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Zhong J, Guo L, Wang Y, Jiang X, Wang C, Xiao Y, Wang Y, Zhou F, Wu C, Chen L, Wang X, Wang J, Cao B, Li M, Ren L. Gut Microbiota Improves Prognostic Prediction in Critically Ill COVID-19 Patients Alongside Immunological and Hematological Indicators. Research (Wash D C) 2024; 7:0389. [PMID: 38779486 PMCID: PMC11109594 DOI: 10.34133/research.0389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 04/22/2024] [Indexed: 05/25/2024]
Abstract
The gut microbiota undergoes substantial changes in COVID-19 patients; yet, the utility of these alterations as prognostic biomarkers at the time of hospital admission, and its correlation with immunological and hematological parameters, remains unclear. The objective of this study is to investigate the gut microbiota's dynamic change in critically ill patients with COVID-19 and evaluate its predictive capability for clinical outcomes alongside immunological and hematological parameters. In this study, anal swabs were consecutively collected from 192 COVID-19 patients (583 samples) upon hospital admission for metagenome sequencing. Simultaneously, blood samples were obtained to measure the concentrations of 27 cytokines and chemokines, along with hematological and biochemical indicators. Our findings indicate a significant correlation between the composition and dynamics of gut microbiota with disease severity and mortality in COVID-19 patients. Recovered patients exhibited a higher abundance of Veillonella and denser interactions among gut commensal bacteria compared to deceased patients. Furthermore, the abundance of gut commensal bacteria exhibited a negative correlation with the concentration of proinflammatory cytokines and organ damage markers. The gut microbiota upon admission showed moderate prognostic prediction ability with an AUC of 0.78, which was less effective compared to predictions based on immunological and hematological parameters (AUC 0.80 and 0.88, respectively). Noteworthy, the integration of these three datasets yielded a higher predictive accuracy (AUC 0.93). Our findings suggest the gut microbiota as an informative biomarker for COVID-19 prognosis, augmenting existing immune and hematological indicators.
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Affiliation(s)
- Jiaxin Zhong
- Beijing Institute of Genomics, Chinese Academy of Sciences, and China National Center for Bioinformation, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Li Guo
- National Health Commission Key Laboratory of Systems Biology of Pathogens, State Key Laboratory of Respiratory Health and Multimorbidity and Christophe Mérieux Laboratory, National Institute of Pathogen Biology,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Key Laboratory of Respiratory Disease Pathogenomics,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yeming Wang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital,
Capital Medical University, Beijing, China
- National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases,
Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Xuan Jiang
- Beijing Institute of Genomics, Chinese Academy of Sciences, and China National Center for Bioinformation, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Chun Wang
- Beijing Institute of Genomics, Chinese Academy of Sciences, and China National Center for Bioinformation, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Yan Xiao
- National Health Commission Key Laboratory of Systems Biology of Pathogens, State Key Laboratory of Respiratory Health and Multimorbidity and Christophe Mérieux Laboratory, National Institute of Pathogen Biology,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Key Laboratory of Respiratory Disease Pathogenomics,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ying Wang
- National Health Commission Key Laboratory of Systems Biology of Pathogens, State Key Laboratory of Respiratory Health and Multimorbidity and Christophe Mérieux Laboratory, National Institute of Pathogen Biology,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Key Laboratory of Respiratory Disease Pathogenomics,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fei Zhou
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital,
Capital Medical University, Beijing, China
- National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases,
Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Chao Wu
- National Health Commission Key Laboratory of Systems Biology of Pathogens, State Key Laboratory of Respiratory Health and Multimorbidity and Christophe Mérieux Laboratory, National Institute of Pathogen Biology,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Key Laboratory of Respiratory Disease Pathogenomics,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lan Chen
- National Health Commission Key Laboratory of Systems Biology of Pathogens, State Key Laboratory of Respiratory Health and Multimorbidity and Christophe Mérieux Laboratory, National Institute of Pathogen Biology,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Key Laboratory of Respiratory Disease Pathogenomics,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xinming Wang
- National Health Commission Key Laboratory of Systems Biology of Pathogens, State Key Laboratory of Respiratory Health and Multimorbidity and Christophe Mérieux Laboratory, National Institute of Pathogen Biology,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Key Laboratory of Respiratory Disease Pathogenomics,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianwei Wang
- National Health Commission Key Laboratory of Systems Biology of Pathogens, State Key Laboratory of Respiratory Health and Multimorbidity and Christophe Mérieux Laboratory, National Institute of Pathogen Biology,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Key Laboratory of Respiratory Disease Pathogenomics,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bin Cao
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital,
Capital Medical University, Beijing, China
- National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases,
Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Mingkun Li
- Beijing Institute of Genomics, Chinese Academy of Sciences, and China National Center for Bioinformation, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - LiLi Ren
- National Health Commission Key Laboratory of Systems Biology of Pathogens, State Key Laboratory of Respiratory Health and Multimorbidity and Christophe Mérieux Laboratory, National Institute of Pathogen Biology,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Key Laboratory of Respiratory Disease Pathogenomics,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Zheng Y, Feng J, Ling M, Yu Y, Tao Y, Wang X. A comprehensive review on targeting cluster of differentiation: An attractive strategy for inhibiting viruses through host proteins. Int J Biol Macromol 2024; 269:132200. [PMID: 38723834 DOI: 10.1016/j.ijbiomac.2024.132200] [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: 03/04/2024] [Revised: 04/20/2024] [Accepted: 05/06/2024] [Indexed: 05/13/2024]
Abstract
Viral infections continue to pose a significant global public health threat. Targeting host proteins, such as cluster of differentiation (CD) macromolecules, may offer a promising alternative approach to developing antiviral treatments. CDs are cell-surface biological macromolecules mainly expressed on leukocytes that viruses can use to enter cells, thereby evading immune detection and promoting their replication. The manipulation of CDs by viruses may represent an effective and clever means of survival through the prolonged co-evolution of hosts and viruses. Targeting of CDs is anticipated to hinder the invasion of related viruses, modulate the body's immune system, and diminish the incidence of subsequent inflammation. They have become crucial for biomedical diagnosis, and some have been used as valuable tools for resisting viral infections. However, a summary of the structures and functions of CDs involved in viral infection is currently lacking. The development of drugs targeting these biological macromolecules is restricted both in terms of their availability and the number of compounds currently identified. This review provides a comprehensive analysis of the critical role of CD proteins in virus invasion and a list of relevant targeted antiviral agents, which will serve as a valuable reference for future research in this field.
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Affiliation(s)
- Youle Zheng
- National Reference Laboratory of Veterinary Drug Residues (HZAU), MAO Key Laboratory for Detection of Veterinary Drug Residues, Huazhong Agricultural University, Wuhan, Hubei 430070, China
| | - Jin Feng
- National Reference Laboratory of Veterinary Drug Residues (HZAU), MAO Key Laboratory for Detection of Veterinary Drug Residues, Huazhong Agricultural University, Wuhan, Hubei 430070, China
| | - Min Ling
- National Reference Laboratory of Veterinary Drug Residues (HZAU), MAO Key Laboratory for Detection of Veterinary Drug Residues, Huazhong Agricultural University, Wuhan, Hubei 430070, China
| | - Yixin Yu
- National Reference Laboratory of Veterinary Drug Residues (HZAU), MAO Key Laboratory for Detection of Veterinary Drug Residues, Huazhong Agricultural University, Wuhan, Hubei 430070, China
| | - Yanfei Tao
- National Reference Laboratory of Veterinary Drug Residues (HZAU), MAO Key Laboratory for Detection of Veterinary Drug Residues, Huazhong Agricultural University, Wuhan, Hubei 430070, China
| | - Xu Wang
- National Reference Laboratory of Veterinary Drug Residues (HZAU), MAO Key Laboratory for Detection of Veterinary Drug Residues, Huazhong Agricultural University, Wuhan, Hubei 430070, China; MOA Laboratory for Risk Assessment of Quality and Safety of Livestock and Poultry Products, Huazhong Agricultural University, Wuhan, Hubei 430070, China.
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Khosla S, Del Rios M, Chisolm-Straker M, Bilal S, Jang TB, Wang H, Hartley M, Loo GT, d'Etienne JP, Newgard CD, Courtney DM, Choo EK, Lin MP, Kline JA. Pandemic phase-related racial and ethnic disparities in COVID-19 positivity and outcomes among patients presenting to emergency departments during the first two pandemic waves in the USA. Emerg Med J 2024; 41:201-209. [PMID: 38429072 DOI: 10.1136/emermed-2023-213101] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 01/29/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND In many countries including the USA, the UK and Canada, the impact of COVID-19 on people of colour has been disproportionately high but examination of disparities in patients presenting to ED has been limited. We assessed racial and ethnic differences in COVID-19 positivity and outcomes in patients presenting to EDs in the USA, and the effect of the phase of the pandemic on these outcomes. METHODS This is a retrospective cohort study of adult patients tested for COVID-19 during, or 14 days prior to, the index ED visit in 2020. Data were obtained from the National Registry of Suspected COVID-19 in Emergency Care network which has data from 155 EDs across 27 US states. Hierarchical models were used to account for clustering by hospital. The outcomes included COVID-19 diagnosis, hospitalisation at index visit, subsequent hospitalisation within 30 days and 30-day mortality. We further stratified the analysis by time period (early phase: March-June 2020; late phase: July-September 2020). RESULTS Of the 26 111 adult patients, 38% were non-Hispanic White (NHW), 29% Black, 20% Hispanic/Latino, 3% Asian and 10% all others; half were female. The median age was 56 years (IQR 40-69), and 53% were diagnosed with COVID-19; of those, 59% were hospitalised at index visit. Of those discharged from ED, 47% had a subsequent hospitalisation in 30 days. Hispanic/Latino patients had twice (adjusted OR (aOR) 2.3; 95% CI 1.8 to 3.0) the odds of COVID-19 diagnosis than NHW patients, after adjusting for age, sex and comorbidities. Black, Asian and other minority groups also had higher odds of being diagnosed (compared with NHW patients). On stratification, this association was observed in both phases for Hispanic/Latino patients. Hispanic/Latino patients had lower odds of hospitalisation at index visit, but when stratified, this effect was only observed in early phase. Subsequent hospitalisation was more likely in Asian patients (aOR 3.1; 95% CI 1.1 to 8.7) in comparison with NHW patients. Subsequent ED visit was more likely in Blacks and Hispanic/Latino patients in late phase. CONCLUSION We found significant differences in ED outcomes that are not explained by comorbidity burden. The gap decreased but persisted during the later phase in 2020.
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Affiliation(s)
- Shaveta Khosla
- Emergency Medicine, University of Illinois Chicago, Chicago, Illinois, USA
| | - Marina Del Rios
- Emergency Medicine, University of Illinois Chicago, Chicago, Illinois, USA
- Emergency Medicine, University of Iowa, Iowa City, Iowa, USA
| | | | - Saadiyah Bilal
- Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Timothy B Jang
- Harbor-UCLA Medical Center, Emergency Medicine, David Geffen School of Medicine at UCLA, Torrance, California, USA
| | - Hao Wang
- Emergency Medicine, John Peter Smith Health Network, Fort Worth, Texas, USA
| | - Molly Hartley
- Portsmouth Regional Hospital, Portsmouth, New Hampshire, USA
| | - George T Loo
- Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - James P d'Etienne
- Emergency Medicine, John Peter Smith Health Network, Fort Worth, Texas, USA
| | - Craig D Newgard
- Emergency Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | | | - Esther K Choo
- Emergency Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Michelle P Lin
- Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Emergency Medicine, Stanford University, Stanford, California, USA
| | - Jeffrey A Kline
- Emergency Medicine, Wayne State University, Detroit, Michigan, USA
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Conte C, Cipponeri E, Roden M. Diabetes Mellitus, Energy Metabolism, and COVID-19. Endocr Rev 2024; 45:281-308. [PMID: 37934800 PMCID: PMC10911957 DOI: 10.1210/endrev/bnad032] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 08/30/2023] [Accepted: 11/01/2023] [Indexed: 11/09/2023]
Abstract
Obesity, diabetes mellitus (mostly type 2), and COVID-19 show mutual interactions because they are not only risk factors for both acute and chronic COVID-19 manifestations, but also because COVID-19 alters energy metabolism. Such metabolic alterations can lead to dysglycemia and long-lasting effects. Thus, the COVID-19 pandemic has the potential for a further rise of the diabetes pandemic. This review outlines how preexisting metabolic alterations spanning from excess visceral adipose tissue to hyperglycemia and overt diabetes may exacerbate COVID-19 severity. We also summarize the different effects of SARS-CoV-2 infection on the key organs and tissues orchestrating energy metabolism, including adipose tissue, liver, skeletal muscle, and pancreas. Last, we provide an integrative view of the metabolic derangements that occur during COVID-19. Altogether, this review allows for better understanding of the metabolic derangements occurring when a fire starts from a small flame, and thereby help reducing the impact of the COVID-19 pandemic.
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Affiliation(s)
- Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome 00166, Italy
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan 20099, Italy
| | - Elisa Cipponeri
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan 20099, Italy
| | - Michael Roden
- Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf 40225, Germany
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf 40225, Germany
- German Center for Diabetes Research, Partner Düsseldorf, Neuherberg 85764, Germany
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Alvarado M, Campos-Campos L, Guerrero-Romero F, Simental-Mendía LE. The Triglycerides and Glucose Index Is an Independent Risk Factor for Acute Respiratory Distress Syndrome in Patients with COVID-19. Metab Syndr Relat Disord 2024. [PMID: 38315780 DOI: 10.1089/met.2023.0247] [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: 02/07/2024] Open
Abstract
Introduction: Although it has been observed that the triglycerides and glucose (TyG) index, a biomarker of insulin resistance, is associated with severity and morbidity by COVID-19, evidence is still scarce. Therefore, the objective of this study was to determine whether the TyG index is associated with both the degree of severity and mortality by acute respiratory distress syndrome (ARDS) in patients with COVID-19. Methods: Men and women aged 20 years or more with diagnosis of COVID-19 were included in a case-control study. Exclusion criteria were pregnancy, cancer, autoimmune diseases, autoimmune treatment, and incomplete data. Patients with severe COVID-19 ARDS were allocated into the case group, and those with mild or moderate COVID-19 ARDS in the control group. COVID-19 was defined by a positive reverse transcriptase-polymerase chain reaction test for SARS-CoV-2, and ARDS was defined according to the Berlin criteria. Results: A total of 206 patients were included and allocated into the case (n = 103) and control (n = 103) groups. The logistic regression analysis adjusted by age, sex, and body mass index showed that the TyG index is significantly associated with moderate [odds ratio (OR) = 6.0; 95% confidence interval (CI): 1.1-30.6] and severe (OR = 9.5; 95% CI: 2.4-37.5) COVID-19 ARDS, and death (OR = 10.1; 95% CI: 2.2-46.5). Conclusion: The results of our study show a significant and independent association of the TyG index with ARDS and mortality in patients with COVID-19.
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Affiliation(s)
- Maria Alvarado
- Hospital General de Zona No. 1, Instituto Mexicano del Seguro Social, Durango, México
| | - Lizette Campos-Campos
- Hospital General de Zona No. 1, Instituto Mexicano del Seguro Social, Durango, México
| | - Fernando Guerrero-Romero
- Unidad de Investigación Biomédica, Delegación Durango, Instituto Mexicano del Seguro Social, Durango, México
| | - Luis E Simental-Mendía
- Unidad de Investigación Biomédica, Delegación Durango, Instituto Mexicano del Seguro Social, Durango, México
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Knauft K, Zilioli S, Tarraf W, Rorai V, Perry TE, Lichtenberg PA. Social connectedness in older Urban African-American adults during the COVID-19 pandemic: the roles of education and partnership. Aging Ment Health 2023:1-8. [PMID: 37986033 PMCID: PMC11102929 DOI: 10.1080/13607863.2023.2282682] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 11/03/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVE This study examined education, partnership status, and the moderating role of the lockdown period on social connectedness during the COVID-19 pandemic in a sample of urban African-American older adults. METHODS Five hundred thirty-four African-American adults living in Detroit (91.0% female, Mage = 74.53) reported demographic information pre-pandemic and answered one social connectedness questionnaire between April and December 2020. RESULTS Participants interviewed after the lockdown (post-June 2020) reported more loneliness than those interviewed during the lockdown (April-June, 2020). Married/partnered participants reported less loneliness and social isolation. Loneliness did not differ between those with high education levels interviewed during the lockdown compared to post-lockdown. However, among individuals with low education levels, those interviewed after the lockdown reported more loneliness than those interviewed during the lockdown period. CONCLUSION Our findings suggest partnership status is associated with more social connectedness during the pandemic and education accentuates the effects of forced isolation related to loneliness among urban African-American older adults.
