. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1318:179-196. [PMID: 33973179 DOI: 10.1007/978-3-030-63761-3_11] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the third coronavirus causing an outbreak in the twenty-first century. It is related to a contagious coronavirus disease (COVID-19), which its high pace of spreading allowed it to lie to the whole world and be turned into a pandemic only a few months after the identification of the first case. Currently, the reverse transcription-polymerase chain reaction (RT-PCR) test of throat swap is the gold standard of diagnosis; however, several studies have reported false-negative results with non-ideal sensitivity. Because this pandemic constitutes a significant burden on global healthcare systems and due to the high transmission rate of the virus, an accurate diagnosis algorithm is needed to reduce the missing case number. A comprehensive clinical examination and taking a history of all systems (not just limited to the respiratory system) combined with hematologic laboratory tests and chest imaging can lead to a sensitive diagnosis, severity assessment, and RT-PCT test interpretation. This chapter focuses on clinical characteristics, hematologic laboratory, and chest imaging features in COVID-19.
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Affiliation(s)
- Mahsa Eskian
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran. .,Department of Radiology, Center for Evidence-Based Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. .,Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Nima Rezaei
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran. .,Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. .,Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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203
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Griswold D, Gempeler A, Rosseau G, Kaseje N, Johnson WD, Kolias A, Hutchinson PJ, Rubiano AM. Chest Computed Tomography for the Diagnosis of COVID-19 in Emergency Trauma Surgery Patients Who Require Urgent Care During the Pandemic: Protocol for an Umbrella Review. JMIR Res Protoc 2021; 10:e25207. [PMID: 33878019 PMCID: PMC8104001 DOI: 10.2196/25207] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 12/01/2020] [Accepted: 03/17/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Many health care facilities in low- and middle-income countries are inadequately resourced. COVID-19 has the potential to decimate surgical health care services unless health systems take stringent measures to protect health care workers from viral exposure and ensure the continuity of specialized care for patients. Among these measures, the timely diagnosis of COVID-19 is paramount to ensure the use of protective measures and isolation of patients to prevent transmission to health care personnel caring for patients with an unknown COVID-19 status or contact during the pandemic. Besides molecular and antibody tests, chest computed tomography (CT) has been assessed as a potential tool to aid in the screening or diagnosis of COVID-19 and could be valuable in the emergency care setting. OBJECTIVE This paper presents the protocol for an umbrella review that aims to identify and summarize the available literature on the diagnostic accuracy of chest CT for COVID-19 in trauma surgery patients requiring urgent care. The objective is to inform future recommendations on emergency care for this category of patients. METHODS We will conduct several searches in the L·OVE (Living Overview of Evidence) platform for COVID-19, a system that performs automated regular searches in PubMed, Embase, Cochrane Central Register of Controlled Trials, and over 30 other sources. The search results will be presented according to PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis). This review will preferentially consider systematic reviews of diagnostic test accuracy studies, as well as individual studies of such design, if not included in the systematic reviews, that assessed the sensitivity and specificity of chest CT in emergency trauma surgery patients. Critical appraisal of the included studies for risk of bias will be conducted. Data will be extracted using a standardized data extraction tool. Findings will be summarized narratively, and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach will be used to grade the certainty of evidence. RESULTS Ethics approval is not required for this systematic review, as there will be no patient involvement. The search for this systematic review commenced in October 2020, and we expect to publish the findings in early 2021. The plan for dissemination is to publish the findings in a peer-reviewed journal and present our results at conferences that engage the most pertinent stakeholders. CONCLUSIONS During the COVID-19 pandemic, protecting health care workers from infection is essential. Up-to-date information on the efficacy of diagnostic tests for detecting COVID-19 is essential. This review will serve an important role as a thorough summary to inform evidence-based recommendations on establishing effective policy and clinical guideline recommendations. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42020198267; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=198267. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/25207.
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Affiliation(s)
- Dylan Griswold
- National Institute of Health Research Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom.,Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Andrés Gempeler
- Clinical Research Center, Fundación Valle del Lili, Cali, Colombia
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| | | | - Walter D Johnson
- Schools of Medicine and Public Health, Loma Linda University, Loma Linda, CA, United States
| | - Angelos Kolias
- National Institute of Health Research Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom.,Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Peter J Hutchinson
- National Institute of Health Research Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom.,Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Andres M Rubiano
- National Institute of Health Research Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom.,Neuroscience Institute, INUB-MEDITECH Research Group, El Bosque University, Bogota, Colombia
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204
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Pietschmann J, Voepel N, Voß L, Rasche S, Schubert M, Kleines M, Krause HJ, Shaw TM, Spiegel H, Schroeper F. Development of Fast and Portable Frequency Magnetic Mixing-Based Serological SARS-CoV-2-Specific Antibody Detection Assay. Front Microbiol 2021; 12:643275. [PMID: 34025604 PMCID: PMC8132704 DOI: 10.3389/fmicb.2021.643275] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 03/23/2021] [Indexed: 01/11/2023] Open
Abstract
A novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) emerged in China in December 2019, causing an ongoing, rapidly spreading global pandemic. Worldwide, vaccination is now expected to provide containment of the novel virus, resulting in an antibody-mediated immunity. To verify this, serological antibody assays qualitatively as well as quantitatively depicting the amount of generated antibodies are of great importance. Currently available test methods are either laboratory based or do not have the ability to indicate an estimation about the immune response. To overcome this, a novel and rapid serological magnetic immunodetection (MID) point-of-care (PoC) assay was developed, with sensitivity and specificity comparable to laboratory-based DiaSorin Liaison SARS-CoV-2 S1/S2 IgG assay. To specifically enrich human antibodies against SARS-CoV-2 in immunofiltration columns (IFCs) from patient sera, a SARS-CoV-2 S1 antigen was transiently produced in plants, purified and immobilized on the IFC. Then, an IgG-specific secondary antibody could bind to the retained antibodies, which was finally labeled using superparamagnetic nanoparticles. Based on frequency magnetic mixing technology (FMMD), the magnetic particles enriched in IFC were detected using a portable FMMD device. The obtained measurement signal correlates with the amount of SARS-CoV-2-specific antibodies in the sera, which could be demonstrated by titer determination. In this study, a MID-based assay could be developed, giving qualitative as well as semiquantitative results of SARS-CoV-2-specific antibody levels in patient's sera within 21 min of assay time with a sensitivity of 97% and a specificity of 92%, based on the analysis of 170 sera from hospitalized patients that were tested using an Food and Drug Administration (FDA)-certified chemiluminescence assay.
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Affiliation(s)
- Jan Pietschmann
- Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Aachen, Germany
| | - Nadja Voepel
- Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Aachen, Germany
| | - Leonie Voß
- Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Aachen, Germany
| | - Stefan Rasche
- Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Aachen, Germany
| | - Max Schubert
- Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Aachen, Germany
| | - Michael Kleines
- Laboratory Diagnostic Center, University Hospital RWTH Aachen, Aachen, Germany
| | - Hans-Joachim Krause
- Institute of Biological Information Processing, Bioelectronics (IBI-3), Forschungszentrum Jülich, Jülich, Germany
| | | | - Holger Spiegel
- Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Aachen, Germany
| | - Florian Schroeper
- Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Aachen, Germany
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205
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Chachlani M, Misurati M, Jolly K, Ahmad E, Bright M. A Safe Approach to Percutaneous Tracheostomy for COVID-19 Patients in Intensive Care. Cureus 2021; 13:e14663. [PMID: 34055514 PMCID: PMC8148621 DOI: 10.7759/cureus.14663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
The novel coronavirus disease 2019 (COVID-19) has placed a burden on critical care facilities worldwide. Patients who remain critically unwell with COVID-19 require prolonged periods of ventilation, and the burden of both the resources during a pandemic and the slow respiratory wean must be managed. Percutaneous tracheostomies are commonplace in long-term intensive care patients, yet little is known about their role in COVID-19, particularly how operator safety is maintained during the procedure. Here, we describe an approach designed to minimize cross-infection of the operators undertaking percutaneous tracheostomies within this subset of patients. Focus should be on non-technical skills, prolonged periods of pre-oxygenation, and minimal ventilation during the procedure to minimize the risk of aerosolization generated from an open breathing system. Our modified technique demonstrates successful early experiences with no operators testing positive for COVID-19 or developing symptoms following any performed procedure.
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Affiliation(s)
- Menka Chachlani
- Critical Care Directorate, New Cross Hospital, Wolverhampton, GBR
| | - Mohammad Misurati
- Critical Care Directorate, Royal Wolverhampton NHS Trust, Wolverhampton, GBR
| | - Karan Jolly
- Orolaryngology, Royal Wolverhampton NHS Trust, Wolverhampton, GBR
| | - Ebrahim Ahmad
- Critical Care Directorate, Royal Wolverhampton NHS Trust, Wolverhampton, GBR
| | - Michael Bright
- Critical Care Directorate, Royal Wolverhampton NHS Trust, Wolverhampton, GBR
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206
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Keshta AS, Mallah SI, Al Zubaidi K, Ghorab OK, Keshta MS, Alarabi D, Abousaleh MA, Salman MT, Taha OE, Zeidan AA, Elsaid MF, Tang P. COVID-19 versus SARS: A comparative review. J Infect Public Health 2021; 14:967-977. [PMID: 34130121 PMCID: PMC8064890 DOI: 10.1016/j.jiph.2021.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 04/11/2021] [Accepted: 04/15/2021] [Indexed: 12/15/2022] Open
Abstract
The two genetically similar severe acute respiratory syndrome coronaviruses, SARS-CoV-1 and SARS-CoV-2, have each been responsible for global epidemics of vastly different scales. Although both viruses arose from similar origins, they quickly diverged due to differences in their transmission dynamics and spectrum of clinical presentations. The potential involvement of multiple organs systems, including the respiratory, cardiac, gastrointestinal and neurological, during infection necessitates a comprehensive understanding of the clinical pathogenesis of each virus. The management of COVID-19, initially modelled after SARS and other respiratory illnesses, has continued to evolve as we accumulate more knowledge and experience during the pandemic, as well as develop new therapeutics and vaccines. The impact of these two coronaviruses has been profound for our health care and public health systems, and we hope that the lessons learned will not only bring the current pandemic under control, but also prevent and reduce the impact of future pandemics.
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Affiliation(s)
- Ahmed S Keshta
- School of Medicine, Royal College of Surgeons in Ireland - Bahrain, Busaiteen, Kingdom of Bahrain
| | - Saad I Mallah
- School of Medicine, Royal College of Surgeons in Ireland - Bahrain, Busaiteen, Kingdom of Bahrain
| | - Khaled Al Zubaidi
- Division of Paediatric Infectious Diseases, Hamad Medical Corporation, Doha, Qatar
| | - Omar K Ghorab
- School of Medicine, Royal College of Surgeons in Ireland - Bahrain, Busaiteen, Kingdom of Bahrain
| | - Mohamed S Keshta
- School of Medicine, Royal College of Surgeons in Ireland - Bahrain, Busaiteen, Kingdom of Bahrain
| | - Dalal Alarabi
- School of Medicine, Royal College of Surgeons in Ireland - Bahrain, Busaiteen, Kingdom of Bahrain
| | - Mohammad A Abousaleh
- School of Medicine, Royal College of Surgeons in Ireland - Bahrain, Busaiteen, Kingdom of Bahrain
| | - Mustafa Thaer Salman
- School of Medicine, Royal College of Surgeons in Ireland - Bahrain, Busaiteen, Kingdom of Bahrain
| | - Omer E Taha
- School of Medicine, Royal College of Surgeons in Ireland - Bahrain, Busaiteen, Kingdom of Bahrain
| | - Anas A Zeidan
- School of Medicine, Royal College of Surgeons in Ireland - Bahrain, Busaiteen, Kingdom of Bahrain
| | - Mahmoud F Elsaid
- Division of Pediatric Neurology, Hamad Medical Corporation, Doha, Qatar; Division of Neurology, Sidra Medicine, Doha, Qatar; Department of Pediatrics, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Patrick Tang
- Department of Pathology, Sidra Medicine, Doha, Qatar; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine - Qatar, Doha, Qatar.
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207
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Ali AM, Kunugi H. Skeletal Muscle Damage in COVID-19: A Call for Action. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:372. [PMID: 33921429 PMCID: PMC8069858 DOI: 10.3390/medicina57040372] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 04/05/2021] [Accepted: 04/09/2021] [Indexed: 12/11/2022]
Abstract
Both laboratory investigations and body composition quantification measures (e.g., computed tomography, CT) portray muscle loss in symptomatic Coronavirus disease 2019 (COVID-19) patients. Muscle loss is associated with a poor prognosis of the disease. The exact mechanism of muscle damage in COVID-19 patients, as well as the long-term consequences of muscle injury in disease survivors, are unclear. The current review briefly summarizes the literature for mechanisms, assessment measures, and interventions relevant to skeletal muscle insult in COVID-19 patients. Muscle injury is likely to be attributed to the cytokine storm, disease severity, malnutrition, prolonged physical inactivity during intensive care unit (ICU) stays, mechanical ventilation, and myotoxic drugs (e.g., dexamethasone). It has been assessed by imaging and non-imaging techniques (e.g., CT and electromyography), physical performance tests (e.g., six-minute walk test), anthropometric measures (e.g., calf circumference), and biomarkers of muscle dystrophy (e.g., creatine kinase). Interventions directed toward minimizing muscle loss among COVID-19 patients are lacking. However, limited evidence shows that respiratory rehabilitation improves respiratory function, muscle strength, quality of life, and anxiety symptoms in recovering older COVID-19 patients. Neuromuscular electrical stimulation may restore muscle condition in ICU-admitted patients, albeit empirical evidence is needed. Given the contribution of malnutrition to disease severity and muscle damage, providing proper nutritional management for emaciated patients may be one of the key issues to achieve a better prognosis and prevent the after-effects of the disease. Considerable attention to longer-term consequences of muscle injury in recovering COVID-19 patients is necessary.
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Affiliation(s)
- Amira Mohammed Ali
- Department of Psychiatric Nursing and Mental Health, Faculty of Nursing, Alexandria University, Alexandria 21527, Egypt
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8553, Japan
| | - Hiroshi Kunugi
- Department of Psychiatry, School of Medicine, Teikyo University, Tokyo 173-8605, Japan;
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan
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208
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Rogero-Blanco E, González-García V, García RM, Muñoz-Molina P, Machin-Hamalainen S, López-Rodríguez JA. Characteristics of a COVID-19 confirmed case series in primary care (COVID-19-PC project): a cross-sectional study. BMC FAMILY PRACTICE 2021; 22:66. [PMID: 33832436 PMCID: PMC8028572 DOI: 10.1186/s12875-021-01419-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 03/17/2021] [Indexed: 11/17/2022]
Abstract
Background To estimate the prevalence of symptoms and signs related to a COVID-19 case series confirmed by polymerase chain reaction (PCR) for SARS-CoV-2. Risk factors and the associated use of health services will also be analysed. Methods Observational, descriptive, retrospective case series study. The study was performed at two Primary Care Health Centres located in Madrid, Spain. The subjects studied were all PCR SARS-CoV-2 confirmed cases older than 18 years, diagnosed from the beginning of the community transmission (March 13) until April 15, 2020. We collected sociodemographic, clinical, health service utilization and clinical course variables during the following months. All data was gathered by their own attending physician, and electronic medical records were reviewed individually. Statistical analysis: A descriptive analysis was carried out and a Poisson regression model was adjusted to study associated factors to Health Services use. Results Out of the 499 patients studied from two health centres, 55.1% were women and mean age was 58.2 (17.3). 25.1% were healthcare professionals. The most frequent symptoms recorded related to COVID-19 were cough (77.9%; CI 95% 46.5–93.4), fever (77.7%; CI95% 46.5–93.4) and dyspnoea (54.1%, CI95% 46.6–61.4). 60.7% were admitted to hospital. 64.5% first established contact with their primary care provider before going to the hospital, with a mean number of 11.4 Healthcare Providers Encounters with primary care during all the follow-up period. The number of visit-encounters with primary care was associated with being male [IRR 1.072 (1.013, 1.134)], disease severity {from mild respiratory infection [IRR 1.404 (1.095, 1.801)], up to bilateral pneumonia [IRR 1.852 (1.437,2.386)]}, and the need of a work leave [IRR 1.326 (1.244, 1.413]. Conclusion Symptoms and risk factors in our case series are similar to those in other studies. There was a high number of patients with atypical unilateral or bilateral pneumonia. Care for COVID has required a high use of healthcare resources such as clinical encounters and work leaves.
