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Henao-Agudelo JS, Ayala S, Badiel M, Zea-Vera AF, Matta Cortes L. Classical monocytes-low expressing HLA-DR is associated with higher mortality rate in SARS-CoV-2+ young patients with severe pneumonia. Heliyon 2024; 10:e24099. [PMID: 38268832 PMCID: PMC10803910 DOI: 10.1016/j.heliyon.2024.e24099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 12/29/2023] [Accepted: 01/03/2024] [Indexed: 01/26/2024] Open
Abstract
Aims This study aimed to investigate whether monocyte dysregulation and hyperinflammation serve as predictive markers for mortality in young patients with SARS-CoV-2 severe pneumonia. Methods A prospective cohort study was conducted in a tertiary-level public University Hospital in Colombia. Forty young adults (18-50 years of age) with severe pneumonia and SARS-CoV-2 infection confirmed by qPCR, were enrroled. Serum cytokines and the monocyte phenotype profile, including PDL1/HLA-DR expression, were determined during the first 24 h of hospitalization. Routine laboratory parameters were measured throughout patient follow-up until either death or hospital discharge. We also included a cohort of twenty-five healthy control subjects. Key findings Elevated levels of IL-10, IL-8, and IL-6 cytokines emerged as robust predictors of mortality in young adults with severe pneumonia due to SARS-CoV-2 infected. A descriptive analysis revealed a cumulative mortality rate of 30 % in unvaccinated and ICU-admitted patients. Patients who died had significantly lower expression of HLA-DR on their classical monocytes subsets (CD14+CD16-) than survivors and healthy controls. Lower expression of HLA-DR was associated with greater clinical severity (APACHE≥12) and bacterial coinfection (relative risk 2.5 95%CI [1.18-5.74]). Notably, the expression of HLA-DR in 27.5 % of CD14+/CD16- monocytes was associated with a significantly lower probability of survival. Significance The early reduction in HLA-DR expression within classical monocytes emerged as an independent predictor of mortality, irrespective of comorbidities. Together with PD-L1 expression and cytokine alterations, these findings support the notion that monocyte immunosuppression plays a fundamental role in the pathogenesis and mortality of young patients infected with SARS-CoV-2. These findings hold significant implications for risk assessment and therapeutic strategies in managing critically ill young adults with SARS-CoV-2 infection.
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Affiliation(s)
| | - Sebastian Ayala
- Department of Internal Medicine, Universidad del Valle, Cali, Colombia
- Hospital Universitario del Valle Evaristo García, Cali, Colombia
| | - Marisol Badiel
- Department of Internal Medicine, Universidad del Valle, Cali, Colombia
- Hospital Universitario del Valle Evaristo García, Cali, Colombia
| | - Andrés F. Zea-Vera
- School of Basic Sciences, Universidad del Valle, Cali, Colombia
- LCIM//Division of Intramural Research, NIAID, National Institutes of Health, Bethesda, MD, USA
| | - Lorena Matta Cortes
- Department of Internal Medicine, Universidad del Valle, Cali, Colombia
- Hospital Universitario del Valle Evaristo García, Cali, Colombia
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Xu CB, Su SS, Yu J, Lei X, Lin PC, Wu Q, Zhou Y, Li YP. Risk factors and predicting nomogram for the clinical deterioration of non-severe community-acquired pneumonia. BMC Pulm Med 2024; 24:57. [PMID: 38280994 PMCID: PMC10821265 DOI: 10.1186/s12890-023-02813-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 12/11/2023] [Indexed: 01/29/2024] Open
Abstract
BACKGROUND Currently, there remains insufficient focus on non-severe community-acquired pneumonia (CAP) patients who are at risk of clinical deterioration, and there is also a dearth of research on the related risk factors. Early recognition of hospitalized patients at risk of clinical deterioration will be beneficial for their clinical management. METHOD A retrospective study was conducted in The First Affiliated Hospital of Wenzhou Medical University, China, spanning from January 1, 2018 to April 30, 2022, and involving a total of 1,632 non-severe CAP patients. Based on whether their condition worsened within 72 h of admission, patients were divided into a clinical deterioration group and a non-clinical deterioration group. Additionally, all patients were randomly assigned to a training set containing 75% of patients and a validation set containing 25% of patients. In the training set, risk factors for clinical deterioration in patients with non-severe CAP were identified by using LASSO regression analysis and multivariate logistic regression analysis. A nomogram was developed based on identified risk factors. The effectiveness of the nomogram in both the training and validation sets was assessed using Receiver Operating Characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). RESULTS Age, body mass index (BMI), body temperature, cardiovascular comorbidity, respiratory rate, LDH level, lymphocyte count and D-dimer level were identified as risk factors associated with the clinical deterioration of non-severe CAP within 72 h of admission. The area under curve (AUC) value of the nomogram was 0.78 (95% CI: 0.74-0.82) in the training set and 0.75 (95% CI: 0.67-0.83) in the validation set. Furthermore, the calibration curves for both the training and validation sets indicated that the predicted probability of clinical deterioration aligned with the actual probability. Additionally, DCA revealed clinical utility for the nomogram at a specific threshold probability. CONCLUSION The study successfully identified the risk factors linked to the clinical deterioration of non-severe CAP and constructed a nomogram for predicting the probability of deterioration. The nomogram demonstrated favorable predictive performance and has the potential to aid in the early identification and management of non-severe CAP patients at elevated risk of deterioration.