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Affiliation(s)
| | - Samuele Zilioli
- Department of Psychology, Wayne State University
- Department of Family Medicine and Public Health Sciences, Wayne State University
| | | | | | - Tam E. Perry
- Institute of Gerontology, Wayne State University
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Corsini CA, Filgueiras PS, Almeida NB, Miranda DAD, Gomes SV, Lourenço AJ, Bicalho CM, Assis JVD, Amorim RN, Silva RA, Vilela RV, Lima TM, Abreu DPD, Alvim RG, Castilho LR, Martins-Filho OA, Otta DA, Grenfell RF. Antibody response and soluble mediator profile in the first six months following acute SARS-CoV-2 infection. Sci Rep 2023; 13:18606. [PMID: 37903875 PMCID: PMC10616118 DOI: 10.1038/s41598-023-43263-y] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/21/2023] [Indexed: 11/01/2023] Open
Abstract
The COVID-19 pandemic has caused a severe global health and economic crisis, with significant consequences for human mortality and morbidity. Therefore, there is an urgent need for more studies on the immune response to SARS-CoV-2 infection, both to enhance its effectiveness and prevent its deleterious effects. This study presents the chronology of antibodies during six months after infection in hospitalized patients and the kinetics of serum soluble mediators of the cellular response triggered by SARS-CoV-2. Samples and clinical data from 330 patients hospitalized at the Hospital da Baleia in Belo Horizonte, Brazil, who were suspected of having COVID-19, were collected at the time of hospitalization and during 6 months after infection. The immune response was analyzed by enzyme-linked immunosorbent assay (ELISA) and flow cytometry. There was a significant difference in IgM specific antibody titers from the 7th to 60th days after infection between COVID-19 negative and positive patients. Soon after 60 days after infection, antibody levels started to reduce, becoming similar to the antibody levels of the COVID-19 negative patients. IgG specific antibodies started to be detectable after 9 days of infection and antibody levels were comparatively higher in positive patients as soon as after 7 days. Furthermore, IgG levels remained higher in these patients during the complete period of 180 days after infection. The study observed similar antibody profiles between different patient groups. The soluble systemic biomarkers evaluated showed a decrease during the six months after hospitalization, except for CCL11, CXCL8, CCL3, CCL4, CCL5, IL-6, IFN-g, IL-17, IL-5, FGF-basic, PDGF, VEGF, G-CSF, and GM-CSF. The results indicate that IgM antibodies are more prominent in the early stages of infection, while IgG antibodies persist for a longer period. Additionally, the study identified that patients with COVID-19 have elevated levels of biomarkers after symptom onset, which decrease over time.
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Affiliation(s)
- Camila A Corsini
- Diagnosis and Therapy of Infectious Diseases and Cancer, Oswaldo Cruz Foundation (FIOCRUZ), 1715 Augusto de Lima Avenue, Belo Horizonte, Minas Gerais, 30190-002, Brazil
| | - Priscilla S Filgueiras
- Diagnosis and Therapy of Infectious Diseases and Cancer, Oswaldo Cruz Foundation (FIOCRUZ), 1715 Augusto de Lima Avenue, Belo Horizonte, Minas Gerais, 30190-002, Brazil
- Department of Pathology, College of Medicine, Federal University of Minas Gerais, 6627 Avenida Presidente Antônio Carlos, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Nathalie Bf Almeida
- Diagnosis and Therapy of Infectious Diseases and Cancer, Oswaldo Cruz Foundation (FIOCRUZ), 1715 Augusto de Lima Avenue, Belo Horizonte, Minas Gerais, 30190-002, Brazil
| | - Daniel Ap de Miranda
- Diagnosis and Therapy of Infectious Diseases and Cancer, Oswaldo Cruz Foundation (FIOCRUZ), 1715 Augusto de Lima Avenue, Belo Horizonte, Minas Gerais, 30190-002, Brazil
| | - Sarah Vc Gomes
- Diagnosis and Therapy of Infectious Diseases and Cancer, Oswaldo Cruz Foundation (FIOCRUZ), 1715 Augusto de Lima Avenue, Belo Horizonte, Minas Gerais, 30190-002, Brazil
| | - Adelina Junia Lourenço
- Diagnosis and Therapy of Infectious Diseases and Cancer, Oswaldo Cruz Foundation (FIOCRUZ), 1715 Augusto de Lima Avenue, Belo Horizonte, Minas Gerais, 30190-002, Brazil
- Hospital da Baleia, Benjamin Guimarães Foundation, 1464 Juramento Street, Belo Horizonte, Minas Gerais, 30285-408, Brazil
| | - Cecilia Mf Bicalho
- Hospital da Baleia, Benjamin Guimarães Foundation, 1464 Juramento Street, Belo Horizonte, Minas Gerais, 30285-408, Brazil
| | - Jessica V de Assis
- Diagnosis and Therapy of Infectious Diseases and Cancer, Oswaldo Cruz Foundation (FIOCRUZ), 1715 Augusto de Lima Avenue, Belo Horizonte, Minas Gerais, 30190-002, Brazil
- Department of Pathology, College of Medicine, Federal University of Minas Gerais, 6627 Avenida Presidente Antônio Carlos, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Raquel Nh Amorim
- Diagnosis and Therapy of Infectious Diseases and Cancer, Oswaldo Cruz Foundation (FIOCRUZ), 1715 Augusto de Lima Avenue, Belo Horizonte, Minas Gerais, 30190-002, Brazil
| | - Raphael A Silva
- Hospital da Baleia, Benjamin Guimarães Foundation, 1464 Juramento Street, Belo Horizonte, Minas Gerais, 30285-408, Brazil
| | - Raquel Vr Vilela
- Hospital da Baleia, Benjamin Guimarães Foundation, 1464 Juramento Street, Belo Horizonte, Minas Gerais, 30285-408, Brazil
| | - Tulio M Lima
- Cell Culture Engineering Laboratory, COPPE, Universidade Federal do Rio de Janeiro, 550 Pedro Calmon Avenue, Rio de Janeiro, Rio de Janeiro, 21941-598, Brazil
| | - Daniel Pb de Abreu
- Cell Culture Engineering Laboratory, COPPE, Universidade Federal do Rio de Janeiro, 550 Pedro Calmon Avenue, Rio de Janeiro, Rio de Janeiro, 21941-598, Brazil
| | - Renata Gf Alvim
- Cell Culture Engineering Laboratory, COPPE, Universidade Federal do Rio de Janeiro, 550 Pedro Calmon Avenue, Rio de Janeiro, Rio de Janeiro, 21941-598, Brazil
| | - Leda R Castilho
- Cell Culture Engineering Laboratory, COPPE, Universidade Federal do Rio de Janeiro, 550 Pedro Calmon Avenue, Rio de Janeiro, Rio de Janeiro, 21941-598, Brazil
| | - Olindo A Martins-Filho
- Grupo Integrado de Pesquisa em Biomarcadores, Oswaldo Cruz Foundation (FIOCRUZ), 1715 Augusto de Lima Avenue, Belo Horizonte, Minas Gerais, 30190-002, Brazil
| | - Dayane A Otta
- Grupo Integrado de Pesquisa em Biomarcadores, Oswaldo Cruz Foundation (FIOCRUZ), 1715 Augusto de Lima Avenue, Belo Horizonte, Minas Gerais, 30190-002, Brazil
| | - Rafaella Fq Grenfell
- Diagnosis and Therapy of Infectious Diseases and Cancer, Oswaldo Cruz Foundation (FIOCRUZ), 1715 Augusto de Lima Avenue, Belo Horizonte, Minas Gerais, 30190-002, Brazil.
- Department of Pathology, College of Medicine, Federal University of Minas Gerais, 6627 Avenida Presidente Antônio Carlos, Belo Horizonte, Minas Gerais, 31270-901, Brazil.
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, 501 DW Brooks Drive, Athens, GA, 30602-7387, USA.
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Cai Z, Wu X, Song Z, Sun S, Su Y, Wang T, Cheng X, Yu Y, Yu C, Chen E, Chen W, Yu Y, Linkermann A, Min J, Wang F. Metformin potentiates nephrotoxicity by promoting NETosis in response to renal ferroptosis. Cell Discov 2023; 9:104. [PMID: 37848438 PMCID: PMC10582023 DOI: 10.1038/s41421-023-00595-3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/16/2023] [Indexed: 10/19/2023] Open
Abstract
Given the rapidly aging population, aging-related diseases are becoming an excessive burden on the global healthcare system. Metformin has been shown to be beneficial to many age-related disorders, as well as increase lifespan in preclinical animal models. During the aging process, kidney function progressively declines. Currently, whether and how metformin protects the kidney remains unclear. In this study, among longevity drugs, including metformin, nicotinamide, resveratrol, rapamycin, and senolytics, we unexpectedly found that metformin, even at low doses, exacerbated experimentally-induced acute kidney injury (AKI) and increased mortality in mice. By single-cell transcriptomics analysis, we found that death of renal parenchymal cells together with an expansion of neutrophils occurs upon metformin treatment after AKI. We identified programmed cell death by ferroptosis in renal parenchymal cells and blocking ferroptosis, or depleting neutrophils protects against metformin-induced nephrotoxicity. Mechanistically, upon induction of AKI, ferroptosis in renal parenchymal cells initiates the migration of neutrophils to the site of injury via the surface receptor CXCR4-bound to metformin-iron-NGAL complex, which results in NETosis aggravated AKI. Finally, we demonstrated that reducing iron showed protective effects on kidney injury, which supports the notion that iron plays an important role in metformin-triggered AKI. Taken together, these findings delineate a novel mechanism underlying metformin-aggravated nephropathy and highlight the mechanistic relationship between iron, ferroptosis, and NETosis in the resulting AKI.
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Affiliation(s)
- Zhaoxian Cai
- The Second Affiliated Hospital, The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Cancer Center, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- The First Affiliated Hospital, Basic Medical Sciences, School of Public Health, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Xiaotian Wu
- The Second Affiliated Hospital, The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Cancer Center, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Zijun Song
- The Second Affiliated Hospital, The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Cancer Center, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Shumin Sun
- The Second Affiliated Hospital, The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Cancer Center, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yunxing Su
- The Second Affiliated Hospital, The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Cancer Center, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Tianyi Wang
- The First Affiliated Hospital, Basic Medical Sciences, School of Public Health, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Xihao Cheng
- The Second Affiliated Hospital, The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Cancer Center, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yingying Yu
- The Second Affiliated Hospital, The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Cancer Center, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Chao Yu
- The Second Affiliated Hospital, The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Cancer Center, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - En Chen
- College of Pharmaceutical Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Wenteng Chen
- College of Pharmaceutical Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yongping Yu
- College of Pharmaceutical Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Andreas Linkermann
- Division of Nephrology, Department of Internal Medicine III, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Dresden, Germany
- Division of Nephrology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Junxia Min
- The Second Affiliated Hospital, The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Cancer Center, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
| | - Fudi Wang
- The Second Affiliated Hospital, The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Cancer Center, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
- The First Affiliated Hospital, Basic Medical Sciences, School of Public Health, Hengyang Medical School, University of South China, Hengyang, Hunan, China.
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9
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Li X, Fan C, Tang J, Zhang N. Meta-analysis of liver injury in patients with COVID-19. Medicine (Baltimore) 2023; 102:e34320. [PMID: 37478243 PMCID: PMC10662882 DOI: 10.1097/md.0000000000034320] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 06/22/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) is a major public health problem threatening human health. It can lead to multiple system complications, among which liver damage is also a common complication of COVID-19. The pathogenesis of liver injury is complex and involves the interaction of multiple factors. This study aims to investigate the incidence and risk factors of liver injury in COVID-19 patients and analyze the impact of liver injury on clinical prognosis of patients, so as to provide corresponding basis for clinical diagnosis and treatment. METHODS PubMed and Cochrane Library were searched in computer to collect original studies on liver injury cases, laboratory indicators and clinical outcomes in COVID-19 patients. Articles were screened according to inclusion and exclusion criteria, and data were meta-analyzed using Stata12.0 software. RESULTS A total of 49 studies, including 23,611 patients with COVID-19, had a prevalence of liver injury of 39.63%. Subgroup analysis found that patients in the Americas had the highest incidence of liver injury at 43.7% and lowest in Africa (25.99%). The vast majority of liver injury is manifested by aminotransferase or bilirubin levels greater than 1 times the upper limit of normal (49.16%). The older the age, the male, the associated chronic liver disease, and the higher the levels of white blood cells, neutrophils, and C-reactive protein, the higher the risk of liver injury. The use of hormones, hydroxychloroquine, and tocilizumab increases the risk of liver injury. Patients with concurrent liver injury have longer hospital stays, are more likely to progress to severe cases, and have a higher risk of death than patients without liver injury. CONCLUSION The incidence of liver injury in COVID-19 patients was high, affected by age, gender, chronic liver disease, inflammatory state and medication, and patients with liver injury were hospitalized longer and were more likely to have a poor prognosis. Therefore, clinical attention should be paid to early intervention.
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Affiliation(s)
- Xinghai Li
- Department of Minimally Invasive Intervention, Ganzhou People’s Hospital, Ganzhou, China
| | - Caiping Fan
- Department of Minimally Invasive Intervention, Ganzhou People’s Hospital, Ganzhou, China
| | - Jin Tang
- Department of Gastroenterology, Ganzhou People’s Hospital, Ganzhou, China
| | - Ning Zhang
- Department of Gastroenterology, Ganzhou People’s Hospital, Ganzhou, China
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10
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Kim SJ. Relationship between nurses' knowledge of COVID-19, professional quality of life, and practice during the COVID-19 pandemic: A descriptive correlational study. PLoS One 2023; 18:e0287457. [PMID: 37347781 PMCID: PMC10286984 DOI: 10.1371/journal.pone.0287457] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 06/06/2023] [Indexed: 06/24/2023] Open
Abstract
The purpose of this study was to examine knowledge, professional quality of life, and practices among nurses during the coronavirus disease 2019 (COVID-19) pandemic and explore factors associated with nurses' practice. A total of 167 nurses were recruited from 4 general hospitals for this cross-sectional study, which was conducted from June to July 2021. Using SPSS/WIN 22, the collected data were analyzed using descriptive statistics, t-tests, analysis of variance, Pearson's correlation coefficients, and hierarchical multiple regression analysis. The mean age of the participants was 31.43, and the sample comprised 144 women (86.2%) and 23 men (13.8%). The results indicated that practice was negatively correlated with burnout (r = -.18, p = .017). The regression model explained 24.1% of the variance. For general characteristics in Model 1, education on COVID-19 management (β = .18, p = .014) was the factor most associated with nurses' practice. In Model 2, with professional quality of life added, burnout (β = -.21, p = .003) was the only influential factor. These results highlight the need to establish an effective prevention system for infectious diseases such as COVID-19, including education programs pertinent to the prevention and management of infection that improve the modifiable predictors of nurses' practice-education and burnout.
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Affiliation(s)
- Sun Ju Kim
- Chungnam National University Se-Jong Hospital, Sejong-si, Republic of Korea
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11
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Nambi G, Alghadier M, Vellaiyan A, Ebrahim EE, Aldhafian OR, Mohamed SHP, Albalawi HFA, Chevidikunnan MF, Khan F, Mani P, Saleh AK, Alshahrani NN. Role of Tele-Physical Therapy Training on Glycemic Control, Pulmonary Function, Physical Fitness, and Health-Related Quality of Life in Patients with Type 2 Diabetes Mellitus (T2DM) Following COVID-19 Infection-A Randomized Controlled Trial. Healthcare (Basel) 2023; 11:1791. [PMID: 37372908 DOI: 10.3390/healthcare11121791] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/08/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
The use of tele-rehabilitation (TR) in type 2 diabetes mellitus (T2DM) following COVID-19 infection remains unexplored. Hence, the purpose of this study was to determine the clinical effects of tele-physical therapy (TPT) on T2DM following COVID-19 infection. The eligible participants were randomized into two groups, a tele-physical therapy group (TPG; n = 68) and a control group (CG; n = 68). The TPG received tele-physical therapy for four sessions a week for eight weeks, and the CG received patient education for 10 min. The outcome measures were HbA1c levels, pulmonary function (forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), FEV1/FVC, maximum voluntary ventilation (MVV), and peak exploratory flow (PEF)), physical fitness, and quality of life (QOL). The difference between the groups in HbA1c levels at 8 weeks was 0.26 (CI 95% 0.02 to 0.49), which shows greater improvement in the tele-physical therapy group than the control group. Similar changes were noted between the two groups after 6 months and at 12 months resulting in 1.02 (CI 95% 0.86 to 1.17). The same effects were found in pulmonary function (FEV1, FVC, FEV1/FVC, MVV, and PEF), physical fitness, and QOL (p = 0.001). The reports of this study show that tele-physical therapy programs may result in improved glycemic control and improve the pulmonary function, physical fitness, and quality of life of T2DM patients following COVID-19 infection.