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Affiliation(s)
- Eloisa Rogero-Blanco
- Primary Health Care Centre General Ricardos, Calle General Ricardos 131, 28019, Madrid, Spain.,Health Services Research On Chronic Patients Network (REDISSEC), Madrid, Spain
| | | | - Rodrigo Medina García
- Primary Health Care Centre General Ricardos, Calle General Ricardos 131, 28019, Madrid, Spain
| | | | | | - Juan A López-Rodríguez
- Primary Health Care Centre General Ricardos, Calle General Ricardos 131, 28019, Madrid, Spain.,Health Services Research On Chronic Patients Network (REDISSEC), Madrid, Spain.,Medical Specialties and Public Health Department, School of Health Sciences, University Rey Juan Carlos Alcorcón, Madrid, Spain.,Research Support Unit, Primary Care Management, Madrid, Spain
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209
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Shi S, Wang F, Li J, Li Y, Li W, Wu X, Kou S, Wu Y, Wang X, Pei C, Huang D, Qiu H, Wang P, Wang Z. The effect of Chinese herbal medicine on digestive system and liver functions should not be neglected in COVID-19: An updated systematic review and meta-analysis. IUBMB Life 2021; 73:739-760. [PMID: 33725395 PMCID: PMC8250823 DOI: 10.1002/iub.2467] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 02/05/2023]
Abstract
Gastrointestinal symptoms and liver injury are common in patients with coronavirus disease 2019 (COVID-19). However, profiles of different pharmaceutical interventions used are relatively underexplored. Chinese herbal medicine (CHM) has been increasingly used for patients with COVID-19, but the efficacy of CHM used in COVID-19 on gastrointestinal symptoms and liver functions has not been well studied with definitive results based on the updated studies. The present study aimed at testing the efficacy of CHM on digestive symptoms and liver function (primary outcomes), the aggravation of COVID-19, and the time to viral assay conversion (secondary outcomes), among patients with COVID-19, compared with standard pharmacotherapy. The literature search was undertaken in 11 electronic databases from December 1, 2019 up to November 8, 2020. Appraisal of the evidence was conducted with Cochrane risk of bias tool or Newcastle Ottawa Scale. A random-effects model or subgroup analysis was conducted when significant heterogeneity was identified in the meta-analysis. The certainty of the evidence was assessed with the grading of recommendations assessment, development, and evaluation approach. Forty-eight included trials involving 4,704 participants were included. Meta-analyses favored CHM plus standard pharmacotherapy for COVID-19 on reducing the aggravation of COVID-19 and the time to viral assay conversion compared with standard pharmacotherapy. However, the present CHM as a complementary therapy for treating COVID-19 may not be beneficial for improving most gastrointestinal symptoms and liver function based on the current evidence. More well-conducted trials are warranted to confirm the potential efficacy of CHM furtherly.
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Affiliation(s)
- Shihua Shi
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Fei Wang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jiang Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yulong Li
- Laboratory of Ethnopharmacology, West China School of Pharmacy, West China Hospital, Sichuan University, Chengdu, China
| | - Weihao Li
- Cardiology Division, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoping Wu
- National Clinical Research Center for Chinese Medicine, Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Shuo Kou
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yongcan Wu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaomin Wang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Caixia Pei
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Demei Huang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Heng Qiu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Peili Wang
- National Clinical Research Center for Chinese Medicine, Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhenxing Wang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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210
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Griswold DP, Gempeler A, Kolias A, Hutchinson PJ, Rubiano AM. Personal protective equipment for reducing the risk of COVID-19 infection among health care workers involved in emergency trauma surgery during the pandemic: An umbrella review. J Trauma Acute Care Surg 2021; 90:e72-e80. [PMID: 33433175 PMCID: PMC7996059 DOI: 10.1097/ta.0000000000003073] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 11/30/2020] [Accepted: 12/26/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Health care facilities in low- and middle-income countries are inadequately resourced to adhere to current COVID-19 prevention recommendations. Recommendations for surgical emergency trauma care measures need to be adequately informed by available evidence and adapt to particular settings. To inform future recommendations, we set to summarize the effects of different personal protective equipment (PPE) on the risk of COVID-19 infection in health personnel caring for trauma surgery patients. METHODS We conducted an umbrella review using Living Overview of Evidence platform for COVID-19, which performs regular automated searches in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and more than 30 other sources. Systematic reviews of experimental and observational studies assessing the efficacy of PPE were included. Indirect evidence from other health care settings was also considered. Risk of bias was assessed with the AMSTAR II tool (Assessing the Methodological Quality of Systematic Reviews, Ottawa, ON, Canada), and the Grading of Recommendations, Assessment, Development, and Evaluation approach for grading the certainty of the evidence is reported (registered in International Prospective Register of Systematic Reviews, CRD42020198267). RESULTS Eighteen studies that fulfilled the selection criteria were included. There is high certainty that the use of N95 respirators and surgical masks is associated with a reduced risk of COVID-19 when compared with no mask use. In moderate- to high-risk environments, N95 respirators are associated with a further reduction in risk of COVID-19 infection compared with surgical masks. Eye protection also reduces the risk of contagion in this setting. Decontamination of masks and respirators with ultraviolet germicidal irradiation, vaporous hydrogen peroxide, or dry heat is effective and does not affect PPE performance or fit. CONCLUSION The use of PPE drastically reduces the risk of COVID-19 compared with no mask use in health care workers. N95 and equivalent respirators provide more protection than surgical masks. Decontamination and reuse appear feasible to overcome PPE shortages and enhance the allocation of limited resources. These effects are applicable to emergency trauma care and should inform future recommendations. LEVEL OF EVIDENCE Review, level II.
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211
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Jiang W, Majumder S, Kumar S, Subramaniam S, Li X, Khedri R, Mondal T, Abolghasemian M, Satia I, Deen MJ. A Wearable Tele-Health System towards Monitoring COVID-19 and Chronic Diseases. IEEE Rev Biomed Eng 2021; 15:61-84. [PMID: 33784625 PMCID: PMC8905615 DOI: 10.1109/rbme.2021.3069815] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a pandemic since early 2020. The coronavirus disease 2019 (COVID-19) has already caused more than two million deaths worldwide and affected people's physical and mental health. COVID-19 patients with mild symptoms are generally required to self-isolate and monitor for symptoms at least for 14 days in the case the disease turns towards severe complications. Here, we overviewed the impact of COVID-19 on the patients' general health with a focus on their cardiovascular, respiratory and mental health, and investigated several existing patient monitoring systems. We addressed the limitations of these systems and proposed a wearable telehealth solution for monitoring a set of physiological parameters that are critical for COVID-19 patients such as body temperature, heart rate, heart rate variability, blood oxygen saturation, respiratory rate, blood pressure, and cough. This physiological information can be further combined to potentially estimate the lung function using artificial intelligence (AI) and sensor fusion techniques. The prototype, which includes the hardware and a smartphone app, showed promising results with performance comparable to or better than similar commercial devices, thus potentially making the proposed system an ideal wearable solution for long-term monitoring of COVID-19 patients and other chronic diseases.
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212
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The Role of Nutrition in the COVID-19 Pandemic. Nutrients 2021; 13:nu13041093. [PMID: 33801645 PMCID: PMC8066707 DOI: 10.3390/nu13041093] [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: 02/11/2021] [Revised: 03/14/2021] [Accepted: 03/24/2021] [Indexed: 12/15/2022] Open
Abstract
SARS-CoV-2, the cause of the COVID-19 disease, is posing unprecedent challenges. In the literature, increasing evidence highlights how malnutrition negatively affects the immune system functionality, impairing protection from infections. The current review aims to summarize the complex relationship between SARS-CoV-2 infection and nutritional status and the effects of malnutrition in terms of disease severity, patients' recovery time, incidence of complications and mortality rate. Current studies evaluating the possibility of modulating nutrition and supplementation in combination with pharmacological treatments in the clinical setting to prevent, support, and overcome infection are also described. The discussion of the most recent pertinent literature aims to lay the foundations for making reasonable assumptions and evaluations for a nutritional "best practice" against COVID-19 pandemic and for the definition of sound cost-effective strategies to assist healthcare systems in managing patients and individuals in their recovery from COVID-19.
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213
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Hurst JH, McCumber AW, Aquino JN, Rodriguez J, Heston SM, Lugo DJ, Rotta AT, Turner NA, Pfeiffer TS, Gurley TC, Moody MA, Denny TN, Rawls JF, Woods CW, Kelly MS. Age-related changes in the upper respiratory microbiome are associated with SARS-CoV-2 susceptibility and illness severity. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.03.20.21252680. [PMID: 33791716 PMCID: PMC8010748 DOI: 10.1101/2021.03.20.21252680] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Children are less susceptible to SARS-CoV-2 and typically have milder illness courses than adults. We studied the nasopharyngeal microbiomes of 274 children, adolescents, and young adults with SARS-CoV-2 exposure using 16S rRNA gene sequencing. We find that higher abundances of Corynebacterium species are associated with SARS-CoV-2 infection and SARS-CoV-2-associated respiratory symptoms, while higher abundances of Dolosigranulum pigrum are present in SARS-CoV-2-infected individuals without respiratory symptoms. We also demonstrate that the abundances of these bacteria are strongly, and independently, associated with age, suggesting that the nasopharyngeal microbiome may be a potentially modifiable mechanism by which age influences SARS-CoV-2 susceptibility and severity. SUMMARY Evaluation of nasopharyngeal microbiome profiles in children, adolescents, and young adults with a SARS-CoV-2-infected close contact identified specific bacterial species that vary in abundance with age and are associated with SARS-CoV-2 susceptibility and the presence of SARS-CoV-2-associated respiratory symptoms.
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214
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Dong Y, Yao YD. IoT Platform for COVID-19 Prevention and Control: A Survey. IEEE ACCESS : PRACTICAL INNOVATIONS, OPEN SOLUTIONS 2021; 9:49929-49941. [PMID: 34812390 PMCID: PMC8545211 DOI: 10.1109/access.2021.3068276] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/09/2021] [Indexed: 05/18/2023]
Abstract
As a result of the worldwide transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), coronavirus disease 2019 (COVID-19) has evolved into an unprecedented pandemic. Currently, with unavailable pharmaceutical treatments and low vaccination rates, this novel coronavirus results in a great impact on public health, human society, and global economy, which is likely to last for many years. One of the lessons learned from the COVID-19 pandemic is that a long-term system with non-pharmaceutical interventions for preventing and controlling new infectious diseases is desirable to be implemented. Internet of things (IoT) platform is preferred to be utilized to achieve this goal, due to its ubiquitous sensing ability and seamless connectivity. IoT technology is changing our lives through smart healthcare, smart home, and smart city, which aims to build a more convenient and intelligent community. This paper presents how the IoT could be incorporated into the epidemic prevention and control system. Specifically, we demonstrate a potential fog-cloud combined IoT platform that can be used in the systematic and intelligent COVID-19 prevention and control, which involves five interventions including COVID-19 Symptom Diagnosis, Quarantine Monitoring, Contact Tracing & Social Distancing, COVID-19 Outbreak Forecasting, and SARS-CoV-2 Mutation Tracking. We investigate and review the state-of-the-art literatures of these five interventions to present the capabilities of IoT in countering against the current COVID-19 pandemic or future infectious disease epidemics.
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Affiliation(s)
- Yudi Dong
- Department of Electrical and Computer EngineeringStevens Institute of TechnologyHobokenNJ07030USA
| | - Yu-Dong Yao
- Department of Electrical and Computer EngineeringStevens Institute of TechnologyHobokenNJ07030USA
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215
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Guillén Martínez A, Andreu Gálvez M, Rodríguez Sanz S, Hernández Ruiz P, García Morillas A, Esteban Sánchez T. Incidence of smell and taste disorders and associated factors in patients with mild to moderate COVID-19. Otolaryngol Pol 2021; 75:1-5. [PMID: 33724231 DOI: 10.5604/01.3001.0014.3451] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
<b>Objectives:</b> To determine the incidence of smell and taste disorders in our health department and to analyse the factors that could be associated with these symptoms in patients with COVID-19. <br><b>Methods:</b> We conducted an observational descriptive study of all patients with COVID-19 in our health area diagnosed between 2020/03/10 and 2020/04/14. Factors related to smell and taste disorders were analysed. <br><b>Results:</b> A total of 126 patients, 63 women and 63 men, aged 16-80 years, were included. As many as 69 patients (62.7%) presented hyposmia, and 58 (46%) of them had anosmia. A total of 75 patients (59.5%) presented hypogeusia, and 57 (45.2%) of them had ageusia. The risk factors that were most commonly associated with these disorders were the female sex (adjusted odds ratio, aOR 2.43 for smell disorders and 2.44 for taste disorders), allergic rhinitis (aOR 3.34 for smell disorders) and a younger age. A protective factor was arterial hypertension (aOR 0.51 for smell disorders and 0.35 for taste disorders). A history of tonsillectomy was the risk factor for taste disorder (aOR 5.23). <br><b>Conclusion:</b> Our results indicate that these sensory disorders occurred more frequently in female patients and in young patients with mild to moderate COVID-19 infection who progressed with mild nasal congestion, posterior rhinorrhoea and without anterior rhinorrhoea. The recovery of taste occurred before the recovery of smell.
