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Calonico S, Del Valle JCL, Di Tella R. Risk factors for COVID-19 in-hospital mortality in Argentina: A competing risk survival analysis. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0000816. [PMID: 38180953 PMCID: PMC10769012 DOI: 10.1371/journal.pgph.0000816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 09/18/2023] [Indexed: 01/07/2024]
Abstract
COVID-19 poses dire threats for low and middle-income countries (LMICs). Yet, there remains limited rigorous evidence describing the characteristics and outcomes of hospitalized patients for LMICs, and often the evidence was based on small samples and/or unicentric. The objective of this study was to examine risk factors of COVID-19 mortality in Argentina, a hard-hit middle-income Latin American country. We analyze data on 5,146 COVID-19 patients from 11 centers across 10 cities in Argentina, making this one of the largest multi-centric retrospective observational descriptive studies in the LMICs. Information on demographics and co-morbidities was extracted from medical records. Outcomes of relevance consisted of whether the patient was discharged or deceased (as established in medical records), along with date of each event. We use survival models that account for competing risks. Median age was 60 years (IQR: 48-72), there were fewer women (40.8%) hospitalized than men (59.2%), and the most prevalent comorbidities were hypertension (40.9%), diabetes (20.0%) and obesity (19.1%). Patients were hospitalized for a median duration of 8 days (IQR: 5-13), and in-hospital mortality was 18.1%, though it varied substantially across health centers (95%CI: 17.1%-19.2%). Baseline characteristics most associated with in-hospital mortality were respiratory rate (adjusted HR = 3.6, 95%CI: 2.5-5.4 for ≥ 26 breathes/min), older age (adjusted HR = 2.5, 95%CI: 2.0-3.3 for the 80+ age group), and chronic kidney disease (adjusted HR = 2.2, 95%CI: 1.8-2.8). Associations were attenuated when survival models did not account for the competing risk of being discharged. We document lower mortality rates than those in prior studies, likely due to a lower prevalence of comorbidities amongst patients in our sample. Compared with standard Cox models, we find that, when using competing risk models, risk factors have a larger role in explaining COVID-19 mortality. Overall, we provide rigorous evidence describing the characteristics and outcomes of hospitalized patients for LMICs. Thus, our findings are useful to conduct a more accurate in-hospital monitoring of patient subgroups who may be at greater risk. They also provide valuable guidance for public health and policy efforts in Argentina and other developing countries.
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Affiliation(s)
- Sebastian Calonico
- Department of Health Policy and Management, Mailman School of Public Health, ColumbiaUniversity, NYC, New York, United States of America
| | | | - Rafael Di Tella
- Harvard Business School, Harvard University, Cambridge, Massachusetts, United States of America
- National Bureau of Economic Research, Cambridge, Massachusetts, United States of America
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San Martín-López JV, Mesa N, Bernal-Bello D, Morales-Ortega A, Rivilla M, Guerrero M, Calderón R, Farfán AI, Rivas L, Soria G, Izquierdo A, Madroñal E, Duarte M, Piedrabuena S, Toledano-Macías M, Marrero J, de Ancos C, Frutos B, Cristóbal R, Velázquez L, Mora B, Cuenca P, Satué JÁ, Ayala-Larrañaga I, Carpintero L, Lara C, Llerena ÁR, García V, García de Viedma V, Prieto S, González-Pereira N, Bravo C, Mariño C, Lechuga LA, Tarancón J, Gonzalo S, Moreno S, Ruiz-Giardin JM. Seven Epidemic Waves of COVID-19 in a Hospital in Madrid: Analysis of Severity and Associated Factors. Viruses 2023; 15:1839. [PMID: 37766248 PMCID: PMC10538062 DOI: 10.3390/v15091839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/21/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Background: COVID-19 has evolved during seven epidemic waves in Spain. Our objective was to describe changes in mortality and severity in our hospitalized patients. (2) Method: This study employed a descriptive, retrospective approach for COVID-19 patients admitted to the Hospital de Fuenlabrada (Madrid, Spain) until 31 December 2022. (3) Results: A total of 5510 admissions for COVID-19 were recorded. The first wave accounted for 1823 (33%) admissions and exhibited the highest proportion of severe patients: 65% with bilateral pneumonia and 83% with oxygen saturation under 94% during admission and elevated levels of CRP, IL-6, and D-dimer. In contrast, the seventh wave had the highest median age (79 years) and comorbidity (Charlson: 2.7), while only 3% of patients had bilateral pneumonia and 3% required intubation. The overall mortality rate was 10.3%. The first wave represented 39% of the total. The variables related to mortality were age (OR: 1.08, 1.07-1.09), cancer (OR: 1.99, 1.53-2.60), dementia (OR: 1.82, 1.20-2.75), the Charlson index (1.38, 1.31-1.47), the need for high-flow oxygen (OR: 6.10, 4.94-7.52), mechanical ventilation (OR: 11.554, 6.996-19.080), and CRP (OR: 1.04, 1.03-1.06). (4) Conclusions: The variables associated with mortality included age, comorbidity, respiratory failure, and inflammation. Differences in the baseline characteristics of admitted patients explained the differences in mortality in each wave. Differences observed between patients admitted in the latest wave and the earlier ones suggest that COVID-19 has evolved into a distinct disease, requiring a distinct approach.
