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Xie Z, Stallings-Smith S, Patel S, Case S, Hong YR. COVID-19 booster vaccine uptake and reduced risks for long-COVID: A cross-sectional study of a U.S. adult population. Vaccine 2024:S0264-410X(24)00509-7. [PMID: 38670844 DOI: 10.1016/j.vaccine.2024.04.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 04/08/2024] [Accepted: 04/23/2024] [Indexed: 04/28/2024]
Abstract
Long-COVID (having symptoms lasting 3 months or longer post-infection) is an emerging public health concern, yet research on whether COVID-19 booster vaccines can mitigate this condition is limited. This study examined associations between booster uptake and long-COVID prevalence among U.S. adults. Data were analyzed from 8757 adults aged 18 years or older with a history of COVID-19 infection from the 2022 National Health Interview Survey. Weighted prevalence and logistic regression models examined relationships between self-reported COVID-19 booster vaccination status and long-COVID, adjusting for sociodemographics and health factors. 19.5 % reported experiencing long-COVID. Individuals receiving the COVID-19 booster vaccine had significantly lower adjusted odds of long-COVID (OR 0.75, 95 % CI 0.61-0.93) compared to unvaccinated individuals. Overall, these findings suggest that COVID-19 booster vaccination is associated with a reduced prevalence of long-COVID among the U.S. adult population, underscoring the importance of optimizing booster uptake to mitigate the long-term impacts of COVID-19.
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Affiliation(s)
- Zhigang Xie
- Department of Public Health, University of North Florida, Jacksonville, FL, United States.
| | | | - Shraddha Patel
- Department of Public Health, University of North Florida, Jacksonville, FL, United States
| | - Stuart Case
- Department of Health Services Research, Management, and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Young-Rock Hong
- Department of Health Services Research, Management, and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
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Hu CY, Cui WS, Lei Y, Tang YW, Zhang YY, Su QM, Peng F, Zeng YF, Song JL, Luo CN, Zhou Y, Li XY, Zhao ZX. Comparison of Azvudine and Nirmatrelvir/Ritonavir and Combined Use in Patients with COVID-19. Infect Drug Resist 2023; 16:7797-7808. [PMID: 38148771 PMCID: PMC10750493 DOI: 10.2147/idr.s433186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/29/2023] [Indexed: 12/28/2023] Open
Abstract
Purpose To compare the effectiveness of azvudine and nirmatrelvir/ritonavir for the treatment of coronavirus disease (COVID-19). Patients and Methods We conducted a retrospective analysis of data from 576 patients with COVID-19, comprising 195 patients without antiviral therapy, 226 patients treated with azvudine, 114 patients treated with nirmatrelvir/ritonavir, and 41 patients were treated with azvudine and nirmatrelvir/ritonavir concurrently. We compared their symptoms, mortality rates, and the length and cost of hospitalization. Results The incidence of symptoms was similar in patients treated with azvudine and in those treated with nirmatrelvir/ritonavir. However, among patients experiencing weakness, the duration of weakness was significantly shorter in the azvudine group than in the nirmatrelvir/ritonavir group (P=0.029). Mortality did not differ significantly between the azvudine group and the nirmatrelvir/ritonavir group (18.14% vs.10.53%, P=0.068). Among "severe patients", the mortality rate was markedly lower in patients treated with nirmatrelvir/ritonavir than in patients treated with azvudine (16.92% vs.32.17%, P=0.026). In patients with hepatic insufficiency, those treated with nirmatrelvir/ritonavir had substantially lower mortality than those treated with azvudine (15.09% vs.34.25%, P=0.016). In addition, patients treated with nirmatrelvir/ritonavir had longer hospital stays (P=0.002) and higher hospital costs (P<0.001) than those receiving azvudine. Compared with patients treated with nirmatrelvir/ritonavir or azvudine alone, patients taking nirmatrelvir/ritonavir and azvudine concurrently had no significant improvement in survival (P>0.05), length of stay (P>0.05), or hospital costs (P>0.05). Conclusion Azvudine is recommended for patients with non-severe COVID-19 with weakness. Nirmatrelvir/ritonavir is recommended for patients with severe COVID-19, to reduce mortality, and it could be the best choice for patients with hepatic insufficiency. The concurrent use of nirmatrelvir/ritonavir and azvudine in patients with COVID-19 could be not recommended.
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Affiliation(s)
- Cheng-Yi Hu
- Department of Infectious Diseases, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, People’s Republic of China
| | - Wen-Shuai Cui
- Department of Infectious Diseases, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, People’s Republic of China
| | - Yi Lei
- Department of Infectious Diseases, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, People’s Republic of China
| | - Yu-Wen Tang
- Department of Infectious Diseases, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, People’s Republic of China
| | - Yan-Yan Zhang
- Department of Infectious Diseases, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, People’s Republic of China
| | - Qi-Min Su
- Department of Infectious Diseases, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, People’s Republic of China
| | - Fang Peng
- Department of Critical Care Medicine, the Third Affiliated Hospital of Guang Zhou Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Yun-Fei Zeng
- Department of Infectious Diseases, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, People’s Republic of China
| | - Jia-Lin Song
- Department of Infectious Diseases, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, People’s Republic of China
| | - Cheng-Na Luo
- Department of Infectious Diseases, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, People’s Republic of China
| | - Yan Zhou
- Department of Infectious Diseases, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, People’s Republic of China
| | - Xin-Yan Li
- Department of Infectious Diseases, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, People’s Republic of China
| | - Zhu-Xiang Zhao
- Department of Infectious Diseases, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, People’s Republic of China
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Gershfeld-Litvin A, Ressler I. Psychological experiences of patients recovering from severe COVID-19 in rehabilitation: A qualitative study. J Health Psychol 2023; 28:1320-1330. [PMID: 37246370 PMCID: PMC10227547 DOI: 10.1177/13591053231174940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
The aim of this study was to describe the experiences of post-sedation COVID-19 patients in rehabilitation. Eleven Israeli men and women were interviewed in semi-structured interviews. They were patients recovering in a neurological rehabilitation unit from severe COVID-19 post-mechanical ventilation and sedation. Five themes were generated through thematic analysis: "an unexpected turn of events," "filling the gaps," "emotional reactions," "ambiguity regarding medical condition," and "sense and meaning-making." Findings suggest a need for improved communication between patients and medical staff to enhance a sense of control and coherence. Psychological support should be considered to facilitate sense and meaning-making processes during hospitalization.
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Joshi D, Nyhoff LE, Zarnitsyna VI, Moreno A, Manning K, Linderman S, Burrell AR, Stephens K, Norwood C, Mantus G, Ahmed R, Anderson EJ, Staat MA, Suthar MS, Wrammert J. Infants and young children generate more durable antibody responses to SARS-CoV-2 infection than adults. iScience 2023; 26:107967. [PMID: 37822504 PMCID: PMC10562792 DOI: 10.1016/j.isci.2023.107967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/25/2023] [Accepted: 09/15/2023] [Indexed: 10/13/2023] Open
Abstract
As SARS-CoV-2 becomes endemic, it is critical to understand immunity following early-life infection. We evaluated humoral responses to SARS-CoV-2 in 23 infants/young children. Antibody responses to SARS-CoV-2 spike antigens peaked approximately 30 days after infection and were maintained up to 500 days with little apparent decay. While the magnitude of humoral responses was similar to an adult cohort recovered from mild/moderate COVID-19, both binding and neutralization titers to WT SARS-CoV-2 were more durable in infants/young children, with spike and RBD IgG antibody half-life nearly 4X as long as in adults. IgG subtype analysis revealed that while IgG1 formed the majority of the response in both groups, IgG3 was more common in adults and IgG2 in infants/young children. These findings raise important questions regarding differential regulation of humoral immunity in infants/young children and adults and could have broad implications for the timing of vaccination and booster strategies in this age group.
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Affiliation(s)
- Devyani Joshi
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, GA, USA
- Centers for Childhood Infections and Vaccines, Children’s Healthcare of Atlanta, Emory University Department of Pediatrics Department of Medicine, Atlanta, GA, USA
| | - Lindsay E. Nyhoff
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, GA, USA
- Centers for Childhood Infections and Vaccines, Children’s Healthcare of Atlanta, Emory University Department of Pediatrics Department of Medicine, Atlanta, GA, USA
| | | | - Alberto Moreno
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, GA, USA
- Emory National Primate Research Center, Atlanta, GA, USA
- Department of Medicine, Emory University, School of Medicine, Atlanta, GA, USA
| | - Kelly Manning
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, GA, USA
- Emory National Primate Research Center, Atlanta, GA, USA
| | - Susanne Linderman
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, GA, USA
- Department of Microbiology and Immunology, Emory University, Atlanta, GA, USA
| | - Allison R. Burrell
- Division of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Environmental and Public Health Sciences, Division of Epidemiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Kathy Stephens
- Centers for Childhood Infections and Vaccines, Children’s Healthcare of Atlanta, Emory University Department of Pediatrics Department of Medicine, Atlanta, GA, USA
| | - Carson Norwood
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, GA, USA
- Centers for Childhood Infections and Vaccines, Children’s Healthcare of Atlanta, Emory University Department of Pediatrics Department of Medicine, Atlanta, GA, USA
| | - Grace Mantus
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, GA, USA
- Centers for Childhood Infections and Vaccines, Children’s Healthcare of Atlanta, Emory University Department of Pediatrics Department of Medicine, Atlanta, GA, USA
| | - Rafi Ahmed
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, GA, USA
- Department of Microbiology and Immunology, Emory University, Atlanta, GA, USA
| | - Evan J. Anderson
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, USA
- Centers for Childhood Infections and Vaccines, Children’s Healthcare of Atlanta, Emory University Department of Pediatrics Department of Medicine, Atlanta, GA, USA
- Department of Medicine, Emory University, School of Medicine, Atlanta, GA, USA
| | - Mary A. Staat
- Division of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Mehul S. Suthar
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, GA, USA
- Centers for Childhood Infections and Vaccines, Children’s Healthcare of Atlanta, Emory University Department of Pediatrics Department of Medicine, Atlanta, GA, USA
- Department of Microbiology and Immunology, Emory University, Atlanta, GA, USA
- Emory National Primate Research Center, Atlanta, GA, USA
| | - Jens Wrammert
- Division of Infectious Diseases, Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, GA, USA
- Centers for Childhood Infections and Vaccines, Children’s Healthcare of Atlanta, Emory University Department of Pediatrics Department of Medicine, Atlanta, GA, USA
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Dada SA, Dele-Ojo BF, Raimi TH, Ojo P, Adeoti AO, Fadare JO, Rafiu MO, Dada OE, Olabanji JK. Clinical and Epidemiological Characteristics of Hospitalized COVID-19 Patients in an Isolation Centre in South-West Nigeria. Cureus 2023; 15:e46992. [PMID: 38021567 PMCID: PMC10640905 DOI: 10.7759/cureus.46992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION The clinical presentation of coronavirus disease 2019 (COVID-19) can vary widely, and while the primary infection involves the respiratory system, other organs can also be affected. This study presents the clinical and epidemiological characteristics of hospitalized COVID-19 patients in a tertiary hospital in Ado Ekiti, South-West Nigeria. MATERIALS AND METHODS This is a retrospective study involving COVID-19 patients admitted to the isolation ward between August 2020 and January 2021. The data used for this study was obtained from the patient's medical record, which includes demographic characteristics, clinical presentation, baseline co-morbidities, and laboratory investigations. RESULTS The average age of the patients was 60.3 years, and more than two-thirds were male. The most common symptoms were fever, shortness of breath, cough, and tiredness. Comorbidities identified among the patients included diabetes mellitus, heart disease, obesity, and chronic kidney disease. The most common radiological findings were bilateral homogeneous patchy opacities and peripheral fluffy infiltrates. The overall mortality rate was 21.9%, with 13 deaths in patients with severe disease. Age and duration of admission were found to be significant predictors of death. CONCLUSION The results of this study provide valuable insights into the clinical presentation of COVID-19 in Nigeria and may guide future management strategies for similar infections.
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Affiliation(s)
- Samuel A Dada
- Department of Medicine, Ekiti State University Teaching Hospital, Ado Ekiti, NGA
| | - Bolade F Dele-Ojo
- Department of Medicine, Ekiti State University Teaching Hospital, Ado Ekiti, NGA
| | - Taiwo H Raimi
- Department of Medicine, Ekiti State University Teaching Hospital, Ado Ekiti, NGA
| | - Peter Ojo
- Department of Medicine, Ekiti State University Teaching Hospital, Ado Ekiti, NGA
| | - Adekunle O Adeoti
- Department of Medicine, Ekiti State University Teaching Hospital, Ado Ekiti, NGA
| | - Joseph O Fadare
- Department of Medicine, Ekiti State University Teaching Hospital, Ado Ekiti, NGA
| | - Mojeed O Rafiu
- Department of Internal Medicine, Institute of Viral Haemorrhagic Fever and Emergent Pathogens, Irrua Specialist Teaching Hospital, Irrua Edo State, NGA
| | - Oluwamayowa E Dada
- Department of Health Information Management, Federal Teaching Hospital, Ido Ekiti, NGA
| | - Jimoh K Olabanji
- Department of Surgery, Ekiti State University Teaching Hospital, Ado Ekiti, NGA
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Li Y, Li L, Wu G, Xie G, Yi L, Zhu J, Liang S, Huang Y, Chen J, Ji S, Sun F, Liu R. The unique interplay of mitochondrial oxidative phosphorylation (OXPHOS) and immunity and its potential implication for the sex- and age-related morbidity of severe COVID-19 patients. MedComm (Beijing) 2023; 4:e371. [PMID: 37750090 PMCID: PMC10518039 DOI: 10.1002/mco2.371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 08/11/2023] [Accepted: 08/19/2023] [Indexed: 09/27/2023] Open
Abstract
Aged male patients are more vulnerable to severe or critical symptoms of COVID-19, but the underlying mechanism remains elusive. In this study, we analyzed previously published scRNA-seq data from a large cohort of COVID-19 patients, castrated and regenerated mice, and bulk RNA-seq of a RNAi library of 400 genes, and revealed that both immunity and OXPHOS displayed cell-type-, sex-, and age-related variation in the severe or critical COVID-19 patients during disease progression, with a more prominent increase in immunity and decrease in OXPHOS in myeloid cells in the males relative to the females (60-69 years old). Male severe or critical patients above 70 years old were an exception in that the compromised negative correlation between OXPHOS and immunity in these patients was associated with its disordered transcriptional regulation. Finally, the expression levels of OXPHOS and androgens were revealed to be positively correlated, and the responses of macrophages to android fluctuation were more striking than other types of detected immune cells in the castrated mice model. Therefore, the interplay of OXPHOS and immunity displayed a cell-type-specific, age-related, and sex-biased pattern, and the underlying potential regulatory role of the hormonal milieu should not be neglected.