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Affiliation(s)
- Alberto Guillén Martínez
- Department of Otorhinolaryngology and Head and Neck Surgery. University Hospital Santa Lucía (Cartagena, Spain)
| | - Marina Andreu Gálvez
- Department of Otorhinolaryngology and Head and Neck Surgery. University Hospital Santa Lucía (Cartagena, Spain)
| | - Sara Rodríguez Sanz
- Department of Otorhinolaryngology and Head and Neck Surgery. University Hospital Santa Lucía (Cartagena, Spain)
| | - Paula Hernández Ruiz
- Department of Otorhinolaryngology and Head and Neck Surgery. University Hospital Santa Lucía (Cartagena, Spain)
| | - Antonio García Morillas
- Department of Otorhinolaryngology and Head and Neck Surgery. University Hospital Santa Lucía (Cartagena, Spain)
| | - Tomás Esteban Sánchez
- Department of Otorhinolaryngology and Head and Neck Surgery. University Hospital Santa Lucía (Cartagena, Spain)
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Váncsa S, Dembrovszky F, Farkas N, Szakó L, Teutsch B, Bunduc S, Nagy R, Párniczky A, Erőss B, Péterfi Z, Hegyi P. Repeated SARS-CoV-2 Positivity: Analysis of 123 Cases. Viruses 2021; 13:512. [PMID: 33808867 PMCID: PMC8003803 DOI: 10.3390/v13030512] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/15/2021] [Accepted: 03/16/2021] [Indexed: 12/29/2022] Open
Abstract
Repeated positivity and reinfection with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) is a significant concern. Our study aimed to evaluate the clinical significance of repeatedly positive testing after coronavirus disease 2019 (COVID-19) recovery. We performed a systematic literature search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. With available individual patient data reporting on repeatedly SARS-CoV-2 positive (RSP) patients, case reports, and case series were included in this analysis. We performed a descriptive analysis of baseline characteristics of repeatedly positive cases. We assessed the cases according to the length of their polymerase chain reaction (PCR) negative interval between the two episodes. Risk factors for the severity of second episodes were evaluated. Overall, we included 123 patients with repeated positivity from 56 publications, with a mean repeated positivity length of 47.8 ± 29.9 days. Younger patients were predominant in the delayed (>90 days) recurrent positive group. Furthermore, comparing patients with RSP intervals of below 60 and above 60 days, we found that a more severe disease course can be expected if the repeated positivity interval is shorter. Severe and critical disease courses might predict future repeatedly positive severe and critical COVID-19 episodes. In conclusion, our results show that the second episode of SARS-CoV-2 positivity is more severe if it happens within 60 days after the first positive PCR. On the other hand, the second episode's severity correlates with the first.
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Affiliation(s)
- Szilárd Váncsa
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (S.V.); (F.D.); (N.F.); (L.S.); (B.T.); (S.B.); (R.N.); (A.P.); (B.E.)
- János Szentágothai Research Center, University of Pécs, 7624 Pécs, Hungary
| | - Fanni Dembrovszky
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (S.V.); (F.D.); (N.F.); (L.S.); (B.T.); (S.B.); (R.N.); (A.P.); (B.E.)
- János Szentágothai Research Center, University of Pécs, 7624 Pécs, Hungary
| | - Nelli Farkas
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (S.V.); (F.D.); (N.F.); (L.S.); (B.T.); (S.B.); (R.N.); (A.P.); (B.E.)
- János Szentágothai Research Center, University of Pécs, 7624 Pécs, Hungary
- Institute of Bioanalysis, Medical School, University of Pécs, 7624 Pécs, Hungary
| | - Lajos Szakó
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (S.V.); (F.D.); (N.F.); (L.S.); (B.T.); (S.B.); (R.N.); (A.P.); (B.E.)
- János Szentágothai Research Center, University of Pécs, 7624 Pécs, Hungary
| | - Brigitta Teutsch
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (S.V.); (F.D.); (N.F.); (L.S.); (B.T.); (S.B.); (R.N.); (A.P.); (B.E.)
- János Szentágothai Research Center, University of Pécs, 7624 Pécs, Hungary
| | - Stefania Bunduc
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (S.V.); (F.D.); (N.F.); (L.S.); (B.T.); (S.B.); (R.N.); (A.P.); (B.E.)
- Fundeni Clinical Institute, Gastroenterology, Hepatology and Liver Transplant Department, 022328 Bucharest, Romania
- Doctoral School, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Rita Nagy
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (S.V.); (F.D.); (N.F.); (L.S.); (B.T.); (S.B.); (R.N.); (A.P.); (B.E.)
- Heim Pál National Pediatric Institute, 1089 Budapest, Hungary
| | - Andrea Párniczky
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (S.V.); (F.D.); (N.F.); (L.S.); (B.T.); (S.B.); (R.N.); (A.P.); (B.E.)
- János Szentágothai Research Center, University of Pécs, 7624 Pécs, Hungary
- Heim Pál National Pediatric Institute, 1089 Budapest, Hungary
- Doctoral School of Theoretical Medicine, Faculty of Medicine, University of Szeged, 6720 Szeged, Hungary
| | - Bálint Erőss
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (S.V.); (F.D.); (N.F.); (L.S.); (B.T.); (S.B.); (R.N.); (A.P.); (B.E.)
- János Szentágothai Research Center, University of Pécs, 7624 Pécs, Hungary
| | - Zoltán Péterfi
- Division of Infectious Diseases, First Department of Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary
| | - Péter Hegyi
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (S.V.); (F.D.); (N.F.); (L.S.); (B.T.); (S.B.); (R.N.); (A.P.); (B.E.)
- János Szentágothai Research Center, University of Pécs, 7624 Pécs, Hungary
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217
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Pouw N, van de Maat J, Veerman K, ten Oever J, Janssen N, Abbink E, Reijers M, de Mast Q, Hoefsloot W, van Crevel R, Slieker K, van Apeldoorn M, Blaauw M, Dofferhoff A, Hoogerwerf J. Clinical characteristics and outcomes of 952 hospitalized COVID-19 patients in The Netherlands: A retrospective cohort study. PLoS One 2021; 16:e0248713. [PMID: 33735205 PMCID: PMC7971488 DOI: 10.1371/journal.pone.0248713] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 03/04/2021] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To describe clinical characteristics, disease course and outcomes in a large and well-documented cohort of hospitalized COVID-19 patients in the Netherlands. METHODS We conducted a multicentre retrospective cohort study in The Netherlands including 952 of 1183 consecutively hospitalized patients that were admitted to participating hospitals between March 2nd, 2020, and May 22nd, 2020. Clinical characteristics and laboratory parameters upon admission and during hospitalization were collected until July 1st. RESULTS The median age was 69 years (IQR 58-77 years) and 605 (63.6%) were male. Cardiovascular disease was present in 558 (58.6%) patients. The median time of onset of symptoms prior to hospitalization was 7 days (IQR 5-10). A non ICU admission policy was applicable in 312 (32.8%) patients and in 165 (56.3%) of the severely ill patients admitted to the ward. At admission and during hospitalization, severely ill patients had higher values of CRP, LDH, ferritin and D-dimer with higher neutrophil counts and lower lymphocyte counts. Overall in-hospital mortality was 25.1% and 183 (19.1%) patients were admitted to ICU, of whom 56 (30.6%) died. Patients aged ≥70 years had high mortality, both at the ward (52.4%) and ICU (47.4%). The median length of ICU stay was 8 days longer in patients aged ≥70 years compared to patients aged ≤60 years. CONCLUSION Hospitalized COVID-19 patients aged ≥70 years had high mortality and longer ICU stay compared to patients aged ≤60 years. These findings in combination with the patient burden of an ICU admission and possible long term complications after discharge should encourage us to further investigate the benefit of ICU admission in elderly and fragile COVID-19-patients.
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Affiliation(s)
- Niels Pouw
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Josephine van de Maat
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Karin Veerman
- Department of Internal Medicine, St. Maartenskliniek, Nijmegen, The Netherlands
| | - Jaap ten Oever
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nico Janssen
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Evertine Abbink
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Monique Reijers
- Department of Pulmonary Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Quirijn de Mast
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Wouter Hoefsloot
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Reinout van Crevel
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Kitty Slieker
- Department of Internal Medicine, Bernhoven Hospital, Uden, The Netherlands
| | - Marjan van Apeldoorn
- Department of Internal Medicine, Jeroen Bosch Hospital, ‘s-Hertogenbosch, The Netherlands
| | - Marc Blaauw
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Internal Medicine, Bernhoven Hospital, Uden, The Netherlands
| | - Anton Dofferhoff
- Department of Internal Medicine, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Jacobien Hoogerwerf
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
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218
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Bumiller-Bini V, de Freitas Oliveira-Toré C, Carvalho TM, Kretzschmar GC, Gonçalves LB, Alencar NDM, Gasparetto MA, Beltrame MH, Winter Boldt AB. MASPs at the crossroad between the complement and the coagulation cascades - the case for COVID-19. Genet Mol Biol 2021; 44:e20200199. [PMID: 33729332 PMCID: PMC7982787 DOI: 10.1590/1678-4685-gmb-2020-0199] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 01/20/2021] [Indexed: 01/08/2023] Open
Abstract
Components of the complement system and atypical parameters of coagulation were reported in COVID-19 patients, as well as the exacerbation of the inflammation and coagulation activity. Mannose binding lectin (MBL)- associated serine proteases (MASPs) play an important role in viral recognition and subsequent activation of the lectin pathway of the complement system and blood coagulation, connecting both processes. Genetic variants of MASP1 and MASP2 genes are further associated with different levels and functional efficiency of their encoded proteins, modulating susceptibility and severity to diseases. Our review highlights the possible role of MASPs in SARS-COV-2 binding and activation of the lectin pathway and blood coagulation cascades, as well as their associations with comorbidities of COVID-19. MASP-1 and/or MASP-2 present an increased expression in patients with COVID-19 risk factors: diabetes, arterial hypertension and cardiovascular disease, chronic kidney disease, chronic obstructive pulmonary disease, and cerebrovascular disease. Based also on the positive results of COVID-19 patients with anti-MASP-2 antibody, we propose the use of MASPs as a possible biomarker of the progression of COVID-19 and the investigation of new treatment strategies taking into consideration the dual role of MASPs, including MASP inhibitors as promising therapeutic targets against COVID-19.
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Affiliation(s)
- Valéria Bumiller-Bini
- Universidade Federal do Paraná (UFPR), Departamento de Genética, Laboratório de Genética Molecular Humana, Curitiba, PR, Brazil
- Universidade Federal do Paraná (UFPR), Departamento de Genética, Programa de Pós-Graduação em Genética, Curitiba, PR, Brazil
| | - Camila de Freitas Oliveira-Toré
- Universidade Federal do Paraná (UFPR), Programa de Pós-Graduação em Medicina Interna e Ciências da Saúde, Laboratório de Imunopatologia Molecular, Curitiba, PR, Brazil
| | - Tamyres Mingorance Carvalho
- Universidade Federal do Paraná (UFPR), Departamento de Genética, Programa de Pós-Graduação em Genética, Curitiba, PR, Brazil
- Universidade Federal do Paraná, Departamento de Genética, Laboratório de Citogenética Humana e Oncogenética, Curitiba, PR, Brazil
| | - Gabriela Canalli Kretzschmar
- Universidade Federal do Paraná (UFPR), Departamento de Genética, Laboratório de Genética Molecular Humana, Curitiba, PR, Brazil
- Universidade Federal do Paraná (UFPR), Departamento de Genética, Programa de Pós-Graduação em Genética, Curitiba, PR, Brazil
| | - Letícia Boslooper Gonçalves
- Universidade Federal do Paraná (UFPR), Departamento de Genética, Programa de Pós-Graduação em Genética, Curitiba, PR, Brazil
- Universidade Federal do Paraná (UFPR), Departamento de Genética, Laboratório de Imunogenética e Histocompatibilidade (LIGH), Curitiba, PR, Brazil
| | - Nina de Moura Alencar
- Fundação Oswaldo Cruz (Fiocruz), Instituto Carlos Chagas, Programa de Pós-Graduação em Biociências e Biotecnologia, Laboratório de Virologia Molecular, Curitiba, PR, Brazil
| | - Miguel Angelo Gasparetto
- Universidade Federal do Paraná (UFPR), Departamento de Genética, Laboratório de Genética Molecular Humana, Curitiba, PR, Brazil
| | - Marcia Holsbach Beltrame
- Universidade Federal do Paraná (UFPR), Departamento de Genética, Laboratório de Genética Molecular Humana, Curitiba, PR, Brazil
| | - Angelica Beate Winter Boldt
- Universidade Federal do Paraná (UFPR), Departamento de Genética, Laboratório de Genética Molecular Humana, Curitiba, PR, Brazil
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Velasco-Rodríguez D, Alonso-Dominguez JM, Vidal Laso R, Lainez-González D, García-Raso A, Martín-Herrero S, Herrero A, Martínez Alfonzo I, Serrano-López J, Jiménez-Barral E, Nistal S, Pérez Márquez M, Askari E, Castillo Álvarez J, Núñez A, Jiménez Rodríguez Á, Heili-Frades S, Pérez-Calvo C, Górgolas M, Barba R, Llamas-Sillero P. Development and validation of a predictive model of in-hospital mortality in COVID-19 patients. PLoS One 2021; 16:e0247676. [PMID: 33661939 PMCID: PMC7932507 DOI: 10.1371/journal.pone.0247676] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 02/11/2021] [Indexed: 12/23/2022] Open
Abstract
We retrospectively evaluated 2879 hospitalized COVID-19 patients from four hospitals to evaluate the ability of demographic data, medical history, and on-admission laboratory parameters to predict in-hospital mortality. Association of previously published risk factors (age, gender, arterial hypertension, diabetes mellitus, smoking habit, obesity, renal failure, cardiovascular/ pulmonary diseases, serum ferritin, lymphocyte count, APTT, PT, fibrinogen, D-dimer, and platelet count) with death was tested by a multivariate logistic regression, and a predictive model was created, with further validation in an independent sample. A total of 2070 hospitalized COVID-19 patients were finally included in the multivariable analysis. Age 61–70 years (p<0.001; OR: 7.69; 95%CI: 2.93 to 20.14), age 71–80 years (p<0.001; OR: 14.99; 95%CI: 5.88 to 38.22), age >80 years (p<0.001; OR: 36.78; 95%CI: 14.42 to 93.85), male gender (p<0.001; OR: 1.84; 95%CI: 1.31 to 2.58), D-dimer levels >2 ULN (p = 0.003; OR: 1.79; 95%CI: 1.22 to 2.62), and prolonged PT (p<0.001; OR: 2.18; 95%CI: 1.49 to 3.18) were independently associated with increased in-hospital mortality. A predictive model performed with these parameters showed an AUC of 0.81 in the development cohort (n = 1270) [sensitivity of 95.83%, specificity of 41.46%, negative predictive value of 98.01%, and positive predictive value of 24.85%]. These results were then validated in an independent data sample (n = 800). Our predictive model of in-hospital mortality of COVID-19 patients has been developed, calibrated and validated. The model (MRS-COVID) included age, male gender, and on-admission coagulopathy markers as positively correlated factors with fatal outcome.