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Affiliation(s)
- Cheng-Bin Xu
- The Key Laboratory of Interventional Pulmonology of Zhejiang Province, Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, South Baixiang, Ouhai District, Wenzhou, Zhejiang Province, 325015, People's Republic of China
| | - Shan-Shan Su
- The Key Laboratory of Interventional Pulmonology of Zhejiang Province, Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, South Baixiang, Ouhai District, Wenzhou, Zhejiang Province, 325015, People's Republic of China
| | - Jia Yu
- The Key Laboratory of Interventional Pulmonology of Zhejiang Province, Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, South Baixiang, Ouhai District, Wenzhou, Zhejiang Province, 325015, People's Republic of China
| | - Xiong Lei
- The Key Laboratory of Interventional Pulmonology of Zhejiang Province, Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, South Baixiang, Ouhai District, Wenzhou, Zhejiang Province, 325015, People's Republic of China
| | - Peng-Cheng Lin
- The Key Laboratory of Interventional Pulmonology of Zhejiang Province, Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, South Baixiang, Ouhai District, Wenzhou, Zhejiang Province, 325015, People's Republic of China
| | - Qing Wu
- The Center of Laboratory and Diagnosis, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, 325015, People's Republic of China
| | - Ying Zhou
- The Key Laboratory of Interventional Pulmonology of Zhejiang Province, Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, South Baixiang, Ouhai District, Wenzhou, Zhejiang Province, 325015, People's Republic of China.
| | - Yu-Ping Li
- The Key Laboratory of Interventional Pulmonology of Zhejiang Province, Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, South Baixiang, Ouhai District, Wenzhou, Zhejiang Province, 325015, People's Republic of China.
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Kyagambiddwa T, Kintu TM, Miiro E, Nabalamba F, Asiimwe GS, Namutebi AM, Abeya FC, Lumori BA, Ijuka I, Muhindo RK, Mutekanga A, Musinguzi R, Natuhwera F, Ngonzi J, Nuwagira E. Thirty-Day Outcomes of Young and Middle-Aged Adults Admitted with Severe COVID-19 in Uganda: A Retrospective Cohort Study. Infect Drug Resist 2023; 16:2923-2932. [PMID: 37197696 PMCID: PMC10184892 DOI: 10.2147/idr.s405256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/28/2023] [Indexed: 05/19/2023] Open
Abstract
Background There is scarcity of data regarding young and middle-aged adults hospitalized with severe Corona Virus Disease 2019 (COVID-19) in Africa. In this study, we describe the clinical characteristics and 30-day survival among adults aged 18 to 49 years admitted with severe COVID-19 in Uganda. Methods We reviewed treatment records of patients admitted with severe COVID-19 across five COVID-19 treatment units (CTU) in Uganda. We included individuals aged 18 to 49 years, who had a positive test or met the clinical criteria for COVID-19. We defined severe COVID-19 as having an oxygen saturation <94%, lung infiltrates >50% on imaging and presence of a co-morbidity that required admission in the CTU. Our main outcome was the 30-day survival from the time of admission. We used a Cox proportional hazards model to determine the factors associated with 30-day survival at a 5% level of significance. Results Of the 246 patient files reviewed, 50.8% (n = 125) were male, the mean ± (standard deviation) age was 39 ± 8 years, majority presented with cough, 85.8% (n = 211) and median C-reactive protein (interquartile range) was 48 (47.5, 178.8) mg/L. The 30-day mortality was 23.9% (59/246). At admission, anemia (hazard ratio (HR): 3.00, 95% confidence interval (CI), 1.32-6.82; p = 0.009) and altered mental state (GCS <15) (HR: 6.89, 95% CI: 1.48-32.08, p = 0.014) were significant predictors of 30-day mortality. Conclusion There was a high 30-day mortality among young and middle-aged adults with severe COVID-19 in Uganda. Early recognition and targeted management of anemia and altered consciousness are needed to improve clinical outcomes.
