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Kumar N, Syed Sulaiman SA, Hashmi FK, Noor A, Ahmad R, Qureshi A, Jhatial F, Sheikh Ghadzi SM. Exploring the Clinical Features, Management of Hypertension, and Predictors of Severity in Hospitalized Hypertensive COVID-19 Patients. Cureus 2024; 16:e61356. [PMID: 38947593 PMCID: PMC11214652 DOI: 10.7759/cureus.61356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2024] [Indexed: 07/02/2024] Open
Abstract
Background Hypertension significantly contributes to the severity, prolonged hospitalization, the need for intensive care, and mortality of COVID-19 patients. However, the data is still evolving. This study investigated the predictors of severity among hypertensive COVID-19 patients. Methodology This cohort study included 333 hospitalized hypertensive COVID-19 patients at the Indus Hospital, Karachi, Pakistan, from April 2021 to October 2021. The study evaluated the clinical features, antihypertensive therapy, and predictors of severity. A multivariable binary logistic regression model was used to determine severity predictors using IBM SPSS Statistics for Windows, Version 27.0 (Released 2020; IBM Corp., Armonk, NY, USA). Results The majority of hypertensive COVID-19 patients were females (54.7%), aged <65 years (55.8%), and coexisted with diabetes mellitus (56.5%). The independent predictors of severity were male (aOR 2.65, 95% CI, 1.08-6.51; p < 0.033), fever (aOR 3.52, 95% CI, 1.24-9.92; p = 0.017), shortness of breath (aOR 4.49, 95% CI, 1.73-11.63; p = 0.002), oxygen saturation (<90%) (aOR 87.39, 95% CI, 19.15-398.75; p < 0.001), and D-dimer (>0.5 mcg/ml) (aOR 3.03, 95% CI, 1.19-7.71; p = 0.020). Conclusions Our study concluded that males with fever before admission, shortness of breath, lower oxygen saturation, and elevated D-dimer are the predictors of severity among hypertensive COVID-19 patients.
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Affiliation(s)
- Narendar Kumar
- Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang, MYS
- Pharmacy Practice, Faculty of Pharmacy, University of Sindh, Jamshoro, PAK
| | - Syed Azhar Syed Sulaiman
- Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang, MYS
| | | | - Ahmed Noor
- Cardiology, Indus Hospital & Health Network, Karachi, PAK
| | - Rabbiya Ahmad
- Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang, MYS
| | - Ali Qureshi
- Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang, MYS
| | - Faheem Jhatial
- Pharmacy Services, Indus Hospital & Health Network, Karachi, PAK
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Batman A, Ekici M, Menekse TS, Ciftciler R, Yazici D. Predictive Value of Nutrition and Inflammation-Related Indices on Prognosis in Type 2 Diabetes Mellitus Patients with Coronavirus Disease-2019. SISLI ETFAL HASTANESI TIP BULTENI 2024; 58:55-61. [PMID: 38808055 PMCID: PMC11128691 DOI: 10.14744/semb.2023.36699] [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: 09/05/2023] [Revised: 10/23/2023] [Accepted: 11/01/2023] [Indexed: 05/30/2024]
Abstract
Objectives This study aimed to demonstrate how the prognostic nutritional index (PNI) and systemic immune-inflammatory index (SII) help predict the severity and prognosis of patients with type 2 diabetes (T2DM) and coronavirus disease (COVID-19). Methods This retrospective cohort study included 501 T2DM patients (male, 42.1%; female, 57.9%) who were hospitalized due to COVID-19 between April 2020 and December 2020. The patients were divided into survivors and non-survivors. After comparing demographic and laboratory data between the groups, the correlation of PNI and SII with clinical and laboratory data was evaluated. Results The median (interquartile) ages of the non-survivor and survivor groups were 74 (15) and 69 (14) years, respectively, and the difference was significant (p<0.001). The PNI was significantly lower in the non-survivor group than in the survivor group (p<0.001). The SII was significantly higher in the non-survivor group than in the survivor group (p<0.001). PNI was negatively correlated with glucose levels (r=-0.115, p=0.011). If the cut-off PNI value of 29.1 was used, it had a sensitivity and specificity of 76.2% and 76.3%, respectively, in predicting the severity of the illness and the risk of death in T2DM patients. Conclusion Consequently, the PNI and SII levels are effective in predicting survival and disease severity in patients with COVID-19 and T2DM.
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Affiliation(s)
- Adnan Batman
- Department of Endocrinology and Metabolism, Koc University Faculty of Medicine, Istanbul, Türkiye
| | - Mustafa Ekici
- Department of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Tugba Sanalp Menekse
- Department of Emergency Medicine, Aksaray Training and Research Hospital, Aksaray, Türkiye
| | - Rafiye Ciftciler
- Department of Hematology, Selcuk University Faculty of Medicine, Konya, Türkiye
| | - Dilek Yazici
- Department of Endocrinology and Metabolism, Koc University Faculty of Medicine, Istanbul, Türkiye
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de Oliveira MI, Aciole MR, Neves PAF, Silva VPOE, Silva MPOE, de Lorena VMB, de Araújo PSR. A stronger antibody response in increased disease severity of SARS-CoV-2. BMC Infect Dis 2024; 24:17. [PMID: 38166763 PMCID: PMC10762998 DOI: 10.1186/s12879-023-08923-4] [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: 04/23/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND An assessment of the factors that interfere with serum levels and the persistence of anti-SARs-CoV-2 IgG antibodies is essential in order to estimate the risk of reinfection and to plan vaccination. We analyzed the impact of the severity of coronavirus disease 2019 (COVID-19) and the clinical and biological factors regarding the persistence of SARs-CoV-2 anti-spike protein (IgG-S) antibodies at 12 months. METHODS This was an observational, longitudinal study with individuals who had recovered from COVID-19 between August 2020 and June 2021. Peripheral blood samples were collected from volunteers who were hospitalized (SERIOUS COVID-19) and those who required no hospitalization (COVID-19 LIGHT). Samples were grouped according to days after symptom onset: up to 90, between 91 and 180, ≥ 180 days after symptom onset. A semiquantitative test for IgG anti-spike protein S1(IgG-S1) was used. RESULTS We analyzed 238 individuals who had recovered from COVID-19, of whom 87 had been hospitalized and 151 had not. They provided 148 and 220 samples, respectively. Among those hospitalized, males (65.5%), volunteers aged over 60 years (41.1%), comorbidities such as arterial hypertension (67.8%) and diabetes mellitus (37.9%) were most frequent. We observed higher median serum IgG-S1 titers among those who had recovered from COVID-19 and had been hospitalized, at all collection time intervals (p < 0.001). We observed a weak correlation of increasing age with humoral IgG-S1 response (Spearman correlation = 0.298). There was a greater probability of IgG-S1 antibody persistence over time among samples from hospitalized individuals compared to samples from non-hospitalized participants (p = 0.001). CONCLUSION This study has revealed higher titers and a higher probability of the persistence of IgG-S1 in severe cases after SARs-CoV-2 primary infection in unvaccinated recovered patients. Thus, in this study, the severe clinical presentation of COVID-19 was the main factor influencing serum levels and the persistence of IgG-S1 antibodies in COVID-19.
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Affiliation(s)
- Marta Iglis de Oliveira
- Department of Tropical Medicine, Medical Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil
- Department of Infectious Diseases, Hospital das Clínicas, Brazilian Company of Hospital Services (EBSERH), Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Melayne Rocha Aciole
- Department of Tropical Medicine, Medical Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Patrícia Areias Feitosa Neves
- Department of Tropical Medicine, Medical Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | | | | | - Virginia Maria Barros de Lorena
- Department of Tropical Medicine, Medical Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil
- Department of Immunology, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Fiocruz-PE, Recife, Pernambuco, Brazil
| | - Paulo Sérgio Ramos de Araújo
- Department of Tropical Medicine, Medical Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil.
- Department of Parasitology, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Fiocruz-PE, Recife, Pernambuco, Brazil.
- Department of Infectious Diseases, Hospital das Clínicas, Brazilian Company of Hospital Services (EBSERH), Federal University of Pernambuco, Recife, Pernambuco, Brazil.
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Islam R, Ahmed S, Chakma SK, Mahmud T, Al Mamun A, Islam Z, Islam MM. Smoking and pre-existing co-morbidities as risk factors for developing severity of COVID-19 infection: Evidence from a field hospital in a rural area of Bangladesh. PLoS One 2023; 18:e0295040. [PMID: 38064450 PMCID: PMC10707513 DOI: 10.1371/journal.pone.0295040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 11/15/2023] [Indexed: 12/18/2023] Open
Abstract
Since August 2020; the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) in collaboration with UNICEF has been operating a COVID-19 field hospital at the Teknaf sub-district of Cox's Bazar in Bangladesh. This paper is focused on estimating the effects of a history of tobacco smoking and pre-existing co-morbidities on the severity of COVID-19 infection among adult patients admitted into the aforesaid hospital. We conducted a retrospective data analysis of COVID-19 adult patients hospitalized from August 27, 2020 to April 20, 2022. Based on inclusion criteria; a total of 788 admitted patients were included in the analysis. We conducted a Chi-squared test and Fisher's exact test for the categorical variables to see their associations. Multinomial logistic regression models were performed to explore the risk factors for the severity of COVID-19 infection. Among 788 patients, 18.4%, 18.8%, 13%, 7.1%, 3.4%, and 1.9% have had a history of smoking, hypertension, diabetes, chronic obstructive pulmonary disease (COPD), cardiovascular diseases (CVD), and asthma respectively. Overall, the mean age of the patients was 40.3 ± 16.4 years and 51% were female. In multivariate analysis, history of smoking and co-morbidities were identified as the risk factors for the severity of COVID-19 infection; the history of smoking was found linked with an increase in the risk of developing critical, severe, and moderate level of COVID-19 infection- notably 3.17 times (RRR = 3.17; 95% CI: 1.3-7.68), 2.98 times (RRR = 2.98; 95% CI: 1.87-4.76) and 1.96 times (RRR = 1.96; 95% CI: 1.25-3.08) respectively more than the patients who never smoked. It was evident that patients with at least one of the selected co-morbidities such as hypertension, diabetes, COPD, CVD, and asthma exhibited a significantly higher likelihood of experiencing severe illness of COVID-19 compared to patients without any co-morbidity. History of tobacco smoking and pre-existing co-morbidities were significantly associated with an increased severity of COVID-19 infection.
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Affiliation(s)
- Rashadul Islam
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sayem Ahmed
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Samar Kishor Chakma
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Tareq Mahmud
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Abdullah Al Mamun
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Ziaul Islam
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - M. Munirul Islam
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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Luo C, Wu H, Wang J, Xiang Y, Yang C, You Z, Zhou N, Li W, Li Z, Tao J, Long Q, Zhou P, Chen J, Zhang Y, Dou H, He Y, Chu L, Song C. Management of a nursing unit in a COVID-19 shelter hospital in China: A case study. Public Health Nurs 2023; 40:885-894. [PMID: 37579051 DOI: 10.1111/phn.13246] [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: 09/28/2022] [Revised: 08/02/2023] [Accepted: 08/07/2023] [Indexed: 08/16/2023]
Abstract
OBJECTIVE Fangcang shelter hospital is a form of large temporary hospital developed in China to tackle public health events. Through the case study and analysis of managing a nursing unit in a huge Fangcang shelter hospital transformed from the National Exhibition and Convention Center during the Omicron wave in Shanghai, China between April 9, 2022 and May 24, 2022, this paper aimed to highlight critical implications of public health nurses in health emergencies. DESIGN A case study was conducted using data collected from a nursing unit with 570 beds. The five characteristics of management were organized as follows: human resource management, establishment and optimization of the core workflow, safety management of high-risk patients, the grid cooperation mechanism with patient volunteers, as well as humanistic nursing. RESULTS Analysis of the data of the nursing unit indicated close team cooperation, efficient and orderly process scheduling, good outcomes of patients, and the indispensable role of volunteers. CONCLUSION Practice indicated that nursing unit management in a large Fangcang shelter hospital is important to ensure medical order and efficiency. This practical experience can provide valuable reference and data to support for the nursing management of large-scale public health events, such as infectious disease epidemics.