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Affiliation(s)
- Gopal Nambi
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
| | - Mshari Alghadier
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
| | - Arul Vellaiyan
- Department of Nursing, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
| | - Elturabi Elsayed Ebrahim
- Department of Nursing, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
| | - Osama R Aldhafian
- Department of Surgery, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
| | - Shahul Hameed Pakkir Mohamed
- Department of Physical Therapy, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk 71491, Saudi Arabia
| | - Hani Fahad Ateeq Albalawi
- Department of Physical Therapy, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk 71491, Saudi Arabia
| | - Mohamed Faisal Chevidikunnan
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Fayaz Khan
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Paramasivan Mani
- Department of Rehabilitation Sciences, King Saud Bin Abdulaziz University for Health Sciences, Al Mubaraz 36428, Saudi Arabia
| | - Ayman K Saleh
- Department of Surgery, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
- Department of Orthopedic, Faculty of Medicine for Girls, Al-Azhar University, Cairo 11651, Egypt
| | - Naif N Alshahrani
- Orthopedic Surgery Department, King Fahad Medical City, Ministry of Health, Riyadh 12231, Saudi Arabia
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12
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Abstract
Introduction The purpose of this study was to examine the sociodemographic and health-related factors associated with food insecurity and the association between food insecurity and COVID-19 infection using a nationally representative sample in the U.S. Methods Cross-sectional data of 61,050 adults (aged ≥18 years) from the 2020 and 2021 National Health Interview Survey were analyzed. Food insecurity was measured by the 10-item U.S. Department of Agriculture Food Security Survey Module. Weighted multivariable logistic regression models were used to estimate associations with food insecurity. Results A total of 6.8% of the National Health Interview Survey participants lived in food-insecure households, and 18.9% tested positive for COVID-19 infection. Young (aged 18-34 years) or middle (aged 35-64 years) age, female sex, minor race/ethnicity (Hispanic/non-Hispanic Black/non-Hispanic Asian/others), education level less than high school, unmarried status, unemployment, poverty (below the federal poverty level), having no health insurance, a larger number of adults and children in the household, poorer self-reported health status, and the presence of chronic conditions were significantly associated with food insecurity (AOR ranged from 1.20 to 3.15, all p<0.0001). Food insecurity was independently associated with positive COVID-19 infection (AOR=1.25, 95% CI=1.11, 1.40), controlling for sociodemographic and health-related factors. The greatest magnitude of the association was observed for the non-Hispanic Black participants (AOR=1.47, 95% CI=1.15, 1.88), female participants (AOR=1.44, 95% CI=1.20, 1.71), and those below the federal poverty level (AOR=1.39, 95% CI=1.12, 1.73) across all the subgroups. Conclusions Food insecurity disproportionately affected vulnerable subgroups such as young adults, female individuals, minority race/ethnicity groups, and those with lower socioeconomic status, and was associated with positive COVID-19 infection. Policies addressing food insecurity may help to reduce the likelihood of COVID-19 infection, especially for those vulnerable subgroups.
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Affiliation(s)
- Jiahui Cai
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington, Bloomington, Indiana
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13
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Paul A, Sharif MM, Bari MS, Miah MT, Amin MR, Mahanta J, Jabed MA, Zaman S, Upama RA, Nath TK. Comorbidity and Post-COVID-19 Complications of Hospitalized Patients in Bangladesh. Asia Pac J Public Health 2023; 35:318-319. [PMID: 36995082 PMCID: PMC10064188 DOI: 10.1177/10105395231164702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Affiliation(s)
- Alak Paul
- Department of Geography and Environmental Studies, University of Chittagong, Chittagong, Bangladesh
| | | | | | | | | | - Janardan Mahanta
- Department of Statistics, University of Chittagong, Chittagong, Bangladesh
| | - Md. Akib Jabed
- Center for Participatory Research and Development, Dhaka, Bangladesh
| | - Sifat Zaman
- Department of Geography and Environmental Studies, University of Chittagong, Chittagong, Bangladesh
| | - Romeo Afrin Upama
- Department of Geography and Environmental Studies, University of Chittagong, Chittagong, Bangladesh
| | - Tapan Kumar Nath
- School of Environmental and Geographical Sciences, University of Nottingham Malaysia, Semenyih, Malaysia
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14
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Widhani A, Koesnoe S, Maria S, Widjanarko AL, Karjadi TH, Hasibuan AS, Yunihastuti E, Rengganis I, Djauzi S. Factors Related to Severity, Hospitalization, and Mortality of COVID-19 Infection among Patients with Autoimmune Diseases. Trop Med Infect Dis 2023; 8:tropicalmed8040227. [PMID: 37104352 PMCID: PMC10145988 DOI: 10.3390/tropicalmed8040227] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/14/2023] [Accepted: 04/14/2023] [Indexed: 04/28/2023] Open
Abstract
Patients with an autoimmune disease could be at higher risk of a poor outcome when contracting COVID-19 infection due to aberrant immune responses and use of immunosuppressant therapies for chronic autoimmune treatment. Here, we conducted a retrospective study to identify the factors related to severity, hospitalization, and mortality among patients with autoimmune diseases. We found 165 cases of patients with pre-existing autoimmune diseases who had contracted COVID-19 between March 2020 and September 2022. Data on demographical characteristics; autoimmune diagnosis and treatment; COVID-19 vaccination status; and time, severity, and outcome of COVID-19 infection were collected. Most of the subjects were female (93.3%) and autoimmune diagnoses included systemic lupus erythematosus (54.5%), Sjogren's syndrome (33.5%), antiphospholipid syndrome (23%), vasculitis (5.5%), autoimmune thyroid disease (3.6%), rheumatoid arthritis (3.03%), and inflammatory bowel disease (3.03%) among other autoimmune diseases. There were four COVID-19-related deaths in this study. Factors associated with moderate to severe COVID-19 infection in patients with autoimmune diseases included not being vaccinated against COVID-19, taking a steroid of ≥10 mg prednisone-equivalent per day, and having a cardiovascular disease. Taking a steroid of ≥10 mg prednisone-equivalent per day was also associated with hospitalization in the event of COVID-19 infection, while cardiovascular diseases also showed a significant correlation to mortality in patients with autoimmune diseases who had been hospitalized with COVID-19 infection.
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Affiliation(s)
- Alvina Widhani
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
- Department of Internal Medicine, Universitas Indonesia Hospital, Depok 16424, Indonesia
| | - Sukamto Koesnoe
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
| | - Suzy Maria
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
| | - Annisa Layalia Widjanarko
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
| | - Teguh Harjono Karjadi
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
| | - Anshari Saifuddin Hasibuan
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
| | - Evy Yunihastuti
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
| | - Iris Rengganis
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
| | - Samsuridjal Djauzi
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
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Adjei-Fremah S, Lara N, Anwar A, Garcia DC, Hemaktiathar S, Ifebirinachi CB, Anwar M, Lin FC, Samuel R. The Effects of Race/Ethnicity, Age, and Area Deprivation Index (ADI) on COVID-19 Disease Early Dynamics: Washington, D.C. Case Study. J Racial Ethn Health Disparities 2023; 10:491-500. [PMID: 35169993 PMCID: PMC8853370 DOI: 10.1007/s40615-022-01238-1] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 12/23/2021] [Accepted: 01/10/2022] [Indexed: 12/24/2022]
Abstract
The COVID-19 pandemic and its associated mitigation strategies have significant psychosocial, behavioral, socioeconomic, and health impacts, particularly in vulnerable US populations. Different factors have been identified as influencers of the transmission rate; however, the effects of area deprivation index (as a measure of social determinants of health, SDoH) as a factor on COVID-19 disease early dynamics have not been established. We determined the effects of area deprivation index (ADI) and demographic factors on COVID-19 outcomes in Washington, D.C. This retrospective study used publicly available data on COVID-19 cases and mortality of Washington, D.C., during March 31st-July 4th, 2020. The main predictors included area deprivation index (ADI), age, and race/ethnicity. The ADI of each census block groups in D.C. (n=433) were obtained from Neighborhood Atlas map. Using a machine learning-based algorithm, the outcome variables were partitioned into time intervals: time duration (Pi, days), rate of change coefficient (Ei), and time segment load (Pi×Ei) for transmission rate and mortality. Correlation analysis and multiple linear regression models were used to determine associations between predictors and outcome variables. COVID-19 early transmission rate (E1) was highly correlated with ADI (SDoH; r= 0.88, p=0.0044) of the Washington, D.C. community. We also found positive association between ADI, age (0-17 years, r=0.91, p=0.0019), and race (African American/Black, r=0.86; p=0.0068) and COVID-19 outcomes. There was high variability in early transmission across the geographic regions (i.e., wards) of Washington, D.C., and this variability was driven by race/ethnic composition and ADI. Understanding the association of COVID-19 disease early transmission and mortality dynamics and key socio-demographic risk factors such as age, race, and ADI, as a measure of social determinants, will contribute to health equity/equality and distribution of economic resources/assistance and is essential for future predictive modeling of the COVID-19 pandemic to limit morbidity and mortality.
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Affiliation(s)
| | - Niara Lara
- North Carolina Agricultural and Technical State University, Greensboro, NC, USA
| | - Azreen Anwar
- North Carolina Agricultural and Technical State University, Greensboro, NC, USA
| | | | | | | | - Mohd Anwar
- North Carolina Agricultural and Technical State University, Greensboro, NC, USA
| | - Feng-Chang Lin
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Raymond Samuel
- North Carolina Agricultural and Technical State University, Greensboro, NC, USA
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16
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Su N, Donders MCHCM, Ho JPTF, Vespasiano V, de Lange J, Loos BG. Development and external validation of prediction models for critical outcomes of unvaccinated COVID-19 patients based on demographics, medical conditions and dental status. Heliyon 2023; 9:e15283. [PMID: 37064437 PMCID: PMC10084632 DOI: 10.1016/j.heliyon.2023.e15283] [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] [Received: 07/07/2022] [Revised: 03/18/2023] [Accepted: 03/31/2023] [Indexed: 04/18/2023] Open
Abstract
Background Multiple prediction models were developed for critical outcomes of COVID-19. However, prediction models using predictors which can be easily obtained in clinical practice and on dental status are scarce. Aim The study aimed to develop and externally validate prediction models for critical outcomes of COVID-19 for unvaccinated adult patients in hospital settings based on demographics, medical conditions, and dental status. Methods A total of 285 and 352 patients from two hospitals in the Netherlands were retrospectively included as derivation and validation cohorts. Demographics, medical conditions, and dental status were considered potential predictors. The critical outcomes (death and ICU admission) were considered endpoints. Logistic regression analyses were used to develop two models: for death alone and for critical outcomes. The performance and clinical values of the models were determined in both cohorts. Results Age, number of teeth, chronic kidney disease, hypertension, diabetes, and chronic obstructive pulmonary diseases were the significant independent predictors. The models showed good to excellent calibration with observed: expected (O:E) ratios of 0.98 (95%CI: 0.76 to 1.25) and 1.00 (95%CI: 0.80 to 1.24), and discrimination with shrunken area under the curve (AUC) values of 0.85 and 0.79, based on the derivation cohort. In the validation cohort, the models showed good to excellent discrimination with AUC values of 0.85 (95%CI: 0.80 to 0.90) and 0.78 (95%CI: 0.73 to 0.83), but an overestimation in calibration with O:E ratios of 0.65 (95%CI: 0.49 to 0.85) and 0.67 (95%CI: 0.52 to 0.84). Conclusion The performance of the models was acceptable in both derivation and validation cohorts. Number of teeth was an additive important predictor of critical outcomes of COVID-19. It is an easy-to-apply tool in hospitals for risk stratification of COVID-19 prognosis.
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Affiliation(s)
- Naichuan Su
- Department of Oral Public Health, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Marie-Chris H C M Donders
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, the Netherlands
- Department of Oral and Maxillofacial Surgery, Isala Zwolle, Zwolle, the Netherlands
| | - Jean-Pierre T F Ho
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, the Netherlands
- Department of Oral and Maxillofacial Surgery, Northwest Clinics, Alkmaar, the Netherlands
| | - Valeria Vespasiano
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, the Netherlands
| | - Jan de Lange
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, the Netherlands
- Department of Oral and Maxillofacial Surgery, Isala Zwolle, Zwolle, the Netherlands
| | - Bruno G Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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17
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SeyedAlinaghi S, Bagheri A, Razi A, Mojdeganlou P, Mojdeganlou H, Afsahi AM, Afzalian A, Paranjkhoo P, Shahidi R, Mirzapour P, Pashaei Z, Habibi MA, Shahbazi P, Nooralioghli Parikhani S, Farizani Gohari NS, Popoola Y, Mehraeen E, Hackett D. Late Complications of COVID-19; An Umbrella Review on Current Systematic Reviews. Arch Acad Emerg Med 2023; 11:e28. [PMID: 37215236 PMCID: PMC10197916 DOI: 10.22037/aaem.v11i1.1907] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Introduction Several clinical manifestations have been discovered for COVID-19 since the emergence of SARS-CoV-2, which can be classified into early, medium, and long-term complications. However, late complications can be present after recovery from acute COVID-19 illness. The present study aims to comprehensively review the available evidence of late complications related to COVID-19. Method A search was conducted, using keywords, through electronic databases, which included Scopus, Web of Science, PubMed, and Embase up to August 29, 2022. Study selection was performed according to a strict inclusion and exclusion criteria. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) checklist was followed, and studies were appraised using the National Institute of Health (NIH) quality assessment and risk of bias tool. Results In total, 50 studies were included, and nine distinct COVID-19 late complication categories were identified. A review of these studies revealed that neurologic and psychiatric (n=41), respiratory (n=27), musculoskeletal and rheumatologic (n=22), cardiovascular (n=9), and hepatic and gastrointestinal (n=6) complications were the most prevalent complications of long COVID-19. Conclusion Almost all human body systems are affected by late complications of COVID-19 with different severity and prevalence. Fatigue and some other neuropsychiatric symptoms are the most common late complications among long COVID-19 patients. Respiratory symptoms including dyspnea (during exercise), cough, and chest tightness were the next most prevalent long-term complications of COVID-19. Since these complications are persistent and late, being aware of the signs and symptoms is essential for the healthcare providers and patients.
