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Al-Taie A, Arueyingho O, Khoshnaw J, Hafeez A. Clinical outcomes of multidimensional association of type 2 diabetes mellitus, COVID-19 and sarcopenia: an algorithm and scoping systematic evaluation. Arch Physiol Biochem 2024; 130:342-360. [PMID: 35704400 DOI: 10.1080/13813455.2022.2086265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/25/2022] [Accepted: 05/31/2022] [Indexed: 01/08/2023]
Abstract
BACKGROUND The aim of this study was to provide a scoping and comprehensive review for the clinical outcomes from the cross-link of Type 2 diabetes mellitus (T2DM), COVID-19, and sarcopenia. METHODS By using PRISMA guidelines and searching through different databases that could provide findings of evidence on the association of T2DM, COVID-19, and sarcopenia. RESULTS Thirty-three studies reported a relationship between sarcopenia with T2DM, twenty-one studies reported the prognosis COVID-19 in patients with T2DM, ten studies reported the prognosis of COVID-19 in patients with sarcopenia, five studies discussed the outcomes of sarcopenia in patients with COVID-19, and one study reported sarcopenia outcomes in the presence of T2DM and COVID-19. CONCLUSION There is an obvious multidimensional relationship between T2DM, COVID-19 and sarcopenia which can cause prejudicial effects, poor prognosis, prolonged hospitalisation, lowered quality of life and a higher mortality rate during the current COVID-19 pandemic.
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Affiliation(s)
- Anmar Al-Taie
- Clinical Pharmacy Department, Faculty of Pharmacy, Istinye University, Istanbul, Turkey
| | - Oritsetimeyin Arueyingho
- EPSRC Centre for Doctoral Training in Digital Health and Care, University of Bristol, Bristol, UK
| | - Jalal Khoshnaw
- Pharmacy Department, Faculty of Pharmacy, Girne American University, Mersin, Turkey
| | - Abdul Hafeez
- Department of Pharmaceutics, Glocal School of Pharmacy, Glocal University, Saharanpur, Uttar Pradesh, India
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Reimondo G, Solitro F, Puglisi S, Balbi M, Tiranti GM, Perini AME, Cultrera A, Brero D, Botto C, Perotti P, Caramello V, Boccuzzi A, Pia A, Veltri A, Terzolo M. Serendipitous Adrenal Hyperplasia in Patients Admitted to the Emergency Department for Suspected SARS-CoV-2 Infection is Linked to Increased Mortality. Arch Med Res 2024; 55:103010. [PMID: 38805767 DOI: 10.1016/j.arcmed.2024.103010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 05/13/2024] [Accepted: 05/15/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND Few data are available on adrenal morphology in patients with acute diseases, although it is known that endogenous glucocorticoids are essential for survival under stress conditions and that an adequate response is driven by activation of the hypothalamic-pituitary-adrenal (HPA) axis. AIMS The aim of this study was to assess adrenal morphology in patients with acute disease compared with patients with non-acute disease. METHODS This cross-sectional study included: 402 patients admitted to the emergency department (ED) for suspected SARS-CoV-2 infection (March-May, 2020) [main cohort]; 200 patients admitted to the ED for acute conditions (December 2018-February 2019) [control group A]; 200 outpatients who underwent radiological evaluation of non-acute conditions (January-February 2019) [control group B]. Chest and/or abdominal CT scans were reviewed to identify adrenal nodules or hyperplasia. RESULTS In the main cohort, altered adrenal morphology was found in 24.9% of the patients (15.4% adrenal hyperplasia; 9.5% adrenal nodules). The frequency of adrenal hyperplasia was higher both in the main cohort (15.4%) and control group A (15.5%) compared to control group B (8.5%; p = 0.02 and p = 0.03, respectively). In the main cohort, 14.9% patients died within 30 d. According to a multivariate analysis, adrenal hyperplasia was an independent risk factor for mortality (p = 0.04), as were older age (p <0.001) and active cancer (p = 0.01). CONCLUSIONS The notable frequency of adrenal hyperplasia in patients with acute diseases suggests an exaggerated activation of the HPA axis due to stressful conditions. The increased risk of short-term mortality found in patients with adrenal hyperplasia suggests that it may be a possible hallmark of worse prognosis.
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Affiliation(s)
- Giuseppe Reimondo
- Internal Medicine 1, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy
| | - Federica Solitro
- Radiology Unit, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy
| | - Soraya Puglisi
- Internal Medicine 1, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy.
| | - Maurizio Balbi
- Radiology Unit, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy
| | - Giorgio Maria Tiranti
- Radiology Unit, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy
| | - Anna Maria Elena Perini
- Internal Medicine 1, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy
| | - Alessandra Cultrera
- Internal Medicine 1, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy
| | - Dalila Brero
- Internal Medicine 1, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy
| | - Cristina Botto
- Internal Medicine 1, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy
| | - Paola Perotti
- Internal Medicine 1, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy
| | | | - Adriana Boccuzzi
- Emergency Medicine, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - Anna Pia
- Internal Medicine 1, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy
| | - Andrea Veltri
- Radiology Unit, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy
| | - Massimo Terzolo
- Internal Medicine 1, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy
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Chan K, Baker J, Conroy A, Rubens M, Ramamoorthy V, Saxena A, Roy M, Jimenez J, Chaparro S. Burden of cardiovascular disease on coronavirus disease 2019 hospitalizations in the USA. Coron Artery Dis 2024:00019501-990000000-00234. [PMID: 38785219 DOI: 10.1097/mca.0000000000001390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
BACKGROUND Patients with cardiovascular disease (CVD) and risk factors have increased rates of adverse events and mortality after hospitalization for coronavirus disease 2019 (COVID-19). In this study, we attempted to identify and assess the effects of CVD on COVID-19 hospitalizations in the USA using a large national database. METHODS The current study was a retrospective analysis of data from the US National (Nationwide) Inpatient Sample from 2020. All adult patients 18 years of age and older who were admitted with the primary diagnosis of COVID-19 were included. The primary outcome was in-hospital mortality, while secondary outcomes included prolonged hospital length of stay, mechanical ventilation, and disposition other than home. Prolonged hospital length of stay was defined as a length of stay greater than the 75th percentile for the full sample. The diagnoses were identified using the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes. RESULTS A total of 1 050 040 patients were included in the study, of which 454 650 (43.3%) had prior CVD. Patients with CVD had higher mortality during COVID-19 hospitalization (19.3 vs. 5.0%, P < 0.001). Similarly, these patients had a higher rate of prolonged hospital length of stay (34.5 vs. 21.0%, P < 0.001), required mechanical ventilation (15.4 vs. 5.6%, P < 0.001), and were more likely to be discharged to a disposition other than home (62.5 vs. 32.3%, P < 0.001). Mean hospitalization cost was also higher in patients with CVD during hospitalization ($24 023 vs. $15 320, P < 0.001). Conditional logistic regression analysis showed that the odds of in-hospital mortality [odds ratio (OR), 3.23; 95% confidence interval (CI), 2.91-3.45] were significantly higher for COVID-19 hospitalizations with CVD, compared with those without CVD. Similarly, prolonged hospital length (OR, 1.82; 95% CI, 1.43-2.23), mechanical ventilation (OR, 3.31; 95% CI, 3.06-3.67), and disposition other than home (OR, 2.01; 95% CI, 1.87-2.21) were also significantly higher for COVID-19 hospitalizations with coronary artery disease. CONCLUSION Our study showed that the presence of CVD has a significant negative impact on the prognosis of patients hospitalized for COVID-19. There was an associated increase in mortality, length of stay, ventilator use, and adverse discharge dispositions among COVID-19 patients with CVD. Adjustment in treatment for CVD should be considered when providing care to patients hospitalized for COVID-19 to mitigate some of the adverse hospital outcomes.
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Affiliation(s)
- Kelvin Chan
- Department of Internal Medicine, Nova Southeastern University, Fort Lauderdale
| | - Jiana Baker
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University
| | - Abigail Conroy
- Department of Internal Medicine, Nova Southeastern University, Fort Lauderdale
| | - Muni Rubens
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University
- Department of Heart Failure, Miami Cardiac and Vascular Medicine, Baptist Health South Florida, Miami, Florida, USA
- Universidad Espiritu Santo, Guayaquil, Ecuador
| | | | - Anshul Saxena
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University
- Center for Advanced Analytics, Baptist Health South Florida, Miami, Florida, USA
| | - Mukesh Roy
- Department of Heart Failure, Miami Cardiac and Vascular Medicine, Baptist Health South Florida, Miami, Florida, USA
| | - Javier Jimenez
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University
- Department of Heart Failure, Miami Cardiac and Vascular Medicine, Baptist Health South Florida, Miami, Florida, USA
| | - Sandra Chaparro
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University
- Department of Heart Failure, Miami Cardiac and Vascular Medicine, Baptist Health South Florida, Miami, Florida, USA
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Tadie MB, Yimer YS, Taye G. Determinants of COVID-19 severity in Ethiopia: a multicentre case-control study. BMJ Open 2024; 14:e083076. [PMID: 38803268 DOI: 10.1136/bmjopen-2023-083076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVE It was necessary to understand the determinants of severe COVID-19 in order to deliver targeted healthcare services to prevent further complications and mortality. Identifying the factors associated with severe COVID-19 in Addis Ababa, Ethiopia, is the aim of this study. DESIGN A case-control study was conducted from October 2021 to March 2022. SETTING The study was conducted at three public COVID-19 treatment centres including Ekka Kotebe General, St. Peter Hospital and St. Paul's Hospital. PARTICIPANTS The study participants were COVID-19 patients admitted to three COVID-19 treatment centres. Cases were patients admitted with severe COVID-19, and controls were patients with mild or moderate COVID-19. A total of 306 patients (153 cases and 153 controls) selected by simple random sampling technique participated in this study. OUTCOME MEASURES AND ANALYSIS Data were collected by a face-to-face or telephone interviewer using a structured questionnaire. COVID-19 admission category, clinical and biomedical characteristics and comorbidity-related data were extracted from the participant's medical record. Multivariable binary logistic regression analysis was used to identify predictors of COVID-19 severity. RESULTS The odds of being old were 4.54 times higher among severe COVID-19 cases (adjusted odds ratio (AOR)=4.54, 95% CI=2.499 to 8.24), the odds of being male were 2.72 times higher among severe COVID-19 cases (AOR=2.72, 95% CI=1.46 to 5.057), being vaccinated for COVID-19 decreases the severity by 55.1% (AOR=0.449, 95% CI=0.251 to 0.801), having good knowledge about COVID-19 decreases by 65% (AOR=0.35%, 95% CI=0.195 to 0.63) among patients with severe COVID-19, the odds of being diabetic were 10.2 times higher among severe COVID-19 cases (AOR=10.2, 95% CI=4.596 to 22.61) and the odds of being hypertensive were 2.3 times higher among severe COVID-19 cases (AOR=2.26, 95% CI=1.092 to 4.685). CONCLUSION Male, older age, diabetes or hypertension comorbidity, COVID-19 vaccination and having inadequate knowledge about COVID-19 were determinant factors of severe COVID-19.
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Affiliation(s)
| | - Yimer Seid Yimer
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Girma Taye
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
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Al-Kuraishy HM, Mazhar Ashour MH, Saad HM, Batiha GES. COVID-19 and β-thalassemia: in lieu of evidence and vague nexus. Ann Hematol 2024; 103:1423-1433. [PMID: 37405444 DOI: 10.1007/s00277-023-05346-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 06/27/2023] [Indexed: 07/06/2023]
Abstract
Coronavirus disease 19 (COVID-19) is an infectious disease caused by severe acute respiratory coronavirus 2 (SARS-CoV-2) causing acute systemic disorders and multi-organ damage. β-thalassemia (β-T) is an autosomal recessive disorder leading to the development of anemia. β-T may lead to complications such as immunological disorders, iron overload, oxidative stress, and endocrinopathy. β-T and associated complications may increase the risk of SARS-CoV-2, as inflammatory disturbances and oxidative stress disorders are linked with COVID-19. Therefore, the objective of the present review was to elucidate the potential link between β-T and COVID-19 regarding the underlying comorbidities. The present review showed that most of the β-T patients with COVID-19 revealed mild to moderate clinical features, and β-T may not be linked with Covid-19 severity. Though patients with transfusion-dependent β-T (TDT) develop less COVID-19 severity compared to non-transfusion-depend β-T(NTDT), preclinical and clinical studies are recommended in this regard.
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Affiliation(s)
- Hayder M Al-Kuraishy
- Department of Clinical Pharmacology and Therapeutic Medicine, College of Medicine, Al-Mustansiriyiah University, Box 14132, Baghdad, Iraq
| | | | - Hebatallah M Saad
- Department of Pathology, Faculty of Veterinary Medicine, Matrouh University, Marsa Matruh, 51744, Egypt.
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, AlBeheira, Damanhour, 22511, Egypt
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Abraham R, Biju A, Ittyachen AM. Diabetes Mellitus and Other Comorbidities: Outcome among Covid-19 Patients in Kerala: A Retrospective Observational Study. J Family Med Prim Care 2024; 13:1544-1549. [PMID: 38827707 PMCID: PMC11141971 DOI: 10.4103/jfmpc.jfmpc_1529_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 06/04/2024] Open
Abstract
Background Covid-19 was declared by the WHO as a pandemic in 2020; India was also severely affected. Diabetes, a major lifestyle disorder, has seen its prevalence rate rising in developing countries. India is home to the world's second-largest population of diabetes. Several studies have reported greater severity and mortality of Covid-19 in diabetic patients. Methodology This was a hospital-based retrospective study done in a rural-based medical college in Kerala State. Data was collected using a semi-structured proforma and analysis was performed using Statistical Package for Social Sciences software version 25. The study was part of the STS research program of the Indian Council of Medical Research (ICMR). Results There were 567 patients in the study. Those with pre-existing diabetes had a worse outcome compared to those with newly detected diabetes. The presence of CKD was associated with a poor outcome. Patients admitted to the ICU, and those on assisted ventilation also had a lower survival rate; within the subgroup, those on non-invasive ventilation had a better outcome. Conclusion Mortality in Covid-19 is multifactorial. Those with diabetes have a poor outcome. Comorbidities have been reported to confer a high mortality rate in Covid-19 but this was not so in our study (except for CKD). Variability in outcome with respect to comorbidities and better outcomes in those who were non-invasively ventilated calls for more research to establish the relationship between pre-existing conditions and severity of disease. The use of non-invasive ventilation could also provide succor to resource-limited communities.
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Affiliation(s)
- Rahael Abraham
- Department of Medicine, M.O.S.C Medical College and Hospital, Kolenchery, Ernakulam District, Kerala, India
| | - Asha Biju
- Department of Medicine, M.O.S.C Medical College and Hospital, Kolenchery, Ernakulam District, Kerala, India
| | - Abraham M. Ittyachen
- Department of Medicine, M.O.S.C Medical College and Hospital, Kolenchery, Ernakulam District, Kerala, India
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Servais T, Laurent F, Roland T, Rossi C, De Groote E, Godart V, Repetto E, Ponchon M, Chasseur P, Crenier L, Van Eeckhoudt S, Yango J, Oriot P, Morisca Gavriliu M, Rouhard S, Deketelaere B, Maiter D, Hermans MP, Yombi JC, Orioli L. Mortality-related risk factors of inpatients with diabetes and COVID-19: A multicenter retrospective study in Belgium. ANNALES D'ENDOCRINOLOGIE 2024; 85:36-43. [PMID: 37574109 DOI: 10.1016/j.ando.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 06/01/2023] [Accepted: 08/03/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND AND AIMS We describe mortality-related risk factors of inpatients with diabetes and coronavirus disease 2019 (COVID-19) in Belgium. METHODS We conducted a multicenter retrospective study from March to May, 2020, in 8 Belgian centers. Data on admission of patients with diabetes and COVID-19 were collected. Survivors were compared to non-survivors to identify prognostic risk factors for in-hospital death using multivariate analysis in both the total population and in the subgroup of patients admitted in the intensive care unit (ICU). RESULTS The study included 375 patients. The mortality rate was 26.4% (99/375) in the total population and 40% (27/67) in the ICU. Multivariate analysis identified older age (HR 1.05 [CI 1.03-1.07], P<0.0001) and male gender (HR 2.01 [1.31-3.07], P=0.0013) as main independent risk factors for in-hospital death in the total population. Metformin (HR 0.51 [0.34-0.78], P=0.0018) and renin-angiotensin-aldosterone system blockers (HR 0.56 [0.36-0.86], P=0.0088) use before admission were independent protective factors. In the ICU, chronic kidney disease (CKD) was identified as an independent risk factor for death (HR 4.96 [2.14-11.5], P<0.001). CONCLUSION In-hospital mortality due to the first wave of COVID-19 pandemic in Belgium was high in patients with diabetes. We found that advanced age and male gender were independent risk factors for in-hospital death. We also showed that metformin use before admission was associated with a significant reduction of COVID-19-related in-hospital mortality. Finally, we showed that CKD is a COVID-19-related mortality risk factor in patients with diabetes admitted in the ICU.