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Affiliation(s)
- Yinchuan Li
- Institute of Reproductive MedicineMedical School of Nantong UniversityNantongJiangsuP. R. China
| | - Lei Li
- National Clinical Research Center for Obstetric & Gynecologic DiseasesDepartment of Obstetrics and GynecologyPeking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingP. R. China
| | - Guanghao Wu
- School of Materials Science and EngineeringBeijing Institute of TechnologyBeijingP. R. China
| | - Gangcai Xie
- Institute of Reproductive MedicineMedical School of Nantong UniversityNantongJiangsuP. R. China
| | - Lirong Yi
- Institute of Reproductive MedicineMedical School of Nantong UniversityNantongJiangsuP. R. China
| | - Jie Zhu
- National Key Laboratory of Biochemical EngineeringInstitute of Process EngineeringChinese Academy of SciencesBeijingP. R. China
- University of Chinese Academy of SciencesBeijingP. R. China
| | - ShiYu Liang
- National Key Laboratory of Biochemical EngineeringInstitute of Process EngineeringChinese Academy of SciencesBeijingP. R. China
| | - Ya‐ru Huang
- National Key Laboratory of Biochemical EngineeringInstitute of Process EngineeringChinese Academy of SciencesBeijingP. R. China
| | - Juan Chen
- National Clinical Research Center for Obstetric & Gynecologic DiseasesDepartment of Obstetrics and GynecologyPeking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingP. R. China
| | - Shaoyang Ji
- National Key Laboratory of Biochemical EngineeringInstitute of Process EngineeringChinese Academy of SciencesBeijingP. R. China
| | - Fei Sun
- Institute of Reproductive MedicineMedical School of Nantong UniversityNantongJiangsuP. R. China
| | - Rui‐tian Liu
- National Key Laboratory of Biochemical EngineeringInstitute of Process EngineeringChinese Academy of SciencesBeijingP. R. China
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Onodera Y, Liang J, Li Y, Griffin B, Thanabalasingam T, Lu C, Zhu J, Liu M, Moraes T, Zheng W, Khateeb J, Khang J, Huang Y, Jerkic M, Nakane M, Baker A, Orser B, Chen YW, Wirnsberger G, Penninger JM, Rotstein OD, Slutsky AS, Li Y, Mubareka S, Zhang H. Inhalation of ACE2 as a therapeutic target on sex-bias differences in SARS-CoV-2 infection and variant of concern. iScience 2023; 26:107470. [PMID: 37609639 PMCID: PMC10440513 DOI: 10.1016/j.isci.2023.107470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/02/2023] [Accepted: 07/21/2023] [Indexed: 08/24/2023] Open
Abstract
Despite similar infection rates, COVID-19 has resulted in more deaths in men than women. To understand the underlying mechanisms behind this sex-biased difference in disease severity, we infected K18-human angiotensin converting enzyme 2 (ACE2) mice of both sexes with SARS-CoV-2. Our study revealed a unique protein expression profile in the lung microenvironment of female mice. As a result, they were less vulnerable to severe infection, with higher ACE2 expression and a higher estrogen receptor α (ERα)/androgen receptor (AR) ratio that led to increased antiviral factor levels. In male mice, inhaling recombinant ACE2 neutralized the virus and maintained the ERα/AR ratio, thereby protecting the lungs. Our findings suggest that inhaling recombinant ACE2 could serve as a decoy receptor against SARS-CoV-2 and protect male mice by offsetting ERα-associated protective mechanisms. Additionally, our study supports the potential effectiveness of recombinant ACE2 therapy in human lung organoids infected with the Delta variant.
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Affiliation(s)
- Yu Onodera
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Jady Liang
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
- Department of Physiology, University of Toronto, Toronto, ON, Canada
| | - Yuchong Li
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
- The State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Bryan Griffin
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Department of Medical Microbiology and Infectious Disease, Sunnybrook Health Science Centre, Toronto, ON, Canada
| | - Thenuka Thanabalasingam
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Cong Lu
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - JiaYi Zhu
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
- Department of Physiology, University of Toronto, Toronto, ON, Canada
| | - Mingyao Liu
- Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Theo Moraes
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Wenhua Zheng
- Faculty of Health Science, University of Macau, Macau, China
| | - Jasmin Khateeb
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
- Department of Internal Medicine D, Rambam Health Care Campus, Haifa, Israel
| | - Julie Khang
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Yongbo Huang
- The State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Mirjana Jerkic
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Masaki Nakane
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Andrew Baker
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
| | - Beverley Orser
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada
| | - Ya-Wen Chen
- Black Family Stem Cell Institute, Department of Cell, Developmental and Regenerative Biology, Icahn School of Medicine at Mount Sinai, New York city, NY, USA
| | | | - Josef M. Penninger
- Institute of Molecular Biotechnology of the Austrian Academy of Sciences, Vienna, Austria
- Department of Medical Genetics, Life Sciences Institute, University of British Columbia, Vancouver, BC, Canada
| | - Ori D. Rotstein
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
- Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Arthur S. Slutsky
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
- The State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
| | - Yimin Li
- The State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Samira Mubareka
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Department of Medical Microbiology and Infectious Disease, Sunnybrook Health Science Centre, Toronto, ON, Canada
| | - Haibo Zhang
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
- Department of Physiology, University of Toronto, Toronto, ON, Canada
- The State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
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Getahun GK, Dinku A, Jara D, Shitemaw T, Negash Z. Magnitude and associated factors of mortality among patients admitted with COVID-19 in Addis Ababa, Ethiopia. PLOS Glob Public Health 2023; 3:e0000420. [PMID: 37590230 PMCID: PMC10434868 DOI: 10.1371/journal.pgph.0000420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 07/19/2023] [Indexed: 08/19/2023]
Abstract
The COVID-19 pandemic continues to grow around the world and has caused enormous mortality and morbidity. The severity and mortality of coronavirus disease are associated with various comorbidities. The infection fatality rate was reported to be inconsistent with different studies. Therefore, the aim of this study was to assess the magnitude and factors associated with mortality among patients admitted to Eka Kotebe General Hospital, Addis Ababa, Ethiopia. An institutional-based cross-sectional study was conducted at Eka Kotebe General Hospital among patients who were admitted for COVID-19 from January 15, 2021, to June 30, 2021. A total of 393 records of patients were selected by simple random sampling. Data was extracted from compiled data forms where available information was already tabulated. Data was entered and analyzed using SPSS version 25. The determinant factors associated with mortality among COVID-19 patients were identified using bivariate and multivariable logistic regression analysis. A statistical association was declared with multivariable logistic regression using a 95% confidence interval and a P-value of less than 0.05. The proportion of COVID-19 mortality among patients admitted to Eka Kotebe General Hospital was 8.1% (95% CI (5.4-10.8%)). Age >50 years [AOR = 7.91; 95% CI (2.34-25.70)], being male [AOR = 2.09; 95% CI (1.20-3.65)], having diabetes mellitus [AOR = 2.64; 95% CI (1.30-5.35)], having hypertension [AOR = 2.67; 95% CI (1.22-5.88)] and having chronic kidney disease [AOR = 12.04; 95% CI (4.03-14.22)] were determinant factors of COVID-19 mortality. The current study findings revealed that COVID-19 mortality was high among hospitalized COVID-19 patients. Furthermore, age, gender, diabetes mellitus, hypertension, and chronic kidney disease were discovered to be independent predictors of COVID-19 mortality. Therefore, older COVID-19 patients and those with established comorbidities such as hypertension, diabetes, and end-stage renal disease should receive comprehensive preventative efforts, including vaccination.
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Affiliation(s)
- Genanew Kassie Getahun
- Menelik II Medical and Health Science College, Kotebe Metropolitan University, Addis Ababa, Ethiopia
| | | | - Dube Jara
- Debre Markos University, Debre Markos, Ethiopia
| | - Tewodros Shitemaw
- Menelik II Medical and Health Science College, Kotebe Metropolitan University, Addis Ababa, Ethiopia
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9
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Graydon EK, Malloy AM, Machmach K, Sun P, Paquin-Proulx D, Lizewski S, Lizewski R, Weir DL, Goforth CW, Anderson SK, Letizia AG, Mitre E. High baseline frequencies of natural killer cells are associated with asymptomatic SARS-CoV-2 infection. Curr Res Immunol 2023; 4:100064. [PMID: 37645658 PMCID: PMC10461189 DOI: 10.1016/j.crimmu.2023.100064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/26/2023] [Accepted: 06/03/2023] [Indexed: 08/31/2023] Open
Abstract
This study tested the hypothesis that high frequencies of natural killer (NK) cells are protective against symptomatic SARS-CoV-2 infection. Samples were utilized from the COVID-19 Health Action Response for Marines study, a prospective, observational study of SARS-CoV-2 infection in which participants were enrolled prior to infection and then serially monitored for development of symptomatic or asymptomatic infection. Frequencies and phenotypes of NK cells (CD3-CD14-CD19-CD56+) were assessed by flow cytometry. Individuals that developed asymptomatic infections were found to have higher pre-infection frequencies of total NK cells compared to symptomatic individuals (10.61% [SD 4.5] vs 8.33% [SD 4.6], p = 0.011). Circulating total NK cells decreased over the course of infection, reaching a nadir at 4 weeks, while immature NK cells increased, a finding confirmed by multidimensional reduction analysis. These results indicate that NK cells likely play a key role in controlling the severity of clinical illness in individuals infected with SARS-CoV-2.
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Affiliation(s)
- Elizabeth K. Graydon
- Department of Microbiology and Immunology, Uniformed Services University, Bethesda, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | | | - Kawthar Machmach
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring MD, USA
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Peifang Sun
- Infectious Disease Directorate, Naval Medical Research Center, Silver Spring, MD, USA
| | - Dominic Paquin-Proulx
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring MD, USA
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | | | | | - Dawn L. Weir
- Infectious Disease Directorate, Naval Medical Research Center, Silver Spring, MD, USA
| | - Carl W. Goforth
- Infectious Disease Directorate, Naval Medical Research Center, Silver Spring, MD, USA
| | - Stephen K. Anderson
- Basic Science Program, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Andrew G. Letizia
- Infectious Disease Directorate, Naval Medical Research Center, Silver Spring, MD, USA
| | - Edward Mitre
- Department of Microbiology and Immunology, Uniformed Services University, Bethesda, MD, USA
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10
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Wang S, Quan L, Ding M, Kang JH, Koenen KC, Kubzansky LD, Branch-Elliman W, Chavarro JE, Roberts AL. Depression, worry, and loneliness are associated with subsequent risk of hospitalization for COVID-19: a prospective study. Psychol Med 2023; 53:4022-4031. [PMID: 35586906 PMCID: PMC9924056 DOI: 10.1017/s0033291722000691] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Pre-pandemic psychological distress is associated with increased susceptibility to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, but associations with the coronavirus disease 2019 (COVID-19) severity are not established. The authors examined the associations between distress prior to SARS-CoV-2 infection and subsequent risk of hospitalization. METHODS Between April 2020 (baseline) and April 2021, we followed 54 781 participants from three ongoing cohorts: Nurses' Health Study II (NHSII), Nurses' Health Study 3 (NHS3), and the Growing Up Today Study (GUTS) who reported no current or prior SARS-CoV-2 infection at baseline. Chronic depression was assessed during 2010-2019. Depression, anxiety, worry about COVID-19, perceived stress, and loneliness were measured at baseline. SARS-CoV-2 infection and hospitalization due to COVID-19 was self-reported. Relative risks (RRs) were calculated by Poisson regression. RESULTS 3663 participants reported a positive SARS-CoV-2 test (mean age = 55.0 years, standard deviation = 13.8) during follow-up. Among these participants, chronic depression prior to the pandemic [RR = 1.72; 95% confidence interval (CI) 1.20-2.46], and probable depression (RR = 1.81, 95% CI 1.08-3.03), being very worried about COVID-19 (RR = 1.79; 95% CI 1.12-2.86), and loneliness (RR = 1.81, 95% CI 1.02-3.20) reported at baseline were each associated with subsequent COVID-19 hospitalization, adjusting for demographic factors and healthcare worker status. Anxiety and perceived stress were not associated with hospitalization. Depression, worry about COVID-19, and loneliness were as strongly associated with hospitalization as were high cholesterol and hypertension, established risk factors for COVID-19 severity. CONCLUSIONS Psychological distress may be a risk factor for hospitalization in patients with SARS-CoV-2 infection. Assessment of psychological distress may identify patients at greater risk of hospitalization. Future work should examine whether addressing distress improves physical health outcomes.
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Affiliation(s)
- Siwen Wang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Luwei Quan
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ming Ding
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jae H Kang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Psychiatric Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Westyn Branch-Elliman
- Department of Medicine, VA Boston Healthcare System, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Jorge E Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Andrea L Roberts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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11
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Baid D, Yun B, Zang E. Explaining the higher COVID-19 mortality rates among disproportionately Black counties: A decomposition analysis. SSM Popul Health 2023; 22:101360. [PMID: 36785652 PMCID: PMC9908585 DOI: 10.1016/j.ssmph.2023.101360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/01/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023] Open
Abstract
Background Why is COVID-19 mortality higher in counties with a disproportionately large (>13.4%) share of Black residents (hereafter "Black counties") relative to others ("non-Black counties")? Existing literature points to six categories of determinants: (1) social distancing, (2) COVID-19 testing, (3) socioeconomic characteristics, (4) environmental characteristics, (5) prevalence of (pre-existing) chronic health conditions, and (6) demographic characteristics. The relative importance of these determinants has not yet been thoroughly examined. Methods We built a dataset consisting of 21 sub-indicators across the six categories of determinants for 3108 US counties and their COVID-19 mortality over the period of January 22, 2020-December 31, 2020. Applying the Gelbach's decomposition, we quantified which determinants were most (or least) associated with the COVID-19 mortality disparity between Black and non-Black counties. Results We find that COVID-19 death rates were 26 percent higher in Black counties compared to non-Black counties. This disparity was almost completely explained by the six categories of determinants included in our model. Decomposition analyses indicate that county-level demographic and population health characteristics explained most of this disparity. Among all sub-indicators considered, the greater proportion of females and smaller proportion of rural residents in Black counties were the two largest contributors to the COVID-19 mortality gap between Black and non-Black counties. Proportions of diabetic residents, uninsured residents, and the degree of income inequality also significantly contributed to the gap in COVID-19 mortality. Conclusion The COVID-19 mortality gap between Black and non-Black counties was largely explained by pre-pandemic differences in demographic and population health characteristics. Policies aiming to reduce the prevalence of chronic conditions and uninsured residents in Black counties would have helped narrow the COVID-19 mortality gap between Black and non-Black counties in 2020.