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Affiliation(s)
- Juan Víctor San Martín-López
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, 28029 Madrid, Spain;
| | - Nieves Mesa
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - David Bernal-Bello
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Alejandro Morales-Ortega
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
- Departamento de Medicina y Especialidades Médicas, Universidad de Alcalá, 28871 Madrid, Spain
| | - Marta Rivilla
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Marta Guerrero
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Ruth Calderón
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Ana I. Farfán
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Luis Rivas
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Guillermo Soria
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Aída Izquierdo
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Elena Madroñal
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Miguel Duarte
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Sara Piedrabuena
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - María Toledano-Macías
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Jorge Marrero
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Cristina de Ancos
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Begoña Frutos
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Rafael Cristóbal
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Laura Velázquez
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Belén Mora
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Paula Cuenca
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - José Á. Satué
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Ibone Ayala-Larrañaga
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Lorena Carpintero
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Celia Lara
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Álvaro R. Llerena
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Virginia García
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Vanessa García de Viedma
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Santiago Prieto
- Servicio de Laboratorio Clínico, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (S.P.); (N.G.-P.)
| | - Natalia González-Pereira
- Servicio de Laboratorio Clínico, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (S.P.); (N.G.-P.)
| | - Cristina Bravo
- Servicio de Farmacia, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (C.B.); (C.M.)
| | - Carolina Mariño
- Servicio de Farmacia, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (C.B.); (C.M.)
| | - Luis Antonio Lechuga
- Sistemas, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (L.A.L.); (J.T.)
| | - Jorge Tarancón
- Sistemas, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (L.A.L.); (J.T.)
| | - Sonia Gonzalo
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Santiago Moreno
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, 28029 Madrid, Spain;
- Departamento de Medicina y Especialidades Médicas, Universidad de Alcalá, 28871 Madrid, Spain
- Servicio de Enfermedades Infecciosas, Hospital U. Ramón y Cajal, IRYCIS, 28034 Madrid, Spain
| | - José M. Ruiz-Giardin
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, 28029 Madrid, Spain;
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3
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Andersen AL, Gribsholt SB, Pedersen L, Thomsen RW, Benfield TL, Søgaard O, Nielsen SL, Omland LH, Lindegaard B, Richelsen B, Bodilsen J, Bruun JM. The impact of age and obesity on outcomes among patients hospitalized with COVID-19 in Denmark: A nationwide cohort study. Obes Sci Pract 2023; 9:355-363. [PMID: 37546282 PMCID: PMC10399535 DOI: 10.1002/osp4.659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 01/04/2023] Open
Abstract
Purpose Obesity may alter the severity of infection with Coronavirus disease 2019 (COVID-19). Age may impact the association between body weight and severity of COVID-19 in patients with obesity. The aim of the study was to examine the association between obesity and severity of infection in a Danish cohort hospitalized with COVID-19 in the initial wave of the pandemic. Patients and methods Based on data from the nationwide, clinical database: COVID-DK, risks of intensive care unit (ICU) admission, invasive mechanical ventilation (IMV), and mortality were compared among patients with and without obesity. Interaction with age was examined and we used Inverse Probability of Treatment Weighting regression for confounder adjustment. Results Among 524 patients, 142 (27%) were admitted to the ICU, 112 (21%) required IMV, and 109 (21%) died. Compared to COVID-19 patients without obesity, patients with obesity displayed a non-significant increased risk of ICU admission (Relative Risk [RR] 1.19, 95% Confidence Interval [CI] 0.88; 1.60), IMV (RR 1.23, CI 0.86; 1.75) and mortality (RR 1.21, CI 0.84; 1.75). COVID-19 patients with obesity, <60 years had highly increased risk of ICU admission (RR 1.92, CI 1.14; 3.24) and IMV (RR 1.95, CI 1.09; 3.49). Conclusions In hospitalized COVID-19 patients, obesity conferred an approximately 20% increased risk for ICU admission, IMV, and death, although these relationships did not reach statistical significance. COVID-19 patients with obesity and <60 years had an almost doubled risk of ICU admission and IMV.
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Affiliation(s)
- Anton Lund Andersen
- Steno Diabetes Centre AarhusAarhus University HospitalAarhus NDenmark
- Danish National Centre for ObesityAarhus NDenmark
| | - Sigrid Bjerge Gribsholt
- Steno Diabetes Centre AarhusAarhus University HospitalAarhus NDenmark
- Danish National Centre for ObesityAarhus NDenmark
- Department of Endocrinology and Internal MedicineAarhus University HospitalAarhus NDenmark
| | - Lars Pedersen
- Department of Clinical EpidemiologyAarhus University HospitalAarhus NDenmark
| | | | - Thomas Lars Benfield
- Department of Infectious DiseasesCopenhagen University Hospital, Amager and HvidovreHvidovreDenmark
- Department of Clinical MedicineFaculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Ole Søgaard
- Department Infectious DiseaseAarhus University HospitalAarhusDenmark
- Department of Clinical MedicineAarhus UniversityAarhus CDenmark
| | | | - Lars Haukali Omland
- Department of Infectious DiseasesCopenhagen University Hospital, RigshospitaletCopenhagenDenmark
| | - Birgitte Lindegaard
- Department of Clinical MedicineFaculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
- Department of Pulmonary and Infectious DiseasesUniversity Hospital of Copenhagen, North Zealand HospitalHillerødDenmark
- Centre for Physical ActivityCopenhagen University Hospital, RigshospitaletCopenhagenDenmark
| | - Bjørn Richelsen
- Steno Diabetes Centre AarhusAarhus University HospitalAarhus NDenmark
- Department of Endocrinology and Internal MedicineAarhus University HospitalAarhus NDenmark
- Department of Clinical MedicineAarhus UniversityAarhus CDenmark
| | - Jacob Bodilsen
- Department of Infectious DiseasesAalborg University HospitalAalborgDenmark
| | - Jens Meldgaard Bruun
- Steno Diabetes Centre AarhusAarhus University HospitalAarhus NDenmark
- Danish National Centre for ObesityAarhus NDenmark
- Department of Clinical MedicineAarhus UniversityAarhus CDenmark
