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Gururangan K, Peschansky VJ, Van Hyfte G, Agarwal P, Blank LJ, Mathew B, Goldstein J, Kwon CS, McCarthy L, Cohen A, Chan AHW, Deng P, Dhamoon M, Gutzwiller E, Hao Q, He C, Klenofsky B, Lemus HN, Marcuse L, Navis A, Heredia Nunez WD, Luckey MN, Schorr EM, Singh A, Tantillo GB, Ufongene C, Young JJ, Balchandani P, Festa JR, Naasan G, Charney AW, Nadkarni GN, Jetté N. Neuropsychiatric complications of coronavirus disease 2019: Mount Sinai Health System cohort study. J Neurol 2024:10.1007/s00415-024-12370-9. [PMID: 38656620 DOI: 10.1007/s00415-024-12370-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 03/29/2024] [Accepted: 04/03/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE To describe the frequency of neuropsychiatric complications among hospitalized patients with coronavirus disease 2019 (COVID-19) and their association with pre-existing comorbidities and clinical outcomes. METHODS We retrospectively identified all patients hospitalized with COVID-19 within a large multicenter New York City health system between March 15, 2020 and May 17, 2021 and randomly selected a representative cohort for detailed chart review. Clinical data, including the occurrence of neuropsychiatric complications (categorized as either altered mental status [AMS] or other neuropsychiatric complications) and in-hospital mortality, were extracted using an electronic medical record database and individual chart review. Associations between neuropsychiatric complications, comorbidities, laboratory findings, and in-hospital mortality were assessed using multivariate logistic regression. RESULTS Our study cohort consisted of 974 patients, the majority were admitted during the first wave of the pandemic. Patients were treated with anticoagulation (88.4%), glucocorticoids (24.8%), and remdesivir (10.5%); 18.6% experienced severe COVID-19 pneumonia (evidenced by ventilator requirement). Neuropsychiatric complications occurred in 58.8% of patients; 39.8% experienced AMS; and 19.0% experienced at least one other complication (seizures in 1.4%, ischemic stroke in 1.6%, hemorrhagic stroke in 1.0%) or symptom (headache in 11.4%, anxiety in 6.8%, ataxia in 6.3%). Higher odds of mortality, which occurred in 22.0%, were associated with AMS, ventilator support, increasing age, and higher serum inflammatory marker levels. Anticoagulant therapy was associated with lower odds of mortality and AMS. CONCLUSION Neuropsychiatric complications of COVID-19, especially AMS, were common, varied, and associated with in-hospital mortality in a diverse multicenter cohort at an epicenter of the COVID-19 pandemic.
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Affiliation(s)
- Kapil Gururangan
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Veronica J Peschansky
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Grace Van Hyfte
- Department of Population Health Science and Policy, Institute of Health Care Delivery Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Parul Agarwal
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Science and Policy, Institute of Health Care Delivery Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Leah J Blank
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Science and Policy, Institute of Health Care Delivery Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brian Mathew
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jonathan Goldstein
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Churl-Su Kwon
- Departments of Neurosurgery, Neurology, Epidemiology, and the Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
| | - Louise McCarthy
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ariella Cohen
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Andy Ho Wing Chan
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Pojen Deng
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mandip Dhamoon
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Eveline Gutzwiller
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Qing Hao
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Celestine He
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Britany Klenofsky
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Hernan Nicolas Lemus
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lara Marcuse
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Allison Navis
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Mallory N Luckey
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Emily M Schorr
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Anuradha Singh
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Gabriela B Tantillo
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | - Claire Ufongene
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - James J Young
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Priti Balchandani
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joanne R Festa
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Barbara and Maurice Deane Center for Wellness and Cognitive Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Georges Naasan
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Barbara and Maurice Deane Center for Wellness and Cognitive Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alexander W Charney
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Girish N Nadkarni
- Division of Data Driven and Digital Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nathalie Jetté
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Population Health Science and Policy, Institute of Health Care Delivery Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, 1403 29 Street NW, Calgary, AB, T2N 2T9, Canada.
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Lin C, Li M, Lin Y, Zhang Y, Xu H, Chen B, Yan X, Xu Y. Impact of plasma Epstein-Barr virus DNA in posttreatment nasopharyngeal carcinoma patients after SARS-CoV-2 infection. Infect Agent Cancer 2024; 19:8. [PMID: 38486290 PMCID: PMC10938826 DOI: 10.1186/s13027-024-00570-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/01/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Nasopharyngeal carcinoma (NPC) is prevalent in southern China. EBV DNA is the most useful biomarker in NPC. However, the value of EBV DNA in posttreatment NPC patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains unclear. METHODS Sixty-four eligible NPC patients were enrolled between December 2022 and February 2023. Patients who met the following criteria were included: had non-metastatic NPC, completed radical treatment, were first firstly infected with SARS-CoV-2 and their EBV DNA changed from undetectable to detectable. RESULTS At the end of follow-up, 81.25% (52/64) of patients were confirmed not to relapse with undetectable EBV DNA (no-relapse). In addition, 18.75% (12/64) of patients experienced relapse with consistent detection of EBV DNA (yes-relapse). For all 64 patients, the average time from diagnosis of coronavirus disease 2019 (COVID-19) to detection of detectable EBV DNA was 35.41 days (2 to 139 days). For 52 no-relapse patients, the average time from EBV DNA changing from detectable to undetectable was 63.12 days (6 to 147 days). The levels of EBV DNA were greater in yes-relapse patients than that in no-relapse patients, and the average of EBV DNA levels were 1216 copies/ml and 53.18 copies/ml, respectively. Using 62.3 copies/mL as the threshold, the area under the curve for EBV DNA was 0.88 for distinguishing yes-relapse patients from no-relapse patients. The sensitivity and specificity were 81.97% (95% CI 0.71-0.95) and 86.67% (95% CI 0.70-0.95), respectively. CONCLUSION For NPC patients infected with SARS-CoV-2, EBV DNA alone is insufficient for monitoring relapse after radical therapy. Long-term follow-up and underlying mechanistic investigations of EBV DNA changes are urgently needed.
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Affiliation(s)
- Cheng Lin
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
- Interdisciplinary College of Medicine and Engineering, Fuzhou University, Fuzhou, Fujian, China
| | - Meifang Li
- Department of Medical Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Yingying Lin
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Yu Zhang
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Hanchuan Xu
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Bijuan Chen
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Xia Yan
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Yun Xu
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China.
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Wang S, Zhu R, Zhang C, Guo Y, Lv M, Zhang C, Bian C, Jiang R, Zhou W, Guo L. Effects of the pre-existing coronary heart disease on the prognosis of COVID-19 patients: A systematic review and meta-analysis. PLoS One 2023; 18:e0292021. [PMID: 37815980 PMCID: PMC10564240 DOI: 10.1371/journal.pone.0292021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 09/11/2023] [Indexed: 10/12/2023] Open
Abstract
Although studies have shown severe Coronavirus disease 2019 (COVID-19) outcomes in patients with pre-existing coronary heart disease (CHD), the prognosis of COVID-19 patients with pre-existing CHD remains uncertain primarily due to the limited number of patients in existing studies. This study aimed to investigate the impacts of pre-existing CHD on the prognosis of COVID-19 patients. Five electronic databases were searched for eligible studies. This article focused on cohort and case-control studies involving the prognosis of COVID-19 patients with pre-existing CHD. The meta-analysis was performed using a random effects model. The odds ratios (ORs) and 95% confidence intervals (CIs) were used as valid indicators. The study was registered in PROSPERO with the identifier: CRD42022352853. A total of 81 studies, involving 157,439 COVID-19 patients, were included. The results showed that COVID-19 patients with pre-existing CHD exhibited an elevated risk of mortality (OR = 2.45; 95%CI: [2.04, 2.94], P < 0.001), severe/critical COVID-19 (OR = 2.57; 95%CI: [1.98, 3.33], P < 0.001), Intensive Care Unit or Coronary Care Unit (ICU/CCU) admission: (OR = 2.75, 95%CI: [1.61, 4.72], P = 0.002), and reduced odds of discharge/recovery (OR = 0.43, 95%CI: [0.28, 0.66], P < 0.001) compared to COVID-19 patients without pre-existing CHD. Subgroup analyses indicated that the prognosis of COVID-19 patients with pre-existing CHD was influenced by publication year, follow-up duration, gender, and hypertension. In conclusion, pre-existing CHD significantly increases the risk of poor prognosis in patients with COVID-19, particularly in those male or hypertensive patients.