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Affiliation(s)
- Tonny Kyagambiddwa
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Timothy Mwanje Kintu
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Emmanuel Miiro
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Franchesca Nabalamba
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Gloria Suubi Asiimwe
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Fardous C Abeya
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Boniface A Lumori
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Rose K Muhindo
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Andrew Mutekanga
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | | | - Joseph Ngonzi
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Edwin Nuwagira
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- Tuberculosis Treatment Unit, Mbarara Regional Referral Hospital, Mbarara, Uganda
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Freire APCF, Amin S, Lira FS, Morano AEVA, Pereira T, Coelho-E-Silva MJ, Caseiro A, Christofaro DGD, Dos Santos VR, Júnior OM, Pinho RA, Silva BSDA. Autonomic Function Recovery and Physical Activity Levels in Post-COVID-19 Young Adults after Immunization: An Observational Follow-Up Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2251. [PMID: 36767620 PMCID: PMC9915325 DOI: 10.3390/ijerph20032251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/19/2023] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
Coronavirus disease 2019 (COVID-19) has detrimental multi-system consequences. Symptoms may appear during the acute phase of infection, but the literature on long-term recovery of young adults after mild to moderate infection is lacking. Heart rate variability (HRV) allows for the observation of autonomic nervous system (ANS) modulation post-SARS-CoV-2 infection. Since physical activity (PA) can help improve ANS modulation, investigating factors that can influence HRV outcomes after COVID-19 is essential to advancements in care and intervention strategies. Clinicians may use this research to aid in the development of non-medication interventions. At baseline, 18 control (CT) and 20 post-COVID-19 (PCOV) participants were observed where general anamnesis was performed, followed by HRV and PA assessment. Thus, 10 CT and 7 PCOV subjects returned for follow-up (FU) evaluation 6 weeks after complete immunization (two doses) and assessments were repeated. Over the follow-up period, a decrease in sympathetic (SNS) activity (mean heart rate: p = 0.0024, CI = -24.67--3.26; SNS index: p = 0.0068, CI = -2.50--0.32) and increase in parasympathetic (PNS) activity (mean RR: p = 0.0097, CI = 33.72-225.51; PNS index: p = 0.0091, CI = -0.20-1.47) were observed. At follow-up, HRV was not different between groups (p > 0.05). Additionally, no differences were observed in PA between moments and groups. This study provides evidence of ANS recovery after SARS-CoV-2 insult in young adults over a follow-up period, independent of changes in PA.