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Pinho CT, Vidal AF, Negri Rocha TC, Oliveira RRM, da Costa Barros MC, Closset L, Azevedo-Pinheiro J, Braga-da-Silva C, Silva CS, Magalhães LL, do Carmo Pinto PD, Souza GBS, dos Santos Vieira JR, Burbano RMR, de Sousa MS, de Souza JES, Nunes G, da Silva MB, da Costa PF, Salgado CG, Sousa RCM, Degrave WMS, Ribeiro-dos-Santos Â, Oliveira G. Transmission dynamics of SARS-CoV-2 variants in the Brazilian state of Pará. Front Public Health 2023; 11:1186463. [PMID: 37790714 PMCID: PMC10543262 DOI: 10.3389/fpubh.2023.1186463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/30/2023] [Indexed: 10/05/2023] Open
Abstract
Introduction After three years since the beginning of the pandemic, the new coronavirus continues to raise several questions regarding its infectious process and host response. Several mutations occurred in different regions of the SARS-CoV-2 genome, such as in the spike gene, causing the emergence of variants of concern and interest (VOCs and VOIs), of which some present higher transmissibility and virulence, especially among patients with previous comorbidities. It is essential to understand its spread dynamics to prevent and control new biological threats that may occur in the future. In this population_based retrospective observational study, we generated data and used public databases to understand SARS-CoV-2 dynamics. Methods We sequenced 1,003 SARS-CoV-2 genomes from naso-oropharyngeal swabs and saliva samples from Pará from May 2020 to October 2022. To gather epidemiological data from Brazil and the world, we used FIOCRUZ and GISAID databases. Results Regarding our samples, 496 (49.45%) were derived from female participants and 507 (50.55%) from male participants, and the average age was 43 years old. The Gamma variant presented the highest number of cases, with 290 (28.91%) cases, followed by delta with 53 (5.28%). Moreover, we found seven (0.69%) Omicron cases and 651 (64.9%) non-VOC cases. A significant association was observed between sex and the clinical condition (female, p = 8.65e-08; male, p = 0.008961) and age (p = 3.6e-10). Discussion Although gamma had been officially identified only in December 2020/January 2021, we identified a gamma case from Belém (capital of Pará State) dated May 2020 and three other cases in October 2020. This indicates that this variant was circulating in the North region of Brazil several months before its formal identification and that Gamma demonstrated its actual transmission capacity only at the end of 2020. Furthermore, the public data analysis showed that SARS-CoV-2 dispersion dynamics differed in Brazil as Gamma played an important role here, while most other countries reported a new infection caused by the Delta variant. The genetic and epidemiological information of this study reinforces the relevance of having a robust genomic surveillance service that allows better management of the pandemic and that provides efficient solutions to possible new disease-causing agents.
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Affiliation(s)
- Catarina T. Pinho
- Laboratório de Genética Humana e Médica, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
| | | | | | | | - Maria Clara da Costa Barros
- Laboratório de Genética Humana e Médica, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Pará, Belém, Pará, Brazil
| | - Laura Closset
- Laboratório de Genética Humana e Médica, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
| | - Jhully Azevedo-Pinheiro
- Laboratório de Genética Humana e Médica, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Pará, Belém, Pará, Brazil
| | - Cíntia Braga-da-Silva
- Laboratório de Genética Humana e Médica, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Pará, Belém, Pará, Brazil
| | - Caio Santos Silva
- Laboratório de Genética Humana e Médica, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
| | - Leandro L. Magalhães
- Laboratório de Genética Humana e Médica, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Pará, Belém, Pará, Brazil
| | - Pablo Diego do Carmo Pinto
- Laboratório de Genética Humana e Médica, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
| | - Giordano Bruno Soares Souza
- Laboratório de Genética Humana e Médica, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
| | - José Ricardo dos Santos Vieira
- Laboratório de Genética Humana e Médica, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
| | | | | | - Jorge Estefano Santana de Souza
- Programa de Pós-Graduação em Bioinformática, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Bioinformatics Núcleo Multidisciplinar de Bioinformática, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | | | - Moises Batista da Silva
- Laboratório de Dermatologia e Imunologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Marituba, Pará, Brazil
| | - Patrícia Fagundes da Costa
- Laboratório de Dermatologia e Imunologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Marituba, Pará, Brazil
| | - Claudio Guedes Salgado
- Laboratório de Dermatologia e Imunologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Marituba, Pará, Brazil
| | | | - Wim Maurits Sylvain Degrave
- Laboratório de Genômica Funcional e Bioinformática, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Ândrea Ribeiro-dos-Santos
- Laboratório de Genética Humana e Médica, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Pará, Belém, Pará, Brazil
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Chandel A, Leazer S, Alcover KC, Farley J, Berk J, Jayne C, Mcnutt R, Olsen M, Allard R, Yang J, Johnson C, Tripathi A, Rechtin M, Leon M, Williams M, Sheth P, Messer K, Chung KK, Collen J. Intensive Care and Organ Support Related Mortality in Patients With COVID-19: A Systematic Review and Meta-Analysis. Crit Care Explor 2023; 5:e0876. [PMID: 36890875 PMCID: PMC9988289 DOI: 10.1097/cce.0000000000000876] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023] Open
Abstract
To perform a systematic review and meta-analysis to generate estimates of mortality in patients with COVID-19 that required hospitalization, ICU admission, and organ support. DATA SOURCES A systematic search of PubMed, Embase, and the Cochrane databases was conducted up to December 31, 2021. STUDY SELECTION Previously peer-reviewed observational studies that reported ICU, mechanical ventilation (MV), renal replacement therapy (RRT) or extracorporeal membrane oxygenation (ECMO)-related mortality among greater than or equal to 100 individual patients. DATA EXTRACTION Random-effects meta-analysis was used to generate pooled estimates of case fatality rates (CFRs) for in-hospital, ICU, MV, RRT, and ECMO-related mortality. ICU-related mortality was additionally analyzed by the study country of origin. Sensitivity analyses of CFR were assessed based on completeness of follow-up data, by year, and when only studies judged to be of high quality were included. DATA SYNTHESIS One hundred fifty-seven studies evaluating 948,309 patients were included. The CFR for in-hospital mortality, ICU mortality, MV, RRT, and ECMO were 25.9% (95% CI: 24.0-27.8%), 37.3% (95% CI: 34.6-40.1%), 51.6% (95% CI: 46.1-57.0%), 66.1% (95% CI: 59.7-72.2%), and 58.0% (95% CI: 46.9-68.9%), respectively. MV (52.7%, 95% CI: 47.5-58.0% vs 31.3%, 95% CI: 16.1-48.9%; p = 0.023) and RRT-related mortality (66.7%, 95% CI: 60.1-73.0% vs 50.3%, 95% CI: 42.4-58.2%; p = 0.003) decreased from 2020 to 2021. CONCLUSIONS We present updated estimates of CFR for patients hospitalized and requiring intensive care for the management of COVID-19. Although mortality remain high and varies considerably worldwide, we found the CFR in patients supported with MV significantly improved since 2020.