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Affiliation(s)
- Diego Velasco-Rodríguez
- Department of Hematology, Hospital Universitario Fundación Jiménez Díaz, IIS-FJD, Madrid, Spain
| | | | - Rosa Vidal Laso
- Department of Hematology, Hospital Universitario Fundación Jiménez Díaz, IIS-FJD, Madrid, Spain
| | - Daniel Lainez-González
- Department of Hematology, Hospital Universitario Fundación Jiménez Díaz, IIS-FJD, Madrid, Spain
| | - Aránzazu García-Raso
- Department of Hematology, Hospital Universitario Fundación Jiménez Díaz, IIS-FJD, Madrid, Spain
| | - Sara Martín-Herrero
- Department of Hematology, Hospital Universitario Fundación Jiménez Díaz, IIS-FJD, Madrid, Spain
| | - Antonio Herrero
- Department of Information Technology, Quironsalud, Madrid, Spain
| | - Inés Martínez Alfonzo
- Department of Hematology, Hospital Universitario Fundación Jiménez Díaz, IIS-FJD, Madrid, Spain
| | - Juana Serrano-López
- Department of Hematology, Hospital Universitario Fundación Jiménez Díaz, IIS-FJD, Madrid, Spain
| | - Elena Jiménez-Barral
- Department of Hematology, Hospital Universitario Fundación Jiménez Díaz, IIS-FJD, Madrid, Spain
| | - Sara Nistal
- Department of Internal Medicine, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - Manuel Pérez Márquez
- Intensive Care Unit, Hospital Universitario Fundación Jiménez Díaz, IIS-FJD, Madrid, Spain
| | - Elham Askari
- Department of Hematology, Hospital Universitario Fundación Jiménez Díaz, IIS-FJD, Madrid, Spain
| | - Jorge Castillo Álvarez
- Department of Internal Medicine, Hospital Universitario Fundación Jiménez Díaz, IIS-FJD, Madrid, Spain
| | - Antonio Núñez
- Department of Internal Medicine, Hospital General de Villalba, Collado Villalba, Madrid, Spain
| | | | - Sarah Heili-Frades
- Department of Pneumology, Hospital Universitario Fundación Jiménez Díaz, IIS-FJD, Madrid, Spain
| | - César Pérez-Calvo
- Intensive Care Unit, Hospital Universitario Fundación Jiménez Díaz, IIS-FJD, Madrid, Spain
| | - Miguel Górgolas
- Department of Internal Medicine, Hospital Universitario Fundación Jiménez Díaz, IIS-FJD, Madrid, Spain
| | - Raquel Barba
- Department of Internal Medicine, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - Pilar Llamas-Sillero
- Department of Hematology, Hospital Universitario Fundación Jiménez Díaz, IIS-FJD, Madrid, Spain
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Core Outcome Measures for Trials in People With Coronavirus Disease 2019: Respiratory Failure, Multiorgan Failure, Shortness of Breath, and Recovery. Crit Care Med 2021; 49:503-516. [PMID: 33400475 PMCID: PMC7892260 DOI: 10.1097/ccm.0000000000004817] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Supplemental Digital Content is available in the text. OBJECTIVES: Respiratory failure, multiple organ failure, shortness of breath, recovery, and mortality have been identified as critically important core outcomes by more than 9300 patients, health professionals, and the public from 111 countries in the global coronavirus disease 2019 core outcome set initiative. The aim of this project was to establish the core outcome measures for these domains for trials in coronavirus disease 2019. DESIGN: Three online consensus workshops were convened to establish outcome measures for the four core domains of respiratory failure, multiple organ failure, shortness of breath, and recovery. SETTING: International. PATIENTS: About 130 participants (patients, public, and health professionals) from 17 countries attended the three workshops. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Respiratory failure, assessed by the need for respiratory support based on the World Health Organization Clinical Progression Scale, was considered pragmatic, objective, and with broad applicability to various clinical scenarios. The Sequential Organ Failure Assessment was recommended for multiple organ failure, because it was routinely used in trials and clinical care, well validated, and feasible. The Modified Medical Research Council measure for shortness of breath, with minor adaptations (recall period of 24 hr to capture daily fluctuations and inclusion of activities to ensure relevance and to capture the extreme severity of shortness of breath in people with coronavirus disease 2019), was regarded as fit for purpose for this indication. The recovery measure was developed de novo and defined as the absence of symptoms, resumption of usual daily activities, and return to the previous state of health prior to the illness, using a 5-point Likert scale, and was endorsed. CONCLUSIONS: The coronavirus disease 2019 core outcome set recommended core outcome measures have content validity and are considered the most feasible and acceptable among existing measures. Implementation of the core outcome measures in trials in coronavirus disease 2019 will ensure consistency and relevance of the evidence to inform decision-making and care of patients with coronavirus disease 2019.
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Silva RN, Goulart CDL, Oliveira MR, Tacao GY, Back GD, Severin R, Faghy MA, Arena R, Borghi-Silva A. Cardiorespiratory and skeletal muscle damage due to COVID-19: making the urgent case for rehabilitation. Expert Rev Respir Med 2021; 15:1107-1120. [PMID: 33606567 DOI: 10.1080/17476348.2021.1893169] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION It has become increasingly evident that COVID-19 contributes to multiorgan pathophysiology. The systemic inflammatory response increases both pro-inflammatory cytokine and chemokine levels, leading to immune dysregulation and increasing the likelihood of incurring cardiac and pulmonary injuries. AREAS COVERED Longer periods of hospitalization (~20 days) increase susceptibility to ICU-acquired muscle weakness and deconditioning, which decreases muscle function and functional capacity. These conditions affect the quality of life in the post-COVID-19 period and require multi-disciplinary approaches to rehabilitate the cardiopulmonary and musculoskeletal systems of these patients. In this context, this narrative review, which included articles published in the Embase, PEDro and PubMed databases up to December 2020, is focused on discussing the essential role of exercise and rehabilitation health professionals in the COVID-19 recovery process, from hospitalization to hospital discharge, addressing strategies for professionals to mitigate the cardiac and pulmonary impairments associated with hospitalization to home or ambulatory rehabilitation, purposing ways to conduct rehabilitation programs to restore their functional status and quality of life after the infection. EXPERT OPINION In the current environment, these findings further point to the vital role of rehabilitation health professionals in the coming years and the urgent need to develop strategies to assist COVID-19 survivors.
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Affiliation(s)
- Rebeca Nunes Silva
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of São Carlos (Ufscar), Monjolinho, Zip-code: São Carlos, SP, Brazil
| | - Cássia Da Luz Goulart
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of São Carlos (Ufscar), Monjolinho, Zip-code: São Carlos, SP, Brazil
| | - Murilo Rezende Oliveira
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of São Carlos (Ufscar), Monjolinho, Zip-code: São Carlos, SP, Brazil
| | - Guilherme Yassuyuki Tacao
- Department of Physiotherapy, Postgraduate Program in Physiotherapy, Faculty of Science and Technology, São Paulo State University (UNESP), Zip-code: Presidente Prudente, SP, Brazil
| | - Guilherme Dionir Back
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of São Carlos (Ufscar), Monjolinho, Zip-code: São Carlos, SP, Brazil
| | - Richard Severin
- Department of Physical Therapy, Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA.,Department of Physical Therapy Department, College of Applied Health Science, the University of Illinois at Chicago, Chicago, IL, USA.,Department of Physical Therapy, Robbins College of Applied Health Sciences, Baylor University, Waco, TX, USA
| | - Mark A Faghy
- Department of Physical Therapy, Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA.,Department School of Human Sciences, Human Science Research Centre, University of Derby, Derby, UK
| | - Ross Arena
- Department of Physical Therapy, Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA.,Department of Physical Therapy Department, College of Applied Health Science, the University of Illinois at Chicago, Chicago, IL, USA
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of São Carlos (Ufscar), Monjolinho, Zip-code: São Carlos, SP, Brazil.,Department of Physical Therapy, Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA
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Hilser JR, Han Y, Biswas S, Gukasyan J, Cai Z, Zhu R, Tang WHW, Deb A, Lusis AJ, Hartiala JA, Allayee H. Association of serum HDL-cholesterol and apolipoprotein A1 levels with risk of severe SARS-CoV-2 infection. J Lipid Res 2021; 62:100061. [PMID: 33667465 PMCID: PMC7923911 DOI: 10.1016/j.jlr.2021.100061] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 02/09/2021] [Accepted: 02/21/2021] [Indexed: 01/08/2023] Open
Abstract
Individuals with features of metabolic syndrome are particularly susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus associated with the severe respiratory disease, coronavirus disease 2019 (COVID-19). Despite considerable attention dedicated to COVID-19, the link between metabolic syndrome and SARS-CoV-2 infection remains unclear. Using data from the UK Biobank, we investigated the relationship between severity of COVID-19 and metabolic syndrome-related serum biomarkers measured prior to SARS-CoV-2 infection. Logistic regression analyses were used to test biomarker levels and biomarker-associated genetic variants with SARS-CoV-2-related outcomes. Among SARS-CoV-2-positive cases and negative controls, a 10 mg/dl increase in serum HDL-cholesterol or apolipoprotein A1 levels was associated with ∼10% reduced risk of SARS-CoV-2 infection, after adjustment for age, sex, obesity, hypertension, type 2 diabetes, and coronary artery disease. Evaluation of known genetic variants for HDL-cholesterol revealed that individuals homozygous for apolipoprotein E4 alleles had ∼2- to 3-fold higher risk of SARS-CoV-2 infection or mortality from COVID-19 compared with apolipoprotein E3 homozygotes, even after adjustment for HDL-cholesterol levels. However, cumulative effects of all evaluated HDL-cholesterol-raising alleles and Mendelian randomization analyses did not reveal association of genetically higher HDL-cholesterol levels with decreased risk of SARS-CoV-2 infection. These results implicate serum HDL-cholesterol and apolipoprotein A1 levels measured prior to SAR-CoV-2 exposure as clinical risk factors for severe COVID-19 infection but do not provide evidence that genetically elevated HDL-cholesterol levels are associated with SAR-CoV-2 infection.
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Affiliation(s)
- James R Hilser
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA; Department of Biochemistry and Molecular Medicine, University of Southern California, Los Angeles, CA, USA
| | - Yi Han
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA; Department of Biochemistry and Molecular Medicine, University of Southern California, Los Angeles, CA, USA
| | - Subarna Biswas
- Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Janet Gukasyan
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA; Department of Biochemistry and Molecular Medicine, University of Southern California, Los Angeles, CA, USA
| | - Zhiheng Cai
- Department of Biochemistry and Molecular Medicine, University of Southern California, Los Angeles, CA, USA
| | - Ruowei Zhu
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA; Department of Biochemistry and Molecular Medicine, University of Southern California, Los Angeles, CA, USA
| | - W H Wilson Tang
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland OH, USA; Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland OH, USA
| | - Arjun Deb
- Department of Medicine, David Geffen School of Medicine of UCLA, Los Angeles, CA, USA
| | - Aldons J Lusis
- Department of Medicine, David Geffen School of Medicine of UCLA, Los Angeles, CA, USA; Department of Human Genetics, David Geffen School of Medicine of UCLA, Los Angeles, CA, USA; Department of Microbiology, Immunology, and Molecular Genetics, David Geffen School of Medicine of UCLA, Los Angeles, CA, USA
| | - Jaana A Hartiala
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Hooman Allayee
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA; Department of Biochemistry and Molecular Medicine, University of Southern California, Los Angeles, CA, USA.
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Griswold DP, Gempeler A, Kolias AG, Hutchinson PJ, Rubiano AM. Personal protective equipment for reducing the risk of COVID-19 infection among healthcare workers involved in emergency trauma surgery during the pandemic: an umbrella review protocol. BMJ Open 2021; 11:e045598. [PMID: 33653763 PMCID: PMC7929636 DOI: 10.1136/bmjopen-2020-045598] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Many healthcare facilities in low-income and middle-income countries are inadequately resourced and may lack optimal organisation and governance, especially concerning surgical health systems. COVID-19 has the potential to decimate these already strained surgical healthcare services unless health systems take stringent measures to protect healthcare workers (HCWs) from viral exposure and ensure the continuity of specialised care for patients. The objective of this broad evidence synthesis is to identify and summarise the available literature regarding the efficacy of different personal protective equipment (PPE) in reducing the risk of COVID-19 infection in health personnel caring for patients undergoing trauma surgery in low-resource environments. METHODS We will conduct several searches in the L·OVE (Living OVerview of Evidence) platform for COVID-19, a system that performs automated regular searches in PubMed, Embase, Cochrane Central Register of Controlled Trials and over 30 other sources. The search results will be presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram. This review will preferentially consider systematic reviews of experimental and quasi-experimental studies, as well as individual studies of such designs, evaluating the effect of different PPE on the risk of COVID-19 infection in HCWs involved in emergency trauma surgery. Critical appraisal of eligible studies for methodological quality will be conducted. Data will be extracted using the standardised data extraction tool in Covidence. Studies will, when possible, be pooled in a statistical meta-analysis using JBI SUMARI. The Grading of Recommendations, Assessment, Development and Evaluation approach for grading the certainty of evidence will be followed and a summary of findings will be created. ETHICS AND DISSEMINATION Ethical approval is not required for this review. The plan for dissemination is to publish review findings in a peer-reviewed journal and present findings at high-level conferences that engage the most pertinent stakeholders. PROSPERO REGISTRATION NUMBER CRD42020198267.
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Affiliation(s)
- Dylan P Griswold
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Andres Gempeler
- Clinical Research, Fundación Valle del Lili, Cali, Valle del Cauca, Colombia
| | - Angelos G Kolias
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Peter J Hutchinson
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Andres M Rubiano
- Neuroscience Institute, INUB-MEDITECH Research Group, El Bosque University, Bogotá, Colombia
- Neurological Surgery Service, Vallesalud Clinic, Cali, Colombia
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224
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Impact of Ethnicity and Underlying Comorbidity on COVID-19 Inhospital Mortality: An Observational Study in Abu Dhabi, UAE. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6695707. [PMID: 33708993 PMCID: PMC7930915 DOI: 10.1155/2021/6695707] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/17/2021] [Accepted: 02/08/2021] [Indexed: 01/02/2023]
Abstract
Background The UAE reported its first cluster of COVID 2019 in a group of returned travellers from Wuhan in January 2020. Various comorbidities are associated with worse disease prognosis. Understanding the impact of ethnicity on the disease outcome is an important public health issue but data from our region is lacking. Aim We aim to identify comorbidities among patients hospitalized for COVID-19 that are associated with inhospital death. Also, to assess if ethnicity is correlated with increased risk of death. Patients and Method. The study is a single-centre, observational study in Shaikh Shakhbout Medical City, Abu Dhabi. Patients admitted with COVID-19, between 1st of March and the end of May, were enrolled. Records were studied for demography, comorbidity, and ethnicity. Ethnicity was divided into Arabs (Gulf, North Africa, and the Levant), South Asia (India, Pakistan, Bangladesh, Nepal, and Afghanistan), Africans, the Philippines, and others. The study was approved by the Department of Health of Abu Dhabi. Results 1075 patients (972 males) were enrolled. There were 24 nationalities under 5 ethnicity groups. Mean (average) age was 51 years (20–81). 101 (9.4%) died with deceased patients being significantly older. Death risk was not significantly influenced by sex. Duration of hospitalization among survivors was 6.2 days (0.2–40.4) with older patients and men staying longer (P < 0.01). Comorbidities of diabetes, hypertension, cardiovascular disease, chronic renal disease, liver disease, and malignancy were associated with higher risk of mortality univariate, but only liver disease reached statistical significance after adjustment for age. The highest percentage of death was seen in Arab Levant (21.2) followed by the Asian Afghan (18.8); however, differences among ethnicities did not reach statistical significance (P = 0.086). Conclusion COVID-19 outcome was worse in older people and those with comorbidities. Men and older patients required longer hospitalization. Ethnicity is not seen to impact the risk of mortality.
