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Cui C, Timbrook TT, Polacek C, Heins Z, Rosenthal NA. Disease burden and high-risk populations for complications in patients with acute respiratory infections: a scoping review. Front Med (Lausanne) 2024; 11:1325236. [PMID: 38818396 PMCID: PMC11138209 DOI: 10.3389/fmed.2024.1325236] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 04/24/2024] [Indexed: 06/01/2024] Open
Abstract
Background Acute respiratory infections (ARIs) represent a significant public health concern in the U.S. This study aimed to describe the disease burden of ARIs and identify U.S. populations at high risk of developing complications. Methods This scoping review searched PubMed and EBSCO databases to analyze U.S. studies from 2013 to 2022, focusing on disease burden, complications, and high-risk populations associated with ARIs. Results The study included 60 studies and showed that ARI is associated with a significant disease burden and healthcare resource utilization (HRU). In 2019, respiratory infection and tuberculosis caused 339,703 cases per 100,000 people, with most cases being upper respiratory infections and most deaths being lower respiratory infections. ARI is responsible for millions of outpatient visits, especially for influenza and pneumococcal pneumonia, and indirect costs of billions of dollars. ARI is caused by multiple pathogens and poses a significant burden on hospitalizations and outpatient visits. Risk factors for HRU associated with ARI include age, chronic conditions, and socioeconomic factors. Conclusion The review underscores the substantial disease burden of ARIs and the influence of age, chronic conditions, and socioeconomic status on developing complications. It highlights the necessity for targeted strategies for high-risk populations and effective pathogen detection to prevent severe complications and reduce HRU.
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Affiliation(s)
- Chendi Cui
- PINC, AI Applied Sciences, Premier Inc., Charlotte, NC, United States
| | - Tristan T. Timbrook
- Global Medical Affairs, bioMérieux, Inc., Salt Lake City, UT, United States
- University of Utah College of Pharmacy, Salt Lake City, UT, United States
| | - Cate Polacek
- PINC, AI Applied Sciences, Premier Inc., Charlotte, NC, United States
| | - Zoe Heins
- Global Medical Affairs, bioMérieux, Inc., Salt Lake City, UT, United States
| | - Ning A. Rosenthal
- PINC, AI Applied Sciences, Premier Inc., Charlotte, NC, United States
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2
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Eichenbaum A, Tate AD. Health Inequity in Georgia During the COVID-19 Pandemic: An Ecological Analysis Assessing the Relationship Between County-Level Racial/Ethnic and Economic Polarization Using the ICE and SARS-CoV-2 Cases, Hospitalizations, and Deaths in Georgia as of October 2020. Health Equity 2022; 6:230-239. [PMID: 35402766 PMCID: PMC8985538 DOI: 10.1089/heq.2021.0118] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2022] [Indexed: 11/28/2022] Open
Abstract
Introduction The coronavirus disease 2019 (COVID-19) pandemic disproportionately burdens communities of color in the United States. The prevalence of preexisting conditions in these populations has not accounted for the observed health inequities. A growing body of research indicates a significant role of racialized residential segregation and income inequality on health outcomes. The Index of Concentration at the Extremes (ICE) is a metric which captures socio-spatial and economic polarization that has proven to be a valuable predictor of a large variety of health outcomes. Objectives The primary objective of this ecologic study was to determine the impact of socio-spatial and economic segregation on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) morbidity and mortality in Georgia. Methods The ICE scores for racial/ethnic, economic, and racialized economic segregation for each county in Georgia (n=159) were calculated and investigated as predictors of increased SARS-CoV-2 positivity rate, case-hospitalization rate, and case-mortality rate after controlling for the prevalence of preexisting conditions (diabetes, obesity, and smoking) and potential barriers to care (uninsured rate). Results Counties with the largest income disparity had 1.57 times the case rate (p<0.0001) and 1.7 times (p<0.01) the case-mortality rate compared to the most privileged counties. Cases in counties with the largest racialized economic segregation were 1.8 times more likely to be hospitalized (p<0.0001). Conclusion Racialized economic segregation is a strong correlate of pandemic health inequities in Georgia and highlights the need for structural interventions to address barriers to minority and vulnerable population health. Increased focus and efforts to address the structural and systematic barriers faced by communities of color is necessary to address health inequities.
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Affiliation(s)
- Amit Eichenbaum
- College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Allan D. Tate
- Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia, USA
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Dupont A, Couffignal C, Arias C, Salah K, Phillips-Houlbraq M, Le Brun M, Taillé C. Outcomes and risk factors with COVID-19 or influenza in hospitalized asthma patients. Respir Res 2022; 23:342. [PMID: 36514068 PMCID: PMC9745693 DOI: 10.1186/s12931-022-02265-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND At the time of the SARS-CoV-2 emergence, asthma patients were initially considered vulnerable because respiratory viruses, especially influenza, are associated with asthma exacerbations, increased risk of hospitalization and more severe disease course. We aimed to compare the asthma prevalence in patients hospitalized for COVID-19 or influenza and risk factors associated with poor prognosis with the diseases. METHODS This retrospective cohort study used the Paris university hospitals clinical data warehouse to identify adults hospitalized for COVID-19 (January to June 2020) or influenza (November 2017 to March 2018 for the 2017-2018 influenza period and November 2018 to March 2019 for the 2018-2019 period). Asthma patients were identified with J45 and J46 ICD-10 codes. Poor outcomes were defined as admission in intensive care or death. RESULTS Asthma prevalence was significantly higher among influenza than COVID-19 patients (n = 283/3 119, 9.1%, 95% CI [8.1-10.1] in 2017-2018 and n = 309/3 266, 9.5%, 95% CI [8.5-10.5] in 2018-2019 versus n = 402/9 009, 4.5%, 95% CI [4.0-4.9]). For asthma patients, 31% with COVID-19 were admitted to an intensive care unit versus 23% and 21% with influenza. Obesity was a risk factor for the 2017-2018 influenza period, smoking and heart failure for the 2018-2019 period. Among COVID-19 patients with asthma, smoking and obesity were risk factors for the severe form. CONCLUSIONS In this study, patients with an asthma ICD-10 code were less represented among COVID-19 patients than among influenza-infected ones. However, outcomes were poorer for COVID-19 than influenza patients, both with asthma. These data highlight the importance of protective shields and vaccination against influenza and COVID-19 in this population.