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Affiliation(s)
- Chunmei Luo
- Department of Orthopedics, Xinqiao Hospital, Army Medical University, Chongqing, China
- The First Unit, The Third Department, The First Hospital, National Exhibition and Convention Center (Shanghai) Fangcang Shelter Hospital, Shanghai, China
| | - Hongmei Wu
- The First Unit, The Third Department, The First Hospital, National Exhibition and Convention Center (Shanghai) Fangcang Shelter Hospital, Shanghai, China
- Respiratory and Critical Care Medical Center, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Juan Wang
- Department of Orthopedics, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Yingying Xiang
- The First Unit, The Third Department, The First Hospital, National Exhibition and Convention Center (Shanghai) Fangcang Shelter Hospital, Shanghai, China
- Department of Nursing Administration, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Caidie Yang
- The First Unit, The Third Department, The First Hospital, National Exhibition and Convention Center (Shanghai) Fangcang Shelter Hospital, Shanghai, China
- Respiratory and Critical Care Medical Center, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Zhiwei You
- Department of Orthopedics, Xinqiao Hospital, Army Medical University, Chongqing, China
- The First Unit, The Third Department, The First Hospital, National Exhibition and Convention Center (Shanghai) Fangcang Shelter Hospital, Shanghai, China
| | - Nian Zhou
- The First Unit, The Third Department, The First Hospital, National Exhibition and Convention Center (Shanghai) Fangcang Shelter Hospital, Shanghai, China
- Respiratory and Critical Care Medical Center, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Wei Li
- The First Unit, The Third Department, The First Hospital, National Exhibition and Convention Center (Shanghai) Fangcang Shelter Hospital, Shanghai, China
- Operation Room, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Zhi Li
- The First Unit, The Third Department, The First Hospital, National Exhibition and Convention Center (Shanghai) Fangcang Shelter Hospital, Shanghai, China
- Department of Emergency, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Jun Tao
- The First Unit, The Third Department, The First Hospital, National Exhibition and Convention Center (Shanghai) Fangcang Shelter Hospital, Shanghai, China
- Department of Hematology, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Qin Long
- The First Unit, The Third Department, The First Hospital, National Exhibition and Convention Center (Shanghai) Fangcang Shelter Hospital, Shanghai, China
- Department of Thoracic Surgery, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Peihua Zhou
- The First Unit, The Third Department, The First Hospital, National Exhibition and Convention Center (Shanghai) Fangcang Shelter Hospital, Shanghai, China
- Respiratory and Critical Care Medical Center, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Jian Chen
- The First Unit, The Third Department, The First Hospital, National Exhibition and Convention Center (Shanghai) Fangcang Shelter Hospital, Shanghai, China
- Department of Neurology, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Yu Zhang
- The First Unit, The Third Department, The First Hospital, National Exhibition and Convention Center (Shanghai) Fangcang Shelter Hospital, Shanghai, China
- Department of General Surgery, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Heng Dou
- The First Unit, The Third Department, The First Hospital, National Exhibition and Convention Center (Shanghai) Fangcang Shelter Hospital, Shanghai, China
- Respiratory and Critical Care Medical Center, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Ying He
- The First Unit, The Third Department, The First Hospital, National Exhibition and Convention Center (Shanghai) Fangcang Shelter Hospital, Shanghai, China
- Department of Neurology, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Lingling Chu
- The First Unit, The Third Department, The First Hospital, National Exhibition and Convention Center (Shanghai) Fangcang Shelter Hospital, Shanghai, China
- Department of Nursing Administration, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Caiping Song
- The First Unit, The Third Department, The First Hospital, National Exhibition and Convention Center (Shanghai) Fangcang Shelter Hospital, Shanghai, China
- Office of Hospital Administration, Xinqiao Hospital, Army Medical University, Chongqing, China
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Abid A, Umar A, Qamar S. Disease Outcomes of COVID-19 in Diabetic and Hypertensive Patients During the Hospital Stay. Cureus 2023; 15:e46943. [PMID: 38022228 PMCID: PMC10640684 DOI: 10.7759/cureus.46943] [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] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
Background A single-stranded RNA genome-encapsulated virus known as severe acute respiratory syndrome coronavirus 2 is known to cause severe acute respiratory syndrome in humans. People with diabetes and hypertension are often more susceptible to developing coronavirus disease 2019 (COVID-19) and experience a disproportionately higher rate of morbidity and death compared to the general population. The COVID-19 pandemic has become an urgent worldwide issue. Therefore, the main goal of this study is to assess how diabetes and hypertension, both separately and together, affect clinical outcomes in terms of morbidity and mortality in patients hospitalized with COVID-19. This study aimed to evaluate the disease outcomes in hypertensive and diabetic patients hospitalized with COVID-19. Methodology This descriptive, cross-sectional study was conducted from June 2022 to November 2022. Using purposive selective sampling, a total of 90 known hypertensive and diabetic patients with COVID-19 aged 18-90 years admitted in COVID-19 isolation wards and intensive care units (ICUs) of Mayo Hospital Lahore were recruited in this study after obtaining informed consent and IRB approval from the Institutional Review Board of King Edward Medical University, Lahore. Patients who did not provide consent, patients whose positive polymerase chain reaction reports for COVID-19 were not available, pregnant females, and patients with other comorbidities were excluded from the study. Data were collected from the COVID-19 isolation medical wards and ICUs from patient charts containing age, the status of hypertension and diabetes, disease status, severity, and levels of inflammatory markers, i.e., D-dimers, serum lactate dehydrogenase (LDH), serum ferritin, C-reactive protein (CRP). Data were analyzed using SPSS version 23 (IBM Corp., Armonk, NY, USA). Quantitative variables such as age were presented as mean ± SD. Qualitative variables such as hypertension, diabetes, and levels of inflammatory markers were presented as frequency and percentages. Results In this study, 90 patients were included, with 51 (57%) females and 39 (43%) males, all of whom were either hypertensive, diabetic, or both. In total, 70 (78%) patients were admitted to ICUs and 20 (22%) to COVID-19 medical isolation wards. Among 70 ICU patients, 39 (43.3%) were on continuous positive airway pressure/bilevel positive airway pressure, seven (7.8%) were on ventilators, and 44 (48.8%) were on normal oxygen masks/non-rebreather masks with high-flow oxygen. Overall, 100% of the patients included in the study had raised levels of inflammatory markers, low lymphocyte count, and increased neutrophil count. In total, 84 (93%) patients had severely high and six (7%) patients had moderately high CRP levels. Moreover, 33 (36.7%) patients had severely high and 57 (63.3%) patients had moderately high D-dimer levels. Further, 25 (28%) patients had severely high, 26 (29%) patients had moderately high, and 39 (43.3%) patients had significantly raised levels of serum ferritin. In total, 21 (23%) patients had severely high, 37 (41%) had moderately high, and 32 (36%) had significantly raised levels of serum LDH. Among the 90 patients, 65 (73%) expired and 25 (27%) survived. Of the expired patients, 62 (95%) were admitted to ICUs, and three (5%) were admitted to wards. Conclusions Diabetes and hypertension are strong predictors of COVID-19 severity in terms of morbidity and mortality due to respiratory deterioration.
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Affiliation(s)
- Amina Abid
- Internal Medicine, Mayo Hospital Lahore, Lahore, PAK
- Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
| | - Arooj Umar
- Internal Medicine, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, GBR
| | - Samina Qamar
- Pathology, King Edward Medical University, Lahore, PAK
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Genena SESR, Fadhil MM, Mansour MM, Attwa AHM, Khalil MMIM. Expression pattern of long non-coding RNAs MALAT1 and MEG3 in COVID-19 patients. J Gene Med 2023; 25:e3532. [PMID: 37209019 DOI: 10.1002/jgm.3532] [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: 09/01/2022] [Revised: 03/24/2023] [Accepted: 05/05/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND COVID-19 is a novel infectious disease for which no specific treatment exists. It is likely that a combination of genetic and non-genetic factors predispose to it. Expression levels of genes that are involved in the interaction with SARS-CoV-2 or the host response are thought to play a role in disease susceptibility and severity. It is crucial to explore biomarkers for disease severity and outcome. Herein, we studied the expression levels and effects of long non-coding metastasis-associated lung adenocarcinoma transcript 1 (lnc-MALAT1) and long non-coding maternally expressed gene 3 (lnc-MEG3) in COVID-19 patients. The study enrolled 35 hospitalized and 35 non-hospitalized COVID-19 patients, and 35 healthy controls. A chest computed tomography (CT) scan, complete blood count (CBC), ferritin, C-reactive protein (CRP), D-dimer and analysis of lnc-MALAT1 and lnc-MEG3 expression were done. RESULTS There was a significant relation between ferritin, CRP, D-dimer levels, oxygen saturation, CT-CORADS score and disease severity. Lnc-MALAT1 was significantly higher but lnc-MEG3 was significantly lower in patients vs. controls, and in hospitalized vs. non-hospitalized patients. Elevated MALAT1 and reduced MEG3 levels were significantly associated with more elevated ferritin, CRP, D-dimer levels, lower oxygen saturation, higher CT-CORADS score and poor survival. Moreover, MALAT1 and MEG3 levels displayed higher sensitivity and specificity as predictors of COVID-19 severity compared with other prognostic biochemical markers such as ferritin, CRP, and D-dimer. CONCLUSIONS MALAT1 levels are higher, whereas MEG3 levels are lower in COVID-19 patients. Both are linked to disease severity and mortality and could emerge as predictive biomarkers for COVID-19 severity and therapeutic targets.
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Affiliation(s)
- Shaimaa El Sayed Ramadan Genena
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Menoufia University, Menoufia Governorate, Egypt
| | - Maher Mishaal Fadhil
- Department of Zoology Physiology, Faculty of Science, Menoufia University, Menoufia Governorate, Egypt
| | - Manal Monir Mansour
- Department of Clinical Pathology, Faculty of Medicine, Menoufia University, Menoufia Governorate, Egypt
| | - Asrar Helal Mahrous Attwa
- Department of Chest disease and Tuberculosis, Faculty of Medicine, Menoufia University, Menoufia Governorate, Egypt
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Khatib R, Glowacki N, Lauffenburger JC, Reddy A, Dennert K, Triscari D. Association Between the 10-Year ASCVD Risk Score and COVID-19 Complications Among Healthy Adults (Analysis from the National Cohort COVID Collaborative). Am J Cardiol 2023; 202:201-207. [PMID: 37454637 DOI: 10.1016/j.amjcard.2023.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/21/2023] [Accepted: 05/07/2023] [Indexed: 07/18/2023]
Abstract
COVID-19 complications have been linked to worse outcomes among patients with established atherosclerotic cardiovascular disease (ASCVD). Less is known about the cumulative consequences of multiple ASCVD risk factors on COVID-19 outcomes. We evaluated the dose-response associations between 10-year ASCVD risk scores and COVID-19 complications. The National COVID-19 Cohort Collaborative collects electronic health record data from over 70 US health systems. Our analysis was limited to patients with positive COVID-19 tests without documented ASCVD events at the time of the first positive test. We evaluated the dose-response associations between 10-year ASCVD risk scores, categorized into categorized as low (<7.5%), intermediate (7.5% to 20.0%), or high (>20.0%), and COVID-19 complications, including hospitalizations and mortality. We reported the outcomes using multivariable-adjusted hazard ratios and 95% confidence intervals (CIs). Our cohort included 120,335 patients with documented positive COVID-19 test results who were free of ASCVD events. The mean age was 51.9 ± 16.1 years, 59.4% were women, 15.3% were Black, and 13.7% were Hispanic/Latino. Overall, 15,363 patients (12.8%) were hospitalized and 2,058 (1.7%) died. Patients at intermediate risk of developing ASCVD were had a 1.49 (95% CI 1.41 to 1.56) increased risk of hospitalization and 1.77 (95% CI 1.76 to 1.79) increased risk of mortality compared with patients at low risk. Patients at high risk had a 2.23 (95% CI 2.10 to 2.38) increased risk of hospitalization and a 5.98 (95% CI 5.93 to 6.03) increased risk of mortality. In conclusion, patients in this nationwide cohort at high risk of developing ASCVD are at substantially greater risk of COVID-19 complications. COVID-19 mitigation efforts should focus on these patient populations.
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Affiliation(s)
- Rasha Khatib
- Advocate Aurora Health, Advocate Aurora Research Institute, Downers Grove, Illinois.
| | - Nicole Glowacki
- Advocate Aurora Health, Advocate Aurora Research Institute, Downers Grove, Illinois
| | - Julie C Lauffenburger
- Center for Healthcare Delivery Sciences (C4HDS), Department of Medicine, Brigham and Women's Hospital; and Harvard Medical School, Boston, Massachusetts; Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital; and Harvard Medical School, Boston, Massachusetts
| | - Alex Reddy
- Advocate Aurora Health, Advocate Aurora Research Institute, Downers Grove, Illinois
| | - Kate Dennert
- Advocate Aurora Health, Advocate Aurora Research Institute, Downers Grove, Illinois
| | - David Triscari
- Advocate Aurora Health, Advocate Aurora Research Institute, Downers Grove, Illinois
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Geng Y, Nie Q, Liu F, Pei Y, Chen Q, Zhang H, Zhou H, Zhou J, Jiang H, Xu J. Understanding clinical characteristics influencing adverse outcomes of Omicron infection: a retrospective study with propensity score matching from a Fangcang hospital. Front Cell Infect Microbiol 2023; 13:1115089. [PMID: 37228665 PMCID: PMC10203467 DOI: 10.3389/fcimb.2023.1115089] [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: 12/03/2022] [Accepted: 04/13/2023] [Indexed: 05/27/2023] Open
Abstract
Objectives The epidemic of coronavirus disease 2019 (COVID-19) is causing global health concerns. The aim of this study was to evaluate influence of clinical characteristics on outcomes during the Omicron outbreak. Methods A total of 25182 hospitalized patients were enrolled, including 39 severe patients and 25143 non-severe patients. Propensity score matching (PSM) was applied to balance the baseline characteristics. Logistic regression analysis was used to assess the risk of severe disease, as well as the risk of prolonged viral shedding time (VST) and increased length of hospital stay (LOS). Results Before PSM, patients in the severe group were older, had higher symptom scores, and had a higher proportion of comorbidities (p<0.001). After PSM, there were no significant differences in age, gender, symptom score and comorbidities between severe (n=39) and non-severe (n=156) patients. Symptoms of fever (OR=6.358, 95%CI 1.748-23.119, p=0.005) and diarrhea (OR=6.523, 95%CI 1.061-40.110, p=0.043) were independent risk factors for development of severe disease. In non-severe patients, higher symptom score was associated with prolonged VST (OR=1.056, 95% CI 1.000-1.115, p=0.049) and LOS (OR=1.128, 95% CI 1.039-1.225, p=0.004); older age was associated with longer LOS (OR=1.045, 95% CI 1.007-1.084, p=0.020). Conclusion The overall condition of the Shanghai Omicron epidemic was relatively mild. Potential risk factors for fever, diarrhea, and higher symptom score can help clinicians to predict clinical outcomes in COVID-19 patients.