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Affiliation(s)
- Saikun Wang
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Ruiting Zhu
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Chengwei Zhang
- Department of Anesthesiology, The Second Hospital of Jilin University, Changchun, Jilin, China
| | - Yingze Guo
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Mengjiao Lv
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Changyue Zhang
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Ce Bian
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Ruixue Jiang
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Wei Zhou
- The First Hospital of Jilin University, Changchun, Jilin, China
| | - Lirong Guo
- School of Nursing, Jilin University, Changchun, Jilin, China
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Cáceres Ramírez C, Lora Mantilla AJ, Parra Gómez LA, Ortegón Vargas V, Posso Paz M, Flórez Esparza V, Gómez Lahitton E, Villabona Flórez SJ, Rocha Lezama MC, Camacho López PA. General Hospitalization and Intensive Care Unit-Related Factors of COVID-19 Patients in Northeastern Colombia: Baseline Characteristics of a Cohort Study. Cureus 2023; 15:e43888. [PMID: 37746500 PMCID: PMC10515459 DOI: 10.7759/cureus.43888] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Objective This study aims to describe demographic and clinical characteristics and the factors associated with the risk of COVID-19 general hospitalization and intensive care unit (ICU) care of patients who consulted in a third-level hospital in Santander, Colombia. Methods We used baseline data from an ambidirectional cohort study. We included all patients with positive real-time polymerase chain reaction (PCR) tests for COVID-19 who came to the emergency room (ER) for respiratory symptoms related to COVID-19. Information regarding patients' baseline characteristics and symptoms was collected through telephone interviews and review of medical records. Vital signs were extracted from medical records as well. Results We enrolled 3,030 patients, predominantly men, with a median age of 60 (interquartile range (IQR): 44-73). Symptoms of the acute phase varied between men and women. Men presented with more respiratory symptoms, and women had general symptoms. Hypertension, obesity, and diabetes were common risk factors for hospital admission. Antibiotic consumption may also play a role in hospital admission. Conclusions Male sex, older age, hypertension, obesity, prior thrombotic events, and self-medicated antibiotics were associated with general hospitalization. Hypertension, obesity, diabetes, and cancer were associated with ICU admission. The Charlson comorbidity index (CCI) is a powerful tool for evaluate the impact of pre-existing health conditions on COVID-19 hospital admission. We highlight the importance of these findings as possible predictors in our region.
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Affiliation(s)
- Catalina Cáceres Ramírez
- Research, Development, and Technological Innovation Department, Fundación Oftalmológica de Santander, Floridablanca, COL
| | - Alvaro José Lora Mantilla
- Research, Development, and Technological Innovation Department, Fundación Oftalmológica de Santander, Floridablanca, COL
| | - Laura Alejandra Parra Gómez
- Research, Development, and Technological Innovation Department, Fundación Oftalmológica de Santander, Floridablanca, COL
| | - Valentina Ortegón Vargas
- Research, Development, and Technological Innovation Department, Fundación Oftalmológica de Santander, Floridablanca, COL
| | - Mariam Posso Paz
- Research, Development, and Technological Innovation Department, Fundación Oftalmológica de Santander, Floridablanca, COL
| | - Valeria Flórez Esparza
- Research, Development, and Technological Innovation Department, Fundación Oftalmológica de Santander, Floridablanca, COL
| | - Edgar Gómez Lahitton
- Research, Development, and Technological Innovation Department, Fundación Oftalmológica de Santander, Floridablanca, COL
| | | | - Maria Catalina Rocha Lezama
- Research, Development, and Technological Innovation Department, Fundación Oftalmológica de Santander, Floridablanca, COL
| | - Paul Anthony Camacho López
- Research, Development, and Technological Innovation Department, Fundación Oftalmológica de Santander, Floridablanca, COL
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Yang Y, Lu Y, Jiang B. Population-weighted exposure to green spaces tied to lower COVID-19 mortality rates: A nationwide dose-response study in the USA. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 851:158333. [PMID: 36041607 PMCID: PMC9420198 DOI: 10.1016/j.scitotenv.2022.158333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/23/2022] [Accepted: 08/23/2022] [Indexed: 05/29/2023]
Abstract
The COVID-19 pandemic has caused a huge loss of human life globally. However, few studies investigated the link between exposure to green space and risk of COVID-19 mortality rate, while also distinguishing the effects of various types of green space, considering the spatial distribution of human population and green space, and identifying the optimal buffer distances of nearby green space. It is critical and pressing to fill these significant knowledge gaps to protect and promote billions of people's health and life across the world. This study adopted a negative binomial generalized linear mixed-effects model to examine the association between the ratios of various types of green space, population-weighted exposure to those various types of green space, and COVID-19 mortality rates across 3025 counties in the USA, adjusted for sociodemographic, pre-existing chronic disease, policy and regulation, behavioral, and environmental factors. The findings show that greater exposure to forest was associated with lower COVID-19 mortality rates, while developed open space had mixed associations with COVID-19 mortality rates. Forest outside park had the largest effect size across all buffer distances, followed by forest inside park. The optimal exposure buffer distance was 1 km for forest outside park, with per one-unit of increase in exposure associated with a 9.9 % decrease in COVID-19 mortality rates (95 % confidence interval (CI): 6.9 %-12.8 %). The optimal exposure buffer distance of forest inside park was 400 m, with per one-unit of increase in exposure associated with a 4.7 % decrease in mortality rates (95 % CI: 2.4 %-6.9 %). The results suggest that greater exposure to green spaces, especially to nearby forests, may mitigate the risk of COVID-19 mortality. Although findings of an ecological study cannot be directly used to guide medical interventions, this study may pave a critical new way for future research and practice across multiple disciplines.
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Affiliation(s)
- Yuwen Yang
- Urban Environments and Human Health Lab, HKUrbanLabs, Faculty of Architecture, The University of Hong Kong, Hong Kong SAR; Division of Landscape Architecture, Department of Architecture, The University of Hong Kong, Hong Kong SAR
| | - Yi Lu
- Department of Architecture and Civil Engineering, College of Engineering, City University of Hong Kong, Hong Kong SAR
| | - Bin Jiang
- Urban Environments and Human Health Lab, HKUrbanLabs, Faculty of Architecture, The University of Hong Kong, Hong Kong SAR; Division of Landscape Architecture, Department of Architecture, The University of Hong Kong, Hong Kong SAR.