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Affiliation(s)
- Abhimanyu Chandel
- Department of Pulmonary and Critical Care Medicine, Walter Reed National Medical Center, Bethesda, MD
| | - Sahar Leazer
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD
- The Metis Foundation, San Antonio, TX
| | - Karl C Alcover
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD
| | - Josiah Farley
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD
| | - Joshua Berk
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD
| | - Christopher Jayne
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD
| | - Ryan Mcnutt
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD
| | - Meredith Olsen
- Department of Pulmonary and Critical Care Medicine, Walter Reed National Medical Center, Bethesda, MD
| | - Rhonda Allard
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD
| | - Jiahong Yang
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD
| | - Caitlyn Johnson
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD
| | - Ananya Tripathi
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD
| | - Maria Rechtin
- Department of Pulmonary and Critical Care Medicine, Walter Reed National Medical Center, Bethesda, MD
| | - Mathew Leon
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD
| | - Mathias Williams
- Department of Pulmonary and Critical Care Medicine, Walter Reed National Medical Center, Bethesda, MD
| | - Phorum Sheth
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD
| | - Kyle Messer
- Department of Pulmonary and Critical Care Medicine, Walter Reed National Medical Center, Bethesda, MD
| | - Kevin K Chung
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD
| | - Jacob Collen
- Department of Pulmonary and Critical Care Medicine, Walter Reed National Medical Center, Bethesda, MD
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD
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6
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Concha-Velasco F, Moncada-Arias AG, Antich MK, Delgado-Flores CJ, Ramírez-Escobar C, Ochoa-Linares M, Velásquez-Cuentas L, Dueñas de la Cruz H, Loyola S. Factors Associated with COVID-19 Death in a High-Altitude Peruvian Setting during the First 14 Months of the Pandemic: A Retrospective Multicenter Cohort Study in Hospitalized Patients. Trop Med Infect Dis 2023; 8:133. [PMID: 36977134 PMCID: PMC10051565 DOI: 10.3390/tropicalmed8030133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 02/25/2023] Open
Abstract
Risk factors for COVID-19 death in high-altitude populations have been scarcely described. This study aimed to describe risk factors for COVID-19 death in three referral hospitals located at 3399 m in Cusco, Peru, during the first 14 months of the pandemic. A retrospective multicenter cohort study was conducted. A random sample of ~50% (1225/2674) of adult hospitalized patients who died between 1 March 2020 and 30 June 2021 was identified. Of those, 977 individuals met the definition of death by COVID-19. Demographic characteristics, intensive care unit (ICU) admission, invasive respiratory support (IRS), disease severity, comorbidities, and clinical manifestation at hospital admission were assessed as risk factors using Cox proportional-hazard models. In multivariable models adjusted by age, sex, and pandemic periods, critical disease (vs. moderate) was associated with a greater risk of death (aHR: 1.27; 95%CI: 1.14-1.142), whereas ICU admission (aHR: 0.39; 95%CI: 0.27-0.56), IRS (aHR: 0.37; 95%CI: 0.26-0.54), the ratio of oxygen saturation (ROX) index ≥ 5.3 (aHR: 0.87; 95%CI: 0.80-0.94), and the ratio of SatO2/FiO2 ≥ 122.6 (aHR: 0.96; 95%CI: 0.93-0.98) were associated with a lower risk of death. The risk factors described here may be useful in assisting decision making and resource allocation.