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Affiliation(s)
- Axelle Dupont
- grid.50550.350000 0001 2175 4109Clinical Research, Biostatistics and Epidemiology Department, AP-HP Nord-Université Paris Cité, HUPNVS, Paris, France ,grid.512950.aUniversité Paris Cité and Université Sorbonne Paris Nord, INSERM, IAME, Paris, France ,grid.411119.d0000 0000 8588 831XINSERM CIC-EC 1425, Hôpital Bichat Claude Bernard, Paris, France
| | - Camille Couffignal
- grid.50550.350000 0001 2175 4109Clinical Research, Biostatistics and Epidemiology Department, AP-HP Nord-Université Paris Cité, HUPNVS, Paris, France ,grid.512950.aUniversité Paris Cité and Université Sorbonne Paris Nord, INSERM, IAME, Paris, France ,grid.411119.d0000 0000 8588 831XINSERM CIC-EC 1425, Hôpital Bichat Claude Bernard, Paris, France
| | - Camila Arias
- grid.50550.350000 0001 2175 4109Clinical Research, Biostatistics and Epidemiology Department, AP-HP Nord-Université Paris Cité, HUPNVS, Paris, France ,grid.411119.d0000 0000 8588 831XINSERM CIC-EC 1425, Hôpital Bichat Claude Bernard, Paris, France
| | - Kankoe Salah
- grid.50550.350000 0001 2175 4109Clinical Research, Biostatistics and Epidemiology Department, AP-HP Nord-Université Paris Cité, HUPNVS, Paris, France ,grid.411119.d0000 0000 8588 831XINSERM CIC-EC 1425, Hôpital Bichat Claude Bernard, Paris, France
| | - Mathilde Phillips-Houlbraq
- grid.411119.d0000 0000 8588 831XRespiratory Diseases Department, AP-HP Nord-Université Paris Cité, Hôpital Bichat Claude Bernard, Paris, France
| | - Mathilde Le Brun
- grid.411119.d0000 0000 8588 831XRespiratory Diseases Department, AP-HP Nord-Université Paris Cité, Hôpital Bichat Claude Bernard, Paris, France
| | - Camille Taillé
- grid.411119.d0000 0000 8588 831XINSERM CIC-EC 1425, Hôpital Bichat Claude Bernard, Paris, France ,grid.411119.d0000 0000 8588 831XRespiratory Diseases Department, AP-HP Nord-Université Paris Cité, Hôpital Bichat Claude Bernard, Paris, France ,grid.7429.80000000121866389INSERM U1152, Paris, France
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Laires PA, Dias S, Gama A, Moniz M, Pedro AR, Soares P, Aguiar P, Nunes C. The Association Between Chronic Disease and Serious COVID-19 Outcomes and Its Influence on Risk Perception: Survey Study and Database Analysis. JMIR Public Health Surveill 2021; 7:e22794. [PMID: 33433397 PMCID: PMC7806339 DOI: 10.2196/22794] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 12/13/2020] [Accepted: 12/14/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND COVID-19, a viral respiratory disease first reported in December 2019, quickly became a threat to global public health. Further understanding of the epidemiology of the SARS-CoV-2 virus and the risk perception of the community may better inform targeted interventions to reduce the impact and spread of COVID-19. OBJECTIVE In this study, we aimed to examine the association between chronic diseases and serious outcomes following COVID-19 infection, and to explore its influence on people's self-perception of risk for worse COVID-19 outcomes. METHODS This study draws data from two databases: (1) the nationwide database of all confirmed COVID-19 cases in Portugal, extracted on April 28, 2020 (n=20,293); and (2) the community-based COVID-19 Barometer survey, which contains data on health status, perceptions, and behaviors during the first wave of COVID-19 (n=171,087). We assessed the association between relevant chronic diseases (ie, respiratory, cardiovascular, and renal diseases; diabetes; and cancer) and death and intensive care unit (ICU) admission following COVID-19 infection. We identified determinants of self-perception of risk for severe COVID-19 outcomes using logistic regression models. RESULTS Respiratory, cardiovascular, and renal diseases were associated with mortality and ICU admission among patients hospitalized due to COVID-19 infection (odds ratio [OR] 1.48, 95% CI 1.11-1.98; OR 3.39, 95% CI 1.80-6.40; and OR 2.25, 95% CI 1.66-3.06, respectively). Diabetes and cancer were associated with serious outcomes only when considering the full sample of COVID-19-infected cases in the country (OR 1.30, 95% CI 1.03-1.64; and OR 1.40, 95% CI 1.03-1.89, respectively). Older age and male sex were both associated with mortality and ICU admission. The perception of risk for severe COVID-19 disease in the study population was 23.9% (n=40,890). This was markedly higher for older adults (n=5235, 46.4%), those with at least one chronic disease (n=17,647, 51.6%), or those in both of these categories (n=3212, 67.7%). All included diseases were associated with self-perceptions of high risk in this population. CONCLUSIONS Our results demonstrate the association between some prevalent chronic diseases and increased risk of worse COVID-19 outcomes. It also brings forth a greater understanding of the community's risk perceptions of serious COVID-19 disease. Hence, this study may aid health authorities to better adapt measures to the real needs of the population and to identify vulnerable individuals requiring further education and awareness of preventive measures.