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Khongthaw B, Dulta K, Chauhan PK, Kumar V, Ighalo JO. Lycopene: a therapeutic strategy against coronavirus disease 19 (COVID- 19). Inflammopharmacology 2022; 30:1955-1976. [PMID: 36050507 PMCID: PMC9436159 DOI: 10.1007/s10787-022-01061-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/18/2022] [Indexed: 02/07/2023]
Abstract
Lycopene is a group of phytochemicals found in nature, primarily in fruits and vegetables. Lycopene is thought to protect against a variety of diseases attributed to its antioxidant capabilities. Lycopene has anti-inflammatory, anti-cancer, and immunity-boosting qualities, among other biological and pharmacological benefits. COVID-19 (coronavirus disease 19) is an infectious disease caused by the SARS-CoV-2 virus, which has recently emerged as one of the world's leading causes of death. Patients may be asymptomatic or show signs of respiratory, cytokine release syndrome, gastrointestinal, or even multiple organ failure, all of which can lead to death. In COVID-19, inflammation, and cytokine storm are the key pathogenic mechanisms, according to SARS-CoV-2 infection symptoms. ARDS develops in some vulnerable hosts, which is accompanied by an inflammatory "cytokine syndrome" that causes lung damage. Immunological and inflammatory markers were linked to disease severity in mild and severe COVID-19 cases, implying that inflammatory markers, including IL-6, CRP, ESR, and PCT were significantly linked with COVID-19 severity. Patients with severe illness have reduced levels of several immune subsets, including CD4 + T, NK, and CD8 + cells. As a result, lycopene can be commended for bolstering physiological defenses against COVID-19 infections.
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Affiliation(s)
- Banlambhabok Khongthaw
- Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, 173229, India
| | - Kanika Dulta
- Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, 173229, India
| | - Pankaj Kumar Chauhan
- Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, 173229, India.
| | - Vinod Kumar
- Department of Life Sciences, Graphic Era (Deemed to be University), Dehradun, Uttarakhand, 248002, India
| | - Joshua O Ighalo
- Department of Chemical Engineering, Nnamdi Azikiwe University, P. M. B. 5025, Awka, Nigeria.
- Department of Chemical Engineering, Kansas State University, Manhattan, KS, USA.
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Lambert B, Stopard IJ, Momeni-Boroujeni A, Mendoza R, Zuretti A. Using patient biomarker time series to determine mortality risk in hospitalised COVID-19 patients: A comparative analysis across two New York hospitals. PLoS One 2022; 17:e0272442. [PMID: 35981055 PMCID: PMC9387798 DOI: 10.1371/journal.pone.0272442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 07/19/2022] [Indexed: 01/08/2023] Open
Abstract
A large range of prognostic models for determining the risk of COVID-19 patient mortality exist, but these typically restrict the set of biomarkers considered to measurements available at patient admission. Additionally, many of these models are trained and tested on patient cohorts from a single hospital, raising questions about the generalisability of results. We used a Bayesian Markov model to analyse time series data of biomarker measurements taken throughout the duration of a COVID-19 patient’s hospitalisation for n = 1540 patients from two hospitals in New York: State University of New York (SUNY) Downstate Health Sciences University and Maimonides Medical Center. Our main focus was to quantify the mortality risk associated with both static (e.g. demographic and patient history variables) and dynamic factors (e.g. changes in biomarkers) throughout hospitalisation, by so doing, to explain the observed patterns of mortality. By using our model to make predictions across the hospitals, we assessed how predictive factors generalised between the two cohorts. The individual dynamics of the measurements and their associated mortality risk were remarkably consistent across the hospitals. The model accuracy in predicting patient outcome (death or discharge) was 72.3% (predicting SUNY; posterior median accuracy) and 71.3% (predicting Maimonides) respectively. Model sensitivity was higher for detecting patients who would go on to be discharged (78.7%) versus those who died (61.8%). Our results indicate the utility of including dynamic clinical measurements when assessing patient mortality risk but also highlight the difficulty of identifying high risk patients.
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Affiliation(s)
- Ben Lambert
- Department of Computer Science, University of Oxford, Oxford, Oxfordshire, United Kingdom
- Department of Mathematics, College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, United Kingdom
- * E-mail:
| | - Isaac J. Stopard
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Amir Momeni-Boroujeni
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - Rachelle Mendoza
- Department of Pathology, SUNY Downstate Health Sciences University, Brooklyn, NY, United States of America
| | - Alejandro Zuretti
- Department of Pathology, SUNY Downstate Health Sciences University and Maimonides Medical Center, Brooklyn, NY, United States of America
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Hehar J, Todter E, Lahiri SW. Association of Patient Characteristics, Diabetes, BMI, and Obesity With Severe COVID-19 in Metropolitan Detroit, MI. Clin Diabetes 2022; 40:141-152. [PMID: 35669303 PMCID: PMC9160544 DOI: 10.2337/cd21-0065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Identification of specific risk factors for severe coronavirus disease 2019 (COVID-19) is crucial for prevention of poor outcomes and mortality. This retrospective cohort study of patients hospitalized with COVID-19 demonstrated that older age, male sex, Black race, diabetes, elevated BMI, and elevated inflammatory markers were correlated with critical illness in COVID-19. Older age, male sex, diabetes, and inflammatory markers, but not elevated BMI, were associated with mortality. Despite having greater odds of critical illness, Black patients had lower odds of death than White patients. Older age, male sex, diabetes, and elevated inflammatory markers were significantly associated with venous thromboembolism. These findings suggest a need to aggressively identify and manage modifiable risk factors (i.e., diabetes and elevated BMI) and encourage vaccination of at-risk individuals to prevent poor outcomes from COVID-19.
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Affiliation(s)
- Jaspreet Hehar
- Department of Internal Medicine, Division of Endocrinology, Diabetes, Bone and Mineral Disorders, Henry Ford Health System, Detroit, MI
| | - Erika Todter
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI
| | - Sharon W. Lahiri
- Department of Internal Medicine, Division of Endocrinology, Diabetes, Bone and Mineral Disorders, Henry Ford Health System, Detroit, MI
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Ming W, Zuo J, Han J, Chen J. The impact of comorbid allergic airway disease on the severity and mortality of COVID-19: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2022; 279:1675-1690. [PMID: 34519838 PMCID: PMC8438912 DOI: 10.1007/s00405-021-07072-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/05/2021] [Indexed: 12/29/2022]
Abstract
PURPOSE To analyze the impact of AAD on the severity and mortality of COVID-19 patients and compare clinical outcomes between patients with and without AAD. METHODS In the systematic review and meta-analysis, we searched PubMed, Embase, Web of Science for studies reporting allergic rhinitis, asthma prevalence in COVID-19 patients and compared clinical outcomes, and excluded duplicate publications, reviews, comments, single or few cases reports (< 100 cases). We determined the pooled effect estimates using random effect model. RESULTS Thirty-four studies (345,091) were finally included for the meta-analysis. On the basis of 32 studies (337,821) involving with the severity of COVID-19, we did not find significant association between AAD and the severity of COVID-19 (p = 0.35, OR 1.10, 95% CI 0.90-1.35). Subgroup analysis indicated there was no the variability in the prevalence of AAD among COVID-19 patients in different study designs, disease categories, countries, the definition of severity, and population size of AAD. Based on 21 studies (306,331) involving with the mortality of COVID-19, AAD was significantly associated with the decreased mortality of COVID-19 (p < 0.05, OR 0.83, 95% CI 0.70-0.99). The subgroup analysis showed AAD was not associated with the mortality of COVID-19 in different countries or regions. Based on the population size of AAD, we found AAD within 100 cases was not associated with the mortality of COVID-19 (p = 0.63, OR 1.15, 95% CI 0.65-2.03). Moreover, study design was possible heterogeneity source as the heterogeneity I2 was reduced to 0 in prospective studies. CONCLUSION The preexisting AAD was not inclined to deteriorate the course of COVID-19. The prevalence of AAD was not associated with the severity of COVD-19 patients and inclined to be significantly associated with the decreased mortality risk of COVID-19.