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225
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Ileri C, Dogan Z, Ozben B, Karaoglu C, Gunay N, Tigen K, Basat S, Uyan C. Evaluation of the relation between cardiac biomarkers and thorax computed tomography findings in COVID-19 patients. Biomark Med 2021; 15:285-293. [PMID: 33501850 PMCID: PMC7863677 DOI: 10.2217/bmm-2020-0388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 12/22/2020] [Indexed: 01/08/2023] Open
Abstract
Background: Troponin levels may be elevated in COVID-19 infection. The aim of this study was to the explore relation between troponin levels and COVID-19 severity. Materials, methods & Results: One hundred and forty consecutive patients with COVID-19 pneumonia were included. Diagnosis of COVID-19 pneumonia was based on positive chest computed tomography (CT) findings. Quantitative PCR test was performed in all patients. Only 74 patients were quantitative PCR-positive. Twenty four patients had severe CT findings and 27 patients had progressive disease. These patients had significantly lower albumin and higher ferritin, D-dimer, lactate dehydrogenase, C-reactive protein, and high-sensitivity cardiac troponin I (hs-cTnI). Conclusion: COVID-19 patients with severe CT findings and progressive disease had higher hs-cTnI levels suggesting the use of hs-cTnI in risk stratification.
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Affiliation(s)
- Cigdem Ileri
- Department of Cardiology, Umraniye Research & Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Zekeriya Dogan
- Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey
| | - Beste Ozben
- Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey
| | - Cagla Karaoglu
- Department of Internal Medicine, Umraniye Research & Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Nuran Gunay
- Department of Cardiology, Umraniye Research & Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Kursat Tigen
- Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey
| | - Sema Basat
- Department of Internal Medicine, Umraniye Research & Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Cihangir Uyan
- Department of Cardiology, Umraniye Research & Training Hospital, University of Health Sciences, Istanbul, Turkey
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226
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De Groot CJ, Poitou Bernert C, Coupaye M, Clement K, Paschou SA, Charmandari E, Kanaka-Gantenbein C, Wabitsch M, Buddingh EP, Nieuwenhuijsen B, Marina L, Johannsson G, Van Den Akker ELT. Clinical management of patients with genetic obesity during COVID-19 pandemic: position paper of the ESE Growth & Genetic Obesity COVID-19 Study Group and Rare Endo-ERN main thematic group on Growth and Obesity. Endocrine 2021; 71:653-662. [PMID: 33512658 PMCID: PMC7845285 DOI: 10.1007/s12020-021-02619-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 01/08/2021] [Indexed: 12/13/2022]
Abstract
This article aims to provide guidance on prevention and treatment of COVID-19 in patients with genetic obesity. Key principals of the management of patients with genetic obesity during COVID-19 pandemic for patients that have contracted COVID-19 are to be aware of: possible adrenal insufficiency (e.g., POMC deficiency, PWS); a more severe course in patients with concomitant immunodeficiency (e.g., LEP and LEPR deficiency), although defective leptin signalling could also be protective against the pro-inflammatory phenotype of COVID-19; disease severity being masked by insufficient awareness of symptoms in syndromic obesity patients with intellectual deficit (in particular PWS); to adjust medication dose to increased body size, preferably use dosing in m2; the high risk of malnutrition in patients with Sars-Cov2 infection, even in case of obesity. Key principals of the obesity management during the pandemic are to strive for optimal obesity management and a healthy lifestyle within the possibilities of the regulations to prevent weight (re)gain and to address anxiety within consultations, since prevalence of anxiety for COVID-19 is underestimated.
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Affiliation(s)
- Cornelis Jan De Groot
- Pediatric Endocrinology and Obesity Center CGG Erasmus MC, Rotterdam and Willem Alexander Children's Hospital, LUMC, Leiden, the Netherlands.
| | - Christine Poitou Bernert
- Assistance Publique-Hôpitaux de Paris, Reference Center for Rare Diseases (PRADORT, Prader-Willi Syndrome and other rare obesities), Nutrition Department, Pitié-Salpêtrière hospital, Paris, France
- Sorbonne Université/INSERM, Nutrition and obesities; systemic approaches (NutriOmics) research Unit, Paris, France
| | - Muriel Coupaye
- Assistance Publique-Hôpitaux de Paris, Reference Center for Rare Diseases (PRADORT, Prader-Willi Syndrome and other rare obesities), Nutrition Department, Pitié-Salpêtrière and Louis-Mourier hospitals, Paris, France
| | - Karine Clement
- Sorbonne Université/INSERM, Nutrition and obesities; systemic approaches (NutriOmics) research Unit, Paris, France
- Assistance Publique-Hopitaux de Paris, Nutrition Department, Pitie-Salpetriere Hospital, Paris, France
| | - Stavroula A Paschou
- Division of Endocrinology, Diabetes and Metabolism, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Charmandari
- Pediatric and Adolescent Endocrinology, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
- Division of Endocrinology, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, 11527, Greece
| | - Christina Kanaka-Gantenbein
- Division of Endocrinology, Diabetes and Metabolism, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Martin Wabitsch
- Division of Pediatric Endocrinology and Diabetes Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | | | | | - Ljiljana Marina
- Assistant Professor Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Gudmundur Johannsson
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg and Department of Endocrinology, Sahlgrenska University Hospital, SE-413 45, Gothenburg, Sweden
| | - E L T Van Den Akker
- Pediatric Endocrinology and Obesity Center CGG, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands.
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Gupta N, John A, Kokkottil MS, Varma M, Umakanth S, Saravu K. Clinical profile and outcomes of asymptomatic vs. symptomatic travellers diagnosed with COVID-19: An observational study from a coastal town in South India. Drug Discov Ther 2021; 15:1-8. [PMID: 33642450 DOI: 10.5582/ddt.2020.03068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Despite the high number of coronavirus disease-19 (COVID-19) cases from India, there are few reports from India describing the clinical epidemiology of COVID-19. This study aimed to describe the clinical/epidemiological characteristics and outcomes of asymptomatic vs. symptomatic COVID-19 patients. This was a retrospective chart review of all admitted patients with COVID-19 above 18 years with a history of travel within one month of the admission. The patients were categorized into asymptomatic and symptomatic. The symptomatic patients were further classified into mild, moderate and severe. The demographic profile, risk factors, clinical features, laboratory parameters, treatment details and outcome of all patients were recorded. The clinical and laboratory parameters were compared between symptomatic patients and asymptomatic patients. Of the 127 recruited patients, 75 were asymptomatic. Of the 52 symptomatic patients, 41 patients were classified as a mild illness. The mean age of the patients was 44.5 ± 15 years. A total of 73 patients had one or more risk factors. The male patients were more commonly found to be symptomatic compared to female patients. Neutrophil-lymphocyte ratio, C-reactive protein and lactate dehydrogenase were significantly elevated in symptomatic patients. A total of five individuals required supplemental oxygen therapy, and one of them required mechanical ventilation. All the patients had favourable outcomes. Asymptomatic and mild illness form a significant proportion of positive patients and have excellent outcomes without therapeutic interventions.
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Affiliation(s)
- Nitin Gupta
- Department of Infectious Diseases, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.,Manipal Center for Infectious Diseases, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Anupa John
- Department of Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Mohammed Safeer Kokkottil
- Department of Infectious Diseases, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Muralidhar Varma
- Department of Infectious Diseases, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shashikiran Umakanth
- Department of Medicine, Dr TMA Pai Hospital, Melaka Manipal Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Kavitha Saravu
- Department of Infectious Diseases, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.,Manipal Center for Infectious Diseases, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
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228
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Wurth R, Hajdenberg M, Barrera FJ, Shekhar S, Copacino CE, Moreno-Peña PJ, Gharib OAM, Porter F, Hiremath S, Hall JE, Schiffrin EL, Eisenhofer G, Bornstein SR, Brito JP, González-González JG, Stratakis CA, Rodríguez-Gutiérrez R, Hannah-Shmouni F. Scoping review of COVID-19-related systematic reviews and meta-analyses: can we really have confidence in their results? Postgrad Med J 2021; 98:372-379. [PMID: 33637639 PMCID: PMC7918809 DOI: 10.1136/postgradmedj-2020-139392] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 12/12/2020] [Indexed: 12/22/2022]
Abstract
Aim The aim of this study was to systematically appraise the quality of a sample of COVID-19-related systematic reviews (SRs) and discuss internal validity threats affecting the COVID-19 body of evidence. Design We conducted a scoping review of the literature. SRs with or without meta-analysis (MA) that evaluated clinical data, outcomes or treatments for patients with COVID-19 were included. Main outcome measures We extracted quality characteristics guided by A Measurement Tool to Assess Systematic Reviews-2 to calculate a qualitative score. Complementary evaluation of the most prominent published limitations affecting the COVID-19 body of evidence was performed. Results A total of 63 SRs were included. The majority were judged as a critically low methodological quality. Most of the studies were not guided by a pre-established protocol (39, 62%). More than half (39, 62%) failed to address risk of bias when interpreting their results. A comprehensive literature search strategy was reported in most SRs (54, 86%). Appropriate use of statistical methods was evident in nearly all SRs with MAs (39, 95%). Only 16 (33%) studies recognised heterogeneity in the definition of severe COVID-19 as a limitation of the study, and 15 (24%) recognised repeated patient populations as a limitation. Conclusion The methodological and reporting quality of current COVID-19 SR is far from optimal. In addition, most of the current SRs fail to address relevant threats to their internal validity, including repeated patients and heterogeneity in the definition of severe COVID-19. Adherence to proper study design and peer-review practices must remain to mitigate current limitations.
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Affiliation(s)
- Rachel Wurth
- NICHD, National Institutes of Health, Bethesda, Maryland, USA
| | - Michelle Hajdenberg
- College of Arts and Sciences, Washington University in St Louis, St Louis, Missouri, USA
| | - Francisco J Barrera
- Endocrinology Division, Department of Internal Medicine, University Hospital "Dr. Jose E. González", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.,Knowledge and Evaluation Research, Mayo Clinic, Rochester, Minnesota, USA.,Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Skand Shekhar
- NICHD, National Institutes of Health, Bethesda, Maryland, USA.,Clinical Research Branch, NIEHS, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Pablo J Moreno-Peña
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Omar A M Gharib
- NICHD, National Institutes of Health, Bethesda, Maryland, USA
| | - Forbes Porter
- NICHD, National Institutes of Health, Bethesda, Maryland, USA
| | - Swapnil Hiremath
- University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - Janet E Hall
- Clinical Research Branch, NIEHS, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Graeme Eisenhofer
- Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Stefan R Bornstein
- Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Juan P Brito
- Knowledge and Evaluation Research, Mayo Clinic, Rochester, Minnesota, USA
| | - José Gerardo González-González
- Endocrinology Division, Department of Internal Medicine, University Hospital "Dr. Jose E. González", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.,Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | | | - René Rodríguez-Gutiérrez
- Endocrinology Division, Department of Internal Medicine, University Hospital "Dr. Jose E. González", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico.,Knowledge and Evaluation Research, Mayo Clinic, Rochester, Minnesota, USA.,Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
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Sang S, Sun R, Coquet J, Carmichael H, Seto T, Hernandez-Boussard T. Learning From Past Respiratory Infections to Predict COVID-19 Outcomes: Retrospective Study. J Med Internet Res 2021; 23:e23026. [PMID: 33534724 PMCID: PMC7901593 DOI: 10.2196/23026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/09/2020] [Accepted: 02/01/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND For the clinical care of patients with well-established diseases, randomized trials, literature, and research are supplemented with clinical judgment to understand disease prognosis and inform treatment choices. In the void created by a lack of clinical experience with COVID-19, artificial intelligence (AI) may be an important tool to bolster clinical judgment and decision making. However, a lack of clinical data restricts the design and development of such AI tools, particularly in preparation for an impending crisis or pandemic. OBJECTIVE This study aimed to develop and test the feasibility of a "patients-like-me" framework to predict the deterioration of patients with COVID-19 using a retrospective cohort of patients with similar respiratory diseases. METHODS Our framework used COVID-19-like cohorts to design and train AI models that were then validated on the COVID-19 population. The COVID-19-like cohorts included patients diagnosed with bacterial pneumonia, viral pneumonia, unspecified pneumonia, influenza, and acute respiratory distress syndrome (ARDS) at an academic medical center from 2008 to 2019. In total, 15 training cohorts were created using different combinations of the COVID-19-like cohorts with the ARDS cohort for exploratory purposes. In this study, two machine learning models were developed: one to predict invasive mechanical ventilation (IMV) within 48 hours for each hospitalized day, and one to predict all-cause mortality at the time of admission. Model performance was assessed using the area under the receiver operating characteristic curve (AUROC), sensitivity, specificity, positive predictive value, and negative predictive value. We established model interpretability by calculating SHapley Additive exPlanations (SHAP) scores to identify important features. RESULTS Compared to the COVID-19-like cohorts (n=16,509), the patients hospitalized with COVID-19 (n=159) were significantly younger, with a higher proportion of patients of Hispanic ethnicity, a lower proportion of patients with smoking history, and fewer patients with comorbidities (P<.001). Patients with COVID-19 had a lower IMV rate (15.1 versus 23.2, P=.02) and shorter time to IMV (2.9 versus 4.1 days, P<.001) compared to the COVID-19-like patients. In the COVID-19-like training data, the top models achieved excellent performance (AUROC>0.90). Validating in the COVID-19 cohort, the top-performing model for predicting IMV was the XGBoost model (AUROC=0.826) trained on the viral pneumonia cohort. Similarly, the XGBoost model trained on all 4 COVID-19-like cohorts without ARDS achieved the best performance (AUROC=0.928) in predicting mortality. Important predictors included demographic information (age), vital signs (oxygen saturation), and laboratory values (white blood cell count, cardiac troponin, albumin, etc). Our models had class imbalance, which resulted in high negative predictive values and low positive predictive values. CONCLUSIONS We provided a feasible framework for modeling patient deterioration using existing data and AI technology to address data limitations during the onset of a novel, rapidly changing pandemic.
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Affiliation(s)
- Shengtian Sang
- Department of Medicine, Biomedical Informatics, Stanford University, Stanford, CA, United States
| | - Ran Sun
- Department of Medicine, Biomedical Informatics, Stanford University, Stanford, CA, United States
| | - Jean Coquet
- Department of Medicine, Biomedical Informatics, Stanford University, Stanford, CA, United States
| | | | - Tina Seto
- Technology and Digital Solutions, Stanford University, Stanford, CA, United States
| | - Tina Hernandez-Boussard
- Department of Medicine, Biomedical Informatics, Stanford University, Stanford, CA, United States
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230
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Al-Ruweidi MKAA, Ali FH, Shurbaji S, Popelka A, Yalcin HC. Dexamethasone and transdehydroandrosterone significantly reduce pulmonary epithelial cell injuries associated with mechanical ventilation. J Appl Physiol (1985) 2021; 130:1143-1151. [PMID: 33600286 PMCID: PMC8384562 DOI: 10.1152/japplphysiol.00574.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Many patients who suffer from pulmonary diseases cannot inflate their lungs normally, as they need mechanical ventilation (MV) to assist them. The stress associated with MV can damage the delicate epithelium in small airways and alveoli, which can cause complications resulting in ventilation-induced lung injuries (VILIs) in many cases, especially in patients with acute respiratory distress syndrome (ARDS). Therefore, efforts were directed to develop safe modes for MV. In our work, we propose a different approach to decrease injuries of epithelial cells (EpCs) upon MV. We alter EpCs’ cytoskeletal structure to increase their survival rate during airway reopening conditions associated with MV. We tested two anti-inflammatory drugs dexamethasone (DEX) and transdehydroandrosterone (DHEA) to alter the cytoskeleton. Cultured rat L2 alveolar EpCs were exposed to airway reopening conditions using a parallel-plate perfusion chamber. Cells were exposed to a single bubble propagation to simulate stresses associated with mechanical ventilation in both control and study groups. Cellular injury and cytoskeleton reorganization were assessed via fluorescence microscopy, whereas cell topography was studied via atomic force microscopy (AFM). Our results indicate that culturing cells in media, DEX solution, or DHEA solution did not lead to cell death (static cultures). Bubble flows caused significant cell injury. Preexposure to DEX or DHEA decreased cell death significantly. The AFM verified alteration of cell mechanics due to actin fiber depolymerization. These results suggest potential beneficial effects of DEX and DHEA for ARDS treatment for patients with COVID-19. They are also critical for VILIs and applicable to future clinical studies. NEW & NOTEWORTHY Preexposure of cultured cells to either dexamethasone or transdehydroandrosterone significantly decreases cellular injuries associated with mechanical ventilation due to their ability to alter the cell mechanics. This is an alternative protective method against VILIs instead of common methods that rely on modification of mechanical ventilator modes.