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Affiliation(s)
- Yanxia Geng
- Department of Intensive Care Unit, The Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, China
| | - Qingfang Nie
- Department of Intensive Care Unit, The Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, China
| | - Feifei Liu
- Department of Intensive Care Unit, The Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, China
| | - Yinghao Pei
- Department of Intensive Care Unit, The Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, China
| | - Qiuhua Chen
- Department of Intensive Care Unit, The Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, China
| | - Haidong Zhang
- Department of Intensive Care Unit, The Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, China
| | - Haiqi Zhou
- Department of Intensive Care Unit, The Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, China
| | - Jiang Zhou
- Department of Intensive Care Unit, The Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, China
| | - Hua Jiang
- Department of Intensive Care Unit, The Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, China
| | - Jing Xu
- Department of Nosocomial Infection Control, The Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, China
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10
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Espiritu AI, Sucaldito MSFP, Ona DID, Apor ADAO, Sy MCC, Anlacan VMM, Jamora RDG. Clinical outcomes in COVID-19 among patients with hypertension in the Philippine CORONA Study. Eur J Med Res 2023; 28:62. [PMID: 36732874 PMCID: PMC9894742 DOI: 10.1186/s40001-022-00969-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 12/21/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE To describe the association between hypertension and clinical outcomes in a cohort of patients with coronavirus disease 2019 (COVID-19). DESIGN Retrospective cohort study. SETTING Thirty-seven (37) hospitals in the Philippines. PATIENTS 10,881 patients admitted for COVID-19 from February to December 2020. MEASUREMENTS AND MAIN RESULTS Among the 10,881 patients included in the Philippine CORONA Study, 3647 (33.5%) had hypertension. On regression analysis adjusted for confounders (age group, sex, smoking history, diabetes, chronic cardiac disease, chronic kidney disease, chronic respiratory disease, chronic neurologic disease, chronic liver disease, HIV/AIDS, and malignancy), patients with hypertension had significantly greater odds of in-hospital mortality (OR 1.33, 95% CI 1.17-1.52), respiratory failure (OR 1.99, 95% CI 1.75-2.28), ICU admission (OR 2.16, 95% CI 1.90-2.45) and severe/critical disease (OR 1.57, 95% CI 1.41-1.75), compared to patients without hypertension. The time-to-event analysis with confounder adjustment also showed that hypertension was significantly associated with shorter time-to-event outcomes of in-hospital mortality (HR 1.13, 95% CI 1.01-1.26), respiratory failure (HR 1.86, 95% CI 1.65-2.10), and ICU admission (HR 1.99, 95% CI 1.76-2.23). CONCLUSIONS Our analysis of nationwide data confirmed previous findings that hypertension is an independent risk factor for worse clinical outcomes among patients hospitalized for COVID-19, with increased odds of in-hospital mortality, respiratory failure, ICU admission, and severe/critical COVID-19. More specific studies should be done to elucidate the impact of hypertension characteristics, such as chronicity, severity, drug therapy, and level of control on these clinical outcomes.
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Affiliation(s)
- Adrian I. Espiritu
- grid.11159.3d0000 0000 9650 2179Division of Adult Neurology, Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines ,grid.11159.3d0000 0000 9650 2179Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Manila, Philippines ,grid.17063.330000 0001 2157 2938Department of Medicine (Division of Neurology) and Department of Psychiatry, University of Toronto, Toronto, ON Canada
| | - Ma. Sergia Fatima P. Sucaldito
- grid.11159.3d0000 0000 9650 2179Department of Medicine, Philippine General Hospital, University of the Philippines, Manila, Philippines
| | - Deborah Ignacia D. Ona
- grid.11159.3d0000 0000 9650 2179Division of Hypertension, Department of Medicine, Philippine General Hospital, University of the Philippines, Manila, Philippines
| | - Almira Doreen Abigail O. Apor
- grid.11159.3d0000 0000 9650 2179Division of Adult Neurology, Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Marie Charmaine C. Sy
- grid.11159.3d0000 0000 9650 2179Division of Adult Neurology, Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Veeda Michelle M. Anlacan
- grid.11159.3d0000 0000 9650 2179Division of Adult Neurology, Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Roland Dominic G. Jamora
- grid.11159.3d0000 0000 9650 2179Division of Adult Neurology, Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines ,grid.416846.90000 0004 0571 4942Institute for Neurosciences, St. Luke’s Medical Center, Quezon City, Philippines ,grid.416846.90000 0004 0571 4942Institute for Neurosciences, St. Luke’s Medical Center, Global City, Philippines
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11
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Ayubi E, Torkaman Asadi F, Borzouei S, Alafchi B, Faghih Soleimani M, Khosronejad S, Khazaei S, Talebi SS. Effects of Hypertension Alone and in Comorbidity with Diabetes on Death within 30 Days among Inpatients with COVID-19 Infection. J Res Health Sci 2022; 22:e00565. [PMID: 37571936 PMCID: PMC10422163 DOI: 10.34172/jrhs.2022.100] [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: 10/09/2022] [Revised: 11/15/2022] [Accepted: 12/07/2022] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Hypertension and diabetes are common comorbidities in patients with COVID-19 and could be influencing the mortality of such patients. The present study aimed to evaluate the effects of hypertension alone and in comorbidity with diabetes on the death within 30 days among inpatients with COVID-19 in presence of well-known determinates of COVID-19 death. STUDY DESIGN A case-control study. METHODS Four groups of COVID-19 inpatients including controls, diabetes alone, hypertension alone, and hypertension and diabetes comorbidities were defined. Each study groups did not have underlying diseases other than hypertension and diabetes. Demographic and general characteristics, underlying diseases, and hospital course events were extracted from medical records. The outcome of interest was alive at discharge/ death within 30 days after admission. Multivariable binary logistic analysis was employed to estimate the effect measures. RESULTS The number of death within 30 days among controls (n=1359), diabetes alone (159), hypertension alone (406) and hypertension and diabetes comorbidities (188) were 12.68%, 15.72%, 20.74% and 26.74%, respectively. According to three multivariable analyses after adjusting older age, hospital length of stay, and intensive care unit (ICU) admission separately, the odds of death within 30 days in COVID-19 patients with having hypertension and diabetes comorbidities was 1.58, 2.13 and 1.91 times of patients without such comorbidities, respectively (P<0.015). The effect of hypertension alone was also significant after adjusting hospital length of stay and ICU admission but not for older age. CONCLUSION Our results suggest that comorbidities, such as hypertension and diabetes may be associated with COVID-19-related deaths independent of other underlying diseases, older age, and adverse hospital course events.
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Affiliation(s)
- Erfan Ayubi
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fatemeh Torkaman Asadi
- Department of Infectious Disease, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
- Infectious Disease Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Shiva Borzouei
- Department of Internal Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Behnaz Alafchi
- Modeling Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Saman Khosronejad
- Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Salman Khazaei
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyed Saman Talebi
- Department of Internal Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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12
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Kabia AU, Li P, Jin Z, Tan X, Liu Y, Feng Y, Yu K, Hu M, Jiang D, Cao G. The effects of hypertension on the prognosis of coronavirus disease 2019: a systematic review and meta-analysis on the interactions with age and antihypertensive treatment. J Hypertens 2022; 40:2323-2336. [PMID: 35950998 PMCID: PMC9640264 DOI: 10.1097/hjh.0000000000003266] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 05/02/2022] [Accepted: 06/29/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Hypertension and angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) have been reported to be associated with the prognosis of COVID-19, but the findings remain controversial. Here, we conducted a systematic review to summarize the current evidence. METHODS We retrieved all the studies by MEDLINE via PubMed, CENTRAL, and Embase using the MeSH terms until 30 April 2021. A fixed or random effect model was applied to calculate pooled adjusted odds ratio (AOR) with 95% confidence interval (CI). Interactive analysis was performed to identify the interaction effect of hypertension and age on in-hospital mortality. RESULTS In total, 86 articles with 18 775 387 COVID-19 patients from 18 countries were included in this study. The pooled analysis showed that the COVID-19 patients with hypertension had increased risks of in-hospital mortality and other adverse outcomes, compared with those without hypertension, with an AOR (95% CI) of 1.36 (1.28-1.45) and 1.32 (1.24-1.41), respectively. The results were mostly repeated in countries with more than three independent studies. Furthermore, the effect of hypertension on in-hospital mortality is more evident in younger and older COVID-19 patients than in 60-69-year-old patients. ACEI/ARBs did not significantly affect the mortality and adverse outcomes of COVID-19 patients, compared with those receiving other antihypertensive treatments. CONCLUSION Hypertension is significantly associated with an increased risk of in-hospital mortality and adverse outcomes in COVID-19. The effect of hypertension on in-hospital mortality among consecutive age groups followed a U-shaped curve. ACEI/ARB treatments do not increase in-hospital mortality and other poor outcomes of COVID-19 patients with hypertension.
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Affiliation(s)
| | | | | | | | - Yilong Liu
- School of Basic Medicine Sciences, Second Military Medical University
| | - Yuqi Feng
- School of Basic Medicine Sciences, Second Military Medical University
| | - Keyao Yu
- School of Basic Medicine Sciences, Second Military Medical University
| | | | - Dongming Jiang
- Shanghai East Hospital, Key Laboratory of Arrhythmias, Ministry of Education, Tongji University School of Medicine, Tongji University, Shanghai, China
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13
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Ghilari YED, Iskandar A, Wiratama BS, Hartopo AB. Joint Effect of Diabetes Mellitus and Hypertension on COVID-19 in-Hospital Mortality Stratified by Age Group and Other Comorbidities: A Cohort Retrospective Study Using Hospital-Based Data in Sleman, Yogyakarta. Healthcare (Basel) 2022; 10:2103. [PMID: 36292550 PMCID: PMC9601841 DOI: 10.3390/healthcare10102103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 10/18/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
The joint effect of diabetes mellitus and hypertension on COVID-19 has rarely been evaluated but had potential as a major risk factor. This study aims to investigate the joint effect between diabetes mellitus and hypertension on in-hospital mortality among COVID-19 patients in Yogyakarta stratified by age groups and other comorbidities status. Methods: This cohort retrospective study collected data from two major hospitals in the Sleman district and a total of 2779 hospitalized COVID-19 patients were included in this study. The study outcome was COVID-19 in-hospital mortality (deceased or discharged alive) and the main risk factors were diabetes mellitus (DM) and hypertension (HT). The multiple logistic regression model was utilized to estimate adjusted odds ratio (AOR) and calculate the joint effect. Results: COVID-19 patients who have both DM and hypertension were three times (AOR: 3.21; 95% CI: 2.45-4.19) more likely to have in-hospital mortality than those without both comorbidities. The highest risk of in-hospital mortality was found in COVID-19 patients without other comorbidities (other than DM and HT) and younger age (age 0-40 years), with AOR equal to 22.40 (95% CI: 6.61-75.99). Conclusions: This study identified a joint effect between diabetes mellitus and hypertension which increases the risk of in-hospital mortality among COVID-19 patients. Targeted public health, clinical, and health education intervention should be carried out on individuals with diabetes mellitus and/or hypertension.
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Affiliation(s)
- Yampa Eksa Daidella Ghilari
- Master of Public Health Program, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
| | - Arik Iskandar
- Master of Public Health Program, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
| | - Bayu Satria Wiratama
- Master of Public Health Program, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
- Department of Biostatistics, Epidemiology, and Population Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei 110, Taiwan
| | - Anggoro Budi Hartopo
- Department of Cardiology and Vascular Medicine, Faculty of medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
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14
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Shi YF, Jiang YP, Wang XZ, Sun PP, Zhu NJ, Wang K, Zhang ZQ, Liu YY, Huo J, Wang XR, Ding B. Chiral Luminescent Sensor Eu-BTB@d-Carnitine Applied in the Highly Effective Ratiometric Sensing of Curing Drugs and Biomarkers for Diabetes and Hypertension. Inorg Chem 2022; 61:15921-15935. [PMID: 36170648 DOI: 10.1021/acs.inorgchem.2c02126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Chiral drugs are of great significance in drug development and life science because one pair of enantiomers has a different combination mode with target biological active sites, leading to a vast difference in physical activity. Metal-organic framework (MOF)-based chiral hybrid materials with specific chiral sites have excellent applications in the highly effective sensing of drug enantiomers. Sitagliptin and clonidine are effective curing drugs for controlling diabetes and hypertension, while insulin and norepinephrine are the biomarkers of these two diseases. Excessive use of sitagliptin and clonidine can cause side effects such as stomach pain, nausea, and headaches. Herein, through post-synthetic strategy, MOF-based chiral hybrid material Eu-BTB@d-carnitine (H3BTB = 1,3,5-benzenetrisbenzoic acid) was synthesized. Eu-BTB@d-carnitine has dual emission peaks at 417 and 616 nm when excited at 330 nm. Eu-BTB@d-carnitine can be applied in luminescent recognition toward sitagliptin and clonidine with high sensitivity and low detection limit (for sitagliptin detection, Ksv is 7.43 × 106 [M-1]; for clonidine detection, Ksv is 9.09 × 106 [M-1]; limit of detection (LOD) for sitagliptin is 10.21 nM, and LOD of clonidine is 8.34 nM). In addition, Eu-BTB@d-carnitine can further realize highly sensitive detection of insulin in human fluids with a high Ksv (2.08 × 106 [M-1]) and a low LOD (15.48 nM). On the other hand, norepinephrine also can be successfully discriminated by the hybrid luminescent platform of Eu-BTB@d-carnitine and clonidine with a high Ksv value of 4.79 × 106 [M-1] and a low LOD of 8.37 nM. As a result, the chiral hybrid material Eu-BTB@d-carnitine can be successfully applied in the highly effective ratiometric sensing of curing drugs and biomarkers for diabetes and hypertension.