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Affiliation(s)
- Wei Ming
- Department of Otolaryngology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, China.
| | - Jingjing Zuo
- Department of Otolaryngology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, China
| | - Jibo Han
- Department of Otolaryngology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, China
| | - Jinhui Chen
- Department of Otolaryngology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, China
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10
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Pérez MJF, Carbonell FB, Sanchis MÁN, Argudo SC, González AM, de Enterría Ramos IG, Candelaria Ayuso Raya M, Rabadán FE. Factores asociados con una evolución desfavorable en pacientes diagnosticados de COVID-19 y seguidos en atención primaria en 2020. Aten Primaria 2022; 54:102372. [PMID: 35777137 PMCID: PMC9050582 DOI: 10.1016/j.aprim.2022.102372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 12/15/2022] Open
Abstract
Objetivo Conocer los factores asociados con una evolución desfavorable (ED) de pacientes diagnosticados de COVID-19 con seguimiento total o parcial en atención primaria. Diseño Serie de casos. Emplazamiento Centro de salud urbano. Participantes Pacientes de 18 o más años diagnosticados de COVID-19, con confirmación analítica, en 2020 y seguidos por sus médicos de familia, seleccionados por muestreo sistemático. Mediciones principales Variable dependiente: ingreso en hospital o fallecimiento por COVID-19. Variables independientes: edad, sexo, antecedentes personales, y datos clínicos y de tratamiento relacionados con la enfermedad. Análisis estadístico, con SPSS 25.0: estadística descriptiva, comparación de proporciones (X2) y medianas (U de Mann-Whitney). Se completó el análisis con regresión logística. Resultados Se incluyeron en el estudio 610 pacientes, cuya mediana de edad era de 49 años (rango intercuartiles: 35-61); 51,8% eran mujeres. Presentaron ED 14,9% (IC 95%: 12,0-17,8). Las variables sociodemográficas o relacionadas con antecedentes personales que mostraron una asociación independiente con una ED fueron edad (OR: 1,066; IC 95%:1,038-1,095), sexo (OR para hombre: 3,277; IC 95%: 1,304-8,235) y ser fumador o exfumador (OR: 2,565; IC 95%: 1,135-5,800). En cuanto a variables clínicas propias de la enfermedad, esa asociación se encontró para alteración de la conciencia (OR: 62,829; IC 95%: 9,177-430,149), disnea (OR: 14,339; IC 95%:6,046-34,009), expectoración (OR: 4,764; IC 95%: 1,858-12,213) y astenia (OR: 3,993; IC 95%: 1,705-9,351). Conclusiones Presentaron una ED 14,9% de los pacientes diagnosticados de COVID-19. Una mayor edad, el sexo masculino y ser fumador o exfumador aumentaban la probabilidad de ED. Los datos clínicos que mejor predecían la ED fueron alteración de la conciencia, disnea, expectoración y astenia.
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11
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Childhood obesity and risk of SARS-CoV-2 infection. Int J Obes (Lond) 2022; 46:1155-1159. [PMID: 35173279 PMCID: PMC8853122 DOI: 10.1038/s41366-022-01094-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 01/28/2022] [Accepted: 02/03/2022] [Indexed: 11/26/2022]
Abstract
Objective To estimate the association between childhood obesity and the risk of SARS-CoV-2 infection in a cohort followed from 4 to 12 years of age. Methods The data were obtained from two independent sources: the Longitudinal Childhood Obesity Study (ELOIN) and the epidemiological surveillance system data from the Community of Madrid (Spain), which served to identify the population within the cohort with confirmed SARS-CoV-2 infection. The SARS-CoV-2 registry was cross-checked with the cohort population at 11–12 years of age. A total of 2018 eligible participants were identified in the cohort, who underwent physical examinations at 4, 6, and 9 years of age during which weight, height, and waist circumference were recorded. General obesity (GO) was determined according to the WHO-2007 criteria whereas abdominal obesity (AO) was defined based on the International Diabetes Federation (IDF) criteria. The relative risks (RRs) of infection were estimated using a Poisson regression model and adjusted by sociodemographic variables, physical activity, and perceived health reported by the parents. Results The accumulated incidence of SARS-CoV-2 infection was 8.6% (95% CI: 7.3–9.8). The estimated RR of SARS-CoV-2 infection was 2.53 (95% CI: 1.56–4.10) and 2.56 (95% CI: 1.55–4.21) for children 4–9 years old with stable GO and AO, respectively, compared with those who did not present GO. Conclusions Childhood obesity is an independent risk factor for SARS-CoV-2 infection. This study provides new evidence that indicates that obesity increases the vulnerability of the paediatric population to infectious diseases.
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12
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Abdolahi N, Norouzi A, Golsha R, Khodabakhshi B, Sohrabi A, Gharib MH, Khandashpoor M, Tavassoli S, Peivandi B, Fazel A, Isapanah Amlashi F, Livani S, Roshandel G, Besharat S, Shirzad-Aski H. Clinical Presentations of the Survivor and Non-survivor Hospitalized Patients with COVID-19 in the Golestan Province of Iran during the First Peak of the Epidemics. TANAFFOS 2022; 21:146-153. [PMID: 36879730 PMCID: PMC9985124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 09/28/2021] [Indexed: 03/08/2023]
Abstract
Background Considering the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, which causes coronavirus disease 2019 (COVID-19), we aimed to report the clinical features of 427 patients with COVID-19 and the outcomes after one-month admission to major teaching hospitals in the northeast of Iran. Materials and Methods Data of patients hospitalized with COVID-19 from 20 February 2020 to 20 April 2020 was analyzed using the R software. The cases and their outcomes were monitored up to one month following their admission. Results Among 427 patients with a median age of 53 years (50.8% male), 81 (19%) were directly admitted to the ICU ward, and 68 (16%) died during the study. The mean (SD) lengths of hospital stay were significantly higher in the non-survivors (6 (9) days) than survivors (4 (5) days) (P = 0.018). Ventilation need was reported in 67.6% of the non-survivors and 0.8% of the survivors (P < 0.001). Cough (72.8%), fever (69.3%), and dyspnea (64.0%) were the most common symptoms. There were more comorbidities in the severe cases (73.5%) and non-survivor (77.5%). Liver and kidney damage were significantly more common in non-survivors. Ninety percent of the patients had at least one abnormal chest CT scan finding, including crazy paving and consolidation patterns (27.1%), followed by the ground-glass opacity (24.7%). Conclusion Results showed that the patients' age, underlying comorbidities, levels of SpO2, and laboratory findings at the time of admission may predict the progress of the disease and can be considered mortality-related factors.
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Affiliation(s)
- Nafiseh Abdolahi
- Golestan Rheumatology Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Alireza Norouzi
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Roghieh Golsha
- Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Behnaz Khodabakhshi
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran.,Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Ahmad Sohrabi
- Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran.,Cancer Control Research Center, Cancer Control Foundation, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hadi Gharib
- Golestan Rheumatology Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mahmoud Khandashpoor
- Clinical Research Development Unit (CRDU), Sayad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran
| | - Samane Tavassoli
- Golestan Rheumatology Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Babak Peivandi
- Clinical Research Development Unit (CRDU), Sayad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran
| | - Abdolreza Fazel
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran.,Clinical Research Development Unit (CRDU), 5th Azar Hospital, Golestan University of Medical Sciences, Gorgan, Iran
| | - Fazel Isapanah Amlashi
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Somayeh Livani
- Clinical Research Development Unit (CRDU), Sayad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Sima Besharat
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran.,Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran.,Clinical Research Development Unit (CRDU), Sayad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran
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13
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Gawish R, Starkl P, Pimenov L, Hladik A, Lakovits K, Oberndorfer F, Cronin SJF, Ohradanova-Repic A, Wirnsberger G, Agerer B, Endler L, Capraz T, Perthold JW, Cikes D, Koglgruber R, Hagelkruys A, Montserrat N, Mirazimi A, Boon L, Stockinger H, Bergthaler A, Oostenbrink C, Penninger JM, Knapp S. ACE2 is the critical in vivo receptor for SARS-CoV-2 in a novel COVID-19 mouse model with TNF- and IFNγ-driven immunopathology. eLife 2022; 11:e74623. [PMID: 35023830 PMCID: PMC8776253 DOI: 10.7554/elife.74623] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/22/2021] [Indexed: 11/27/2022] Open
Abstract
Despite tremendous progress in the understanding of COVID-19, mechanistic insight into immunological, disease-driving factors remains limited. We generated maVie16, a mouse-adapted SARS-CoV-2, by serial passaging of a human isolate. In silico modeling revealed how only three Spike mutations of maVie16 enhanced interaction with murine ACE2. maVie16 induced profound pathology in BALB/c and C57BL/6 mice, and the resulting mouse COVID-19 (mCOVID-19) replicated critical aspects of human disease, including early lymphopenia, pulmonary immune cell infiltration, pneumonia, and specific adaptive immunity. Inhibition of the proinflammatory cytokines IFNγ and TNF substantially reduced immunopathology. Importantly, genetic ACE2-deficiency completely prevented mCOVID-19 development. Finally, inhalation therapy with recombinant ACE2 fully protected mice from mCOVID-19, revealing a novel and efficient treatment. Thus, we here present maVie16 as a new tool to model COVID-19 for the discovery of new therapies and show that disease severity is determined by cytokine-driven immunopathology and critically dependent on ACE2 in vivo.