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Affiliation(s)
- SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - AmirBehzad Bagheri
- Interdisciplinary Consortium on Advanced Motion Performance, Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Armin Razi
- School of medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hengameh Mojdeganlou
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Amir Masoud Afsahi
- Department of Radiology, School of Medicine, University of California, San Diego (UCSD), California, USA
| | - Arian Afzalian
- School of medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Parinaz Paranjkhoo
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan 0019, Armenia
| | - Ramin Shahidi
- School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Pegah Mirzapour
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Pashaei
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Habibi
- Clinical Research Development Center, Qom University of Medical Sciences, Qom, Iran
| | - Parmida Shahbazi
- Orthopedic Department, Orthopedic Surgery Research Center (OSRC), Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Yusuf Popoola
- Health Information Management Unit, Department of Computer Science, Adeleke University, Ede, Nigeria
| | - Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran
| | - Daniel Hackett
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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18
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Segalo S, Kiseljakovic E, Papic E, Joguncic A, Pasic A, Sahinagic M, Lepara O, Sporisevic L. The Role of Hemogram-derived Ratios in COVID-19 Severity Stratification in a Primary Healthcare Facility. Acta Inform Med 2023; 31:41-47. [PMID: 37038490 PMCID: PMC10082658 DOI: 10.5455/aim.2023.31.41-47] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 03/15/2023] [Indexed: 04/12/2023] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) can cause a wide clinical spectrum, ranging from asymptomatic to severe disease with a high mortality rate. In view of the current pandemic and the increasing influx of patients into healthcare facilities, there is a need to identify simple and reliable tools for stratifying patients. Objective Study aimed to analyze whether hemogram-derived ratios (HDRs) can be used to identify patients with a risk of developing a severe clinical form and admission to hospital. Methods This cross-sectional and observational study included 500 patients with a confirmed diagnosis of COVID-19. Data on clinical features and laboratory parameters were collected from medical records and 13 HDRs were calculated and analyzed. Descriptive and inferential statistics were included in the analysis. Results Of the 500 patients, 43.8% had a severe form of the disease. Lymphocytopenia, monocytopenia, higher C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were found in severe patients (p < 0.05). Significantly higher neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), neutrophil-to-platelet ratio (NPR), neutrophil-to-lymphocyte-to-platelet ratio (NLPR) and CRP-to-lymphocyte ratio (CRP/Ly) values were found in severe patients (p < 0.001). In addition, they have statistically significant prognostic potential (p < 0.001). The area under the curve (AUC) for CRP/Ly, dNLR, NLPR, NLR, and NPR were 0.693, 0.619, 0.619, 0.616, and 0.603, respectively. The sensitivity and specificity were 65.7% and 65.6% for CRP/Ly, 51.6% and 70.8 for dNLR, 61.6% and 57.3% for NLPR, 40.6% and 80.4% for NLR, and 48.8% and 69.1% for NPR. Conclusion The results of the study suggest that NLR, dNLR, CRP/Ly, NPR, and NLPR can be considered as potentially useful markers for stratifying patients with a severe form of the disease. HDRs derived from routine blood tests results should be included in common laboratory practice since they are readily available, easy to calculate, and inexpensive.
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Affiliation(s)
- Sabina Segalo
- University of Sarajevo, Faculty of Health Studies, Sarajevo, Bosnia and Herzegovina
| | - Emina Kiseljakovic
- University of Sarajevo, Faculty of Medicine, Sarajevo, Bosnia and Herzegovina
| | - Emsel Papic
- University of Sarajevo, Faculty of Health Studies, Sarajevo, Bosnia and Herzegovina
| | - Anes Joguncic
- University of Sarajevo, Faculty of Health Studies, Sarajevo, Bosnia and Herzegovina
- Public Health Institute of Canton Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Aleksandra Pasic
- University of Sarajevo, Faculty of Health Studies, Sarajevo, Bosnia and Herzegovina
- Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Mubera Sahinagic
- Public Institution Medical Center of Sarajevo Canton, Sarajevo, Bosnia and Herzegovina
| | - Orhan Lepara
- University of Sarajevo, Faculty of Medicine, Sarajevo, Bosnia and Herzegovina
| | - Lutvo Sporisevic
- Public Institution Medical Center of Sarajevo Canton, Sarajevo, Bosnia and Herzegovina
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19
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Yang T, Wang SC, Ye L, Maimaitiyiming Y, Naranmandura H. Targeting viral proteins for restraining SARS-CoV-2: focusing lens on viral proteins beyond spike for discovering new drug targets. Expert Opin Drug Discov 2023; 18:247-268. [PMID: 36723288 DOI: 10.1080/17460441.2023.2175812] [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: 02/02/2023]
Abstract
INTRODUCTION Emergence of highly infectious SARS-CoV-2 variants are reducing protection provided by current vaccines, requiring constant updates in antiviral approaches. The virus encodes four structural and sixteen nonstructural proteins which play important roles in viral genome replication and transcription, virion assembly, release , entry into cells, and compromising host cellular defenses. As alien proteins to host cells, many viral proteins represent potential targets for combating the SARS-CoV-2. AREAS COVERED Based on literature from PubMed and Web of Science databases, the authors summarize the typical characteristics of SARS-CoV-2 from the whole viral particle to the individual viral proteins and their corresponding functions in virus life cycle. The authors also discuss the potential and emerging targeted interventions to curb virus replication and spread in detail to provide unique insights into SARS-CoV-2 infection and countermeasures against it. EXPERT OPINION Our comprehensive analysis highlights the rationale to focus on non-spike viral proteins that are less mutated but have important functions. Examples of this include: structural proteins (e.g. nucleocapsid protein, envelope protein) and extensively-concerned nonstructural proteins (e.g. NSP3, NSP5, NSP12) along with the ones with relatively less attention (e.g. NSP1, NSP10, NSP14 and NSP16), for developing novel drugs to overcome resistance of SARS-CoV-2 variants to preexisting vaccines and antibody-based treatments.
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Affiliation(s)
- Tao Yang
- Department of Hematology of First Affiliated Hospital, and Department of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Si Chun Wang
- Department of Hematology of First Affiliated Hospital, and Department of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Linyan Ye
- Department of Hematology of First Affiliated Hospital, and Department of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yasen Maimaitiyiming
- Department of Hematology of First Affiliated Hospital, and Department of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Zhejiang Province Key Laboratory of Haematology Oncology Diagnosis and Treatment, Hangzhou, Zhejiang, China.,Department of Neurobiology, NHC and CAMS Key Laboratory of Medical Neurobiology, School of Brain Science and Brain Medicine, and MOE Frontier Science Center for Brain Science and Brain-machine Integration, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Hua Naranmandura
- Department of Hematology of First Affiliated Hospital, and Department of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.,Zhejiang Province Key Laboratory of Haematology Oncology Diagnosis and Treatment, Hangzhou, Zhejiang, China.,Cancer Center, Zhejiang University, Hangzhou, Zhejiang, China
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20
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Filev R, Lyubomirova M, Hristova J, Bogov B, Kalinov K, Sviranov D, Rostaing L. Serum and Urinary Biomarkers in COVID-19 Patients with or without Baseline Chronic Kidney Disease. J Pers Med 2023; 13:382. [PMID: 36983566 PMCID: PMC10051063 DOI: 10.3390/jpm13030382] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
In a prospective, observational, non-interventional, single-center study, we assessed various plasma and urinary biomarkers of kidney injury (neutrophil gelatinase-associated Lipocain [NGAL], kidney-injury molecule-1 [KIM-1], and interleukin-18 [IL-18]); inflammation (IL-6, C-reactive protein [CRP]); plus angiotensin converting enzyme 2 (ACE2) in 120 COVID-19 patients (of whom 70 had chronic kidney disease (CKD) at emergency-department (ED) admission). Our aim was to correlate the biomarkers with the outcomes (death, acute kidney injury [AKI]). All patients had received a chest-CT scan at admission to calculate the severity score (0–5). Biomarkers were also assessed in healthy volunteers and non-COVID-19-CKD patients. These biomarkers statistically differed across subgroups, i.e., they were significantly increased in COVID-19 patients, except for urinary (u)KIM1 and uIL-18. Amongst the biomarkers, only IL-6 was independently associated with mortality, along with AKI and not using remdesivir. Regarding the prediction of AKI, only IL-6 and uKIM1 were significantly elevated in patients presenting with AKI. However, AKI could not be predicted. Having high baseline IL-6 levels was associated with subsequent ventilation requirement and death. The mortality rate was almost 90% when the chest CT-scan severity score was 3 or 4 vs. 6.8% when the severity score was 0–2 (p < 0.0001).
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21
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Qamar MA, Kogut LM, Tebha SS, Arif A, Ninmol J, Abdul Razzaque MR, Qamar K, Yosufi A. Collapsing focal segmental glomerulosclerosis secondary to COVID-19: A systematic review and meta-analysis. Ann Med Surg (Lond) 2023; 85:92-101. [PMID: 36845824 DOI: 10.1097/MS9.0000000000000107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 12/22/2022] [Indexed: 02/28/2023] Open
Abstract
The renal system manifestations of coronavirus disease-2019 have been documented extensively; however, scientific literature remains scarce regarding collapsing glomerulopathy hence the need for this investigation. Methods A comprehensive review was conducted covering a timeline from 1 January 2020 to 5 February 2022 without any restrictions. The data extraction was conducted independently, and articles were assessed for the risk of bias. Data analysis was conducted using Comprehensive Meta-Analysis version 3.3.070 and RevMan version 5.4 for pooled proportions and risk ratio (RR) between dialysis-dependent and independent treatment groups with a P-value less than 0.05 considered significant. Results A total of 38 studies were included in this review, including 74 (65.9%) males. The mean age was 54.2 years old. The most common symptoms reported were related to the respiratory system (59.6%, 95% CI: 50.4-68.2%) and hematuria (34.2%, 95% CI: 26.1-43.4). Antibiotics (25.9%, 95% CI: 12.9-45.3%) was the commonest management used. Proteinuria was the most reported laboratory finding at 89.5% (95% CI: 82.4-93.9%), while the commonest microscopic finding was acute tubular injury (77.2%, 95% CI: 68.6-84.0%). An increased risk of the presence of symptoms (P=0.005) and microscopic findings (P=0.0003) related to collapsing glomerulopathy in dialysis-dependent group was noted with increased management (P=0.01) used in this group for coronavirus disease-2019 infection. Conclusion The findings of this study portray the prognostic value of the variables (symptoms and microscopic findings, etc.) reported in the analysis. Hence this study serves as a foundation for future investigations that minimize the study's limitations to provide a more robust conclusion.
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22
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Zanon M, Neri M, Pizzolitto S, Radaelli D, Concato M, Peruch M, D'Errico S. Liver pathology in COVID-19 related death and leading role of autopsy in the pandemic. World J Gastroenterol 2023; 29:200-220. [PMID: 36683722 PMCID: PMC9850946 DOI: 10.3748/wjg.v29.i1.200] [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] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/14/2022] [Accepted: 12/21/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Information on liver involvement in patients with coronavirus disease 2019 is currently fragmented.
AIM To highlight the pathological changes found during the autopsy of severe acute respiratory syndrome coronavirus 2 positive patients.
METHODS A systematic literature search on PubMed was carried out until June 21, 2022.
RESULTS A literature review reveals that pre-existing liver disease and elevation of liver enzyme in these patients are not common; liver enzyme elevations tend to be seen in those in critical conditions. Despite the poor expression of viral receptors in the liver, it seems that the virus is able to infect this organ and therefore cause liver damage. Unfortunately, to date, the search for the virus inside the liver is not frequent (16% of the cases) and only a small number show the presence of the virus. In most of the autopsy cases, macroscopic assessment is lacking, while microscopic evaluation of livers has revealed the frequent presence of congestion (42.7%) and steatosis (41.6%). Less frequent is the finding of hepatic inflammation or necrosis (19%) and portal inflammation (18%). The presence of microthrombi, frequently found in the lungs, is infrequent in the liver, with only 12% of cases presenting thrombotic formations within the vascular tree.
CONCLUSION To date, the greatest problem in interpreting these modifications remains the association of the damage with the direct action of the virus, rather than with the inflammation or alterations induced by hypoxia and hypovolemia in patients undergoing oxygen therapy and decompensated patients.
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Affiliation(s)
- Martina Zanon
- Department of Medical Surgical and Health Sciences, University of Trieste, Trieste 34149, Italy
| | - Margherita Neri
- Department of Medical Sciences, University of Ferrara, Ferrara 44121, Italy
| | - Stefano Pizzolitto
- Department of Pathology, Santa Maria della Misericordia University Hospital, Udine 33100, Italy
| | - Davide Radaelli
- Department of Medical Surgical and Health Sciences, University of Trieste, Trieste 34149, Italy
| | - Monica Concato
- Department of Medical Surgical and Health Sciences, University of Trieste, Trieste 34149, Italy
| | - Michela Peruch
- Department of Medical Surgical and Health Sciences, University of Trieste, Trieste 34149, Italy
| | - Stefano D'Errico
- Department of Medical Surgical and Health Sciences, University of Trieste, Trieste 34149, Italy
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23
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Abstract
The maintenance of iron homeostasis is essential for proper cardiac function. A growing body of evidence suggests that iron imbalance is the common denominator in many subtypes of cardiovascular disease. In the past 10 years, ferroptosis, an iron-dependent form of regulated cell death, has become increasingly recognized as an important process that mediates the pathogenesis and progression of numerous cardiovascular diseases, including atherosclerosis, drug-induced heart failure, myocardial ischaemia-reperfusion injury, sepsis-induced cardiomyopathy, arrhythmia and diabetic cardiomyopathy. Therefore, a thorough understanding of the mechanisms involved in the regulation of iron metabolism and ferroptosis in cardiomyocytes might lead to improvements in disease management. In this Review, we summarize the relationship between the metabolic and molecular pathways of iron signalling and ferroptosis in the context of cardiovascular disease. We also discuss the potential targets of ferroptosis in the treatment of cardiovascular disease and describe the current limitations and future directions of these novel treatment targets.
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Affiliation(s)
- Xuexian Fang
- grid.410595.c0000 0001 2230 9154Department of Nutrition and Toxicology, School of Public Health, State Key Laboratory of Experimental Hematology, Hangzhou Normal University, Hangzhou, China ,grid.13402.340000 0004 1759 700XThe Fourth Affiliated Hospital, The First Affiliated Hospital, Institute of Translational Medicine, School of Public Health, Cancer Center, State Key Laboratory of Experimental Hematology, Zhejiang University School of Medicine, Hangzhou, China ,grid.412017.10000 0001 0266 8918The First Affiliated Hospital, The Second Affiliated Hospital, Basic Medical Sciences, School of Public Health, Hengyang Medical School, University of South China, Hengyang, China
| | - Hossein Ardehali
- grid.16753.360000 0001 2299 3507Feinberg Cardiovascular and Renal Research Institute, Northwestern University, Chicago, IL USA
| | - Junxia Min
- The Fourth Affiliated Hospital, The First Affiliated Hospital, Institute of Translational Medicine, School of Public Health, Cancer Center, State Key Laboratory of Experimental Hematology, Zhejiang University School of Medicine, Hangzhou, China.
| | - Fudi Wang
- The Fourth Affiliated Hospital, The First Affiliated Hospital, Institute of Translational Medicine, School of Public Health, Cancer Center, State Key Laboratory of Experimental Hematology, Zhejiang University School of Medicine, Hangzhou, China. .,The First Affiliated Hospital, The Second Affiliated Hospital, Basic Medical Sciences, School of Public Health, Hengyang Medical School, University of South China, Hengyang, China.
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24
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Trajanoska M, Trajanov R, Eftimov T. Dietary, comorbidity, and geo-economic data fusion for explainable COVID-19 mortality prediction. Expert Syst Appl 2022; 209:118377. [PMID: 35945970 PMCID: PMC9352652 DOI: 10.1016/j.eswa.2022.118377] [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] [Received: 12/05/2021] [Revised: 07/08/2022] [Accepted: 08/01/2022] [Indexed: 06/15/2023]
Abstract
Many factors significantly influence the outcomes of infectious diseases such as COVID-19. A significant focus needs to be put on dietary habits as environmental factors since it has been deemed that imbalanced diets contribute to chronic diseases. However, not enough effort has been made in order to assess these relations. So far, studies in the field have shown that comorbid conditions influence the severity of COVID-19 symptoms in infected patients. Furthermore, COVID-19 has exhibited seasonal patterns in its spread; therefore, considering weather-related factors in the analysis of the mortality rates might introduce a more relevant explanation of the disease's progression. In this work, we provide an explainable analysis of the global risk factors for COVID-19 mortality on a national scale, considering dietary habits fused with data on past comorbidity prevalence and environmental factors such as seasonally averaged temperature geolocation, economic and development indices, undernourished and obesity rates. The innovation in this paper lies in the explainability of the obtained results and is equally essential in the data fusion methods and the broad context considered in the analysis. Apart from a country's age and gender distribution, which has already been proven to influence COVID-19 mortality rates, our empirical analysis shows that countries with imbalanced dietary habits generally tend to have higher COVID-19 mortality predictions. Ultimately, we show that the fusion of the dietary data set with the geo-economic variables provides more accurate modeling of the country-wise COVID-19 mortality rates with respect to considering only dietary habits, proving the hypothesis that fusing factors from different contexts contribute to a better descriptive analysis of the COVID-19 mortality rates.