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Affiliation(s)
- Drishti Baid
- Sol Price School of Public Policy, University of Southern California, Los Angeles, CA, USA,Corresponding author. Sol Price School of Public Policy, University of Southern California, Los Angeles, CA, USA
| | - Boseong Yun
- Department of Sociology, Yale University, New Haven, CT, USA
| | - Emma Zang
- Department of Sociology, Yale University, New Haven, CT, USA
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12
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Lundberg G, Toleva O, Cutchins A. Sex and Age: 2 Predictors of Cardiovascular Events With COVID-19 Infection. JACC Adv 2023; 2:100325. [PMID: 37250381 PMCID: PMC10171236 DOI: 10.1016/j.jacadv.2023.100325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Gina Lundberg
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Olga Toleva
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Alexis Cutchins
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
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13
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Joshi D, Nyhoff LE, Zarnitsyna VI, Moreno A, Manning K, Linderman S, Burrell AR, Stephens K, Norwood C, Mantus G, Ahmed R, Anderson EJ, Staat MA, Suthar MS, Wrammert J. Infants and young children generate more durable antibody responses to SARS-CoV-2 infection than adults. medRxiv 2023:2023.04.10.23288360. [PMID: 37090559 PMCID: PMC10120804 DOI: 10.1101/2023.04.10.23288360] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
Since the emergence of SARS-CoV-2, research has shown that adult patients mount broad and durable immune responses to infection. However, response to infection remains poorly studied in infants/young children. In this study, we evaluated humoral responses to SARS-CoV-2 in 23 infants/young children before and after infection. We found that antibody responses to SARS-CoV-2 spike antigens peaked approximately 30 days after infection and were maintained up to 500 days with little apparent decay. While the magnitude of humoral responses was similar to an adult cohort recovered from mild/moderate COVID-19, both binding and neutralization titers to WT SARS-CoV-2 were more durable in infants/young children, with Spike and RBD IgG antibody half-life nearly 4X as long as in adults. The functional breadth of adult and infant/young children SARS-CoV-2 responses were comparable, with similar reactivity against panel of recent and previously circulating viral variants. Notably, IgG subtype analysis revealed that while IgG1 formed the majority of both adults' and infants/young children's response, IgG3 was more common in adults and IgG2 in infants/young children. These findings raise important questions regarding differential regulation of humoral immunity in infants/young children and adults and could have broad implications for the timing of vaccination and booster strategies in this age group.
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14
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Harrison TG, Tam TA, Elliott MJ, Ahmed SB, Riehl-Tonn V, Swamy AKR, Benham JL, Peterson J, MacRae JM. Sex differences in COVID-19 symptoms and outcomes in people with kidney failure treated with dialysis: a prospective cohort study. J Nephrol 2023; 36:851-860. [PMID: 36087218 PMCID: PMC9463668 DOI: 10.1007/s40620-022-01448-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 08/20/2022] [Indexed: 01/08/2023]
Abstract
BACKGROUND People with kidney failure treated with dialysis are at increased risk of SARS-CoV-2 infection, and severe COVID-19 outcomes such as hospitalization and death. Though there are well-defined sex differences in outcomes for the general population with COVID-19, we do not know whether this translates into kidney failure populations. We aimed to estimate the differences in COVID-19 symptoms and clinical outcomes between males and females treated with maintenance dialysis. METHODS In this prospective observational cohort study, we included adults treated with maintenance dialysis in Southern Alberta, Canada that tested positive for COVID-19 between March 2020 and February 2022. We examined the association between sex (dichotomized as male and female) with COVID-19 symptoms including fever, cough, malaise, shortness of breath, muscle joints/aches, nausea and/or vomiting, loss of appetite, diarrhea, headache, sore throat, and loss of smell/taste using chi-square or Fisher's exact tests. Secondary outcomes included 30-day hospitalization, ICU admission, and death. RESULTS Of 1,329 cohort participants, 246 (18.5%) tested positive for SARS-CoV-2 and were included in our study, including 95 females (39%). Of 207 participants with symptoms assessed, females had less frequent fever (p = 0.003), and more nausea or vomiting (p = 0.003) compared to males, after correction for multiple testing. Males exhibited no symptoms 25% of the time, compared with 10% of females (p = 0.01, not significant when corrected for multiple testing). We did not identify statistically significant differences in clinical outcomes between the sexes, though vaccinated patients had lower odds of hospitalization. CONCLUSIONS Sex differences in COVID-19 symptoms were identified in a cohort of patients treated with maintenance dialysis, which may inform sex-specific screening strategies in dialysis units. Further work is necessary to examine mechanisms for identified sex differences.
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Affiliation(s)
- Tyrone G Harrison
- Department of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Trinity A Tam
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Meghan J Elliott
- Department of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Sofia B Ahmed
- Department of Medicine, University of Calgary, Calgary, AB, Canada
- Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | | | - Asha K R Swamy
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jamie L Benham
- Department of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | | | - Jennifer M MacRae
- Department of Medicine, University of Calgary, Calgary, AB, Canada.
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
- Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
- Departments of Medicine and Cardiac Sciences, Alberta Kidney Care South, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
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15
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Abstract
Since the summer of 2020, the rate of coronavirus cases in the United States has been higher in rural areas than in urban areas, raising concerns that patients with coronavirus disease 2019 (COVID-19) will overwhelm under-resourced rural hospitals. Using data from the University of Minnesota COVID-19 Hospitalization Tracking Project and the U.S. Department of Health and Human Services, we document disparities in COVID-19 hospitalization rates between rural and urban areas. We show that rural-urban differences in COVID-19 admission rates were minimal in the summer of 2020 but began to diverge in fall 2020. Rural areas had statistically higher hospitalization rates from September 2020 through early 2021, after which rural-urban admission rates re-converged. The insights in this article are relevant to policymakers as they consider the adequacy of hospital resources across rural and urban areas during the COVID-19 pandemic.
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Affiliation(s)
- Yi Zhu
- University of Minnesota, Minneapolis, USA
| | - Caitlin Carroll
- University of Minnesota, Minneapolis, USA
- Caitlin Carroll, Division of Health Policy and Management, School of Public Health, University of Minnesota, 420 Delaware St. SE, MMC 729 Mayo, Minneapolis, MN 55455, USA.
| | - Khoa Vu
- University of Minnesota, Minneapolis, USA
| | - Soumya Sen
- University of Minnesota, Minneapolis, USA
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16
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Miller RAJ, Williams AP, Kovats S. Sex chromosome complement and sex steroid signaling underlie sex differences in immunity to respiratory virus infection. Front Pharmacol 2023; 14:1150282. [PMID: 37063266 PMCID: PMC10097973 DOI: 10.3389/fphar.2023.1150282] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/08/2023] [Indexed: 04/18/2023] Open
Abstract
Epidemiological studies have revealed sex differences in the incidence and morbidity of respiratory virus infection in the human population, and often these observations are correlated with sex differences in the quality or magnitude of the immune response. Sex differences in immunity and morbidity also are observed in animal models of respiratory virus infection, suggesting differential dominance of specific immune mechanisms. Emerging research shows intrinsic sex differences in immune cell transcriptomes, epigenomes, and proteomes that may regulate human immunity when challenged by viral infection. Here, we highlight recent research into the role(s) of sex steroids and X chromosome complement in immune cells and describe how these findings provide insight into immunity during respiratory virus infection. We focus on the regulation of innate and adaptive immune cells by receptors for androgen and estrogens, as well as genes with a propensity to escape X chromosome inactivation. A deeper mechanistic knowledge of these pathways will help us to understand the often significant sex differences in immunity to endemic or pandemic respiratory pathogens such as influenza viruses, respiratory syncytial viruses and pathogenic coronaviruses.
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Affiliation(s)
- Reegan A. J. Miller
- Arthritis and Clinical Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, United States
- Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Abigael P. Williams
- Arthritis and Clinical Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, United States
- Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Susan Kovats
- Arthritis and Clinical Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, United States
- Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
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17
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e Silva Malzone JR, Ribeiro AP, de Souza TS, Wilbert DD, Novo NF, Juliano Y. Clinical and Epidemiological Characteristics of Patients with COVID-19 Admitted to the Intensive Care Unit: A Two-Year Retrospective Analysis. Life (Basel) 2023; 13:life13030741. [PMID: 36983896 PMCID: PMC10059043 DOI: 10.3390/life13030741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/05/2023] [Accepted: 02/18/2023] [Indexed: 03/12/2023] Open
Abstract
In March 2020, COVID-19 was characterized as a pandemic by the World Health Organization. Hospitalized patients affected by COVID-19 presented with severe respiratory and motor impairment, especially those who required intensive treatment and invasive mechanical ventilation, with sequelae that extended after the period of hospitalization. Thus, the aim of the current study was to verify the clinical and epidemiological characteristics of patients with COVID-19 admitted to the Intensive Care Unit in 2020 and 2021, according to age group. Methods: A retrospective cohort study. Data were collected through the “ICUs Brasileiras” between March 2020 and November 2021 for severe acute respiratory syndrome (SARS) due to COVID-19. The following were analyzed: the number of hospital admissions, days in the ICU and hospital, clinical aspects (non-invasive or invasive ventilatory support, comorbidities, frailty, SAPS 3 and SOFA severity scales, use of amines and renal support), and ICU and hospital mortality rate. Results: A total of 166,966 ICU hospital admissions were evaluated over the evaluated quarters. The main results showed a peak in the number of hospitalizations between March and May 2021, with a higher percentage of males. The peak of ICU admissions for 7 days was between March and May 2021 and 21 days between March and May 2020. In addition, higher deaths were observed in the age groups between 40 and 80 years between 2020 and 2021, with the group above 81 being the age group with the highest mortality. Mortality in the ICU of ventilated patients was higher in the age group above 70 years. Another observation was the predominance of SAPS 3 and the peak of mechanical ventilation for more than 7 days between June and August 2021. Conclusion: The clinical and epidemiological characteristics of patients with COVID-19 were influenced by age group, showing higher mortality over 81 years and over 70 years in the ICU supported by mechanical ventilation, maintained for 7 days from June to August 2021. The years 2020 and 2021 also showed differences for patients with COVID-19, with greater hospitalization between March and May 2021, especially in the ICU for 7 days, and between March and May 2020 for the 21-day period.
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Affiliation(s)
| | - Ana Paula Ribeiro
- Health Science Post-Graduate Department, School of Medicine, University Santo Amaro, São Paulo 04829-300, Brazil
- Physical Therapy Department, School of Medicine, University of Sao Paulo, São Paulo 05360-160, Brazil
- Correspondence: or ; Tel.: +55-11-99139-2168
| | - Tatiane Silva de Souza
- Health Science Post-Graduate Department, School of Medicine, University Santo Amaro, São Paulo 04829-300, Brazil
| | - Debora Driemeyer Wilbert
- Health Science Post-Graduate Department, School of Medicine, University Santo Amaro, São Paulo 04829-300, Brazil
| | - Neil Ferreira Novo
- Health Science Post-Graduate Department, School of Medicine, University Santo Amaro, São Paulo 04829-300, Brazil
| | - Yara Juliano
- Health Science Post-Graduate Department, School of Medicine, University Santo Amaro, São Paulo 04829-300, Brazil
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18
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Nowalk MP, Sax TM, Susick M, Taylor LH, Clarke LG, Dauer K, Clarke K, Moehling Geffel K, Zimmerman RK, Balasubramani G. Effect of mild COVID-19 on health-related quality of life. Brain Behav Immun Health 2023; 28:100596. [PMID: 36713477 PMCID: PMC9870615 DOI: 10.1016/j.bbih.2023.100596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 11/29/2022] [Accepted: 01/21/2023] [Indexed: 01/25/2023] Open
Abstract
Background Little is known about the effects of a mild SARS-CoV-2 infection on health-related quality of life. Methods This prospective observational study of symptomatic adults (18-87 years) who sought outpatient care for an acute respiratory illness, was conducted from 3/30/2020 to 4/30/2021. Participants completed the Short Form Health Survey (SF-12) at enrollment and 6-8 weeks later, to report their physical and mental health function levels as measured by the physical health and mental health composite scores (PHC and MHC, respectively). PHC and MHC scores for COVID-19 cases and non-COVID cases were compared using t-tests. Multivariable regression modeling was used to determine predictors of physical and mental health function at follow-up. Results Of 2301 enrollees, 426 COVID-19 cases and 547 non-COVID cases completed both surveys. PHC improved significantly from enrollment to follow-up for both COVID-19 cases (5.4 ± 0.41; P < 0.001) and non-COVID cases (3.3 ± 0.32; P < 0.001); whereas MHC improved significantly for COVID-19 cases (1.4 ± 0.51; P < 0.001) and decreased significantly for non-COVID cases (-0.8 ± 0.37; P < 0.05). Adjusting for enrollment PHC, the most important predictors of PHC at follow-up included male sex (β = 1.17; SE = 0.5; P = 0.021), having COVID-19 (β = 1.99; SE = 0.54; P < 0.001); and non-white race (β = -2.01; SE = 0.70; P = 0.004). Adjusting for enrollment MHC, the most important predictors of MHC at follow-up included male sex (β = 1.92; SE = 0.63; P = 0.002) and having COVID-19 (β = 2.42; SE = 0.67; P < 0.001). Conclusion Both COVID-19 cases and non-COVID cases reported improved physical health function at 6-8 weeks' convalescence; whereas mental health function improved among COVID-19 cases but declined among non-COVID cases. Both physical and mental health functioning were significantly better among males with COVID-19 than females.