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Affiliation(s)
- Thomas Servais
- Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium
| | - France Laurent
- Department of Infectiology, Centre Hospitalier Universitaire Ambroise Paré, Boulevard John Fitzgerald Kennedy 2, 7000 Mons, Belgium
| | - Thomas Roland
- Department of Infectiology, Centre Hospitalier Universitaire Ambroise Paré, Boulevard John Fitzgerald Kennedy 2, 7000 Mons, Belgium
| | - Camelia Rossi
- Department of Infectiology, Centre Hospitalier Universitaire Ambroise Paré, Boulevard John Fitzgerald Kennedy 2, 7000 Mons, Belgium
| | - Elodie De Groote
- Department of Infectiology, Hôpital de Jolimont, Rue Ferrer 159, 7100 Haine-Saint-Paul, Belgium
| | - Valérie Godart
- Department of Endocrinology-Diabetology, Hôpital de Jolimont, Rue Ferrer 159, 7100 Haine-Saint-Paul, Belgium
| | - Ernestina Repetto
- Department of Infectiology, Clinique Saint-Jean, Boulevard du Jardin Botanique 32, 1000 Brussels, Belgium
| | - Michel Ponchon
- Department of Endocrinology-Diabetology, Clinique Saint-Jean, Boulevard du Jardin Botanique 32, 1000 Brussels, Belgium
| | - Pascale Chasseur
- Department of Endocrinology, Hôpital Erasme, Cliniques Universiraires de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium
| | - Laurent Crenier
- Department of Endocrinology, Hôpital Erasme, Cliniques Universiraires de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium
| | - Sandrine Van Eeckhoudt
- Department of Internal Medicine and Infectious Diseases, Clinique Saint-Luc Bouge, Rue Saint-Luc 8, 5004 Namur, Belgium
| | - John Yango
- Department of Endocrinology-Diabetology, Clinique Saint-Luc Bouge, Rue Saint-Luc 8, 5004 Namur, Belgium
| | - Philippe Oriot
- Department of Diabetology, Centre Hospitalier de Mouscron, Avenue de Fécamp 49, 7700 Mouscron, Belgium
| | - Mirela Morisca Gavriliu
- Department of Diabetology, Centre Hospitalier de Mouscron, Avenue de Fécamp 49, 7700 Mouscron, Belgium
| | - Stéphanie Rouhard
- Department of Endocrinology-Diabetology, Centre Hospitalier Régional de Huy, Rue Delloye Matthieu 2, 4500 Huy, Belgium
| | - Benjamin Deketelaere
- Institute of Statistics, Biostatistics and Actuarial Sciences, Université Catholique de Louvain, Rue des Wallons 6, 1348 Ottignies-Louvain-La-Neuve, Belgium
| | - Dominique Maiter
- Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium
| | - Michel Paul Hermans
- Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium
| | - Jean Cyr Yombi
- Department of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium
| | - Laura Orioli
- Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium; Endocrinology, Diabetology and Nutrition, Institute of Clinical and Experimental Research, Université Catholique de Louvain, Avenue Hippocrate 55, 1200 Brussels, Belgium.
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Khan Z, Mlawa G, Islam S, Elshowaya S, Saleem M. A Retrospective Study on the Outcome of Coronavirus Disease 2019 (COVID-19) Patients Admitted to a District General Hospital and Predictors of High Mortality. Cureus 2024; 16:e53432. [PMID: 38435221 PMCID: PMC10908435 DOI: 10.7759/cureus.53432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND The clinical features and severity of coronavirus disease 2019 (COVID-19) vary between patients and countries. Patients with certain conditions are predisposed to poor outcomes compared with those without medical conditions, such as diabetes, dementia, and hypertension (HTN). METHODS The aim of this retrospective study was to assess factors associated with higher mortality in patients with COVID-19 infections and to identify the reason for hospital admission in these patients. The study was performed on patients admitted between 1 and 31 March 2020. Data collection was done retrospectively from electronic medical records. RESULTS There were 269 patient admissions during this period, of which 147 were included in this audit. The mean age of COVID-19-positive patients was 62.8 years and 65.9 years for COVID-19-negative patients during this period. Forty-seven patients requiring hospital admission were COVID-19 positive and 93 were COVID-19 negative. There were no COVID-19 swabs in the seven patients included in the audit. Approximately 50% of the COVID-19-positive patients presented with fever and shortness of breath (sob), followed by dyspnea and cough (seven patients). The most common comorbidity was HTN, followed by type 2 diabetes mellitus (T2DM) and ischemic heart disease (IHD). The survival rate was 72.3% in COVID-19-positive patients and 80% in COVID-19-negative patients. The average length of stay was 14.4 days for COVID-19-positive survivors compared to 7.8 days for COVID-19-negative survivors. Most patients who tested positive for COVID-19 infection received oseltamivir vaccination and antibiotics. The presence of HTN, diabetes mellitus (DM), age, and organ failure was associated with a high mortality risk. CONCLUSION Our study supports the findings of previous studies that diabetes, HTN, coronary artery disease, old age, and organ failure were associated with high mortality in patients admitted to hospitals with COVID-19 infections.
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Affiliation(s)
- Zahid Khan
- Acute Medicine, Mid and South Essex NHS Foundation Trust, Southend-on-Sea, GBR
- Cardiology, Barts Heart Centre, London, GBR
- Cardiology and General Medicine, Barking, Havering and Redbridge University Hospitals NHS Trust, London, GBR
- Cardiology, Royal Free Hospital, London, GBR
| | - Gideon Mlawa
- Internal Medicine and Diabetes and Endocrinology, Barking, Havering and Redbridge University Hospitals NHS Trust, London, GBR
| | - Saiful Islam
- General Medicine and Gastroenterology, Barking, Havering and Redbridge University Hospitals NHS Trust, London, GBR
| | - Suhier Elshowaya
- Internal Medicine and Diabetes and Endocrinology, Barking, Havering and Redbridge University Hospitals NHS Trust, London, GBR
| | - Mohammad Saleem
- Internal Medicine, Barking, Havering and Redbridge University Hospitals NHS Trust, London, GBR
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Hopkins R, Young KG, Thomas NJ, Godwin J, Raja D, Mateen BA, Challen RJ, Vollmer SJ, Shields BM, McGovern AP, Dennis JM. Risk factor associations for severe COVID-19, influenza and pneumonia in people with diabetes to inform future pandemic preparations: UK population-based cohort study. BMJ Open 2024; 14:e078135. [PMID: 38296292 PMCID: PMC10831438 DOI: 10.1136/bmjopen-2023-078135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 01/17/2024] [Indexed: 02/03/2024] Open
Abstract
OBJECTIVE This study aimed to compare clinical and sociodemographic risk factors for severe COVID-19, influenza and pneumonia, in people with diabetes. DESIGN Population-based cohort study. SETTING UK primary care records (Clinical Practice Research Datalink) linked to mortality and hospital records. PARTICIPANTS Individuals with type 1 and type 2 diabetes (COVID-19 cohort: n=43 033 type 1 diabetes and n=584 854 type 2 diabetes, influenza and pneumonia cohort: n=42 488 type 1 diabetes and n=585 289 type 2 diabetes). PRIMARY AND SECONDARY OUTCOME MEASURES COVID-19 hospitalisation from 1 February 2020 to 31 October 2020 (pre-COVID-19 vaccination roll-out), and influenza and pneumonia hospitalisation from 1 September 2016 to 31 May 2019 (pre-COVID-19 pandemic). Secondary outcomes were COVID-19 and pneumonia mortality. Associations between clinical and sociodemographic risk factors and each outcome were assessed using multivariable Cox proportional hazards models. In people with type 2 diabetes, we explored modifying effects of glycated haemoglobin (HbA1c) and body mass index (BMI) by age, sex and ethnicity. RESULTS In type 2 diabetes, poor glycaemic control and severe obesity were consistently associated with increased risk of hospitalisation for COVID-19, influenza and pneumonia. The highest HbA1c and BMI-associated relative risks were observed in people aged under 70 years. Sociodemographic-associated risk differed markedly by respiratory infection, particularly for ethnicity. Compared with people of white ethnicity, black and south Asian groups had a greater risk of COVID-19 hospitalisation, but a lesser risk of pneumonia hospitalisation. Risk factor associations for type 1 diabetes and for type 2 diabetes mortality were broadly consistent with the primary analysis. CONCLUSIONS Clinical risk factors of high HbA1c and severe obesity are consistently associated with severe outcomes from COVID-19, influenza and pneumonia, especially in younger people. In contrast, associations with sociodemographic risk factors differed by type of respiratory infection. This emphasises that risk stratification should be specific to individual respiratory infections.
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Affiliation(s)
- Rhian Hopkins
- Institute of Biomedical & Clinical Science, University of Exeter Medical School, Exeter, UK
| | - Katherine G Young
- Institute of Biomedical & Clinical Science, University of Exeter Medical School, Exeter, UK
| | - Nicholas J Thomas
- Institute of Biomedical & Clinical Science, University of Exeter Medical School, Exeter, UK
| | - James Godwin
- Institute of Biomedical & Clinical Science, University of Exeter Medical School, Exeter, UK
| | - Daniyal Raja
- Institute of Biomedical & Clinical Science, University of Exeter Medical School, Exeter, UK
| | - Bilal A Mateen
- The Alan Turing Institute, London, UK
- Institute of Health Informatics, University College London, London, UK
| | - Robert J Challen
- Engineering Mathematics, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration South West Peninsula, Exeter, UK
| | | | - Beverley M Shields
- Institute of Biomedical & Clinical Science, University of Exeter Medical School, Exeter, UK
| | - Andrew P McGovern
- Institute of Biomedical & Clinical Science, University of Exeter Medical School, Exeter, UK
| | - John M Dennis
- Institute of Biomedical & Clinical Science, University of Exeter Medical School, Exeter, UK
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10
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Tshongo C, Baguma M, Mateso G, Makali SL, Bedha A, Mwene‐Batu P, Mihigo M, Nzabara F, Balola C, Kabuya P, Bapolisi A, Masimango MI, Bahizire E, Maheshe‐Balemba G, Shindano TA, Cirhuza C. Hyperglycemia and elevated C-reactive protein are independent predictors of hospital mortality in hospitalized COVID-19 patients in South-Kivu, eastern Democratic Republic of the Congo: A cross-sectional study. Health Sci Rep 2024; 7:e1803. [PMID: 38213779 PMCID: PMC10782469 DOI: 10.1002/hsr2.1803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/29/2023] [Accepted: 12/14/2023] [Indexed: 01/13/2024] Open
Abstract
Background and Aim The coronavirus disease 2019 (COVID-19) pandemic was a priority public health problem because of its high mortality rate. This study mainly aimed to determine factors associated with a poor outcome in COVID-19 hospitalized patients in South-Kivu, an eastern province of the Democratic Republic of the Congo (DRC). Methods This observational study retrospectively evaluated medical records of patients consecutively admitted for probable or confirmed COVID-19 between May 01 and July 31, 2020 at the Hôpital Provincial Général de Référence de Bukavu (HPGRB), a tertiary hospital located in South-Kivu. A binary logistic regression model was performed to determine the predictors of mortality. Results A total of 157 hospitalized COVID-19 patients aged 57.7 (13.2) years were included in this study. Male gender (69.4%), older age (52.9%), medical history of diabetes (38.2%), and arterial hypertension (35.1%) were the most frequent risk factors. Most patients presented with fever (73.3%), cough (72.6%), and dyspnea (66.2%). Overall, 45.1% of patients died. Intrahospital mortality was significantly associated with advanced age [odds ratio, OR (95% confidence interval, CI) = 2.34 (1.06-5.38)], hypoxemia [OR (95% CI) = 4.67 (2.02-10.77)], hyperglycemia [OR (95% CI) = 2.14 (1.06-4.31)], kidney failure [OR (95% CI) = 2.82 (1.4-5.68)], hyperleukocytosis [OR (95% CI) = 3.33 (1.67-6.66)], and higher C-reactive protein (CRP) levels [OR (95% CI) = 3.93 (1.93-8.01)]. After adjustment for various covariates, only higher CRP levels [OR (95% CI) = 3.23 (1.23-8.5)] and hyperglycemia [OR (95% CI) = 2.5 (1.02-6.11)] at admission were independently associated with mortality. Conclusion Hyperglycemia and marked inflammatory syndrome were the major predictors of poor outcomes in patients hospitalized for COVID-19 in South-Kivu. These two factors should be quantified at hospital admission to establish the patient's prognosis.
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Affiliation(s)
- Christian Tshongo
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Marius Baguma
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
- Center for Tropical Diseases and Global Health (CTDGH)Université Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
| | - Guy‐Quesney Mateso
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Samuel Lwamushi Makali
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
- École Régionale de Santé PubliqueUniversité Catholique de BukavuBukavuDemocratic Republic of the Congo
| | - Aline Bedha
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Pacifique Mwene‐Batu
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
- École Régionale de Santé PubliqueUniversité Catholique de BukavuBukavuDemocratic Republic of the Congo
| | - Martine Mihigo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Fabrice Nzabara
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Cordule Balola
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Pierre Kabuya
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Achille Bapolisi
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Mannix I. Masimango
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Esto Bahizire
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
| | - Ghislain Maheshe‐Balemba
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
- École Régionale de Santé PubliqueUniversité Catholique de BukavuBukavuDemocratic Republic of the Congo
| | - Tony A. Shindano
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
- Center for Tropical Diseases and Global Health (CTDGH)Université Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
| | - Cikomola Cirhuza
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
- Center for Tropical Diseases and Global Health (CTDGH)Université Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
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11
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Mansoori A, Hosseini N, Ghazizadeh H, Aghasizadeh M, Drroudi S, Sahranavard T, Izadi HS, Amiriani A, Farkhani EM, Ferns GA, Ghayour-Mobarhan M, Moohebati M, Esmaily H. Association between biochemical and hematologic factors with COVID-19 using data mining methods. BMC Infect Dis 2023; 23:897. [PMID: 38129798 PMCID: PMC10734144 DOI: 10.1186/s12879-023-08676-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 10/06/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND AND AIM Coronavirus disease (COVID-19) is an infectious disease that can spread very rapidly with important public health impacts. The prediction of the important factors related to the patient's infectious diseases is helpful to health care workers. The aim of this research was to select the critical feature of the relationship between demographic, biochemical, and hematological characteristics, in patients with and without COVID-19 infection. METHOD A total of 13,170 participants in the age range of 35-65 years were recruited. Decision Tree (DT), Logistic Regression (LR), and Bootstrap Forest (BF) techniques were fitted into data. Three models were considered in this study, in model I, the biochemical features, in model II, the hematological features, and in model II, both biochemical and homological features were studied. RESULTS In Model I, the BF, DT, and LR algorithms identified creatine phosphokinase (CPK), blood urea nitrogen (BUN), fasting blood glucose (FBG), total bilirubin, body mass index (BMI), sex, and age, as important predictors for COVID-19. In Model II, our BF, DT, and LR algorithms identified BMI, sex, mean platelet volume (MPV), and age as important predictors. In Model III, our BF, DT, and LR algorithms identified CPK, BMI, MPV, BUN, FBG, sex, creatinine (Cr), age, and total bilirubin as important predictors. CONCLUSION The proposed BF, DT, and LR models appear to be able to predict and classify infected and non-infected people based on CPK, BUN, BMI, MPV, FBG, Sex, Cr, and Age which had a high association with COVID-19.
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Affiliation(s)
- Amin Mansoori
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Applied Mathematics, Ferdowsi University of Mashhad, Mashhad, Iran
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nafiseh Hosseini
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
- Faculty of Medicine, Islamic Azad University of Mashhad, Mashhad, Iran
| | - Hamideh Ghazizadeh
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
- Division of Clinical Biochemistry, CALIPER Program, Pediatric Laboratory Medicine, the Hospital for Sick Children, Toronto, ON, Canada
| | - Malihe Aghasizadeh
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Susan Drroudi
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Toktam Sahranavard
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hanie Salmani Izadi
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Amiriani
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ehsan Mosa Farkhani
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, BN1 9PH, Sussex, UK
| | - Majid Ghayour-Mobarhan
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Moohebati
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Habibollah Esmaily
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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12
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van Herpt TTW, van Rosmalen F, Hulsewé HPMG, van der Horst-Schrivers ANA, Driessen M, Jetten R, Zelis N, de Galan BE, van Kuijk SMJ, van der Horst ICC, van Bussel BCT. Hyperglycemia and glucose variability are associated with worse survival in mechanically ventilated COVID-19 patients: the prospective Maastricht Intensive Care Covid Cohort. Diabetol Metab Syndr 2023; 15:253. [PMID: 38057908 DOI: 10.1186/s13098-023-01228-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 11/22/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Data on hyperglycemia and glucose variability in relation to diabetes mellitus, either known or unknown in ICU-setting in COVID-19, are scarce. We prospectively studied daily glucose variables and mortality in strata of diabetes mellitus and glycosylated hemoglobin among mechanically ventilated COVID-19 patients. METHODS We used linear-mixed effect models in mechanically ventilated COVID-19 patients to investigate mean and maximum difference in glucose concentration per day over time. We compared ICU survivors and non-survivors and tested for effect-modification by pandemic wave 1 and 2, diabetes mellitus, and admission HbA1c. RESULTS Among 232 mechanically ventilated COVID-19 patients, 21.1% had known diabetes mellitus, whereas 16.9% in wave 2 had unknown diabetes mellitus. Non-survivors had higher mean glucose concentrations (ß 0.62 mmol/l; 95%CI 0.20-1.06; ß 11.2 mg/dl; 95% CI 3.6-19.1; P = 0.004) and higher maximum differences in glucose concentrations per day (ß 0.85 mmol/l; 95%CI 0.37-1.33; ß 15.3; 95%CI 6.7-23.9; P = 0.001). Effect modification by wave, history of diabetes mellitus and admission HbA1c in associations between glucose and survival was not present. Effect of higher mean glucose concentrations was modified by pandemic wave (wave 1 (ß 0.74; 95% CI 0.24-1.23 mmol/l) ; (ß 13.3; 95%CI 4.3-22.1 mg/dl)) vs. (wave 2 (ß 0.37 (95%CI 0.25-0.98) mmol/l) (ß 6.7 (95% ci 4.5-17.6) mg/dl)). CONCLUSIONS Hyperglycemia and glucose variability are associated with mortality in mechanically ventilated COVID-19 patients irrespective of the presence of diabetes mellitus.
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Affiliation(s)
- Thijs T W van Herpt
- Department of Intensive Care Medicine, Maastricht University Medical Centre +, Debyelaan 25, 6229 HX, Maastricht, the Netherlands.