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Affiliation(s)
- Ana Paula Coelho Figueira Freire
- Department of Health Sciences, Central Washington University, Ellensburg, WA 98926, USA
- Physiotherapy Department, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente 19050-920, Brazil
- Exercise and Immunometabolism Research Group, Postgraduate Program in Movement Sciences, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente 19060-900, Brazil
| | - Shaan Amin
- Department of Health Sciences, Central Washington University, Ellensburg, WA 98926, USA
| | - Fabio Santos Lira
- Exercise and Immunometabolism Research Group, Postgraduate Program in Movement Sciences, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente 19060-900, Brazil
- Faculty of Sport Science and Physical Education, University of Coimbra, CIDAF, 3000-456 Coimbra, Portugal
| | - Ana Elisa von Ah Morano
- Exercise and Immunometabolism Research Group, Postgraduate Program in Movement Sciences, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente 19060-900, Brazil
| | - Telmo Pereira
- Faculty of Sport Science and Physical Education, University of Coimbra, CIDAF, 3000-456 Coimbra, Portugal
- Polytechnic of Coimbra, ESTESC, 3046-854 Coimbra, Portugal
- Laboratory for Applied Health Research (LabinSaúde), 3046-854 Coimbra, Portugal
| | - Manuel-João Coelho-E-Silva
- Faculty of Sport Science and Physical Education, University of Coimbra, CIDAF, 3000-456 Coimbra, Portugal
| | - Armando Caseiro
- Polytechnic of Coimbra, ESTESC, 3046-854 Coimbra, Portugal
- Laboratory for Applied Health Research (LabinSaúde), 3046-854 Coimbra, Portugal
- Molecular Physical-Chemistry R & D Unit, Faculty of Science and Technology, University of Coimbra, 3004-535 Coimbra, Portugal
| | - Diego Giulliano Destro Christofaro
- Postgraduate Program in Movement Sciences, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente 19060-900, Brazil
| | - Vanessa Ribeiro Dos Santos
- Exercise and Immunometabolism Research Group, Postgraduate Program in Movement Sciences, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente 19060-900, Brazil
| | - Osmar Marchioto Júnior
- Exercise and Immunometabolism Research Group, Postgraduate Program in Movement Sciences, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente 19060-900, Brazil
| | - Ricardo Aurino Pinho
- Graduate Program in Health Sciences, School of Medicine, Pontificia Universidade Catolica Do Parana, Curitiba 80215-901, Brazil
| | - Bruna Spolador de Alencar Silva
- Exercise and Immunometabolism Research Group, Postgraduate Program in Movement Sciences, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente 19060-900, Brazil
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Li H, Liu J, Hu X, Wei S, Jun W. Practices, Knowledge, and Attitudes of Chinese University Students Toward Traditional Chinese Herbal Medicine for the Control of COVID-19. Infect Drug Resist 2022; 15:6951-6962. [PMID: 36474905 PMCID: PMC9719682 DOI: 10.2147/idr.s387292] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/23/2022] [Indexed: 02/05/2024] Open
Abstract
BACKGROUND The application of traditional Chinese herbal medicine has been officially recommended and strongly promoted in China as an important complement to conventional prevention and treatment for COVID-19. Capturing the practices, knowledge and attitudes of young adult population toward using Chinese herbs for COVID-19 is important for understanding the future of Chinese herbal medicine over the coming decades. METHODS This cross-sectional questionnaire-based study was conducted from May to June, 2022, among 313 student volunteers in Wuhan University of Science and Technology, a provincial comprehensive university in China. RESULTS Results showed that only 18% of students had used Chinese herbs to prevent COVID-19. The main information sources were social media, the students' family members, relatives, friends, etc. as well as the healthcare professionals. However, most students only sometimes paid close attention to related reports and news articles in social media. Clear pharmacological and toxicological properties of herbs were considered by 43% students as the most important factor to promote their own application of Chinese herbs to fight COVID-19. The mean knowledge score was 1.64 out of 5. Students' overall attitudes toward application of Chinese herbal medicine to fight COVID-19 were very positive. CONCLUSION These data suggests most university young adults had a positive attitude but lack of practices and knowledge towards traditional Chinese herbal medicine for COVID-19 control.