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Affiliation(s)
- Yang Fan Shi
- Tianjin Key Laboratory of Structure and Performance for Functional Molecule, College of Chemistry, Tianjin Normal University, 393 Binshui West Road, Tianjin 300387, PR China
| | - Yu Peng Jiang
- Tianjin Key Laboratory of Structure and Performance for Functional Molecule, College of Chemistry, Tianjin Normal University, 393 Binshui West Road, Tianjin 300387, PR China
| | - Xing Ze Wang
- Tianjin Key Laboratory of Structure and Performance for Functional Molecule, College of Chemistry, Tianjin Normal University, 393 Binshui West Road, Tianjin 300387, PR China
| | - Ping Ping Sun
- Tianjin Key Laboratory of Structure and Performance for Functional Molecule, College of Chemistry, Tianjin Normal University, 393 Binshui West Road, Tianjin 300387, PR China
| | - Na Jia Zhu
- Tianjin Key Laboratory of Structure and Performance for Functional Molecule, College of Chemistry, Tianjin Normal University, 393 Binshui West Road, Tianjin 300387, PR China
| | - Kuo Wang
- Tianjin Key Laboratory of Structure and Performance for Functional Molecule, College of Chemistry, Tianjin Normal University, 393 Binshui West Road, Tianjin 300387, PR China
| | - Zi Qing Zhang
- Tianjin Key Laboratory of Structure and Performance for Functional Molecule, College of Chemistry, Tianjin Normal University, 393 Binshui West Road, Tianjin 300387, PR China
| | - Yuan Yuan Liu
- Tianjin Key Laboratory of Structure and Performance for Functional Molecule, College of Chemistry, Tianjin Normal University, 393 Binshui West Road, Tianjin 300387, PR China
| | - JianZhong Huo
- Tianjin Key Laboratory of Structure and Performance for Functional Molecule, College of Chemistry, Tianjin Normal University, 393 Binshui West Road, Tianjin 300387, PR China
| | - Xin Rui Wang
- Tianjin Key Laboratory of Structure and Performance for Functional Molecule, College of Chemistry, Tianjin Normal University, 393 Binshui West Road, Tianjin 300387, PR China
| | - Bin Ding
- Tianjin Key Laboratory of Structure and Performance for Functional Molecule, College of Chemistry, Tianjin Normal University, 393 Binshui West Road, Tianjin 300387, PR China
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15
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Wojciechowska W, Terlecki M, Klocek M, Pac A, Olszanecka A, Stolarz-Skrzypek K, Jastrzębski M, Jankowski P, Ostrowska A, Drożdż T, Prejbisz A, Dobrowolski P, Januszewicz A, Krzanowski M, Małecki MT, Grodzicki T, Kreutz R, Rajzer M. Impact of Arterial Hypertension and Use of Antihypertensive Pharmacotherapy on Mortality in Patients Hospitalized due to COVID-19: The CRACoV-HHS Study. Hypertension 2022; 79:2601-2610. [PMID: 36082666 PMCID: PMC9553221 DOI: 10.1161/hypertensionaha.122.19575] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Cardiovascular diseases including arterial hypertension are common comorbidities among patients hospitalized due to COVID-19. We assessed the influence of preexisting hypertension and its pharmacological treatment on in-hospital mortality in patients hospitalized with COVID-19.
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Affiliation(s)
- Wiktoria Wojciechowska
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland. (W.W., M.T., M. Klocek, A. Olszanecka, K.S.S., M.J., P.J., A. Ostrowska, T.D., M.R.)
| | - Michał Terlecki
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland. (W.W., M.T., M. Klocek, A. Olszanecka, K.S.S., M.J., P.J., A. Ostrowska, T.D., M.R.)
| | - Marek Klocek
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland. (W.W., M.T., M. Klocek, A. Olszanecka, K.S.S., M.J., P.J., A. Ostrowska, T.D., M.R.)
| | - Agnieszka Pac
- Department of Epidemiology, Jagiellonian University Medical College, Krakow, Poland. (A.P.)
| | - Agnieszka Olszanecka
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland. (W.W., M.T., M. Klocek, A. Olszanecka, K.S.S., M.J., P.J., A. Ostrowska, T.D., M.R.)
| | - Katarzyna Stolarz-Skrzypek
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland. (W.W., M.T., M. Klocek, A. Olszanecka, K.S.S., M.J., P.J., A. Ostrowska, T.D., M.R.)
| | - Marek Jastrzębski
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland. (W.W., M.T., M. Klocek, A. Olszanecka, K.S.S., M.J., P.J., A. Ostrowska, T.D., M.R.)
| | - Piotr Jankowski
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland. (W.W., M.T., M. Klocek, A. Olszanecka, K.S.S., M.J., P.J., A. Ostrowska, T.D., M.R.)
| | - Aleksandra Ostrowska
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland. (W.W., M.T., M. Klocek, A. Olszanecka, K.S.S., M.J., P.J., A. Ostrowska, T.D., M.R.)
| | - Tomasz Drożdż
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland. (W.W., M.T., M. Klocek, A. Olszanecka, K.S.S., M.J., P.J., A. Ostrowska, T.D., M.R.)
| | - Aleksander Prejbisz
- Department of Hypertension, National Institute of Cardiology, Warsaw, Poland (A.P., P.D., A.J.)
| | - Piotr Dobrowolski
- Department of Hypertension, National Institute of Cardiology, Warsaw, Poland (A.P., P.D., A.J.)
| | - Andrzej Januszewicz
- Department of Hypertension, National Institute of Cardiology, Warsaw, Poland (A.P., P.D., A.J.)
| | - Marcin Krzanowski
- Department of Rheumatology and Immunology, Jagiellonian University Medical College, Krakow, Poland. (M. Krzanowski)
| | - Maciej T Małecki
- Department of Metabolic Diseases and Diabetology, Jagiellonian University Medical College, Krakow, Poland. (M.T.M.)
| | - Tomasz Grodzicki
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Krakow, Poland. (T.G.)
| | - Reinhold Kreutz
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Clinical Pharmacology and Toxicology, Berlin, Germany (R.K.)
| | - Marek Rajzer
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland. (W.W., M.T., M. Klocek, A. Olszanecka, K.S.S., M.J., P.J., A. Ostrowska, T.D., M.R.)
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16
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Summers C, Griffiths F, Cave J, Panesar A. Understanding the Security and Privacy Concerns About the Use of Identifiable Health Data in the Context of the COVID-19 Pandemic: Survey Study of Public Attitudes Toward COVID-19 and Data-Sharing. JMIR Form Res 2022; 6:e29337. [PMID: 35609306 PMCID: PMC9273043 DOI: 10.2196/29337] [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: 04/02/2021] [Revised: 05/10/2022] [Accepted: 05/22/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic increased the availability and use of population and individual health data to optimize tracking and analysis of the spread of the virus. Many health care services have had to rapidly digitalize in order to maintain the continuity of care provision. Data collection and dissemination have provided critical support for defending against the spread of the virus since the beginning of the pandemic; however, little is known about public perceptions of and attitudes toward the use, privacy, and security of data. OBJECTIVE The goal of this study is to better understand people's willingness to share data in the context of the COVID-19 pandemic. METHODS A web-based survey was conducted on individuals' use of and attitudes toward health data for individuals aged 18 years and older, and in particular, with a reported diagnosis of a chronic health condition placing them at the highest risk of severe COVID-19. RESULTS In total, 4764 individuals responded to this web-based survey, of whom 4674 (98.1%) reported a medical diagnosis of at least 1 health condition (3 per person on average), with type 2 diabetes (n=2974, 62.7%), hypertension (n=2147, 45.2%), and type 1 diabetes (n=1299, 27.4%) being most prominent in our sample. In general, more people are comfortable with sharing anonymized data than personally identifiable data. People reported feeling comfortable sharing data that were able to benefit others; 66% (3121 respondents) would share personal identifiable data if its primary purpose was deemed beneficial for the health of others. Almost two-thirds (n=3026; 63.9%) would consent to sharing personal, sensitive health data with government or health authority organizations. Conversely, over a quarter of respondents (n=1297, 27.8%) stated that they did not trust any organization to protect their data, and 54% (n=2528) of them reported concerns about the implications of sharing personal information. Almost two-thirds (n=3054, 65%) of respondents were concerned about the provisions of appropriate legislation that seeks to prevent data misuse and hold organizations accountable in the case of data misuse. CONCLUSIONS Although our survey focused mainly on the views of those living with chronic health conditions, the results indicate that data sensitivity is highly contextual. More people are more comfortable with sharing anonymized data rather than personally identifiable data. Willingness to share data also depended on the receiving body, highlighting trust as a key theme, in particular who may have access to shared personal health data and how they may be used in the future. The nascency of legal guidance in this area suggests a need for humanitarian guidelines for data responsibility during disaster relief operations such as pandemics and for involving the public in their development.
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Affiliation(s)
| | - Frances Griffiths
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Jonathan Cave
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
- Department of Economics, University of Warwick, Coventry, United Kingdom
- Data Ethics Group, The Alan Turing Institute, London, United Kingdom
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Ashour L. Roles of the ACE/Ang II/AT1R pathway, cytokine release, and alteration of tight junctions in COVID-19 pathogenesis. Tissue Barriers 2022; 11:2090792. [PMID: 35726726 PMCID: PMC10161962 DOI: 10.1080/21688370.2022.2090792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
This paper shows how SARS-CoV-2 alters tight junctions (TJs) in human organs. The effect of SARS-CoV-2 on the ACE/Ang II/AT1R pathway and immune cells culminates in the release of numerous pro-inflammatory mediators, leading to the presence of certain symptoms in COVID-19, such as acute lung injury (ALI), pulmonary hypertension, and pulmonary fibrosis. Furthermore, the cytokines released alter different TJs components. The study shows how the irregular release of pro-inflammatory cytokines leads to claudin disruption in various tissues of the body, resulting in different symptoms, such as alveolar fibrosis, pulmonary edema, conjunctivitis, altered fertility in males, gastrointestinal symptoms, Covid toes, and others. SARS-CoV-2 also alters occludin expression in the endothelial and blood-testis barriers (BTB) resulting in edema and altered fertility. Viral disruption of JAM-A leads to activation of the RhoA GTPase, which leads to ALI. Taken together, these results define ACE/Ang II/AT1R pathway receptors and tight junctional components as potential therapeutic targets in COVID-19.
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Affiliation(s)
- Laith Ashour
- Faculty of Medicine, Al-Balqa Applied University, Al-Salt, Jordan
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18
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Bai S, Dhrolia M, Qureshi H, Qureshi R, Nasir K, Ahmad A. Comparison of COVID-19 Inactivated Virus Vaccine Immunogenicity Between Healthy Individuals and Patients on Hemodialysis: A Single-Center Study From Pakistan. Cureus 2022; 14:e24153. [PMID: 35582560 PMCID: PMC9107616 DOI: 10.7759/cureus.24153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2022] [Indexed: 11/07/2022] Open
Abstract
Introduction This study compares the immune response after coronavirus disease 2019 (COVID-19) inactivated virus vaccine between healthy individuals (HI) and patients on hemodialysis (HD). Methods In this cross-sectional, comparative study, the presence or absence of immunoglobulin G (IgG) anti-S antibody and IgG anti-S antibody titer was compared between HI, and patients on HD after two doses of COVID-19 vaccine. Results A total of 81 participants, 50 (61.7%) HD patients and 31 (38.3%) HI, were studied. The mean age was 52.9±12 in HD patients and 42±12.4 in HI. Vaccination responder rates were 80.6% in HI and 72% in HD patients after the first dose (p=0.38) and 93.5% in HI and 94% in HD at the third week of the second dose of the vaccine (p=0.93). The mean IgG antibody titer was 156.3±113.8 in HI and 143.4 ± 117.8 in HD patients (p=0.538) after the first dose and 186.7 ± 97.9 in HI and 180.6 ± 105.8 in HD patients (p=0.552) at three weeks of the second dose. No statistically significant difference was found in antibody titer with respect to gender, age, vaccine (BBIBP-CorV or Conovac), and hypertension. Diabetic HD patients had a lower antibody titer than non-diabetic HD patients (p=0.03) while participants who had a history of COVID-19 infection had a higher IgG titer (p = 0.001). The levels of IgG titer in the same patient increased, corresponding to the doses of vaccine (p <0.001). No HD patient developed COVID-19 infection till the third week of vaccination. Conclusion This study demonstrates a similar humoral response after COVID-19 inactivated virus vaccination in HD patients and HI. The response was lower among diabetic patients on HD and better in those with previous COVID-19 infection.