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Affiliation(s)
- Riem Gawish
- Laboratory of Infection Biology, Department of Medicine I, Medical University of ViennaViennaAustria
| | - Philipp Starkl
- Laboratory of Infection Biology, Department of Medicine I, Medical University of ViennaViennaAustria
| | - Lisabeth Pimenov
- Laboratory of Infection Biology, Department of Medicine I, Medical University of ViennaViennaAustria
| | - Anastasiya Hladik
- Laboratory of Infection Biology, Department of Medicine I, Medical University of ViennaViennaAustria
| | - Karin Lakovits
- Laboratory of Infection Biology, Department of Medicine I, Medical University of ViennaViennaAustria
| | | | - Shane JF Cronin
- Institute of Molecular Biotechnology of the Austrian Academy of SciencesViennaAustria
| | - Anna Ohradanova-Repic
- Molecular Immunology Unit, Institute for Hygiene and Applied Immunology, Center for Pathophysiology, Infectiology and Immunology, Medical University of ViennaViennaAustria
| | | | - Benedikt Agerer
- CeMM, Research Center for Molecular Medicine of the Austrian Academy of SciencesViennaAustria
| | - Lukas Endler
- CeMM, Research Center for Molecular Medicine of the Austrian Academy of SciencesViennaAustria
| | - Tümay Capraz
- Institute of Molecular Modeling and Simulation, Department of Material Sciences and Process Engineering, University of Natural Resources and Life SciencesViennaAustria
| | - Jan W Perthold
- Institute of Molecular Modeling and Simulation, Department of Material Sciences and Process Engineering, University of Natural Resources and Life SciencesViennaAustria
| | - Domagoj Cikes
- Institute of Molecular Biotechnology of the Austrian Academy of SciencesViennaAustria
| | - Rubina Koglgruber
- Institute of Molecular Biotechnology of the Austrian Academy of SciencesViennaAustria
| | - Astrid Hagelkruys
- Institute of Molecular Biotechnology of the Austrian Academy of SciencesViennaAustria
| | - Nuria Montserrat
- Pluripotency for Organ Regeneration, Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Technology (BIST), Catalan Institution for Research and Advanced Studies (ICREA)BarcelonaSpain
- Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y NanomedicinaMadridSpain
| | - Ali Mirazimi
- Karolinska Institute and Karolinska University Hospital, Department of Laboratory Medicine, Unit of Clinical MicrobiologyStockholmSweden
- National Veterinary InstituteUppsalaSweden
| | | | - Hannes Stockinger
- Molecular Immunology Unit, Institute for Hygiene and Applied Immunology, Center for Pathophysiology, Infectiology and Immunology, Medical University of ViennaViennaAustria
| | - Andreas Bergthaler
- CeMM, Research Center for Molecular Medicine of the Austrian Academy of SciencesViennaAustria
| | - Chris Oostenbrink
- Institute of Molecular Modeling and Simulation, Department of Material Sciences and Process Engineering, University of Natural Resources and Life SciencesViennaAustria
| | - Josef M Penninger
- Institute of Molecular Biotechnology of the Austrian Academy of SciencesViennaAustria
- Department of Medical Genetics, Life Sciences Institute, University of British ColumbiaVancouverCanada
| | - Sylvia Knapp
- Laboratory of Infection Biology, Department of Medicine I, Medical University of ViennaViennaAustria
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14
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Wanhella KJ, Fernandez-Patron C. Biomarkers of ageing and frailty may predict COVID-19 severity. Ageing Res Rev 2022; 73:101513. [PMID: 34838734 PMCID: PMC8611822 DOI: 10.1016/j.arr.2021.101513] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/11/2021] [Accepted: 11/09/2021] [Indexed: 01/08/2023]
Abstract
Coronavirus Disease 2019 (COVID-19) is caused by the novel coronavirus, Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) - the culprit of an ongoing pandemic responsible for the loss of over 3 million lives worldwide within a year and a half. While the majority of SARS-CoV-2 infected people develop no or mild symptoms, some become severely ill and may die from COVID-19-related complications. In this review, we compile and comment on a number of biomarkers that have been identified and are expected to enhance the detection, protection and treatment of individuals at high risk of developing severe illnesses, as well as enable the monitoring of COVID-19 prognosis and responsiveness to therapeutic interventions. Consistent with the emerging notion that the majority of COVID-19 deaths occur in older and frail individuals, we researched the scientific literature and report the identification of a subset of COVID-19 biomarkers indicative of increased vulnerability to developing severe COVID-19 in older and frail patients. Mechanistically, increased frailty results from reduced disease tolerance, a phenomenon aggravated by ageing and comorbidities. While biomarkers of ageing and frailty may predict COVID-19 severity, biomarkers of disease tolerance may predict resistance to COVID-19 with socio-economic factors such as access to adequate health care remaining as major non-biomolecular influencers of COVID-19 outcomes.
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15
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Wang L, Yang LM, Pei SF, Chong YZ, Guo Y, Gao XL, Tang QY, Li Y, Feng FM. CRP, SAA, LDH, and DD predict poor prognosis of coronavirus disease (COVID-19): a meta-analysis from 7739 patients. Scandinavian Journal of Clinical and Laboratory Investigation 2021; 81:679-686. [PMID: 34762008 DOI: 10.1080/00365513.2021.2000635] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Understanding factors associated with disease severity and mortality from coronavirus disease (COVID-19) was critical for effective risk stratification. We aimed to investigate the association between biomarkers of clinical laboratory tests, including serum C-reactive protein (CRP), serum amyloid protein (SAA), lactate dehydrogenase (LDH), and D-dimer (DD) and poor prognosis of COVID-19. We have searched many studies on COVID-19 on PubMed (Medline), Web of Science and Cochrane until 1 March 2021. The interest of this study was original articles reporting on laboratory testing projects and outcome of patients with COVID-19 that comprises mortality, acute respiratory distress syndrome (ARDS), need for care in an intensive care unit (ICU), and severe COVID-19. After synthesizing all data, we performed meta-analysis of random effects, and determined mean difference (MD) and standard mean difference at the biomarker level for different disease severity. A total of 7,739 patients with COVID-19 were pooled from 32 studies. CRP was significantly associated with poor prognosis of COVID-19 (SMD = 0.98, 95% CI = (0.85, 1.11), p < .001). Elevated SAA was associated with an increased composite poor outcome in COVID-19 (SMD = 1.06, 95% CI = (0.39, 1.72), p = .002). An elevated LDH was associated with a composite poor outcome (SMD = 1.18, 95% CI = (1.00, 1.36), p < .001). Patients with a composite poor outcome had a higher DD level (SMD = 0.91, 95% CI = (0.79, 1.02), p < .001). This meta-analysis showed that elevated serum CRP, SAA, LDH, and DD were associated with a poor outcome in COVID-19.