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands.
| | - Frank van Rosmalen
- Department of Intensive Care Medicine, Maastricht University Medical Centre +, Debyelaan 25, 6229 HX, Maastricht, the Netherlands
| | - Hendrica P M G Hulsewé
- Department of Intensive Care Medicine, Maastricht University Medical Centre +, Debyelaan 25, 6229 HX, Maastricht, the Netherlands
| | - Anouk N A van der Horst-Schrivers
- Department of Emergency Medicine, Maastricht University Medical Centre +, Maastricht, The Netherlands
- Department of Endocrinology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Mariëlle Driessen
- Department of Intensive Care Medicine, Maastricht University Medical Centre +, Debyelaan 25, 6229 HX, Maastricht, the Netherlands
| | - Robin Jetten
- Department of Intensive Care Medicine, Maastricht University Medical Centre +, Debyelaan 25, 6229 HX, Maastricht, the Netherlands
| | - Noortje Zelis
- Department of Internal Medicine, Maastricht University Medical Centre +, Maastricht, The Netherlands
| | - Bastiaan E de Galan
- Department of Endocrinology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Sander M J van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Iwan C C van der Horst
- Department of Intensive Care Medicine, Maastricht University Medical Centre +, Debyelaan 25, 6229 HX, Maastricht, the Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Bas C T van Bussel
- Department of Intensive Care Medicine, Maastricht University Medical Centre +, Debyelaan 25, 6229 HX, Maastricht, the Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
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13
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Zhu Y, He J, Li Y, Cao M, Cheng Y, Zhang F, Yang G. Influencing factors of hospitalization in maintenance haemodialysis outpatients after a diagnosis of COVID-19. Ann Med 2023; 55:2286638. [PMID: 38056005 PMCID: PMC10836266 DOI: 10.1080/07853890.2023.2286638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 11/16/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND The clinical manifestations of maintenance haemodialysis (MHD) outpatients diagnosed with coronavirus disease 2019 (COVID-19) are highly heterogeneous. They are prone to progress to severe conditions, and they often require hospitalization. To better guide the management of MHD outpatients, this retrospective observational study assessed risk factors for hospitalization of MHD patients after a diagnosis of COVID-19. METHODS The demographic data, comorbidities, laboratory indicators and imaging data of 128 MHD outpatients at our haemodialysis centre with confirmed COVID-19 infection from December 2022 to January 2023 were collected. The relationships between these factors and hospitalization of patients were analyzed. RESULTS Among the 128 patients, 25 (19.53%) were hospitalized. One of the 25 inpatients was mechanically ventilated, and two of them died. Multivariate logistic regression analysis showed that the hospitalization rate was correlated with age, comorbid diabetes and peripheral blood lymphocyte count. CONCLUSION Older age, comorbid diabetes and lower lymphocyte count are important risk factors for hospitalization of MHD outpatients after a diagnosis of COVID-19. Focusing on these factors may help in early identification of patients who may need to be admitted due to potential disease progression.
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Affiliation(s)
- Yanlin Zhu
- Department of Nephrology, General Hospital of Western Theater Command, Chengdu, PR China
| | - Jie He
- Department of Nephrology, General Hospital of Western Theater Command, Chengdu, PR China
| | - Yunming Li
- Department of Statistics, General Hospital of Western Theater Command, Chengdu, PR China
| | - Mingyuan Cao
- Department of Statistics, General Hospital of Western Theater Command, Chengdu, PR China
| | - Yue Cheng
- Department of Nephrology, General Hospital of Western Theater Command, Chengdu, PR China
| | - Fan Zhang
- Department of Nephrology, General Hospital of Western Theater Command, Chengdu, PR China
| | - Guchuan Yang
- Department of Medical management, General Hospital of Western Theater Command, Chengdu, PR China
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14
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Feng B, Zheng D, Yang L, Su Z, Tang L, Zhu Y, Xu X, Wang Q, Lin Q, Hu J, Lin M, Huang L, Zhou X, Liu H, Li S, Pan W, Shi R, Lu Y, Wu B, Ding B, Wang Z, Guo J, Zhang Z, Zheng G, Liu Y. Post-hospitalization rehabilitation alleviates long-term immune repertoire alteration in COVID-19 convalescent patients. Cell Prolif 2023; 56:e13450. [PMID: 36938980 PMCID: PMC10542649 DOI: 10.1111/cpr.13450] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/27/2023] [Accepted: 03/02/2023] [Indexed: 03/21/2023] Open
Abstract
The global pandemic of Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an once-in-a-lifetime public health crisis. Among hundreds of millions of people who have contracted with or are being infected with COVID-19, the question of whether COVID-19 infection may cause long-term health concern, even being completely recovered from the disease clinically, especially immune system damage, needs to be addressed. Here, we performed seven-chain adaptome immune repertoire analyses on convalescent COVID-19 patients who have been discharged from hospitals for at least 6 months. Surprisingly, we discovered lymphopenia, reduced number of unique CDR3s, and reduced diversity of the TCR/BCR immune repertoire in convalescent COVID-19 patients. In addition, the BCR repertoire appears to be activated, which is consistent with the protective antibody titres, but serological experiments reveal significantly lower IL-4 and IL-7 levels in convalescent patients compared to those in healthy controls. Finally, in comparison with convalescent patients who did not receive post-hospitalization rehabilitation, the convalescent patients who received post-hospitalization rehabilitation had attenuated immune repertoire abnormality, almost back to the level of healthy control, despite no detectable clinic demographic difference. Overall, we report the potential long-term immunological impairment for COVID-19 infection, and correction of this impairment via post-hospitalization rehabilitation may offer a new prospect for COVID-19 recovery strategy.
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15
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Gedefie A, Birara T, Misganaw S, Bambo GM, Kebede SS, Tilahun M, Mohammed O, Kassa Y, Bisetegn H, Alemayehu E. Clinical profiles, epidemiological characteristics and treatment outcomes of COVID-19 patients in North-eastern Ethiopia: A retrospective cohort study. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002285. [PMID: 37729157 PMCID: PMC10511068 DOI: 10.1371/journal.pgph.0002285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 08/31/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND COVID-19 is a rapidly emerging global health threat and economic disaster. The epidemiology and outcomes of COVID-19 patients in Ethiopia are scarce. Thus, the present study aimed to assess clinical profiles, epidemiological characteristics, and treatment outcomes of patients with COVID-19 and to identify determinants of the disease outcome among COVID-19 patients in North-eastern Ethiopia. METHODS A retrospective observational cohort study was conducted in North-eastern Ethiopia, from May 2020 to Jan 2022 on a total of 364 SARS-COV-2 infected patients. Demographic and clinical data were abstracted from the medical records of patients. Bivariable and multivariable analyses were conducted to determine the factors associated with the mortality of COVID-19 patients and variables with a P-value < 0.05 were considered statistically significant. RESULT Among 364 COVID-19 patients included in this study, two-thirds (68.1%) were males with a median age of 34 years. The majority; 42.9% & 33.0% respectively cases were detected at the health facility and community level surveillance. Furthermore, 6.6% of patients had pre-existing comorbidities of which diabetes mellitus (23.1%) and hypertension (15.3%) had the highest frequency. The symptomatic rate of COVID-19 patients was 30.5%. The most common clinical presentations were cough (26.9%), fever (26.1%), and shortness of breath (15.2%). Moreover, the mortality rate of COVID-19 patients was 4.1% which was independently predicted by a history of underlining co-morbidity (AHR:6.09; 95%CI:1.299-28.56; P = 0.022) and a history of severe or critical conditions (AHR 11.8; 95%CI:4.89-28.83; P = 0.003). CONCLUSION Severe or critical acute COVID-19 and underlining comorbidities are associated with higher mortality. Therefore, critical follow-up and management should be given to patients with underlying diseases is required.
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Affiliation(s)
- Alemu Gedefie
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Tadesse Birara
- Department of Information System, College of Informatics, Wollo University, Kombolcha, Ethiopia
| | - Sisay Misganaw
- Department of Information System, College of Informatics, Wollo University, Kombolcha, Ethiopia
| | - Getachew Mesfin Bambo
- Department of Medical Laboratory Sciences, College of Health Sciences, Mizan-Tepi University, Mizan, Ethiopia
| | - Samuel Sahile Kebede
- Department of Medical Laboratory Sciences, College of Health Sciences, Mizan-Tepi University, Mizan, Ethiopia
| | - Mihret Tilahun
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Ousman Mohammed
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Yeshimebet Kassa
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Habtye Bisetegn
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Ermiyas Alemayehu
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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16
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Alawadi F, Bashier A, Bin Hussain AA, Al-Hashmi N, Bachet FAT, Hassanein MMA, Zidan MA, Soued R, Khamis AH, Mukhopadhyay D, Abdul F, Osama A, Sulaiman F, Farooqi MH, Bayoumi RAL. Risk and predictors of severity and mortality in patients with type 2 diabetes and COVID-19 in Dubai. World J Diabetes 2023; 14:1259-1270. [PMID: 37664471 PMCID: PMC10473944 DOI: 10.4239/wjd.v14.i8.1259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/25/2023] [Accepted: 06/19/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Globally, patients with diabetes suffer from increased disease severity and mortality due to coronavirus disease 2019 (COVID-19). Old age, high body mass index (BMI), comorbidities, and complications of diabetes are recognized as major risk factors for infection severity and mortality. AIM To investigate the risk and predictors of higher severity and mortality among in-hospital patients with COVID-19 and type 2 diabetes (T2D) during the first wave of the pandemic in Dubai (March-September 2020). METHODS In this cross-sectional nested case-control study, a total of 1083 patients with COVID-19 were recruited. This study included 890 men and 193 women. Of these, 427 had T2D and 656 were non-diabetic. The clinical, radiographic, and laboratory data of the patients with and without T2D were compared. Independent predictors of mortality in COVID-19 non-survivors were identified in patients with and without T2D. RESULTS T2D patients with COVID-19 were older and had higher BMI than those without T2D. They had higher rates of comorbidities such as hypertension, ischemic heart disease, heart failure, and more life-threatening complications. All laboratory parameters of disease severity were significantly higher than in those without T2D. Therefore, these patients had a longer hospital stay and a significantly higher mortality rate. They died from COVID-19 at a rate three times higher than patients without. Most laboratory and radiographic severity indices in non-survivors were high in patients with and without T2D. In the univariate analysis of the predictors of mortality among all COVID-19 non-survivors, significant associations were identified with old age, increased white blood cell count, lym-phopenia, and elevated serum troponin levels. In multivariate analysis, only lymphopenia was identified as an independent predictor of mortality among T2D non-survivors. CONCLUSION Patients with COVID-19 and T2D were older with higher BMI, more comorbidities, higher disease severity indices, more severe proinflammatory state with cardiac involvement, and died from COVID-19 at three times the rate of patients without T2D. The identified mortality predictors will help healthcare workers prioritize the management of patients with COVID-19.
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Affiliation(s)
- Fatheya Alawadi
- Department of Endocrinology, Dubai Academic Health Corporation, Dubai, United Arab Emirates
| | - Alaaeldin Bashier
- Department of Endocrinology, Dubai Academic Health Corporation, Dubai, United Arab Emirates
| | | | - Nada Al-Hashmi
- Department of Endocrinology, Dubai Academic Health Corporation, Dubai, United Arab Emirates
| | - Fawzi Al Tayb Bachet
- Department of Endocrinology, Dubai Academic Health Corporation, Dubai, United Arab Emirates
| | | | - Marwan Abdelrahim Zidan
- Department of Medical Education and Research, Dubai Academic Health Corporation, Dubai, United Arab Emirates
| | - Rania Soued
- Department of Radiology, Mediclinic City Hospital, Dubai, United Arab Emirates
| | - Amar Hassan Khamis
- College of Medicine, Mohamed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Debasmita Mukhopadhyay
- College of Medicine, Mohamed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Fatima Abdul
- College of Medicine, Mohamed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Aya Osama
- College of Medicine, Mohamed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Fatima Sulaiman
- College of Medicine, Mohamed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | | | - Riad Abdel Latif Bayoumi
- Basic Medical Sciences, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
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Lázaro A, Zaranza M, Meneses G, Aragão N, Freire M, Guimarães Á, Beliero A, Dantas M, Forte L, Martins A, Daher E, Albuquerque P, da Silva G. Predictors of mortality in critically ill patients with COVID-19 and diabetes. Braz J Med Biol Res 2023; 56:e12728. [PMID: 37585916 PMCID: PMC10427161 DOI: 10.1590/1414-431x2023e12728] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/29/2023] [Indexed: 08/18/2023] Open
Abstract
The COVID-19 pandemic has challenged the entire world, and patients with diabetes mellitus (DM) have been particularly affected. We aimed to evaluate predictors of mortality during the first 30 days of hospitalization in critically ill patients with COVID-19 and comorbid DM. This prospective study included 110 critically ill patients admitted with COVID-19 infection. Thirty-two (29%) patients had a previous diagnosis of DM. Clinical variables, laboratory tests, and vascular biomarkers, such as VCAM-1, syndecan-1, ICAM-1, angiopoietin-1, and angiopoeitin-2, were evaluated after intensive care unit (ICU) admission. A comparison was made between patients with and without DM. No difference in mortality was observed between the groups (48.7 vs 46.9%, P=0.861). In the multivariate Cox regression analysis, VCAM-1 levels at ICU admission (HR: 1 [1-1.001], P<0.006) were associated with death in patients with DM. Among patients with DM, advanced age (HR 1.063 [1.031-1.096], P<0.001), increased Ang-2/Ang-1 ratio (HR: 4.515 [1.803-11.308] P=0.001), and need for dialysis (HR: 3.489 [1.409-8.642], P=0.007) were independent predictors of death. Higher levels of VCAM-1 in patients with DM was better at predicting death of patients with severe COVID-19 and comorbid DM, and their cut-off values were useful for stratifying patients with a worse prognosis. Vascular biomarkers VCAM-1 and Ang-2/Ang-1 ratio were predictors of death in patients with severe COVID-19 and comorbid DM and those without DM. Additionally, kidney injury was associated with an increased risk of death.
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Affiliation(s)
- A.P.P. Lázaro
- Programa de Pós-Graduação em Saúde Coletiva, Curso de Medicina, Centro de Ciências da Saúde, Universidade de Fortaleza, Fortaleza, CE, Brasil
- Centro de Ciências da Saúde, Curso de Medicina, Universidade de Fortaleza, Fortaleza, CE, Brasil
| | - M.S. Zaranza
- Programa de Pós-Graduação em Ciências Médicas, Departamento de Medicina Clínica, Curso de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
- Instituto José Frota (IJF) Hospital, Fortaleza, CE, Brasil
| | - G.C. Meneses
- Programa de Pós-Graduação em Ciências Médicas, Departamento de Medicina Clínica, Curso de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - N.L. Aragão
- Programa de Pós-Graduação em Ciências Médicas, Departamento de Medicina Clínica, Curso de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
- Instituto José Frota (IJF) Hospital, Fortaleza, CE, Brasil
| | - M.V.P. Freire
- Centro de Ciências da Saúde, Curso de Medicina, Universidade de Fortaleza, Fortaleza, CE, Brasil
| | - Á.R. Guimarães
- Programa de Pós-Graduação em Ciências Médicas, Departamento de Medicina Clínica, Curso de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - A.M. Beliero
- Instituto José Frota (IJF) Hospital, Fortaleza, CE, Brasil
| | - M.M.P. Dantas
- Programa de Pós-Graduação em Ciências Médicas, Departamento de Medicina Clínica, Curso de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
- Instituto José Frota (IJF) Hospital, Fortaleza, CE, Brasil
| | - L.C. Forte
- Centro de Ciências da Saúde, Curso de Medicina, Universidade de Fortaleza, Fortaleza, CE, Brasil
| | - A.M.C. Martins
- Departamento de Análises Clínicas e Toxicológicas, Curso de Farmácia, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - E.F. Daher
- Programa de Pós-Graduação em Ciências Médicas, Departamento de Medicina Clínica, Curso de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - P.L.M.M. Albuquerque
- Centro de Ciências da Saúde, Curso de Medicina, Universidade de Fortaleza, Fortaleza, CE, Brasil
- Instituto José Frota (IJF) Hospital, Fortaleza, CE, Brasil
| | - G.B. da Silva
- Programa de Pós-Graduação em Saúde Coletiva, Curso de Medicina, Centro de Ciências da Saúde, Universidade de Fortaleza, Fortaleza, CE, Brasil
- Centro de Ciências da Saúde, Curso de Medicina, Universidade de Fortaleza, Fortaleza, CE, Brasil
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Zhou XY, Huang SF, Lin JX, Zhi HN, Xiao L, Wang XZ, Guo KH, Zhou L, Long T, You HM, Lin MR, Luo XY, Sun WP, Zeng CP. Clinical characteristics and acute complication of COVID-19 patients with diabetes: a multicenter, retrospective study in Southern China. Front Endocrinol (Lausanne) 2023; 14:1237832. [PMID: 37645409 PMCID: PMC10461553 DOI: 10.3389/fendo.2023.1237832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 07/27/2023] [Indexed: 08/31/2023] Open
Abstract
Aims This study aims to describe the clinical characteristics, laboratory data and complications of hospitalized COVID-19 patients with type 2 diabetes mellitus (T2DM) since epidemic prevention and control optimization was adjusted in December 2022 in China. Methods This retrospective multicenter study included 298 patients with confirmed type 2 diabetes mellitus with or without COVID-19. We collected data from the first wave of the pandemic in The Fifth Affiliated Hospital of Guangzhou Medical University, Loudi Central Hospital and The First People's Hospital of Xiangtan from December 1, 2022 to February 1, 2023. We extracted baseline data, clinical symptoms, acute complications, laboratory findings, treatment and outcome data of each patient from electronic medical records. Results For among 298 hospitalized patients with type 2 diabetes, 136 (45.6%) were COVID-19 uninfected, and 162 (54.4%) were COVID-19 infected. We found that the incidence of cough, fatigue, fever, muscle soreness, sore throat, shortness of breath, hyposmia, hypogeusia and polyphagia (all p<0.01) were significantly higher in the exposure group. They showed higher levels of ketone (p=0.04), creatinine (p<0.01), blood potassium (p=0.01) and more diabetic ketoacidosis (p<0.01). Patients with COVID-19 less use of metformin (p<0.01), thiazolidinediones (p<0.01) and SGLT2 (p<0.01) compared with patients without COVID-19. Conclusion COVID-19 patients with diabetes showed more severe respiratory and constitutional symptoms and an increased proportion of hyposmia and hypogeusia. Moreover, COVID-19 patients with diabetes have a higher incidence of acute complications, are more prone to worsening renal function, and are more cautious about the use of antidiabetic drugs.