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McFarlane E, Linschoten M, Asselbergs FW, Lacy PS, Jedrzejewski D, Williams B. The impact of pre-existing hypertension and its treatment on outcomes in patients admitted to hospital with COVID-19. Hypertens Res 2022; 45:834-845. [PMID: 35352027 PMCID: PMC8963889 DOI: 10.1038/s41440-022-00893-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 02/22/2022] [Accepted: 02/24/2022] [Indexed: 12/30/2022]
Abstract
The impact of pre-existing hypertension on outcomes in patients with the novel corona virus (SARS-CoV-2) remains controversial. To address this, we examined the impact of pre-existing hypertension and its treatment on in-hospital mortality in patients admitted to hospital with Covid-19. Using the CAPACITY-COVID patient registry we examined the impact of pre-existing hypertension and guideline-recommended treatments for hypertension on in-hospital mortality in unadjusted and multi-variate-adjusted analyses using logistic regression. Data from 9197 hospitalised patients with Covid-19 (median age 69 [IQR 57–78] years, 60.6% male, n = 5573) was analysed. Of these, 48.3% (n = 4443) had documented pre-existing hypertension. Patients with pre-existing hypertension were older (73 vs. 62 years, p < 0.001) and had twice the occurrence of any cardiac disease (49.3 vs. 21.8%; p < 0.001) when compared to patients without hypertension. The most documented class of anti-hypertensive drugs were angiotensin receptor blockers (ARB) or angiotensin converting enzyme inhibitors (ACEi) (n = 2499, 27.2%). In-hospital mortality occurred in (n = 2020, 22.0%), with more deaths occurring in those with pre-existing hypertension (26.0 vs. 18.2%, p < 0.001). Pre-existing hypertension was associated with in-hospital mortality in unadjusted analyses (OR 1.57, 95% CI 1.42,1.74), no significant association was found following multivariable adjustment for age and other hypertension-related covariates (OR 0.97, 95% CI 0.87,1.10). Use of ACEi or ARB tended to have a protective effect for in-hospital mortality in fully adjusted models (OR 0.88, 95% CI 0.78,0.99). After appropriate adjustment for confounding, pre-existing hypertension, or treatment for hypertension, does not independently confer an increased risk of in-hospital mortality patients hospitalized with Covid-19. ![]()
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Affiliation(s)
- Ewan McFarlane
- Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, UK
| | - Marijke Linschoten
- Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Folkert W Asselbergs
- Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, UK.,Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.,National Institute for Health Research Biomedical Research Center, University College London Hospitals, London, UK.,Health Data Research United Kingdom and Institute of Health Informatics, University College London, London, UK
| | - Peter S Lacy
- Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, UK
| | - Dawid Jedrzejewski
- Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, UK
| | - Bryan Williams
- Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, UK. .,National Institute for Health Research Biomedical Research Center, University College London Hospitals, London, UK.
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20
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Tzeravini E, Stratigakos E, Siafarikas C, Tentolouris A, Tentolouris N. The Role of Diabetes and Hyperglycemia on COVID-19 Infection Course-A Narrative Review. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 3:812134. [PMID: 36992740 PMCID: PMC10012165 DOI: 10.3389/fcdhc.2022.812134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/31/2022] [Indexed: 01/08/2023]
Abstract
It was previously reported that subjects with diabetes mellitus (DM) are more vulnerable to several bacterial or viral infections. In the era of coronavirus disease 2019 (COVID-19) pandemic, it is reasonable to wonder whether DM is a risk factor for COVID-19 infection, too. It is not yet clear whether DM increases the risk for contracting COVID-19 infection or not. However, patients with DM when infected are more likely to develop severe or even fatal COVID-19 disease course than patients without DM. Certain characteristics of DM patients may also deteriorate prognosis. On the other hand, hyperglycemia per se is related to unfavorable outcomes, and the risk may be higher for COVID-19 subjects without pre-existing DM. In addition, individuals with DM may experience prolonged symptoms, need readmission, or develop complications such as mucormycosis long after recovery from COVID-19; close follow-up is hence necessary in some selected cases. We here present a narrative review of the literature in order to set light into the relationship between COVID-19 infection and DM/hyperglycemia.
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Affiliation(s)
- Evangelia Tzeravini
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | | | - Chris Siafarikas
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Anastasios Tentolouris
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Nikolaos Tentolouris
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
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21
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Bailey CJ, Gwilt M. Diabetes, Metformin and the Clinical Course of Covid-19: Outcomes, Mechanisms and Suggestions on the Therapeutic Use of Metformin. Front Pharmacol 2022; 13:784459. [PMID: 35370738 PMCID: PMC8964397 DOI: 10.3389/fphar.2022.784459] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 02/21/2022] [Indexed: 12/18/2022] Open
Abstract
Objectives: Pre-existing or new diabetes confers an adverse prognosis in people with Covid-19. We reviewed the clinical literature on clinical outcomes in metformin-treated subjects presenting with Covid-19. Methods: Structured PubMed search: metformin AND [covid (ti) OR covid-19 (ti) OR covid19 (ti) OR coronavirus (ti) OR SARS-Cov2 (ti)], supplemented with another PubMed search: "diabetes AND [covid OR covid-19 OR covid19 OR coronavirus (i) OR SARS-Cov2 (ti)]" (limited to "Clinical Study", "Clinical Trial", "Controlled Clinical Trial", "Meta-Analysis", "Observational Study", "Randomized Controlled Trial", "Systematic Review"). Results: The effects of metformin on the clinical course of Covid-19 were evaluated in retrospective analyses: most noted improved clinical outcomes amongst type 2 diabetes patients treated with metformin at the time of hospitalisation with Covid-19 infection. These outcomes include reduced admission into intensive care and reduced mortality in subgroups with versus without metformin treatment. Conclusion: The pleiotropic actions of metformin associated with lower background cardiovascular risk may mediate some of these effects, for example reductions of insulin resistance, systemic inflammation and hypercoagulability. Modulation by metformin of the cell-surface ACE2 protein (a key binding target for SARS-CoV 2 spike protein) via the AMP kinase pathway may be involved. While pre-existing metformin treatment offers potentially beneficial effects and can be continued when Covid-19 infection is not severe, reports of increased acidosis and lactic acidosis in patients with more severe Covid-19 disease remind that metformin should be withdrawn in patients with hypoxaemia or acute renal disease. Prospective study of the clinical and metabolic effects of metformin in Covid-19 is warranted.
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22
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Mahmood ZS, Fadhil HY, Abdul Hussein TA, Ad'hiah AH. Severity of coronavirus disease 19: Profile of inflammatory markers and ACE (rs4646994) and ACE2 (rs2285666) gene polymorphisms in Iraqi patients. Meta Gene 2022; 31:101014. [PMID: 35036327 PMCID: PMC8744396 DOI: 10.1016/j.mgene.2022.101014] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/07/2021] [Accepted: 01/06/2022] [Indexed: 12/27/2022] Open
Abstract
Susceptibility to coronavirus disease 2019 (COVID-19) and disease severity has recently been associated with inflammatory markers and genetic polymorphisms of ACE (angiotensin-converting enzyme) and ACE2 genes, but the evidence has been inconclusive. This case-control study (99 COVID-19 patients and 96 controls) sought to assess the significance of age, C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR) and SARS-CoV-2 RT-PCR cycle threshold (Ct) in severity of COVID-19. Besides, two variants of ACE and ACE2 genes (rs4646994 and rs2285666, respectively) were analyzed to determine their role in COVID-19 susceptibility and/or disease severity. Results revealed that age, CRP and NLR were significantly elevated in severe cases compared to moderate cases, while RT-PCR Ct value was significantly decreased. Allele and genotypes of both variants were not associated with COVID-19 risk, with the exception of rs2285666 A allele. It showed a significantly higher frequency in female patients than in female controls (probability = 0.041). In conclusion, the study indicated the role of age, CRP, NLR and SARS-CoV-2 RT-PCR Ct in susceptibility to COVID-19 severity. However, analysis of the ACE and ACE2 gene variants (rs4646994 and rs2285666, respectively) showed that the two variants were not associated with the risk of developing COVID-19.
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Affiliation(s)
- Zainab S Mahmood
- Department of Biology, College of Science, University of Baghdad, Baghdad, Iraq
| | - Hula Y Fadhil
- Department of Biology, College of Science, University of Baghdad, Baghdad, Iraq
| | | | - Ali H Ad'hiah
- Tropical-Biological Research Unit, College of Science, University of Baghdad, Baghdad, Iraq
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23
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Bepouka B, Situakibanza H, Sangare M, Mandina M, Mayasi N, Longokolo M, Odio O, Mangala D, Isekusu F, Kayembe JM, Nachega J, Mbula M. Mortality associated with COVID-19 and hypertension in sub-Saharan Africa. A systematic review and meta-analysis. J Clin Hypertens (Greenwich) 2022; 24:99-105. [PMID: 35083847 PMCID: PMC8845466 DOI: 10.1111/jch.14417] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/04/2021] [Accepted: 12/10/2021] [Indexed: 01/08/2023]
Abstract
Hypertension is a common comorbidity in COVID-19 patients. However, little data is available on mortality in COVID-19 patients with hypertension in sub-Saharan Africa (SSA). Herein, the authors conducted a systematic review of research articles published from January 1, 2020 to July 1, 2021. Our aim was to evaluate the magnitude of COVID-19 mortality in patients with hypertension in SSA. Following the PRISMA guidelines, two independent investigators conducted the literature review to collect relevant data. The authors used a random effect model to estimate the odds ratio, or hazard ratio, with a 95% confidence interval (CI). Furthermore, the authors used Egger's tests to check for publication bias. For mortality analysis, the authors included data on 29 945 COVID-19 patients from seven publications. The authors assessed the heterogeneity across studies with the I2 test. Finally, the pooled analysis revealed that hypertension was associated with an increased odds of mortality among COVID-19 inpatients (OR 1.32; 95% CI, 1.13-1.50). Our analysis revealed neither substantial heterogeneity across studies nor a publication bias. Therefore, our prespecified results provided new evidence that hypertension could increase the risk of mortality from COVID-19 in SSA.
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Affiliation(s)
- Ben Bepouka
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Democratic Republic of Congo, Kinshasa, USA
| | - Hippolyte Situakibanza
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Democratic Republic of Congo, Kinshasa, USA
| | - Modibo Sangare
- Faculty of Medicine and Odontostomatology (FMOS), University of Sciences, Techniques & Technologies of Bamako (USTTB), Bamako, Mali
| | - Madone Mandina
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Democratic Republic of Congo, Kinshasa, USA
| | - Nadine Mayasi
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Democratic Republic of Congo, Kinshasa, USA
| | - Murielle Longokolo
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Democratic Republic of Congo, Kinshasa, USA
| | - Ossam Odio
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Democratic Republic of Congo, Kinshasa, USA
| | - Donatien Mangala
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Democratic Republic of Congo, Kinshasa, USA
| | - Fiston Isekusu
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Democratic Republic of Congo, Kinshasa, USA
| | - Jean Marie Kayembe
- Pneumology Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, DRC, Kinshasa, USA
| | - Jean Nachega
- Department of Medicine, Centre for Infectious Diseases, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; and Department of Epidemiology, Infectious Diseases and Microbiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Marcel Mbula
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Democratic Republic of Congo, Kinshasa, USA
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24
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Tadic M, Cuspidi C. Resistant hypertension and COVID-19: tip of the iceberg? J Hum Hypertens 2022; 36:693-694. [PMID: 34508157 PMCID: PMC8429887 DOI: 10.1038/s41371-021-00607-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 08/24/2021] [Accepted: 09/03/2021] [Indexed: 01/08/2023]
Affiliation(s)
- Marijana Tadic
- Klinik für Innere Medizin II, Universitätsklinikum Ulm, Albert-Einstein Allee 23, 89081, Ulm, Germany.
| | - Cesare Cuspidi
- grid.7563.70000 0001 2174 1754Department of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy
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25
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Mahallawi WH, Ibrahim NA, Mumena WA. Effectiveness of COVID-19 Vaccines in Patients Under Maintenance Hemodialysis. Risk Manag Healthc Policy 2021; 14:5081-5088. [PMID: 35002344 PMCID: PMC8722686 DOI: 10.2147/rmhp.s345686] [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: 11/03/2021] [Accepted: 12/09/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Several published data on the dialysis population showed that antibody levels decreased after COVID-19 vaccinations in comparison to the overall population. We aimed to illustrate the persistence of humoral response after receiving second dose of the Pfizer or AstraZeneca vaccines in patients under maintenance hemodialysis (HD). METHODS A total of 119 adult patients on HD who were recruited from a single hemodialysis center in Madinah, Saudi Arabia. An enzyme-linked immunosorbent assay (ELISA) was utilized to measure the specific antibody response to the spike protein in the serum samples. RESULTS Mean age of patients was 48.5 ± 13.5 years, while mean time since starting the renal dialysis was 5.09 ± 5.29 years. Blood samples were collected after 89.2 ± 25.7 days of receiving the second dose of the vaccines. A very high positive correlation between anti-S IgG antibodies in pre- and post-dialysis was found (rs= 0.93, p < 0.001). Additionally, there was a high positive correlation between anti-S IgG antibody collected at baseline and follow-up blood samples (30 days apart) (rs= 0.82, p < 0.001). Moreover, patients who received Pfizer had significantly higher mean change in anti-S IgG antibodies compared to patients who received AstraZeneca (0.41 ± 0.94 vs 0.03 ± 0.30, respectively, p = 0.026). CONCLUSION The majority of the patients included in this study were able to yield an immune response to the vaccine after receiving the two doses. Persistence of IgG antibodies in the majority of the patients on HD in response to COVID-19 vaccines is encouraging in terms of continuing to vaccinate this category of patients in addition to monitoring them.
