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Wang Y, Li K, Zeng J, Lu S, Deng W. The risk of common hypoglycemic and antihypertensive medications and COVID-19: A 2-sample Mendelian randomization study. Medicine (Baltimore) 2024; 103:e36423. [PMID: 38335406 PMCID: PMC10860956 DOI: 10.1097/md.0000000000036423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/12/2023] [Accepted: 11/10/2023] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND It has been reported that diabetes and hypertension increase the adverse outcomes of coronavirus disease 2019 (COVID-19). Aside from the inherent factors of diabetes and hypertension, it remains unclear whether antidiabetic or antihypertensive medications contribute to the increased adverse outcomes of COVID-19. The effect of commonly used antidiabetic and antihypertensive medications on COVID-19 outcomes has been inconsistently concluded in existing observational studies. Conducting a systematic study on the causal relationship between these medications and COVID-19 would be beneficial in guiding their use during the COVID-19 pandemic. METHODS We employed the 2-sample Mendelian randomization approach to assess the causal relationship between 5 commonly used antidiabetic medications (SGLT-2 inhibitors, Sulfonylureas, Insulin analogues, Thiazolidinediones, GLP-1 analogues) and 3 commonly used antihypertensive medications (calcium channel blockers [CCB], ACE inhibitors, β-receptor blockers [BB]), and COVID-19 susceptibility, hospitalization, and severe outcomes. The genetic variations in the drug targets of the 5 antidiabetic medications and 3 antihypertensive medications were utilized as instrumental variables. European population-specific genome-wide association analysis (GWAS) data on COVID-19 from the Host Genetics Initiative meta-analyses were obtained, including COVID-19 susceptibility (n = 2597,856), COVID-19 hospitalization (n = 2095,324), and COVID-19 severity (n = 1086,211). The random-effects inverse variance-weighted estimation method was employed as the primary assessment technique, with various sensitivity analyses conducted to evaluate heterogeneity and pleiotropy. RESULTS There were no potential associations between the genetic variations in the drug targets of the 5 commonly used antidiabetic medications (SGLT-2 inhibitors, Sulfonylureas, Insulin analogues, Thiazolidinediones, GLP-1 analogues) and the 3 commonly used antihypertensive medications (CCBs, ACE inhibitors, BBs) with COVID-19 susceptibility, hospitalization, and severity (all P > .016). CONCLUSION The findings from this comprehensive Mendelian randomization analysis suggest that there may be no causal relationship between the 5 commonly used antidiabetic medications (SGLT-2 inhibitors, Sulfonylureas, Insulin analogues, Thiazolidinediones, GLP-1 analogues) and the 3 commonly used antihypertensive medications (CCBs, ACE inhibitors, BBs) with COVID-19 susceptibility, hospitalization, and severity.
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Affiliation(s)
- Ya Wang
- Endocrinology Department, Liuzhou Peoples’ Hospital Affiliated to Guangxi Medical University, Liuzhou, Guangxi, China
| | - Kai Li
- Orthopedics Department, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China
| | - Jiaxing Zeng
- Department of Traumatic Surgery & Microsurgery & Hand Surgery, Guangxi Zhuang Autonomous Region People’s Hospital, Nanning, Guangxi, China
| | - Shunyu Lu
- Department of Pharmacy, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Wangsheng Deng
- Emergency Department, Longhua People’s Hospital, Shenzhen, Guangdong, China
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Mehrizi R, Golestani A, Malekpour MR, Karami H, Nasehi MM, Effatpanah M, Ranjbaran H, Shahali Z, Sari AA, Daroudi R. Drug prescription patterns and their association with mortality and hospitalization duration in COVID-19 patients: insights from big data. Front Public Health 2023; 11:1280434. [PMID: 38164450 PMCID: PMC10758044 DOI: 10.3389/fpubh.2023.1280434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024] Open
Abstract
Background Different medication prescription patterns have been associated with varying course of disease and outcomes in COVID-19. Health claims data is a rich source of information on disease treatment and outcomes. We aimed to investigate drug prescription patterns and their association with mortality and hospitalization via insurance data for a relatively long period of the pandemic in Iran. Methods We retrieved hospitalized patients' data from Iran Health Insurance Organization (IHIO) spanning 26 months (2020-2022) nationwide. Included were patients with ICD-10 codes U07.1/U07.2 for confirmed/suspected COVID-19. A case was defined as a single hospitalization event for an individual patient. Multiple hospitalizations of a patient within a 30-day interval were aggregated into a single case, while hospitalizations with intervals exceeding 30 days were treated as independent cases. The Anatomical Therapeutic Chemical (ATC) was used for medications classification. The two main study outcomes were general and intensive care unit (ICU) hospitalization periods and mortality. Besides, various demographic and clinical associate factors were analyzed to derive the associations with medication prescription patterns and study outcomes using accelerated failure time (AFT) and logistic regression models. Results During the 26 months of the study period, 1,113,678 admissions with COVID-19 diagnosis at hospitals working in company with IHIO were recorded. 