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Affiliation(s)
- Fátima Concha-Velasco
- Universidad Continental, Cusco 08000, Peru
- Dirección de Epidemiología e Investigación, Gerencia Regional de Salud (GERESA), Cusco 08200, Peru
| | - Ana G. Moncada-Arias
- Dirección de Epidemiología e Investigación, Gerencia Regional de Salud (GERESA), Cusco 08200, Peru
| | - María K. Antich
- Dirección de Epidemiología e Investigación, Gerencia Regional de Salud (GERESA), Cusco 08200, Peru
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima 150135, Peru
| | | | - Cesar Ramírez-Escobar
- Dirección de Epidemiología e Investigación, Gerencia Regional de Salud (GERESA), Cusco 08200, Peru
| | | | | | | | - Steev Loyola
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima 150135, Peru
- Doctorado en Medicina Tropical, Facultad de Medicina, Universidad de Cartagena, Cartagena de Indias 130014, Colombia
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7
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Almada L, Angiolini SC, Dho ND, Dutto J, Gazzoni Y, Manzone-Rodríguez C, Marín C, Ponce NE, Arroyo DS, Quiróz JN, Iribarren P, Cerbán FM, Morón G, Amezcua Vesely MC, Cervi L, Chiapello LS, Fozzatti L, Icely PA, Maccioni M, Montes CL, Motrán CC, Rodríguez-Galán MC, Stempin CC, Viano ME, Mena C, Bertone M, Abiega CD, Escudero D, Kahn A, Caeiro JP, Maletto BA, Acosta Rodríguez EV, Gruppi A, Sotomayor CE. Different cytokine and chemokine profiles in hospitalized patients with COVID-19 during the first and second outbreaks from Argentina show no association with clinical comorbidities. Front Immunol 2023; 14:1111797. [PMID: 36817433 PMCID: PMC9929547 DOI: 10.3389/fimmu.2023.1111797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/09/2023] [Indexed: 02/04/2023] Open
Abstract
Background COVID-19 severity has been linked to an increased production of inflammatory mediators called "cytokine storm". Available data is mainly restricted to the first international outbreak and reports highly variable results. This study compares demographic and clinical features of patients with COVID-19 from Córdoba, Argentina, during the first two waves of the pandemic and analyzes association between comorbidities and disease outcome with the "cytokine storm", offering added value to the field. Methods We investigated serum concentration of thirteen soluble mediators, including cytokines and chemokines, in hospitalized patients with moderate and severe COVID-19, without previous rheumatic and autoimmune diseases, from the central region of Argentina during the first and second infection waves. Samples from healthy controls were also assayed. Clinical and biochemical parameters were collected. Results Comparison between the two first COVID-19 waves in Argentina highlighted that patients recruited during the second wave were younger and showed less concurrent comorbidities than those from the first outbreak. We also recognized particularities in the signatures of systemic cytokines and chemokines in patients from both infection waves. We determined that concurrent pre-existing comorbidities did not have contribution to serum concentration of systemic cytokines and chemokines in COVID-19 patients. We also identified immunological and biochemical parameters associated to inflammation which can be used as prognostic markers. Thus, IL-6 concentration, C reactive protein level and platelet count allowed to discriminate between death and discharge in patients hospitalized with severe COVID-19 only during the first but not the second wave. Conclusions Our data provide information that deepens our understanding of COVID-19 pathogenesis linking demographic features of a COVID-19 cohort with cytokines and chemokines systemic concentration, presence of comorbidities and different disease outcomes. Altogether, our findings provide information not only at local level by delineating inflammatory/anti-inflammatory response of patients but also at international level addressing the impact of comorbidities and the infection wave in the variability of cytokine and chemokine production upon SARS-CoV-2 infection.
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Affiliation(s)
- Laura Almada
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Sofía Carla Angiolini
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Nicolás Daniel Dho
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Jeremías Dutto
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Yamila Gazzoni
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Clarisa Manzone-Rodríguez
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Constanza Marín
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Nicolás Eric Ponce
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Daniela Soledad Arroyo
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Juan Nahuel Quiróz
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Pablo Iribarren
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Fabio Marcelo Cerbán
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Gabriel Morón
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - María Carolina Amezcua Vesely
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Laura Cervi
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Laura Silvina Chiapello
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Laura Fozzatti
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Paula Alejandra Icely
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Mariana Maccioni
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Carolina Lucia Montes
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Claudia Cristina Motrán
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - María Cecilia Rodríguez-Galán
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Cinthia Carolina Stempin
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - María Estefanía Viano
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Cristian Mena
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Mariana Bertone
- Instituto Universitario de Ciencias Biomédicas de Córdoba (IUCBC), Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - Claudio Daniel Abiega
- Instituto Universitario de Ciencias Biomédicas de Córdoba (IUCBC), Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - Daiana Escudero
- Instituto Universitario de Ciencias Biomédicas de Córdoba (IUCBC), Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - Adrián Kahn
- Instituto Universitario de Ciencias Biomédicas de Córdoba (IUCBC), Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - Juan Pablo Caeiro
- Instituto Universitario de Ciencias Biomédicas de Córdoba (IUCBC), Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - Belkys Angélica Maletto
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Eva Virginia Acosta Rodríguez
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Adriana Gruppi
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Claudia Elena Sotomayor
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
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Naorungroj T, Viarasilpa T, Tongyoo S, Detkaew A, Pinpak T, Wimolwattanaphan R, Ratanarat R, Promsin P, Thamrongpiroj P, Phumpichet A, Permpikul C. Characteristics, outcomes, and risk factors for in-hospital mortality of COVID-19 patients: A retrospective study in Thailand. Front Med (Lausanne) 2023; 9:1061955. [PMID: 36687414 PMCID: PMC9846200 DOI: 10.3389/fmed.2022.1061955] [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: 10/05/2022] [Accepted: 12/05/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction Data on the characteristics and outcomes of patients hospitalized for Coronavirus Disease 2019 (COVID-19) in Thailand are limited. Objective To determine characteristics and outcomes and identify risk factors for hospital mortality for hospitalized patients with COVID-19. Methods We retrospectively reviewed the medical records of patients who had COVID-19 infection and were admitted to the cohort ward or ICUs at Siriraj Hospital between January 2020 and December 2021. Results Of the 2,430 patients included in this study, 229 (9.4%) died; the mean age was 54 years, 40% were men, 81% had at least one comorbidity, and 13% required intensive care unit (ICU). Favipiravir (86%) was the main antiviral treatment. Corticosteroids and rescue anti-inflammatory therapy were used in 74 and 6%, respectively. Admission to the ICU was the only factor associated with reduced mortality [odds ratio (OR) 0.01, 95% confidence interval (CI) 0.01-0.05, P < 0.001], whereas older age (OR 14.3, 95%CI 5.76-35.54, P < 0.001), high flow nasal cannula (HFNC; OR 9.2, 95% CI 3.9-21.6, P < 0.001), mechanical ventilation (OR 269.39, 95%CI 3.6-2173.63, P < 0.001), septic shock (OR 7.79, 95%CI, 2.01-30.18, P = 0.003), and hydrocortisone treatment (OR 27.01, 95%CI 5.29-138.31, P < 0.001) were factors associated with in-hospital mortality. Conclusion The overall mortality of hospitalized patients with COVID-19 was 9%. The only factor associated with reduced mortality was admission to the ICU. Therefore, appropriate selection of patients for admission to the ICU, strategies to limit disease progression and prevent intubation, and early detection and prompt treatment of nosocomial infection can improve survival in these patients.