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Affiliation(s)
- Mary Patricia Nowalk
- University of Pittsburgh School of Medicine, Department of Family Medicine, Pittsburgh, PA, USA
| | - Theresa M. Sax
- University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology, Pittsburgh, PA, USA
| | - Michael Susick
- University of Pittsburgh School of Medicine, Department of Family Medicine, Pittsburgh, PA, USA
| | - Louise H. Taylor
- University of Pittsburgh School of Medicine, Department of Family Medicine, Pittsburgh, PA, USA
| | - Lloyd G. Clarke
- UPMC Health System Department of Pharmacy, Division of Infectious Diseases/Pharmacy Department, Pittsburgh, PA, USA
| | - Klancie Dauer
- University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology, Pittsburgh, PA, USA
| | - Karen Clarke
- University of Pittsburgh School of Medicine, Department of Family Medicine, Pittsburgh, PA, USA
| | - Krissy Moehling Geffel
- University of Pittsburgh School of Medicine, Department of Family Medicine, Pittsburgh, PA, USA
| | - Richard K. Zimmerman
- University of Pittsburgh School of Medicine, Department of Family Medicine, Pittsburgh, PA, USA
| | - G.K. Balasubramani
- University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology, Pittsburgh, PA, USA
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19
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Dogra A, Krishna V, Parkash A, Mehta A, Varma T. Evaluation of Characteristics and Outcomes of COVID-19 Between First Wave and Second Wave: Study From a Tertiary Cancer Care Centre, Delhi, India. Cureus 2023; 15:e35386. [PMID: 36994249 PMCID: PMC10042523 DOI: 10.7759/cureus.35386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2023] [Indexed: 03/31/2023] Open
Abstract
Background and objectives The second wave of coronavirus disease-19 (COVID-19) had several severe consequences in the form of rising cases, deaths, and overwhelming health infrastructure in India. However, the similarities and differences between the characteristics of the first and second waves have yet to be explained. The objectives of the study were to compare the incidence, clinical management, and mortality rates between two waves. Methods The COVID-19 data collated from Rajiv Gandhi Cancer Institute and Research Centre, Delhi between the first wave (1 April 2020 to 27 February 2021) and second wave (1 March 2021 to 30 June 2021) were evaluated in terms of incidence, the clinical course of the disease, and mortality rates. Results The number of subjects hospitalized in the first and second waves was 289 and 564, respectively. Compared to the first wave, the proportion of patients with severe disease was higher (9.7% vs. 37.8%). Several parameters such as age group, grade of disease, the reason for hospitalization, values of peripheral oxygen saturation, type of respiratory support, response to therapy, vital status, and others show statistically significant differences between the two waves (P<0.001). The mortality rate in the second wave was significantly higher (20.2% vs. 2.4%, P<0.001) than in the first wave. Interpretation and conclusions The clinical course and outcomes of COVID-19 significantly differ between the first and second waves. There is a higher incidence of hospitalized patients (66.1% vs. 33.9%) with drastically increased case fatality rate in the second wave. Disease severity in the first wave is four times lower than in the second wave. The second wave was quite devastating, which led to the shortage of critical care facilities and the loss of a significant number of lives.
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Affiliation(s)
- Atika Dogra
- Department of Research, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, IND
| | - Vidya Krishna
- Department of Research and Development, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, IND
| | - Anuj Parkash
- Department of Biochemistry, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, IND
| | - Anurag Mehta
- Department of Laboratory and Transfusion Services and Department of Research, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, IND
| | - Tarun Varma
- Department of Internal Medicine, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, IND
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20
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Thangavel H, Dhanyalayam D, Lizardo K, Oswal N, Dolgov E, Perlin DS, Nagajyothi JF. Susceptibility of Fat Tissue to SARS-CoV-2 Infection in Female hACE2 Mouse Model. Int J Mol Sci 2023; 24:1314. [PMID: 36674830 PMCID: PMC9863100 DOI: 10.3390/ijms24021314] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/30/2022] [Accepted: 12/24/2022] [Indexed: 01/12/2023] Open
Abstract
The coronavirus disease (COVID-19) is a highly contagious viral illness caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). COVID-19 has had a catastrophic effect globally causing millions of deaths worldwide and causing long-lasting health complications in COVID-19 survivors. Recent studies including ours have highlighted that adipose tissue can act as a reservoir where SARS-CoV-2 can persist and cause long-term health problems. Here, we evaluated the effect of SARS-CoV-2 infection on adipose tissue physiology and the pathogenesis of fat loss in a murine COVID-19 model using humanized angiotensin-converting enzyme 2 (hACE2) mice. Since epidemiological studies reported a higher mortality rate of COVID-19 in males than in females, we examined hACE2 mice of both sexes and performed a comparative analysis. Our study revealed for the first time that: (a) viral loads in adipose tissue and the lungs differ between males and females in hACE2 mice; (b) an inverse relationship exists between the viral loads in the lungs and adipose tissue, and it differs between males and females; and (c) CoV-2 infection alters immune signaling and cell death signaling differently in SARS-CoV-2 infected male and female mice. Overall, our data suggest that adipose tissue and loss of fat cells could play important roles in determining susceptibility to CoV-2 infection in a sex-dependent manner.
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Affiliation(s)
| | | | | | | | | | | | - Jyothi F. Nagajyothi
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110, USA
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21
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Han E, Gyöngyösi M. [Long COVID-A New Challenge in Medicine: Focus on Pregnancy and Breastfeeding]. J Gynakol Endokrinol 2023; 33:7-12. [PMID: 36747883 PMCID: PMC9893966 DOI: 10.1007/s41974-023-00250-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/05/2023] [Indexed: 02/05/2023]
Abstract
Long COVID (coronavirus disease) has been described as a new multi-organ disease, which appears to be more prevalent in women than in men. Pregnant and breastfeeding women are a special subgroup of patients to consider with long COVID, as only scarce data have been collected to date. Menstrual changes are commonly observed during or after COVID-19; some studies also attribute slight changes of cycle length to previous inoculation against the virus. Pregnant women who have a symptomatic infection with severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) are at a higher risk for adverse outcomes and pregnancy-associated complications. Moreover, more and robust data are required to evaluate vertical transmission. COVID vaccines are the most effective tool against the pandemic, as they prevent infection, but also appear to be able to ease long COVID symptoms. Vaccines have been proven safe and effective in both pregnant and breastfeeding women. This article aims to present current data on long COVID in pregnant and breastfeeding women and elucidate risk factors and possible treatment options.
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Affiliation(s)
- Emilie Han
- Abteilung für Kardiologie, Universitätsklinik für Innere Medizin II, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090 Wien, Österreich
| | - Mariann Gyöngyösi
- Abteilung für Kardiologie, Universitätsklinik für Innere Medizin II, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090 Wien, Österreich
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22
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Nelson K, Prior JC, Kalidasan D, Tanenbaum C, Shirin S, Berger C, Goshtasebi A. Letter to the Editor From Nelson et al: "Understanding the Link Between Obesity and Severe COVID-19 Outcomes: Causal Mediation by Systemic Inflammatory Response". J Clin Endocrinol Metab 2022; 108:e11-e12. [PMID: 36268884 PMCID: PMC9619845 DOI: 10.1210/clinem/dgac619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/07/2022] [Indexed: 02/03/2023]
Affiliation(s)
- Kaitlin Nelson
- Centre for Menstrual Cycle and Ovulation Research (Endocrinology/UBC), University of British Columbia, Vancouver, British Columbia V5Z 1M9, Canada
- BC Women's Health Research Institute, University of British Columbia, Vancouver, British Columbia V6H 3N1, Canada
| | - Jerilynn C Prior
- Correspondence: Jerilynn C. Prior, MD, Division of Endocrinology, Department of Medicine, University of British Columbia Faculty of Medicine, 2775 Laurel St, Ste 4111, Vancouver, BC V5Z 1M9, Canada.
| | - Dharani Kalidasan
- Centre for Menstrual Cycle and Ovulation Research (Endocrinology/UBC), University of British Columbia, Vancouver, British Columbia V5Z 1M9, Canada
| | - Cara Tanenbaum
- Institute of Gender and Health of the Canadian Institutes for Health Research, Université de Montréal, Montreal, Quebec H3W 1W5, Canada
- Medicine and Pharmacology, Université de Montréal, Montreal, Quebec H3C 3J7, Canada
| | - Sonia Shirin
- Centre for Menstrual Cycle and Ovulation Research (Endocrinology/UBC), University of British Columbia, Vancouver, British Columbia V5Z 1M9, Canada
- BC Women's Health Research Institute, University of British Columbia, Vancouver, British Columbia V6H 3N1, Canada
| | - Claudie Berger
- Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Center, Montreal, Quebec H3H 2R9, Canada
| | - Azita Goshtasebi
- Centre for Menstrual Cycle and Ovulation Research (Endocrinology/UBC), University of British Columbia, Vancouver, British Columbia V5Z 1M9, Canada
- BC Women's Health Research Institute, University of British Columbia, Vancouver, British Columbia V6H 3N1, Canada
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23
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Nishimi K, Neylan TC, Bertenthal D, Dolsen EA, Seal KH, O'Donovan A. Post-traumatic stress disorder and risk for hospitalization and death following COVID-19 infection. Transl Psychiatry 2022; 12:482. [PMID: 36411283 DOI: 10.1038/s41398-022-02156-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 09/02/2022] [Accepted: 09/06/2022] [Indexed: 11/23/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is associated with an increased risk for physical illnesses and early mortality. However, we do not know if it also increases the risk for adverse outcomes of coronavirus disease 2019 (COVID-19). In this retrospective cohort study, we examined associations of PTSD and other psychiatric disorders with risk for hospitalization and death in the 60 days following a COVID-19 infection in 228,367 U.S. Department of Veteran Affairs (VA) patients who tested positive for COVID-19 between February 2020 and August 2021 (age m = 60.6, 89.5% male). Generalized linear models estimated associations of PTSD and other psychiatric disorders with outcomes following a positive SARS-CoV-2 test, adjusting for socio-demographic, medical, and behavioral factors. Among 228,367 VA patients, 25.6% had PTSD, and 28.2% had a psychiatric disorder other than PTSD. In the 60 days following a positive COVID-19 test, 15% of patients were hospitalized, and 6% died. Patients with PTSD had an increased risk for both hospitalization (adjusted relative risk, ARR = 1.18, 95% CI 1.15-1.21) and death (ARR = 1.13, 95% CI 1.08-1.19) relative to those with no psychiatric disorders, adjusting for socio-demographics. Estimates remained significant when models were additionally adjusted for medical comorbidities and smoking. Patients with other psychiatric disorders also had an increased risk of adverse COVID-19 outcomes, with larger effect sizes than PTSD in older (≥65 years) but not younger patients. In this large-scale study of VA patients, individuals with PTSD, and other psychiatric disorders, had heightened vulnerability to severe adverse outcomes of COVID-19; thus, individuals with PTSD should also be considered at higher risk for severe COVID-19 outcomes, and potentially prioritized for vaccination, screening, and early treatment intervention for COVID-19.
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24
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Klein A, Puldon K, Dilchert S, Hartogensis W, Chowdhary A, Anglo C, Pandya LS, Hecht FM, Mason AE, Smarr BL. Methods for detecting probable COVID-19 cases from large-scale survey data also reveal probable sex differences in symptom profiles. Front Big Data 2022; 5:1043704. [PMID: 36438983 PMCID: PMC9685297 DOI: 10.3389/fdata.2022.1043704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/26/2022] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Daily symptom reporting collected via web-based symptom survey tools holds the potential to improve disease monitoring. Such screening tools might be able to not only discriminate between states of acute illness and non-illness, but also make use of additional demographic information so as to identify how illnesses may differ across groups, such as biological sex. These capabilities may play an important role in the context of future disease outbreaks. OBJECTIVE Use data collected via a daily web-based symptom survey tool to develop a Bayesian model that could differentiate between COVID-19 and other illnesses and refine this model to identify illness profiles that differ by biological sex. METHODS We used daily symptom profiles to plot symptom progressions for COVID-19, influenza (flu), and the common cold. We then built a Bayesian network to discriminate between these three illnesses based on daily symptom reports. We further separated out the COVID-19 cohort into self-reported female and male subgroups to observe any differences in symptoms relating to sex. We identified key symptoms that contributed to a COVID-19 prediction in both males and females using a logistic regression model. RESULTS Although the Bayesian model performed only moderately well in identifying a COVID-19 diagnosis (71.6% true positive rate), the model showed promise in being able to differentiate between COVID-19, flu, and the common cold, as well as periods of acute illness vs. non-illness. Additionally, COVID-19 symptoms differed between the biological sexes; specifically, fever was a more important symptom in identifying subsequent COVID-19 infection among males than among females. CONCLUSION Web-based symptom survey tools hold promise as tools to identify illness and may help with coordinated disease outbreak responses. Incorporating demographic factors such as biological sex into predictive models may elucidate important differences in symptom profiles that hold implications for disease detection.
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Affiliation(s)
- Amit Klein
- Department of Bioengineering, University of California, San Diego, La Jolla, CA, United States
| | - Karena Puldon
- Osher Center for Integrative Health, University of California, San Francisco, San Francisco, CA, United States
| | - Stephan Dilchert
- Department of Management, Zicklin School of Business, Baruch College, The City University of New York, New York, NY, United States
| | - Wendy Hartogensis
- Osher Center for Integrative Health, University of California, San Francisco, San Francisco, CA, United States
| | - Anoushka Chowdhary
- Osher Center for Integrative Health, University of California, San Francisco, San Francisco, CA, United States
| | - Claudine Anglo
- Osher Center for Integrative Health, University of California, San Francisco, San Francisco, CA, United States
| | - Leena S. Pandya
- Osher Center for Integrative Health, University of California, San Francisco, San Francisco, CA, United States
| | - Frederick M. Hecht
- Osher Center for Integrative Health, University of California, San Francisco, San Francisco, CA, United States
| | - Ashley E. Mason
- Osher Center for Integrative Health, University of California, San Francisco, San Francisco, CA, United States
| | - Benjamin L. Smarr
- Department of Bioengineering, University of California, San Diego, La Jolla, CA, United States
- Halicioglu Data Science Institute, University of California, San Diego, La Jolla, CA, United States
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25
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Colnago M, Benvenuto GA, Casaca W, Negri RG, Fernandes EG, Cuminato JA. Risk Factors Associated with Mortality in Hospitalized Patients with COVID-19 during the Omicron Wave in Brazil. Bioengineering (Basel) 2022; 9:bioengineering9100584. [PMID: 36290552 PMCID: PMC9598428 DOI: 10.3390/bioengineering9100584] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/03/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
Considering the imminence of new SARS-CoV-2 variants and COVID-19 vaccine availability, it is essential to understand the impact of the disease on the most vulnerable groups and those at risk of death from the disease. To this end, the odds ratio (OR) for mortality and hospitalization was calculated for different groups of patients by applying an adjusted logistic regression model based on the following variables of interest: gender, booster vaccination, age group, and comorbidity occurrence. A massive number of data were extracted and compiled from official Brazilian government resources, which include all reported cases of hospitalizations and deaths associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Brazil during the “wave” of the Omicron variant (BA.1 substrain). Males (1.242; 95% CI 1.196–1.290) aged 60–79 (3.348; 95% CI 3.050–3.674) and 80 years or older (5.453; 95% CI 4.966–5.989), and hospitalized patients with comorbidities (1.418; 95% CI 1.355–1.483), were more likely to die. There was a reduction in the risk of death (0.907; 95% CI 0.866–0.951) among patients who had received the third dose of the anti-SARS-CoV-2 vaccine (booster). Additionally, this big data investigation has found statistical evidence that vaccination can support mitigation plans concerning the current scenario of COVID-19 in Brazil since the Omicron variant and its substrains are now prevalent across the entire country.