917,198 cases were detected from the database, among which 51.91% were females and 48.09% were males. Among the main groups of medications, antithrombotics (55.84% [95% CI: 55.74-55.94]), corticosteroids (54.14% [54.04-54.24]), and antibiotics (42.22% [42.12-42.32]) were the top used medications among cases with COVID-19. Investigation of the duration of hospitalization based on main medication groups showed antithrombotics (adjusted median ratio = 0.94 [0.94-0.95]) were significantly associated with shorter periods of overall hospitalization. Also, antithrombotics (adjusted odds ratio = 0.74 [95%CI, 0.73-0.76]), corticosteroids (0.97 [0.95-0.99]), antivirals (0.82 [0.80-0.83]), and ACE inhibitor/ARB (0.79 [0.77-0.80]) were significantly associated with lower mortality. Conclusion Over 2 years of investigation, antithrombotics, corticosteroids, and antibiotics were the top medications for hospitalized patients with COVID-19. Trends in medication prescription varied based on various factors across the country. Medication prescriptions could potentially significantly impact the trends of mortality and hospitalization during epidemics, thereby affecting both health and economic burdens.
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Affiliation(s)
- Reza Mehrizi
- National Center for Health Insurance Research, Tehran, Iran
| | - Ali Golestani
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Reza Malekpour
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Karami
- National Center for Health Insurance Research, Tehran, Iran
| | - Mohammad Mahdi Nasehi
- National Center for Health Insurance Research, Tehran, Iran
- Pediatric Neurology Research Center, Research Institute for Children Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Effatpanah
- National Center for Health Insurance Research, Tehran, Iran
- School of Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Ranjbaran
- National Center for Health Insurance Research, Tehran, Iran
- Immunogenetics Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zahra Shahali
- National Center for Health Insurance Research, Tehran, Iran
| | - Ali Akbari Sari
- Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Rajabali Daroudi
- Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Xu Q, Li F, Chen X. Factors Affecting Mortality in Elderly Hypertensive Hospitalized Patients with COVID-19: A Retrospective Study. Clin Interv Aging 2023; 18:1905-1921. [PMID: 38020447 PMCID: PMC10674107 DOI: 10.2147/cia.s431271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/07/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose Corona Virus Disease 2019 (COVID-19) endangers the health and survival of the elderly. We tried to explore factors especially kidney function which affected mortality in elderly hypertensive patients with COVID-19. Methods We conducted a retrospective research of 748 COVID-19 elderly patients (≥65 years old) at Zhejiang Hospital. This study compared demographic data, laboratory values, comorbidities, treatments, and clinical outcomes of hypertension and non-hypertension participants, and subgroup analysis of age and frailty was conducted in the hypertension population. Survival analysis was used to determine risk factors for death in elderly patients with COVID-19. Results Our study revealed that the elderly hypertensive patients with COVID-19 had higher blood urea nitrogen (BUN), serum uric acid (UA), serum creatinine (Scr), lower estimated glomerular filtration rate (eGFR), higher incidence of severity, admission to intensive care unit (ICU) and death, and longer in-hospital stay than non-hypertensive patients, which also occurred in the very elderly hypertensive patients compared with younger hypertensive patients and frail hypertensive patients compared with no-frail hypertensive patients. In addition, the prevalence of acute kidney injury (AKI) was higher in the oldest old hypertensive patients and frail hypertensive patients. Multivariate survival analysis indicated that the independent risk factors for death from COVID-19 were age ≥80 years, heart failure, antiviral therapy, calcium channel blocker (CCB) therapy, mechanical ventilation, AKI, and eGFR<60 mL/min per 1.73 m2. Conclusion The results of the present study suggested that the elderly hypertensive patients with COVID-19 would have more serious kidney injury, more serious disease progression and higher mortality, which also occurred in very elderly and frailty subgroup. Kidney dysfunction was closely related to mortality in elderly patients with COVID-19.