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Affiliation(s)
- Hao Li
- Department of Pharmacy, Medical College, Wuhan University of Science and Technology, Wuhan, People’s Republic of China
| | - Juan Liu
- Department of Pharmacy, Medical College, Wuhan University of Science and Technology, Wuhan, People’s Republic of China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, People’s Republic of China
| | - Xinyi Hu
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, People’s Republic of China
| | - Songyi Wei
- Department of Pharmacy, Medical College, Wuhan University of Science and Technology, Wuhan, People’s Republic of China
| | - Wang Jun
- Department of Pharmacy, Medical College, Wuhan University of Science and Technology, Wuhan, People’s Republic of China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, People’s Republic of China
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Association between chemosensory dysfunctions and inflammatory biomarkers in patients with SARS-CoV-2 infection: a systematic review and meta-analysis. Inflammopharmacology 2022; 30:2079-2087. [PMID: 36097300 PMCID: PMC9467422 DOI: 10.1007/s10787-022-01066-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 09/01/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND There is evidence that chemosensory dysfunctions, including smell and taste disorders, are common findings in patients with SARS-CoV-2 infection. However, the underlying biological mechanisms and the role of inflammatory markers are still poorly understood. AIM To investigate the inflammatory biomarkers levels in patients with COVID-19 presenting chemosensory dysfunctions. METHODS This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. A systematic literature search was performed from January 1, 2020, to May 12, 2022. Observational studies that provided data on hematological, biochemical, infection-related indices and cellular immunity, and coagulation function in patients with COVID-19 experiencing smell and/or taste disorders were considered eligible. Effect sizes were reported as standardized mean difference (SMD) with 95% confidence intervals (CI). A negative effect size indicated that the inflammatory biomarker levels were lower among patients with chemosensory dysfunctions. RESULTS Eleven studies were included. Patients with chemosensory disturbances had lower levels of leukocytes (SMD - 0.18, 95% CI - 0.35 to - 0.01, p = 0.04), lactate dehydrogenase (SMD - 0.45, 95% CI - 0.82 to - 0.09, p = 0.01), IL-6 (SMD - 0.25, 95% CI - 0.44 to - 0.06, p < 0.01), and C-reactive protein (SMD - 0.33, 95% CI - 0.58 to - 0.08, p < 0.01) than patients without chemosensory disturbances. CONCLUSION Patients with SARS-CoV-2 infection who have olfactory and gustatory disorders have a lower inflammatory response than patients who do not have chemosensory alterations. The presence of these symptoms may indicate a more favorable clinical course for COVID-19.
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Stojanovic Z, Gonçalves-Carvalho F, Marín A, Abad Capa J, Domínguez J, Latorre I, Lacoma A, Prat-Aymerich C. Advances in diagnostic tools for respiratory tract infections: from tuberculosis to COVID-19 - changing paradigms? ERJ Open Res 2022; 8:00113-2022. [PMID: 36101788 PMCID: PMC9235056 DOI: 10.1183/23120541.00113-2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 05/31/2022] [Indexed: 11/05/2022] Open
Abstract
Respiratory tract infections (RTIs) are one of the most common reasons for seeking healthcare, but are amongst the most challenging diseases in terms of clinical decision-making. Proper and timely diagnosis is critical in order to optimise management and prevent further emergence of antimicrobial resistance by misuse or overuse of antibiotics. Diagnostic tools for RTIs include those involving syndromic and aetiological diagnosis: from clinical and radiological features to laboratory methods targeting both pathogen detection and host biomarkers, as well as their combinations in terms of clinical algorithms. They also include tools for predicting severity and monitoring treatment response. Unprecedented milestones have been achieved in the context of the COVID-19 pandemic, involving the most recent applications of diagnostic technologies both at genotypic and phenotypic level, which have changed paradigms in infectious respiratory diseases in terms of why, how and where diagnostics are performed. The aim of this review is to discuss advances in diagnostic tools that impact clinical decision-making, surveillance and follow-up of RTIs and tuberculosis. If properly harnessed, recent advances in diagnostic technologies, including omics and digital transformation, emerge as an unprecedented opportunity to tackle ongoing and future epidemics while handling antimicrobial resistance from a One Health perspective.
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Affiliation(s)
- Zoran Stojanovic
- Pneumology Dept, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
- Ciber Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Co-first authors
| | - Filipe Gonçalves-Carvalho
- Pneumology Dept, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
- Ciber Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Co-first authors
| | - Alicia Marín
- Pneumology Dept, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
- Ciber Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Jorge Abad Capa
- Pneumology Dept, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