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Affiliation(s)
- Marilaine Colnago
- Institute of Chemistry, São Paulo State University (UNESP), Araraquara 14800-060, Brazil
| | - Giovana A. Benvenuto
- Faculty of Science and Technology (FCT), São Paulo State University (UNESP), Presidente Prudente 19060-900, Brazil
| | - Wallace Casaca
- Institute of Biosciences, Letters and Exact Sciences, São Paulo State University (UNESP), São José do Rio Preto 15054-000, Brazil
- Correspondence:
| | - Rogério G. Negri
- Science and Technology Institute, São Paulo State University (UNESP), São José dos Campos 12247-004, Brazil
| | - Eder G. Fernandes
- Immunization Division—Centre of Epidemiology Surveillance of the São Paulo State Health Department, São Paulo 01246-000, Brazil
| | - José A. Cuminato
- Institute of Mathematics and Computer Science, São Paulo University (USP), São Carlos 13566-590, Brazil
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26
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Wang ZP, Hua M, Jiu T, Ge RL, Bai Z. Biofunctional roles of estrogen in coronavirus disease 2019: Beyond a steroid hormone. Front Pharmacol 2022; 13:1003469. [PMID: 36339571 PMCID: PMC9626865 DOI: 10.3389/fphar.2022.1003469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/06/2022] [Indexed: 09/26/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), epidemic poses a major global public health threat with more than one million daily new infections and hundreds of deaths. To combat this global pandemic, efficient prevention and management strategies are urgently needed. Together with the main characteristics of COVID-19, impaired coagulation with dysfunctions of the immune response in COVID-19 pathophysiology causes high mortality and morbidity. From recent clinical observations, increased expression of specific types of estrogen appears to protect patients from SARS-CoV-2 infection, thereby, reducing mortality. COVID-19 severity is less common in women than in men, particularly in menopausal women. Furthermore, estrogen levels are negatively correlated with COVID-19 severity and mortality. These findings suggest that estrogen plays a protective role in the pathophysiology of COVID-19. In this review, we discuss the potential roles of estrogen in blocking the SARS-CoV-2 from invading alveolar cells and replicating, and summarize the potential mechanisms of anti-inflammation, immune modulation, reactive oxygen species resistance, anti-thrombosis, vascular dilation, and vascular endothelium protection. Finally, the potential therapeutic effects of estrogen against COVID-19 are reviewed. This review provides insights into the role of estrogen and its use as a potential strategy to reduce the mortality associated with COVID-19, and possibly other viral infections and discusses the possible challenges and pertinent questions.
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Affiliation(s)
- Zhong-Ping Wang
- Clinical Medicine, School of Medicine, Qinghai University, Xining, China
- Department of Respiratory and Critical Diseases, Affiliated Hospital of Qinghai University, Xining, China
| | - Mao Hua
- Department of Respiratory and Critical Diseases, Affiliated Hospital of Qinghai University, Xining, China
| | - Tai Jiu
- Department of Respiratory and Critical Diseases, Affiliated Hospital of Qinghai University, Xining, China
| | - Ri-Li Ge
- Research Center of High-Altitude Medicine, School of Medicine, Qinghai University, Xining, China
- Joint Lab of Qinghai-Utah for High Altitude Medicine, School of Medicine, Qinghai University, Xining, China
| | - Zhenzhong Bai
- Clinical Medicine, School of Medicine, Qinghai University, Xining, China
- Research Center of High-Altitude Medicine, School of Medicine, Qinghai University, Xining, China
- Joint Lab of Qinghai-Utah for High Altitude Medicine, School of Medicine, Qinghai University, Xining, China
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27
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Nader M, Zmerli O, Platt DE, Hamdan H, Hamdash S, Tayeh RA, Azar J, Kadi D, Sultan Y, Bazarbachi T, Karayakoupoglou G, Zalloua P, Azar E. Observational study of factors associated with morbidity and mortality from COVID-19 in Lebanon, 2020-2021. PLoS One 2022; 17:e0275101. [PMID: 36260598 DOI: 10.1371/journal.pone.0275101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 09/11/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic claimed millions of lives worldwide without clear signs of abating despite several mitigation efforts and vaccination campaigns. There have been tremendous interests in understanding the etiology of the disease particularly in what makes it severe and fatal in certain patients. Studies have shown that COVID-19 patients with kidney injury on admission were more likely to develop severe disease, and acute kidney disease was associated with high mortality in COVID-19 hospitalized patients. METHODS This study investigated 819 COVID-19 patients admitted between January 2020-April 2021 to the COVID-19 ward at a tertiary care center in Lebanon and evaluated their vital signs and biomarkers while probing for two main outcomes: intubation and fatality. Logistic and Cox regressions were performed to investigate the association between clinical and metabolic variables and disease outcomes, mainly intubation and mortality. Times were defined in terms of admission and discharge/fatality for COVID-19, with no other exclusions. RESULTS Regression analysis revealed that the following are independent risk factors for both intubation and fatality respectively: diabetes (p = 0.021 and p = 0.04), being overweight (p = 0.021 and p = 0.072), chronic kidney disease (p = 0.045 and p = 0.001), and gender (p = 0.016 and p = 0.114). Further, shortness of breath (p<0.001), age (p<0.001) and being overweight (p = 0.014) associated with intubation, while fatality with shortness of breath (p<0.001) in our group of patients. Elevated level of serum creatinine was the highest factor associated with fatality (p = 0.002), while both white blood count (p<0.001) and serum glutamic-oxaloacetic transaminase levels (p<0.001) emerged as independent risk factors for intubation. CONCLUSIONS Collectively our data show that high creatinine levels were significantly associated with fatality in our COVID-19 study patients, underscoring the importance of kidney function as a main modulator of SARS-CoV-2 morbidity and favor a careful and proactive management of patients with elevated creatinine levels on admission.
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Abstract
Awareness of the influence of sex ands gender on the natural history of several diseases is increasing. Community-acquired pneumonia (CAP) is the most common acute respiratory disease, and it is associated with both morbidity and mortality across all age groups. Although a role for sex- and gender-based differences in the development and associated complications of CAP has been postulated, there is currently high uncertainty on the actual contribution of these factors in the epidemiology and clinical course of CAP. More evidence has been produced on the topic during the last decades, and sex- and gender-based differences have also been extensively studied in COVID-19 patients since the beginning of the SARS-CoV-2 pandemic. This review aims to provide an extensive outlook of the role of sex and gender in the epidemiology, pathogenesis, treatment, and outcomes of patients with CAP, and on the future research scenarios, with also a specific focus on COVID-19.
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Affiliation(s)
- Bernadette Corica
- Department of Translational and Precision Medicine, Sapienza-University of Rome, Viale del Policlinico 155, 00162, Rome, Italy
| | - Francesco Tartaglia
- Department of Translational and Precision Medicine, Sapienza-University of Rome, Viale del Policlinico 155, 00162, Rome, Italy
| | - Tania D'Amico
- Department of Translational and Precision Medicine, Sapienza-University of Rome, Viale del Policlinico 155, 00162, Rome, Italy
| | - Giulio Francesco Romiti
- Department of Translational and Precision Medicine, Sapienza-University of Rome, Viale del Policlinico 155, 00162, Rome, Italy
| | - Roberto Cangemi
- Department of Translational and Precision Medicine, Sapienza-University of Rome, Viale del Policlinico 155, 00162, Rome, Italy.
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Vasa A, Kini M, Neugarten J, Bellin E, Golestaneh L. Does comorbidity burden explain the higher COVID-19 mortality risk among men? A retrospective cross-sectional analysis of a well-defined cohort of patients in Bronx, New York. BMJ Open 2022; 12:e063862. [PMID: 36581961 PMCID: PMC9437736 DOI: 10.1136/bmjopen-2022-063862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES Men have a higher mortality rate and more severe COVID-19 infection than women. The mechanism for this is unclear. We hypothesise that innate sex differences, rather than comorbidity burden, drive higher male mortality. DESIGN Retrospective cohort. SETTING Montefiore Health System (MHS) in Bronx, New York, USA. PARTICIPANTS A cohort population of 364 992 patients at MHS between 1 January 2018 and 1 January 2020 was defined, from which individuals hospitalised during the pre-COVID period (1 January 2020-15 February 2020) (n=5856) and individuals hospitalised during the COVID-19 surge (1 March 2020-15 April 2020) (n=4793) were examined for outcomes. A subcohort with confirmed COVID-19+ hospitalisation was also examined (n=1742). PRIMARY AND SECONDARY OUTCOME MEASURES Hospitalisation and in-hospital mortality. RESULTS Men were older, had more comorbidities, lower body mass index and were more likely to smoke. Unadjusted logistic regression showed a higher odds of death in hospitalised men than women during both the pre-COVID-19 and COVID-19 periods (pre-COVID-19, OR: 1.66 vs COVID-19 OR: 1.98). After adjustment for relevant clinical and demographic factors, the higher risk of male death attenuated towards the null in the pre-COVID-19 period (OR 1.36, 95% CI 1.05 to 1.76) but remained significantly higher in the COVID-19 period (OR 2.02; 95% CI 1.73 to 2.34).In the subcohort of COVID-19+ hospitalised patients, men had 1.37 higher odds of in-hospital death (95% CI 1.09 to 1.72), which was not altered by adjustment for comorbidity (OR remained at 1.38 (95% CI 1.08 to 1.76)) but was attenuated with addition of initial pulse oximetry on presentation (OR 1.26, 95% CI 0.99 to 1.62). CONCLUSIONS Higher male mortality risk during the COVID-19 period despite adjustment for comorbidity supports the role of innate physiological susceptibility to COVID-19 death. Attenuation of higher male risk towards the null after adjustment for severity of lung disease in hospitalised COVID-19+ patients further supports the role of higher severity of COVID-19 pneumonia in men.
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Affiliation(s)
- Aastha Vasa
- Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA
| | - Maya Kini
- Rye Country Day School, Rye, New York, USA
| | - Joel Neugarten
- Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA
| | - Eran Bellin
- Epidemiology and Population Health, Montefiore Medical Center, Yonkers, New York, USA
| | - Ladan Golestaneh
- Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA
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30
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Cabral P. E-cigarette use and intentions related to psychological distress among cigarette, e-cigarette, and cannabis vape users during the start of the COVID-19 pandemic. BMC Psychol 2022; 10:201. [PMID: 35971158 PMCID: PMC9376900 DOI: 10.1186/s40359-022-00910-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 08/01/2022] [Indexed: 11/10/2022] Open
Abstract
Background This study examines associations between psychological distress, intentions to use e-cigarettes, and cigarette smoking, e-cigarette use, and cannabis consumption through e-cigarette use among a diverse sample of U.S. young adults. Procedures Young adults (N = 314; 72.5% female) were recruited to complete an online survey during the first few months of the COVID-19 pandemic. Results Associations between psychological distress and cigarette smoking, e-cigarette use, cannabis vaping, and intentions to use e-cigarettes were found. Current e-cigarette use (OR = 1.23, 95% CI 1.17, 1.28, p < .001; 7.5%) and cannabis vaping (OR = 2.03, 95% CI 1.88, 2.18, p < .001; 10%) was higher among female, possibly due to the significantly higher psychological distress reported among females. Interactions between intentions to use e-cigarettes and psychological distress variables were found for all smoking and vaping behaviors. Conclusions Public health efforts should increase focus on providing psychological services for young adults to improve coping strategies that are alternative to smoking and vaping behaviors.
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Affiliation(s)
- Patricia Cabral
- Department of Psychology, Occidental College, 1600 Campus Road, Los Angeles, CA, 90041, USA.
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31
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Adjorlolo S, Adjorlolo P, Andoh-Arthur J, Ahiable EK, Kretchy IA, Osafo J. Post-Traumatic Growth and Resilience among Hospitalized COVID-19 Survivors: A Gendered Analysis. Int J Environ Res Public Health 2022; 19:ijerph191610014. [PMID: 36011649 PMCID: PMC9408188 DOI: 10.3390/ijerph191610014] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/06/2022] [Accepted: 08/08/2022] [Indexed: 05/16/2023]
Abstract
The literature on behavioral outcomes associated with the COVID-19 pandemic is inundated with mental health burdens such as depression and stress disorders. The current study investigated gender invariance on resilience and post-traumatic growth (PTG) as positive psychological changes associated with the COVID-19 pandemic. A total of 381 survivors of the COVID-19 infection completed measurements of resilience, PTG, violence and stigma experience, and mental health problems like post-traumatic stress disorder (PTSD). The data were analyzed using descriptive statistics, correlation, multivariate regression, and a latent profile analysis. The results revealed that more than half of the participants had high scores on resilience (53.6%) and PTG (60.9%). The positive psychological changes, although independent of each other, were moderated by gender, and influenced by the negative experiences of participants such as stigma, violence, and PTSD. Latent profile analyses revealed three classes of participants, two of which were characterized by high scores on mental health problems and PTG. The clusters were invariant across gender. Surviving COVID-19 contributed to resilience and PTG. These can be targeted for intervention programs to mitigate the mental health burden occasioned by the pandemic.