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Affiliation(s)
- Qun Xu
- School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of China
| | - Fangzhou Li
- Department of Geriatrics, Zhejiang Provincial Hospital of Chinese Medicine, Hangzhou, Zhejiang Province, People’s Republic of China
| | - Xujiao Chen
- Department of Geriatrics, Zhejiang Provincial Hospital of Chinese Medicine, Hangzhou, Zhejiang Province, People’s Republic of China
- Zhejiang Hospital, Hangzhou, Zhejiang Province, People's Republic of China
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Santos MMS, Pereira IJ, Cuboia N, Reis-Pardal J, Adrião D, Cardoso T, Aragão I, Santos L, Sarmento A, Rosa RG, Granja C, Teixeira C, Azevedo L. Predictors of early and long-term mortality after ICU discharge in critically ill COVID-19 patients: A prospective cohort study. PLoS One 2023; 18:e0293883. [PMID: 37917761 PMCID: PMC10621933 DOI: 10.1371/journal.pone.0293883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/23/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND To mitigate mortality among critically ill COVID-19 patients, both during their Intensive Care Unit (ICU) stay and following ICU discharge, it is crucial to measure its frequency, identify predictors and to establish an appropriate post-ICU follow-up strategy. METHODS In this multicentre, prospective cohort study, we included 586 critically ill COVID-19 patients. RESULTS We observed an overall ICU mortality of 20.1% [95%CI: 17.1% to 23.6%] (118/586) and an overall hospital mortality of 25.4% [95%CI: 22.1% to 29.1%] (149/586). For ICU survivors, 30 days (early) post-ICU mortality was 5.3% [95%CI: 3.6% to 7.8%] (25/468) and one-year (late) post-ICU mortality was 7.9% [95%CI: 5.8% to 10.8%] (37/468). Pre-existing conditions/comorbidities were identified as the main independent predictors of mortality after ICU discharge: hypertension and heart failure were independent predictors of early mortality; and hypertension, chronic kidney disease, chronic obstructive pulmonary disease and cancer were independent predictors of late mortality. CONCLUSION Early and late post-ICU mortality exhibited an initial surge (in the first 30 days post-ICU) followed by a subsequent decline over time. Close monitoring of critically ill COVID-19 post-ICU survivors, especially those with pre-existing conditions, is crucial to prevent adverse outcomes, reduce mortality and to establish an appropriate follow-up strategy.