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Affiliation(s)
- Xiao-ying Zhou
- Department of Endocrinology and Metabolism, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shao-feng Huang
- Department of Endocrinology and Metabolism, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jun-xu Lin
- Department of Endocrinology, The Affiliated Loudi Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Hai-ni Zhi
- Department of Endocrinology, The Affiliated Loudi Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Lu Xiao
- Department of Endocrinology and Metabolism, Loudi Central Hospital, Loudi, China
| | - Xiang-zhu Wang
- Department of Endocrinology and Metabolism, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Kai-heng Guo
- Department of Endocrinology and Metabolism, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Lin Zhou
- Department of Endocrinology and Metabolism, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Tao Long
- Department of Endocrinology and Metabolism, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Hui-min You
- Department of Endocrinology and Metabolism, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ming-run Lin
- Department of Endocrinology and Metabolism, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiang-ya Luo
- Department of Endocrinology and Metabolism, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wei-ping Sun
- Department of Endocrinology and Metabolism, Loudi Central Hospital, Loudi, China
| | - Chun-ping Zeng
- Department of Endocrinology and Metabolism, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Abduljabbar MH, Alhawsawi GA, Aldharman SS, Alshahrani KI, Alshehri RA, Alshehri AA, Abukhudair AT, Alghamdi MA. Persistence of Symptoms Following Infection With COVID-19 Among Patients With Type 1 and Type 2 Diabetes Mellitus in Saudi Arabia. Cureus 2023; 15:e43556. [PMID: 37719634 PMCID: PMC10502517 DOI: 10.7759/cureus.43556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2023] [Indexed: 09/19/2023] Open
Abstract
BACKGROUND In Saudi Arabia, information on the persistence of COVID-19-related complications in diabetic patients, their associations with the type of diabetes mellitus (DM), and the role of uncontrolled DM in the complications remains elusive. This study aims to fill this gap. This study aimed to examine the persistence of COVID-19 complications in diabetic patients. METHOD A simple randomized, cross-sectional, questionnaire-based study among patients with type 1 and 2 DM following infection with COVID-19 in Saudi Arabia. RESULT In the present study, a total of 674 participants were included. Among the COVID-19 symptoms, fatigue (65.6%) was reported the most frequently, followed by headache (62.3%) and cough (59.8%). About 44% of patients reported high blood sugar levels, including 25.5% with elevated fasting (>126 mg/dL) and 18.5% with elevated postprandial (>200 mg/dL) glucose levels. We also report that age > 55 years [OR= 1.66 (1.01-2.56), p=0.045], anti-diabetic medications [OR= 2.10 (1.82-3.91), p=0.022], multiple comorbidities [OR= 3.21 (1.98-4.85), p=0.005], chest pain [OR= 2.54 (0.96-3.81), p=0.003], and joint pain [OR= 1.64 (0.73-2.94), p=0.025] were independently associated with COVID-19-related complications in diabetic patients. CONCLUSION The most common persistent symptoms in diabetic patients with COVID-19 infection are fatigue, headaches, and cough. Advanced age and use of antidiabetic medications were independently associated with COVID-19-related complications in diabetic patients.
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Affiliation(s)
- Maram H Abduljabbar
- Department of Pharmacology and Toxicology, College of Pharmacy, Taif University, Taif, SAU
| | | | - Sarah S Aldharman
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
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20
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Schlesinger S, Lang A, Christodoulou N, Linnerz P, Pafili K, Kuss O, Herder C, Neuenschwander M, Barbaresko J, Roden M. Risk phenotypes of diabetes and association with COVID-19 severity and death: an update of a living systematic review and meta-analysis. Diabetologia 2023; 66:1395-1412. [PMID: 37204441 PMCID: PMC10198038 DOI: 10.1007/s00125-023-05928-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 03/16/2023] [Indexed: 05/20/2023]
Abstract
AIMS/HYPOTHESIS To provide a systematic overview of the current body of evidence on high-risk phenotypes of diabetes associated with COVID-19 severity and death. METHODS This is the first update of our recently published living systematic review and meta-analysis. Observational studies investigating phenotypes in individuals with diabetes and confirmed SARS-CoV-2 infection with regard to COVID-19-related death and severity were included. The literature search was conducted from inception up to 14 February 2022 in PubMed, Epistemonikos, Web of Science and the COVID-19 Research Database and updated using PubMed alert to 1 December 2022. A random-effects meta-analysis was used to calculate summary relative risks (SRRs) with 95% CIs. The risk of bias was evaluated using the Quality in Prognosis Studies (QUIPS) tool and the certainty of evidence using the GRADE approach. RESULTS A total of 169 articles (147 new studies) based on approximately 900,000 individuals were included. We conducted 177 meta-analyses (83 on COVID-19-related death and 94 on COVID-19 severity). Certainty of evidence was strengthened for associations between male sex, older age, blood glucose level at admission, chronic insulin use, chronic metformin use (inversely) and pre-existing comorbidities (CVD, chronic kidney disease, chronic obstructive pulmonary disease) and COVID-19-related death. New evidence with moderate to high certainty emerged for the association between obesity (SRR [95% CI] 1.18 [1.04, 1.34], n=21 studies), HbA1c (53-75 mmol/mol [7-9%]: 1.18 [1.06, 1.32], n=8), chronic glucagon-like peptide-1 receptor agonist use (0.83 [0.71, 0.97], n=9), pre-existing heart failure (1.33 [1.21, 1.47], n=14), pre-existing liver disease (1.40 [1.17, 1.67], n=6), the Charlson index (per 1 unit increase: 1.33 [1.13, 1.57], n=2), high levels of C-reactive protein (per 5 mg/l increase: 1.07 [1.02, 1.12], n=10), aspartate aminotransferase level (per 5 U/l increase: 1.28 [1.06, 1.54], n=5), eGFR (per 10 ml/min per 1.73 m2 increase: 0.80 [0.71, 0.90], n=6), lactate dehydrogenase level (per 10 U/l increase: 1.03 [1.01, 1.04], n=7) and lymphocyte count (per 1×109/l increase: 0.59 [0.40, 0.86], n=6) and COVID-19-related death. Similar associations were observed between risk phenotypes of diabetes and severity of COVID-19, with some new evidence on existing COVID-19 vaccination status (0.32 [0.26, 0.38], n=3), pre-existing hypertension (1.23 [1.14, 1.33], n=49), neuropathy and cancer, and high IL-6 levels. A limitation of this study is that the included studies are observational in nature and residual or unmeasured confounding cannot be ruled out. CONCLUSIONS/INTERPRETATION Individuals with a more severe course of diabetes and pre-existing comorbidities had a poorer prognosis of COVID-19 than individuals with a milder course of the disease. REGISTRATION PROSPERO registration no. CRD42020193692. PREVIOUS VERSION This is a living systematic review and meta-analysis. The previous version can be found at https://link.springer.com/article/10.1007/s00125-021-05458-8 FUNDING: The German Diabetes Center (DDZ) is funded by the German Federal Ministry of Health and the Ministry of Culture and Science of the State North Rhine-Westphalia. This study was supported in part by a grant from the German Federal Ministry of Education and Research to the German Center for Diabetes Research (DZD).
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Affiliation(s)
- Sabrina Schlesinger
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany.
| | - Alexander Lang
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Nikoletta Christodoulou
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Philipp Linnerz
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Kalliopi Pafili
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Oliver Kuss
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany
- Centre for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Christian Herder
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Manuela Neuenschwander
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany
| | - Janett Barbaresko
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Michael Roden
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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Ashktorab H, Oskrochi G, Challa SR, Chirumamilla LG, Ahangarzadeh F, Jones-Wonni B, Shayegh N, Rashid M, Naqvi Z, Ekpe E, Sabyasachi S, Zenabe A, Brim H. High Prevalence of Diabetes Among Hospitalized COVID-19 Minority Patients: Data from a Single Tertiary Hospital. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01714-2. [PMID: 37500830 DOI: 10.1007/s40615-023-01714-2] [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: 04/03/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND AND AIM Type 2 diabetes mellitus (DM) is a common comorbidity in the minority population and is associated with poor outcomes in COVID-19 patients. We hypothesized that COVID-19 patients with pre-existing diabetes mellitus are prone to fatal outcomes compared to non-diabetic patients. We aimed to illustrate the characteristics and outcomes and identify the risk factors for in-hospital mortality of COVID-19 patients with DM. METHODS In this single-center retrospective study, electronic medical records of hospitalized patients with confirmed COVID-19 diagnosis at Howard University Hospital (HUH) from March 2020 to Dec 2021 were analyzed. Clinical, demographic, and serological information, as well as outcomes, were recorded and analyzed. RESULTS Among 463 COVID-19 patients, 66.3% (n = 307) were African Americans (AA) and 35.9% (n = 166) had diabetes, with a mean age of 64 years. The majority of the diabetic patients were AA (n = 123, 74.1%) and had a higher mortality rate (n = 26, 74.3%) compared to others. Length of stay in the hospital is significantly more for the diabetic than for the non-diabetic patients (11.3 vs. 8.3 days, p = 0.03). A higher proportion of ICU admission (32.3% vs. 17.9%, p = < 0.001), intubation (17% vs. 11.7%, p = 0.04), and increased mortality (21.1% vs. 12.2%, p = 0.01) were identified in COVID-19 patients with DM than in those with no DM. Among DM patients, non-survivors were older (69.9 vs. 62.9 years). DM patients were more likely to have underlying hypertension (72.3% vs. 43.3%, p = < 0.001), obesity (44.8% vs. 32.1%, p = 0.007), chronic kidney disease (23.6 vs. 11.8%, p = 0.001), and cardiovascular disease (29.5% vs. 14.3%, p = 0.001) than the non-DM patients. HbA1C above 9%, indicating poorly controlled hyperglycemia, was associated with poor outcome among the DM subjects. AST (23.5% vs. 31.3%) and creatinine (61.4% vs. 37.9%) were significantly more elevated in DM COVID-19 patients (all p-values < 0.05). The levels of serum troponin (42.5% vs. 30.9%, p = 0.03), interleukin-6 (67.2 vs. 50%, p = 0.04), ferritin (65.6% vs. 44.6%, p = 0.03), procalcitonin (58.1% vs. 46.1, p = 0.03), and D-dimers (92.8% vs. 86.5%, p = 0.04) were significantly higher in DM patients as compared to those in non-DM COVID-19 patients, indicating more susceptibility of diabetic COVID-19 patients to coagulation dysfunction and inflammatory storm. CONCLUSION The prevalence of DM is high among hospitalized COVID-19 patients in our cohort. While DM patients have a higher mortality rate and ICU admission than non-DM patients, other factors such as underlying comorbidities, old age, elevated creatinine, AST, serum inflammatory markers, and D-dimer are more significant predictors of fatal outcomes. DM patients had higher metabolic derangements, hypercoagulability, and severe inflammatory response. No significant difference of outcome was noted between DM patients of different races in our cohort. In the diabetic group, it appears that race may not significantly contribute to the observed mortality disparity. This could be attributed to the significant influence of diabetes, which acts as a major effector, potentially overshadowing the significance of race in this context.
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Affiliation(s)
- Hassan Ashktorab
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, 2041 Georgia Avenue, N.W., Washington, D.C., 20060, USA.
| | - Gholamreza Oskrochi
- College of Engineering and Technology, American University of the Middle East, Egaila, Kuwait
| | - Suryanarayana Reddy Challa
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, 2041 Georgia Avenue, N.W., Washington, D.C., 20060, USA
| | - Lakshmi G Chirumamilla
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, 2041 Georgia Avenue, N.W., Washington, D.C., 20060, USA
| | - Faezeh Ahangarzadeh
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, 2041 Georgia Avenue, N.W., Washington, D.C., 20060, USA
| | - Boubini Jones-Wonni
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, 2041 Georgia Avenue, N.W., Washington, D.C., 20060, USA
| | - Nader Shayegh
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, 2041 Georgia Avenue, N.W., Washington, D.C., 20060, USA
| | - Mudasir Rashid
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, 2041 Georgia Avenue, N.W., Washington, D.C., 20060, USA
| | - Zainab Naqvi
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, 2041 Georgia Avenue, N.W., Washington, D.C., 20060, USA
| | - Elizabeth Ekpe
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, 2041 Georgia Avenue, N.W., Washington, D.C., 20060, USA
| | - Sen Sabyasachi
- Department of Medicine (Endocrinology) and Biochemistry & Molecular Medicine, The George Washington University, and Associate Chief Endocrinology, Veterans Affairs Medical Center, Washington, DC, USA
| | - Anteneh Zenabe
- Endocrinology Division, Department of Medicine, Howard University College of Medicine, Washington, DC, USA
| | - Hassan Brim
- Department of Pathology and Cancer Center, Howard University College of Medicine, Washington, DC, USA
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22
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Hamaway S, Nwokoma U, Goldberg M, Salifu MO, Saha S, Boursiquot R. Impact of diabetes on COVID-19 patient health outcomes in a vulnerable racial minority community. PLoS One 2023; 18:e0286252. [PMID: 37478111 PMCID: PMC10361494 DOI: 10.1371/journal.pone.0286252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 05/11/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Diabetes is a growing health concern in the United States and especially New York City. New York City subsequently became an epicenter for the coronavirus pandemic in the Spring of 2020. Previous studies suggest that diabetes is a risk factor for adverse outcomes in COVID-19. OBJECTIVE To investigate the association between diabetes and COVID-19 outcomes as well as assess other covariates that may impact health outcomes. DESIGN Retrospective cohort study of COVID-19 hospitalized patients from March to May, 2020. PARTICIPANTS In total, 1805 patients were tested for COVID-19 and 778 tested positive for COVID-19. Patients were categorized into 2 groups: diabetes (measured by an Hba1c >6.5 or had a history of diabetes) and those without diabetes. RESULTS After controlling for other comorbidities, diabetes was associated with increased risk of mortality (aRR = 1.28, 95% CI 1.03-1.57, p = 0.0231) and discharge to tertiary care centers (aRR = 1.69, 95% CI 1.04-2.77, p = 0.036). compared to non-diabetes. Age and coronary artery disease (CAD) increased the risk of mortality among diabetic patients compared to patients with diabetes alone without CAD or advanced age. The diabetes cohort had more patients with resolving acute respiratory failure (62.2%), acute kidney injury secondary to COVID-19 (49.0%) and sepsis secondary to COVID-19 (30.1%). CONCLUSION This investigation found that COVID-19 patients with diabetes had increased mortality, multiple complications at discharge, and increased rates of admission to a tertiary care center than those without diabetes suggesting a more severe and complicated disease course that required additional services at time of discharge.
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Affiliation(s)
- Stefan Hamaway
- Department of Medicine, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, United States of America
- SUNY Downstate College of Medicine, Brooklyn, NY, United States of America
| | - Uchechukwu Nwokoma
- Department of Medicine, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, United States of America
- Office of Diversity Education and Research, SUNY Downstate College of Medicine, Brooklyn, NY, United States of America
| | - Michael Goldberg
- Department of Medicine, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, United States of America
- SUNY Downstate College of Medicine, Brooklyn, NY, United States of America
| | - Moro O Salifu
- Department of Medicine, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, United States of America
| | - Subhash Saha
- Department of Neurology, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, United States of America
| | - Roosevelt Boursiquot
- Department of Medicine, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, United States of America
- Division of Hospital Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- Department of Internal Medicine, Northwell Staten Island University Hospital, Staten Island, NY, United States of America
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Kusumawati M, Koesoemadinata RC, Fatma ZH, Susandi E, Permana H, Soetedjo NNM, Soeroto AY, Bestari B, Andriyoko B, Alisjahbana B, Hartantri Y. The effect of diabetes mellitus on COVID-19 mortality among patients in a tertiary-level hospital in Bandung, Indonesia. PLoS One 2023; 18:e0286797. [PMID: 37319126 PMCID: PMC10270330 DOI: 10.1371/journal.pone.0286797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 05/24/2023] [Indexed: 06/17/2023] Open
Abstract
Immune system dysregulation in people with diabetes mellitus (DM) increases the risk of acquiring severe infection. We compared the clinical characteristics and laboratory parameters of coronavirus disease 2019 (COVID-19) patients with and without DM and estimated the effect of DM on mortality among COVID-19 patients. A retrospective cohort study collecting patients' demographic, clinical characteristics, laboratory parameters and treatment outcomes from medical records was conducted in a hospital in Bandung City from March to December 2020. Univariable and multivariable logistic regression was performed to determine the association between DM and death. A total of 664 COVID-19 patients with positive real-time reverse transcription polymerase chain reaction for severe acute respiratory syndrome coronavirus 2 were included in this study, of whom 147 were with DM. Half of DM patients presented HbA1c ≥10%. DM patients were more likely to present with comorbidities and severe to critical conditions at admission (P <0.001). Laboratory parameters such as neutrophil-lymphocyte count ratio, C-reactive protein, D-dimer, ferritin, and lactate dehydrogenase were higher in the DM group. In the univariate analysis, variables associated with death were COVID-19 severity at baseline, neurologic disease, DM, age ≥60 years, hypertension, cardiovascular disease, and chronic kidney disease. DM remained associated with death (aOR 1.82; 95% CI 1.13-2.93) after adjustment with sex, age, hypertension, cardiovascular disease, and chronic kidney disease. In conclusion, COVID-19 patients with DM are more likely to present with a very high HbA1c, comorbidities, and severe-critical illness. Chronic inflammation in DM patients may be aggravated by the disruption of immune response caused by COVID-19, leading to worse laboratory results and poor outcomes.
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Affiliation(s)
- Maya Kusumawati
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Dr Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, Indonesia
| | - Raspati Cundarani Koesoemadinata
- Research Center for Care and Control of Infectious Disease, Universitas Padjadjaran, Bandung, Indonesia
- Indonesian Society for Clinical Microbiology, Jakarta, Indonesia
| | - Zuhaira Husna Fatma
- Research Center for Care and Control of Infectious Disease, Universitas Padjadjaran, Bandung, Indonesia
| | - Evan Susandi
- Department of Internal Medicine, Faculty of Medicine, Dr Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, Indonesia
| | - Hikmat Permana
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Dr Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, Indonesia
| | - Nanny Natalia Mulyani Soetedjo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Dr Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, Indonesia
- Research Center for Care and Control of Infectious Disease, Universitas Padjadjaran, Bandung, Indonesia
| | - Arto Yuwono Soeroto
- Respirology and Critical Illness Division, Department of Internal Medicine, Faculty of Medicine, Dr Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, Indonesia
| | - Begawan Bestari
- Division of Gastroentero Hepatology, Department of Internal Medicine, Faculty of Medicine, Dr Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, Indonesia
| | - Basti Andriyoko
- Research Center for Care and Control of Infectious Disease, Universitas Padjadjaran, Bandung, Indonesia
- Molecular Biology Division, Department of Clinical Pathology, Faculty of Medicine, Dr Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, Indonesia
| | - Bachti Alisjahbana
- Research Center for Care and Control of Infectious Disease, Universitas Padjadjaran, Bandung, Indonesia
- Division of Tropical and Infectious Disease, Department of Internal Medicine, Faculty of Medicine, Dr Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, Indonesia
| | - Yovita Hartantri
- Research Center for Care and Control of Infectious Disease, Universitas Padjadjaran, Bandung, Indonesia
- Division of Tropical and Infectious Disease, Department of Internal Medicine, Faculty of Medicine, Dr Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, Indonesia
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Gameil MA, Marzouk RE, El-Sebaie AH, Ahmed Eldeeb AA. Influence of time factor and albuminuria on characteristics of patients with type 2 diabetes Mellitus before, during and 1 year after COVID-19 recovery. Diabetol Metab Syndr 2023; 15:126. [PMID: 37312131 DOI: 10.1186/s13098-023-01104-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 06/03/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND The potential effects of time factor and albuminuria on the morbid alterations in patients with type 2 diabetes (T2D) and COVID-19 are still unclear. We aimed to address the morbid alterations and the potential effects of time factor and albuminuria on the patients' characteristics before, during, and 1 year after COVID-19 recovery. METHODS 83 patients with T2D were included, at Mansoura University Hospital, Egypt (July 2021-December 2021). Data of detailed history, physical examination, laboratory tests were recruited from files of the patients. Diagnosis and resolution of COVID-19 were established by Real time polymerase chain reaction (RT-PCR) test of SARS-CoV2. Complete blood count (CBC), renal and hepatic function tests, multiple measures of morning spot urine albumin to creatinine ratio (urine ACR), glycosylated hemoglobin (HBA1c), lipid profile, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Ferritin, neutrophil to lymphocyte ratio (NLR), vitamin D3, intact parathyroid hormone (intact PTH), serum calcium were applied to all participants. RESULTS Our participants had a mean age of 45 years, 60.2% male, 56.6% were hospitalized, and 25.3% were admitted to ICU for severe COVID-19. Albuminuria was prevalent in 71.1% before, 98.8% during, and 92.8% after COVID-19 recovery. Patients with albuminuria showed older age, longer duration of T2D, more frequent severe COVID-19 and hospitalization (p = 0.03, p < 0.001, p = 0.023& p = 0.025) respectively. Body mass index (BMI), mean arterial blood pressure, ESR, CRP, ferritin, NLR, HBA1c, triglycerides to high-density lipoprotein cholesterol (TG/HDL-C) ratio, vitamin D3, serum calcium, alkaline phosphatase (ALP), hepatic aminotransferases, and urine ACR showed significant alterations throughout the study (p < 0.001 for all). Although the interaction between time and albuminuria showed non-significant effect on all studied parameters, we noticed relevant main effects of time factor on Body mass index (BMI), HBA1c, glomerular filtration rate (eGFR), TG/HDL ratio, NLR, vitamin D3, (p < 0.001 for all). Moreover, albuminuria showed main effects on BMI, serum creatinine, and intact PTH (p = 0.019, 0.005 & <0.001), respectively. CONCLUSION The characteristics of patients with T2D significantly altered throughout the study. Time factor and albuminuria exerted relevant main effects on the patients' characteristics without significant effect of their interaction.