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Affiliation(s)
- Samuel Adjorlolo
- Department of Mental Health, School of Nursing and Midwifery, College of Health Sciences, University of Ghana, Legon, Accra P.O. Box LG 43, Ghana
- Research and Grant Institute of Ghana, Legon, Accra P.O. Box LG 1004, Ghana
- Correspondence:
| | - Paul Adjorlolo
- Department of Statistics and Actuarial Science, College of Basic and Applied Sciences, University of Ghana, Legon, Accra P.O. Box LG 43, Ghana
| | - Johnny Andoh-Arthur
- Department of Psychology, School of Social Sciences, College of Humanities, University of Ghana, Legon, Accra P.O. Box LG 84, Ghana
| | | | - Irene Akwo Kretchy
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, Legon, Accra P.O. Box LG 43, Ghana
| | - Joseph Osafo
- Department of Psychology, School of Social Sciences, College of Humanities, University of Ghana, Legon, Accra P.O. Box LG 84, Ghana
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Abstract
OBJECTIVE We conducted literature reviews to uncover differential effects of sex on sequelae from coronavirus disease 2019 (COVID-19) and on long COVID syndrome. METHODS Two authors independently searched OvidSP in Embase, Medline, Biosis, and Derwent Drug File. Publications reporting original, sex-disaggregated data for sequelae of COVID-19 (published before August 2020) and long COVID syndrome (published before June 2021) were included in the reviews. The association between COVID-19 sequelae (i.e. lasting <4 weeks after symptom onset) and sex, and between long COVID syndrome (i.e. lasting >4 weeks after symptom onset) and sex, was determined by odds ratio (OR) and 95% confidence interval (CI) (statistical significance defined by 95% CI not including 1). RESULTS Of 4346 publications identified, 23 and 12 met eligibility criteria for COVID-19 sequelae and long COVID syndrome, respectively. COVID-19 sequelae in the categories of psychiatric/mood (OR = 1.80; 95% CI: 1.35-2.41), ENT (OR = 1.42; 95% CI: 1.39-1.46), musculoskeletal (OR = 1.15; 95% CI: 1.14-1.16), and respiratory (OR = 1.09; 95% CI: 1.08-1.11) were significantly more likely among females (vs. males), whereas renal sequelae (OR = 0.83; 95% CI: 0.75-0.93) were significantly more likely among males. The likelihood of having long COVID syndrome was significantly greater among females (OR = 1.22; 95% CI: 1.13-1.32), with the odds of ENT (OR = 2.28; 95% CI: 1.94-2.67), GI (OR = 1.60; 95% CI: 1.04-2.44), psychiatric/mood (OR = 1.58; 95% CI: 1.37-1.82), neurological (OR = 1.30; 95% CI: 1.03-1.63), dermatological (OR = 1.29; 95% CI: 1.05-1.58), and other (OR = 1.36; 95% CI: 1.25-1.49) disorders significantly higher among females and the odds of endocrine (OR = 0.75; 95% CI: 0.69-0.81) and renal disorders (OR = 0.74; 95% CI: 0.64-0.86) significantly higher among males. CONCLUSIONS Sex-disaggregated differences for COVID-19 sequelae and long COVID syndrome were observed. Few COVID-19 studies report sex-disaggregated data, underscoring the need for further sex-based research/reporting of COVID-19 disease.
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Affiliation(s)
- Shirley V Sylvester
- Johnson & Johnson, Women's Health, Office of the Chief Medical Officer, New Brunswick, NJ, USA
| | - Rada Rusu
- Clinical Operations, Johnson & Johnson, Office of the Chief Medical Officer, Toronto, Canada
| | - Biankha Chan
- Clinical Operations, Johnson & Johnson, Office of the Chief Medical Officer, Toronto, Canada
| | - Martha Bellows
- Johnson & Johnson, Healthcare Technology Center, Providence, RI, USA
| | - Carly O'Keefe
- Johnson & Johnson, Healthcare Technology Center, Providence, RI, USA
| | - Susan Nicholson
- Johnson & Johnson, Women's Health, Office of the Chief Medical Officer, New Brunswick, NJ, USA
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Stillwell RC. Exclusion of women from COVID-19 studies harms women's health and slows our response to pandemics. Biol Sex Differ 2022; 13:27. [PMID: 35676733 PMCID: PMC9175518 DOI: 10.1186/s13293-022-00435-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 05/19/2022] [Indexed: 11/10/2022] Open
Abstract
Sex and gender inclusion are crucial in bringing COVID-19 to an end and preventing the next pandemic. Despite this, almost all research studies on COVID-19 and clinical trials of vaccines do not include data on women. How can we combat the pandemic if half of the human population is left out of COVID-19 research? The life-long consequences of this neglect could be severe for women all over the world, particularly with the emergence of new variants that could exaggerate sex differences even further. Here I review recent studies and argue that taking a gender/sex approach to the study of this pandemic would expedite its end and improve the general health of women in substantial ways.
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Eteraf-Oskouei T, Najafi M. The relationship between the serotonergic system and COVID-19 disease: A review. Heliyon 2022; 8:e09544. [PMID: 35652122 PMCID: PMC9132783 DOI: 10.1016/j.heliyon.2022.e09544] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/07/2022] [Accepted: 05/20/2022] [Indexed: 02/07/2023] Open
Abstract
COVID-19 is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which led to a pandemic started in Wuhan, China, in 2019. The rapid spread of the disease in the world, unprecedented mortality rate, and lack of definitive treatment for the disease have led to a global effort to develop effective vaccines as well as new therapeutic interventions. Immune cells activation with excessive inflammation is an important pathophysiological feature of COVID-19 that may impair the various organs functions. Accordingly, these could cause dysfunction in the brain with some symptoms such as respiratory failure, headache, impaired consciousness, olfactory and taste disorders, and severe neurological disorders such as encephalitis. It was found that there is a two-way communication between the immune system and the nervous system through classical neurotransmitters, hormones, and cytokines. Among neurotransmitters, serotonin plays important roles in the immune system and in regulating inflammatory responses by central and peripheral mechanisms. This article aimed to review the two-way relationship between the immune and the nervous systems by focusing on the serotonergic system and the emerging COVID-19 disease.
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Affiliation(s)
- Tahereh Eteraf-Oskouei
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Moslem Najafi
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
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Elayeete S, Nampeera R, Nsubuga EJ, Nansikombi HT, Kwesiga B, Kadobera D, Amanya G, Ajambo M, Mwanje W, Riolexus AA, Harris JR. Comparative epidemiologic analysis of COVID-19 patients during the first and second waves of COVID-19 in Uganda. IJID Regions 2022; 3:160-167. [PMID: 35720154 PMCID: PMC8942882 DOI: 10.1016/j.ijregi.2022.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/21/2022] [Accepted: 03/21/2022] [Indexed: 10/31/2022]
Abstract
Hospitalized patients were older in Wave 2 Bthan in Wave 1. Hospitalized patients were more likely to be male in Wave 1 than in Wave 2. Coronavirus disease 2019 was more severe in Wave 2 than in Wave 1.
Introduction Methods Findings Interpretation
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Bulka CM, Enggasser AE, Fry RC. Epigenetics at the Intersection of COVID-19 Risk and Environmental Chemical Exposures. Curr Environ Health Rep 2022. [PMID: 35648356 DOI: 10.1007/s40572-022-00353-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW Several environmental contaminants have been implicated as contributors to COVID-19 susceptibility and severity. Immunomodulation and epigenetic regulation have been hypothesized as mediators of this relationship, but the precise underlying molecular mechanisms are not well-characterized. This review examines the evidence for epigenetic modification at the intersection of COVID-19 and environmental chemical exposures. RECENT FINDINGS Numerous environmental contaminants including air pollutants, toxic metal(loid)s, per- and polyfluorinated substances, and endocrine disrupting chemicals are hypothesized to increase susceptibility to the SARS-CoV-2 virus and the risk of severe COVID-19, but few studies currently exist. Drawing on evidence that many environmental chemicals alter the epigenetic regulation of key immunity genes and pathways, we discuss how exposures likely perturb host antiviral responses. Specific mechanisms vary by contaminant but include general immunomodulation as well as regulation of viral entry and recognition, inflammation, and immunologic memory pathways, among others. Associations between environmental contaminants and COVID-19 are likely mediated, in part, by epigenetic regulation of key immune pathways involved in the host response to SARS-CoV-2.
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Mosaed R, Fasihi H, Norouzi A, Anjomanian V, Ardalan MA, Alazmani Noodeh F, Khoshdel AR. Influenza Vaccine and COVID-19 Pandemic: Could This Vaccine Help Limit the Potential Adverse Consequences of SARS-CoV-2? Iran J Pharm Res 2022; 21:e127032. [PMID: 36710988 PMCID: PMC9872545 DOI: 10.5812/ijpr-127032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/04/2022] [Accepted: 04/10/2022] [Indexed: 02/01/2023]
Abstract
The COVID-19 pandemic has prompted researchers to find treatments and vaccines to control SARS-CoV-2. There are some hypotheses about the benefit of respiratory virus vaccines, like MMR, for COVID-19 pneumonia severity, morbidity, and mortality. The influenza vaccine is one of the most frequently used respiratory virus vaccines covered by one of the Iranian insurance institutes. We have a symmetrical group of participants that have received this vaccine that could be compared with each other. We compared 3,379 persons aged 20 - 75 years for the effect of the influenza vaccine on COVID-19 mortality. We ultimately found that it does not affect mortality caused by COVID-19 pneumonia, but it can decrease the hospitalization cost in people over 65 years with a history of chronic disease.
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Affiliation(s)
- Reza Mosaed
- Department of Clinical Pharmacy, School of Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Hossein Fasihi
- Biomaterial and Medicinal Chemistry Research Center, AJA University of Medical Sciences, Tehran, Iran
| | - Amir Norouzi
- Iran Armed Forces Health Insurance Organization, Tehran, Iran
| | | | - Mohammad Afshar Ardalan
- Internal Medicine Department, School of Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Farshid Alazmani Noodeh
- Critical Care Nursing Department, Faculty of Nursing, Aja University of Medical Sciences, Tehran, Iran
| | - Ali Reza Khoshdel
- Department of Public Health, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
- Corresponding Author: Department of Public Health, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
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Piras I, Piazza MF, Piccolo C, Azara A, Piana A, Finco G, Galletta M. Experiences, Emotions, and Health Consequences among COVID-19 Survivors after Intensive Care Unit Hospitalization. IJERPH 2022; 19:ijerph19106263. [PMID: 35627801 PMCID: PMC9141708 DOI: 10.3390/ijerph19106263] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/18/2022] [Accepted: 05/19/2022] [Indexed: 12/24/2022]
Abstract
Literature suggested that COVID-19 patients experienced hospitalization as a physically and psychologically stressful event, with the risk to develop post-traumatic stress symptoms. The study aimed to understand psychological experiences of COVID-19 survivors with severe complications during and after ICU hospitalization, and any relevant health consequences. From October 2020 to January 2021, a qualitative study was conducted in Italy via semi-structured interviews by phone or video call addressed to COVID-19 survivors, randomly enrolled among people who released their stories publicly on newspapers, television, or social media. Fifteen individuals (three women and twelve men with average age of 56.4 years) were interviewed. Four main themes emerged: (i) emotion of fear; (ii) isolation and loneliness; (iii) unawareness about the gravity of the situation as a protective factor; (iv) “Long COVID” as consequences of the disease on physical and psychological health. During hospitalization, 66.7% of participants had mild or moderate values of anxiety and depression. After discharge, 86.7% moved to normal values. The results suggest that long-COVID is an important problem to manage to improve patients’ quality of life. It is essential to guarantee a holistic take in charge starting before the discharge and continuing care after discharge in the community where they live.
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Affiliation(s)
- Ilenia Piras
- Department of Biomedical Sciences, PhD School in Biomedical Sciences (Public Health), University of Sassari, 07100 Sassari, Italy
- Emergency Department SS. Trinità Hospital, ASL Cagliari, 09121 Cagliari, Italy
- Correspondence: or ; Tel.: +39-079228638
| | | | - Cristina Piccolo
- Intensive Care Unit SS. Trinità Hospital, ASL Cagliari, 09121 Cagliari, Italy;
| | - Antonio Azara
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy; (A.A.); (A.P.)
| | - Andrea Piana
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy; (A.A.); (A.P.)
| | - Gabriele Finco
- Intensive Care Unit Policlinico Universitario, Azienda Ospedaliero Universitaria Cagliari, 09042 Monserrato, Italy;
- Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, Italy;
| | - Maura Galletta
- Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, Italy;
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Silva BRO, Rodrigues WF, Abadia DGP, Alves da Silva DA, Andrade e Silva LE, Desidério CS, Farnesi-de-Assunção TS, Costa-Madeira JC, Barbosa RM, Bernardes e Borges AV, Hortolani Cunha ACC, Pereira LQ, Helmo FR, Lemes MR, Barbosa LM, Trevisan RO, Obata MMS, Bueno GF, Mundim FV, Oliveira-Scussel ACM, Monteiro IB, Ferreira YM, Machado GH, Ferreira-Paim K, Moraes-Souza H, da Silva MV, Rodrigues Júnior V, Oliveira CJF. Clinical-Epidemiology Aspect of Inpatients With Moderate or Severe COVID-19 in a Brazilian Macroregion: Disease and Countermeasures. Front Cell Infect Microbiol 2022; 12:899702. [PMID: 35669120 PMCID: PMC9164138 DOI: 10.3389/fcimb.2022.899702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
COVID-19, also known as coronavirus disease 2019, is an infectious viral disease caused by SARS-CoV-2, a novel coronavirus. Since its emergence, its epidemiology has been explored; however, for some regions of the world, COVID-19’s behavior, incidence, and impact remain unclear. In continental nations like Brazil, this lack of knowledge results in nonuniform control, prevention, and treatment measures, which can be controversial in some locations. This study aimed to describe the epidemiological profile of patients with COVID-19 in the macroregion of Triângulo Sul in the state of Minas Gerais (MG), Brazil. Between March 25 and October 21, 2020, data were collected and statistically analyzed from 395 hospitalized patients in the city of Uberaba, MG, suspected to have moderate or severe forms of the disease. Of the 395 suspected cases, 82% were confirmed to be positive for COVID-19. The mean age of positive patients was 58.4 years, and 60.76% were male. Following these patients throughout their hospitalization, a mortality rate of 31.3% was observed. In the population positive for COVID-19, the risk of death increased by 4% for each year of the patient’s age. Likewise, the older the patient, the longer their hospitalization and the higher the risk of developing acute respiratory failure. Among the treatments tested in patients, heparin was associated with protection against mortality, and the absence of anticoagulant use was linked to a more than six times greater risk of death. Finally, comorbidities in patients with COVID-19 were positively correlated with increased hospitalization time. In summary, this study revealed that age, presence of comorbidities, length of hospitalization, and drug treatment considerably altered COVID-19’s lethality. To understand infection rates and the factors involved in COVID-19’s lethality, knowledge of the local epidemiology is necessary.