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Affiliation(s)
- Pedro Almeida Laires
- Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Sónia Dias
- Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Ana Gama
- Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Marta Moniz
- Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Ana R Pedro
- Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Patricia Soares
- Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Pedro Aguiar
- Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Carla Nunes
- Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
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5
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Gok M, Cetinkaya H, Kandemir T, Karahan E, Tuncer İB, Bukrek C, Sahin G. Chronic kidney disease predicts poor outcomes of COVID-19 patients. Int Urol Nephrol 2021; 53:1891-1898. [PMID: 33394281 PMCID: PMC7780605 DOI: 10.1007/s11255-020-02758-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 12/15/2020] [Indexed: 11/28/2022]
Abstract
Purpose The recent outbreak of COVID-19 rapidly spread worldwide. Comorbid diseases are determinants of the severity of COVID-19 infection and mortality. The aim of this study was to explore the potential association between chronic kidney disease (CKD) and the severity of COVID-19 infection. Methods The study included 609 consecutive adult patients (male: 54.52%, mean age: 59.23 ± 15.55 years) hospitalized with the diagnosis of COVID-19 in a tertiary level hospital. Data were collected from the electronic health records of the hospital. The patients were separated into two groups: Group I included COVID-19-positive patients with CKD stage 1–2, and Group II included COVID-19-positive with CKD stage 3–5. The relationships were examined between CKD stage, laboratory parameters and mortality. Results Significant differences were determined between the groups in respect of the inflammation parameters and the parameters used in prognosis. In Group II, statistically significantly higher rates were determined of comorbid diseases [hypertension (p < 0.001) and diabetes mellitus (p < 0.001), acute kidney injury (AKI), which was found to be associated with mortality (p < 0.001), and mortality (p < 0.001)]. In multivariate regression analysis, CKD stage 3–5, AKI, male gender, hypertension, DM and malignancy were found to be significant independent variables increasing mortality. Conclusion The prevelance of CKD stage 3–5 on admission is associated with a high risk of in-hospital mortality in patients with COVID-19. Close follow-up can be recommended for patients with a reduced glomerular filtration rate (GFR).
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Affiliation(s)
- Mahmut Gok
- Nephrology Department, Sultan Abdulhamid Han Training Hospital, Istanbul, Turkey.
| | - Hakki Cetinkaya
- Nephrology Department, Sultan Abdulhamid Han Training Hospital, Istanbul, Turkey
| | - Tugba Kandemir
- Internal Medicine Department, Sultan Abdulhamid Han Training Hospital, Istanbul, Turkey
| | - Erdem Karahan
- Internal Medicine Department, Sultan Abdulhamid Han Training Hospital, Istanbul, Turkey
| | - İzzet Burak Tuncer
- Internal Medicine Department, Sultan Abdulhamid Han Training Hospital, Istanbul, Turkey
| | - Cengiz Bukrek
- Internal Medicine Department, Sultan Abdulhamid Han Training Hospital, Istanbul, Turkey
| | - Gulizar Sahin
- Nephrology Department, Sultan Abdulhamid Han Training Hospital, Istanbul, Turkey
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Ho FK, Petermann-Rocha F, Gray SR, Jani BD, Katikireddi SV, Niedzwiedz CL, Foster H, Hastie CE, Mackay DF, Gill JMR, O'Donnell C, Welsh P, Mair F, Sattar N, Celis-Morales CA, Pell JP. Is older age associated with COVID-19 mortality in the absence of other risk factors? General population cohort study of 470,034 participants. PLoS One 2020; 15:e0241824. [PMID: 33152008 PMCID: PMC7644030 DOI: 10.1371/journal.pone.0241824] [Citation(s) in RCA: 190] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 10/22/2020] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Older people have been reported to be at higher risk of COVID-19 mortality. This study explored the factors mediating this association and whether older age was associated with increased mortality risk in the absence of other risk factors. METHODS In UK Biobank, a population cohort study, baseline data were linked to COVID-19 deaths. Poisson regression was used to study the association between current age and COVID-19 mortality. RESULTS Among eligible participants, 438 (0.09%) died of COVID-19. Current age was associated exponentially with COVID-19 mortality. Overall, participants aged ≥75 years were at 13-fold (95% CI 9.13-17.85) mortality risk compared with those <65 years. Low forced expiratory volume in 1 second, high systolic blood pressure, low handgrip strength, and multiple long-term conditions were significant mediators, and collectively explained 39.3% of their excess risk. The associations between these risk factors and COVID-19 mortality were stronger among older participants. Participants aged ≥75 without additional risk factors were at 4-fold risk (95% CI 1.57-9.96, P = 0.004) compared with all participants aged <65 years. CONCLUSIONS Higher COVID-19 mortality among older adults was partially explained by other risk factors. 'Healthy' older adults were at much lower risk. Nonetheless, older age was an independent risk factor for COVID-19 mortality.
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Affiliation(s)
- Frederick K. Ho
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Fanny Petermann-Rocha
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Stuart R. Gray
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Bhautesh D. Jani
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | | | - Claire L. Niedzwiedz
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Hamish Foster
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Claire E. Hastie
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Daniel F. Mackay
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Jason M. R. Gill
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Catherine O'Donnell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Paul Welsh
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Frances Mair
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Carlos A. Celis-Morales
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Jill P. Pell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
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Bashir S, Moneeba S, Alghamdi A, Alghamdi F, Niaz A, Anan H, Kaleem I. Comorbidities in Patients with COVID-19 and Their Impact on the Severity of the Disease. JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2020. [DOI: 10.1055/s-0040-1718848] [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]
Abstract
AbstractInfection with COVID-19 is associated with significant morbidity, especially in patients with chronic medical conditions. At least one-fifth of cases require supportive care in intensive care units, which have limited availability in most developing countries. A literature search was conducted on PubMed, Medline, Scopus, Embase, and Google Scholar to find articles published by May 7, 2020 on the role of comorbidities in patients with COVID-19 and the impact of comorbidities on the disease. This review highlighted that patients with comorbidities are more likely to experience severe disease than those with no other conditions; that is, comorbidities correlated with greater disease severity in patients with COVID-19. Proper screening of COVID-19 patients should include careful inquiries into their medical history; this will help healthcare providers identify patients who are more likely to develop serious disease or experience adverse outcomes. Better protection should also be given to patients with COVID-19 and comorbidities upon confirmation of the diagnosis. This literature review showed that the comorbidities most often associated with more severe cases of COVID-19 are hypertension, cardiovascular disease, and diabetes. Individuals with these comorbidities should adopt restrictive measures to prevent exposure to COVID-19, given their higher risk of severe disease.