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Affiliation(s)
- Mohammed Ali Gameil
- Endocrinology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt.
| | - Rehab Elsayed Marzouk
- Lecturer of Medical Biochemistry, Medical Biochemistry Department, Faculty of Medicine, Helwan University, Helwan, 0000-0002, 5551- 1540, Cairo, Egypt
| | - Ahmed Hassan El-Sebaie
- Clinical Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt
| | - Ahmed Ahmed Ahmed Eldeeb
- Associate professor of Internal medicine, Nephrology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, 0000-0002, 3238-3064, Dakahlia, Egypt
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25
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Ghazizadeh H, Shakour N, Ghoflchi S, Mansoori A, Saberi-Karimiam M, Rashidmayvan M, Ferns G, Esmaily H, Ghayour-Mobarhan M. Use of data mining approaches to explore the association between type 2 diabetes mellitus with SARS-CoV-2. BMC Pulm Med 2023; 23:203. [PMID: 37308948 DOI: 10.1186/s12890-023-02495-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 05/25/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Corona virus causes respiratory tract infections in mammals. The latest type of Severe Acute Respiratory Syndrome Corona-viruses 2 (SARS-CoV-2), Corona virus spread in humans in December 2019 in Wuhan, China. The purpose of this study was to investigate the relationship between type 2 diabetes mellitus (T2DM), and their biochemical and hematological factors with the level of infection with COVID-19 to improve the treatment and management of the disease. MATERIAL AND METHOD This study was conducted on a population of 13,170 including 5780 subjects with SARS-COV-2 and 7390 subjects without SARS-COV-2, in the age range of 35-65 years. Also, the associations between biochemical factors, hematological factors, physical activity level (PAL), age, sex, and smoking status were investigated with the COVID-19 infection. RESULT Data mining techniques such as logistic regression (LR) and decision tree (DT) algorithms were used to analyze the data. The results using the LR model showed that in biochemical factors (Model I) creatine phosphokinase (CPK) (OR: 1.006 CI 95% (1.006,1.007)), blood urea nitrogen (BUN) (OR: 1.039 CI 95% (1.033, 1.047)) and in hematological factors (Model II) mean platelet volume (MVP) (OR: 1.546 CI 95% (1.470, 1.628)) were significant factors associated with COVID-19 infection. Using the DT model, CPK, BUN, and MPV were the most important variables. Also, after adjustment for confounding factors, subjects with T2DM had higher risk for COVID-19 infection. CONCLUSION There was a significant association between CPK, BUN, MPV and T2DM with COVID-19 infection and T2DM appears to be important in the development of COVID-19 infection.
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Affiliation(s)
- Hamideh Ghazizadeh
- The Hospital for Sick Children, CALIPER Program, Division of Clinical Biochemistry, Pediatric Laboratory Medicine, Toronto, ON, Canada
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Neda Shakour
- Department of Medical Chemistry, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sahar Ghoflchi
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amin Mansoori
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Maryam Saberi-Karimiam
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Rashidmayvan
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Nutrition, Food Sciences and Clinical Biochemistry, School of Medicine, Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Gordon Ferns
- Division of Medical Education, Brighton and Sussex Medical School, Brighton, UK
| | - Habibollah Esmaily
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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26
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Akinosoglou K, Schinas G, Bletsa E, Bristianou M, Lanaras L, Michailides C, Katsikas T, Barkas F, Liberopoulos E, Kotsis V, Tentolouris K, Grigoropoulou P, Frangou A, Basoulis D, Alexiou Z, Daganou M, Bostantzoglou C, Dimakopoulou V, Koutsoukou A, Pefanis A, Baraboutis IG, Agelonidou E, Tentolouris N. COVID-19 Outcomes and Diabetes Mellitus: A Comprehensive Multicenter Prospective Cohort Study. Microorganisms 2023; 11:1416. [PMID: 37374918 DOI: 10.3390/microorganisms11061416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/17/2023] [Accepted: 05/24/2023] [Indexed: 06/29/2023] Open
Abstract
The link between type 2 diabetes (T2D) and the severe outcomes of COVID-19 has raised concerns about the optimal management of patients with T2D. This study aimed to investigate the clinical characteristics and outcomes of T2D patients hospitalized with COVID-19 and explore the potential associations between chronic T2D treatments and adverse outcomes. This was a multicenter prospective cohort study of T2D patients hospitalized with COVID-19 in Greece during the third wave of the pandemic (February-June 2021). Among the 354 T2D patients included in this study, 63 (18.6%) died during hospitalization, and 16.4% required ICU admission. The use of DPP4 inhibitors for the chronic management of T2D was associated with an increased risk of in-hospital death (adjusted odds ratio (adj. OR) 2.639, 95% confidence interval (CI) 1.148-6.068, p = 0.022), ICU admission (adj. OR = 2.524, 95% CI: 1.217-5.232, p = 0.013), and progression to ARDS (adj. OR = 2.507, 95% CI: 1.278-4.916, p = 0.007). Furthermore, the use of DPP4 inhibitors was significantly associated with an increased risk of thromboembolic events (adjusted OR of 2.249, 95% CI: 1.073-4.713, p = 0.032) during hospitalization. These findings highlight the importance of considering the potential impact of chronic T2D treatment regiments on COVID-19 and the need for further studies to elucidate the underlying mechanisms.
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Affiliation(s)
- Karolina Akinosoglou
- Department of Internal Medicine, Faculty of Medicine, University of Patras, University Hospital of Patras, 265 04 Patras, Greece
| | - Georgios Schinas
- Department of Internal Medicine, Faculty of Medicine, University of Patras, University Hospital of Patras, 265 04 Patras, Greece
| | - Evanthia Bletsa
- Department of Internal Medicine, General Hospital of Lamia, 351 00 Lamia, Greece
| | - Magdaline Bristianou
- Department of Internal Medicine, General Hospital of Lamia, 351 00 Lamia, Greece
| | - Leonidas Lanaras
- Department of Internal Medicine, General Hospital of Lamia, 351 00 Lamia, Greece
| | - Charalambos Michailides
- 1st Department of Internal Medicine, General Hospital of Athens "G. Gennimatas", 115 27 Athens, Greece
| | - Theodoros Katsikas
- 1st Department of Internal Medicine, General Hospital of Athens "G. Gennimatas", 115 27 Athens, Greece
| | - Fotios Barkas
- 2nd Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, 451 10 Ioannina, Greece
| | - Evangelos Liberopoulos
- 2nd Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, 451 10 Ioannina, Greece
| | - Vasileios Kotsis
- 3rd Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, General Hospital of Thessaloniki "Papageorgiou", 564 29 Thessaloniki, Greece
| | | | - Pinelopi Grigoropoulou
- Department of Internal Medicine, General Hospital of Athens "Elpis", 115 22 Athens, Greece
| | - Archontoula Frangou
- Department of Internal Medicine, General Hospital of Athens "Elpis", 115 22 Athens, Greece
| | - Dimitrios Basoulis
- 1st Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece
| | - Zoi Alexiou
- General Hospital of Eleusis "Thriasio", 196 00 Athens, Greece
| | - Mary Daganou
- Intensive Care Unit, General Hospital for Thoracic Diseases "Sotiria", 115 27 Athens, Greece
| | | | - Vasiliki Dimakopoulou
- Department of Internal Medicine, Faculty of Medicine, University of Patras, University Hospital of Patras, 265 04 Patras, Greece
| | - Antonia Koutsoukou
- 1st University Pulmonology Clinic and ICU, Medical School, National and Kapodistrian University of Athens, General Hospital for Thoracic Diseases "Sotiria", 115 27 Athens, Greece
| | - Angelos Pefanis
- Department of Medicine and 1st Department of Infectious Diseases, General Hospital for Thoracic Diseases "Sotiria", 115 27 Athens, Greece
| | - Ioannis G Baraboutis
- Department of Internal Medicine, "Pammakaristos" Hospital, 111 44 Athens, Greece
| | - Eleni Agelonidou
- Department of Internal Medicine, "Pammakaristos" Hospital, 111 44 Athens, Greece
| | - Nikolaos Tentolouris
- 1st Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece
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Beltrami S, Rizzo S, Caccuri F, Rizzo R, Bortolotti D, Schiuma G. SARS-CoV-2 Systemic Effects: New Clues. Microorganisms 2023; 11:1209. [PMID: 37317183 DOI: 10.3390/microorganisms11051209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/07/2023] [Indexed: 06/16/2023] Open
Abstract
To date, much discussion has been had on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) lung infection associated with COVID-19 onset, of which the major manifestation is characterized by a "cytokine storm" [...].
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Affiliation(s)
- Silvia Beltrami
- Department of Chemical, Pharmaceutical and Agricultural Science, University of Ferrara, 44121 Ferrara, Italy
| | - Sabrina Rizzo
- Department of Chemical, Pharmaceutical and Agricultural Science, University of Ferrara, 44121 Ferrara, Italy
| | - Francesca Caccuri
- Department of Microbiology and Virology, "Spedali Civili", 25126 Brescia, Italy
| | - Roberta Rizzo
- Department of Chemical, Pharmaceutical and Agricultural Science, University of Ferrara, 44121 Ferrara, Italy
| | - Daria Bortolotti
- Department of Chemical, Pharmaceutical and Agricultural Science, University of Ferrara, 44121 Ferrara, Italy
| | - Giovanna Schiuma
- Department of Chemical, Pharmaceutical and Agricultural Science, University of Ferrara, 44121 Ferrara, Italy
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28
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Barkhordarian M, Behbood A, Ranjbar M, Rahimian Z, Prasad A. Overview of the cardio-metabolic impact of the COVID-19 pandemic. Endocrine 2023; 80:477-490. [PMID: 37103684 PMCID: PMC10133915 DOI: 10.1007/s12020-023-03337-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 02/21/2023] [Indexed: 04/28/2023]
Abstract
Evidence has shown that cardiometabolic disorders (CMDs) are amongst the top contributors to COVID-19 infection morbidity and mortality. The reciprocal impact of COVID-19 infection and the most common CMDs, the risk factors for poor composite outcome among patients with one or several underlying diseases, the effect of common medical management on CMDs and their safety in the context of acute COVID-19 infection are reviewed. Later on, the changes brought by the COVID-19 pandemic quarantine on the general population's lifestyle (diet, exercise patterns) and metabolic health, acute cardiac complications of different COVID-19 vaccines and the effect of CMDs on the vaccine efficacy are discussed. Our review identified that the incidence of COVID-19 infection is higher among patients with underlying CMDs such as hypertension, diabetes, obesity and cardiovascular disease. Also, CMDs increase the risk of COVID-19 infection progression to severe disease phenotypes (e.g. hospital and/or ICU admission, use of mechanical ventilation). Lifestyle modification during COVID-19 era had a great impact on inducing and worsening of CMDs. Finally, the lower efficacy of COVID-19 vaccines was found in patients with metabolic disease.
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Affiliation(s)
- Maryam Barkhordarian
- Department of Medicine, Division of Cardiology, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Arezoo Behbood
- MPH department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Maryam Ranjbar
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Zahra Rahimian
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Anand Prasad
- Division of Cardiology, Department of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
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Kandinata SG, Soelistijo SA, Pranoto A, Triyono EA. Random Blood Glucose, but Not HbA1c, Was Associated with Mortality in COVID-19 Patients with Type 2 Diabetes Mellitus—A Retrospective Study. PATHOPHYSIOLOGY 2023; 30:136-143. [PMID: 37092526 PMCID: PMC10123645 DOI: 10.3390/pathophysiology30020012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 03/05/2023] [Accepted: 04/03/2023] [Indexed: 04/08/2023] Open
Abstract
Previous studies have yielded inconsistent results on whether glycated hemoglobin (HbA1c) and random blood glucose (RBG) are associated with mortality of coronavirus disease 2019 (COVID-19) patients with type 2 diabetes mellitus (T2DM). This study aimed to assess the association of HbA1c and RBG with mortality among COVID-19 patients with T2DM. A retrospective study was conducted on 237 patients with COVID-19 and T2DM (survival (n = 169) and non-survival groups (n = 68)). Data on socio-demography, comorbidities, clinical symptoms, laboratory examination, and mortality were collected. Patients in the non-survival group had an older age range as compared with those in the survival group (60 (52.3–65.0) vs. 56.0 (48.5–61.5) years, p = 0.009). There was no statistical gender difference between the two groups. After matching was done, chronic kidney disease, NLR, d-dimer, procalcitonin, and random blood glucose were higher in the non-survival group compared to the survival group (p < 0.05). HbA1c levels were similar in survivors and non-survivors (8.7% vs. 8.9%, p=0.549). The level of RBG was independently associated with mortality of COVID-19 patients with T2DM (p = 0.003, adjusted OR per 1-SD increment 2.55, 95% CI: 1.36–4.76). In conclusion, RBG was associated with the mortality of COVID-19 patients with T2DM, but HbA1c was not.
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Affiliation(s)
- Stefanus Gunawan Kandinata
- Department of Internal Medicine, Dr. Soetomo General Academic Hospital—Faculty of Medicine, Airlangga University, Surabaya 60132, Indonesia
| | - Soebagijo Adi Soelistijo
- Endocrinology, Metabolism and Diabetes Unit, Department of Internal Medicine, Dr. Soetomo General Academic Hospital—Faculty of Medicine, Airlangga University, Surabaya 60132, Indonesia
| | - Agung Pranoto
- Endocrinology, Metabolism and Diabetes Unit, Department of Internal Medicine, Dr. Soetomo General Academic Hospital—Faculty of Medicine, Airlangga University, Surabaya 60132, Indonesia
| | - Erwin Astha Triyono
- Tropical and Infectious Disease Unit, Department of Internal Medicine, Dr. Soetomo General Academic Hospital—Faculty of Medicine, Airlangga University, Surabaya 60132, Indonesia
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30
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Anwardeen NR, Cyprian FS, Yassine HM, Al-Thani AA, Abdallah AM, Emara MM, Elrayess MA. The retrospective study of the metabolic patterns of BCG-vaccination in type-2 diabetic individuals in COVID-19 infection. Front Immunol 2023; 14:1146443. [PMID: 37122708 PMCID: PMC10131282 DOI: 10.3389/fimmu.2023.1146443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/27/2023] [Indexed: 04/08/2023] Open
Abstract
BackgroundThe cross-protective nature of Bacillus Calmette-Guerin (BCG) vaccine against SARS-CoV-2 virus was previously suggested, however its effect in COVID-19 patients with type 2 diabetes (T2D) and the underlying metabolic pathways has not been addressed. This study aims to investigate the difference in the metabolomic patterns of type 2 diabetic patients with BCG vaccination showing different severity levels of COVID-19 infection.MethodsSixty-seven COVID-19 patients were categorized into diabetic and non-diabetic individuals who had been previously vaccinated or not with BCG vaccination. Targeted metabolomics were performed from serum samples from all patients using tandem mass spectrometry. Statistical analysis included multivariate and univariate models.ResultsData suggested that while BCG vaccination may provide protection for individuals who do not have diabetes, it appears to be linked to more severe COVID-19 symptoms in T2D patients (p = 0.02). Comparing the metabolic signature of BCG vaccinated T2D individuals to non-vaccinated counterparts revealed that amino acid (sarcosine), cholesterol esters (CE 20:0, 20:1, 22:2), carboxylic acid (Aconitic acid) were enriched in BCG vaccinated T2D patients, whereas spermidine, glycosylceramides (Hex3Cer(d18:1_22:0), Hex2Cer(d18:1/22:0), HexCer(d18:1/26:1), Hex2Cer(d18:1/24:0), HexCer(d18:1/22:0) were higher in BCG vaccinated non- T2D patients. Furthermore, data indicated a decrease in sarcosine synthesis from glycine and choline and increase in spermidine synthesis in the BCG vaccinated cohort in T2D and non-T2D groups, respectively.ConclusionThis pilot study suggests increased severity of COVID-19 in BCG vaccinated T2D patients, which was marked by decreased sarcosine synthesis, perhaps via lower sarcosine-mediated removal of viral antigens.