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Affiliation(s)
- Mahmoud Khatib A A Al-Ruweidi
- Biomedical Research Centre, Qatar University, Doha, Qatar.,Department of Chemistry and Earth Sciences, Qatar University, Doha, Qatar
| | | | - Samar Shurbaji
- Biomedical Research Centre, Qatar University, Doha, Qatar
| | - Anton Popelka
- Center of Advanced Materials, Qatar University, Doha, Qatar
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231
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Zhou X, Wang Z, Li S, Liu T, Wang X, Xia J, Zhao Y. Machine Learning-Based Decision Model to Distinguish Between COVID-19 and Influenza: A Retrospective, Two-Centered, Diagnostic Study. Risk Manag Healthc Policy 2021; 14:595-604. [PMID: 33623450 PMCID: PMC7895911 DOI: 10.2147/rmhp.s291498] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 01/18/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Considering the current situation of the novel coronavirus disease (COVID-19) epidemic control, it is highly likely that COVID-19 and influenza may coincide during the approaching winter season. However, there is no available tool that can rapidly and precisely distinguish between these two diseases in the absence of laboratory evidence of specific pathogens. METHODS Laboratory-confirmed COVID-19 and influenza patients between December 1, 2019 and February 29, 2020, from Zhongnan Hospital of Wuhan University (ZHWU) and Wuhan No.1 Hospital (WNH) located in Wuhan, China, were included for analysis. A machine learning-based decision model was developed using the XGBoost algorithms. RESULTS Data of 357 COVID-19 and 1893 influenza patients from ZHWU were split into a training and a testing set in the ratio 7:3, while the dataset from WNH (308 COVID-19 and 312 influenza patients) was preserved for an external test. Model-based decision tree selected age, serum high-sensitivity C-reactive protein and circulating monocytes as meaningful indicators for classifying COVID-19 and influenza cases. In the training, testing and external sets, the model achieved good performance in identifying COVID-19 from influenza cases with a corresponding area under the receiver operating characteristic curve (AUC) of 0.94 (95% CI 0.93, 0.96), 0.93 (95% CI 0.90, 0.96), and 0.84 (95% CI: 0.81, 0.87), respectively. CONCLUSION Machine learning provides a tool that can rapidly and accurately distinguish between COVID-19 and influenza cases. This finding would be particularly useful in regions with massive co-occurrences of COVID-19 and influenza cases while limited resources for laboratory testing of specific pathogens.
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Affiliation(s)
- Xianlong Zhou
- Emergency Center, Hubei Clinical Research Center for Emergency and Resuscitation, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, People’s Republic of China
| | - Zhichao Wang
- Emergency Department, Wuhan No. 1 Hospital, Wuhan, Hubei, 430022, People’s Republic of China
| | - Shaoping Li
- Emergency Center, Hubei Clinical Research Center for Emergency and Resuscitation, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, People’s Republic of China
| | - Tanghai Liu
- Information Center, Wuhan No. 1 Hospital, Wuhan, Hubei, 430022, People’s Republic of China
| | - Xiaolin Wang
- Gennlife (Beijing) Biotechnology Co. Ltd, Haidian, Beijing, 100080, People’s Republic of China
| | - Jian Xia
- Emergency Center, Hubei Clinical Research Center for Emergency and Resuscitation, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, People’s Republic of China
| | - Yan Zhao
- Emergency Center, Hubei Clinical Research Center for Emergency and Resuscitation, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, People’s Republic of China
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232
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Liu Q, Huang N, Li A, Zhou Y, Liang L, Song X, Yang Z, Zhou X. Effect of low-dose aspirin on mortality and viral duration of the hospitalized adults with COVID-19. Medicine (Baltimore) 2021; 100:e24544. [PMID: 33578548 PMCID: PMC7886487 DOI: 10.1097/md.0000000000024544] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 11/05/2020] [Accepted: 01/07/2021] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT To clarify the effect of aspirin on mortality and viral duration in adults infected with respiratory syndrome coronavirus 2 (SARS-Cov-2).After propensity score-matched (PSM) case-control analyses 24 pairs of patients were enrolled and followed up for 2 months. Both 30-day and 60-day mortality in the aspirin group were significantly lower than that in the non-aspirin group (P = .021 and P = .030, respectively). The viral duration time between the 2 groups was not significantly different (P = .942).Among adults (with hypertension, cardiovascular diseases) infected with SARS-Cov-2, low-dose aspirin medication (100 mg/day) was associated with lower risk of mortality compared with non-aspirin users.
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Affiliation(s)
- Qiang Liu
- Department of Infectious Disease, Yichang Central People's Hospital, The First College of Clinical Medical Science, China Three Gorges University, Yichang
| | - Na Huang
- Department of Infectious Disease, Yichang Central People's Hospital, The First College of Clinical Medical Science, China Three Gorges University, Yichang
| | - Anni Li
- Department of Infectious Disease, Yichang Central People's Hospital, The First College of Clinical Medical Science, China Three Gorges University, Yichang
| | - Yuanhong Zhou
- Department of Infectious Disease, Yichang Central People's Hospital, The First College of Clinical Medical Science, China Three Gorges University, Yichang
| | - Liang Liang
- Department of Infectious Disease, Yichang Central People's Hospital, The First College of Clinical Medical Science, China Three Gorges University, Yichang
| | - Xinyu Song
- Department of Infectious Disease, Yichang Central People's Hospital, The First College of Clinical Medical Science, China Three Gorges University, Yichang
| | - Zhanqiu Yang
- State Key Laboratory of Virology, Institute of Medical Virology, School of Medicine, Wuhan University, Wuhan, Hubei, China
| | - Xiaolin Zhou
- Department of Infectious Disease, Yichang Central People's Hospital, The First College of Clinical Medical Science, China Three Gorges University, Yichang
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233
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Olumade TJ, Uzairue LI. Clinical characteristics of 4499 COVID-19 patients in Africa: A meta-analysis. J Med Virol 2021; 93:3055-3061. [PMID: 33543800 PMCID: PMC8013423 DOI: 10.1002/jmv.26848] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/19/2021] [Accepted: 01/31/2021] [Indexed: 01/08/2023]
Abstract
The novel coronavirus disease‐2019 (COVID‐19) pandemic that started in December 2019 has affected over 95 million people and killed over 2 million people as of January 19, 2021. While more studies are published to help us understand the virus, there is a dearth of studies on the clinical characteristics and associated outcomes of the severe acute respiratory syndrome coronavirus 2 on the African continent. We evaluated evidence from previous studies in Africa available in six databases between January 1 and October 6, 2020. Meta‐analysis was then performed using Open‐Meta Analyst and Jamovi software. A total of seven studies, including 4499 COVID‐19 patients, were included. The result of the meta‐analysis showed that 68.8% of infected patients were male. Common symptoms presented (with their incidences) were fever (42.8%), cough (33.3%), headache (11.3%), and breathing problems (16.8%). Other minor occurring symptoms included diarrhea (7.5%) and rhinorrhea (9.4%). Fatality rate was 5.6%. There was no publication bias in the study. This study presents the first description and analysis of the clinical characteristics of COVID‐19 patients in Africa. The most common symptoms are fever, cough, and breathing problems.
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Affiliation(s)
- Testimony Jesupamilerin Olumade
- Department of Biological Sciences, Redeemer's University, Ede, Osun, Nigeria.,African Centre of Excellence for Genomics of Infectious Diseases, Redeemer's University, Ede, Osun, Nigeria
| | - Leonard Ighodalo Uzairue
- Department of Microbiology, College of Biosciences, Federal University of Agriculture, Abeokuta, Ogun, Nigeria.,Department of Medical Laboratory Science, Faculty of Basic Medical Sciences, Federal University, Oye-Ekiti, Ekiti, Nigeria
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234
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Influence of aging on T cell response and renin-angiotensin system imbalance during SARS-CoV-2 infection. Immunol Lett 2021; 232:35-38. [PMID: 33581170 PMCID: PMC7874963 DOI: 10.1016/j.imlet.2021.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/03/2021] [Accepted: 02/06/2021] [Indexed: 01/18/2023]
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235
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Preciado P, Tapia Silva LM, Ye X, Zhang H, Wang Y, Waguespack P, Kooman JP, Kotanko P. Arterial oxygen saturation and hypoxemia in hemodialysis patients with COVID-19. Clin Kidney J 2021; 14:1222-1228. [PMID: 34094520 PMCID: PMC7929020 DOI: 10.1093/ckj/sfab019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Indexed: 01/09/2023] Open
Abstract
Background Maintenance hemodialysis (MHD) patients are particularly vulnerable to coronavirus disease 2019 (COVID-19), a viral disease that may cause interstitial pneumonia, impaired alveolar gas exchange and hypoxemia. We ascertained the time course of intradialytic arterial oxygen saturation (SaO2) in MHD patients between 4 weeks pre-diagnosis and the week post-diagnosis of COVID-19. Methods We conducted a quality improvement project in confirmed COVID-19 in-center MHD patients from 11 dialysis facilities. In patients with an arterio-venous access, SaO2 was measured 1×/min during dialysis using the Crit-Line monitor (Fresenius Medical Care, Waltham, MA, USA). We extracted demographic, clinical, treatment and laboratory data, and COVID-19-related symptoms from the patients’ electronic health records. Results Intradialytic SaO2 was available in 52 patients (29 males; mean ± standard deviation age 66.5 ± 15.7 years) contributing 338 HD treatments. Mean time between onset of symptoms indicative of COVID-19 and diagnosis was 1.1 days (median 0; range 0–9). Prior to COVID-19 diagnosis the rate of HD treatments with hypoxemia, defined as treatment-level average SaO2 <90%, increased from 2.8% (2–4 weeks pre-diagnosis) to 12.2% (1 week) and 20.7% (3 days pre-diagnosis). Intradialytic O2 supplementation increased sharply post-diagnosis. Eleven patients died from COVID-19 within 5 weeks. Compared with patients who recovered from COVID-19, demised patients showed a more pronounced decline in SaO2 prior to COVID-19 diagnosis. Conclusions In HD patients, hypoxemia may precede the onset of clinical symptoms and the diagnosis of COVID-19. A steep decline of SaO2 is associated with poor patient outcomes. Measurements of SaO2 may aid the pre-symptomatic identification of patients with COVID-19.
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Affiliation(s)
| | | | - Xiaoling Ye
- Renal Research Institute New York, New York, NY, USA
| | - Hanjie Zhang
- Renal Research Institute New York, New York, NY, USA
| | - Yuedong Wang
- Department of Statistics and Applied Probability, University of California at Santa Barbara, Santa Barbara, CA, USA
| | | | - Jeroen P Kooman
- Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Peter Kotanko
- Renal Research Institute New York, New York, NY, USA.,Icahn School of Medicine at Mount Sinai New York, NY, USA
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Blair PW, Brown DM, Jang M, Antar AAR, Keruly JC, Bachu VS, Townsend JL, Tornheim JA, Keller SC, Sauer L, Thomas DL, Manabe YC. The Clinical Course of COVID-19 in the Outpatient Setting: A Prospective Cohort Study. Open Forum Infect Dis 2021; 8:ofab007. [PMID: 33614816 PMCID: PMC7881750 DOI: 10.1093/ofid/ofab007] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 01/04/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Outpatient coronavirus disease 2019 (COVID-19) has been insufficiently characterized. To determine the progression of disease and determinants of hospitalization, we conducted a prospective cohort study. METHODS Outpatient adults with positive reverse transcription polymerase chain reaction results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were recruited by phone between April 21 and July 23, 2020, after receiving outpatient or emergency department testing within a large health network in Maryland, United States. Symptoms were collected by participants on days 0, 3, 7, 14, 21, and 28, and portable pulse oximeter oxygen saturation (SaO2), heart rate, and temperature were collected for 15 consecutive days. Baseline demographics, comorbid conditions, and vital signs were evaluated for risk of subsequent hospitalization using negative binomial and logistic regression. RESULTS Among 118 SARS-CoV-2-infected outpatients, the median age (interquartile range [IQR]) was 56.0 (50.0-63.0) years, and 50 (42.4%) were male. Among individuals in the first week of illness (n = 61), the most common symptoms included weakness/fatigue (65.7%), cough (58.8%), headache (45.6%), chills (38.2%), and anosmia (27.9%). Participants returned to their usual health a median (IQR) of 20 (13-38) days from symptom onset, and 66.0% of respondents were at their usual health during the fourth week of illness. Over 28 days, 10.9% presented to the emergency department and 7.6% required hospitalization. The area under the receiver operating characteristics curve for the initial home SaO2 for predicting subsequent hospitalization was 0.86 (95% CI, 0.73-0.99). CONCLUSIONS Symptoms often persisted but uncommonly progressed to hospitalization among outpatients with COVID-19. Home SaO2 may be a helpful tool to stratify risk of hospitalization.
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Affiliation(s)
- Paul W Blair
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Austere Environments Consortium for Enhanced Sepsis Outcomes, Henry M. Jackson Foundation, Bethesda, Maryland, USA
| | - Diane M Brown
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Minyoung Jang
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Annukka A R Antar
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jeanne C Keruly
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Vismaya S Bachu
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jennifer L Townsend
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jeffrey A Tornheim
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Sara C Keller
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Lauren Sauer
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David L Thomas
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Yukari C Manabe
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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237
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Hodgson SH, Mansatta K, Mallett G, Harris V, Emary KRW, Pollard AJ. What defines an efficacious COVID-19 vaccine? A review of the challenges assessing the clinical efficacy of vaccines against SARS-CoV-2. THE LANCET. INFECTIOUS DISEASES 2021; 21:e26-e35. [PMID: 33125914 PMCID: PMC7837315 DOI: 10.1016/s1473-3099(20)30773-8] [Citation(s) in RCA: 389] [Impact Index Per Article: 129.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/05/2020] [Accepted: 09/14/2020] [Indexed: 12/11/2022]
Abstract
The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused more than 1 million deaths in the first 6 months of the pandemic and huge economic and social upheaval internationally. An efficacious vaccine is essential to prevent further morbidity and mortality. Although some countries might deploy COVID-19 vaccines on the strength of safety and immunogenicity data alone, the goal of vaccine development is to gain direct evidence of vaccine efficacy in protecting humans against SARS-CoV-2 infection and COVID-19 so that manufacture of efficacious vaccines can be selectively upscaled. A candidate vaccine against SARS-CoV-2 might act against infection, disease, or transmission, and a vaccine capable of reducing any of these elements could contribute to disease control. However, the most important efficacy endpoint, protection against severe disease and death, is difficult to assess in phase 3 clinical trials. In this Review, we explore the challenges in assessing the efficacy of candidate SARS-CoV-2 vaccines, discuss the caveats needed to interpret reported efficacy endpoints, and provide insight into answering the seemingly simple question, "Does this COVID-19 vaccine work?"