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Affiliation(s)
- Milena Trajanoska
- Faculty of Computer Science and Engineering, Ss. Cyril and Methodius, University - Skopje, 1000, Macedonia
| | - Risto Trajanov
- Faculty of Computer Science and Engineering, Ss. Cyril and Methodius, University - Skopje, 1000, Macedonia
| | - Tome Eftimov
- Computer Systems Department, Jožef Stefan Institute, Ljubljana 1000, Slovenia
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25
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Filev R, Rostaing L, Lyubomirova M, Bogov B, Kalinov K, Svinarov D. Renin-angiotensin-aldosterone system blockers in Bulgarian COVID-19 patients with or without chronic kidney disease. Medicine (Baltimore) 2022; 101:e31988. [PMID: 36482641 PMCID: PMC9726321 DOI: 10.1097/md.0000000000031988] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
When angiotensin-converting enzyme inhibitor/angiotensin receptor blocker-treated patients present with SARS-CoV-2 infection there is a debate to know whether renin-angiotensin-aldosterone (RAAS) blockers should be stopped or not. We conducted a prospective observational study in Bulgarian COVID-19-infected patients with or without chronic kidney disease (CKD) to assess whether maintenance RAAS blocker therapy has an impact on SARS-CoV-2 infection and its complications. We included 120 in-patient COVID-19 subjects, of whom 70 had CKD and 50 had normal renal function. A total of 30% of the patients (total number of 36 patients, 21 females) were receiving RAAS therapy at admission and it was maintained throughout hospitalization. The overall mortality was 19.2% (23 patients); there was no significant difference across the 2 groups (P-value = .21), except in RAAS blockers-treated hypertensive patients who had a significantly lower mortality as compared to non-RAAS-blockers-treated hypertensive patients (P = .04). Regarding subsequent intensive-care unit admission, there were 50% less patients in the RAAS group (4 out of 36, i.e., 11%) as compared to 19 out of 84 from the non-RAAS group, that is, 22.6% (P = .29). Overall, 37 patients developed acute kidney injury (any stage by KDIGO); of them 14 (37.8%) were receiving RAAS blockers. Acute kidney injury was not significantly associated with the use of RAAS blockers (P-value = .28). Likewise, both in non-CKD and in CKD patients the use of RAAS blockers did not have an impact on renal function recovery after SARS-CoV-2 infection. Finally, regarding RAAS blockers and the biological parameters outcome only D-dimers were significantly lower at the follow-up as compared to that in non-RAAS blocker treated patients. RAAS blockers benefited patients with hypertension by lowering mortality rate. Other than that, RAAS blocker therapy continuation during SARS-CoV-2 infection in CKD and non-CKD patients had no significant impact upon major outcomes.
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Affiliation(s)
- Rumen Filev
- Department of Nephrology, Internal disease Clinic, University Hospital “Saint Anna,” Sofia, Bulgaria
- Medical University Sofia, Bulgaria
| | - Lionel Rostaing
- Nephrology, Hemodialysis, Apheresis and Kidney Transplantation Department, Grenoble University Hospital, Grenoble, France
- Grenoble Alpes University, Grenoble, France
- * Correspondence: Lionel Rostaing, Nephrology, Hemodialysis, Apheresis and Kidney Transplantation Department, Grenoble University Hospital, Grenoble, France (e-mail: )
| | - Mila Lyubomirova
- Department of Nephrology, Internal disease Clinic, University Hospital “Saint Anna,” Sofia, Bulgaria
- Medical University Sofia, Bulgaria
| | - Boris Bogov
- Department of Nephrology, Internal disease Clinic, University Hospital “Saint Anna,” Sofia, Bulgaria
- Medical University Sofia, Bulgaria
| | | | - Dobrin Svinarov
- Medical University Sofia, Bulgaria
- Department of Clinical Laboratory, University Hospital “Alexandrovska,” Sofia, Bulgaria
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Heinzl MW, Kolenchery L, Resl M, Klammer C, Black A, Obendorf F, Schinagl L, Feldbauer R, Pohlhammer J, Wagner T, Berger T, Dieplinger B, Clodi M. High Anti-CoV2S Antibody Levels at Hospitalization Are Associated with Improved Survival in Patients with COVID-19 Vaccine Breakthrough Infection. Int J Environ Res Public Health 2022; 19:15581. [PMID: 36497655 PMCID: PMC9740194 DOI: 10.3390/ijerph192315581] [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] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Although vaccination against COVID-19 is highly effective, breakthrough infections occur, often leading to severe courses and death. The extent of protection provided by individual antibody levels in breakthrough infections is still unknown and cut-off levels have yet to be determined. METHODS In 80 consecutive fully vaccinated patients hospitalized between August and December 2021 with COVID-19 breakthrough infection (Delta variant), anti-CoV2S antibody levels were analyzed for the endpoint of death. RESULTS Ten out of the 12 patients who died (83.3%) had antibody levels < 600 U/mL; 5 (41.7%) of these had antibody levels < 200 U/mL. Only 2 patients with a level of >600 U/mL died from vaccine breakthrough infection. Correction for the number of comorbidities and age revealed that anti-CoV2S antibody levels at the time of hospitalization were a significant predictor for reduced risk of death (OR = 0.402 for every 1000 U/mL, p = 0.018). CONCLUSIONS In this retrospective data analysis, we show that almost all patients who died from COVID-19 vaccine breakthrough infection had antibody levels < 600 U/mL, most of them below 200 U/mL. In logistic regression corrected for the number of comorbidities and age, anti-CoV2S antibody levels at the time of hospitalization proved to be a significantly protective predictor against death.
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Affiliation(s)
- Matthias Wolfgang Heinzl
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
- ICMR—Institute for Cardiovascular and Metabolic Research, Johannes Kepler Universität Linz (JKU Linz), 4020 Linz, Austria
| | - Lisa Kolenchery
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
- ICMR—Institute for Cardiovascular and Metabolic Research, Johannes Kepler Universität Linz (JKU Linz), 4020 Linz, Austria
| | - Michael Resl
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
- ICMR—Institute for Cardiovascular and Metabolic Research, Johannes Kepler Universität Linz (JKU Linz), 4020 Linz, Austria
| | - Carmen Klammer
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
- ICMR—Institute for Cardiovascular and Metabolic Research, Johannes Kepler Universität Linz (JKU Linz), 4020 Linz, Austria
| | - Anne Black
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
| | - Florian Obendorf
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
| | - Lukas Schinagl
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
- ICMR—Institute for Cardiovascular and Metabolic Research, Johannes Kepler Universität Linz (JKU Linz), 4020 Linz, Austria
| | - Roland Feldbauer
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
| | - Johannes Pohlhammer
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
| | - Thomas Wagner
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
| | - Thomas Berger
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
| | - Benjamin Dieplinger
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
| | - Martin Clodi
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
- ICMR—Institute for Cardiovascular and Metabolic Research, Johannes Kepler Universität Linz (JKU Linz), 4020 Linz, Austria
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Llauradó G, Vlacho B, Wargny M, Ruan Y, Franch-Nadal J, Domingo P, Gourdy P, Saulnier PJ, Hadjadj S, Wild SH, Rea R, Cariou B, Khunti K, Mauricio D; CORONADO, the ABCD COVID-19 diabetes national audit, HM Hospitales investigators and the Hospital del Mar - Hospital de la Santa Creu i Sant Pau Diabetes Research Group. The association between macrovascular complications and intensive care admission, invasive mechanical ventilation, and mortality in people with diabetes hospitalized for coronavirus disease-2019 (COVID-19). Cardiovasc Diabetol 2022; 21:216. [PMID: 36261811 DOI: 10.1186/s12933-022-01657-8] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 09/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is not clear whether pre-existing macrovascular complications (ischemic heart disease, stroke or peripheral artery disease) are associated with health outcomes in people with diabetes mellitus hospitalized for COVID-19. METHODS We conducted cohort studies of adults with pre-existing diabetes hospitalized for COVID-19 infection in the UK, France, and Spain during the early phase of the pandemic (between March 2020-October 2020). Logistic regression models adjusted for demographic factors and other comorbidities were used to determine associations between previous macrovascular disease and relevant clinical outcomes: mortality, intensive care unit (ICU) admission and use of invasive mechanical ventilation (IMV) during the hospitalization. Output from individual logistic regression models for each cohort was combined in a meta-analysis. RESULTS Complete data were available for 4,106 (60.4%) individuals. Of these, 1,652 (40.2%) had any prior macrovascular disease of whom 28.5% of patients died. Mortality was higher for people with compared to those without previous macrovascular disease (37.7% vs 22.4%). The combined crude odds ratio (OR) for previous macrovascular disease and mortality for all four cohorts was 2.12 (95% CI 1.83-2.45 with an I2 of 60%, reduced after adjustments for age, sex, type of diabetes, hypertension, microvascular disease, ethnicity, and BMI to adjusted OR 1.53 [95% CI 1.29-1.81]) for the three cohorts. Further analysis revealed that ischemic heart disease and cerebrovascular disease were the main contributors of adverse outcomes. However, proportions of people admitted to ICU (adjOR 0.48 [95% CI 0.31-0.75], I2 60%) and the use of IMV during hospitalization (adjOR 0.52 [95% CI 0.40-0.68], I2 37%) were significantly lower for people with previous macrovascular disease. CONCLUSIONS This large multinational study of people with diabetes mellitus hospitalized for COVID-19 demonstrates that previous macrovascular disease is associated with higher mortality and lower proportions admitted to ICU and treated with IMV during hospitalization suggesting selective admission criteria. Our findings highlight the importance correctly assess the prognosis and intensive monitoring in this high-risk group of patients and emphasize the need to design specific public health programs aimed to prevent SARS-CoV-2 infection in this subgroup.
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Afraie M, Mohammadzedeh P, Azami M, Khateri S, Zamani K, Moradpour F, Moradi Y. The association of chronic liver disorders with exacerbation of symptoms and complications related to COVID‐19: A systematic review and meta‐analysis of cohort studies. Clinical Respiratory J 2022; 16:777-792. [DOI: 10.1111/crj.13552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/15/2022] [Accepted: 10/05/2022] [Indexed: 11/07/2022]
Affiliation(s)
- Maryam Afraie
- Department of Epidemiology and Biostatistics, Faculty of Medicine Kurdistan University of Medical Sciences Sanandaj Iran
| | - Pardis Mohammadzedeh
- Department of Epidemiology and Biostatistics, Faculty of Medicine Kurdistan University of Medical Sciences Sanandaj Iran
| | - Mobin Azami
- Student Research Committee Kurdistan University of Medical Sciences Sanandaj Iran
| | - Sorour Khateri
- Department of Physical Medicine and Rehabilitation Hamedan University of Medical Sciences Hamedan Iran
| | - Kamran Zamani
- Student Research Committee Kurdistan University of Medical Sciences Sanandaj Iran
| | - Farhad Moradpour
- Social Determinants of Health Research Center, Research Institute for Health Development Kurdistan University of Medical Sciences Sanandaj Iran
| | - Yousef Moradi
- Social Determinants of Health Research Center, Research Institute for Health Development Kurdistan University of Medical Sciences Sanandaj Iran
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Kopańska M, Kuduk B, Łagowska A, Mytych W, Muchacka R, Banaś-Za̧bczyk A. Quantitative electroencephalography interpretation of human brain activity after COVID-19 before and after Sudarshan Kriya Yoga. Front Hum Neurosci 2022; 16:988021. [PMID: 36277052 PMCID: PMC9585660 DOI: 10.3389/fnhum.2022.988021] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 09/12/2022] [Indexed: 12/02/2022] Open
Abstract
The COVID-19 pandemic has affected the entire world. The SARS-CoV-2 virus is wreaking havoc globally, leading to serious health problems and even death. The purpose of this study is to present the brainwave variability pattern using QEEG after exposure to COVID-19 and to introduce the subject of the Sudarshan Kriya Yoga (SKY)-based breathing technique. QEEG is one of the basic neurological examinations through which we can compare the changes in the nervous system after SARS-CoV-2 virus infection and observe the variation of brainwave frequencies with a breathing technique.
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Affiliation(s)
- Marta Kopańska
- Department of Pathophysiology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
- *Correspondence: Marta Kopańska
| | - Barbara Kuduk
- Student's Science Club “Reh-Tech”, University of Rzeszow, Rzeszow, Poland
| | - Anna Łagowska
- Student's Science Club “Reh-Tech”, University of Rzeszow, Rzeszow, Poland
| | - Wiktoria Mytych
- Student's Science Club “Reh-Tech”, University of Rzeszow, Rzeszow, Poland
| | - Renata Muchacka
- Department of Animal Physiology and Toxicology, Pedagogical University of Cracow, Kraków, Poland
| | - Agnieszka Banaś-Za̧bczyk
- Department of Biology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
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Alnamshan MM. Potential histopathological and immunological effects of SARS-CoV-2 on the liver. BRAZ J BIOL 2022; 82:e262008. [PMID: 36074418 DOI: 10.1590/1519-6984.262008] [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: 03/17/2022] [Accepted: 07/05/2022] [Indexed: 12/15/2022] Open
Abstract
The coronavirus disease outbreak of 2019 (COVID-19) poses a serious threat to public health worldwide. Lung injury is the most common complication of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. However, other organs, including the liver, can also be affected. Currently, there is limited evidence that liver impairment is associated with severe SARS-CoV-2 infection. Clinicians will need to determine whether liver injury is caused by an underlying liver condition, COVID-19 therapy, the virus directly, or immune-mediated inflammation or represents a complicated disease course in the context of COVID-19. To address the scarcity of data on histopathological changes and immunological effects on the liver with COVID-19 positivity, we analyze and summarize recent findings. We searched PubMed, Medline, Google Scholar, Science Direct, Scopus, and Web of Science databases up to December 1, 2021, identifying published studies with the search terms "Histopathology in COVID-19," "COVID-19," "Pathological changes in liver in COVID-19," "Liver pathology in COVID-19," "immunological effects in liver in COVID-19," and "SARS-CoV-2." This concise review will aid clinicians and researchers in better understanding the tissue histopathology and immunological consequences of SARS-CoV-2 on the liver, enabling improved care planning and avoiding future dangers.
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Affiliation(s)
- M M Alnamshan
- Imam Abdulrahman Bin Faisal University, College of Science, Department of Biology, Dammam, Saudi Arabia
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Kopańska M, Ochojska D, Mytych W, Lis MW, Banaś-Ząbczyk A. Development of a brain wave model based on the quantitative analysis of EEG and EEG biofeedback therapy in patients with panic attacks during the COVID-19 pandemic. Sci Rep 2022; 12:14908. [PMID: 36050377 PMCID: PMC9436169 DOI: 10.1038/s41598-022-19068-w] [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: 04/06/2022] [Accepted: 08/24/2022] [Indexed: 11/24/2022] Open
Abstract
The current global crisis facing the world is the COVID-19 pandemic. Infection from the SARS-CoV-2 virus leads to serious health complications and even death. As it turns out, COVID-19 not only physically assails the health of those infected, but also leads to serious mental illness regardless of the presence of the disease. Social isolation, fear, concern for oneself and one's loved ones, all of this occurs when a pandemic overloads people. People exhibit numerous neurological disorders that have never happened to them before. Patients are diagnosed with frequent panic attacks, the result of which can be seen in their Quantitative Electroencephalogram results. This test may be one of the main diagnostic tools of the COVID-19 pandemic. From the results obtained, it is possible to compare and draw conclusions. This method of testing effectively allows EEG biofeedback training and observes its effect on brain activity. The feedback received in this way gives us the opportunity to properly tailor a protocol for the patient and their conditions. Numerous studies support the effectiveness of EEG biofeedback for panic attacks and other psychiatric disorders. The purpose of our study was to show the effectiveness of EEG biofeedback with a Quantitative Electroencephalogram of the brainwave pattern after having COVID-19 and what symptoms may result.