- Ciber Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Jose Domínguez
- Ciber Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Microbiology Department, Institut d'Investigació Germans Trias i Pujol, Badalona, Spain
| | - Irene Latorre
- Ciber Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Microbiology Department, Institut d'Investigació Germans Trias i Pujol, Badalona, Spain
| | - Alicia Lacoma
- Ciber Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Microbiology Department, Institut d'Investigació Germans Trias i Pujol, Badalona, Spain
- Co-senior authors
| | - Cristina Prat-Aymerich
- Ciber Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Microbiology Department, Institut d'Investigació Germans Trias i Pujol, Badalona, Spain
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Co-senior authors
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Hamler TC, Nguyen AW, Mouzon DM, Taylor HO, Qin W, Cobb RJ. COVID-19 and Psychological Distress: Racial Differences Among Middle-Aged and Older Adults. THE GERONTOLOGIST 2022; 62:780-791. [PMID: 35349690 PMCID: PMC9154222 DOI: 10.1093/geront/gnac043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES COVID-19 has disproportionately impacted older adults and Black individuals. Research has focused on physical outcomes, with less attention to the psychological effects of COVID-19. The objective of this study was to examine the interplay between perceptions of the COVID-19 outbreak as a threat to one's day-to-day life, race, and psychological distress among middle-aged and older men and women. RESEARCH DESIGN AND METHODS Analyses were conducted on a subsample of self-identified non-Latino Whites and Black individuals aged 50 and older (N = 3,834) from the American Trends Panel. Psychological distress was assessed with 5 items adapted from the Center for Epidemiologic Studies Depression Scale and Generalized Anxiety Disorder-7. Perceived COVID-19 day-to-day threat was assessed with a single question. Negative binomial regressions tested the study aim. RESULTS Perceptions of COVID-19 day-to-day threat were positively associated with psychological distress. Black individuals reported lower distress than Whites. Regardless of gender, greater perceptions of COVID-19 day-to-day threats were associated with greater distress among both White respondents and Black respondents. However, this association was weaker among Black respondents than White respondents. Among men only, the association between COVID-19 day-to-day threat and distress varied by race, patterned similarly to the race differences identified in the total sample. This association did not vary by race among women. DISCUSSION AND IMPLICATIONS This study contributes to the emerging literature focused on older adults and COVID-19 related stressors and psychological distress. An intersectional lens shows how structural oppression may shape perceptions of the pandemic. Future work should consider coexisting intersections in marginalized identities and mental health during COVID-19.
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Affiliation(s)
- Tyrone C Hamler
- Graduate School of Social Work, University of Denver, Denver, Colorado, USA
| | - Ann W Nguyen
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Dawne M Mouzon
- Edward J. Bloustein School of Planning and Public Policy, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Harry O Taylor
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Weidi Qin
- Population Studies Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Ryon J Cobb
- Department of Sociology, University of Georgia, Athens, Georgia, USA
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Almutairi MS, Assiri AM, Almohammed OA. Predictors of Poor Outcome among Critically Ill COVID-19 Patients: A Nationally Representative Sample of the Saudi Arabian Population. J Clin Med 2022; 11:jcm11102818. [PMID: 35628942 PMCID: PMC9147701 DOI: 10.3390/jcm11102818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/11/2022] [Accepted: 05/13/2022] [Indexed: 01/08/2023] Open
Abstract
The outbreak and continuing impact of COVID-19 have significantly increased the rates of hospitalization and admissions to intensive care units (ICU). This study evaluates clinical outcomes in critically ill patients and investigates variables tied to poor prognosis. A secondary database analysis was conducted to investigate the predictors of poor outcome among critically ill COVID-19 patients in Saudi Arabia. Multivariable logistic regression analysis was used to assess the association between various demographic characteristics, comorbidities, and COVID-19 symptoms and patients’ poor prognosis, as a composite outcome. A total of 2257 critically ill patients were identified (male (71.8%), and elderly (37.3%)). The mortality rate was 50.0%, and the composite poor outcome was 68.4%. The predictors of poor outcome were being elderly (OR = 4.79, 95%CI 3.19−7.18), obesity (OR = 1.43, 95%CI 1.1−1.87), having a severe or critical case at admission (OR = 6.46, 95%CI 2.34−17.8; OR = 22.3, 95%CI 11.0−45, respectively), and some signs and symptoms of COVID-19 such as shortness of breath, feeling fatigued or headache, respiratory rate ≥ 30/min, PaO2/FiO2 ratio < 300, and altered consciousness. In conclusion, identifying high-risk populations that are expected to have a poor prognosis based on their criteria upon admission helps policymakers and practitioners better triage patients when faced with limited healthcare resources.