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Affiliation(s)
- Shahid Bashir
- Neuroscience Center, King Fahad Specialist Hospital Dammam, Dammam, Saudi Arabia
| | - Sadaf Moneeba
- Department of Bioinformatics and Biotechnology, International Islamic University Islamabad, Islamabad, Pakistan
| | - Alaa Alghamdi
- King Fahad University Hospital, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Fouad Alghamdi
- Neuroscience Center, King Fahad Specialist Hospital Dammam, Dammam, Saudi Arabia
| | - Asim Niaz
- Neuroscience Center, King Fahad Specialist Hospital Dammam, Dammam, Saudi Arabia
| | - Hadeel Anan
- Neuroscience Center, King Fahad Specialist Hospital Dammam, Dammam, Saudi Arabia
| | - Imdad Kaleem
- Department of Bioinformatics and Biosciences, COMSATS University (CUI), Islamabad, Pakistan
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Zhou Y, Yang Q, Chi J, Dong B, Lv W, Shen L, Wang Y. Comorbidities and the risk of severe or fatal outcomes associated with coronavirus disease 2019: A systematic review and meta-analysis. Int J Infect Dis 2020; 99:47-56. [PMID: 32721533 PMCID: PMC7381888 DOI: 10.1016/j.ijid.2020.07.029] [Citation(s) in RCA: 253] [Impact Index Per Article: 50.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/08/2020] [Accepted: 07/19/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Existing findings regarding the relationship between comorbidities and the severity of coronavirus disease 2019 (COVID-19) are inconsistent and insufficient. The aim of this study was to evaluate the association between different comorbidities and the severity of COVID-19. METHODS The PubMed, Embase, and Cochrane Library databases were searched to identify studies reporting the rates of comorbidities in COVID-19 patients with severe/fatal outcomes. Subgroup analyses were conducted according to disease severity and the country of residence. Odds ratios (OR) with 95% confidence intervals (CI) were pooled using random-effects models. RESULTS A total of 34 eligible studies were identified. In patients with severe/fatal COVID-19, the most prevalent chronic comorbidities were obesity (42%, 95% CI 34-49%) and hypertension (40%, 95% CI 35-45%), followed by diabetes (17%, 95% CI 15-20%), cardiovascular disease (13%, 95% CI 11-15%), respiratory disease (8%, 95% CI 6-10%), cerebrovascular disease (6%, 95% CI 4-8%), malignancy (4%, 95% CI 3-6%), kidney disease (3%, 95% CI 2-4%), and liver disease (2%, 95% CI 1-3%). In order of the prediction, the pooled ORs of the comorbidities in patients with severe or fatal COVID-19 when compared to patients with non-severe/fatal COVID-19 were as follows: chronic respiratory disease, OR 3.56 (95% CI 2.87-4.41); hypertension, OR 3.17 (95% CI 2.46-4.08); cardiovascular disease, OR 3.13 (95% CI 2.65-3.70); kidney disease, OR 3.02 (95% CI 2.23-4.08); cerebrovascular disease, OR 2.74 (95% CI 1.59-4.74); malignancy, OR 2.73 (95% CI 1.73-4.21); diabetes, OR 2.63 (95% CI 2.08-3.33); and obesity, OR 1.72 (95% CI 1.04-2.85). No correlation was observed between liver disease and COVID-19 aggravation (OR 1.54, 95% CI 0.95-2.49). CONCLUSIONS Chronic comorbidities, including obesity, hypertension, diabetes, cardiovascular disease, cerebrovascular disease, respiratory disease, kidney disease, and malignancy are clinical risk factors for a severe or fatal outcome associated with COVID-19, with obesity being the most prevalent and respiratory disease being the most strongly predictive. Knowledge of these risk factors could help clinicians better identify and manage the high-risk populations.
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Affiliation(s)
- Yue Zhou
- Department of Endocrinology, Affiliated Hospital of Medical College Qingdao University, Qingdao, China
| | - Qing Yang
- Institute of Biophysics, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Beijing, China
| | - Jingwei Chi
- Department of Endocrinology, Affiliated Hospital of Medical College Qingdao University, Qingdao, China
| | - Bingzi Dong
- Department of Endocrinology, Affiliated Hospital of Medical College Qingdao University, Qingdao, China
| | - Wenshan Lv
- Department of Endocrinology, Affiliated Hospital of Medical College Qingdao University, Qingdao, China
| | - Liyan Shen
- Department of Endocrinology, Affiliated Hospital of Medical College Qingdao University, Qingdao, China.
| | - Yangang Wang
- Department of Endocrinology, Affiliated Hospital of Medical College Qingdao University, Qingdao, China.