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9
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Percutaneous tracheostomy in the ICU: a review of the literature and recent updates. Curr Opin Pulm Med 2023; 29:47-53. [PMID: 36378112 DOI: 10.1097/mcp.0000000000000928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE OF REVIEW The following article summarizes the current available knowledge regarding tracheostomy techniques, indications, contraindications, procedure timing, use of assisted technologies and tracheostomy feasibility and safety in high-risk populations. In light of the ongoing corona virus disease (COVID-19) pandemic, a focus was placed on tracheostomy in this unique patient group. RECENT FINDINGS Percutaneous dilatation tracheostomy (PDT) is commonly used in the ICU setting. It has been shown to be well tolerated and feasible in a diverse patient population including those regarded to be at high risk such as the obese, coagulopathic and acute respiratory failure patient. This patient profile presented itself frequently in the recent COVID-19 pandemic. Indeed studies showed that PDT is well tolerated in COVID-19 ICU patients leading to reduced ICU length of stay (LOS), decrease in ventilator-associated pneumonia rate (VAP) and reduced duration on invasive mechanical ventilation (IMV). Despite initial concerns, virus transmission from patient to healthcare provider (HCP) was shown to be negligible when proper precautions are taken. SUMMARY Bedside PDT in the ICU is a well tolerated procedure having the potential to benefit both the individual patient as well as to improve resource utilization of the healthcare system.
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10
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Mousavi SF, Ebrahimi M, Moghaddam SAA, Moafi N, Jafari M, Tavakolian A, Heidary M. Evaluating the characteristics of patients with SARS-CoV-2 infection admitted during COVID-19 peaks: A single-center study. VACUNAS 2023; 24:27-36. [PMID: 36062028 PMCID: PMC9424515 DOI: 10.1016/j.vacun.2022.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 08/13/2022] [Indexed: 02/08/2023]
Abstract
Background Nowadays, the world is facing a coronavirus disease (COVID-19) pandemic, elicited by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). At the time of studying, five COVID-19 waves occurred in Iran. We aimed to evaluate the characteristics of patients with SARS-CoV-2 infection admitted to Vasei Hospital of Sabzevar, Iran during COVID-19 peaks. Methods Clinical manifestations, laboratory findings, radiological findings, and underlying diseases of patients with COVID-19 were obtained from electronic medical records. Then, this information was compared in patients with SARS-CoV-2 infection to the peaks of COVID-19. Results The highest and lowest respiratory involvements were observed in the third (74.6%) and fourth (38.8%) peaks, respectively. The most common radiological finding in all peaks was ground-glass opacity (28.98%), followed by consolidation, which was the highest (14.6%) in peak three. The lymphocyte count decreased in all peaks. Its highest reduction (16.12) occurred in the third peak. The SpO2 was lower than normal range in all peaks, except for the second (90.77%) and fifth (91.06%) peaks. Dyspnea (52.36%) was the most and dizziness (1.26%) and sore throat (0.6%) were the least frequent symptoms. The mortality rates were 14. 4%, 18.2%, 23%, 9.02%, and 9.4% in the first to fifth peaks, respectively. Conclusion As different variants of the SARS-CoV-2 virus were predominant in each wave, COVID-19 patients had different features in various peaks. The fifth wave of COVID-19 had the highest number of hospitalized patients, while the first peak had the lowest number. Perhaps, the significant increase in testing capacity in the fifth wave and its long time period are the reasons for this growth. Most of the clinical symptoms were similar in all peaks, but the incidence was different. As patients hospitalized in the third peak had the highest rate of underlying disease, it can be a reason for the increase in the death rate of patients. We did not observe any significant differences in laboratory tests among the patients during different peaks. Thus, we should be vigilant in continuously studying the characteristics of the disease, and be able to modify treatments rapidly if necessary.