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Affiliation(s)
- Marta Kopańska
- Department of Pathophysiology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland.
| | - Danuta Ochojska
- Department of Psychology, Institute of Pedagogy, College of Social Sciences, University of Rzeszow, 35-959, Rzeszow, Poland
| | - Wiktoria Mytych
- Students Science Club "Reh-Tech", University of Rzeszow, Rzeszow, Poland
| | - Marcin W Lis
- Department of Zoology and Animal Welfare, Faculty of Animal Science, University of Agriculture in Cracow, 30-059, Cracow, Poland
| | - Agnieszka Banaś-Ząbczyk
- Department of Biology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
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Liu H, Wang J, Geng Y, Li K, Wu H, Chen J, Chai X, Li S, Zheng D. Fine-Grained Assessment of COVID-19 Severity Based on Clinico-Radiological Data Using Machine Learning. Int J Environ Res Public Health 2022; 19:10665. [PMID: 36078380 PMCID: PMC9518491 DOI: 10.3390/ijerph191710665] [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] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/21/2022] [Accepted: 08/24/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The severe and critical cases of COVID-19 had high mortality rates. Clinical features, laboratory data, and radiological features provided important references for the assessment of COVID-19 severity. The machine learning analysis of clinico-radiological features, especially the quantitative computed tomography (CT) image analysis results, may achieve early, accurate, and fine-grained assessment of COVID-19 severity, which is an urgent clinical need. OBJECTIVE To evaluate if machine learning algorithms using CT-based clinico-radiological features could achieve the accurate fine-grained assessment of COVID-19 severity. METHODS The clinico-radiological features were collected from 78 COVID-19 patients with different severities. A neural network was developed to automatically measure the lesion volume from CT images. The severity was clinically diagnosed using two-type (severe and non-severe) and fine-grained four-type (mild, regular, severe, critical) classifications, respectively. To investigate the key features of COVID-19 severity, statistical analyses were performed between patients' clinico-radiological features and severity. Four machine learning algorithms (decision tree, random forest, SVM, and XGBoost) were trained and applied in the assessment of COVID-19 severity using clinico-radiological features. RESULTS The CT imaging features (CTscore and lesion volume) were significantly related with COVID-19 severity (p < 0.05 in statistical analysis for both in two-type and fine-grained four-type classifications). The CT imaging features significantly improved the accuracy of machine learning algorithms in assessing COVID-19 severity in the fine-grained four-type classification. With CT analysis results added, the four-type classification achieved comparable performance to the two-type one. CONCLUSIONS CT-based clinico-radiological features can provide an important reference for the accurate fine-grained assessment of illness severity using machine learning to achieve the early triage of COVID-19 patients.
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Affiliation(s)
- Haipeng Liu
- Research Centre for Intelligent Healthcare, Coventry University, Coventry CV1 5FB, UK
| | - Jiangtao Wang
- Research Centre for Intelligent Healthcare, Coventry University, Coventry CV1 5FB, UK
| | - Yayuan Geng
- Scientific Research Department, HY Medical Technology, B-2 Building, Dongsheng Science Park, Beijing 100192, China
| | - Kunwei Li
- Department of Radiology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China
| | - Han Wu
- College of Engineering, Mathematics and Physical Sciences, Streatham Campus, University of Exeter, North Park Road, Exeter EX4 4QF, UK
| | - Jian Chen
- Department of Radiology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China
| | - Xiangfei Chai
- Scientific Research Department, HY Medical Technology, B-2 Building, Dongsheng Science Park, Beijing 100192, China
| | - Shaolin Li
- Department of Radiology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China
- Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China
| | - Dingchang Zheng
- Research Centre for Intelligent Healthcare, Coventry University, Coventry CV1 5FB, UK
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Lear-Claveras A, Oliván-Blázquez B, Clavería A, Couso-Viana S, Puente-Comesaña J, Magallón Botaya R. Sex Differences in Clinical Parameters, Pharmacological and Health-Resource Utilization in a Population With Hypertension Without a Diagnosis of COVID-19. Int J Public Health 2022; 67:1604913. [PMID: 36090835 PMCID: PMC9453807 DOI: 10.3389/ijph.2022.1604913] [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] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/20/2022] [Indexed: 11/27/2022] Open
Abstract
Objectives: Determine the changes in clinical, pharmacological and healthcare resource use parameters, between the 6 months prior to the lockdown and the 6 months following its end, in a population with hypertension who did not have a diagnosis of COVID-19. Methods: Real world data observational study of 245,979 persons aged >16 years with hypertension in Aragon (Spain). Clinical (systolic-diastolic blood pressure, estimated glomerular filtration rate (eGFR), blood creatinine, cholesterol, triglycerides and anthropometric measures); pharmacological (diuretics, calcium channel antagonists, and ACE inhibitors); and utilization of healthcare resources were considered. We performed the Student’s T-test for matched samples (quantitative) and the Chi-squared test (qualitative) to analyze differences between periods. Results: SBP, DBP, parameters of renal function and triglycerides displayed a significant, albeit clinically irrelevant, worsening in women. In men only DBP and eGFR showed a worsening, although to a lesser extent than in women. Certain antihypertensive drugs and health-resource utilization remained below pre-pandemic levels across the 6 months post-lockdown. Conclusion: Changes in lifestyles, along with difficulties in access to routine care has not substantially compromised the health and quality of life of patients with hypertension.
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Affiliation(s)
- Ana Lear-Claveras
- Aragonese Research Group in Primary Care (Grupo Aragonés de Investigación en Atención Primaria/GAIAP), Aragón Health Research Institute, Zaragoza, Spain
| | - Bárbara Oliván-Blázquez
- Aragonese Research Group in Primary Care (Grupo Aragonés de Investigación en Atención Primaria/GAIAP), Aragón Health Research Institute, Zaragoza, Spain
- Department of Psychology and Sociology, Faculty of Social Sciences, University of Zaragoza, Zaragoza, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
| | - Ana Clavería
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
- I-Saúde Group, Galicia South Health Research Institute, Vigo, Spain
- Vigo Health Area, SERGAS, Vigo, Spain
- *Correspondence: Ana Clavería,
| | - Sabela Couso-Viana
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
- Vigo Health Area, SERGAS, Vigo, Spain
| | - Jesús Puente-Comesaña
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
- Vigo Health Area, SERGAS, Vigo, Spain
| | - Rosa Magallón Botaya
- Aragonese Research Group in Primary Care (Grupo Aragonés de Investigación en Atención Primaria/GAIAP), Aragón Health Research Institute, Zaragoza, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
- Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
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Palermo Dos Santos AC, Japur CC, Passos CR, Lunardi TCP, Lovato WJ, Pena GDG. Nutritional risk, not obesity, is associated with mortality in critically ill COVID-19 patients. Obes Res Clin Pract 2022; 16:379-385. [PMID: 36041995 PMCID: PMC9395293 DOI: 10.1016/j.orcp.2022.08.005] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/04/2022] [Accepted: 08/18/2022] [Indexed: 11/29/2022]
Abstract
Background Despite the identification of obesity as a risk factor for higher rates of hospital and Intensive Care Unit (ICU) admissions and complications due to COVID-19, the association between obesity and mortality in critically ill COVID-19 patients remains controversial, and the nutritional risk is little considered. Hence, our study sought to evaluate the association between obesity, nutritional risk, and mortality in critically ill patients diagnosed with COVID-19. Methods Retrospective study were condutcted including adult critically ill COVID-19 patients admitted to an ICU between April 2020 and March 2021. Clinical and laboratory data were collected from electronic medical records. Obesity was classified by body mass index ≥ 30 kg/m2. A mNUTRIC score of ≥ 5 indicated high nutritional risk. Multiple Cox Regression was used to estimate the association between mNUTRIC, obesity, and mortality. Results From 71 patients aged 59 (± 15) years, 71.8 % were male. The frequencies of obesity (58.7 %) and death (49.3 %) were high, but obesity was not associated with mortality. Based on mNUTRIC, 85.9 % of patients were at high nutritional risk, presenting a higher frequency of mortality than patients at low nutritional risk (50.8 % vs 40.0 %; p = 0.014). Multiple Cox Regression showed that for each unit increase in mNUTRIC score the probability of death almost doubled, regardless of the presence of obesity (HR = 1.74; p < 0.001). Conclusions A higher nutritional risk was positively associated with mortality in critically ill COVID-19 patients, regardless of obesity, showing the importance of early identification of nutritional risk for appropriate nutritional interventions in this population.
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Affiliation(s)
- Ana Carolina Palermo Dos Santos
- Multiprofessional Residency Program in Urgency and Emergency of the Hospital das Clínicas of Ribeirão Preto Medical School, University of São Paulo, 1000 Bernardino de Campos Street, Ribeirão Preto, SP 14015130, Brazil.
| | - Camila Cremonezi Japur
- Division of Nutrition and Metabolism, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, 3900 Bandeirantes Avenue, Ribeirão Preto, SP 14049900, Brazil.
| | - Clara Romanholi Passos
- Nutrition Department of the Hospital das Clínicas of Ribeirão Preto Medical School, University of São Paulo, 1000 Bernardino de Campos Street, Ribeirão Preto, SP 14015130, Brazil.
| | - Thereza Cristina Pereira Lunardi
- Nutrition Department of the Hospital das Clínicas of Ribeirão Preto Medical School, University of São Paulo, 1000 Bernardino de Campos Street, Ribeirão Preto, SP 14015130, Brazil.
| | - Wilson José Lovato
- Intensive Care Unit of the Emergency Unit of the Hospital das Clínicas of Ribeirão Preto Medical School, University of São Paulo, 1000 Bernardino de Campos Street, Ribeirão Preto, SP 14015130, Brazil.
| | - Geórgia das Graças Pena
- Graduate Program in Health Sciences, Federal University of Uberlandia, 1720 Pará Avenue, Uberlândia, MG 38405320, Brazil.
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Kowall B, Kostev K, Landgraf R, Hauner H, Bierwirth R, Rathmann W. Effects of the COVID-19 pandemic on clinically diagnosed psychiatric disorders in persons with type 2 diabetes. Diabet Med 2022; 39:e14852. [PMID: 35426166 PMCID: PMC9111356 DOI: 10.1111/dme.14852] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 04/13/2022] [Indexed: 11/29/2022]
Abstract
AIMS To examine whether the incidence rates of diagnosed depression, anxiety disorders and stress reactions, as well as prescription rates of antidepressants and anxiolytics were higher during the COVID-19 pandemic than before in persons with type 2 diabetes in Germany. Contrary to earlier studies, clinical diagnoses of psychiatric disorders (ICD classification) were used. METHODS The German Disease Analyzer (DA) database is an outpatient database containing routine data on patients´ diseases and treatments provided by a representative panel of physician practices selected from across Germany. We assessed incidence rates of depressive disorders (ICD-10: F32, F33), anxiety disorders (F41) and stress reactions (F43) in quarters from January 2019 to March 2021 in 95,765 people with type 2 diabetes included in the DA in 2019 (mean age 68.9 years, 58% men). Prescription rates of antidepressants and anxiolytics in quarters from January 2020 to March 2021 were compared with prescription rates from 1 year earlier. RESULTS During the study period, the incidence rate of newly diagnosed depressive disorders in persons with type 2 diabetes declined slightly, while the incidence rates of anxiety and stress disorders remained largely constant. The rates of new prescriptions for antidepressants and anxiolytics were lower in all quarters of 2020 and in the first quarter of 2021 than in the quarters 1 year earlier. Diabetes-related complications were more prevalent in persons with incident psychiatric disorders than in those without. CONCLUSIONS No increase in the incidence rates of clinically diagnosed psychiatric disorders was observed during the COVID-19 pandemic in Germany in persons with type 2 diabetes.
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Affiliation(s)
- Bernd Kowall
- Institute for Medical Informatics, Biometry and EpidemiologyUniversity Hospital EssenEssenGermany
| | | | | | - Hans Hauner
- Institute of Nutritional MedicineSchool of MedicineTechnical University of MunichMunichGermany
| | | | - Wolfgang Rathmann
- Institute for Biometrics and EpidemiologyGerman Diabetes CenterLeibniz Center for Diabetes Research at Heinrich Heine University DüsseldorfDüsseldorfGermany
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Rohani-Rasaf M, Mirjalili K, Vatannejad A, Teimouri M. Are lipid ratios and triglyceride-glucose index associated with critical care outcomes in COVID-19 patients? PLoS One 2022; 17:e0272000. [PMID: 35913952 PMCID: PMC9342722 DOI: 10.1371/journal.pone.0272000] [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: 01/05/2022] [Accepted: 07/11/2022] [Indexed: 11/20/2022] Open
Abstract
Lipid ratios and the triglyceride and glucose index (TyG) could be a simple biochemical marker of insulin resistance (IR). The current study was carried out to examine the correlation between triglyceride to high-density lipoprotein-cholesterol (TG/HDL-C), total cholesterol to HDL-C (TC/HDL-C), low-density lipoprotein-cholesterol to HDL-C ratio (LDL-C/HDL-C), as well as TyG index with the severity and mortality of severe coronavirus disease 2019 (COVID-19). A total of 1228 confirmed COVID-19 patients were included in the current research. Regression models were performed to evaluate the correlation between the lipid index and severity and mortality of COVID-19. The TyG index and TG/HDL-C levels were significantly higher in the severe patients (P<0.05). TG/HDL-C, LDL-C/HDL-C, TC/HDL-C ratios, and TyG index were significantly lower in survivor cases (P<0.05). Multivariate logistic regression analysis demonstrated that predictors of the severity adjusted for age, sex and BMI were TyG index, TG/HDL-C ratio (OR = 1.42 CI:1.10–1.82, OR = 1.06 CI: 1.02–1.11, respectively). This analysis showed that TG/HDL-C, TC/HDL-C, LDL-C/HDL-C ratios, and TyG index statistically are correlated with COVID-19 mortality (OR = 1.12 CI:1.06–1.18, OR = 1.24 CI:1.05–1.48, OR = 1.47 CI:1.19–1.80, OR = 1.52 CI:1.01–2.31, respectively). In summary, the TyG index and lipid ratios such as TC/HDL-C, TG/HDL-C, LDL-C/HDL-C could be used as an early indicator of COVID-19 mortality. Furthermore, the study revealed that TyG index and TG/HDL-C indices are biochemical markers of COVID-19 severe prognosis.
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Affiliation(s)
- Marzieh Rohani-Rasaf
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Kosar Mirjalili
- Student Research Committee, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Akram Vatannejad
- Department of Comparative Biosciences, Faculty of Veterinary Medicine, University of Tehran, Iran
| | - Maryam Teimouri
- Department of Clinical Biochemistry, School of Allied Medical Science, Shahroud University of Medical Sciences, Shahroud, Iran
- * E-mail:
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Temesgen Abebe H, Mitiku Ashebir M, Mohamedniguss Ebrahim M, Berhe Zelelow Y, Mulugeta Bezabih A, Redae Tefere G, Fseha Teklehaimanot B, Hintsa S, Leul Welderufael A. Epidemiological and Clinical Characteristics of COVID-19 Patients in Northern Ethiopia: A Retrospective Cohort Study. Infect Drug Resist 2022; 15:3579-3588. [PMID: 35837540 PMCID: PMC9273636 DOI: 10.2147/idr.s345936] [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: 12/30/2021] [Accepted: 06/21/2022] [Indexed: 01/08/2023] Open
Abstract
Purpose COVID-19, caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is an emerging global public health problem. The disease is believed to affect older people and is accompanied by clinical features such as fever, shortness of breath, and coughing. Currently, there is a lack of information regarding the characteristics of COVID-19 patients in Ethiopia. Thus, this paper aims to evaluate the epidemiological and clinical features of COVID-19 patients in Tigray, Northern Ethiopia. Patients and Methods A total of 6,637 symptomatic and asymptomatic COVID-19 patients collected from six isolation and treatment centers in Tigray between May 7 and October 28, 2020 were retrospectively analyzed. Chi-square test or Fisher’s exact test was used to compare the epidemiological and clinical characteristics of COVID-19 patients as appropriate. A p-value <0.05 was considered statistically significant. Results The mean age of the patients was 31.3±12.8. SARS-CoV-2 infects men more than women with a ratio of 1.85:1. About 16% of the patients were symptomatic, of which 13.3% (95% CI=11.3–15.4%) were admitted to intensive care units and 6.1% (95% CI=4.5–7.6%) were non-survivors. The mortality rate was increased up to 40.3% (95% CI=32.1–48.4%) among patients with severe illness. A higher proportion of deaths were observed in men (73.2%) and 55.4% were in the age group of ≥50 years. About 4.3% (282 of 6,637) had one or more coexisting comorbidities; the most common being cardiovascular diseases (30.1%) and diabetes mellitus (23.8%). The comorbidity rate in the non-survivor group was significantly higher than in the survivor group (p-value <0.001). Conclusion The proportion of symptomatic patients was low. Non-survival was linked with old age and the existence of comorbidities. The findings of this study can help in the design of appropriate management strategies for COVID-19 patients, such as giving due emphasis to COVID-19 patients who are old and with comorbidities.