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Affiliation(s)
| | - Farhan S. Cyprian
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Hadi M. Yassine
- Biomedical Research Center (BRC), QU Health, Qatar University, Doha, Qatar
- College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Asmaa A. Al-Thani
- Biomedical Research Center (BRC), QU Health, Qatar University, Doha, Qatar
- College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Abdallah M. Abdallah
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Mohamed M. Emara
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Mohamed A. Elrayess
- Biomedical Research Center (BRC), QU Health, Qatar University, Doha, Qatar
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Doha, Qatar
- *Correspondence: Mohamed A. Elrayess,
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31
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Colley J, Dambha-Miller H, Stuart B, Bartholomew J, Benton M, Baykoca J, Price H. Home monitoring of haemoglobin A 1c in diabetes: A systematic review and narrative synthesis on accuracy, reliability and patient acceptability. Diabet Med 2023; 40:e15033. [PMID: 36562666 DOI: 10.1111/dme.15033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 12/02/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022]
Abstract
AIM In the UK people with diabetes who do not attend annual review appointments often have higher haemoglobin A1c (HbA1c ) levels. We aim to determine the acceptability of self-collected posted capillary blood samples, and if they produce accurate and reliable HbA1c results. METHODS We include adult studies comparing capillary blood to venous blood for measuring HbA1c . We exclude methods not suitable for postage. Electronic databases of MEDLINE, Embase, CINAHL, Web of Science, Google Scholar and OpenGrey were searched from inception to September 2021, as well as relevant conference abstracts. Two reviewers performed study selection, data extraction and risk of bias assessment independently. Narrative synthesis was performed. RESULTS Our search retrieved 3747 records. Following de-duplication and screening 30 articles were included. The mean difference (MD) and limits of agreement (LoA) between capillary and venous HbA1c were smaller and narrower respectively when micro/capillary tubes (micro/cap) were used for capillary blood storage compared to dried blood spots (capDBS) (micro/cap MD range -0.4 to 1.4 mmol/mol vs. capDBS MD range -4.3 to 7.2 mmol/mol, micro/cap LoA width 2.4 to 6 mmol/mol vs. capDBS LoA width 11.7 to 16.8 mmol/mol). After using self-collection kits, 83%-96% of participants reported satisfaction, 87%-99% found it easy and 69%-94% reported they would use it again. CONCLUSION Microtubes/capillary tubes look promising as a method of self-collecting and posting capillary blood samples for the measurement of HbA1c based on the accuracy and reliability findings presented. DBS samples demonstrated comparatively poorer accuracy. Data on acceptability were limited and further research is needed.
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Affiliation(s)
- Jack Colley
- Research and Development Department, Southern Health NHS Foundation Trust, Southampton, UK
| | | | - Beth Stuart
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | - Jazz Bartholomew
- Research and Development Department, Southern Health NHS Foundation Trust, Southampton, UK
| | - Madeleine Benton
- Department of Psychological Medicine, Kings College London, London, UK
| | - Jeni Baykoca
- Department of Psychological Medicine, Kings College London, London, UK
| | - Hermione Price
- Research and Development Department, Southern Health NHS Foundation Trust, Southampton, UK
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Li R, Shen M, Yang Q, Fairley CK, Chai Z, McIntyre R, Ong JJ, Liu H, Lu P, Hu W, Zou Z, Li Z, He S, Zhuang G, Zhang L. Global Diabetes Prevalence in COVID-19 Patients and Contribution to COVID-19- Related Severity and Mortality: A Systematic Review and Meta-analysis. Diabetes Care 2023; 46:890-897. [PMID: 36826982 PMCID: PMC10090902 DOI: 10.2337/dc22-1943] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 01/26/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND COVID-19 and diabetes both contribute to large global disease burdens. PURPOSE To quantify the prevalence of diabetes in various COVID-19 disease stages and calculate the population attributable fraction (PAF) of diabetes to COVID-19-related severity and mortality. DATA SOURCES Systematic review identified 729 studies with 29,874,938 COVID-19 patients. STUDY SELECTION Studies detailed the prevalence of diabetes in subjects with known COVID-19 diagnosis and severity. DATA EXTRACTION Study information, COVID-19 disease stages, and diabetes prevalence were extracted. DATA SYNTHESIS The pooled prevalence of diabetes in stratified COVID-19 groups was 14.7% (95% CI 12.5-16.9) among confirmed cases, 10.4% (7.6-13.6) among nonhospitalized cases, 21.4% (20.4-22.5) among hospitalized cases, 11.9% (10.2-13.7) among nonsevere cases, 28.9% (27.0-30.8) among severe cases, and 34.6% (32.8-36.5) among deceased individuals, respectively. Multivariate metaregression analysis explained 53-83% heterogeneity of the pooled prevalence. Based on a modified version of the comparative risk assessment model, we estimated that the overall PAF of diabetes was 9.5% (7.3-11.7) for the presence of severe disease in COVID-19-infected individuals and 16.8% (14.8-18.8) for COVID-19-related deaths. Subgroup analyses demonstrated that countries with high income levels, high health care access and quality index, and low diabetes disease burden had lower PAF of diabetes contributing to COVID-19 severity and death. LIMITATIONS Most studies had a high risk of bias. CONCLUSIONS The prevalence of diabetes increases with COVID-19 severity, and diabetes accounts for 9.5% of severe COVID-19 cases and 16.8% of deaths, with disparities according to country income, health care access and quality index, and diabetes disease burden.
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Affiliation(s)
- Rui Li
- China–Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Mingwang Shen
- China–Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
- Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, China
| | - Qianqian Yang
- China–Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Christopher K. Fairley
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Zhonglin Chai
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Robert McIntyre
- Bariatric and Metabolic Surgery, King’s College Hospital, London, U.K
| | - Jason J. Ong
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Hanting Liu
- China–Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Pengyi Lu
- China–Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Wenyi Hu
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
- Department of Surgery (Ophthalmology), The University of Melbourne, Melbourne, Australia
| | - Zhuoru Zou
- China–Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Zengbin Li
- China–Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Shihao He
- China–Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Guihua Zhuang
- China–Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
- Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, China
| | - Lei Zhang
- China–Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
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Chevalier K, Genin M, Jean TP, Avouac J, Flipo RM, Georgin-Lavialle S, El Mahou S, Pertuiset E, Pham T, Servettaz A, Marotte H, Domont F, Chazerain P, Devaux M, Mekinian A, Sellam J, Fautrel B, Rouzaud D, Ebstein E, Costedoat-Chalumeau N, Richez C, Hachulla E, Mariette X, Seror R. CovAID: Identification of factors associated with severe COVID-19 in patients with inflammatory rheumatism or autoimmune diseases. Front Med (Lausanne) 2023; 10:1152587. [PMID: 37035330 PMCID: PMC10075312 DOI: 10.3389/fmed.2023.1152587] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 02/27/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction Autoimmune/inflammatory rheumatic diseases (AIRDs) patients might be at-risk of severe COVID-19. However, whether this is linked to the disease or to its treatment is difficult to determine. This study aimed to identify factors associated with occurrence of severe COVID-19 in AIRD patients and to evaluate whether having an AIRD was associated with increased risk of severe COVID-19 or death. Materials and methods Two databases were analyzed: the EDS (Entrepôt des Données de Santé, Clinical Data Warehouse), including all patients followed in Paris university hospitals and the French multi-center COVID-19 cohort [French rheumatic and musculoskeletal diseases (RMD)]. First, in a combined analysis we compared patients with severe and non-severe COVID-19 to identify factors associated with severity. Then, we performed a propensity matched score case-control study within the EDS database to compare AIRD cases and non-AIRD controls. Results Among 1,213 patients, 195 (16.1%) experienced severe COVID-19. In multivariate analysis, older age, interstitial lung disease (ILD), arterial hypertension, obesity, sarcoidosis, vasculitis, auto-inflammatory diseases, and treatment with corticosteroids or rituximab were associated with increased risk of severe COVID-19. Among 35,741 COVID-19 patients in EDS, 316 having AIRDs were compared to 1,264 Propensity score-matched controls. AIRD patients had a higher risk of severe COVID-19 [aOR = 1.43 (1.08-1.87), p = 0.01] but analysis restricted to rheumatoid arthritis and spondyloarthritis found no increased risk of severe COVID-19 [aOR = 1.11 (0.68-1.81)]. Conclusion In this multicenter study, we confirmed that AIRD patients treated with rituximab or corticosteroids and/or having vasculitis, auto-inflammatory disease, and sarcoidosis had increased risk of severe COVID-19. Also, AIRD patients had, overall, an increased risk of severe COVID-19 compares general population.
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Affiliation(s)
- Kevin Chevalier
- Department of Rheumatology, Université Paris-Saclay, INSERM UMR 1184: Center for Immunology of Viral Infections and Autoimmune Diseases, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Michaël Genin
- University of Lille, CHU Lille, ULR 2694–METRICS: Evaluation des Technologies de Santé et des Pratiques Médicales, Lille, France
| | | | | | | | | | | | | | - Thao Pham
- Hospital Sainte Marguerite, Rheumatology, Marseille, France
| | - Amelie Servettaz
- Hospital Robert Debré, Internal Medicine, Infectious Diseases and Clinical Immunology, Reims, France
| | - Hubert Marotte
- University Hospital of Saint-Étienne, Rheumatology, Saint-Priest-en-Jarez, France
| | - Fanny Domont
- University Hospitals Pitié Salpêtrière - Charles Foix, Internal Medicine and Clinical Immunology, Paris, France
| | - Pascal Chazerain
- Hopital de la Croix Saint-Simon, Rheumatology and Internal Medicine, Paris, France
| | - Mathilde Devaux
- Saint-Germain-en-Laye Intercommunal Hospital Center, Internal Medicine, Poissy, France
| | - Arsene Mekinian
- Hospital Saint-Antoine AP-HP, Internal Medicine, Paris, France
| | - Jérémie Sellam
- Hospital Saint-Antoine AP-HP, Rheumatology, Paris, France
| | - Bruno Fautrel
- Sorbonne Universite – APHP, Pitie Salpetriere Hospital, Department of Rheumatology, Pierre Louis Institute of Epidemiology and Public Health, INSERM UMRS 1136, Paris, France
| | - Diane Rouzaud
- Bichat-Claude Bernard Hospital, Internal Medicine, Paris, France
| | - Esther Ebstein
- Bichat-Claude Bernard Hospital, Rheumatology, Paris, France
| | | | | | - Eric Hachulla
- Department of Internal Medicine and Clinical Immunology, Referral Centre for Centre for Rare Systemic Autoimmune Diseases North and North-West of France (CeRAINO), CHU Lille, University of Lille, INSERM, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - Xavier Mariette
- Department of Rheumatology, Université Paris-Saclay, INSERM UMR 1184: Center for Immunology of Viral Infections and Autoimmune Diseases, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Raphaèle Seror
- Department of Rheumatology, Université Paris-Saclay, INSERM UMR 1184: Center for Immunology of Viral Infections and Autoimmune Diseases, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
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Scaramuzzo G, Nucera F, Asmundo A, Messina R, Mari M, Montanaro F, Johansen MD, Monaco F, Fadda G, Tuccari G, Hansbro NG, Hansbro PM, Hansel TT, Adcock IM, David A, Kirkham P, Caramori G, Volta CA, Spadaro S. Cellular and molecular features of COVID-19 associated ARDS: therapeutic relevance. J Inflamm (Lond) 2023; 20:11. [PMID: 36941580 PMCID: PMC10027286 DOI: 10.1186/s12950-023-00333-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 02/08/2023] [Indexed: 03/23/2023] Open
Abstract
The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection can be asymptomatic or cause a disease (COVID-19) characterized by different levels of severity. The main cause of severe COVID-19 and death is represented by acute (or acute on chronic) respiratory failure and acute respiratory distress syndrome (ARDS), often requiring hospital admission and ventilator support.The molecular pathogenesis of COVID-19-related ARDS (by now termed c-ARDS) is still poorly understood. In this review we will discuss the genetic susceptibility to COVID-19, the pathogenesis and the local and systemic biomarkers correlated with c-ARDS and the therapeutic options that target the cell signalling pathways of c-ARDS.
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Affiliation(s)
- Gaetano Scaramuzzo
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
- Department of Emergency, Section of Intensive Care and Anesthesia, Azienda Ospedaliera-Universitaria Sant'Anna, Ferrara, Italy
| | - Francesco Nucera
- Pneumologia, Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali (BIOMORF), Università di Messina, Messina, Italy
| | - Alessio Asmundo
- Medicina Legale, Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali (BIOMORF), Università di Messina, Messina, Italy
| | - Roberto Messina
- Intensive Care Unit, Dipartimento di Patologia Umana e dell'Età Evolutiva Gaetano Barresi, Università di Messina, Messina, Italy
| | - Matilde Mari
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
- Department of Emergency, Section of Intensive Care and Anesthesia, Azienda Ospedaliera-Universitaria Sant'Anna, Ferrara, Italy
| | - Federica Montanaro
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
- Department of Emergency, Section of Intensive Care and Anesthesia, Azienda Ospedaliera-Universitaria Sant'Anna, Ferrara, Italy
| | - Matt D Johansen
- Centre for Inflammation, School of Life Sciences, Faculty of Science, Centenary Institute and University of Technology Sydney, Sydney, NSW, Australia
| | - Francesco Monaco
- Chirurgia Toracica, Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali (BIOMORF), Università di Messina, Messina, Italy
| | - Guido Fadda
- Section of Pathological Anatomy, Department of Human Pathology of Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina, Italy
| | - Giovanni Tuccari
- Section of Pathological Anatomy, Department of Human Pathology of Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina, Italy
| | - Nicole G Hansbro
- Centre for Inflammation, School of Life Sciences, Faculty of Science, Centenary Institute and University of Technology Sydney, Sydney, NSW, Australia
| | - Philip M Hansbro
- Centre for Inflammation, School of Life Sciences, Faculty of Science, Centenary Institute and University of Technology Sydney, Sydney, NSW, Australia
| | - Trevor T Hansel
- Medical Research Council and Asthma, UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - Ian M Adcock
- Airway Disease Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - Antonio David
- Intensive Care Unit, Dipartimento di Patologia Umana e dell'Età Evolutiva Gaetano Barresi, Università di Messina, Messina, Italy
| | - Paul Kirkham
- Department of Biomedical Sciences, Faculty of Sciences and Engineering, University of Wolverhampton, West Midlands, Wolverhampton, UK
| | - Gaetano Caramori
- Pneumologia, Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali (BIOMORF), Università di Messina, Messina, Italy.
| | - Carlo Alberto Volta
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
- Department of Emergency, Section of Intensive Care and Anesthesia, Azienda Ospedaliera-Universitaria Sant'Anna, Ferrara, Italy
| | - Savino Spadaro
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
- Department of Emergency, Section of Intensive Care and Anesthesia, Azienda Ospedaliera-Universitaria Sant'Anna, Ferrara, Italy
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35
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Greco C, Pirotti T, Brigante G, Filippini T, Pacchioni C, Trenti T, Simoni M, Santi D. Glycemic control predicts SARS-CoV-2 prognosis in diabetic subjects. Acta Diabetol 2023; 60:817-825. [PMID: 36939895 PMCID: PMC10025792 DOI: 10.1007/s00592-023-02073-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/06/2023] [Indexed: 03/21/2023]
Abstract
AIM The coronavirus disease (COVID)-19 incidence was higher in diabetes mellitus (DM), although several differences should be considered on the basis of characteristics of cohorts evaluated. This study was designed to evaluate the prevalence and potential consequences of COVID-19 in a large diabetic population in Northern Italy. DESIGN Observational, longitudinal, retrospective, clinical study. METHODS Subjects with both type 1 and type 2 DM living in the Province of Modena and submitted to at least one SARS-CoV-2 swab between March 2020 and March 2021 were included. Data were extracted from the Hospital data warehouse. RESULTS 9553 diabetic subjects were enrolled (age 68.8 ± 14.1 years, diabetes duration 11.0 ± 6.9 years, glycated hemoglobin 57.2 ± 16.2 mmol/mol). COVID-19 was detected in 2302 patients (24.1%) with a death rate of 8.9%. The mean age and diabetes duration were significantly lower in infected versus non-infected patients. SARS-CoV-2 infection was more frequent in youngest people, according to quartile of age and retirement pension age of 65 years. No differences were detected considering sex. Higher HbA1c was detected in infected compared to non-infected patient. Death was predicted by diabetes duration and HbA1c. ROC analyses for death risk showed significant threshold for diabetes duration (10.9 years) and age (74.4 years). CONCLUSION In our cohort, SARS-CoV-2 infection correlates with age, diabetes duration and disease control. Diabetic patients with COVID-19 should be carefully followed when older than 74 years and with more than 10 years of DM duration.
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Affiliation(s)
- Carla Greco
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giardini 1355, 41126, Modena, Italy.
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria Di Modena, Ospedale Civile Di Baggiovara, Modena, Italy.
| | - Tommaso Pirotti
- Department of Laboratory Medicine and Anatomy Pathology, Azienda USL Modena, Modena, Italy
| | - Giulia Brigante
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giardini 1355, 41126, Modena, Italy
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria Di Modena, Ospedale Civile Di Baggiovara, Modena, Italy
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Chiara Pacchioni
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria Di Modena, Ospedale Civile Di Baggiovara, Modena, Italy
| | - Tommaso Trenti
- Department of Laboratory Medicine and Anatomy Pathology, Azienda USL Modena, Modena, Italy
| | - Manuela Simoni
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giardini 1355, 41126, Modena, Italy
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria Di Modena, Ospedale Civile Di Baggiovara, Modena, Italy
| | - Daniele Santi
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giardini 1355, 41126, Modena, Italy
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria Di Modena, Ospedale Civile Di Baggiovara, Modena, Italy
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Identification of Clinical Features Associated with Mortality in COVID-19 Patients. OPERATIONS RESEARCH FORUM 2023. [PMCID: PMC9984757 DOI: 10.1007/s43069-022-00191-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
AbstractUnderstanding clinical features and risk factors associated with COVID-19 mortality is needed to early identify critically ill patients, initiate treatments and prevent mortality. A retrospective study on COVID-19 patients referred to a tertiary hospital in Iran between March and November 2020 was conducted. COVID-19-related mortality and its association with clinical features including headache, chest pain, symptoms on computerized tomography (CT), hospitalization, time to infection, history of neurological disorders, having a single or multiple risk factors, fever, myalgia, dizziness, seizure, abdominal pain, nausea, vomiting, diarrhoea and anorexia were investigated. Based on the investigation outcome, decision tree and dimension reduction algorithms were used to identify the aforementioned risk factors. Of the 3008 patients (mean age 59.3 ± 18.7 years, 44% women) with COVID-19, 373 died. There was a significant association between COVID-19 mortality and old age, headache, chest pain, low respiratory rate, oxygen saturation < 93%, need for a mechanical ventilator, having symptoms on CT, hospitalization, time to infection, neurological disorders, cardiovascular diseases and having a risk factor or multiple risk factors. In contrast, there was no significant association between mortality and gender, fever, myalgia, dizziness, seizure, abdominal pain, nausea, vomiting, diarrhoea and anorexia. Our results might help identify early symptoms related to COVID-19 and better manage patients according to the extracted decision tree. The proposed ML models identified a number of clinical features and risk factors associated with mortality in COVID-19 patients. These models if implemented in a clinical setting might help to early identify patients needing medical attention and care. However, more studies are needed to confirm these findings.