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Affiliation(s)
- Mariana M. S. Santos
- MEDCIDS–Medicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE–Center for Health Technology and Services Research (CINTESIS) & Health Research Network Associated Laboratory (RISE), University of Porto, Porto, Portugal
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Isabel J. Pereira
- MEDCIDS–Medicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- Faculty of Medicine, University of Porto, Porto, Portugal
- Polyvalent Intensive Care Medicine Service, Centro Hospitalar de Gaia/Espinho—Vila Nova de Gaia, Vila Nova de Gaia, Portugal
- CriticalMed–Critical Care & Emergency Medicine, CINTESIS—Center for Health, Porto, Portugal
| | - Nelson Cuboia
- MEDCIDS–Medicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE–Center for Health Technology and Services Research (CINTESIS) & Health Research Network Associated Laboratory (RISE), University of Porto, Porto, Portugal
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Joana Reis-Pardal
- MEDCIDS–Medicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE–Center for Health Technology and Services Research (CINTESIS) & Health Research Network Associated Laboratory (RISE), University of Porto, Porto, Portugal
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Diana Adrião
- Polyvalent Intensive Care Medicine Service, Centro Hospitalar de Gaia/Espinho—Vila Nova de Gaia, Vila Nova de Gaia, Portugal
| | - Teresa Cardoso
- Intensive Care Unit (UCIP), Hospital de Santo António, Oporto Hospital Center, University of Oporto, Largo Prof. Abel Salazar, Porto, Portugal
| | - Irene Aragão
- Intensive Care Unit (UCIP), Hospital de Santo António, Oporto Hospital Center, University of Oporto, Largo Prof. Abel Salazar, Porto, Portugal
| | - Lurdes Santos
- CHUSJ-Centro Hospitalar Universitário S. João, Porto, Portugal
- Infectious Diseases Intensive Care Unit-(ID-ICU)- Centro Hospitalar Universitário S. João, Porto, Portugal
- Intensive Care Department, Centro Hospitalar Universitário de São João—Porto, Porto, Portugal
| | - António Sarmento
- CHUSJ-Centro Hospitalar Universitário S. João, Porto, Portugal
- Infectious Diseases Intensive Care Unit-(ID-ICU)- Centro Hospitalar Universitário S. João, Porto, Portugal
- Intensive Care Department, Centro Hospitalar Universitário de São João—Porto, Porto, Portugal
| | - Regis G. Rosa
- Hospital Moinhos de Vento, Porto Alegre, RS, Brazil
- Research Unit, INOVA Medical, Porto Alegre, RS, Brazil
- Brazilian Research in Intensive Care Network (BRICNet), São Paulo, SP, Brazil
| | - Cristina Granja
- Faculty of Medicine, University of Porto, Porto, Portugal
- CriticalMed–Critical Care & Emergency Medicine, CINTESIS—Center for Health, Porto, Portugal
- CHUSJ-Centro Hospitalar Universitário S. João, Porto, Portugal
- Intensive Care Department, Centro Hospitalar Universitário de São João—Porto, Porto, Portugal
- Anaesthesiology Department, Centro Hospitalar Universitário São João, Porto, Portugal
- Department of Surgery and Physiology, Faculdade de Medicina, University of Porto, Porto, Portugal
| | - Cassiano Teixeira
- Brazilian Research in Intensive Care Network (BRICNet), São Paulo, SP, Brazil
- Intensive Care Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- UFCSPA Medical School, Porto Alegre, RS, Brazil
| | - Luís Azevedo
- MEDCIDS–Medicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE–Center for Health Technology and Services Research (CINTESIS) & Health Research Network Associated Laboratory (RISE), University of Porto, Porto, Portugal
- Faculty of Medicine, University of Porto, Porto, Portugal
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Katzmarzyk PT, Myers CA, Nelson MR, Denstel KD, Mire EF, Newton RL, Broyles ST, Kirwan JP. Exploring barriers to SARS-CoV-2 testing uptake in underserved black communities in Louisiana. Am J Hum Biol 2023; 35:e23879. [PMID: 36807397 PMCID: PMC10591290 DOI: 10.1002/ajhb.23879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/27/2023] [Accepted: 02/02/2023] [Indexed: 02/22/2023] Open
Abstract
OBJECTIVE To collect qualitative data on approaches that can potentially reduce barriers to, and create strategies for, increasing SARS-CoV-2 testing uptake in underserved Black communities in Louisiana. METHODS A series of eight focus groups, including 41 participants, were conducted in primarily Black communities. The Nominal Group Technique (NGT) was used to determine perceptions of COVID-19 as a disease, access to testing, and barriers limiting testing uptake. RESULTS Common barriers to SARS-CoV-2 testing were identified as lack of transportation, misinformation/lack of information, lack of time/long wait times, fear of the test being uncomfortable and/or testing positive, the cost of testing, and lack of computer/smartphone/internet. The most impactful approaches identified to increase testing uptake included providing testing within the local communities; testing specifically in heavily traveled areas such as supermarkets, churches, schools, and so forth; providing incentives; engaging local celebrities; and providing information to the community through health fairs, or through churches and schools. The strategies that were deemed to be the easiest to implement revolved around communication about testing, with suggested strategies involving churches, local celebrities or expert leaders, social media, text messages, public service announcements, post cards, or putting up signs in neighborhoods. Providing transportation to testing sites, providing incentives, and bringing the testing to neighborhoods and schools were also identified as easy to implement strategies. CONCLUSIONS Several strategies to increase testing uptake were identified in this population. These strategies need to be tested for effectiveness in real-world settings using experimental and observational study designs.