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Affiliation(s)
- Masaad Saeed Almutairi
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim 51452, Saudi Arabia;
| | - Ahmed M. Assiri
- Health Volunteering Center, Ministry of Health, Riyadh 11176, Saudi Arabia;
| | - Omar A. Almohammed
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
- Pharmacoeconomics Research Unit, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
- Correspondence: ; Tel.: +966-555-10-4065
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Marza AM, Petrica A, Lungeanu D, Sutoi D, Mocanu A, Petrache I, Mederle OA. Risk Factors, Characteristics, and Outcome in Non-Ventilated Patients with Spontaneous Pneumothorax or Pneumomediastinum Associated with SARS-CoV-2 Infection. Int J Gen Med 2022; 15:489-500. [PMID: 35046709 PMCID: PMC8760984 DOI: 10.2147/ijgm.s347178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/22/2021] [Indexed: 11/25/2022] Open
Abstract
Background and Objectives Spontaneous pneumothorax (SP) and spontaneous pneumomediastinum (SPM) have frequently been cited as complications associated with coronavirus disease 2019 (COVID-19) pneumonia, with especially poor prognosis in mechanically ventilated patients. The current literature is controversial regarding the potential risk factors for developing SP or SPM (SP-SPM) in non-ventilated COVID-19 patients. Our research addressed a twofold objective: (a) to investigate the characteristics of patients with SP-SPM (both with and without COVID-19) and compare them to patients with sole COVID-19; (b) to quantify the risk of in-hospital mortality associated with SP-SPM and COVID-19. Patients and Methods A retrospective case–control study was conducted in the emergency departments (ED) of two tertiary hospitals in Timisoara, Romania, over one year (1st April 2020‒31st March 2021; 64,845 records in total) and 70 cases of SP-SPM were identified (both SARS-CoV-2 positives and negatives). The control group comprised COVID-19 patients with no SP-SPM, included at a 2:1 ratio. Logistic regression was employed to quantify the in-hospital mortality risk associated with age, SP-SPM, and COVID-19. Results SP-SPM and COVID-19 were connected with prolonged hospitalization, a higher percentage of intensive care admission, and a higher mortality. SP-SPM increased the odds of death by almost four times in patients of the same age, gender, smoking status, and SARS-CoV-2 infection: OR = 3.758, 95% CI (1.443–9.792). Each additional year of age added 9.4% to the mortality risk: OR = 1.094, 95% CI (1.054–1.135). Conclusion ED physicians should acknowledge these potential risks when attending COVID-19 patients with SP-SPM.
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Affiliation(s)
- Adina Maria Marza
- Department of Surgery, “Victor Babes” University of Medicine and Pharmacy, Timisoara, 300041, Romania
- Emergency Department, Emergency Clinical Municipal Hospital, Timisoara, 300079, Romania
| | - Alina Petrica
- Department of Surgery, “Victor Babes” University of Medicine and Pharmacy, Timisoara, 300041, Romania
- Emergency Department, “Pius Brinzeu” Emergency Clinical County Hospital, Timisoara, 300736, Romania
- Correspondence: Alina Petrica Department of Surgery, “Victor Babes” University of Medicine and Pharmacy, Piata Eftimie Murgu 2, Timisoara, 300041, RomaniaTel +40744772427 Email
| | - Diana Lungeanu
- Center for Modeling Biological Systems and Data Analysis, Department of Functional Sciences, “Victor Babes” University of Medicine and Pharmacy, Timisoara, 300041, Romania
- Diana Lungeanu Center for Modeling Biological Systems and Data Analysis, Department of Functional Sciences, “Victor Babes” University of Medicine and Pharmacy, Piata Eftimie Murgu 2, Timisoara, 300041, Romania Email
| | - Dumitru Sutoi
- Department of Surgery, “Victor Babes” University of Medicine and Pharmacy, Timisoara, 300041, Romania
- Clinic of Anaesthesia and Intensive Care, “Pius Brinzeu” Emergency Clinical County Hospital, Timisoara, 300736, Romania
| | - Alexandra Mocanu
- Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, Timisoara, 300041, Romania
| | - Ioan Petrache
- Department of Surgery, “Victor Babes” University of Medicine and Pharmacy, Timisoara, 300041, Romania
- Clinic of Thoracic Surgery, Emergency Clinical Municipal Hospital, Timisoara, 300079, Romania
| | - Ovidiu Alexandru Mederle
- Department of Surgery, “Victor Babes” University of Medicine and Pharmacy, Timisoara, 300041, Romania
- Emergency Department, Emergency Clinical Municipal Hospital, Timisoara, 300079, Romania
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Mary Grace NC, Babu S, Joseph A, Jacob D, Benjamin A, Anaghajyothi V, Pulpandi S, Jacob C. Pattern of comorbidities and clinical profile of young adults who died due to severe coronavirus disease: A descriptive study. MGM JOURNAL OF MEDICAL SCIENCES 2022. [DOI: 10.4103/mgmj.mgmj_169_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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