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Affiliation(s)
| | - Wellington Francisco Rodrigues
- Department of Immunology, Microbiology and Parasitology, Federal University of Triângulo Mineiro, Uberaba, Brazil
- *Correspondence: Wellington Francisco Rodrigues,
| | - Daniela Gomes Pires Abadia
- Department of Immunology, Microbiology and Parasitology, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Djalma A. Alves da Silva
- Department of Immunology, Microbiology and Parasitology, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Leonardo E. Andrade e Silva
- Department of Immunology, Microbiology and Parasitology, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Chamberttan S. Desidério
- Department of Immunology, Microbiology and Parasitology, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | | | - Juliana C. Costa-Madeira
- Department of Immunology, Microbiology and Parasitology, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Rafaela M. Barbosa
- Department of Immunology, Microbiology and Parasitology, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Anna V. Bernardes e Borges
- Department of Immunology, Microbiology and Parasitology, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | | | - Loren Q. Pereira
- Laboratory of Hematological Research of the Federal University of Triângulo Mineiro and Regional Blood Center of Uberaba - Hemominas Foundation, Uberaba, Brazil
| | - Fernanda R. Helmo
- Department of Immunology, Microbiology and Parasitology, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Marcela Rezende Lemes
- Department of Immunology, Microbiology and Parasitology, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Laís M. Barbosa
- Department of Immunology, Microbiology and Parasitology, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Rafael O. Trevisan
- Department of Immunology, Microbiology and Parasitology, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Malu Mateus Santos Obata
- Department of Immunology, Microbiology and Parasitology, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Giovanna F. Bueno
- Department of Immunology, Microbiology and Parasitology, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Fabiano V. Mundim
- Department of Immunology, Microbiology and Parasitology, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | | | - Ivan B. Monteiro
- UNIMED São Domingos Hospital, Uberaba, MG, Brazil. José Alencar Gomes da Silva Regional Hospital, Uberaba, Brazil
- José Alencar Gomes da Silva Regional Hospital, Uberaba, Brazil
| | | | | | - Kennio Ferreira-Paim
- Department of Immunology, Microbiology and Parasitology, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Hélio Moraes-Souza
- Laboratory of Hematological Research of the Federal University of Triângulo Mineiro and Regional Blood Center of Uberaba - Hemominas Foundation, Uberaba, Brazil
| | - Marcos Vinicius da Silva
- Department of Immunology, Microbiology and Parasitology, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Virmondes Rodrigues Júnior
- Department of Immunology, Microbiology and Parasitology, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Carlo José Freire Oliveira
- Department of Immunology, Microbiology and Parasitology, Federal University of Triângulo Mineiro, Uberaba, Brazil
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Degarege A, Naveed Z, Kabayundo J, Brett-Major D. Heterogeneity and Risk of Bias in Studies Examining Risk Factors for Severe Illness and Death in COVID-19: A Systematic Review and Meta-Analysis. Pathogens 2022; 11:563. [PMID: 35631084 PMCID: PMC9147100 DOI: 10.3390/pathogens11050563] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/02/2022] [Accepted: 05/05/2022] [Indexed: 02/07/2023] Open
Abstract
This systematic review and meta-analysis synthesized the evidence on the impacts of demographics and comorbidities on the clinical outcomes of COVID-19, as well as the sources of the heterogeneity and publication bias of the relevant studies. Two authors independently searched the literature from PubMed, Embase, Cochrane library, and CINAHL on 18 May 2021; removed duplicates; screened the titles, abstracts, and full texts by using criteria; and extracted data from the eligible articles. The variations among the studies were examined by using Cochrane, Q.; I2, and meta-regression. Out of 11,975 articles that were obtained from the databases and screened, 559 studies were abstracted, and then, where appropriate, were analyzed by meta-analysis (n = 542). COVID-19-related severe illness, admission to the ICU, and death were significantly correlated with comorbidities, male sex, and an age older than 60 or 65 years, although high heterogeneity was present in the pooled estimates. The study design, the study country, the sample size, and the year of publication contributed to this. There was publication bias among the studies that compared the odds of COVID-19-related deaths, severe illness, and admission to the ICU on the basis of the comorbidity status. While an older age and chronic diseases were shown to increase the risk of developing severe illness, admission to the ICU, and death among the COVID-19 patients in our analysis, a marked heterogeneity was present when linking the specific risks with the outcomes.
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Affiliation(s)
- Abraham Degarege
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA; (Z.N.); (J.K.); (D.B.-M.)
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Abstract
Aim: To provide a comprehensive understanding of the varying effects of SARS-CoV-2 infection based on sex. Methods: A PubMed search of 470 primary articles was performed, with inclusion based on relevance (sex differences discussed in the target COVID population) and redundancy. PubMed was queried based on title for the keywords “SEX” and “COVID” or “SARS” between 2020 and 2022. Results: For COVID-19, males have increased risk for infectivity and intensive care unit admission and worse overall outcomes compared with females. Genetic predispositions, sex hormones, immune system responses and non-biological causes all contribute to the disparity in COVID-19 responses between the sexes. COVID-19 sex-related determinants of morbidity and mortality remain unclear. Conclusions: Male sex is a risk factor for several overall worse outcomes related to COVID-19. Investigating the sex impact of COVID-19 is an important part of understanding the behavior of the disease. Future work is needed to further explore these relationships and optimize the management of COVID-19 patients based on sex.
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Affiliation(s)
- Rahul Chaturvedi
- Department of Anesthesiology, Weill Cornell Medicine, 525 East 68th Street, Box 124, New York, NY 10065, USA
| | - Briana Lui
- Weill Cornell Medical College, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA
| | - Jamie A Aaronson
- Department of Anesthesiology, Weill Cornell Medicine, 525 East 68th Street, Box 124, New York, NY 10065, USA
| | - Robert S White
- Department of Anesthesiology, Weill Cornell Medicine, 525 East 68th Street, Box 124, New York, NY 10065, USA
| | - Jon D Samuels
- Department of Anesthesiology, Weill Cornell Medicine, 525 East 68th Street, Box 124, New York, NY 10065, USA
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Sarich P, Cabasag CJ, Liebermann E, Vaneckova P, Carle C, Hughes S, Egger S, O'Connell DL, Weber MF, da Costa AM, Caruana M, Bray F, Canfell K, Ginsburg O, Steinberg J, Soerjomataram I. Tobacco smoking changes during the first pre-vaccination phases of the COVID-19 pandemic: A systematic review and meta-analysis. EClinicalMedicine 2022; 47:101375. [PMID: 35434579 PMCID: PMC9002019 DOI: 10.1016/j.eclinm.2022.101375] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 03/07/2022] [Accepted: 03/21/2022] [Indexed: 12/23/2022] Open
Abstract
Background Globally, tobacco smoking remains the largest preventable cause of premature death. The COVID-19 pandemic has forced nations to take unprecedented measures, including 'lockdowns' that might impact tobacco smoking behaviour. We performed a systematic review and meta-analyses to assess smoking behaviour changes during the early pre-vaccination phases of the COVID-19 pandemic in 2020. Methods We searched Medline/Embase/PsycINFO/BioRxiv/MedRxiv/SSRN databases (January-November 2020) for published and pre-print articles that reported specific smoking behaviour changes or intentions after the onset of the COVID-19 pandemic. We used random-effects models to pool prevalence ratios comparing the prevalence of smoking during and before the pandemic, and the prevalence of smoking behaviour changes during the pandemic. The PROSPERO registration number for this systematic review was CRD42020206383. Findings 31 studies were included in meta-analyses, with smoking data for 269,164 participants across 24 countries. The proportion of people smoking during the pandemic was lower than that before, with a pooled prevalence ratio of 0·87 (95%CI:0·79-0·97). Among people who smoke, 21% (95%CI:14-30%) smoked less, 27% (95%CI:22-32%) smoked more, 50% (95%CI:41%-58%) had unchanged smoking and 4% (95%CI:1-9%) reported quitting smoking. Among people who did not smoke, 2% (95%CI:1-3%) started smoking during the pandemic. Heterogeneity was high in all meta-analyses and so the pooled estimates should be interpreted with caution (I2 >91% and p-heterogeneity<0·001). Almost all studies were at high risk of bias due to use of non-representative samples, non-response bias, and utilisation of non-validated questions. Interpretation Smoking behaviour changes during the first phases of the COVID-19 pandemic in 2020 were highly mixed. Meta-analyses indicated that there was a relative reduction in overall smoking prevalence during the pandemic, while similar proportions of people who smoke smoked more or smoked less, although heterogeneity was high. Implementation of evidence-based tobacco control policies and programs, including tobacco cessation services, have an important role in ensuring that the COVID-19 pandemic does not exacerbate the smoking pandemic and associated adverse health outcomes. Funding No specific funding was received for this study.
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Affiliation(s)
- Peter Sarich
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, PO Box 572, Kings Cross, NSW 1340, Australia
| | - Citadel J Cabasag
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Erica Liebermann
- College of Nursing, University of Rhode Island, RI, United States
| | - Pavla Vaneckova
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, PO Box 572, Kings Cross, NSW 1340, Australia
| | - Chelsea Carle
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, PO Box 572, Kings Cross, NSW 1340, Australia
| | - Suzanne Hughes
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, PO Box 572, Kings Cross, NSW 1340, Australia
| | - Sam Egger
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, PO Box 572, Kings Cross, NSW 1340, Australia
| | - Dianne L O'Connell
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, PO Box 572, Kings Cross, NSW 1340, Australia
| | - Marianne F Weber
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, PO Box 572, Kings Cross, NSW 1340, Australia
| | - Allini Mafra da Costa
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Michael Caruana
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, PO Box 572, Kings Cross, NSW 1340, Australia
| | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Karen Canfell
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, PO Box 572, Kings Cross, NSW 1340, Australia
| | - Ophira Ginsburg
- Center for Global Health, National Cancer Institute, MD, United States
| | - Julia Steinberg
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, PO Box 572, Kings Cross, NSW 1340, Australia
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Ho JQ, Sepand MR, Bigdelou B, Shekarian T, Esfandyarpour R, Chauhan P, Serpooshan V, Beura LK, Hutter G, Zanganeh S. The immune response to COVID-19: Does sex matter? Immunology 2022; 166:429-443. [PMID: 35470422 PMCID: PMC9111683 DOI: 10.1111/imm.13487] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/14/2022] [Indexed: 01/08/2023] Open
Abstract
The coronavirus disease 2019 (COVID‐19) pandemic has created unprecedented challenges worldwide. Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) causes COVID‐19 and has a complex interaction with the immune system, including growing evidence of sex‐specific differences in the immune response. Sex‐disaggregated analyses of epidemiological data indicate that males experience more severe symptoms and suffer higher mortality from COVID‐19 than females. Many behavioural risk factors and biological factors may contribute to the different immune response. This review examines the immune response to SARS‐CoV‐2 infection in the context of sex, with emphasis on potential biological mechanisms explaining differences in clinical outcomes. Understanding sex differences in the pathophysiology of SARS‐CoV‐2 infection will help promote the development of specific strategies to manage the disease.
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Affiliation(s)
- Jim Q Ho
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, United States
| | - Mohammad Reza Sepand
- Department of Bioengineering, University of Massachusetts Dartmouth, Dartmouth, Massachusetts, United States
| | - Banafsheh Bigdelou
- Department of Bioengineering, University of Massachusetts Dartmouth, Dartmouth, Massachusetts, United States
| | - Tala Shekarian
- Department of Neurosurgery, University Hospital Basel, Basel, Switzerland
| | - Rahim Esfandyarpour
- Department of Electrical Engineering, University of California Irvine, Irvine, California, United States.,Department of Biomedical Engineering, University of California Irvine, Irvine, California, United States
| | - Prashant Chauhan
- Laboratory of Functional Biology of Protists, Institute of Parasitology, Biology Centre of the Czech Academy of Sciences, České Budějovice, Czech Republic
| | - Vahid Serpooshan
- Wallace H. Coulter Department of Biomedical Engineering, Emory University School of Medicine and Georgia Institute of Technology, Atlanta, Georgia, United States
| | - Lalit K Beura
- Department of Molecular Microbiology and Immunology, Brown University, Providence, Rhode Island, United States
| | - Gregor Hutter
- Department of Neurosurgery, University Hospital Basel, Basel, Switzerland
| | - Steven Zanganeh
- Department of Bioengineering, University of Massachusetts Dartmouth, Dartmouth, Massachusetts, United States
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Cummings KJ, Beckman J, Frederick M, Harrison R, Nguyen A, Snyder R, Chan E, Gibb K, Rodriguez A, Wong J, Murray EL, Jain S, Vergara X. Disparities in COVID-19 fatalities among working Californians. PLoS One 2022; 17:e0266058. [PMID: 35349589 PMCID: PMC8963556 DOI: 10.1371/journal.pone.0266058] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/11/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Information on U.S. COVID-19 mortality rates by occupation is limited. We aimed to characterize 2020 COVID-19 fatalities among working Californians to inform preventive strategies. METHODS We identified laboratory-confirmed COVID-19 fatalities with dates of death in 2020 by matching death certificates to the state's COVID-19 case registry. Working status for decedents aged 18-64 years was determined from state employment records, death certificates, and case registry data and classified as "confirmed working," "likely working," or "not working." We calculated age-adjusted overall and occupation-specific COVID-19 mortality rates using 2019 American Community Survey denominators. RESULTS COVID-19 accounted for 8,050 (9.9%) of 81,468 fatalities among Californians 18-64 years old. Of these decedents, 2,486 (30.9%) were matched to state employment records and classified as "confirmed working." The remainder were classified as "likely working" (n = 4,121 [51.2%]) or "not working" (n = 1,443 [17.9%]) using death certificate and case registry data. Confirmed and likely working COVID-19 decedents were predominantly male (76.3%), Latino (68.7%), and foreign-born (59.6%), with high school or less education (67.9%); 7.8% were Black. The overall age-adjusted COVID-19 mortality rate was 30.0 per 100,000 workers (95% confidence interval [CI], 29.3-30.8). Workers in nine occupational groups had age-adjusted mortality rates higher than this overall rate, including those in farming (78.0; 95% CI, 68.7-88.2); material moving (77.8; 95% CI, 70.2-85.9); construction (62.4; 95% CI, 57.7-67.4); production (60.2; 95% CI, 55.7-65.0); and transportation (57.2; 95% CI, 52.2-62.5) occupations. While occupational differences in mortality were evident across demographic groups, mortality rates were three-fold higher for male compared with female workers and three- to seven-fold higher for Latino and Black workers compared with Asian and White workers. CONCLUSION Californians in manual labor and in-person service occupations experienced disproportionate COVID-19 mortality, with the highest rates observed among male, Latino, and Black workers; these occupational group should be prioritized for prevention.