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Affiliation(s)
- Lin Wang
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Lu Ming Yang
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Sheng Fei Pei
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Ying Zhi Chong
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Yu Guo
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Xue Lei Gao
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Qin Yan Tang
- School of Life Science, North China University of Science and Technology, Tangshan, China
| | - Yue Li
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Fu Min Feng
- School of Public Health, North China University of Science and Technology, Tangshan, China.,School of Life Science, North China University of Science and Technology, Tangshan, China
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16
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Sitanggang JS, Siregar KB, Sitanggang HH, Sprinse Vinolina N. Prevalence and characteristics of cancer patients with COVID-19: a meta-analysis study. F1000Res 2021; 10:975. [PMID: 36051540 PMCID: PMC9382154 DOI: 10.12688/f1000research.53539.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/09/2021] [Indexed: 09/17/2023] Open
Abstract
Background: Cancer patients are considered susceptible to coronavirus disease (COVID-19) due to an immunosuppressive state. This study determined the prevalence of cancer in COVID-19 patients, severe events, case fatality rate, history of anticancer therapy associated with severe events, and type of cancer in cancer patients with COVID-19 in the world. Methods: This study used a meta-analysis study approach, sourcing studies from various countries related to cancer and COVID-19. Inclusion and exclusion criteria were established to select studies. A PRISMA flowchart was presented to assess the selection process. Data from inclusion studies were analyzed using Review Manager 5.4. Results: The prevalence of cancer in COVID-19 patients was 4.63% (95% CI, 3.78-5.49%) worldwide. The lowest prevalence was the Asian study group with 2.36% (95% CI, 1.86-2.87%) and the highest prevalence was the European study group with 10.93% (95% CI, 6.62-15.24%). About 43.26% (95% CI, 34.71-51.80%) of cancer patients with COVID-19 experienced severe events of COVID-19. In total, 58.13% (95% CI, 42.79-73.48%) of cancer patients with COVID-19 who in the last month had a history of anticancer therapy experienced severe events. The prevalence of lung cancer in cancer patients with COVID-19 was 20.23% (95% CI, 7.67-32.78%). Forest plots are also presented related to the results of meta-analysis research. Conclusions: High prevalence of cancer among COVID-19 patients indicates the susceptibility of cancer patients to SARS-CoV-2 infection. Cancer in COVID-19 patients and use of anticancer therapy increase severe events of COVID-19.
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Affiliation(s)
| | - Kamal B. Siregar
- Department of Surgery, Oncology Subdivision, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Henry H. Sitanggang
- Department of Surgery, Head and Neck Oncology Subdivision, Faculty of Medicine, Deli Serdang Hospital, Deli Serdang, Indonesia
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17
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Shin JJ, Jeon S, Unlu S, Par-Young J, Shin MS, Kuster JK, Afinogenova Y, Kang Y, Simonov M, Buller G, Bucala R, Kang I. A distinct association of inflammatory molecules with outcomes of COVID-19 in younger versus older adults. Clin Immunol 2021; 232:108857. [PMID: 34560283 PMCID: PMC8455237 DOI: 10.1016/j.clim.2021.108857] [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] [Received: 07/08/2021] [Revised: 08/16/2021] [Accepted: 09/15/2021] [Indexed: 12/19/2022]
Abstract
Aging can alter immunity affecting host defense. COVID-19 has the most devastating clinical outcomes in older adults, raising the implication of immune aging in determining its severity and mortality. We investigated biological predictors for clinical outcomes in a dataset of 13,642 ambulatory and hospitalized adult COVID-19 patients, including younger (age < 65, n = 566) and older (age ≥ 65, n = 717) subjects, with in-depth analyses of inflammatory molecules, cytokines and comorbidities. Disease severity and mortality in younger and older adults were associated with discrete immune mechanisms, including predominant T cell activation in younger adults, as measured by increased soluble IL-2 receptor alpha, and increased IL-10 in older adults although both groups also had shared inflammatory processes, including acute phase reactants, contributing to clinical outcomes. These observations suggest that progression to severe disease and death in COVID-19 may proceed by different immunologic mechanisms in younger versus older subjects and introduce the possibility of age-based immune directed therapies.
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Affiliation(s)
- Junghee J Shin
- Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Sangchoon Jeon
- Yale University School of Nursing, West Haven, CT 06516, USA
| | - Serhan Unlu
- Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Jennefer Par-Young
- Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Min Sun Shin
- Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - John K Kuster
- Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Yuliya Afinogenova
- Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Yumi Kang
- Department of Internal Medicine, Bridgeport Hospital - Yale New Haven Health, Bridgeport, CT 06610, United States of America
| | - Michael Simonov
- Clinical and Translational Research Accelerator (CTRA), Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Gregory Buller
- Department of Internal Medicine, Bridgeport Hospital - Yale New Haven Health, Bridgeport, CT 06610, United States of America
| | - Richard Bucala
- Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Insoo Kang
- Section of Rheumatology, Allergy & Immunology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA.
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Hausfater P, Charles PE. Le dosage de la procalcitonine peut-il être utile à la prise en charge d’une infection à SARS-CoV-2 aux urgences et en réanimation ? ANNALES FRANCAISES DE MEDECINE D URGENCE 2021. [DOI: 10.3166/afmu-2021-0341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
De nombreuses études d’impact ont validé l’intérêt du dosage de la procalcitonine pour rationaliser les antibiothérapies dans les infections respiratoires basses. En l’absence d’étude prospective interventionnelle spécifiquement chez les patients atteints de Covid-19, le dosage de la procalcitonine peut cependant être utilisé aux urgences comme dans les autres IRB pour l’aide à la décision d’antibiothérapie. La majorité des infections à SARS-CoV-2 non compliquées ont des valeurs de procalcitonine inférieures à 0,25 μg/l. Parallèlement, des concentrations supérieures à 0,5 μg/l peuvent traduire un risque d’évolution vers une forme grave et/ou une co-infection bactérienne. En soins critiques, la procalcitonine est prometteuse chez les patients avec un syndrome de détresse respiratoire aiguë lié à la Covid. Chez ces patients, la pertinence de l’antibiothérapie est à reconsidérer quotidiennement, compte tenu du risque d’infection bactérienne qui évolue tout au long de séjours souvent prolongés, afin de réduire la sélection d’espèces résistantes et de limiter les toxicités.
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19
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Risk Factors for Death Among Hospitalized Patients Aged 21-64 Years Diagnosed with COVID-19-New York City, March 13-April 9, 2020. J Racial Ethn Health Disparities 2021; 9:1584-1599. [PMID: 34374031 PMCID: PMC8352553 DOI: 10.1007/s40615-021-01098-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/14/2021] [Accepted: 06/28/2021] [Indexed: 02/06/2023]
Abstract
Background COVID-19 mortality studies have primarily focused on persons aged ≥ 65 years; less is known about decedents aged <65 years. Methods We conducted a case-control study among NYC residents aged 21–64 years hospitalized with COVID-19 diagnosed March 13–April 9, 2020, to determine risk factors for death. Case-patients (n=343) were hospitalized decedents with COVID-19 and control-patients (n=686) were discharged from hospitalization with COVID-19 and matched 2:1 to case-patients on age and residential neighborhood. Conditional logistic regression models were adjusted for patient sex, insurance status, and marital status. Matched adjusted odds ratios (aORs) were calculated for selected underlying conditions, combinations of conditions, and race/ethnic group. Results Median age of both case-patients and control-patients was 56 years (range: 23–64 years). Having ≥ 1 selected underlying condition increased odds of death 4.45-fold (95% CI: 2.33–8.49). Patients with diabetes; morbid obesity; heart, kidney, or lung disease; cancer; neurologic/neurodevelopmental conditions; mental health conditions; or HIV had significantly increased odds of death. Compared with having neither condition, having both diabetes and obesity or diabetes and heart disease was associated with approximately threefold odds of death. Five select underlying conditions were more prevalent among non-Hispanic Black control-patients than among control-patients of other races/ethnicities. Conclusions and Relevance Selected underlying conditions were risk factors for death, and most prevalent among racial/ethnic minorities. Social services; health care resources, including vaccination; and tailored public health messaging are important for COVID-19 prevention. Strengthening these strategies for racial/ethnic minority groups could minimize COVID-19 racial/ethnic disparities.