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Affiliation(s)
- Waleed H Mahallawi
- Medical Laboratory Technology Department, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | - Nadir A Ibrahim
- Medical Laboratory Technology Department, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | - Walaa A Mumena
- Department of Clinical Nutrition, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
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Sarzani R, Allevi M, Giulietti F, Di Pentima C, Re S, Giordano P, Spannella F. The Identikit of Patient at Risk for Severe COVID-19 and Death: The Dysregulation of Renin-Angiotensin System as the Common Theme. J Clin Med 2021; 10:5883. [PMID: 34945176 PMCID: PMC8704645 DOI: 10.3390/jcm10245883] [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: 11/19/2021] [Revised: 12/13/2021] [Accepted: 12/13/2021] [Indexed: 12/24/2022] Open
Abstract
Since the first months of the coronavirus disease 2019 (COVID-19) pandemic, several specific physiologic traits, such as male sex and older age, or health conditions, such as overweight/obesity, arterial hypertension, metabolic syndrome, and type 2 diabetes mellitus, have been found to be highly prevalent and associated with increased risk of adverse outcomes in hospitalized patients. All these cardiovascular morbidities are widespread in the population and often coexist, thus identifying a common patient phenotype, characterized by a hyper-activation of the "classic" renin-angiotensin system (RAS) and mediated by the binding of angiotensin II (Ang II) to the type 1-receptor. At the same time, the RAS imbalance was proved to be crucial in the genesis of lung injury after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, where angiotensin-converting-enzyme-2 (ACE2) is not only the receptor for SARS-CoV-2, but its down-regulation through internalization and shedding, caused by the virus binding, leads to a further dysregulation of RAS by reducing angiotensin 1-7 (Ang 1-7) production. This focused narrative review will discuss the main available evidence on the role played by cardiovascular and metabolic conditions in severe COVID-19, providing a possible pathophysiological link based on the disequilibrium between the two opposite arms of RAS.
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Affiliation(s)
- Riccardo Sarzani
- Internal Medicine and Geriatrics, IRCCS INRCA, Via della Montagnola 81, 60127 Ancona, Italy; (M.A.); (F.G.); (C.D.P.); (S.R.); (P.G.); (F.S.)
- Department of Clinical and Molecular Sciences, University “Politecnica delle Marche”, Via Tronto 10/a, 60126 Ancona, Italy
| | - Massimiliano Allevi
- Internal Medicine and Geriatrics, IRCCS INRCA, Via della Montagnola 81, 60127 Ancona, Italy; (M.A.); (F.G.); (C.D.P.); (S.R.); (P.G.); (F.S.)
- Department of Clinical and Molecular Sciences, University “Politecnica delle Marche”, Via Tronto 10/a, 60126 Ancona, Italy
| | - Federico Giulietti
- Internal Medicine and Geriatrics, IRCCS INRCA, Via della Montagnola 81, 60127 Ancona, Italy; (M.A.); (F.G.); (C.D.P.); (S.R.); (P.G.); (F.S.)
- Department of Clinical and Molecular Sciences, University “Politecnica delle Marche”, Via Tronto 10/a, 60126 Ancona, Italy
| | - Chiara Di Pentima
- Internal Medicine and Geriatrics, IRCCS INRCA, Via della Montagnola 81, 60127 Ancona, Italy; (M.A.); (F.G.); (C.D.P.); (S.R.); (P.G.); (F.S.)
- Department of Clinical and Molecular Sciences, University “Politecnica delle Marche”, Via Tronto 10/a, 60126 Ancona, Italy
| | - Serena Re
- Internal Medicine and Geriatrics, IRCCS INRCA, Via della Montagnola 81, 60127 Ancona, Italy; (M.A.); (F.G.); (C.D.P.); (S.R.); (P.G.); (F.S.)
- Department of Clinical and Molecular Sciences, University “Politecnica delle Marche”, Via Tronto 10/a, 60126 Ancona, Italy
| | - Piero Giordano
- Internal Medicine and Geriatrics, IRCCS INRCA, Via della Montagnola 81, 60127 Ancona, Italy; (M.A.); (F.G.); (C.D.P.); (S.R.); (P.G.); (F.S.)
| | - Francesco Spannella
- Internal Medicine and Geriatrics, IRCCS INRCA, Via della Montagnola 81, 60127 Ancona, Italy; (M.A.); (F.G.); (C.D.P.); (S.R.); (P.G.); (F.S.)
- Department of Clinical and Molecular Sciences, University “Politecnica delle Marche”, Via Tronto 10/a, 60126 Ancona, Italy
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Batiha GES, Gari A, Elshony N, Shaheen HM, Abubakar MB, Adeyemi SB, Al-kuraishy HM. Hypertension and its management in COVID-19 patients: The assorted view. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2021; 11:200121. [PMID: 34806090 PMCID: PMC8590508 DOI: 10.1016/j.ijcrp.2021.200121] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/31/2021] [Accepted: 11/12/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is suspected to mainly be more deleterious in patients with underlying cardiovascular diseases (CVD). There is a strong association between hypertension and COVID-19 severity. The binding of SARS-CoV-2 to the angiotensin-converting enzyme 2 (ACE2) leads to deregulation of the renin-angiotensin-aldosterone system (RAAS) through down-regulation of ACE2 with subsequent increment of the harmful Ang II serum levels and reduction of the protective Ang-(1-7). Both angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) are commonly used to manage hypertension. OBJECTIVE Objective was to illustrate the potential link between hypertension and COVID-19 regarding the role of angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) in hypertensive patients with COVID-19. METHODS We carried out comprehensive databases search from late December 2019 to early January 2021 by using online engines of Web of Science, Research gate, Scopus, Google Scholar, and PubMed for published and preprinted articles. RESULTS The present study's findings showed that hypertension is regarded as an independent risk factor for COVID-19 severity. Both ACEIs and ARBs are beneficial in managing hypertensive patients. CONCLUSION This study concluded that hypertension increases COVID-19 severity due to underlying endothelial dysfunctions and coagulopathy. COVID-19 might augment the hypertensive complications due to down-regulation of ACE2. The use of ACEIs or ARBs might be beneficial in the management of hypertensive patients with COVID-19.
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Affiliation(s)
- Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, 22511, AlBeheira, Egypt
| | - Abdulrahim Gari
- Department of Obstetrics & Gynecology, Faculty of Medicine, Umm-Al-Qura University, Makkah, Saudi Arabia
- Obstetrics & Gynecology Dept, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Norhan Elshony
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, 22511, AlBeheira, Egypt
| | - Hazem M. Shaheen
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, 22511, AlBeheira, Egypt
| | - Murtala Bello Abubakar
- Department of Physiology, Faculty of Basic Medical Sciences, College of Health Sciences, Usmanu Danfodiyo University, PMB 2254, Sokoto, Nigeria
- Centre for Advanced Medical Research and Training, Usmanu Danfodiyo University, PMB 2254, Sokoto, Nigeria
| | - Sherif Babatunde Adeyemi
- Department of Plant Biology, Faculty of Life Sciences, University of Ilorin, PMB 1515, Ilorin, Nigeria
- CG Bhakta Institute of Biotechnology, Uka Tarsadia University, Gopal Vidyanagar, Bardoli-Mahuva Road, Tarsadi, Surat, 394350, Gujarat, India
| | - Hayder M. Al-kuraishy
- Department of Clinical Pharmacology and Therapeutic Medicine, College of Medicine, AL-mustansiriyiah University, Baghdad, Iraq
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Barman Roy D, Gupta V, Tomar S, Gupta G, Biswas A, Ranjan P, Baitha U, Pandey S, Prakash B, Wig N. Epidemiology and Risk Factors of COVID-19-Related Mortality. Cureus 2021; 13:e20072. [PMID: 34987936 PMCID: PMC8719433 DOI: 10.7759/cureus.20072] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2021] [Indexed: 01/08/2023] Open
Abstract
Introduction During the coronavirus disease 2019 (COVID-19) pandemic in India, several characteristics of hospitalized COVID-19 patients, based on demographics, mortality predictors, and presence of comorbidities, were found to be associated with poor outcomes. The objective of this study was to identify such epidemiological and clinical characteristics among the patients admitted at a tertiary-care center in India that may have predisposed them to COVID-19-related mortality. Methods This retrospective observational study conducted at the Department of Medicine, All India Institute of Medical Sciences, New Delhi, in May 2021 included 141 COVID-19 confirmed patients. The medical history, demographic characteristics, comorbidities, clinical findings, and laboratory data of each patient were obtained. The data were analyzed to identify significant clinical and laboratory parameters that led to the adverse final outcomes. Results Hypertension was the most common comorbidity and the presence of diabetes with hypertension led to poorer final outcomes. Lower oxygen saturation and requirement of oxygen supplementation at admission along with worse prognostic scores during admission led to poorer outcomes. Twenty-seven patients needed non-invasive ventilation (NIV) during the hospital course, and all ultimately landed up among the 56 patients who were managed on invasive mechanical ventilation (IMV). Multivariate logistic regression analysis performed identified COVID-19 severity at admission, co-existence of hypertension and diabetes mellitus, systolic blood pressure less than 90 mm Hg, and serum creatinine greater than 1.2 mg/dL to be associated with higher COVID-19 mortality. Conclusion COVID-19 patients having the co-existence of diabetes and hypertension constitute a high-risk group and may be targeted by prompt vaccination strategies. The presence of severe disease along with a need for oxygen therapy and other intensive care interventions ultimately led to unfavorable outcomes.
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Figueroa-Pizano MD, Campa-Mada AC, Carvajal-Millan E, Martinez-Robinson KG, Chu AR. The underlying mechanisms for severe COVID-19 progression in people with diabetes mellitus: a critical review. AIMS Public Health 2021; 8:720-742. [PMID: 34786431 PMCID: PMC8568590 DOI: 10.3934/publichealth.2021057] [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: 08/23/2021] [Accepted: 10/20/2021] [Indexed: 01/08/2023] Open
Abstract
Diabetes mellitus (DM) has a high incidence of comorbidities among patients with severe coronavirus disease 2019 (COVID-19). The elevated prevalence of DM in the world population makes it a significant risk factor because diabetic individuals appear to be prone to clinical complications and have increased mortality rates. Here, we review the possible underlying mechanisms involved in DM that led to worse outcomes in COVID-19. The impacts of hyperglycemia side effects, secondary comorbidities, weakened innate and adaptive immunity, chronic inflammation, and poor nutritional status, commonly present in DM, are discussed. The role of the SARS-CoV-2 receptor and its polymorphic variations on higher binding affinity to facilitate viral uptake in people with DM were also considered. Clinical differences between individuals with type 1 DM and type 2 DM affected by COVID-19 and the potential diabetogenic effect of SARS-CoV-2 infection were addressed.
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Affiliation(s)
- María D Figueroa-Pizano
- Research Center for Food and Development, CIAD, AC, Carretera Gustavo Enrique Astiazarán Rosas No. 46, C.P. 83304, Hermosillo, Sonora, México
| | - Alma C Campa-Mada
- Research Center for Food and Development, CIAD, AC, Carretera Gustavo Enrique Astiazarán Rosas No. 46, C.P. 83304, Hermosillo, Sonora, México
| | - Elizabeth Carvajal-Millan
- Research Center for Food and Development, CIAD, AC, Carretera Gustavo Enrique Astiazarán Rosas No. 46, C.P. 83304, Hermosillo, Sonora, México
| | - Karla G Martinez-Robinson
- Research Center for Food and Development, CIAD, AC, Carretera Gustavo Enrique Astiazarán Rosas No. 46, C.P. 83304, Hermosillo, Sonora, México
| | - Agustin Rascon Chu
- Research Center for Food and Development, CIAD, AC, Carretera Gustavo Enrique Astiazarán Rosas No. 46, C.P. 83304, Hermosillo, Sonora, México
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Risk of hospitalization and mortality associated with uncontrolled blood pressure in patients with hypertension and COVID-19. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2021; 11:200117. [PMID: 34778888 PMCID: PMC8576055 DOI: 10.1016/j.ijcrp.2021.200117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 11/05/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The role of uncontrolled blood pressure (BP) in COVID-19 severity among patients with hypertension is unclear. We evaluated the association between uncontrolled BP and the risk of hospitalization and/or mortality in patients with hypertension from a large US integrated healthcare system. METHODS We identified patients with hypertension and a positive RT-PCR test result or a diagnosis of COVID-19 between March 1 - September 1, 2020 from Kaiser Permanente Southern California. BP categories was defined using the most recent outpatient BP measurement during 12 months prior to COVID-19 infection. The primary outcome of interest was all-cause hospitalization or mortality within 30 days from COVID-19 infection. RESULTS Among 12,548 patients with hypertension and COVID-19 (mean age = 60 years, 47% male), 63% had uncontrolled BP (≥130/80 mm Hg) prior to COVID-19. Twenty-one percent were hospitalized or died within 30 days of COVID-19 infection. Uncontrolled BP was not associated with higher hospitalization or mortality (adjusted rate ratios for BP ≥ 160/100 mm Hg vs < 130/80 mm Hg = 1.00 [95% CI: 0.87, 1.14]; BP 140-159/90-99 mm Hg vs < 130/80 mm Hg = 1.02 [95% CI: 0.93, 1.11]). These findings were consistent across different age groups, treatment for antihypertensive medications, as well as atherosclerotic cardiovascular disease risk. CONCLUSION Among patients with hypertension, uncontrolled BP prior to COVID-19 infection did not appear to be an important risk factor for 30-day mortality or hospitalization.