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Affiliation(s)
| | - Kushal Mansatta
- University of Oxford Clinical Medical School, Medical Sciences Division, University of Oxford, Oxford, UK
| | - Garry Mallett
- University of Oxford Clinical Medical School, Medical Sciences Division, University of Oxford, Oxford, UK
| | - Victoria Harris
- Nuffield Department of Primary Care Health Sciences, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Oxford, UK
| | - Katherine R W Emary
- Oxford Vaccine Group, University of Oxford, Oxford, UK; NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Andrew J Pollard
- Oxford Vaccine Group, University of Oxford, Oxford, UK; NIHR Oxford Biomedical Research Centre, Oxford, UK
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238
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Labad J, González-Rodríguez A, Cobo J, Puntí J, Farré JM. A systematic review and realist synthesis on toilet paper hoarding: COVID or not COVID, that is the question. PeerJ 2021; 9:e10771. [PMID: 33575133 PMCID: PMC7849510 DOI: 10.7717/peerj.10771] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 12/22/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To explore whether the coronavirus disease 2019 (COVID-19) pandemic is associated with toilet paper hoarding and to assess which risk factors are associated with the risk of toilet paper hoarding. DESIGN A systematic review and realist review were conducted. DATA SOURCES PubMed, Web of Science, Scopus and PsycINFO were searched (systematic review). PubMed, pre-prints and grey literature were also searched (realist review). The databases were searched from inception until October 2020. STUDY SELECTION There were no restrictions on the study design. OUTCOMES AND MEASURES For the systematic review, toilet paper hoarding was the main outcome, and pathological use of toilet paper was the secondary outcome. For the realist review, the context-mechanisms-outcome (CMO) scheme included the COVID-19 pandemic (context), four proposed mechanisms, and one outcome (toilet paper hoarding). The four potential mechanisms were (1) gastrointestinal mechanisms of COVID-19 (e.g. diarrhoea), (2) social cognitive biases, (3) stress-related factors (mental illnesses, personality traits) and (4) cultural aspects (e.g. differences between countries). ELIGIBILITY CRITERIA FOR SELECTING STUDIES All studies of human populations were considered (including general population studies and clinical studies of patients suffering from mental health problems). RESULTS The systematic review identified 14 studies (eight studies for the main outcome, six studies for the secondary outcome). Three surveys identified the role of the COVID-19 threat in toilet paper hoarding in the general population. One study pointed to an association between a personality trait (conscientiousness) and toilet paper buying and stockpiling as well as an additional significant indirect effect of emotionality through the perceived threat of COVID-19 on toilet paper buying and stockpiling. Six case reports of pathological use of toilet paper were also identified, although none of them were associated with the COVID-19 pandemic. The realist review suggested that of all the mechanisms, social cognitive biases and a bandwagon effect were potential contributors to toilet paper hoarding in the general population. The stressful situation (COVID-19 pandemic) and some personality traits (conscientiousness) were found to be associated with toilet paper hoarding. Cultural differences were also identified, with relatively substantial effects of toilet paper hoarding in several Asian regions (Australia, Japan, Taiwan and Singapore). CONCLUSIONS The COVID-19 pandemic has been associated with a worldwide increase in toilet paper hoarding. Social media and social cognitive biases are major contributors and might explain some differences in toilet paper hoarding between countries. Other mental health-related factors, such as the stressful situation of the COVID-19 pandemic, fear of contagion, or particular personality traits (conscientiousness), are likely to be involved. REGISTRATION PROSPERO CRD42020182308.
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Affiliation(s)
- Javier Labad
- Department of Mental Health, Consorci Sanitari del Maresme, Mataró, Spain
- Centro de Investigación Biomédica en Salud Mental (CIBERSAM), Madrid, Spain
- Institut d’Investigació Sanitària Parc Taulí (I3PT), Sabadell, Spain
| | - Alexandre González-Rodríguez
- Institut d’Investigació Sanitària Parc Taulí (I3PT), Sabadell, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autónoma de Barcelona, Cerdanyola del Vallès, Spain
- Department of Mental Health, Parc Taulí Hospital Universitari, Sabadell, Spain
| | - Jesus Cobo
- Centro de Investigación Biomédica en Salud Mental (CIBERSAM), Madrid, Spain
- Institut d’Investigació Sanitària Parc Taulí (I3PT), Sabadell, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autónoma de Barcelona, Cerdanyola del Vallès, Spain
- Department of Mental Health, Parc Taulí Hospital Universitari, Sabadell, Spain
| | - Joaquim Puntí
- Department of Mental Health, Parc Taulí Hospital Universitari, Sabadell, Spain
| | - Josep Maria Farré
- Department of Psychiatry, Psychology and Psychosomatics, Dexeus University Hospital, Barcelona, Spain
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Kristiansen MF, Heimustovu BH, Borg SÁ, Mohr TH, Gislason H, Møller LF, Christiansen DH, Steig BÁ, Petersen MS, Strøm M, Gaini S. Epidemiology and Clinical Course of First Wave Coronavirus Disease Cases, Faroe Islands. Emerg Infect Dis 2021; 27:749-758. [PMID: 33513332 PMCID: PMC7920693 DOI: 10.3201/eid2703.202589] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The Faroe Islands was one of the first countries in the Western Hemisphere to eliminate coronavirus disease (COVID-19). During the first epidemic wave in the country, 187 cases were reported between March 3 and April 22, 2020. Large-scale testing and thorough contact tracing were implemented early on, along with lockdown measures. Transmission chains were mapped through patient history and knowledge of contact with prior cases. The most common reported COVID-19 symptoms were fever, headache, and cough, but 11.2% of cases were asymptomatic. Among 187 cases, 8 patients were admitted to hospitals but none were admitted to intensive care units and no deaths occurred. Superspreading was evident during the epidemic because most secondary cases were attributed to just 3 infectors. Even with the high incidence rate in early March, the Faroe Islands successfully eliminated the first wave of COVID-19 through the early use of contact tracing, quarantine, social distancing, and large-scale testing.
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240
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Weng LM, Su X, Wang XQ. Pain Symptoms in Patients with Coronavirus Disease (COVID-19): A Literature Review. J Pain Res 2021; 14:147-159. [PMID: 33531833 PMCID: PMC7847371 DOI: 10.2147/jpr.s269206] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 01/12/2021] [Indexed: 01/08/2023] Open
Abstract
Purpose On 11 March, 2020, the coronavirus disease (COVID-19) outbreak was declared as a global pandemic by the World Health Organization. It brought substantial physical and psychological burden on individuals and financial loss across countries. Patients with COVID-19 may exhibit various symptoms, such as fever, cough, dyspnea, muscle pain, sore throat, headache, chest pain, and abdominal pain, at 2–14 days after exposure to the novel coronavirus (severe acute respiratory syndrome [SARS]-CoV-2). Pain symptoms present important challenge to clinicians’ diagnosis when treating COVID-19 patients with mild symptoms. Considering the increasing number of confirmed COVID-19 cases, the pain symptoms should be systematically summarized. Results The virus can invade different tissues of the body and cause different pain manifestations. SARS-CoV-2 primarily invades the respiratory system, and patients develop sore throat, fever, cough, and other pneumonia-associated symptoms. Moreover, it infects the nervous system (eg, headache, dizziness, and confusion), digestive system (eg, abdominal pain, diarrhea), and cardiovascular system (eg, chest pain, palmus, and cardiac injury). The incidence rate is 1.7–33.9% for headache, 0.7–47.1% for sore throat, 1.5–61.0% for myalgia/arthralgia, 1.6–17.7% for chest pain, and 1.9–14.5% for abdominal pain. In comparison with chest and abdominal pain, COVID-19 patients are more likely to develop headache, sore throat, and myalgia/arthralgia. Conclusion Different pain reflects the damage of different body systems. Therefore, the summary of pain symptoms for COVID-19 patients can help doctors improve the accuracy and efficiency of diagnosis when treating COVID-19 patients with atypical or mild symptoms and adopt more targeted treatment methods.
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Affiliation(s)
- Lin-Man Weng
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, People's Republic of China
| | - Xuan Su
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, People's Republic of China
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, People's Republic of China.,Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, People's Republic of China
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241
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Pain during and after COVID-19 in Germany and worldwide: a narrative review of current knowledge. Pain Rep 2021; 6:e893. [PMID: 33490851 PMCID: PMC7819701 DOI: 10.1097/pr9.0000000000000893] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/08/2020] [Accepted: 12/11/2020] [Indexed: 01/08/2023] Open
Abstract
COVID-19 may potentially increase the incidence of persisting pain syndromes and worsen symptoms of preexisting chronic pain. Pain is a common symptom accompanying the coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Nonspecific discomfort such as sore throat and body ache are frequent. Parainfectious pain such as headache, myalgia, or neuropathic pain has also been reported. The latter seems to be associated with an autoimmune response or an affection of the peripheral neuromuscular system or the central nervous system because of the viral infection. Furthermore, chronic pain can be a complication of intensive care unit treatment due to COVID-19 itself (such as intensive care–acquired weakness) or of secondary diseases associated with the SARS-CoV-2 infection, including Guillain–Barré syndrome, polyneuritis, critical illness polyneuropathy, or central pain following cerebrovascular events. Data on long-lasting painful symptoms after clinically manifest COVID-19 and their consequences are lacking. In addition, preexisting chronic pain may be exacerbated by limited and disrupted health care and the psychological burden of the COVID-19 pandemic. Medical providers should be vigilant on pain during and after COVID-19.
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242
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He X, Yao F, Chen J, Wang Y, Fang X, Lin X, Long H, Wang Q, Wu Q. The poor prognosis and influencing factors of high D-dimer levels for COVID-19 patients. Sci Rep 2021; 11:1830. [PMID: 33469072 PMCID: PMC7815913 DOI: 10.1038/s41598-021-81300-w] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 01/05/2021] [Indexed: 01/08/2023] Open
Abstract
To explore the value, and influencing factors, of D-dimer on the prognosis of patients with COVID-19. A total of 1,114 patients with confirmed COVID-19 who were admitted to three designated COVID-19 hospitals in Wuhan, China from January 18, 2020, to March 24, 2020, were included in this study. We examined the relationship between peripheral blood levels of D-dimer, and clinical classification and prognosis, as well as its related influencing factors. D-dimer levels were found to be related to the clinical classification and the prognosis of clinical outcome. D-dimer levels were more likely to be abnormal in severely and critically ill patients compared with mild and ordinary cases, while D-dimer levels of patients who had died were significantly higher than those of surviving patients according to the results of the first and last lab tests. The results from ROC analyses for mortality risk showed that the AUCs of D-dimer were 0.909, YI was 0.765 at the last lab test, and a D-dimer value of 2.025 mg/L was regarded to be the optimal probability cutoff for a prognosis of death. In addition, we found that patients with advanced age, male gender, dyspnea symptoms, and some underlying diseases have a higher D-dimer value (p < 0.05). In short, D-dimer is related to the clinical classification and can be used to evaluate the prognosis of COVID-19 patients. The D-dimer value of 2.025 mg/L was the optimal probability cutoff for judging an outcome of death. Advanced age, male gender, dyspnea symptoms, and some underlying diseases are influencing factors for D-dimer levels, which impacts the prognosis of patients.
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Affiliation(s)
- Xiaokang He
- Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China
| | - Fei Yao
- Institute of Infection, Immunology and Tumor Microenvironment, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Medical College, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Jie Chen
- Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China
| | - Yan Wang
- Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China
| | - Xiangming Fang
- Department of Gastroenterology, Puren Hospital, Wuhan University of Science and Technology, Wuhan, 430081, China
| | - Xuan Lin
- China Resources & WISCO General Hospital, Wuhan, 430081, China
| | - Hui Long
- Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China.
| | - Qiang Wang
- Institute of Infection, Immunology and Tumor Microenvironment, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Medical College, Wuhan University of Science and Technology, Wuhan, 430065, China.
| | - Qingming Wu
- Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, 430064, China. .,Institute of Infection, Immunology and Tumor Microenvironment, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Medical College, Wuhan University of Science and Technology, Wuhan, 430065, China.
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243
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Determinants of mortality in a large group of hemodialysis patients hospitalized for COVID-19. BMC Nephrol 2021; 22:29. [PMID: 33446135 PMCID: PMC7808398 DOI: 10.1186/s12882-021-02233-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/04/2021] [Indexed: 01/08/2023] Open
Abstract
Background Maintenance hemodialysis (MHD) patients are at increased risk for coronavirus disease 2019 (COVID-19). The aim of this study was to describe clinical, laboratory, and radiologic characteristics and determinants of mortality in a large group of MHD patients hospitalized for COVID-19. Methods This multicenter, retrospective, observational study collected data from 47 nephrology clinics in Turkey. Baseline clinical, laboratory and radiological characteristics, and COVID-19 treatments during hospitalization, need for intensive care and mechanical ventilation were recorded. The main study outcome was in-hospital mortality and the determinants were analyzed by Cox regression survival analysis. Results Of 567 MHD patients, 93 (16.3%) patients died, 134 (23.6%) patients admitted to intensive care unit (ICU) and 91 of the ones in ICU (67.9%) needed mechanical ventilation. Patients who died were older (median age, 66 [57–74] vs. 63 [52–71] years, p = 0.019), had more congestive heart failure (34.9% versus 20.7%, p = 0.004) and chronic obstructive pulmonary disease (23.6% versus 12.7%, p = 0.008) compared to the discharged patients. Most patients (89.6%) had radiological manifestations compatible with COVID-19 pulmonary involvement. Median platelet (166 × 103 per mm3 versus 192 × 103 per mm3, p = 0.011) and lymphocyte (800 per mm3 versus 1000 per mm3, p < 0.001) counts and albumin levels (median, 3.2 g/dl versus 3.5 g/dl, p = 0.001) on admission were lower in patients who died. Age (HR: 1.022 [95% CI, 1.003–1.041], p = 0.025), severe-critical disease clinical presentation at the time of diagnosis (HR: 6.223 [95% CI, 2.168–17.863], p < 0.001), presence of congestive heart failure (HR: 2.247 [95% CI, 1.228–4.111], p = 0.009), ferritin levels on admission (HR; 1.057 [95% CI, 1.006–1.111], p = 0.028), elevation of aspartate aminotransferase (AST) (HR; 3.909 [95% CI, 2.143–7.132], p < 0.001) and low platelet count (< 150 × 103 per mm3) during hospitalization (HR; 1.864 [95% CI, 1.025–3.390], p = 0.041) were risk factors for mortality. Conclusion Hospitalized MHD patients with COVID-19 had a high mortality rate. Older age, presence of heart failure, clinical severity of the disease at presentation, ferritin level on admission, decrease in platelet count and increase in AST level during hospitalization may be used to predict the mortality risk of these patients.