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Thorne LG, Reuschl A, Zuliani‐Alvarez L, Whelan MVX, Turner J, Noursadeghi M, Jolly C, Towers GJ. SARS-CoV-2 sensing by RIG-I and MDA5 links epithelial infection to macrophage inflammation. EMBO J 2021; 40:e107826. [PMID: 34101213 PMCID: PMC8209947 DOI: 10.15252/embj.2021107826] [Citation(s) in RCA: 123] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/24/2021] [Accepted: 05/28/2021] [Indexed: 12/25/2022] Open
Abstract
SARS-CoV-2 infection causes broad-spectrum immunopathological disease, exacerbated by inflammatory co-morbidities. A better understanding of mechanisms underpinning virus-associated inflammation is required to develop effective therapeutics. Here, we discover that SARS-CoV-2 replicates rapidly in lung epithelial cells despite triggering a robust innate immune response through the activation of cytoplasmic RNA sensors RIG-I and MDA5. The inflammatory mediators produced during epithelial cell infection can stimulate primary human macrophages to enhance cytokine production and drive cellular activation. Critically, this can be limited by abrogating RNA sensing or by inhibiting downstream signalling pathways. SARS-CoV-2 further exacerbates the local inflammatory environment when macrophages or epithelial cells are primed with exogenous inflammatory stimuli. We propose that RNA sensing of SARS-CoV-2 in lung epithelium is a key driver of inflammation, the extent of which is influenced by the inflammatory state of the local environment, and that specific inhibition of innate immune pathways may beneficially mitigate inflammation-associated COVID-19.
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Affiliation(s)
- Lucy G Thorne
- Division of Infection and ImmunityUniversity College LondonLondonUK
| | | | | | | | - Jane Turner
- Division of Infection and ImmunityUniversity College LondonLondonUK
| | | | - Clare Jolly
- Division of Infection and ImmunityUniversity College LondonLondonUK
| | - Greg J Towers
- Division of Infection and ImmunityUniversity College LondonLondonUK
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21
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Thorne LG, Reuschl AK, Zuliani-Alvarez L, Whelan MVX, Turner J, Noursadeghi M, Jolly C, Towers GJ. SARS-CoV-2 sensing by RIG-I and MDA5 links epithelial infection to macrophage inflammation. EMBO J 2021; 40:e107826. [PMID: 34101213 DOI: 10.1101/2020.12.23.424169] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/24/2021] [Accepted: 05/28/2021] [Indexed: 05/18/2023] Open
Abstract
SARS-CoV-2 infection causes broad-spectrum immunopathological disease, exacerbated by inflammatory co-morbidities. A better understanding of mechanisms underpinning virus-associated inflammation is required to develop effective therapeutics. Here, we discover that SARS-CoV-2 replicates rapidly in lung epithelial cells despite triggering a robust innate immune response through the activation of cytoplasmic RNA sensors RIG-I and MDA5. The inflammatory mediators produced during epithelial cell infection can stimulate primary human macrophages to enhance cytokine production and drive cellular activation. Critically, this can be limited by abrogating RNA sensing or by inhibiting downstream signalling pathways. SARS-CoV-2 further exacerbates the local inflammatory environment when macrophages or epithelial cells are primed with exogenous inflammatory stimuli. We propose that RNA sensing of SARS-CoV-2 in lung epithelium is a key driver of inflammation, the extent of which is influenced by the inflammatory state of the local environment, and that specific inhibition of innate immune pathways may beneficially mitigate inflammation-associated COVID-19.
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Affiliation(s)
- Lucy G Thorne
- Division of Infection and Immunity, University College London, London, UK
| | | | | | - Matthew V X Whelan
- Division of Infection and Immunity, University College London, London, UK
| | - Jane Turner
- Division of Infection and Immunity, University College London, London, UK
| | - Mahdad Noursadeghi
- Division of Infection and Immunity, University College London, London, UK
| | - Clare Jolly
- Division of Infection and Immunity, University College London, London, UK
| | - Greg J Towers
- Division of Infection and Immunity, University College London, London, UK
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Gülsen A, König IR, Jappe U, Drömann D. Effect of comorbid pulmonary disease on the severity of COVID-19: A systematic review and meta-analysis. Respirology 2021; 26:552-565. [PMID: 33955623 PMCID: PMC8207055 DOI: 10.1111/resp.14049] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 02/12/2021] [Accepted: 02/24/2021] [Indexed: 01/08/2023]
Abstract
Coronavirus disease 2019 (COVID‐19) caused by infection with severe acute respiratory syndrome coronavirus 2 was first detected in Wuhan, China, in late 2019 and continues to spread worldwide. Persistent questions remain about the relationship between the severity of COVID‐19 and comorbid diseases, as well as other chronic pulmonary conditions. In this systematic review and meta‐analysis, we aimed to examine in detail whether the underlying chronic obstructive pulmonary diseases (COPD), asthma and chronic respiratory diseases (CRDs) were associated with an increased risk of more severe COVID‐19. A comprehensive literature search was performed using five international search engines. In the initial search, 722 articles were identified. After eliminating duplicate records and further consideration of eligibility criteria, 53 studies with 658,073 patients were included in the final analysis. COPD was present in 5.2% (2191/42,373) of patients with severe COVID‐19 and in 1.4% (4203/306,151) of patients with non‐severe COVID‐19 (random‐effects model; OR = 2.58, 95% CI = 1.99–3.34, Z = 7.15, p < 0.001). CRD was present in 8.6% (3780/44,041) of patients with severe COVID‐19 and in 5.7% (16,057/280,447) of patients with non‐severe COVID‐19 (random‐effects model; OR = 2.14, 95% CI = 1.74–2.64, Z = 7.1, p < 0.001). Asthma was present in 2.3% (1873/81,319) of patients with severe COVID‐19 and in 2.2% (11,796/538,737) of patients with non‐severe COVID‐19 (random‐effects model; OR = 1.13, 95% CI = 0.79–1.60, Z = 0.66, p = 0.50). In conclusion, comorbid COPD and CRD were clearly associated with a higher severity of COVID‐19; however, no association between asthma and severe COVID‐19 was identified.