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Atwah B, Iqbal MS, Kabrah S, Kabrah A, Alghamdi S, Tabassum A, Baghdadi MA, Alzahrani H. Susceptibility of Diabetic Patients to COVID-19 Infections: Clinico-Hematological and Complications Analysis. Vaccines (Basel) 2023; 11:vaccines11030561. [PMID: 36992148 DOI: 10.3390/vaccines11030561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/26/2023] [Accepted: 02/27/2023] [Indexed: 03/05/2023] Open
Abstract
Background: Coronavirus disease 2019 has become a global health threat resulting in a catastrophic spread and more than 3.8 million deaths worldwide. It has been suggested that there is a negative influence of diabetes mellites (DM), which is a complex chronic disease, on COVID-19 severe outcomes. Other factors in diabetic patients may also contribute to COVID-19 disease outcomes, such as older age, obesity, hyperglycaemia, hypertension, and other chronic conditions. Methods: A cohort study was conducted on the demographics, clinical information, and laboratory findings of the hospitalised COVID-19 with DM and non-DM patients were obtained from the medical records in King Faisal Specialist Hospital and Research Centre, Saudi Arabia. Results: Among the study population, 108 patients had DM, and 433 were non-DM patients. Patients with DM were more likely to present symptoms such as fever (50.48%), anorexia (19.51%), dry cough (47.96%), shortness of breath (35.29%), chest pain (16.49%), and other symptoms. There was a significant decrease in the mean of haematological and biochemical parameters, such as haemoglobin, calcium, and alkaline phosphate in people with diabetes compared to non-diabetics and a considerable increase in other parameters, such as glucose, potassium, and cardiac troponin. Conclusions: According to the findings of this study, patients who have diabetes have a greater risk of developing more severe symptoms associated with COVID-19 disease. This could result in more patients being admitted to the intensive care unit as well as higher mortality rates.
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Affiliation(s)
- Banan Atwah
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Mohammad Shahid Iqbal
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Saeed Kabrah
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Ahmed Kabrah
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Saad Alghamdi
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Aisha Tabassum
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Mohammed A Baghdadi
- Research Center, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Jeddah 23431, Saudi Arabia
| | - Hissah Alzahrani
- Mathematical Sciences Department, Faculty of Applied Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia
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Mandal SK, Tare M, Deepa PR. COVID-19 infection and metabolic comorbidities: Mitigating role of nutritional sufficiency and drug - nutraceutical combinations of vitamin D. HUMAN NUTRITION & METABOLISM 2023; 31:200179. [PMID: 38620788 PMCID: PMC9762046 DOI: 10.1016/j.hnm.2022.200179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
The vulnerability of human health is amplified in recent times with global increase in non-communicable diseases (due to lifestyle changes and environmental insults) and infectious diseases (caused by newer pathogens and drug-resistance strains). Clinical management of diseases is further complicated by disease severity caused by other comorbid factors. Drug-based therapy may not be the sole approach, particularly in scenarios like the COVID-19 pandemic, where there is no specific drug against SARS-CoV-2. Nutritional interventions are significant in armouring human populations in disease prevention, and as adjunctive therapy for disease alleviation. Amidst ongoing clinical trials to determine the efficacy of Vit. D against infections and associated complications, this review examines the pleiotropic benefits of nutritional adequacy of vitamin D (Vit. D) in combating viral infections (COVID-19), its severity and complications due to co-morbidities (obesity, diabetes, stroke and Kawasaki disease), based on research findings and clinical studies. Supplements of Vit. D in combination with other nutrients, and drugs, are suggested as promising preventive-health and adjunct-treatment strategies in the clinical management of viral infections with metabolic comorbidities.
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Affiliation(s)
- Sumit Kumar Mandal
- Department of Biological Sciences, Birla Institute of Technology and Science, Pilani, Pilani Campus, Rajasthan, India
| | - Meghana Tare
- Department of Biological Sciences, Birla Institute of Technology and Science, Pilani, Pilani Campus, Rajasthan, India
| | - P R Deepa
- Department of Biological Sciences, Birla Institute of Technology and Science, Pilani, Pilani Campus, Rajasthan, India
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Салухов ВВ, Арутюнов ГП, Тарловская ЕИ, Батлук ТИ, Башкинов РА, Самусь ИВ, Мельников ЕС, Трубникова МА, Арутюнов АГ. [The impact of carbohydrate metabolism disorders on the early and long-term clinical outcomes of patients with COVID-19 according to the AKTIV and AKTIV 2 registries]. PROBLEMY ENDOKRINOLOGII 2023; 69:36-49. [PMID: 36842076 PMCID: PMC9978875 DOI: 10.14341/probl13175] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 11/15/2022] [Accepted: 11/15/2022] [Indexed: 02/27/2023]
Abstract
BACKGROUND Numerous studies indicate a high incidence of various disorders of carbohydrate metabolism against the new coronavirus infection. These disorders aggravate the course of infection and increase mortality. Thereby, analysis of risk factors for unfavorable outcomes and assessment of the long-term consequences of COVID-19 in patients with impaired carbohydrate metabolism is of great importance. AIM To investigate the association between carbohydrate metabolism disorders in COVID-19 patients and mortality, course of infection, long-term consequences, as well as to identify risk factors for an unfavorable disease course. MATERIALS AND METHODS A retrospective analysis of data from the combined multicenter non-interventional real-world AKTIV and AKTIV 2 registries was performed. The sample included 9290 patients who had COVID-19 with varying severity from June 29, 2020, to November 29, 2020 (AKTIV) and from October 01, 2020, to March 30, 2021 (AKTIV 2). The patients were divided into 3 groups: Group 1 - patients with intact carbohydrate metabolism, n=6606; Group 2 - patients with newly diagnosed hyperglycemia (NDH), n=1073; Group 3 - patients with a history of type 2 diabetes mellitus (DM2), n=1611. The groups were assessed for clinical and laboratory parameters, comorbidities, mortality, carbohydrate metabolic status, and well-being during the infection and at 12 months. RESULTS The prevalence of carbohydrate metabolism disorders (CMD) was 28,9%, with DM2 patients accounting for 17,3% and patients with newly diagnosed hyperglycemia (NDH) for 11,6%. The mortality rate of patients with hyperglycemia of any origin was 10.6%, which was significantly higher compared to patients without hyperglycemia (3,9%). The probability of lethal outcome increased 2,48-fold in the group of patients with DM2 and 2,04-fold in the group of patients with NDH. At the same time, the probability of a lethal outcome decreased 2,94-fold in patients without CMD. At 12 months, patients with CMD showed a significantly higher frequency and longer persistence of complaints. This trend was more pronounced in patients with DM2 than in those with NDH. Only 1,7% of patients from the NDH group had type 2 diabetes and were receiving oral hypoglycemic medications one year after the infection. A prognostic model was developed to determine the risk of lethal outcome. The model included such known predictors as concomitant ischemic heart disease, history of myocardial infarction or stroke, blood glucose level, and age. CONCLUSION Carbohydrate metabolism disorders aggravate the course of COVID-19 and increase mortality. One year after infection, patients with DM2 and NDH were more likely to have symptoms typical for post-COVID syndrome, and NDH resolved in most cases after the infection.
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Affiliation(s)
| | - Г. П. Арутюнов
- Евразийская Ассоциация Терапевтов; Российский национальный исследовательский медицинский университет им. Н.И. Пирогова
| | - Е. И. Тарловская
- Евразийская Ассоциация Терапевтов; Приволжский исследовательский медицинский университет
| | | | - Р. А. Башкинов
- Евразийская Ассоциация Терапевтов; Северо-Западный государственный медицинский университет имени И.И. Мечникова
| | | | - Е. С. Мельников
- Евразийская Ассоциация Терапевтов; Северо-Западный государственный медицинский университет имени И.И. Мечникова
| | - М. А. Трубникова
- Евразийская Ассоциация Терапевтов; «Фрезениус Медиал Кеа Кубань»
| | - А. Г. Арутюнов
- Евразийская Ассоциация Терапевтов; Национальный институт здравоохранения им. академика С. Авдалбекяна
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Matias AA, Manique I, Sabino T, Rego T, Mihon C, Panarra A, Rizzo M, Silva-Nunes J. Absolute Hyperglycemia versus Stress Hyperglycemia Ratio for the Prognosis of Hospitalized Patients with COVID-19 in the First Months of the Pandemic: A Retrospective Study. Diabetes Ther 2023; 14:335-346. [PMID: 36574200 PMCID: PMC9793808 DOI: 10.1007/s13300-022-01347-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/21/2022] [Indexed: 12/28/2022] Open
Abstract
Diabetes is a risk factor for greater severity of coronavirus disease 2019 (COVID-19). The stress hyperglycemia ratio (SHR) is an independent predictor of critical illness, and it is reported to have a stronger association than absolute hyperglycemia. The aim of this study was to assess the relationship of absolute hyperglycemia and SHR with the severity of COVID-19, since there are no studies investigating SHR in patients with COVID-19. We conducted a retrospective observational study on hospitalized patients with COVID-19 in the first months of the pandemic, regarding absolute hyperglycemia, SHR, and severity outcomes. Of the 374 patients, 28.1% had a previous diagnosis of type 2 diabetes. Absolute hyperglycemia (64.8% versus 22.7%; p < 0.01) and SHR [1.1 (IQR 0.9-1.3) versus 1.0 (IQR 0.9-1.2); p < 0.001] showed a statistically significant association with previous diabetes. Absolute hyperglycemia showed a significant association with clinical severity of COVID-19 (79.0% versus 62.7%; p < 0.001), need for oxygen therapy (74.8% versus 54.4%; p < 0.001), invasive mechanical ventilation (28.6% versus 11.6%; p < 0.001), and intensive care unit (30.3% versus 14.9%; p = 0.002), but not with mortality; by contrast, there was no statistically significant association between SHR and all these parameters. Our results are in agreement with the literature regarding the impact of absolute hyperglycemia on COVID-19 severity outcomes, while SHR was not a significant marker. We therefore suggest that SHR should not be evaluated in all patients admitted in the hospital for COVID-19, and we encourage the standard measures at admission of blood glucose and HbA1c levels.
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Affiliation(s)
- Alexandra A Matias
- Department of Endocrinology, Diabetes and Metabolism, Hospital de Curry Cabral, Centro Hospitalar Universitário Lisboa Central, 1069-166, Lisbon, Portugal.
| | - Inês Manique
- Department of Endocrinology, Diabetes and Metabolism, Hospital de Curry Cabral, Centro Hospitalar Universitário Lisboa Central, 1069-166, Lisbon, Portugal
| | - Teresa Sabino
- Department of Endocrinology, Diabetes and Metabolism, Hospital de Curry Cabral, Centro Hospitalar Universitário Lisboa Central, 1069-166, Lisbon, Portugal
| | - Teresa Rego
- Department of Endocrinology, Diabetes and Metabolism, Hospital de Curry Cabral, Centro Hospitalar Universitário Lisboa Central, 1069-166, Lisbon, Portugal
| | - Claudia Mihon
- Functional Unit of Internal Medicine 7.2, Hospital de Curry Cabral, Centro Hospitalar Universitário Lisboa Central, 1069-166, Lisbon, Portugal
| | - António Panarra
- Functional Unit of Internal Medicine 7.2, Hospital de Curry Cabral, Centro Hospitalar Universitário Lisboa Central, 1069-166, Lisbon, Portugal
| | - Manfredi Rizzo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90100, Palermo, Italy
| | - José Silva-Nunes
- Department of Endocrinology, Diabetes and Metabolism, Hospital de Curry Cabral, Centro Hospitalar Universitário Lisboa Central, 1069-166, Lisbon, Portugal.
- Nova Medical School/Faculdade de Ciências Médicas, Nova University of Lisbon, 1169-056, Lisbon, Portugal.
- Health and Technology Research Center (H&TRC), Escola Superior de Tecnologia da Saúde de Lisboa, 1990-096, Lisbon, Portugal.
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Cheung NW, Gilroy N, Hor A, Jose S, Kairaitis K, Nayyar V, O'Sullivan MVN, Wheatley J, Chipps DR. Diabetes and hyperglycaemia among hospitalised patients with COVID-19 in Western Sydney: a retrospective cohort study. Intern Med J 2023; 53:194-201. [PMID: 36369676 PMCID: PMC9878259 DOI: 10.1111/imj.15975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 11/01/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Diabetes has been recognised as a major risk factor for COVID-19 mortality and hospital complications in earlier studies. AIMS To examine the characteristics of hospitalised COVID-19 patients with diabetes and the impact of diabetes and hyperglycaemia on hospital outcomes. METHODS This was a retrospective cohort study. Admission glucose levels, HbA1c, diabetes status and hospital outcomes were determined for subjects admitted from June to November 2021 by matching a pathology data set, a clinical data set and the hospital administrative database. The outcomes of interest were death, intensive care unit (ICU) admission and length of stay (LOS). RESULTS There were 1515 individuals admitted with COVID-19 with 49 deaths (3.2%) and 205 (13.5%) ICU admissions. The median length of hospital stay was 3.7 days. Three hundred and ten patients (20%) had diabetes, with 46 (15%) newly diagnosed. Patients with diabetes had a higher mortality than patients who did not have diabetes (8% vs 2%, P < 0.001), were more likely to be admitted to ICU (20% vs 12%, P = 0.001) and have longer median LOS stay (6.6 (interquartile range (IQR) 2.9-12.5) vs 2.9 (IQR 0.5-7.1) days, P < 0.001). In multivariate models, neither diabetes nor admission glucose predicted death. Admission glucose level but not diabetes was an independent predictor of ICU admission and LOS. CONCLUSIONS There is a high prevalence of diabetes among patients hospitalised with COVID-19, with worse outcomes. In contrast to previous studies, the association of diabetes with mortality was not significant when adjusted for other variables. This is possibly related to the benefits of vaccination and current medical and ICU interventions.
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Affiliation(s)
- N. Wah Cheung
- Department of Diabetes and EndocrinologyWestmead HospitalSydneyNew South WalesAustralia
- Faculty of Medicine and HealthUniversity of SydneyNew South WalesSydneyAustralia
| | - Nicky Gilroy
- Department of Infectious DiseasesWestmead HospitalSydneyNew South WalesAustralia
| | - Amanda Hor
- Department of Diabetes and EndocrinologyWestmead HospitalSydneyNew South WalesAustralia
| | - Suja Jose
- Department of Diabetes and EndocrinologyWestmead HospitalSydneyNew South WalesAustralia
| | - Kristina Kairaitis
- Faculty of Medicine and HealthUniversity of SydneyNew South WalesSydneyAustralia
- Department of Respiratory and Sleep MedicineWestmead HospitalSydneyNew South WalesAustralia
- Ludwig Engel Centre for Respiratory ResearchThe Westmead Institute for Medical ResearchSydneyNew South WalesAustralia
| | - Vineet Nayyar
- Faculty of Medicine and HealthUniversity of SydneyNew South WalesSydneyAustralia
- Intensive Care ServicesWestmead HospitalSydneyNew South WalesAustralia
| | - Matthew V. N. O'Sullivan
- Faculty of Medicine and HealthUniversity of SydneyNew South WalesSydneyAustralia
- Department of Infectious DiseasesWestmead HospitalSydneyNew South WalesAustralia
- NSW Health PathologyWestmead HospitalNew South WalesSydneyAustralia
| | - John Wheatley
- Faculty of Medicine and HealthUniversity of SydneyNew South WalesSydneyAustralia
- Intensive Care ServicesWestmead HospitalSydneyNew South WalesAustralia
| | - David R. Chipps
- Department of Diabetes and EndocrinologyWestmead HospitalSydneyNew South WalesAustralia
- Faculty of Medicine and HealthUniversity of SydneyNew South WalesSydneyAustralia
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Mauricio D, Vlacho B, Ortega E, Cos-Claramunt X, Mata-Cases M, Real J, Fernandez-Camins B, Franch-Nadal J. Outcome of COVID-19 infection in people with diabetes mellitus or obesity in the primary care setting in Catalonia, Spain: A retrospective cohort study of the initial three waves. Prim Care Diabetes 2023; 17:12-18. [PMID: 36528549 PMCID: PMC9729647 DOI: 10.1016/j.pcd.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 11/24/2022] [Accepted: 12/01/2022] [Indexed: 12/13/2022]
Abstract
AIM We estimate the incidence and risk factors for fatal and non-fatal events among the COVID-19 infected subjects based on the presence of obesity or diabetes during the initial three epidemiological waves in our region. METHODS This was a retrospective cohort study. A primary care database was used to identify persons with COVID-19. We stratified for subjects who either had diabetes mellitus or obesity. The follow-up period for study events was up to 90 days from inclusion. RESULTS In total, 1238,710 subjects were analysed. Subjects with diabetes mellitus or obesity were older and had a worse comorbidity profile compared with groups without these conditions. Fatal events were more frequent among people with diabetes and during the first wave. In the second and third waves, the number of study events decreased. Diabetes was a risk factor for fatal events in all models, while obesity was only in the model adjusted for age, sex, diabetes and COVID-19 waves. HIV, cancer, or autoimmune diseases were risk factors for mortality among subjects with COVID-19 in the fully-adjusted model. CONCLUSIONS Diabetes was an independent risk factor for mortality among people with COVID-19. The number of fatal events decreased during the second and third waves in our region, both in those with diabetes or obesity.
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Affiliation(s)
- Dídac Mauricio
- DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Spain; Department of Endocrinology and Nutrition, Hospital Universitari de la Santa Creu i Sant Pau; Department of Medicine, University of Vic - Central University of Catalonia, Vic, Barcelona, Spain.
| | - Bogdan Vlacho
- DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Spain
| | - Emilio Ortega
- DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi i Suñer, Hospital Clinic, Barcelona, Spain; CIBER of physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Department of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Xavier Cos-Claramunt
- DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain; Innovation office at Institut Català de la Salut, Barcelona, Spain
| | - Manel Mata-Cases
- DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Spain; Primary Health Care Center La Mina, Gerència d'Àmbit d'Atenció Primària Barcelona Ciutat, Institut Català de la Salut, Sant Adrià de Besòs, Spain
| | - Jordi Real
- DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Spain
| | - Berta Fernandez-Camins
- DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; Primary Health Care Center Poblenou, Gerència d'Àmbit d'Atenció Primària Barcelona Ciutat, Institut Català de la Salut, Sant Adrià de Besòs, Spain
| | - Josep Franch-Nadal
- DAP-Cat group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Spain; Department of Medicine, Universitat de Barcelona, Barcelona, Spain; Primary Health Care Center Raval Sud, Gerència d'Àmbit d'Atenció Primària Barcelona Ciutat, Institut Català de la Salut, Sant Adrià de Besòs, Spain.