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Touyz RM, Boyd MO, Guzik T, Padmanabhan S, McCallum L, Delles C, Mark PB, Petrie JR, Rios F, Montezano AC, Sykes R, Berry C. Cardiovascular and Renal Risk Factors and Complications Associated With COVID-19. CJC Open 2021; 3:1257-1272. [PMID: 34151246 PMCID: PMC8205551 DOI: 10.1016/j.cjco.2021.05.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 05/28/2021] [Indexed: 01/08/2023] Open
Abstract
The current COVID-19 pandemic, caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) virus, represents the largest medical challenge in decades. It has exposed unexpected cardiovascular vulnerabilities at all stages of the disease (pre-infection, acute phase, and subsequent chronic phase). The major cardiometabolic drivers identified as having epidemiologic and mechanistic associations with COVID-19 are abnormal adiposity, dysglycemia, dyslipidemia, and hypertension. Hypertension is of particular interest, because components of the renin-angiotensin system (RAS), which are critically involved in the pathophysiology of hypertension, are also implicated in COVID-19. Specifically, angiotensin-converting enzyme-2 (ACE2), a multifunctional protein of the RAS, which is part of the protective axis of the RAS, is also the receptor through which SARS-CoV-2 enters host cells, causing viral infection. Cardiovascular and cardiometabolic comorbidities not only predispose people to COVID-19, but also are complications of SARS-CoV-2 infection. In addition, increasing evidence indicates that acute kidney injury is common in COVID-19, occurs early and in temporal association with respiratory failure, and is associated with poor prognosis, especially in the presence of cardiovascular risk factors. Here, we discuss cardiovascular and kidney disease in the context of COVID-19 and provide recent advances on putative pathophysiological mechanisms linking cardiovascular disease and COVID-19, focusing on the RAS and ACE2, as well as the immune system and inflammation. We provide up-to-date information on the relationships among hypertension, diabetes, and COVID-19 and emphasize the major cardiovascular diseases associated with COVID-19. We also briefly discuss emerging cardiovascular complications associated with long COVID-19, notably postural tachycardia syndrome (POTS).
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Affiliation(s)
- Rhian M. Touyz
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation, Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Marcus O.E. Boyd
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation, Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Tomasz Guzik
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation, Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Sandosh Padmanabhan
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation, Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Linsay McCallum
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation, Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Christian Delles
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation, Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Patrick B. Mark
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation, Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - John R. Petrie
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation, Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Francisco Rios
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation, Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Augusto C. Montezano
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation, Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Robert Sykes
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation, Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Colin Berry
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation, Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
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Nguyen NTV, Chau HN, Le NH, Nguyen HH, Nguyen HA. Impact of Novel Guidelines on Multifactorial Control and Its Association with Mortality in Adult Patients with Hypertension and Newly Diagnosed Type 2 Diabetes: A 4-Year Prospective Multicenter Study. Int J Endocrinol 2021; 2021:9977840. [PMID: 34621312 PMCID: PMC8492251 DOI: 10.1155/2021/9977840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 09/01/2021] [Indexed: 11/18/2022] Open
Abstract
METHODS This prospective, observational study involved adult hypertensive patients with newly diagnosed type 2 diabetes mellitus at two university hospitals in Vietnam. The median time of follow-up was 4 years (August 2016-August 2020). The primary outcome was time to all-cause mortality. RESULTS 246 patients were included with a mean age of 64.5 ± 10.4. 58.5% were females. 64.2% were categorized as high risk. At baseline, ischemic heart disease, dyslipidemia, and chronic kidney disease (CKD) were present in 54.9%, 67.1%, and 41.1% of patients. Renin-angiotensin-aldosterone inhibitor, metformin, and statin were prescribed in 89.8%, 66.3%, and 67.1%. Among three risk factors, LDL-c control was the hardest to achieve, increasing from 5.7% to 8.5%. In contrast, blood pressure control decreased from 56.1% in 2016 to 30.2% in 2020, when the second wave of COVID-19 hit our nation. While contemporary targets resulted in persistently low simultaneous control at 1.2%, significant improvement was observed with conventional criteria (blood pressure < 140/90 mmHg, HbA1c < 7%, LDL-c < 70 mg/dl), increasing from 14.6% to 33.7%. During follow-up, the mortality rate was 24.4 events per 1000 patient-years, exclusively in patients with early newly diagnosed diabetes. Improving control overtime, not at baseline, was associated with less mortality. Conversely, age >75 years (HR = 2.6) and CKD (HR = 4.9) were associated with increased mortality. CONCLUSION These findings demonstrated real-world difficulties in managing hypertension and newly diagnosed diabetes, especially with stringent criteria from novel guidelines. High-risk profile, high mortality, and poor simultaneous control warrant more aggressive cardiorenal protection, focusing more on aging CKD patients with early newly diagnosed diabetes.
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Affiliation(s)
- Ngoc-Thanh-Van Nguyen
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700 000, Vietnam
- Cardiology Department, Nhan Dan Gia Dinh Hospital, Ho Chi Minh City 700 000, Vietnam
- Outpatient Department, University Medical Center, Ho Chi Minh City 700 000, Vietnam
| | - Hoa Ngoc Chau
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700 000, Vietnam
- Cardiology Department, Nhan Dan Gia Dinh Hospital, Ho Chi Minh City 700 000, Vietnam
- Outpatient Department, University Medical Center, Ho Chi Minh City 700 000, Vietnam
| | - Nam Hoai Le
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700 000, Vietnam
- Outpatient Department, University Medical Center, Ho Chi Minh City 700 000, Vietnam
| | - Hai Hoang Nguyen
- Cardiology Department, Nhan Dan Gia Dinh Hospital, Ho Chi Minh City 700 000, Vietnam
| | - Hoai-An Nguyen
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700 000, Vietnam
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Xu J, Xiao W, Liang X, Shi L, Zhang P, Wang Y, Wang Y, Yang H. A meta-analysis on the risk factors adjusted association between cardiovascular disease and COVID-19 severity. BMC Public Health 2021; 21:1533. [PMID: 34380456 PMCID: PMC8355578 DOI: 10.1186/s12889-021-11051-w] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 05/12/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Cardiovascular disease (CVD), one of the most common comorbidities of coronavirus disease 2019 (COVID-19), has been suspected to be associated with adverse outcomes in COVID-19 patients, but their correlation remains controversial. METHOD This is a quantitative meta-analysis on the basis of adjusted effect estimates. PubMed, Web of Science, MedRxiv, Scopus, Elsevier ScienceDirect, Cochrane Library and EMBASE were searched comprehensively to obtain a complete data source up to January 7, 2021. Pooled effects (hazard ratio (HR), odds ratio (OR)) and the 95% confidence intervals (CIs) were estimated to evaluate the risk of the adverse outcomes in COVID-19 patients with CVD. Heterogeneity was assessed by Cochran's Q-statistic, I2test, and meta-regression. In addition, we also provided the prediction interval, which was helpful for assessing whether the variation across studies was clinically significant. The robustness of the results was evaluated by sensitivity analysis. Publication bias was assessed by Begg's test, Egger's test, and trim-and-fill method. RESULT Our results revealed that COVID-19 patients with pre-existing CVD tended more to adverse outcomes on the basis of 203 eligible studies with 24,032,712 cases (pooled ORs = 1.41, 95% CIs: 1.32-1.51, prediction interval: 0.84-2.39; pooled HRs = 1.34, 95% CIs: 1.23-1.46, prediction interval: 0.82-2.21). Further subgroup analyses stratified by age, the proportion of males, study design, disease types, sample size, region and disease outcomes also showed that pre-existing CVD was significantly associated with adverse outcomes among COVID-19 patients. CONCLUSION Our findings demonstrated that pre-existing CVD was an independent risk factor associated with adverse outcomes among COVID-19 patients.
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Affiliation(s)
- Jie Xu
- Department of Epidemiology, School of Public Health, Zhengzhou University, No. 100 of Science Avenue, Zhengzhou, 450001, China
| | - Wenwei Xiao
- Department of Epidemiology, School of Public Health, Zhengzhou University, No. 100 of Science Avenue, Zhengzhou, 450001, China
| | - Xuan Liang
- Department of Epidemiology, School of Public Health, Zhengzhou University, No. 100 of Science Avenue, Zhengzhou, 450001, China
| | - Li Shi
- Department of Epidemiology, School of Public Health, Zhengzhou University, No. 100 of Science Avenue, Zhengzhou, 450001, China
| | - Peihua Zhang
- Department of Epidemiology, School of Public Health, Zhengzhou University, No. 100 of Science Avenue, Zhengzhou, 450001, China
| | - Ying Wang
- Department of Epidemiology, School of Public Health, Zhengzhou University, No. 100 of Science Avenue, Zhengzhou, 450001, China
| | - Yadong Wang
- Department of Toxicology, Henan Center for Disease Control and Prevention, Zhengzhou, 450016, China
| | - Haiyan Yang
- Department of Epidemiology, School of Public Health, Zhengzhou University, No. 100 of Science Avenue, Zhengzhou, 450001, China.
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Haymana C, Demirci I, Tasci I, Cakal E, Salman S, Ertugrul D, Ata N, Unluturk U, Dagdelen S, Atmaca A, Sahin M, Celik O, Demir T, Emral R, Sahin I, Caglayan M, Satman I, Sonmez A. Clinical outcomes of non-diabetic COVID-19 patients with different blood glucose levels: a nationwide Turkish study (TurCoGlycemia). Endocrine 2021; 73:261-269. [PMID: 34156609 PMCID: PMC8218282 DOI: 10.1007/s12020-021-02789-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 06/03/2021] [Indexed: 01/08/2023]
Abstract
PURPOSE New coronavirus disease 2019 (COVID-19) has a worse prognosis in patients with diabetes. However, there are insufficient data about the effect of hyperglycemia on COVID-19 prognosis in non-diabetic patients. This study aimed to investigate the relationship between random blood glucose levels measured at the time of diagnosis and prognosis of COVID-19 disease in non-diabetic patients. METHODS A nationwide retrospective cohort of non-diabetic patients with confirmed COVID-19 infection from 11 March to 30 May 2020 in the Turkish Ministry of Health database was investigated. The patients were stratified into three groups according to blood glucose levels which were <100 mg/dL in group-1, in the range of 100-139 mg/dl in group-2, and the range of 140-199 mg/dl in group-3. Clinical characteristics and outcomes were compared among the groups. The primary outcome was mortality. RESULTS A total of 12,817 non-diabetic patients (median age [IQR]: 44 [25] years, females: 50.9%) were included. Patients in group-2 (5%) and group-3 (14%) had higher mortality rates than patients in group-1 (2.1%). The rates of hospitalization, hospital stays longer than 8 days, intensive care unit (ICU) admission, ICU stay more than 6 days, and mechanical ventilation were also significantly higher in group-3 patients. Likewise, glucose levels in the range of 140-199 mg/dL were an independent associate of mortality and composite of ICU admission and/or mechanical ventilation. CONCLUSION Hyperglycemia at the time of COVID-19 diagnosis is associated with poor prognosis in non-diabetic patients. Clinicians should be more careful in the treatment of non-diabetic COVID-19 patients with hyperglycemia.
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Affiliation(s)
- Cem Haymana
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Gulhane Training and Research Hospital, Ankara, Turkey.