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Affiliation(s)
| | - Candice A. Myers
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Michelle R. Nelson
- Surgeons Group of Baton Rouge, Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, USA
| | - Kara D. Denstel
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Emily F. Mire
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Robert L. Newton
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | | | - John P. Kirwan
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
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Wiegand HF, Fehr M, Glock M, Rueb M, Roth-Sackenheim C, Köhler S, Pogarell O, Horster S, Geschke K, Tüscher O, Lieb K, Falkai P, Hölzel LP, Adorjan K. [COVID-19 vaccination for people with severe mental diseases : Results of the COVID Ψ outpatient survey and recommendations for psychiatry]. DER NERVENARZT 2023:10.1007/s00115-023-01477-5. [PMID: 37138091 PMCID: PMC10155662 DOI: 10.1007/s00115-023-01477-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND Severe mental illnesses are risk factors for SARS-CoV-2-related morbidity and mortality. Vaccination is an effective protection; therefore, high vaccination rates should be a major priority for people with mental illnesses. OBJECTIVES (1) Identification of at-risk groups for non-vaccination and structures and interventions needed for widespread vaccination among people with mental illnesses from the perspective of outpatient psychiatrists and neurologists, (2) discussion of the results in the context of the international literature and (3) recommendations derived from them. MATERIAL AND METHODS Qualitative content analysis of COVID-19 vaccination-related questions from the COVID Ψ online survey of n = 85 psychiatrists and neurologists in Germany. RESULTS In the survey, people with schizophrenia, severe lack of drive, low socioeconomic status and homelessness were seen as risk groups for non-vaccination. Increased and targeted information, education, addressing and motivation and easily accessible vaccination offers by general practitioners, psychiatrists, and neurologists as well as complementary institutions were considered as important interventions. DISCUSSION COVID-19 vaccinations as well as information, motivation and access support should be systematically offered by as many institutions of the psychiatric, psychotherapeutic and complementary care systems in Germany as possible.
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Affiliation(s)
- Hauke Felix Wiegand
- Klinik für Psychiatrie und Psychotherapie der Universitätsmedizin Mainz, Johannes-Gutenberg Universität Mainz, Mainz, Deutschland
| | - Mandy Fehr
- Klinik für Psychiatrie und Psychotherapie der Universitätsmedizin Mainz, Johannes-Gutenberg Universität Mainz, Mainz, Deutschland
| | - Miriam Glock
- Klinik für Psychiatrie und Psychotherapie der Universitätsmedizin Mainz, Johannes-Gutenberg Universität Mainz, Mainz, Deutschland
| | - Mike Rueb
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München (LMU), Numssbaumstr. 7, 80336, München, Deutschland
| | | | - Sabine Köhler
- Berufsverband Deutscher Nervenärzte, Berlin, Deutschland
| | - Oliver Pogarell
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München (LMU), Numssbaumstr. 7, 80336, München, Deutschland
| | - Sophia Horster
- Medizinische Klinik und Poliklinik II, Klinikum der Universität München (LMU), München, Deutschland
| | - Katharina Geschke
- Klinik für Psychiatrie und Psychotherapie der Universitätsmedizin Mainz, Johannes-Gutenberg Universität Mainz, Mainz, Deutschland
| | - Oliver Tüscher
- Klinik für Psychiatrie und Psychotherapie der Universitätsmedizin Mainz, Johannes-Gutenberg Universität Mainz, Mainz, Deutschland
| | - Klaus Lieb
- Klinik für Psychiatrie und Psychotherapie der Universitätsmedizin Mainz, Johannes-Gutenberg Universität Mainz, Mainz, Deutschland
| | - Peter Falkai
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München (LMU), Numssbaumstr. 7, 80336, München, Deutschland
| | - Lars-Peer Hölzel
- Klinik für Psychiatrie und Psychotherapie der Universitätsmedizin Mainz, Johannes-Gutenberg Universität Mainz, Mainz, Deutschland
- Oberberg Parkklinik Wiesbaden Schlangenbad, Schlangenbad, Deutschland
| | - Kristina Adorjan
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München (LMU), Numssbaumstr. 7, 80336, München, Deutschland.