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Affiliation(s)
- Haftom Temesgen Abebe
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.,Laboratory Interdisciplinary Statistical Data Analysis, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | | | | | - Yibrah Berhe Zelelow
- School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | | | - Getachew Redae Tefere
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | | | - Solomon Hintsa
- Department of Public Health, College of Health Sciences, Axum University, Axum, Ethiopia
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Chen X, Ding J, Liu M, Xing K, Ye P, Min J, Zhang Y, Yin T. A Systemic Review and Meta-analysis of the Effect of SARS-CoV-2 Infection on Sperm Parameters. Research (Wash D C) 2022. [DOI: 10.34133/2022/9835731] [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] [Indexed: 01/08/2023] Open
Abstract
Objective. Several studies examined the putative effects of SARS-CoV-2 infection on sperm parameters. However, the results remain controversial. In this study, we conducted the most up-to-date systematic review and meta-analysis to investigate the effect of SARS-CoV-2 infection on sperm quality in COVID-19-positive and COVID-19-negative male participants. Method. Seven databases were searched for literature released through June 10, 2022, containing estimates for the outcomes of interest. Using a random-effects model (REM) or a fixed-effects model (FEM), we analyzed the pooled results. The quality of all included studies was assessed by the Newcastle-Ottawa scale. In addition, we performed a quantitative and subgroup analysis of semen data across all included studies. Results. Fourteen studies were extracted from 10 publications, involving a total of 1174 participates for meta-analysis. Sperm parameters of 521 COVID-19 male patients and 653 controls were analyzed. In 8 case-control studies, the pooled mean difference (MD) of total sperm motility was -5.37% (95% confidence interval (CI): -8.47 to -2.28; p<0.05), suggesting that total motility was significantly impaired in male COVID-19 cases. Subgroup analysis showed a significant decrease in semen volume, sperm concentration, and total motility in 238 patients with a recovery time of less than 90 days. Moreover, in the other 6 included pre- to post-COVID-19 studies, the pooled MDs of sperm concentration, total sperm count, total motility, progressive motility, and normal morphology were −6.54×106/ml (95% CI: -10.27 to -2.81; p<0.05), −38.89×106 (95% CI: -59.20 to -18.58; p<0.05), -7.21% (95% CI: -14.36 to -0.07; p<0.05), -5.12% (95% CI: -8.71 to -1.53; p<0.05), and -1.52% (95% CI: -2.88 to -0.16; p<0.05), respectively, which indicate SARS-CoV-2 infection significantly affected these five sperm parameters. Conclusion. Our results revealed that SARS-CoV-2 infection was significantly correlated with decreased sperm quality. Of six sperm parameters, total motility and sperm concentration were the most significantly decreased parameters. These results suggest a possible negative influence of SARS-CoV-2 infection on testicular function and male fertility. Given the potential detrimental effect of SARS-CoV-2 on semen quality, male reproductive health should be monitored closely in patients with COVID-19. This trial is registered with CRD42021275823.
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Affiliation(s)
- Xi Chen
- Reproductive Medical Centre, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jinli Ding
- Reproductive Medical Centre, Renmin Hospital of Wuhan University, Wuhan, China
| | - Miao Liu
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, China
| | - Kai Xing
- Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Peng Ye
- Department of Pharmacy, Renmin Hospital of Wuhan University, Wuhan, China
| | - Junxia Min
- The First Affiliated Hospital, Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, China
| | - Yan Zhang
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| | - Tailang Yin
- Reproductive Medical Centre, Renmin Hospital of Wuhan University, Wuhan, China
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Li J, Wu J, Long Q, Wu Y, Hu X, He Y, Jiang M, Li J, Zhao L, Yang S, Chen X, Wang M, Zheng J, Wu F, Wu R, Ren L, Bu L, Wang H, Li K, Fu L, Zhang G, Zheng Y, Gao Z. Comprehensive Humoral and Cellular Immune Responses to SARS-CoV-2 Variants in Diverse Chinese Population. Research (Wash D C) 2022; 2022:9873831. [PMID: 35935138 PMCID: PMC9275105 DOI: 10.34133/2022/9873831] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 06/01/2022] [Indexed: 12/26/2022]
Abstract
The SARS-CoV-2 variants have been emerging and have made great challenges to current vaccine and pandemic control strategies. It is urgent to understand the current immune status of various Chinese populations given that the preexisting immunity has been established by national vaccination or exposure to past variants. Using sera from 85 individuals (including 21 convalescents of natural infection, 15 cases which suffered a breakthrough infection after being fully vaccinated, and 49 healthy vaccinees), we showed significantly enhanced neutralizing activities against SRAS-CoV-2 variants in convalescent sera, especially those who had been fully vaccinated. The neutralizing antibodies against Omicron were detectable in 75% of convalescents and 44.9% of healthy vaccinees (p = 0.006), with a GMT of 289.5, 180.9-463.3, and 42.6, 31.3-59, respectively. However, the neutralizing activities were weaker in young convalescents (aged < 18 y), with a detectable rate of 50% and a GMT of 46.4 against Omicron. We also examined and found no pan-sarbecovirus neutralizing activities in vaccinated SARS-CoV-1 survivors. A booster dose could further increase the breadth and magnitude of neutralization against WT and variants of concern (VOCs) to different degrees. In addition, we showed that COVID-19-inactivated vaccines can elicit Omicron-specific T-cell responses. The positive rates of ELISpot reactions were 26.7% (4/15) and 43.8% (7/16) in the full vaccination group and the booster vaccination group, respectively, although without statistically significant difference. The neutralizing antibody titers declined while T-cell responses remain consistent over 6 months. These findings will inform the optimization of public health vaccination and intervention strategies to protect diverse populations against SARS-CoV-2 variants. Advances. Breakthrough infection significantly boosted neutralizing activities against SARS-CoV-2 variants as compared to booster immunization with inactivated vaccine. Vaccine-induced virus-specific T-cell immunity, on the other hand, may compensate for the shortfall. Furthermore, the public health system should target the most vulnerable group due to a poorer protective serological response in both infected and vaccinated adolescents.
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Affiliation(s)
- Jiwei Li
- Department of Respiratory, Critical Care and Sleep Medicine, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China
- School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Jing Wu
- Department of Respiratory, Critical Care and Sleep Medicine, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China
- School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Qiuyue Long
- Department of Respiratory, Critical Care and Sleep Medicine, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China
- School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Yan'an Wu
- Department of Clinical Laboratory, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China
| | - Xiaoyi Hu
- Department of Respiratory, Critical Care and Sleep Medicine, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China
- School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Yukun He
- Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing, China
| | - Mingzheng Jiang
- Department of Respiratory, Critical Care and Sleep Medicine, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China
- School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Jia Li
- Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing, China
| | - Lili Zhao
- Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing, China
| | - Shuoqi Yang
- School of Medicine, Xiamen University, Xiamen, Fujian, China
- Department of Thoracic Surgery, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China
| | - Xiaoyong Chen
- Department of Respiratory, Critical Care and Sleep Medicine, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China
| | - Minghui Wang
- Department of Respiratory, Critical Care and Sleep Medicine, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China
| | - Jianshi Zheng
- Department of Respiratory, Critical Care and Sleep Medicine, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China
| | - Fangfang Wu
- Department of Respiratory, Critical Care and Sleep Medicine, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China
| | - Ruiliang Wu
- Department of Respiratory, Critical Care and Sleep Medicine, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China
| | - Lihong Ren
- Department of Pediatrics, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China
| | - Liang Bu
- Department of Thoracic Surgery, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China
| | - Houzhao Wang
- Department of Clinical Laboratory, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China
| | - Ke Li
- Department of Critical Care Medicine, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China
| | - Lijuan Fu
- Department of Infectious Diseases, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China
| | - Guojun Zhang
- Cancer Research Center and The Department of Breast-Thyroid-Surgery, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China
| | - Yali Zheng
- Department of Respiratory, Critical Care and Sleep Medicine, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China
| | - Zhancheng Gao
- Department of Respiratory, Critical Care and Sleep Medicine, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China
- Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing, China
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Pandey R, Rai D, Tahir MW, Wahab A, Bandyopadhyay D, Lesho E, Laguio-Vila M, Fentanes E, Tariq R, Naidu SS, Aronow WS. Prevalence of comorbidities and symptoms stratified by severity of illness amongst adult patients with COVID-19: a systematic review. Arch Med Sci Atheroscler Dis 2022; 7:e5-e23. [PMID: 35582712 DOI: 10.5114/amsad.2022.115008] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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] [Received: 08/06/2021] [Accepted: 10/27/2021] [Indexed: 02/06/2023] Open
Abstract
Introduction We performed a systematic review of comorbidities and symptoms of adult patients with coronavirus disease 2019 (COVID-19) to evaluate comorbidities, symptoms, and severity. Material and methods We searched databases and extracted comorbidities and symptoms from the included studies. We stratified the similar signs and symptoms in groups and on the basis of severity and compared them with stratified analysis. Individual case reports and case series with < 5 patients were excluded. Results A total of 163 studies with 43,187 patients were included. Mean age was 54.6 years. There were significantly fewer women in the study (43.9% vs. 56.1%, p < 0.0001). Prevalent cardiovascular comorbidities were hypertension (31.9%), obesity (27.9%), hyperlipidemia (26.4%), smoking (18.9%), diabetes mellitus (17.2%), atherosclerotic disease (9.2%) and arrhythmia (5.0%). The most frequently reported constitutional symptoms of COVID-19 were fever (73.9%), fatigue (33.4%), malaise (29.9%), myalgia and/or arthralgia (19.2%), generalized weakness (19.0%), and chills (11.3%). For the cardiovascular system, chest pain and/or tightness were most often reported (19.6%), followed by palpitations (5.2%). Hypertension and diabetes were common in severe disease. Obesity and congestive heart failure were not observed in any non-severe cases. Severe cases compared to non-severe cases more frequently had fever (87.8% vs. 58.5%, p < 0.001), shortness of breath (47.4% vs. 20.6%, p < 0.001), cough (66.8% vs. 62.9%, p < 0.001), sputum production (35.4% vs. 26.5%, p < 0.001) and rhinorrhea (32.2% vs. 7.3%, p < 0.001). Conclusions Hypertension, diabetes, and atherosclerotic diseases are common comorbidities across the world, with obesity as the second most common in the US and more common in men.
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Viana AA, Heubel AD, do Amaral VT, Linares SN, de Oliveira GYO, Martinelli B, Borghi Silva A, Mendes RG, Ciolac EG, Rodrigues B. Can Previous Levels of Physical Activity Affect Risk Factors for Cardiorespiratory Diseases and Functional Capacity after COVID-19 Hospitalization? A Prospective Cohort Study. BioMed Research International 2022; 2022:1-12. [PMID: 35496055 PMCID: PMC9041158 DOI: 10.1155/2022/7854303] [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: 12/23/2021] [Revised: 03/03/2022] [Accepted: 04/09/2022] [Indexed: 11/26/2022]
Abstract
Purpose To evaluate the influence of previous levels of physical activity on hemodynamic, vascular, ventilatory, and functional outcomes after coronavirus disease 2019 (COVID-19) hospitalization. Methods Sixty-three individuals with COVID-19 had their clinical status and previous levels (12 month) of physical activity (Baecke Questionnaire of Habitual Physical Activity) assessed at hospital admission. Individuals were then allocated to lower levels of physical activity (ACTLOWER; N = 22), intermediate levels of physical activity (ACTINTERMEDIATE; N = 22), or higher levels of physical activity (ACTHIGHER; N = 19) groups, according to tertiles of physical activity. Resting hemodynamic (heart rate and brachial/central blood pressures) and vascular (carotid-femoral pulse wave velocity, augmentation index, and brachial artery flow-mediated dilation) variables, pulmonary function (spirometry), respiratory muscle strength (maximal respiratory pressures), and functional capacity (handgrip strength, five-time sit-to-stand, timed-up and go, and six-minute walking tests) were measured at 30 to 45 days after hospital discharge. Results ACTLOWER showed lower levels (P < 0.05) of forced vital capacity, forced expiratory volume in the first second, maximal voluntary ventilation, and maximal expiratory pressure than ACTHIGHER. ACTLOWER also had lower (P = 0.023) walking distance (~21%,) and lower percentage of predicted walking distance (~20%) at six-minute walking test during follow-up than ACTINTERMEDIATE. However, hemodynamic and vascular variables, handgrip strength, five-time sit-to-stand, and timed-up and go were not different among groups. Conclusion ACTLOWER showed impaired ventilatory parameters and walking performance when compared with ACTHIGHER and ACTINTERMEDIATE, respectively. These results suggest that previous levels of physical activity may impact ventilatory and exercise capacity outcomes 30 to 45 days after COVID-19 hospitalization discharge.
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Kopańska M, Barnaś E, Błajda J, Kuduk B, Łagowska A, Banaś-Ząbczyk A. Effects of SARS-CoV-2 Inflammation on Selected Organ Systems of the Human Body. Int J Mol Sci 2022; 23:4178. [PMID: 35456997 PMCID: PMC9025828 DOI: 10.3390/ijms23084178] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/05/2022] [Accepted: 04/08/2022] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION AND PURPOSE OF THE STUDY SARS-CoV-2 virus does not only affect the respiratory system. It may cause damage to many organ systems with long-term effects. The latest scientific reports inform that this virus leaves a long-term trace in the nervous, circulatory, respiratory, urinary and reproductive systems. It manifests itself in disturbances in the functioning of the organs of these systems, causing serious health problems. The aim of the study was to review the latest research into the long-term effects of COVID-19 and determine how common these symptoms are and who is most at risk. Based on a literature review using the electronic scientific databases of PubMed and Web of Science on the long-term effects of SARS-CoV-2 infection, 88 studies were included in the analysis. The information contained in the analyzed literature shows that the SARS-CoV-2 virus can cause multi-organ damage, causing a number of long-term negative health complications. CONCLUSIONS There is evidence that the virus can cause long-term complications lasting more than six months. They mainly concern disturbances in the functioning of the nervous, circulatory and respiratory systems. However, these studies are small or short-lasting, and many are speculative.
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Affiliation(s)
- Marta Kopańska
- Department of Pathophysiology, Institute of Medical Sciences, Medical College, University of Rzeszow, 35-959 Rzeszow, Poland
| | - Edyta Barnaś
- Institute of Health Sciences, Medical College, University of Rzeszow, 35-959 Rzeszow, Poland; (E.B.); (J.B.)
| | - Joanna Błajda
- Institute of Health Sciences, Medical College, University of Rzeszow, 35-959 Rzeszow, Poland; (E.B.); (J.B.)
| | - Barbara Kuduk
- Students Science Club “Reh-Tech”, Institute of Medical Sciences, Medical College, University of Rzeszow, 35-959 Rzeszow, Poland; (B.K.); (A.Ł.)
| | - Anna Łagowska
- Students Science Club “Reh-Tech”, Institute of Medical Sciences, Medical College, University of Rzeszow, 35-959 Rzeszow, Poland; (B.K.); (A.Ł.)
| | - Agnieszka Banaś-Ząbczyk
- Department of Biology, Institute of Medical Sciences, Medical College, University of Rzeszow, 35-959 Rzeszow, Poland;
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Borlotti A, Thomaides-Brears H, Georgiopoulos G, Banerjee R, Robson MD, Fusco DN, Masci PG. The Additive Value of Cardiovascular Magnetic Resonance in Convalescent COVID-19 Patients. Front Cardiovasc Med 2022; 9:854750. [PMID: 35463767 PMCID: PMC9021393 DOI: 10.3389/fcvm.2022.854750] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 02/28/2022] [Indexed: 01/08/2023] Open
Abstract
In COVID-19 the development of severe viral pneumonia that is coupled with systemic inflammatory response triggers multi-organ failure and is of major concern. Cardiac involvement occurs in nearly 60% of patients with pre-existing cardiovascular conditions and heralds worse clinical outcome. Diagnoses carried out in the acute phase of COVID-19 rely upon increased levels of circulating cardiac injury biomarkers and transthoracic echocardiography. These diagnostics, however, were unable to pinpoint the mechanisms of cardiac injury in COVID-19 patients. Identifying the main features of cardiac injury remains an urgent yet unmet need in cardiology, given the potential clinical consequences. Cardiovascular magnetic resonance (CMR) provides an unparalleled opportunity to gain a deeper insight into myocardial injury given its unique ability to interrogate the properties of myocardial tissue. This endeavor is particularly important in convalescent COVID-19 patients as many continue to experience chest pain, palpitations, dyspnea and exertional fatigue, six or more months after the acute illness. This review will provide a critical appraisal of research on cardiovascular damage in convalescent adult COVID-19 patients with an emphasis on the use of CMR and its value to our understanding of organ damage.