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244
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COVID-19 Among Patients With Hepatitis B or Hepatitis C: A Systematic Review. HEPATITIS MONTHLY 2021. [DOI: 10.5812/hepatmon.111617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Context: Hepatic manifestations of Coronavirus Disease 2019 (COVID-19) are common among people living with Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV). Objectives: This systematic review aimed to summarize the evidence on COVID-19 patients living with HBV or HCV co-infections. Data Sources: We searched multiple electronic databases and preprint servers from December 1, 2019, to August 9, 2020. Study Selection: Studies were included if they reported quantitative empirical data on COVID-19 patients living with HBV or HCV co-infections. Data Extraction: Descriptive analyses were reported, and data were synthesized narratively. The quality assessment was completed using the Joanna Briggs Institute critical appraisal tools. Results: Out of the 941 uniquely identified records, 27 studies were included. Of the eligible studies, 232 COVID-19 patients were living with HBV and 22 were living with HCV. Most patients were male, and the mean age was 49.8 and 62.8 years in patients living with HBV and HCV, respectively. Among the reported cases of SARS-CoV-2-HBV co-infection, the proportions of death were 4.7% and 15% in cross-sectional and case series/report studies, respectively. The death proportion was 8.3% among the reported cases of SARS-CoV-2-HCV co-infection. Among COVID-19 patients, 34.1% and 76.2% reported at least one comorbidity besides HBV and HCV infections, mainly hypertension and type 2 diabetes mellitus. The most common COVID-19-related symptoms in both HBV and HCV groups were fever, cough, dyspnea, fatigue, and gastrointestinal symptoms. Conclusions: While understanding the pathogenesis of SARS-CoV-2 requires further investigations, the careful assessment of hepatic manifestations and chronic infections, such as HBV and HCV upon the admission of COVID-19 patients could help reduce multimorbidity among HBV or HCV patients and lead to more favorable health outcomes among them.
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Development and external evaluation of predictions models for mortality of COVID-19 patients using machine learning method. Neural Comput Appl 2021; 35:13037-13046. [PMID: 33424133 PMCID: PMC7783503 DOI: 10.1007/s00521-020-05592-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 12/11/2020] [Indexed: 01/08/2023]
Abstract
To predict the mortality of patients with coronavirus disease 2019 (COVID-19). We collected clinical data of COVID-19 patients between January 18 and March 29 2020 in Wuhan, China . Gradient boosting decision tree (GBDT), logistic regression (LR) model, and simplified LR were built to predict the mortality of COVID-19. We also evaluated different models by computing area under curve (AUC), accuracy, positive predictive value (PPV), and negative predictive value (NPV) under fivefold cross-validation. A total of 2924 patients were included in our evaluation, with 257 (8.8%) died and 2667 (91.2%) survived during hospitalization. Upon admission, there were 21 (0.7%) mild cases, 2051 (70.1%) moderate case, 779 (26.6%) severe cases, and 73 (2.5%) critically severe cases. The GBDT model exhibited the highest fivefold AUC, which was 0.941, followed by LR (0.928) and LR-5 (0.913). The diagnostic accuracies of GBDT, LR, and LR-5 were 0.889, 0.868, and 0.887, respectively. In particular, the GBDT model demonstrated the highest sensitivity (0.899) and specificity (0.889). The NPV of all three models exceeded 97%, while their PPV values were relatively low, resulting in 0.381 for LR, 0.402 for LR-5, and 0.432 for GBDT. Regarding severe and critically severe cases, the GBDT model also performed the best with a fivefold AUC of 0.918. In the external validation test of the LR-5 model using 72 cases of COVID-19 from Brunei, leukomonocyte (%) turned to show the highest fivefold AUC (0.917), followed by urea (0.867), age (0.826), and SPO2 (0.704). The findings confirm that the mortality prediction performance of the GBDT is better than the LR models in confirmed cases of COVID-19. The performance comparison seems independent of disease severity.
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246
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Shurbaji S, El-Sherbiny IM, Alser M, Ali IH, Kordi H, Al-Sadi A, Popelka A, Benslimane F, Yacoub M, Yalcin HC. Nitric Oxide Releasing Hydrogel Nanoparticles Decreases Epithelial Cell Injuries Associated With Airway Reopening. Front Bioeng Biotechnol 2021; 8:579788. [PMID: 33469529 PMCID: PMC7813943 DOI: 10.3389/fbioe.2020.579788] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 11/16/2020] [Indexed: 01/08/2023] Open
Abstract
Acute respiratory distress syndrome (ARDS) is an acute inflammatory lung condition. It is characterized by disruption of gas exchange inside the alveoli, accumulation of protein edema, and an increase in lung stiffness. One major cause of ARDS is a lung infection, such as SARS-COV-2 infection. Lungs of ARDS patients need to be mechanically ventilated for airway reopening. Consequently, ventilation might damage delicate lung tissue leading to excess edema, known as ventilator-induced lung injury (VILI). Mortality of COVID-19 patients under VILI seems to be higher than non-COVID patients, necessitating effective preventative therapies. VILI occurs when small air bubbles form in the alveoli, injuring epithelial cells (EPC) due to shear stress. Nitric oxide (NO) inhalation was suggested as a therapy for ARDS, however, it was shown that it is not effective because of the extremely short half-life of NO. In this study, NO-releasing nanoparticles were produced and tested in an in vitro model, representing airways in the deep lung. Cellular injuries were quantified via fluorescent live/dead assay. Atomic force microscopy (AFM) was used to assess cell morphology. qRT-PCR was performed to assess the expression of inflammatory markers, specifically IL6 and CCL2. ELISA was performed to assess IL6 and confirm qRT-PCR results at the protein level. Finally, ROS levels were assessed in all groups. Here, we show that NO delivery via nanoparticles enhanced EPC survival and recovery, AFM measurements revealed that NO exposure affect cell morphology, while qRT-PCR demonstrated a significant downregulation in IL6 and CCL2 expression when treating the cells to NO both before and after shear exposure. ELISA results for IL6 confirmed qRT-PCR data. ROS experiment results support our findings from previous experiments. These findings demonstrate that NO-releasing nanoparticles can be used as an effective delivery approach of NO to deep lung to prevent/reduce ARDS associated inflammation and cell injuries. This information is particularly useful to treat severe ARDS due to COVID-19 infection. These nanoparticles will be useful when clinically administrated to COVID-19 patients to reduce the symptoms originating from lung distress.
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Affiliation(s)
- Samar Shurbaji
- Biomedical Research Center, Qatar University, Doha, Qatar
| | - Ibrahim M El-Sherbiny
- Nanomedicine Lab, Center of Materials Sciences, Zewail City of Science and Technology, Giza, Egypt
| | - Maha Alser
- Biomedical Research Center, Qatar University, Doha, Qatar
| | - Isra H Ali
- Nanomedicine Lab, Center of Materials Sciences, Zewail City of Science and Technology, Giza, Egypt
| | - Haya Kordi
- Biomedical Research Center, Qatar University, Doha, Qatar.,Department of Biomedical Sciences, College of Health Science-QU Health, Qatar University, Doha, Qatar
| | - Ameena Al-Sadi
- Biomedical Research Center, Qatar University, Doha, Qatar.,Department of Biomedical Sciences, College of Health Science-QU Health, Qatar University, Doha, Qatar
| | - Anton Popelka
- Center for Advanced Materials, Qatar University, Doha, Qatar
| | | | - Magdi Yacoub
- Heart Science Centre, Imperial College, National Heart and Lung Institute, London, United Kingdom
| | - Huseyin C Yalcin
- Biomedical Research Center, Qatar University, Doha, Qatar.,Department of Biomedical Sciences, College of Health Science-QU Health, Qatar University, Doha, Qatar
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247
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Marins TA, Marra AR, Edmond MB, Colombo LRP, Vieira SF, de Oliveira Xavier F, Chauvin AG, Pinho JRR, de Almeida SM, Junior MSD. Adverse drug reactions and drug interactions in the treatment of hospitalized patients with coronavirus disease 2019 (COVID-19). ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2021; 1:e38. [PMID: 36168493 PMCID: PMC9495530 DOI: 10.1017/ash.2021.196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 09/10/2021] [Accepted: 09/14/2021] [Indexed: 04/16/2023]
Abstract
OBJECTIVES To identify drugs that were administered off label to hospitalized patients with suspected coronavirus disease 2019 (COVID-19) and to identify adverse drug reactions (ADRs) and drug-drug interactions associated with these therapies. METHODS This case-control study was conducted in a Brazilian hospital from March to April 2020 among patients with suspected COVID-19, comparing those with positive severe acute respiratory coronavirus virus 2 (SARS-CoV-2) reverse-transcriptase polymerase chain reaction (RT-PCR) results and those with negative results. RESULTS The most commonly used medications in both groups were azithromycin and hydroxychloroquine. There was a significantly higher prevalence of reactions among patients with positive RT-PCR for SARS-CoV-2 (48.5% vs 28.8%; P = .008) in the propensity score-matched cohort, and the most commonly reported ADRs among these patients were diarrhea (43.8%), elevated liver enzymes (31.3%), and nausea and vomiting (29.7%). CONCLUSIONS Our data demonstrate that ADRs and drug-drug interactions are common with off-label treatments for COVID-19.
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Affiliation(s)
- Tatiana A. Marins
- Department of Clinical Pharmacy, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Alexandre R. Marra
- Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil
- Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States
- Author for correspondence: Alexandre R. Marra, PharmD, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, Iowa City, IA52242. E-mail:
| | - Michael B. Edmond
- West Virginia University School of Medicine, Morgantown, West Virginia, United States
| | | | | | | | | | | | - Silvana M. de Almeida
- Department of Clinical Pharmacy, Hospital Israelita Albert Einstein, São Paulo, Brazil
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248
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Liuzzo Scorpo M, Ferrante G, La Grutta S. An Overview of Asthma and COVID-19: Protective Factors Against SARS-COV-2 in Pediatric Patients. Front Pediatr 2021; 9:661206. [PMID: 33996694 PMCID: PMC8116485 DOI: 10.3389/fped.2021.661206] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 03/31/2021] [Indexed: 12/14/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a pandemic infectious disease caused by severe acute respiratory syndrome coronavirus SARS-COV-2. Aberrant innate immunity response and cytokine storm are responsible for the syndrome. Apparently, in asthmatic patients, the inadequate antiviral immune response and the tendency for asthma exacerbation evoked by common respiratory viruses could explain increased susceptibility to SARS-COV-2 infection. However, asthma has not been suggested to be a risk factor in COVID-19 patients. Therefore, in asthmatic patients some potential protective mechanisms against SARS-COV-2 have been hypothesized, like type 2 immune response, number of eosinophils, overproduction of mucus, and asthma treatment, along with behavioral factors not strictly related to asthma, such as social distancing, hygiene measures and wearing facemasks, that contribute to reduce the individual susceptibility to SARS-COV-2 infection. In this mini-review, we will describe the current literature regarding potential protective factors against COVID-19 in children with asthma based on the evidence available so far.
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Affiliation(s)
- Maria Liuzzo Scorpo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Giuliana Ferrante
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Stefania La Grutta
- Institute for Biomedical Research and Innovation, National Research Council, Palermo, Italy
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Plapler PG, de Souza DR, Kaziyama HHS, Battistella LR, de Barros-Filho TEP. Relationship between the coronavirus disease 2019 pandemic and immobilization syndrome. Clinics (Sao Paulo) 2021; 76:e2652. [PMID: 33567050 PMCID: PMC7847256 DOI: 10.6061/clinics/2021/e2652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 12/17/2020] [Indexed: 01/19/2023] Open
Affiliation(s)
- Pérola Grinberg Plapler
- Instituto de Ortopedia e Traumatologia (IOT), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Daniel Rubio de Souza
- Instituto de Ortopedia e Traumatologia (IOT), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
- Instituto de Medicina de Reabilitacao (IMRea), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Helena Hideko Seguchi Kaziyama
- Instituto de Ortopedia e Traumatologia (IOT), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Linamara Rizzo Battistella
- Instituto de Medicina de Reabilitacao (IMRea), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
- *Corresponding author. E-mail: /
| | - Tarcisio Eloy Pessoa de Barros-Filho
- Instituto de Ortopedia e Traumatologia (IOT), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
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Aydin A, Cebi G, Demirtas ZE, Erkus H, Kucukay A, Ok M, Sakalli L, Alpdagtas S, Gunduz O, Ustundag CB. Combating COVID-19 with tissue engineering: a review. EMERGENT MATERIALS 2021; 4:329-349. [PMID: 33235976 PMCID: PMC7677604 DOI: 10.1007/s42247-020-00138-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 11/02/2020] [Indexed: 05/04/2023]
Abstract
The ongoing COVID-19 pandemic triggered by SARS-CoV-2 emerged from Wuhan, China, firstly in December 2019, as well spread to almost all around the world rapidly. The main reason why this disease spreads so many people in a short time is that the virus could be transmitted from an infected person to another by infected droplets. The new emergence of diseases usually may affect multiple organs; moreover, this disease is such an example. Numerous reported studies focus on acute or chronic organ damage caused by the virus. At this point, tissue engineering (TE) strategies can be used to treat the damages with its interdisciplinary approaches. Tissue engineers could design drug delivery systems, scaffolds, and especially biomaterials for the damaged tissue and organs. In this review, brief information about SARS-CoV-2, COVID-19, and epidemiology of the disease will be given at first. After that, the symptoms, the tissue damages in specific organs, and cytokine effect caused by COVID-19 will be described in detail. Finally, it will be attempted to summarize and suggest the appropriate treatments with suitable biomaterials for the damages via TE approaches. The aim of this review is to serve as a summary of currently available tissue damage treatments after COVID-19.
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Affiliation(s)
- Ayca Aydin
- Department of Bioengineering, Faculty of Chemical and Metallurgical Engineering, Yildiz Technical University, 34210 Istanbul, Turkey
| | - Gizem Cebi
- Department of Bioengineering, Faculty of Chemical and Metallurgical Engineering, Yildiz Technical University, 34210 Istanbul, Turkey
| | - Zeynep Ezgi Demirtas
- Department of Bioengineering, Faculty of Chemical and Metallurgical Engineering, Yildiz Technical University, 34210 Istanbul, Turkey
| | - Huseyin Erkus
- Department of Bioengineering, Faculty of Chemical and Metallurgical Engineering, Yildiz Technical University, 34210 Istanbul, Turkey
| | - Aleyna Kucukay
- Department of Bioengineering, Faculty of Chemical and Metallurgical Engineering, Yildiz Technical University, 34210 Istanbul, Turkey
| | - Merve Ok
- Department of Bioengineering, Faculty of Chemical and Metallurgical Engineering, Yildiz Technical University, 34210 Istanbul, Turkey
| | - Latife Sakalli
- Department of Bioengineering, Faculty of Chemical and Metallurgical Engineering, Yildiz Technical University, 34210 Istanbul, Turkey
| | - Saadet Alpdagtas
- Department of Biology, Van Yuzuncu Yil University, 65080 Van, Turkey
| | - Oguzhan Gunduz
- Center for Nanotechnology and Biomaterials Application and Research (NBUAM), Marmara University, 34722 Istanbul, Turkey
- Department of Metallurgical and Materials Engineering, Faculty of Technology, Marmara University, 34722 Istanbul, Turkey
| | - Cem Bulent Ustundag
- Department of Bioengineering, Faculty of Chemical and Metallurgical Engineering, Yildiz Technical University, 34210 Istanbul, Turkey
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