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Malekpour MR, Abbasi-Kangevari M, Shojaee A, Saeedi Moghaddam S, Ghamari SH, Rashidi MM, Namazi Shabestari A, Effatpanah M, Nasehi M, Rezaei M, Farzadfar F. Effect of the chronic medication use on outcome measures of hospitalized COVID-19 patients: Evidence from big data. Front Public Health 2023; 11:1061307. [PMID: 36908454 PMCID: PMC9998941 DOI: 10.3389/fpubh.2023.1061307] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 01/11/2023] [Indexed: 03/14/2023] Open
Abstract
Background Concerns about the role of chronically used medications in the clinical outcomes of the coronavirus disease 2019 (COVID-19) have remarkable potential for the breakdown of non-communicable diseases (NCDs) management by imposing ambivalence toward medication continuation. This study aimed to investigate the association of single or combinations of chronically used medications in NCDs with clinical outcomes of COVID-19. Methods This retrospective study was conducted on the intersection of two databases, the Iranian COVID-19 registry and Iran Health Insurance Organization. The primary outcome was death due to COVID-19 hospitalization, and secondary outcomes included length of hospital stay, Intensive Care Unit (ICU) admission, and ventilation therapy. The Anatomical Therapeutic Chemical (ATC) classification system was used for medication grouping. The frequent pattern growth algorithm was utilized to investigate the effect of medication combinations on COVID-19 outcomes. Findings Aspirin with chronic use in 10.8% of hospitalized COVID-19 patients was the most frequently used medication, followed by Atorvastatin (9.2%) and Losartan (8.0%). Adrenergics in combination with corticosteroids inhalants (ACIs) with an odds ratio (OR) of 0.79 (95% confidence interval: 0.68-0.92) were the most associated medications with less chance of ventilation therapy. Oxicams had the least OR of 0.80 (0.73-0.87) for COVID-19 death, followed by ACIs [0.85 (0.77-0.95)] and Biguanides [0.86 (0.82-0.91)]. Conclusion The chronic use of most frequently used medications for NCDs management was not associated with poor COVID-19 outcomes. Thus, when indicated, physicians need to discourage patients with NCDs from discontinuing their medications for fear of possible adverse effects on COVID-19 prognosis.