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Chen J, Mi B, Yan M, Wang Y, Zhu K, Yu C, Zhang Y, Koyama S, Ren X. The effects of comorbidities on the change of taste and smell in COVID-19 patients. Laryngoscope Investig Otolaryngol 2023; 8:25-33. [PMID: 36846410 PMCID: PMC9948579 DOI: 10.1002/lio2.1012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 12/31/2022] [Accepted: 01/08/2023] [Indexed: 01/21/2023] Open
Abstract
Background Sudden chemosensory changes were considered an early predictor of COVID-19. Here, the effects of comorbidities on changes in taste and smell in COVID-19 patients were investigated based on a worldwide study. Methods Data analyzed here were collected from the Global Consortium for Chemosensory Research (GCCR) core questionnaire, including questions regarding preexisting disease conditions. Overall, the final sample of 12,438 participants who were diagnosed with COVID-19 included patients with preexisting conditions. Mixed linear regression models were used to test our hypothesis, and the p-value of interaction was examined. Results A total of 61,067 participants completed the GCCR questionnaire, including 16,016 participants had preexisting diseases. The multivariate regression analysis showed that individuals with high blood pressure, lung disease, or sinus problems, or neurological diseases exhibited worse self-reported smell loss (p < .05), but no apparent significant differences in the smell or taste recovery. COVID-19 patients with seasonal allergy/hay fever lost their olfactory ability more than patients who did not have it (with 11.90 [9.67, 14.13] vs. without 6.97 [6.04, 7.91], p < .0001). The taste ability, smell loss and taste loss after COVID-19 recovery also decreased in the COVID-19 patients with seasonal allergy/hay fever (p < .001). Preexisting condition of diabetes did not worsen to chemosensory disorder but also had no obvious impact on the chemosensory recovery after acute infection. Preexisting diseases also affected the type of smell change in the COVID-19 patients with seasonal allergy/hay fever or sinus problems (p < .05). Conclusions COVID-19 patients with high blood pressure, lung disease, or sinus problems, or neurological diseases exhibited worse self-reported smell loss, but no differences in the smell or taste recovery. COVID-19 patients with seasonal allergy/hay fever had greater loss of smell and taste, poorer smell and taste recovery. Level of Evidence 4.
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Affiliation(s)
- Jingguo Chen
- Department of Otolaryngology‐Head and Neck SurgerySecond Affiliated Hospital of Xi'an Jiaotong University (Xibei Hospital)Xi'anChina
| | - Baibing Mi
- Department of Epidemiology and Health Statistics, School of Public Health, Health Science CenterXi'an Jiaotong UniversityXi'anChina
| | - Miaojia Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Health Science CenterXi'an Jiaotong UniversityXi'anChina
| | - Yutong Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Health Science CenterXi'an Jiaotong UniversityXi'anChina
| | - Kang Zhu
- Department of Otolaryngology‐Head and Neck SurgerySecond Affiliated Hospital of Xi'an Jiaotong University (Xibei Hospital)Xi'anChina
| | - Chao Yu
- Department of Otolaryngology‐Head and Neck SurgerySecond Affiliated Hospital of Xi'an Jiaotong University (Xibei Hospital)Xi'anChina
| | - Yanni Zhang
- Department of Otolaryngology‐Head and Neck SurgerySecond Affiliated Hospital of Xi'an Jiaotong University (Xibei Hospital)Xi'anChina
| | - Sachiko Koyama
- Department of ChemistryIndiana UniversityBloomingtonIndianaUSA
| | - Xiaoyong Ren
- Department of Otolaryngology‐Head and Neck SurgerySecond Affiliated Hospital of Xi'an Jiaotong University (Xibei Hospital)Xi'anChina
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Hamidi Z, Jabraeili-Siahroud S, Taati-Alamdari Y, Aghbash PS, Shamekh A, Baghi HB. A comprehensive review of COVID-19 symptoms and treatments in the setting of autoimmune diseases. Virol J 2023; 20:1. [PMID: 36611166 PMCID: PMC9824943 DOI: 10.1186/s12985-023-01967-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 01/04/2023] [Indexed: 01/09/2023] Open
Abstract
After the first reporting of the index case of Severe Acute Respiratory Syndrome (SARS)-CoV-2-associated disease at the end of December 2019, the virus spread quickly throughout the world, prompting the WHO on 11 March 2020 to declare the disease a global pandemic. The coronavirus disease 2019 (COVID-19) pandemic, raises concerns for all people, mainly for susceptible population. People with pre-existing diseases, especially individuals with autoimmune disorders, are more at the risk of SARS-CoV-2 infection because of compromised immune system due to frequent use of immunosuppressive drugs and steroids. Patients with autoimmune diseases and their physicians have concerns about these patients' healthcare, since they are at a higher risk for COVID-19 infection, may show severe complications of COVID-19, and may experience probable flares of their pre-existing disease. Even though there have been several studies discussing the relation between COVID-19 and various types of autoimmune diseases, it cannot be ascertained that all patients with autoimmune diseases experience more severe complications of COVID-19 and have more hospitalization or mortality rate. The situation depends on each patient's condition, such as the type and the severity of the underlying autoimmune disease and the kind of treatment they receive. In the present review, we have discussed the effects of COVID-19 pandemic on patients with different autoimmune diseases and their relative concerns about their treatments. As a result, we have reviewed further considerations that should be taken into account for these patients during the pandemic or when they are infected with COVID-19.
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Affiliation(s)
- Zahra Hamidi
- grid.412888.f0000 0001 2174 8913Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran ,grid.412888.f0000 0001 2174 8913Department of Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shaghaiegh Jabraeili-Siahroud
- grid.412888.f0000 0001 2174 8913Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran ,grid.412888.f0000 0001 2174 8913Department of Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yalda Taati-Alamdari
- grid.412888.f0000 0001 2174 8913Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran ,grid.412888.f0000 0001 2174 8913Department of Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parisa Shiri Aghbash
- grid.412888.f0000 0001 2174 8913Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran ,grid.412888.f0000 0001 2174 8913Department of Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Shamekh
- grid.412888.f0000 0001 2174 8913Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran ,grid.412888.f0000 0001 2174 8913Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, P.O. Box 5165665931, Tabriz, Iran
| | - Hossein Bannazadeh Baghi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. .,Department of Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. .,Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, P.O. Box 5165665931, Tabriz, Iran.
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Pinchera B, Schiano Moriello N, Buonomo AR, Di Filippo I, Tanzillo A, Buzzo G, Villari R, Gentile I. Diabetes and SARS-CoV-2 Infection: The Potential Role of Antidiabetic Therapy in the Evolution of COVID-19. Microorganisms 2023; 11:microorganisms11010145. [PMID: 36677437 PMCID: PMC9865860 DOI: 10.3390/microorganisms11010145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/02/2023] [Accepted: 01/05/2023] [Indexed: 01/09/2023] Open
Abstract
Diabetes mellitus represents one of the most frequent comorbidities among patients with COVID-19, constituting a risk factor for a more severe prognosis than that of non-diabetic patients. However, the pathophysiological mechanism underlying this unfavorable outcome is still not completely clear. The goal of our study was to evaluate the potential role of antidiabetic therapy in the evolution of COVID-19.
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Chandra M, Aman AM, Sanusi HD, Umar H. Factors Affecting Outcome in Diabetic Patients with COVID-19: A Cross-sectional Study. Open Access Maced J Med Sci 2023. [DOI: 10.3889/oamjms.2023.8833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023] Open
Abstract
BACKGROUND: Type-2 diabetes mellitus (T2DM) is a chronic disease and often found as a comorbid in COVID-19. Poor glycemic control might play a role in worsening of clinical outcome in COVID-19 patients who lead to increase morbidity and mortality.
AIM: We conducted a study to evaluate relationship between T2DM with or without macrovascular and microvascular complications and cigarette smoking habit with COVID-19 outcomes.
METHODS: A cross-sectional study of hospitalized COVID-19 patients was conducted in Dr. Wahidin Sudirohusodo Hospital, Makassar from May 2020 to August 2020. COVID-19 status was obtained using real-time polymerase chain reaction for SARS-CoV-2, T2DM status was obtained using blood glucose or HbA1c, and other characteristic data were obtained. Mortality was the clinical outcome in our study.
RESULTS: One hundred and six subjects data were enrolled. Most subjects were male (n = 55; 51.9%), and 55–65 year-old (n = 40; 37.7%). Eighty subjects were survived (75.5%) and 26 subjects did not survive (24.5%). Onset of T2DM ≥ 5 years had a higher mortality rate compared to onset < 5 years (34.9% vs. 17.5%; p = 0.041). Other factors such as gender, age, nutritional status, hypertension, heart disease, smoking habit, and HbA1c did not show significant difference in terms of mortality.
CONCLUSION: COVID-19 patients with onset of T2DM for more than 5 years had a worse outcome compared to the onset of T2DM <5 years.
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Krumpolec P, Kodada D, Nyáriová N, Repiská V, Minárik G. COVID-19 and Diabetes Mellitus: Mutual Interplay of Two Diseases. Curr Diabetes Rev 2023; 19:e130922208761. [PMID: 36100987 DOI: 10.2174/1573399819666220913113146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/16/2022] [Accepted: 08/09/2022] [Indexed: 11/22/2022]
Abstract
Currently, when the world is fighting against the rapidly spreading pandemic of COVID-19, the silent epidemic of diabetes should not be set aside. In comparison, while COVID- 19 led to about 6 million deaths in 2021, diabetes caused 6.7 million deaths in the same year. Diabetes mellitus is a serious risk factor for worse outcomes in COVID-19 patients. Moreover, it seems that there is a bidirectional relationship between pre-existing diabetes pandemic and the rapidly spreading COVID-19 pandemic. In this article, we summarize mechanisms by which SARS-CoV-2 infects the host cell and discuss the bidirectional relationship between diabetes and COVID-19. We also focus on clinical variables in which diabetic patients differ from non-diabetic patients and which could have promising predictive value for the course and outcome of diabetic COVID-19 patients' therapy management.
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Affiliation(s)
| | - Dominik Kodada
- Medirex Group Academy n.p.o., Novozamocka 67, Nitra, Slovakia
- Faculty of Medicine, Department of Clinical Biology, Genetics and Clinical Genetics, Comenius University in Bratislava, Sasinkova 4, Bratislava, Slovakia
| | - Nikola Nyáriová
- Medirex Group Academy n.p.o., Novozamocka 67, Nitra, Slovakia
- Faculty of Medicine, Department of Clinical Biology, Genetics and Clinical Genetics, Comenius University in Bratislava, Sasinkova 4, Bratislava, Slovakia
| | - Vanda Repiská
- Faculty of Medicine, Department of Clinical Biology, Genetics and Clinical Genetics, Comenius University in Bratislava, Sasinkova 4, Bratislava, Slovakia
| | - Gabriel Minárik
- Medirex Group Academy n.p.o., Novozamocka 67, Nitra, Slovakia
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Sun J, Liu Q, Wang Y, Wang L, Song X, Zhao X. Five-year prognosis model of esophageal cancer based on genetic algorithm improved deep neural network. Ing Rech Biomed 2023. [DOI: 10.1016/j.irbm.2022.100748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Said KB, Alsolami A, Alreshidi FS, Fathuddin A, Alshammari F, Alrashid F, Aljadani A, Aboras R, Alreshidi F, Alghozwi MH, Alshammari SF, Alharbi NF. Profiles of Independent-Comorbidity Groups in Senior COVID-19 Patients Reveal Low Fatality Associated with Standard Care and Low-Dose Hydroxychloroquine over Antivirals. J Multidiscip Healthc 2023; 16:1215-1229. [PMID: 37153358 PMCID: PMC10162097 DOI: 10.2147/jmdh.s403700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 04/03/2023] [Indexed: 05/09/2023] Open
Abstract
Introduction The lack of feasible therapies and comorbidities aggravate the COVID-19 case-fatality rate (CFR). However, reports examining CFR associations with diabetes, concomitant cardiovascular diseases, chronic kidney disease, and chronic liver disease (CLD) are limited. More studies assessing hydroxychloroquine (Hcq) and antivirals are needed. Purpose To examine associations of COVID-19 CFR in comorbid patient groups each with single comorbidities and after treatment with Hcq, favipiravir, and dexamethasone (Dex), either alone or in combination versus standard care. Methods Using statistical analysis, we descriptively determined these associations among 750 COVID-19 patient groups during the last quarter of 2021. Results A diabetes comorbidity (40%, n=299) showed twice the fatality (CFR 14%) of the others (CFR 7%; P=0.001). Hypertension (Htn) was the second-commonest comorbidity (29.5%, n=221), with similar CFR to diabetes (15% and 7% for Htn and non-Htn, respectively), but with higher significance (P=0.0006167). Although only 4% (n=30) heart failure (HF) was reported, the CFR (40%) was much higher than in those without it (8%). A similar rate (4%) for chronic kidney disease was reported, with CFRs of 33% and 9% among those with and without it, respectively (P=0.00048). Ischemic heart disease was 11% (n=74), followed by chronic liver disease (0.4%) and history of smoking (1%); however, these were not significant due to the sample sizes. Treatment indicated standard care and Hcq alone or in combination were superior (CFR of 4% and 0.5%, respectively) compared to favipiravir (25%) or Dex (38.5%) independently or in combination (35.4%). Furthermore, Hcq performed well (CFR 9%) when combined with Dex (9%; P=4.28-26). Conclusion The dominance of diabetes and other comorbidities with significant association with CFR implied existence of a common virulence mechanism. The superiority of low-dose Hcq and standard care over antivirals warrants further studies.
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Affiliation(s)
- Kamaleldin B Said
- Department of Pathology and Microbiology, College of Medicine, University of Ha’il, Ha’il, 55476, Saudi Arabia
- Genomics, Bioinformatics and Systems Biology, Carleton University, Ottawa, ON K1S 5B6, Canada
- Correspondence: Kamaleldin B Said, Department of Pathology and Microbiology, College of Medicine, University of Ha’il, Ha’il, 55476, Saudi Arabia, Tel +966500771459, Email
| | - Ahmed Alsolami
- Department of Internal Medicine, College of Medicine, University of Ha’il, Ha’il, 55476, Saudi Arabia
| | - Fayez Saud Alreshidi
- Deparmtent of Family, Community Medicine, College of Medicine, University of Ha’il, Ha’il, 55476, Saudi Arabia
| | - Anas Fathuddin
- Department of Plastic Surgery, College of Medicine, University of Ha’il, Ha’il, 55476, Saudi Arabia
| | - Fawwaz Alshammari
- Department of Dermatology, College of Medicine, University of Ha’il, Ha’il, 55476, Saudi Arabia
| | - Fauwaz Alrashid
- Department of Surgery, College of Medicine, University of Ha’il, Ha’il, 55476, Saudi Arabia
| | - Ahmed Aljadani
- Department of Internal Medicine, College of Medicine, University of Ha’il, Ha’il, 55476, Saudi Arabia
| | - Rana Aboras
- Deparmtent of Family, Community Medicine, College of Medicine, University of Ha’il, Ha’il, 55476, Saudi Arabia
| | - Fatmah Alreshidi
- Deparmtent of Family, Community Medicine, College of Medicine, University of Ha’il, Ha’il, 55476, Saudi Arabia
| | - Mohammed H Alghozwi
- Department of Pathology and Microbiology, College of Medicine, University of Ha’il, Ha’il, 55476, Saudi Arabia
| | - Suliman F Alshammari
- Department of Pathology and Microbiology, College of Medicine, University of Ha’il, Ha’il, 55476, Saudi Arabia
| | - Nawaf F Alharbi
- Department of Pathology and Microbiology, College of Medicine, University of Ha’il, Ha’il, 55476, Saudi Arabia
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Ayubi E, Torkaman Asadi F, Borzouei S, Alafchi B, Faghih Soleimani M, Khosronejad S, Khazaei S, Talebi SS. Effects of Hypertension Alone and in Comorbidity with Diabetes on Death within 30 Days among Inpatients with COVID-19 Infection. J Res Health Sci 2022; 22:e00565. [PMID: 37571936 PMCID: PMC10422163 DOI: 10.34172/jrhs.2022.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/15/2022] [Accepted: 12/07/2022] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Hypertension and diabetes are common comorbidities in patients with COVID-19 and could be influencing the mortality of such patients. The present study aimed to evaluate the effects of hypertension alone and in comorbidity with diabetes on the death within 30 days among inpatients with COVID-19 in presence of well-known determinates of COVID-19 death. STUDY DESIGN A case-control study. METHODS Four groups of COVID-19 inpatients including controls, diabetes alone, hypertension alone, and hypertension and diabetes comorbidities were defined. Each study groups did not have underlying diseases other than hypertension and diabetes. Demographic and general characteristics, underlying diseases, and hospital course events were extracted from medical records. The outcome of interest was alive at discharge/ death within 30 days after admission. Multivariable binary logistic analysis was employed to estimate the effect measures. RESULTS The number of death within 30 days among controls (n=1359), diabetes alone (159), hypertension alone (406) and hypertension and diabetes comorbidities (188) were 12.68%, 15.72%, 20.74% and 26.74%, respectively. According to three multivariable analyses after adjusting older age, hospital length of stay, and intensive care unit (ICU) admission separately, the odds of death within 30 days in COVID-19 patients with having hypertension and diabetes comorbidities was 1.58, 2.13 and 1.91 times of patients without such comorbidities, respectively (P<0.015). The effect of hypertension alone was also significant after adjusting hospital length of stay and ICU admission but not for older age. CONCLUSION Our results suggest that comorbidities, such as hypertension and diabetes may be associated with COVID-19-related deaths independent of other underlying diseases, older age, and adverse hospital course events.
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Affiliation(s)
- Erfan Ayubi
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fatemeh Torkaman Asadi
- Department of Infectious Disease, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
- Infectious Disease Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Shiva Borzouei
- Department of Internal Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Behnaz Alafchi
- Modeling Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Saman Khosronejad
- Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Salman Khazaei
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyed Saman Talebi
- Department of Internal Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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