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Affiliation(s)
- Askin Gülsen
- Division of Clinical and Molecular Allergology, Research Center Borstel, Leibniz Lung Center, Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Borstel, Germany.,Interdisciplinary Allergy Outpatient Clinic, Department of Pneumology, University of Luebeck, Luebeck, Germany
| | - Inke R König
- Institute of Medical Biometry and Statistics, Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), University of Luebeck, Luebeck, Germany
| | - Uta Jappe
- Division of Clinical and Molecular Allergology, Research Center Borstel, Leibniz Lung Center, Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Borstel, Germany.,Interdisciplinary Allergy Outpatient Clinic, Department of Pneumology, University of Luebeck, Luebeck, Germany
| | - Daniel Drömann
- Department of Pneumology, Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), University of Luebeck, Luebeck, Germany
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23
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Momeni-Boroujeni A, Mendoza R, Stopard IJ, Lambert B, Zuretti A. A Dynamic Bayesian Model for Identifying High-Mortality Risk in Hospitalized COVID-19 Patients. Infect Dis Rep 2021; 13:239-250. [PMID: 33803753 PMCID: PMC8006025 DOI: 10.3390/idr13010027] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/11/2021] [Accepted: 03/12/2021] [Indexed: 12/15/2022] Open
Abstract
As Coronavirus Disease 2019 (COVID-19) hospitalization rates remain high, there is an urgent need to identify prognostic factors to improve patient outcomes. Existing prognostic models mostly consider the impact of biomarkers at presentation on the risk of a single patient outcome at a single follow up time. We collected data for 553 Polymerase Chain Reaction (PCR)-positive COVID-19 patients admitted to hospital whose eventual outcomes were known. The data collected for the patients included demographics, comorbidities and laboratory values taken at admission and throughout the course of hospitalization. We trained multivariate Markov prognostic models to identify high-risk patients at admission along with a dynamic measure of risk incorporating time-dependent changes in patients' laboratory values. From the set of factors available upon admission, the Markov model determined that age >80 years, history of coronary artery disease and chronic obstructive pulmonary disease increased mortality risk. The lab values upon admission most associated with mortality included neutrophil percentage, red blood cells (RBC), red cell distribution width (RDW), protein levels, platelets count, albumin levels and mean corpuscular hemoglobin concentration (MCHC). Incorporating dynamic changes in lab values throughout hospitalization lead to dramatic gains in the predictive accuracy of the model and indicated a catalogue of variables for determining high-risk patients including eosinophil percentage, white blood cells (WBC), platelets, pCO2, RDW, large unstained cells (LUC) count, alkaline phosphatase and albumin. Our prognostic model highlights the nuance of determining risk for COVID-19 patients and indicates that, rather than a single variable, a range of factors (at different points in hospitalization) are needed for effective risk stratification.
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Affiliation(s)
| | - Rachelle Mendoza
- Downstate Medical Center, Department of Pathology, State University of New York, Brooklyn, NY 11203, USA;
| | - Isaac J. Stopard
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Faculty of Medicine, Imperial College London, London W2 1PG, UK; (I.J.S.); (B.L.)
| | - Ben Lambert
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Faculty of Medicine, Imperial College London, London W2 1PG, UK; (I.J.S.); (B.L.)
| | - Alejandro Zuretti
- Downstate Medical Center, Department of Pathology, State University of New York, Brooklyn, NY 11203, USA;
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24
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Sun M, Shankar R, Ko M, Chang CD, Yeh SJ, Li S, Liu K, Zhou G, Xing J, VanVelsen A, VanVelsen T, Paithankar S, Feng BY, Young K, Strug M, Turco L, Wang Z, Schadt E, Chen R, Li X, Oskotsky T, Sirota M, Glicksberg BS, Nadkarni GN, Moeser AJ, Li L, Kim S, Zhou J, Chen B. Sex differences in viral entry protein expression and host transcript responses to SARS-CoV-2. RESEARCH SQUARE 2020:rs.3.rs-100914. [PMID: 33173861 PMCID: PMC7654875 DOI: 10.21203/rs.3.rs-100914/v1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Epidemiological studies suggest that men exhibit a higher mortality rate to COVID-19 than women, yet the underlying biology is largely unknown. Here, we seek to delineate sex differences in the gene expression of viral entry proteins ACE2 and TMPRSS2, and host transcriptional responses to SARS-CoV-2 through large-scale analysis of genomic and clinical data. We first compiled 220,000 human gene expression profiles from three databases and completed the meta-information through machine learning and manual annotation. Large scale analysis of these profiles indicated that male samples show higher expression levels of ACE2 and TMPRSS2 than female samples, especially in the older group (>60 years) and in the kidney. Subsequent analysis of 6,031 COVID-19 patients at Mount Sinai Health System revealed that men have significantly higher creatinine levels, an indicator of impaired kidney function. Further analysis of 782 COVID-19 patient gene expression profiles taken from upper airway and blood suggested men and women present distinct expression changes. Computational deconvolution analysis of these profiles revealed male COVID-19 patients have enriched kidney-specific mesangial cells in blood compared to healthy patients. Together, this study suggests biological differences in the kidney between sexes may contribute to sex disparity in COVID-19.
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Affiliation(s)
- Mengying Sun
- Department of Computer Science and Engineering, Michigan State University, East Lansing, Michigan, USA
| | - Rama Shankar
- Department of Pediatrics and Human Development, Michigan State University, Grand Rapids, Michigan, USA
| | - Meehyun Ko
- Zoonotic Virus Laboratory, Institut Pasteur Korea, Seongnam, Korea
| | | | - Shan-Ju Yeh
- Department of Pediatrics and Human Development, Michigan State University, Grand Rapids, Michigan, USA
- Department of Electrical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | | | - Ke Liu
- Department of Pediatrics and Human Development, Michigan State University, Grand Rapids, Michigan, USA
| | - Guoli Zhou
- Biomedical Research Informatics Core, Clinical & Translational Sciences Institute, Michigan State University, East Lansing, Michigan, USA
| | - Jing Xing
- Department of Pediatrics and Human Development, Michigan State University, Grand Rapids, Michigan, USA
| | - Austin VanVelsen
- Department of Pediatrics and Human Development, Michigan State University, Grand Rapids, Michigan, USA
| | - Tyler VanVelsen
- Department of Pediatrics and Human Development, Michigan State University, Grand Rapids, Michigan, USA
| | - Shreya Paithankar
- Department of Pediatrics and Human Development, Michigan State University, Grand Rapids, Michigan, USA
| | - Benjamin Y. Feng
- Department of Pediatrics and Human Development, Michigan State University, Grand Rapids, Michigan, USA
| | - Krista Young
- College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Michael Strug
- Department of Obstetrics and Gynecology, Spectrum Health, Grand Rapids, Michigan, USA
- Department of Obstetrics, Gynecology and Reproductive Biology, Michigan State University, Grand Rapids, Michigan, USA
| | - Lauren Turco
- Emergency Medicine Residency, Spectrum Health, Grand Rapids, Michigan, USA
| | | | - Eric Schadt
- Sema4, Stamford, CT, Connecticut, USA
- Department of Genetics and Genomic Sciences, The Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Rong Chen
- Sema4, Stamford, CT, Connecticut, USA
- Department of Genetics and Genomic Sciences, The Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Xiaohong Li
- Van Andel Research Institute, Grand Rapids, Michigan, USA
| | - Tomiko Oskotsky
- Department of Pediatrics and Bakar Computational Health Sciences Institute, University of California, San Francisco, CA, USA
| | - Marina Sirota
- Department of Pediatrics and Bakar Computational Health Sciences Institute, University of California, San Francisco, CA, USA
| | - Benjamin S. Glicksberg
- The Hasso Plattner Institute of Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Girish N. Nadkarni
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Hasso Plattner Institute of Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Charles Bronfman Institute of Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Adam J. Moeser
- Large Animal Clinical Sciences and Department of Physiology, Michigan State University, East Lansing, Michigan, USA
| | - Li Li
- Sema4, Stamford, CT, Connecticut, USA
- Department of Genetics and Genomic Sciences, The Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Seungtaek Kim
- Zoonotic Virus Laboratory, Institut Pasteur Korea, Seongnam, Korea
| | - Jiayu Zhou
- Department of Computer Science and Engineering, Michigan State University, East Lansing, Michigan, USA
| | - Bin Chen
- Department of Pediatrics and Human Development, Michigan State University, Grand Rapids, Michigan, USA
- Department of Pharmacology and Toxicology, Michigan State University, Grand Rapids, Michigan, USA
- Correspondence to Bin Chen:
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