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Guan WJ, Liang WH, He JX, Zhong NS. Cardiovascular comorbidity and its impact on patients with COVID-19. Eur Respir J 2020; 55:13993003.01227-2020. [PMID: 32341104 PMCID: PMC7236831 DOI: 10.1183/13993003.01227-2020] [Citation(s) in RCA: 298] [Impact Index Per Article: 59.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 04/17/2020] [Indexed: 12/17/2022]
Abstract
We truly appreciate the comments from C.E. Leiva Sisnieguez and colleagues, who have performed a further analysis on the potential association between cardiovascular comorbidities and the clinical outcomes of coronavirus disease 2019 (COVID-19), particularly the mortality). We also applaud the suggestion to thoroughly adjust for potential confounding factors when interpreting the association between specific categories of cardiovascular comorbidities (e.g. hypertension) and the clinical outcomes of COVID-19. To this end, we have attempted to incorporate the cardiovascular diseases (including coronary heart disease) into the multivariate regression model [1]. Findings of the model indicated a prominent collinearity between hypertension and coronary heart disease, and we have therefore elected to retain hypertension in the regression model for further analyses. Comorbid hypertension correlates with poorer outcomes in patients with COVID-19https://bit.ly/2zoT9f0
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Affiliation(s)
- Wei-Jie Guan
- State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.,Wei-jie Guan and Wen-hua Liang are joint first authors
| | - Wen-Hua Liang
- Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Wei-jie Guan and Wen-hua Liang are joint first authors
| | - Jian-Xing He
- Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Nan-Shan Zhong
- State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
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10
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Guan WJ, Liang WH, Zhao Y, Liang HR, Chen ZS, Li YM, Liu XQ, Chen RC, Tang CL, Wang T, Ou CQ, Li L, Chen PY, Sang L, Wang W, Li JF, Li CC, Ou LM, Cheng B, Xiong S, Ni ZY, Xiang J, Hu Y, Liu L, Shan H, Lei CL, Peng YX, Wei L, Liu Y, Hu YH, Peng P, Wang JM, Liu JY, Chen Z, Li G, Zheng ZJ, Qiu SQ, Luo J, Ye CJ, Zhu SY, Cheng LL, Ye F, Li SY, Zheng JP, Zhang NF, Zhong NS, He JX. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J 2020; 55:13993003.00547-2020. [PMID: 32217650 PMCID: PMC7098485 DOI: 10.1183/13993003.00547-2020] [Citation(s) in RCA: 2184] [Impact Index Per Article: 436.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 03/13/2020] [Indexed: 02/07/2023]
Abstract
Background The coronavirus disease 2019 (COVID-19) outbreak is evolving rapidly worldwide. Objective To evaluate the risk of serious adverse outcomes in patients with COVID-19 by stratifying the comorbidity status. Methods We analysed data from 1590 laboratory confirmed hospitalised patients from 575 hospitals in 31 provinces/autonomous regions/provincial municipalities across mainland China between 11 December 2019 and 31 January 2020. We analysed the composite end-points, which consisted of admission to an intensive care unit, invasive ventilation or death. The risk of reaching the composite end-points was compared according to the presence and number of comorbidities. Results The mean age was 48.9 years and 686 (42.7%) patients were female. Severe cases accounted for 16.0% of the study population. 131 (8.2%) patients reached the composite end-points. 399 (25.1%) reported having at least one comorbidity. The most prevalent comorbidity was hypertension (16.9%), followed by diabetes (8.2%). 130 (8.2%) patients reported having two or more comorbidities. After adjusting for age and smoking status, COPD (HR (95% CI) 2.681 (1.424–5.048)), diabetes (1.59 (1.03–2.45)), hypertension (1.58 (1.07–2.32)) and malignancy (3.50 (1.60–7.64)) were risk factors of reaching the composite end-points. The hazard ratio (95% CI) was 1.79 (1.16–2.77) among patients with at least one comorbidity and 2.59 (1.61–4.17) among patients with two or more comorbidities. Conclusion Among laboratory confirmed cases of COVID-19, patients with any comorbidity yielded poorer clinical outcomes than those without. A greater number of comorbidities also correlated with poorer clinical outcomes. The presence and number of comorbidities predict clinical outcomes of COVID-19http://bit.ly/3b9ibw5
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Affiliation(s)
- Wei-Jie Guan
- State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.,These authors are joint first authors
| | - Wen-Hua Liang
- Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,These authors are joint first authors
| | - Yi Zhao
- Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,These authors are joint first authors
| | - Heng-Rui Liang
- Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,These authors are joint first authors
| | - Zi-Sheng Chen
- Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,The sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan, China.,These authors are joint first authors
| | - Yi-Min Li
- Dept of Pulmonary and Critical Care Medicine, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiao-Qing Liu
- Dept of Pulmonary and Critical Care Medicine, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ru-Chong Chen
- State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Chun-Li Tang
- State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Tao Wang
- State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Chun-Quan Ou
- State Key Laboratory of Organ Failure Research, Dept of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Li Li
- State Key Laboratory of Organ Failure Research, Dept of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Ping-Yan Chen
- State Key Laboratory of Organ Failure Research, Dept of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Ling Sang
- Dept of Pulmonary and Critical Care Medicine, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wei Wang
- Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jian-Fu Li
- Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Cai-Chen Li
- Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Li-Min Ou
- Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Bo Cheng
- Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shan Xiong
- Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | | | - Jie Xiang
- Wuhan Jin-yintan Hospital, Wuhan, China
| | - Yu Hu
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lei Liu
- Shenzhen Third People's Hospital, Shenzhen, China.,The Second Affiliated Hospital of Southern University of Science and Technology, National Clinical Research Center for Infectious Diseases, Shenzhen, China