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Affiliation(s)
| | | | | | - Narges Moafi
- Student Research Committee, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Mahbobe Jafari
- Student Research Committee, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Ayoub Tavakolian
- Emergency Medicine Department, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Mohsen Heidary
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran,Corresponding authors
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Silva MBG, Pinho CPS, Barros Neto JDA, Petribú MDMV, Dourado KF, Maio R. Relationship between nutritional status, lifestyle and prognosis in patients diagnosed with COVID-19 hospitalized in the state of Pernambuco. REVISTA CIÊNCIAS EM SAÚDE 2022. [DOI: 10.21876/rcshci.v12i4.1296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Objective: To analyze the relationship between nutritional status and lifestyle habits and the prognosis of hospitalized patients with COVID-19 in Pernambuco. Methods: Multicenter, cross-sectional study, associated with prospective analysis variables, involving patients with COVID-19 and admitted to 8 hospitals. Individuals aged ≥ 18 years of both sexes, hospitalized from June 2020 to June 2021, were included. Socioeconomic, clinical, anthropometric, lifestyle and prognostic variables were collected. Results: The sample consisted of 263 individuals with a mean age of 62.9 ± 16.6 years and homogeneous distribution between genders. It was observed that 8.2% were smokers, 20.9% reported alcohol consumption, and 80.1% were sedentary. The anthropometric profile indicated that 49.5% were overweight and 7.0% were underweight. Malnutrition and excess weight were associated with more extended hospital stays (66.7% weight loss and 64.5% weight gain vs. 30.0% eutrophy; p = 0.021), smoking with death (tab 65 .0% vs. non-tab 33.7%; p = 0.006) and need for admission to the intensive care unit (yes 64.3%, no 31.5%; p = 0.014). The frequency of dyspnea was higher in patients who reported drinking alcohol (yes 69.6% vs. no 48.1%; p = 0.007). Physical activity was not associated with any prognostic factor. Conclusion: Nutritional extremes and bad lifestyle habits, such as smoking and alcohol consumption, are risk factors for a poor prognosis in individuals with COVID-19.
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12
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Vassilopoulou E, Bumbacea RS, Pappa AK, Papadopoulos AN, Bumbacea D. Obesity and Infection: What Have We Learned From the COVID-19 Pandemic. Front Nutr 2022; 9:931313. [PMID: 35938136 PMCID: PMC9353573 DOI: 10.3389/fnut.2022.931313] [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: 04/28/2022] [Accepted: 06/14/2022] [Indexed: 01/14/2023] Open
Abstract
Objective The critical role played by the nutritional status in the complications, duration of hospitalization and mortality in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (COVID-19) has emerged from several research studies in diverse populations. Obesity has been associated with an increased risk of serious complications, as the adipose tissue appears to have significant effects on the immune response. The aim of this narrative review was to investigate the relationship between COVID-19 and obesity. Methods We performed a review of papers in the English language derived from PubMed, Science Direct, and Web of Science. The primary outcomes investigated were the severity of the disease, admission to the intensive care unit (ICU), need for intubation, and mortality. Results and Conclusion Review of 44 eligible studies from 18 countries around the world revealed evidence that obesity increases the risk of severe COVID-19 complications, ICU admission, intubation and mortality. Patients with a higher body mass index (BMI) appear to be more vulnerable to SARS-CoV-2 infection, with more severe illness requiring admission to ICU and intubation, and to have higher mortality. A healthy body weight should be targeted as a long-term prevention measure against acute complications of infection, and in the event of COVID-19, overweight and obese patients should be monitored closely.
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Affiliation(s)
- Emilia Vassilopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Roxana Silvia Bumbacea
- Allergy Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Allergy Department, Nephrology Hospital Dr Carol Davila, Bucharest, Romania
| | | | - Athanasios N. Papadopoulos
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Dragos Bumbacea
- Department of Cardio-Thoracic Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of Pneumology and Acute Respiratory Care, Elias Emergency University Hospital, Bucharest, Romania
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Oshinubi K, Buhamra SS, Al-Kandari NM, Waku J, Rachdi M, Demongeot J. Age Dependent Epidemic Modeling of COVID-19 Outbreak in Kuwait, France, and Cameroon. Healthcare (Basel) 2022; 10:healthcare10030482. [PMID: 35326960 PMCID: PMC8954002 DOI: 10.3390/healthcare10030482] [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: 01/11/2022] [Revised: 02/21/2022] [Accepted: 02/28/2022] [Indexed: 02/01/2023] Open
Abstract
Revisiting the classical model by Ross and Kermack-McKendrick, the Susceptible−Infectious−Recovered (SIR) model used to formalize the COVID-19 epidemic, requires improvements which will be the subject of this article. The heterogeneity in the age of the populations concerned leads to considering models in age groups with specific susceptibilities, which makes the prediction problem more difficult. Basically, there are three age groups of interest which are, respectively, 0−19 years, 20−64 years, and >64 years, but in this article, we only consider two (20−64 years and >64 years) age groups because the group 0−19 years is widely seen as being less infected by the virus since this age group had a low infection rate throughout the pandemic era of this study, especially the countries under consideration. In this article, we proposed a new mathematical age-dependent (Susceptible−Infectious−Goneanewsusceptible−Recovered (SIGR)) model for the COVID-19 outbreak and performed some mathematical analyses by showing the positivity, boundedness, stability, existence, and uniqueness of the solution. We performed numerical simulations of the model with parameters from Kuwait, France, and Cameroon. We discuss the role of these different parameters used in the model; namely, vaccination on the epidemic dynamics. We open a new perspective of improving an age-dependent model and its application to observed data and parameters.