| | - Ibrahim Demirci
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Ilker Tasci
- Department of Internal Medicine, University of Health Sciences Turkey, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Ankara, Turkey
| | - Erman Cakal
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Faculty of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Serpil Salman
- Department of Endocrinology and Metabolism, Medica Clinic, Istanbul, Turkey
| | - Derun Ertugrul
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Faculty of Medicine, Kecioren Training and Research Hospital, Ankara, Turkey
| | - Naim Ata
- Department of Strategy Development, Republic of Turkey, Ministry of Health, Ankara, Turkey
| | - Ugur Unluturk
- Department of Endocrinology and Metabolism, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Selcuk Dagdelen
- Department of Endocrinology and Metabolism, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Aysegul Atmaca
- Department of Endocrinology and Metabolism, Samsun 19 Mayis University, Faculty of Medicine, Samsun, Turkey
| | - Mustafa Sahin
- Department of Endocrinology and Metabolism, Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Osman Celik
- Public Hospitals General Directorate, Republic of Turkey, Ministry of Health, Ankara, Turkey
| | - Tevfik Demir
- Department of Endocrinology and Metabolism, Dokuz Eylul University, Faculty of Medicine, Ankara, Turkey
| | - Rifat Emral
- Department of Endocrinology and Metabolism, Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Ibrahim Sahin
- Department of Endocrinology and Metabolism, Malatya Inonu University, Faculty of Medicine, Malatya, Turkey
| | | | - Ilhan Satman
- Department of Endocrinology and Metabolism, Istanbul University, Faculty of Medicine, Istanbul, Turkey
- Turkish Institute of Public Health and Chronic Diseases, Istanbul, Turkey
| | - Alper Sonmez
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Ankara, Turkey
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Sanlialp SC, Sanlialp M. Impact of Hypertension on the Prognosis of COVID-19 Disease and Uncertainties that Need to be Clarified. Angiology 2021; 73:485-486. [PMID: 34261339 PMCID: PMC8968412 DOI: 10.1177/00033197211032784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Sara Cetin Sanlialp
- The Department of Cardiology, 430817Servergazi State Hospital, Denizli, Turkey
| | - Musa Sanlialp
- The Department of Cardiology, 558907Denizli State Hospital, Denizli, Turkey
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Burhamah W, Qahi I, Oroszlányová M, Shuaibi S, Alhunaidi R, Alduwailah M, Alhenaidi M, Mohammad Z. Prognostic Factors and Predictors of In-Hospital Mortality Among COVID-19 Patients Admitted to the Intensive Care Unit: An Aid for Triage, Counseling, and Resource Allocation. Cureus 2021; 13:e16577. [PMID: 34322358 PMCID: PMC8299433 DOI: 10.7759/cureus.16577] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains today a global health pandemic. Those with severe infection are at risk of rapid clinical deterioration; as a result, intensive care unit (ICU) admission is not uncommon in such patients. A number of determinants have been identified as predictors of poor prognosis and in-hospital mortality, ranging from demographic characteristics, laboratory and/or radiological findings. AIM To identify determinants of in-hospital mortality and examine the accuracy of seven early warning scores in predicting in-hospital mortality. METHODS This is a retrospective study conducted in Kuwait from July 2020 to March 2021, and participants were adult patients with a positive test on the real-time polymerase chain reaction (RT-PCR) for SARS-CoV-2 and who met the criteria for ICU admission. Data collected included: demographics, clinical status on hospital arrival, laboratory test results, and ICU course. Furthermore, we calculated seven early warning scores for each of our patients. RESULTS A total of 133 patients were admitted to our COVID-19 ICU with a median age of 59 years. Arrival to ICU on mechanical ventilation (MV), developing in-hospital complications, having chronic kidney disease (CKD), having a high white blood count (WBC), lactate dehydrogenase (LDH), lactate, or urea levels were found to be significant predictors of in-hospital mortality. Furthermore, the 4C mortality score for COVID-19, VACO index for COVID-19 mortality, and the PRIEST COVID-19 clinical severity score proved to be the most superior in predicting in-hospital mortality. CONCLUSION Identifying high-risk patients and those with a poor prognosis allows for efficient triaging and the delivery of high-standard care while minimizing the strain on the healthcare system.
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Affiliation(s)
- Waleed Burhamah
- School of Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Iman Qahi
- Department of General Surgery, Mubarak AlKabeer Hospital, Kuwait, KWT
| | - Melinda Oroszlányová
- College of Engineering and Technology, American University of the Middle East, Kuwait, KWT
| | - Sameera Shuaibi
- Department of Internal Medicine, Al-Adan Hospital, Kuwait, KWT
| | - Razan Alhunaidi
- Department of Internal Medicine, Kuwait University, Health Sciences Center, School of Medicine, Kuwait, KWT
| | - May Alduwailah
- Department of Internal Medicine, Kuwait University, Health Sciences Center, School of Medicine, Kuwait, KWT
| | - Maryam Alhenaidi
- Department of Internal Medicine, Kuwait University, Health Sciences Center, School of Medicine, Kuwait, KWT
| | - Zahraa Mohammad
- Department of Internal Medicine, Kuwait University, Health Sciences Center, School of Medicine, Kuwait, KWT
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Handayani DR, Juliastuti H, Nawangsih EN, Kusmala YY, Rakhmat II, Wibowo A, Pranata R. Prognostic value of fasting hyperglycemia in patients with COVID-19 - Diagnostic test accuracy meta-analysis. ACTA ACUST UNITED AC 2021; 23:100333. [PMID: 33842733 PMCID: PMC8019489 DOI: 10.1016/j.obmed.2021.100333] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 03/23/2021] [Accepted: 03/29/2021] [Indexed: 02/06/2023]
Abstract
Aims This meta-analysis aimed to assess the prognostic value of fasting hyperglycemia in patients with COVID-19. Methods A systematic literature search on PubMed, Embase, and Scopus were performed up until February 18, 2021. Fasting hyperglycemia was defined as fasting plasma glucose level above the reference value. The outcome of interest was poor outcome, which was a composite of mortality and severe COVID-19. The effect estimate was in odds ratio (OR). Results There were 9045 patients from 12 studies included in this systematic review and meta-analysis. The prevalence of fasting hyperglycemia was 29%. The incidence of poor outcome was 15%. Fasting hyperglycemia was associated with poor outcome in COVID-19 (OR 4.72 [3.32, 6.72], p < 0.001; I2: 69.8%, p < 0.001). Subgroup analysis in patients without prior history of diabetes showed that fasting hyperglycemia was associated with poor outcome in COVID-19 (OR 3.387 [2.433, 4.714], p < 0.001; I2: 0, p = 0.90). Fasting hyperglycemia has a sensitivity of 0.57 [0.45, 0.68], specificity of 0.78 [0.70, 0.84], PLR of 2.6 [2.0, 3.3], NLR of 0.55 [0.44, 0.69], DOR of 5 [3, 7], and AUC of 0.74 [0.70, 0.78] for predicting poor outcome. In this pooled analysis, fasting hyperglycemia has a 32% post-test probability for poor outcome, and absence of fasting hyperglycemia confers to a 9% post-test probability. Meta-regression and subgroup analysis showed that the sensitivity and specificity varies by chronic kidney disease but not by age, male (gender), hypertension, and chronic kidney disease. Conclusion Fasting hyperglycemia was associated with mortality in COVID-19 patients, with or without diabetes. Prospero CRD42021237997.
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Affiliation(s)
- Dewi Ratih Handayani
- Department of Biochemistry, Faculty of Medicine, Universitas Jenderal Achmad Yani, Cimahi, Indonesia
| | - Henny Juliastuti
- Department of Biochemistry, Faculty of Medicine, Universitas Jenderal Achmad Yani, Cimahi, Indonesia
| | - Eka Noneng Nawangsih
- Department of Microbiology, Faculty of Medicine, Universitas Jenderal Achmad Yani, Cimahi, Indonesia
| | - Yudith Yunia Kusmala
- Department of Internal Medicine, Faculty of Medicine, Universitas Jenderal Achmad Yani, Cimahi, Indonesia
| | - Iis Inayati Rakhmat
- Department of Biochemistry, Faculty of Medicine, Universitas Jenderal Achmad Yani, Cimahi, Indonesia
| | - Arief Wibowo
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Padjadjaran, Rumah Sakit Umum Pusat Hasan Sadikin, Bandung, Indonesia
| | - Raymond Pranata
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Padjadjaran, Rumah Sakit Umum Pusat Hasan Sadikin, Bandung, Indonesia.,Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia
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Satman I, Demirci I, Haymana C, Tasci I, Salman S, Ata N, Dagdelen S, Sahin I, Emral R, Cakal E, Atmaca A, Sahin M, Celik O, Demir T, Ertugrul D, Unluturk U, Arga KY, Caglayan M, Sonmez A. Unexpectedly lower mortality rates in COVID-19 patients with and without type 2 diabetes in Istanbul. Diabetes Res Clin Pract 2021; 174:108753. [PMID: 33741352 PMCID: PMC7963521 DOI: 10.1016/j.diabres.2021.108753] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 02/18/2021] [Accepted: 03/08/2021] [Indexed: 01/08/2023]
Abstract
AIMS Type 2 diabetes mellitus (T2DM) is a risk factor for severe COVID-19. Our aim was to compare the clinical outcomes of patients with and without T2DM during the first hit of COVID-19 in Istanbul. METHODS A retrospective population-based study was conducted including all consecutive adult symptomatic COVID-19 cases. Patients were confirmed with rt-PCR; treated and monitored in accordance with standard protocols. The primary endpoints were hospitalization and 30-day mortality. RESULTS Of the 93,571 patients, 22.6% had T2DM, with older age and higher BMI. Propensity Score matched evaluation resulted in significantly higher rates of hospitalization (1.5-fold), 30-day mortality (1.6-fold), and pneumonia (1.4-fold). They revealed more severe laboratory deviations, comorbidities, and frequent drug usage than the Non-DM group. In T2DM age, pneumonia, hypertension, obesity, and insulin-based therapies were associated with an increased likelihood of hospitalization; whereas age, male gender, lymphopenia, obesity, and insulin treatment were considerably associated with higher odds of death. CONCLUSIONS COVID-19 patients with T2DM had worse clinical outcomes with higher hospitalization and 30-day mortality rates than those without diabetes. Compared to most territories of the world, COVID-19 mortality was much lower in Istanbul, which may be associated with accessible healthcare provision and the younger structure of the population.
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Affiliation(s)
- Ilhan Satman
- Istanbul University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul, Turkey; The Health Institutes of Turkey, Institute of Public Health and Chronic Diseases, Istanbul, Turkey.
| | - Ibrahim Demirci
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Cem Haymana
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Ilker Tasci
- University of Health Sciences, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Internal Medicine, Ankara, Turkey.
| | - Serpil Salman
- Medica Clinic, Endocrinology and Metabolism, Istanbul, Turkey.
| | - Naim Ata
- Department of Strategy Development, Ministry of Health, Ankara, Turkey.
| | - Selcuk Dagdelen
- Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Ibrahim Sahin
- Inonu University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Malatya, Turkey.
| | - Rifat Emral
- Ankara University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Erman Cakal
- University of Health Sciences, Faculty of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Aysegul Atmaca
- Ondokuz Mayis University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Samsun, Turkey.
| | - Mustafa Sahin
- Ankara University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Osman Celik
- Public Hospitals General Directorate, Republic of Turkey, Ministry of Health, Ankara, Turkey.
| | - Tevfik Demir
- Dokuz Eylul University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Derun Ertugrul
- University of Health Sciences, Faculty of Medicine, Kecioren Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Ugur Unluturk
- Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Kazim Yalcin Arga
- The Health Institutes of Turkey, Institute of Public Health and Chronic Diseases, Istanbul, Turkey; Marmara University, Faculty of Engineering, Department of Bioengineering, Istanbul, Turkey.
| | | | - Alper Sonmez
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey; University of Health Sciences, Gulhane Faculty of Medicine and Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
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Tadic M, Saeed S, Grassi G, Taddei S, Mancia G, Cuspidi C. Hypertension and COVID-19: Ongoing Controversies. Front Cardiovasc Med 2021; 8:639222. [PMID: 33681308 PMCID: PMC7925389 DOI: 10.3389/fcvm.2021.639222] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/06/2021] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has become a worldwide pandemic responsible for millions of deaths around the world. Hypertension has been identified as one of the most common comorbidities and risk factors for severity and adverse outcome in these patients. Recent investigations have raised the question whether hypertension represents a predictor of outcome in COVID-19 patients independently of other common comorbidities such as diabetes, obesity, other cardiovascular diseases, chronic kidney, liver, and pulmonary diseases. However, the impact of chronic and newly diagnosed hypertension in COVID-19 patients has been insufficiently investigated. The same is true for the relationship between blood pressure levels and outcomes in COVID-19 patients. It seems that the long discussion about the impact of angiotensin-converting enzyme inhibitors (ACEI) and blockers of angiotensin I receptors (ARB) on severity and outcome in COVID-19 is approaching an end because the large number of original studies and meta-analyses discarded the initial findings about higher prevalence of ACEI/ARB use in patients with unfavorable outcomes. Nevertheless, there are many controversies in the relationship between hypertension and COVID-19. The aim of this review article is to provide a clinical overview of the currently available evidence regarding the predictive value of hypertension, the effect of blood pressure levels, the impact of previously known and newly diagnosed hypertension, and the effect of antihypertensive therapy on the severity and outcomes in COVID-19 patients.
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Affiliation(s)
- Marijana Tadic
- Department of Cardiology, University Hospital “Dr. Dragisa Misovic - Dedinje”, Belgrade, Serbia
| | - Sahrai Saeed
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Guido Grassi
- Department of Cardiology, University of Milan-Bicocca, Milan, Italy
| | - Stefano Taddei
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giuseppe Mancia
- University of Milano-Bicocca, Milano and Policlinico di Monza, Monza, Italy
| | - Cesare Cuspidi
- Department of Cardiology, University of Milan-Bicocca, Milan, Italy
- Department of Cardiology, Istituto Auxologico Italiano, Scientific Institute for Research, Hospitalization and Healthcare, Milan, Italy
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Salazar MR. Is hypertension without any other comorbidities an independent predictor for COVID-19 severity and mortality? J Clin Hypertens (Greenwich) 2020; 23:232-234. [PMID: 33368990 PMCID: PMC8029681 DOI: 10.1111/jch.14144] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 12/09/2020] [Accepted: 12/10/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Martin R Salazar
- Facultad de Ciencias Médicas, Universidad Nacional de La Plata (UNLP), La Plata, Argentina.,Hospital San Martín, La Plata, Argentina.,Sociedad Argentina de Hipertensión Arterial (SAHA), La Plata, Argentina
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Tadic M, Cuspidi C. The influence of diabetes and hypertension on outcome in COVID-19 patients: Do we mix apples and oranges? J Clin Hypertens (Greenwich) 2020; 23:235-237. [PMID: 33369012 PMCID: PMC8029782 DOI: 10.1111/jch.14145] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 11/27/2020] [Accepted: 11/29/2020] [Indexed: 01/26/2023]
Affiliation(s)
- Marijana Tadic
- University Hospital "Dr. Dragisa Misovic-Dedinje" Department of Cardiology, Belgrade, Serbia
| | - Cesare Cuspidi
- University of Milan-Bicocca, Milan, Italy.,Istituto Auxologico Italiano, IRCCS, Milano, Italy
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