| | - Hong Shan
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Chun-Liang Lei
- Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | | | - Li Wei
- Wuhan No. 1 Hospital, Wuhan Hospital of Traditional Chinese and Western Medicine, Wuhan, China
| | - Yong Liu
- Chengdu Public Health Clinical Medical Center, Chengdu, China
| | - Ya-Hua Hu
- Huangshi Central Hospital of Edong Healthcare Group, Affiliated Hospital of Hubei Polytechnic University, Huangshi, China
| | - Peng Peng
- Wuhan Pulmonary Hospital, Wuhan, China
| | - Jian-Ming Wang
- Tianyou Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Ji-Yang Liu
- The First Hospital of Changsha, Changsha, China
| | - Zhong Chen
- The Third People's Hospital of Hainan Province, Sanya, China
| | - Gang Li
- Huanggang Central Hospital, Huanggang, China
| | | | - Shao-Qin Qiu
- The Third People's Hospital of Yichang, Yichang, China
| | - Jie Luo
- Affiliated Taihe Hospital of Hubei University of Medicine, Shiyan, China
| | | | - Shao-Yong Zhu
- The People's Hospital of Huangpi District, Wuhan, China
| | - Lin-Ling Cheng
- State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Feng Ye
- State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Shi-Yue Li
- State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Jin-Ping Zheng
- State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Nuo-Fu Zhang
- State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Nan-Shan Zhong
- State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Jian-Xing He
- Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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11
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Marshall CJ, Rodriguez HP, Dyer W, Schmittdiel JA. Racial and Ethnic Disparities in Diabetes Care Quality among Women of Reproductive Age in an Integrated Delivery System. Womens Health Issues 2020; 30:191-199. [PMID: 32340896 DOI: 10.1016/j.whi.2020.03.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 03/12/2020] [Accepted: 03/13/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND Diabetes is increasingly prevalent among women of reproductive age, yet little is known about quality of diabetes care for this population at increased risk of diabetes complications and poor maternal and infant health outcomes. Previous studies have identified racial/ethnic disparities in diabetes care, but patterns among women of reproductive age have not been examined. METHODS This retrospective cohort study analyzed 2016 data from Kaiser Permanente Northern California, a large integrated delivery system. Outcomes were quality of diabetes care measures-glycemic testing, glycemic control, and medication adherence-among women ages 18 to 44 with type 1 or type 2 diabetes (N = 9,923). Poisson regression was used to estimate the association between patient race/ethnicity and each outcome, adjusting for other patient characteristics and health care use. RESULTS In this cohort, 83% of participants had type 2 diabetes; 31% and 36% of women with type 2 and type 1 diabetes, respectively, had poor glycemic control (hemoglobin A1c of ≥9%), and approximately one-third of women with type 2 diabetes exhibited nonadherence to diabetes medications. Compared with non-Hispanic White women with type 2 diabetes, non-Hispanic Black women (adjusted risk ratio, 1.2; 95% confidence interval, 1.1-1.3) and Hispanic women (adjusted risk ratio, 1.2; 95% confidence interval, 1.1-1.3) were more likely to have poor control. Findings among women with type 1 diabetes were similar. CONCLUSIONS Our findings indicate opportunities to decrease disparities and improve quality of diabetes care for reproductive-aged women. Elucidating the contributing factors to poor glycemic control and medication adherence in this population, particularly among Black, Hispanic, and Asian women, should be a high research and practice priority.
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Affiliation(s)
- Cassondra J Marshall
- School of Public Health, University of California, Berkeley, Berkeley, California.
| | - Hector P Rodriguez
- School of Public Health, University of California, Berkeley, Berkeley, California
| | - Wendy Dyer
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Julie A Schmittdiel
- Division of Research, Kaiser Permanente Northern California, Oakland, California
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12
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Guan WJ, Liang WH, Zhao Y, Liang HR, Chen ZS, Li YM, Liu XQ, Chen RC, Tang CL, Wang T, Ou CQ, Li L, Chen PY, Sang L, Wang W, Li JF, Li CC, Ou LM, Cheng B, Xiong S, Ni ZY, Xiang J, Hu Y, Liu L, Shan H, Lei CL, Peng YX, Wei L, Liu Y, Hu YH, Peng P, Wang JM, Liu JY, Chen Z, Li G, Zheng ZJ, Qiu SQ, Luo J, Ye CJ, Zhu SY, Cheng LL, Ye F, Li SY, Zheng JP, Zhang NF, Zhong NS, He JX. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J 2020. [PMID: 32217650 DOI: 10.1183/13993003.00547‐2020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) outbreak is evolving rapidly worldwide. OBJECTIVE To evaluate the risk of serious adverse outcomes in patients with COVID-19 by stratifying the comorbidity status. METHODS We analysed data from 1590 laboratory confirmed hospitalised patients from 575 hospitals in 31 provinces/autonomous regions/provincial municipalities across mainland China between 11 December 2019 and 31 January 2020. We analysed the composite end-points, which consisted of admission to an intensive care unit, invasive ventilation or death. The risk of reaching the composite end-points was compared according to the presence and number of comorbidities. RESULTS The mean age was 48.9 years and 686 (42.7%) patients were female. Severe cases accounted for 16.0% of the study population. 131 (8.2%) patients reached the composite end-points. 399 (25.1%) reported having at least one comorbidity. The most prevalent comorbidity was hypertension (16.9%), followed by diabetes (8.2%). 130 (8.2%) patients reported having two or more comorbidities. After adjusting for age and smoking status, COPD (HR (95% CI) 2.681 (1.424-5.048)), diabetes (1.59 (1.03-2.45)), hypertension (1.58 (1.07-2.32)) and malignancy (3.50 (1.60-7.64)) were risk factors of reaching the composite end-points. The hazard ratio (95% CI) was 1.79 (1.16-2.77) among patients with at least one comorbidity and 2.59 (1.61-4.17) among patients with two or more comorbidities. CONCLUSION Among laboratory confirmed cases of COVID-19, patients with any comorbidity yielded poorer clinical outcomes than those without. A greater number of comorbidities also correlated with poorer clinical outcomes.