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Affiliation(s)
- Mohammad-Reza Malekpour
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Abbasi-Kangevari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Shojaee
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Kiel Institute for the World Economy, Kiel, Germany
| | - Seyyed-Hadi Ghamari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Mahdi Rashidi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Namazi Shabestari
- Department of Geriatric Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- National Center for Health Insurance Research, Iran Health Insurance Organization, Tehran, Iran
| | - Mohammad Effatpanah
- National Center for Health Insurance Research, Iran Health Insurance Organization, Tehran, Iran
- Department of Pediatrics, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadmehdi Nasehi
- National Center for Health Insurance Research, Iran Health Insurance Organization, Tehran, Iran
- Pediatric Neurology Department, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Rezaei
- National Center for Health Insurance Research, Iran Health Insurance Organization, Tehran, Iran
- Department of Orthopedics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Hung KC, Huang YT, Chang YJ, Yu CH, Wang LK, Wu CY, Liu PH, Chiu SF, Sun CK. Association between Fibrinogen-to-Albumin Ratio and Prognosis of Hospitalized Patients with COVID-19: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2022; 12:diagnostics12071678. [PMID: 35885582 PMCID: PMC9317445 DOI: 10.3390/diagnostics12071678] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/06/2022] [Accepted: 07/09/2022] [Indexed: 01/08/2023] Open
Abstract
Although the fibrinogen-to-albumin ratio (F/R ratio) has been used as an inflammation marker to predict clinical outcomes in patients with cardiovascular diseases, its association with the prognosis of patients with coronavirus disease 2019 (COVID-19) remains unclear. Electronic databases including EMBASE, MEDLINE, Google Scholar, and Cochrane Library were searched from inception to 20 June 2022. The associations of F/R ratio with poor prognosis (defined as the occurrence of mortality or severe disease) were investigated in patients with COVID-19. A total of 10 studies (seven from Turkey, two from China, one from Croatia) involving 3675 patients published between 2020 and 2022 were eligible for quantitative syntheses. Merged results revealed a higher F/R ratio in the poor prognosis group (standardized mean difference: 0.529, p < 0.001, I2 = 84.8%, eight studies) than that in the good prognosis group. In addition, a high F/R ratio was associated with an increased risk of poor prognosis (odds ratio: 2.684, I2 = 59.5%, five studies). Pooled analysis showed a sensitivity of 0.75, specificity of 0.66, and area under curve of 0.77 for poor prognosis prediction. In conclusion, this meta-analysis revealed a positive correlation between F/A ratio and poor prognostic outcomes of COVID-19. Because of the limited number of studies included, further investigations are warranted to support our findings.
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Affiliation(s)
- Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City 71004, Taiwan; (K.-C.H.); (Y.-J.C.); (C.-H.Y.); (L.-K.W.); (C.-Y.W.)
- Department of Hospital and Health Care Administration, College of Recreation and Health Management, Chia Nan University of Pharmacy and Science, Tainan City 71710, Taiwan
| | - Yen-Ta Huang
- Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City 70101, Taiwan;
| | - Ying-Jen Chang
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City 71004, Taiwan; (K.-C.H.); (Y.-J.C.); (C.-H.Y.); (L.-K.W.); (C.-Y.W.)
- Department of Recreation and Health-Care Management, College of Recreation and Health Management, Chia Nan University of Pharmacy and Science, Tainan City 71710, Taiwan
| | - Chia-Hung Yu
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City 71004, Taiwan; (K.-C.H.); (Y.-J.C.); (C.-H.Y.); (L.-K.W.); (C.-Y.W.)
| | - Li-Kai Wang
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City 71004, Taiwan; (K.-C.H.); (Y.-J.C.); (C.-H.Y.); (L.-K.W.); (C.-Y.W.)
- Department of Hospital and Health Care Administration, College of Recreation and Health Management, Chia Nan University of Pharmacy and Science, Tainan City 71710, Taiwan
| | - Chung-Yi Wu
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City 71004, Taiwan; (K.-C.H.); (Y.-J.C.); (C.-H.Y.); (L.-K.W.); (C.-Y.W.)
| | - Ping-Hsin Liu
- Department of Anesthesiology, E-Da Hospital, Kaohsiung City 82445, Taiwan;
| | - Sheng-Fu Chiu
- Department of Oral and Maxillofacial Surgery, Chi Mei Medical Center, Liouying, Tainan City 73657, Taiwan
- Correspondence: (S.-F.C.); (C.-K.S.)
| | - Cheuk-Kwan Sun
- Department of Emergency Medicine, E-Da Hospital, Kaohsiung City 82445, Taiwan
- College of Medicine, I-Shou University, Kaohsiung City 84001, Taiwan
- Correspondence: (S.-F.C.); (C.-K.S.)
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