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Affiliation(s)
- Kayode Oshinubi
- Laboratory AGEIS EA 7407, Team Tools for e-Gnosis Medical, Faculty of Medicine, University Grenoble Alpes (UGA), 38700 La Tronche, France; (K.O.); (M.R.); (J.D.)
| | - Sana S. Buhamra
- Department of Information Science, Kuwait University, P.O. Box 5969, Safat 13060, Kuwait
- Correspondence:
| | - Noriah M. Al-Kandari
- Department of Statistics and Operations Research, Kuwait University, P.O. Box 5969, Safat 13060, Kuwait;
| | - Jules Waku
- UMMISCO UMI IRD 209 & LIRIMA, University of Yaoundé I, Yaoundé P.O. Box 337, Cameroon;
| | - Mustapha Rachdi
- Laboratory AGEIS EA 7407, Team Tools for e-Gnosis Medical, Faculty of Medicine, University Grenoble Alpes (UGA), 38700 La Tronche, France; (K.O.); (M.R.); (J.D.)
| | - Jacques Demongeot
- Laboratory AGEIS EA 7407, Team Tools for e-Gnosis Medical, Faculty of Medicine, University Grenoble Alpes (UGA), 38700 La Tronche, France; (K.O.); (M.R.); (J.D.)
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Fernandez ML, Benchetrit A, Astudillo OG, Garay AM, De Vedia L, Garcia Bournissen F, Lloveras SC, Orduna TA, Gonzalez GD. COVID-19 and Chagas Disease in Buenos Aires, Argentina. FRONTIERS IN TROPICAL DISEASES 2022. [DOI: 10.3389/fitd.2021.779428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2. COVID-19 leads, in most patients, to mild-to-moderate symptoms, but some develop severe disease and succumbed to death. People with medical conditions have a higher risk of death than those without them. Chagas disease (CD) can cause cardiac diseases in approximately one-third of affected people. The aim of this study is to find out if there is any clinical association between Chagas disease and COVID-19 severity. This is a cohort study of 29 patients who were hospitalized with COVID-19 and had a diagnosis of chronic Trypanosoma cruzi infection. This coinfected cohort was matched by sex, age, presence of comorbidities, and requirement of hospitalization on intensive care unit (ICU) at admission with a control cohort of patients hospitalized due to COVID-19 without CD in a 3:1 ratio (n = 87). The clinical outcomes evaluated were as follows: days of hospitalization, death, and requirement of ICU and mechanical respiratory assistance (MV). The study protocol was approved by the Institutional Ethics in Research Committee. The Chagas disease/COVID-19 coinfected cohort had a median age of 55 years old (49.0, 66.0); 17 (59%) were male. All patients survived the acute COVID-19. Three of them were admitted to the ICU, and two required MV. Twenty-two (75.8%) required supplemental oxygen. There were no statistical differences in any laboratory parameters between the groups except for lactic acid dehydrogenase, which showed higher levels in the coinfected cohort, with a median of 573 U/L (interquartile range: 486.00, 771.00) vs. 476 U/L (346.00, 641.00) in the control group (p = 0.007). There were no differences in clinical outcomes between both groups. On the cohort with Chagas disease, there were zero deaths, three (10.3%) were admitted in the ICU, and two (6.9%) required MV, while for the control group there were six deaths (6.6%), 13 required ICU (14.9%), and 11 required MV (12.6%), without a statistically significant difference. This small series of coinfected Chagas disease and COVID-19 does not suggest differences in clinical evolution compared to non-Chagas patients. This data is similar to a Brazilian cohort. More data of this population with and without cardiomyopathy is needed to optimize the follow-up and recommendation for the population affected by this neglected tropical disease about COVID-19.
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Ji Y, Fang Y, Cheng B, Li L, Fang X. Tracheostomy timing and clinical outcomes in ventilated COVID-19 patients: a systematic review and meta-analysis. Crit Care 2022; 26:40. [PMID: 35135597 PMCID: PMC8822732 DOI: 10.1186/s13054-022-03904-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/26/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The association of tracheostomy timing and clinical outcomes in ventilated COVID-19 patients remains controversial. We performed a meta-analysis to evaluate the impact of early tracheostomy compared to late tracheostomy on COVID-19 patients' outcomes. METHODS We searched Medline, Embase, Cochrane, and Scopus database, along with medRxiv, bioRxiv, and Research Square, from December 1, 2019, to August 24, 2021. Early tracheostomy was defined as a tracheostomy conducted 14 days or less after initiation of invasive mechanical ventilation (IMV). Late tracheostomy was any time thereafter. Duration of IMV, duration of ICU stay, and overall mortality were the primary outcomes of the meta-analysis. Pooled odds ratios (OR) or the mean differences (MD) with 95%CIs were calculated using a random-effects model. RESULTS Fourteen studies with a cumulative 2371 tracheostomized COVID-19 patients were included in this review. Early tracheostomy was associated with significant reductions in duration of IMV (2098 patients; MD - 9.08 days, 95% CI - 10.91 to - 7.26 days, p < 0.01) and duration of ICU stay (1224 patients; MD - 9.41 days, 95% CI - 12.36 to - 6.46 days, p < 0.01). Mortality was reported for 2343 patients and was comparable between groups (OR 1.09, 95% CI 0.79-1.51, p = 0.59). CONCLUSIONS The results of this meta-analysis suggest that, compared with late tracheostomy, early tracheostomy in COVID-19 patients was associated with shorter duration of IMV and ICU stay without modifying the mortality rate. These findings may have important implications to improve ICU availability during the COVID-19 pandemic. Trial registration The protocol was registered at INPLASY (INPLASY202180088).
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Affiliation(s)
- Yun Ji
- Department of Surgical Intensive Care Unit, the Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, Zhejiang, China
| | - Yumin Fang
- Department of Intensive Care Unit, Suichang People's Hospital, Lishui, Zhejiang, China
| | - Baoli Cheng
- Department of Anesthesiology and Intensive Care, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
| | - Libin Li
- Department of Surgical Intensive Care Unit, the Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, Zhejiang, China
| | - Xiangming Fang
- Department of Anesthesiology and Intensive Care, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
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