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Affiliation(s)
- Wei-Jie Guan
- State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.,These authors are joint first authors
| | - Wen-Hua Liang
- Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,These authors are joint first authors
| | - Yi Zhao
- Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,These authors are joint first authors
| | - Heng-Rui Liang
- Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,These authors are joint first authors
| | - Zi-Sheng Chen
- Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,The sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan, China.,These authors are joint first authors
| | - Yi-Min Li
- Dept of Pulmonary and Critical Care Medicine, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiao-Qing Liu
- Dept of Pulmonary and Critical Care Medicine, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ru-Chong Chen
- State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Chun-Li Tang
- State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Tao Wang
- State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Chun-Quan Ou
- State Key Laboratory of Organ Failure Research, Dept of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Li Li
- State Key Laboratory of Organ Failure Research, Dept of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Ping-Yan Chen
- State Key Laboratory of Organ Failure Research, Dept of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Ling Sang
- Dept of Pulmonary and Critical Care Medicine, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wei Wang
- Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jian-Fu Li
- Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Cai-Chen Li
- Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Li-Min Ou
- Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Bo Cheng
- Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shan Xiong
- Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | | | - Jie Xiang
- Wuhan Jin-yintan Hospital, Wuhan, China
| | - Yu Hu
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lei Liu
- Shenzhen Third People's Hospital, Shenzhen, China.,The Second Affiliated Hospital of Southern University of Science and Technology, National Clinical Research Center for Infectious Diseases, Shenzhen, China
| | - Hong Shan
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Chun-Liang Lei
- Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | | | - Li Wei
- Wuhan No. 1 Hospital, Wuhan Hospital of Traditional Chinese and Western Medicine, Wuhan, China
| | - Yong Liu
- Chengdu Public Health Clinical Medical Center, Chengdu, China
| | - Ya-Hua Hu
- Huangshi Central Hospital of Edong Healthcare Group, Affiliated Hospital of Hubei Polytechnic University, Huangshi, China
| | - Peng Peng
- Wuhan Pulmonary Hospital, Wuhan, China
| | - Jian-Ming Wang
- Tianyou Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Ji-Yang Liu
- The First Hospital of Changsha, Changsha, China
| | - Zhong Chen
- The Third People's Hospital of Hainan Province, Sanya, China
| | - Gang Li
- Huanggang Central Hospital, Huanggang, China
| | | | - Shao-Qin Qiu
- The Third People's Hospital of Yichang, Yichang, China
| | - Jie Luo
- Affiliated Taihe Hospital of Hubei University of Medicine, Shiyan, China
| | | | - Shao-Yong Zhu
- The People's Hospital of Huangpi District, Wuhan, China
| | - Lin-Ling Cheng
- State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Feng Ye
- State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Shi-Yue Li
- State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Jin-Ping Zheng
- State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Nuo-Fu Zhang
- State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Nan-Shan Zhong
- State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Jian-Xing He
- Dept of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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13
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Radhakrishnan D, Dell SD, Guttmann A, Shariff SZ, To T. 20-Year trends in severe childhood asthma outcomes: Hospitalizations and intensive care visits. CANADIAN JOURNAL OF RESPIRATORY CRITICAL CARE AND SLEEP MEDICINE 2018. [DOI: 10.1080/24745332.2018.1474401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Dhenuka Radhakrishnan
- Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Ontario, Canada
| | - Sharon D. Dell
- Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Astrid Guttmann
- Institute for Clinical Evaluative Sciences, Ontario, Canada
- Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | | | - Teresa To
- Institute for Clinical Evaluative Sciences, Ontario, Canada
- Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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14
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Schwarze J, Openshaw P, Jha A, Del Giacco SR, Firinu D, Tsilochristou O, Roberts G, Selby A, Akdis C, Agache I, Custovic A, Heffler E, Pinna G, Khaitov M, Nikonova A, Papadopoulos N, Akhlaq A, Nurmatov U, Renz H, Sheikh A, Skevaki C. Influenza burden, prevention, and treatment in asthma-A scoping review by the EAACI Influenza in asthma task force. Allergy 2018; 73:1151-1181. [PMID: 29105786 DOI: 10.1111/all.13333] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2017] [Indexed: 12/19/2022]
Abstract
To address uncertainties in the prevention and management of influenza in people with asthma, we performed a scoping review of the published literature on influenza burden; current vaccine recommendations; vaccination coverage; immunogenicity, efficacy, effectiveness, and safety of influenza vaccines; and the benefits of antiviral drugs in people with asthma. We found significant variation in the reported rates of influenza detection in individuals with acute asthma exacerbations making it unclear to what degree influenza causes exacerbations of underlying asthma. The strongest evidence of an association was seen in studies of children. Countries in the European Union currently recommend influenza vaccination of adults with asthma; however, coverage varied between regions. Coverage was lower among children with asthma. Limited data suggest that good seroprotection and seroconversion can be achieved in both children and adults with asthma and that vaccination confers a degree of protection against influenza illness and asthma-related morbidity to children with asthma. There were insufficient data to determine efficacy in adults. Overall, influenza vaccines appeared to be safe for people with asthma. We identify knowledge gaps and make recommendations on future research needs in relation to influenza in patients with asthma.