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Affiliation(s)
- Kristin J. Cummings
- Occupational Health Branch, California Department of Public Health, Richmond, CA, United States of America
| | - John Beckman
- Occupational Health Branch, California Department of Public Health, Richmond, CA, United States of America
- Public Health Institute, Oakland, CA, United States of America
| | - Matthew Frederick
- Occupational Health Branch, California Department of Public Health, Richmond, CA, United States of America
- Public Health Institute, Oakland, CA, United States of America
| | - Robert Harrison
- Occupational Health Branch, California Department of Public Health, Richmond, CA, United States of America
| | - Alyssa Nguyen
- Infectious Diseases Branch, California Department of Public Health, Richmond, CA, United States of America
| | - Robert Snyder
- Infectious Diseases Branch, California Department of Public Health, Richmond, CA, United States of America
| | - Elena Chan
- Occupational Health Branch, California Department of Public Health, Richmond, CA, United States of America
- Public Health Institute, Oakland, CA, United States of America
| | - Kathryn Gibb
- Occupational Health Branch, California Department of Public Health, Richmond, CA, United States of America
- Public Health Institute, Oakland, CA, United States of America
| | - Andrea Rodriguez
- Occupational Health Branch, California Department of Public Health, Richmond, CA, United States of America
- Public Health Institute, Oakland, CA, United States of America
| | - Jessie Wong
- Occupational Health Branch, California Department of Public Health, Richmond, CA, United States of America
- Public Health Institute, Oakland, CA, United States of America
| | - Erin L. Murray
- Immunization Branch, California Department of Public Health, Richmond, CA, United States of America
| | - Seema Jain
- Infectious Diseases Branch, California Department of Public Health, Richmond, CA, United States of America
| | - Ximena Vergara
- Occupational Health Branch, California Department of Public Health, Richmond, CA, United States of America
- Heluna Health, City of Industry, CA, United States of America
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Brocke SA, Billings GT, Taft-Benz S, Alexis NE, Heise MT, Jaspers I. Woodsmoke particle exposure prior to SARS-CoV-2 infection alters antiviral response gene expression in human nasal epithelial cells in a sex-dependent manner. Am J Physiol Lung Cell Mol Physiol 2022; 322:L479-L494. [PMID: 35107034 PMCID: PMC8917918 DOI: 10.1152/ajplung.00362.2021] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/13/2021] [Accepted: 01/27/2022] [Indexed: 12/25/2022] Open
Abstract
Inhalational exposure to particulate matter (PM) derived from natural or anthropogenic sources alters gene expression in the airways and increases susceptibility to respiratory viral infection. Woodsmoke-derived ambient PM from wildfire events during 2020 was associated with higher COVID-19 case rates in the western United States. We hypothesized that exposure to suspensions of woodsmoke particles (WSPs) or diesel exhaust particles (DEPs) prior to SARS-CoV-2 infection would alter host immune gene expression at the transcript level. Primary human nasal epithelial cells (hNECs) from both sexes were exposed to WSPs or DEPs (22 μg/cm2) for 2 h, followed by infection with SARS-CoV-2 at a multiplicity of infection of 0.5. Forty-six genes related to SARS-CoV-2 entry and host response were assessed. Particle exposure alone minimally affected gene expression, whereas SARS-CoV-2 infection alone induced a robust transcriptional response in hNECs, upregulating type I and III interferons, interferon-stimulated genes, and chemokines by 72 h postinfection (p.i.). This upregulation was higher overall in cells from male donors. However, exposure to WSPs prior to infection dampened expression of antiviral, interferon, and chemokine mRNAs. Sex stratification of these results revealed that WSP exposure downregulated gene expression in cells from females more so than males. We next hypothesized that hNECs exposed to particles would have increased apical viral loads compared with unexposed cells. Although apical viral load was correlated to expression of host response genes, viral titer did not differ between groups. These data indicate that WSPs alter epithelial immune responses in a sex-dependent manner, potentially suppressing host defense to SARS-CoV-2 infection.
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Affiliation(s)
- Stephanie A Brocke
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Grant T Billings
- Crop and Soil Sciences Department, North Carolina State University, Raleigh, North Carolina
| | - Sharon Taft-Benz
- Department of Genetics, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Neil E Alexis
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina, Chapel Hill, North Carolina
| | - Mark T Heise
- Department of Genetics, University of North Carolina School of Medicine, Chapel Hill, North Carolina
- Department of Microbiology and Immunology, University of North Carolina, Chapel Hill, North Carolina
| | - Ilona Jaspers
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina, Chapel Hill, North Carolina
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina, Chapel Hill, North Carolina
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Shlomo IB, Frankenthal H, Laor A, Greenhut AK. Detection of SARS-CoV-2 infection by exhaled breath spectral analysis: Introducing a ready-to-use point-of-care mass screening method. EClinicalMedicine 2022; 45:101308. [PMID: 35224472 PMCID: PMC8856887 DOI: 10.1016/j.eclinm.2022.101308] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/23/2022] [Accepted: 01/31/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The current SARS-CoV-2 pandemic created an urgent need for rapid, infection screening applied to large numbers of asymptomatic individuals. To date, nasal/throat swab polymerase chain reaction (PCR) is considered the "gold standard". However, this is inconducive to mass, point-of-care (POC) testing due to person discomfort during sampling and a prolonged result turnaround. Breath testing for disease specific organic compounds potentially offers a practical, rapid, non-invasive, POC solution. The study compares the Breath of Health, Ltd. (BOH) breath analysis system to PCR's ability to screen asymptomatic individuals for SARS-CoV-2 infection. The BOH system is mobile and combines Fourier-transform infrared (FTIR) spectroscopy with artificial intelligence (AI) to generate results within 2 min and 15 s. In contrast to prior SARS-CoV-2 breath analysis research, this study focuses on diagnosing SARS-CoV-2 via disease specific spectrometric profiles rather than through identifying the disease specific molecules. METHODS Asymptomatic emergency room patients with suspected SARS-CoV-2 exposure in two leading Israeli hospitals were selected between February through April 2021. All were tested via nasal/throat-swab PCR and BOH breath analysis. In total, 297 patients were sampled (mean age 57·08 ± SD 18·86, 156 males, 139 females, 2 unknowns). Of these, 96 were PCR-positive (44 males, 50 females, 2 unknowns), 201 were PCR-negative (112 males, 89 females). One hundred samples were used for AI identification of SARS-CoV-2 distinguishing spectroscopic wave-number patterns and diagnostic algorithm creation. Algorithm validation was tested in 100 proof-of-concept samples (34 PCR-positive, 66 PCR-negative) by comparing PCR with AI algorithm-based breath-test results determined by a blinded medical expert. One hundred additional samples (12 true PCR-positive, 85 true PCR-negative, 3 confounder false PCR-positive [not included in the 297 total samples]) were evaluated by two blinded medical experts for further algorithm validation and inter-expert correlation. FINDINGS The BOH system identified three distinguishing wave numbers for SARS-CoV-2 infection. In the first phase, the single expert identified the first 100 samples correctly, yielding a 1:1 FTIR/AI:PCR correlation. The two-expert second-phase also yielded 1:1 FTIR/AI:PCR correlation for 97 non-confounders and null correlation for the 3 confounders. Inter-expert correlation was 1:1 for all results. In total, the FTIR/AI algorithm demonstrated 100% sensitivity and specificity for SARS-CoV-2 detection when compared with PCR. INTERPRETATION The SARS-CoV-2 method of breath analysis via FTIR with AI-based algorithm demonstrated high PCR correlation in screening for asymptomatic individuals. This is the first practical, rapid, POC breath analysis solution with such high PCR correlation in asymptomatic individuals. Further validation is required with a larger sample size. FUNDING Breath of Health Ltd, Rehovot, Israel provided study funding.
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Affiliation(s)
- Izhar Ben Shlomo
- Emergency Medicine Program, Zefat Academic College, Safed, Israel
| | - Hilel Frankenthal
- Emergency Medicine Program, Zefat Academic College, Safed, Israel
- Pediatric Intensive Care Unit, Rebecca Sieff Hospital, Safed, Israel
| | - Arie Laor
- Breath of Health Ltd., Rehovot, Israel
| | - Ayala Kobo Greenhut
- Emergency Medicine Program, Zefat Academic College, Safed, Israel
- Corresponding author at: Emergency Medicine Program, Zefat Academic College, Ider 42, Haifa, Safed, Israel
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Martin CE, Thakkar B, Taylor DDH, Chapman DA. Disparities by Sex in COVID-19 Risk and Related Harms Among People with Opioid Use Disorder. J Womens Health (Larchmt) 2022; 31:640-647. [PMID: 35171036 PMCID: PMC9133966 DOI: 10.1089/jwh.2021.0457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objectives: (1) Report sex-specific prevalence of coronavirus disease 2019 (COVID-19) test positivity among an opioid use disorder (OUD) cohort (2) Assess sex-specific rates of opioid overdose and mortality. Methods: A retrospective cohort study was performed on all adult patients with OUD who received a COVID-19 test in calendar year 2020 at a large academic medical center in Richmond, Virginia. Our study outcomes were positive COVID-19 test, opioid overdose, and all-cause in-hospital mortality. Sex-stratified multivariable logistic regression assessed sociodemographic factors associated with COVID-19 test positivity. Results: A total of 2,600 patients (males = 1,294, females = 1,306) with OUD received a COVID-19 test. Approximately 5% across both sexes tested positive for COVID-19 (p = 0.420), whereas 7% presented with an opioid overdose (males 10%; females 4%; p < 0.0001). However, mortality rates were similar across sex. Among males, individuals in the other racial group had increased odds of COVID-19 test positivity (adjusted odds ratio or AOR: 5.03, 95% confidence interval [CI]: 1.70-14.88), whereas black females had higher odds of COVID-19 test positivity (AOR: 1.92, 95% CI: 1.01-3.62) compared to their white counterparts. Conclusions: Opioid overdose, more often than COVID-19, impacted the health of patients with OUD presenting to a public safety net health system. Despite a female advantage documented in the general population for COVID-19 susceptibility, COVID-19 test positivity rates were similar across sex in an OUD cohort; yet, racial disparities emerged with notable sex-related variation. Sex and gender are important variables that modify health outcomes, including OUD and COVID-19, and should be further investigated using an intersectionality framework.
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Affiliation(s)
- Caitlin E Martin
- Department of Obstetrics and Gynecology, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA.,Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Bhushan Thakkar
- Department of Obstetrics and Gynecology, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - DaShaunda D H Taylor
- Division of Epidemiology, Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA.,Center on Society and Health, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Derek A Chapman
- Division of Epidemiology, Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA.,Center on Society and Health, Virginia Commonwealth University, Richmond, Virginia, USA
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Alenzi KA, Albalawi WF, Alanazi TS, Alanazi NS, Alsuhaibani DS, Almuwallad N, Alshammari TM. Coronavirus Disease 2019 in Saudi Arabia: A Nationwide Epidemiological Characterization Study. Saudi Pharm J 2022; 30:562-569. [PMID: 35769341 PMCID: PMC9235050 DOI: 10.1016/j.jsps.2022.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 02/21/2022] [Indexed: 01/08/2023] Open
Abstract
Background On March 11th, 2020, The World Health Organization (WHO) declared that the COVID-19 is a pandemic due to its worldwide spread. The COVID-19 pandemic has extended its impact to Saudi Arabia. By mid-February 2021, The Kingdom of Saudi Arabia has reported more than 373,000 COVID-19 cases impacting different population categories (i.e., male, female, different age groups, comorbidities status). The objective of this nationwide study was to describe and explore the characteristics of hospitalized patients diagnosed with COVID-19 in Saudi Arabia. Methods This study was an observational epidemiological study based on collected clinical data from ten health institutions across all regions in Saudi Arabia. The study was conducted during the period from March 2nd, 2020, to January 31st, 2021. The data were collected included demographics, medical information, medications, and laboratory and diagnostic. More detailed information on usually missing factors such as smoking status, comorbidities, length of hospital stay were also collected. Both descriptive and inferential analyses were conducted using the statistical analysis software “SAS®” version 9.4. Results During the study period, 5286 patients were included in this study. Of these, (79.15%) were male. Of all 5286 patients, quite a high number of the studied population 2010 (38.02%) were smokers. The majority of the patients 3436 (65%) were reported to have comorbidities, with hypertension being the most common disease 1725 (32.6%), followed by diabetes 1641(31.04%). A high proportion of the patients, 2220 patients (41.99%), were admitted to the intensive care unit; of these, (33.52%) were on mechanical ventilation. Most patients received anticoagulant prophylaxis medications (n = 4414, 83.5%). All patients were given more than one antibiotic prophylaxis. Overall, the median hospital stay was 5.5 days, and the median length in the intensive care unit was 4.26 days. Around (89.14%) of patients were discharged from the hospital, and (10.8%) died. Conclusion In this real-world study utilizing a large sample size, this study provides confirmatory results on the COVID-19 patients characteristics that are similar to other populations. Healthcare professionals need to give COVID-19 patients with specific characteristics including smoking, diabetes mellitus and cardiac disease more care to avoid losing these patients.
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Molavi G, Zadeh Hosseingholi E, Maddahi S, Jabbari S. Identification of high death risk coronavirus disease-19 patients using blood tests. Adv Biomed Res 2022; 11:58. [PMID: 36124024 PMCID: PMC9482375 DOI: 10.4103/abr.abr_178_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 10/27/2021] [Accepted: 12/18/2021] [Indexed: 11/04/2022] Open
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50
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Megiorni F, Pontecorvi P, Gerini G, Anastasiadou E, Marchese C, Ceccarelli S. Sex-Related Factors in Cardiovascular Complications Associated to COVID-19. Biomolecules 2021; 12:biom12010021. [PMID: 35053169 PMCID: PMC8773922 DOI: 10.3390/biom12010021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/17/2021] [Accepted: 12/22/2021] [Indexed: 12/15/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19), the pandemic infection caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), presents with an extremely heterogeneous spectrum of symptoms and signs. The clinical manifestations seem to be correlated with disease severity. COVID-19 susceptibility and mortality show a significant sex imbalance, with men being more prone to infection and showing a higher rate of hospitalization and mortality compared to women. Such variability can be ascribed to both sex-related biological factors and gender-related behavioral cues. This review will discuss the potential mechanisms accounting for sex/gender influence in vulnerability to COVID-19. Cardiovascular diseases play a central role in determining COVID-19 outcome, whether they are pre-existent or arose upon infection. We will pay particular attention to the impact of sex and gender on cardiovascular manifestations related to COVID-19. Finally, we will discuss the sex-dependent variability in some biomarkers for the evaluation of COVID-19 infection and prognosis. The aim of this work is to highlight the significance of gendered medicine in setting up personalized programs for COVID-19 prevention, clinical evaluation and treatment.
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