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Affiliation(s)
- J Schwarze
- Centre for Inflammation Research, The Queens Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - P Openshaw
- Respiratory Sciences, National Heart and Lung Institute, Imperial College London, London, UK
| | - A Jha
- Respiratory Sciences, National Heart and Lung Institute, Imperial College London, London, UK
| | - S R Del Giacco
- Department of Medical Sciences and Public Health "M. Aresu", University of Cagliari, Cagliari, Italy
| | - D Firinu
- Department of Medical Sciences and Public Health "M. Aresu", University of Cagliari, Cagliari, Italy
| | - O Tsilochristou
- Department of Pediatric Allergology, King's College, London, UK
| | - G Roberts
- Faculty of Medicine, Southampton and David Hide Asthma and Allergy Centre, St Mary's Hospital, University of Southampton, Newport, Isle of Wight, UK
| | - A Selby
- Faculty of Medicine, Southampton and David Hide Asthma and Allergy Centre, St Mary's Hospital, University of Southampton, Newport, Isle of Wight, UK
| | - C Akdis
- Swiss Institute of Allergy and Asthma Research, University of Zurich, Davos, Switzerland
| | - I Agache
- Department of Allergy and Clinical Immunology, Faculty of Medicine, Transylvania University Brasov, Brasov, Romania
| | - A Custovic
- Department of Paediatrics, Imperial College London, London, UK
| | - E Heffler
- Personalized Medicine, Asthma and Allergy Clinic, Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - G Pinna
- Department of Medical Microbiology, National Kapodistrian University of Athens, Athens, Greece
| | - M Khaitov
- National Research Center Institute of Immunology of Federal Medicobiological Agency, Moscow, Russia
| | - A Nikonova
- National Research Center Institute of Immunology of Federal Medicobiological Agency, Moscow, Russia
| | - N Papadopoulos
- Division of Infection, Inflammation & Respiratory Medicine, The University of Manchester, Manchester, UK
- Allergy Department, 2nd Paediatric Clinic, National Kapodistrian University of Athens, Athens, Greece
| | - A Akhlaq
- Department of Health and Hospital Management, Institute of Business Management, Korangi Creek, Karachi, 75190, Pakistan
| | - U Nurmatov
- Division of Population Medicine, School of Medicine, Cardiff University, the National Centre for Population Health and Wellbeing Research, Wales, UK
| | - H Renz
- Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps University Marburg, University Hospital Giessen & Marburg, Marburg, Germany
| | - A Sheikh
- Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - C Skevaki
- Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps University Marburg, University Hospital Giessen & Marburg, Marburg, Germany
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15
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Chao CM, Lai CC, Chan KS, Cheng KC, Chou W, Yuan KS, Chen CM. Outcomes of patients with severe influenza infection admitted to intensive care units: a retrospective study in a medical centre. J Med Microbiol 2017; 66:1421-1428. [DOI: 10.1099/jmm.0.000593] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Affiliation(s)
- Chien-Ming Chao
- Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan, ROC
| | - Chih-Cheng Lai
- Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan, ROC
| | - Khee-Siang Chan
- Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan, ROC
| | - Kuo-Chen Cheng
- Department of Safety Health and Environment, Chung Hwa University of Medical Technology, Tainan, Taiwan, ROC
- Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan, ROC
| | - Willy Chou
- Department of Recreation and Health-Care Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan, ROC
| | - Kuo-Shu Yuan
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan, ROC
- Department of Business Management, National Sun Yat-Sen University, Kaohsiung, Taiwan, ROC
| | - Chin-Ming Chen
- Department of Recreation and Health-Care Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan, ROC
- Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan, ROC
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GARCIA MN, PHILPOTT DC, MURRAY KO, ONTIVEROS A, REVELL PA, CHANDRAMOHAN L, MUNOZ FM. Clinical predictors of disease severity during the 2009-2010 A(HIN1) influenza virus pandemic in a paediatric population. Epidemiol Infect 2015; 143:2939-49. [PMID: 25640583 PMCID: PMC9151054 DOI: 10.1017/s0950268815000114] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 12/05/2014] [Accepted: 01/14/2015] [Indexed: 11/07/2022] Open
Abstract
A novel influenza virus emerged in the United States in spring 2009, rapidly becoming a global pandemic. Children were disproportionally affected by the novel influenza A(H1N1) pandemic virus [A(H1N1)pdm]. This retrospective electronic medical record review study aimed to identify clinical predictors of disease severity of influenza A(HIN1)pdm infection in paediatric patients. Disease severity was defined on an increasing three-level scale from non-hospitalized, hospitalized, and admitted to the intensive care unit (ICU). From April 2009 to June 2010, 696 children presented to Texas Children's Hospital's emergency department, 38% were hospitalized, and 17% were admitted to the ICU. Presenting symptoms associated with severe influenza were dyspnoea [odds ratio (OR) 5·82], tachycardia (OR 2·61) and fatigue (OR 1·96). Pre-existing health conditions associated with disease severity included seizure disorder (OR 4·71), obesity (OR 3·28), lung disease (OR 2·84), premature birth (OR 2·53), haematological disease (OR 2·22), and developmental delay (OR 2·20). According to model fitness tests, presenting symptoms were more likely to predict severe influenza than underlying medical conditions. However, both are important risk factors. Recognition of clinical characteristics associated with severe disease can be used for triaging case management of children during future influenza outbreaks.
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Affiliation(s)
- M. N. GARCIA
- Baylor College of Medicine and Texas Children's Hospital, Department of Pediatrics, Section of Tropical Medicine, and the National School of Tropical Medicine, Houston, TX, USA
| | - D. C. PHILPOTT
- Baylor College of Medicine and Texas Children's Hospital, Department of Pediatrics, Section of Tropical Medicine, and the National School of Tropical Medicine, Houston, TX, USA
| | - K. O. MURRAY
- Baylor College of Medicine and Texas Children's Hospital, Department of Pediatrics, Section of Tropical Medicine, and the National School of Tropical Medicine, Houston, TX, USA
| | - A. ONTIVEROS
- Baylor College of Medicine and Texas Children's Hospital, Department of Pediatrics, Section of Tropical Medicine, and the National School of Tropical Medicine, Houston, TX, USA
| | - P. A. REVELL
- Texas Children's Hospital, Department of Pathology and Immunology, Houston, TX, USA
| | - L. CHANDRAMOHAN
- Texas Children's Hospital, Department of Pathology and Immunology, Houston, TX, USA
| | - F. M. MUNOZ
- Baylor College of Medicine and Texas Children's Hospital, Departments of Pediatrics, Section of Infectious Diseases, and Molecular Virology and Microbiology, Houston, TX, USA
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