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Affiliation(s)
- Alessandra Borlotti
- Perspectum Ltd., Oxford, United Kingdom
- *Correspondence: Alessandra Borlotti,
| | | | - Georgios Georgiopoulos
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Dahlene N. Fusco
- Tulane University School of Medicine, New Orleans, LA, United States
| | - Pier-Giorgio Masci
- Perspectum Ltd., Oxford, United Kingdom
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
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Maimaitiyiming Y, Yang T, Wang QQ, Feng Y, Chen Z, Björklund M, Wang F, Hu C, Hsu CH, Naranmandura H. Heat Treatment Promotes Ubiquitin-Mediated Proteolysis of SARS-CoV-2 RNA Polymerase and Decreases Viral Load. Research (Wash D C) 2022; 2022:9802969. [PMID: 35321260 PMCID: PMC8918953 DOI: 10.34133/2022/9802969] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 01/11/2022] [Indexed: 01/18/2023] Open
Abstract
Despite extensive efforts, COVID-19 pandemic caused by the SARS-CoV-2 virus is still at large. Vaccination is an effective approach to curb virus spread, but several variants (e.g., delta, delta plus, omicron, and IHU) appear to weaken or possibly escape immune protection. Thus, novel and quickly scalable approaches to restrain SARS-CoV-2 are urgently needed. Multiple evidences showed thermal sensitivity of SARS-CoV-2 and negative correlation between environmental temperature and COVID-19 transmission with unknown mechanism. Here, we reveal a potential mechanism by which mild heat treatment destabilizes the wild-type RNA-dependent RNA polymerase (also known as nonstructural protein 12 (NSP12)) of SARS-CoV-2 as well as the P323L mutant commonly found in SARS-CoV-2 variants, including omicron and IHU. Mechanistically, heat treatment promotes E3 ubiquitin ligase ZNF598-dependent NSP12 ubiquitination leading to proteasomal degradation and significantly decreases SARS-CoV-2 RNA copy number and viral titer. A mild daily heat treatment maintains low levels of both wild-type and P323L mutant of NSP12, suggesting clinical potential. Collectively, this novel mechanism, heat-induced NSP12 degradation, suggests a prospective heat-based intervention against SARS-CoV-2.
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Affiliation(s)
- Yasen Maimaitiyiming
- Department of Public Health and Department of Hematology of First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China.,Zhejiang University Cancer Center, Hangzhou 310058, China.,Department of Neurobiology and Department of Neurology of the First Affiliated Hospital, Zhejiang University School of Medicine, NHC and CAMS Key Laboratory of Medical Neurobiology, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou 310058, China
| | - Tao Yang
- Department of Public Health and Department of Hematology of First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China.,Zhejiang University Cancer Center, Hangzhou 310058, China
| | - Qian Qian Wang
- Department of Public Health and Department of Hematology of First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China.,Zhejiang University Cancer Center, Hangzhou 310058, China
| | - Yan Feng
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Zhi Chen
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Mikael Björklund
- Zhejiang University-University of Edinburgh (ZJU-UoE) Institute, Haining 314499, Zhejiang, China
| | - Fudi Wang
- The First Affiliated Hospital, Institute of Translational Medicine, School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China.,Hengyang Medical School, University of South China, Hengyang 421001, China
| | - Chonggao Hu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Chih-Hung Hsu
- Women's Hospital, Institute of Genetics, and Department of Environmental Medicine, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Hua Naranmandura
- Department of Public Health and Department of Hematology of First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China.,Zhejiang University Cancer Center, Hangzhou 310058, China
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Ketfi A, Touahri R, Chabati O, Chemali S, Mahjoub M, Gharnaout M, Djenouhat K, Selatni F, Ben Saad H. Severity factors in Algerian patients hospitalized for COVID-19. Tunis Med 2022; 99:734-743. [PMID: 35261005 PMCID: PMC8796682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Determining the profile of COVID-19 patients with low pulsed hemoglobin saturation in oxygen (SpO2) could help clinicians identify those with a poor prognosis. AIM To identify and to compare the clinical, biological and radiological data of Algerian patients hospitalized for COVID-19 and divided according to the SpO2 measured at admission, at rest, and in ambient air. METHODS A prospective study was carried out on Algerian patients hospitalized for COVID-19 during the period from March 9 to April 30, 2020. The general characteristics of the patients and the clinical, biological and radiological data were determined. RESULTS 86 patients were included in the study [G1: SpO2 >95% (n=51) and G2: SpO2 ≤95% (n=35)]. Compared to G1, G2 was older (48±14 vs. 61±12 years, p=0.0001), included more patients aged ≥ 50 years (37.2 vs. 80.0%, p=0.0001), having an arterial-hypertension (21.6 vs. 45.7%, p=0.0180), a cancer (0.0 vs. 14.3%, p=0.0054), an anemia (25.6 vs. 56.3%, p=0.0069), a leukocytosis (4.7 vs. 21.9%, p=0.0236), a biological inflammatory syndrome (82.5 vs. 100%, p=0.0142), a hyper-uremia (7.0 vs. 37.5%, p=0.0185), a hyper-creatininaemia (4.7 vs. 18.8%, p=0.0356), a tissue damage (41.0 vs. 66.7%, p=0.0341), a diffuse ground-glass opacity (52.0 vs. 71.4%, p=0.0397), band condensations (30.0 vs. 54.3%, p=0.0244), a severe extension (2.0 vs. 25.7%, p=0.0008), and included fewer patients who complained from diarrhea (49.0 vs. 22.9%, p=0.0145), having a nodular ground-glass (66.0 vs. 40.0%, p=0.0177) and a slight extension (78.0 vs. 40.0%, p=0.0004). CONCLUSION Criteria associated with low SpO2 in hospitalized COVID-19 patients were advanced age, a history of arterial-hypertension and cancer, high frequencies of certain biological abnormalities or radiological signs. The diarrhea symptom, the radiological appearance of nodular ground glass, and a slight extension of the radiological lesions appear as protective elements.
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Lam B, Stepanova M, Venkatesan C, Garcia I, Reyes M, Mannan A, Groves S, Desai M, Racila A, Kolacevski A, Henry L, Gerber LH, Younossi ZM. Outcomes of hospitalized patients with COVID-19 during the course of the pandemic in a fully integrated health system. PLoS One 2022; 17:e0263417. [PMID: 35213553 PMCID: PMC8880763 DOI: 10.1371/journal.pone.0263417] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 01/18/2022] [Indexed: 12/21/2022] Open
Abstract
Background Given the rapid spread of COVID-19 and its associated morbidity and mortality, healthcare providers throughout the world have been forced to constantly update and change their care delivery models. Objective To assess the outcomes of COVID-19 hospitalized patients during the course of the pandemic in a well-integrated health system. Methods The study used data from the electronic health medical records to assess trends in clinical profile and outcomes of hospitalized adult COVID-19 patients hospitalized in our 5-hospital health system from March 2020-May 2021 (n = 6865). Integration of the health system began in February 2020 and was fully actualized by March 30, 2020. Results Mortality decreased from 15% during first peak (March-May 2020; the rate includes 19% in March-April and 10% in May 2020) to 6% in summer-fall 2020, increased to 13% during the second peak (November 2020-January 2021), and dropped to 7% during the decline period (February-May 2021) (p<0.01). Resource utilization followed a similar pattern including a decrease in ICU use from 35% (first peak) to 16% (decline period), mechanical ventilation from 16% (first peak, including 45% in March 2020) to 9–11% in subsequent periods (p<0.01). Independent predictors of inpatient mortality across multiple study periods included older age, male sex, higher multi-morbidity scores, morbid obesity, and indicators of severe illness on admission such as oxygen saturation ≤90% and high qSOFA score (all p<0.05). However, admission during the first peak remained independently associated with increased mortality even after adjustment for patient-related factors: odds ratio = 1.8 (1.4–2.4) (p<0.0001). Conclusions The creation of a fully integrated health system allowed us to dynamically respond to the everchanging COVID-19 landscape. In this context, despite the increasing patient acuity, our mortality and resource utilization rates have improved during the pandemic.
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Affiliation(s)
- Brian Lam
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States of America
- Inova Office of Research, Inova Health System, Falls Church, VA, United States of America
- Department of Medicine, Inova Health System, Falls Church, VA, United States of America
| | - Maria Stepanova
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States of America
- Department of Medicine, Inova Health System, Falls Church, VA, United States of America
| | - Chapy Venkatesan
- Department of Medicine, Inova Health System, Falls Church, VA, United States of America
| | - Ivan Garcia
- Department of Medicine, Inova Health System, Falls Church, VA, United States of America
| | - Mary Reyes
- Department of Medicine, Inova Health System, Falls Church, VA, United States of America
| | - Ashiq Mannan
- Department of Medicine, Inova Health System, Falls Church, VA, United States of America
| | - Soleyah Groves
- Department of Medicine, Inova Health System, Falls Church, VA, United States of America
| | - Mehul Desai
- Department of Medicine, Inova Health System, Falls Church, VA, United States of America
| | - Andrei Racila
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States of America
- Department of Medicine, Inova Health System, Falls Church, VA, United States of America
| | - Andrej Kolacevski
- Inova Office of Research, Inova Health System, Falls Church, VA, United States of America
| | - Linda Henry
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States of America
- Department of Medicine, Inova Health System, Falls Church, VA, United States of America
| | - Lynn H. Gerber
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States of America
- Inova Office of Research, Inova Health System, Falls Church, VA, United States of America
- Department of Medicine, Inova Health System, Falls Church, VA, United States of America
| | - Zobair M. Younossi
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States of America
- Inova Office of Research, Inova Health System, Falls Church, VA, United States of America
- Department of Medicine, Inova Health System, Falls Church, VA, United States of America
- * E-mail:
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Salimi A, Aghaziarati M, Roshanfekr Balalami MQ, Rastgoo N, Taghizadeh F, Pirastepoor Z, Bashiri Aghchekand Z, Arman Boroujeny Z, Akhavizadegan H. Outcome, Severity, and Risk of Mortality in Patients with COVID-19 and Chronic Underlying Diseases: A Prospective Study. Arch Clin Infect Dis 2022; 16. [DOI: 10.5812/archcid.111794] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background: The novel coronavirus pandemic, severe acute respiratory syndrome CoV-2 (SARS COV-2), has become a global threat and rapidly spread worldwide. The COVID-19 pandemic has posed a number of challenges, the most notable of which is the management of patients with chronic underlying diseases. Objectives: The present study aimed to evaluate the risk of COVID-19 severity and mortality in patients with chronic underlying diseases. Methods: In this retrospective cohort study, the data on the disease severity and morality of confirmed COVID-19 patients admitted to Baharloo Hospital, Tehran, Iran, from February 2020 to March 2020 were analyzed and reported. Patients’ characteristics, including age, gender, and underlying diseases, were also considered. Results: The study encompassed 1244 patients with the mean age of 53.29 years, among whom there were 573 patients with at least one co-existing chronic disease. Hypertension, diabetes mellitus (DM), and ischemic heart disease (IHD) were the most common co-existing chronic diseases. The findings revealed that underlying diseases were significantly associated with disease mortality and severity. Conclusions: The findings showed that patients with comorbidities were significantly at higher risk of death and severe forms of COVID-19. In this regard, patients with underlying diseases should be of concern.
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ÇETİN A, GÖKÇEK MB, ASLANER H, KAYA ERTEN Z, BENLİ ÖZÇAKIR AC. Post-discharge evaluation of patients with Covid-19 infection. FAMILY PRACTICE AND PALLIATIVE CARE 2022. [DOI: 10.22391/fppc.983957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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O’Donnell MB, Hilliard ME, Cao VT, Bradford MC, Barton KS, Hurtado S, Duran B, Perez SG, Rahman KS, Scott S, Malik FS, DeSalvo DJ, Pihoker C, Zhou C, Rosenberg AR, Yi-Frazier JP. “It Just Kind of Feels Like a Different World Now:” Stress and Resilience for Adolescents With Type 1 Diabetes in the Era of COVID-19. Front Clin Diabetes Healthc 2022; 3:835739. [PMID: 36992786 PMCID: PMC10012077 DOI: 10.3389/fcdhc.2022.835739] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 01/24/2022] [Indexed: 12/16/2022]
Abstract
PurposeThe COVID-19 pandemic has been a major stressor for adolescents. Given the unique implications of the pandemic for youth with type 1 diabetes (T1D), who already navigate multiple stressors as a function of their chronic condition, we aimed to describe the impact of the pandemic on adolescents with T1D and describe their coping strategies and resilience resources.Research MethodIn a 2-site (Seattle WA, Houston TX) clinical trial of a psychosocial intervention targeting stress/resilience, adolescents 13-18 years old with T1D ≥ 1 year and elevated diabetes distress were enrolled August 2020 – June 2021. Participants completed a baseline survey about the pandemic, including open-ended questions about the effects of the pandemic, what was helping them navigate, and how it impacted T1D management. Hemoglobin A1c (A1c) was extracted from clinical records. Free text responses were analyzed using an inductive content approach. Survey responses and A1c were summarized using descriptive statistics and associations were assessed by Chi-squared tests.ResultsAdolescents (n=122) were 56% female. 11% of adolescents reported diagnosis of COVID-19 and 12% had a family member/other important person die from COVID-19 complications. Adolescents described Social Relationships, Personal Health/Safety Practices, Mental Health, Family Relationships, and School to be primary areas affected by COVID-19. Helpful resources included: Learned Skills/Behaviors, Social Support/Community, and Meaning-Making/Faith. Among participants indicating that the pandemic had an impact on their T1D management (n=35), the most commonly described areas were: Food, Self-Care, Health/Safety, Diabetes Appointments, and Exercise. Compared to adolescents who reported minimal difficulty managing T1D during the pandemic (71%), those reporting moderate to extreme difficulty (29%) were more likely to have A1C ≥ 8% (80% vs. 43%, p<.01).ConclusionsResults underscore the pervasive impact of COVID-19 on teens with T1D across multiple major life domains. Their coping strategies aligned with stress, coping, and resilience theories and suggest resilient responses in the face of stress. Despite experiencing pandemic-related stressors in many areas, diabetes-related functioning was relatively protected for most teens, highlighting their diabetes-specific resilience. Discussing the pandemic impact on T1D management may be an important focus for clinicians, especially for adolescents with diabetes distress and above-target A1C.
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Affiliation(s)
- Maeve B. O’Donnell
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, WA, United States
- Department of Pediatrics, Division of Diabetes/Endocrinology, University of Washington School of Medicine, Seattle, WA, United States
- Cambia Palliative Care Center of Excellence, University of Washington School of Medicine, Seattle, WA, United States
| | - Marisa E. Hilliard
- Department of Pediatrics, Texas Children’s Hospital and Baylor College of Medicine, Houston, TX, United States
| | - Viena T. Cao
- Department of Pediatrics, Texas Children’s Hospital and Baylor College of Medicine, Houston, TX, United States
| | - Miranda C. Bradford
- Core for Biostatistics, Epidemiology and Analytics for Research (BEAR) Core, Seattle Children’s Research Institute, Seattle, WA, United States
| | - Krysta S. Barton
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, WA, United States
- Core for Biostatistics, Epidemiology and Analytics for Research (BEAR) Core, Seattle Children’s Research Institute, Seattle, WA, United States
| | - Samantha Hurtado
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, WA, United States
| | - Brenda Duran
- Department of Pediatrics, Texas Children’s Hospital and Baylor College of Medicine, Houston, TX, United States
| | - Samantha Garcia Perez
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, WA, United States
| | - Kiswa S. Rahman
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, WA, United States
| | - Samantha Scott
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, WA, United States
- Department of Psychology, University of Denver, Denver, CO, United States
| | - Faisal S. Malik
- Department of Pediatrics, Division of Diabetes/Endocrinology, University of Washington School of Medicine, Seattle, WA, United States
- Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA, United States
| | - Daniel J. DeSalvo
- Department of Pediatrics, Texas Children’s Hospital and Baylor College of Medicine, Houston, TX, United States
| | - Catherine Pihoker
- Department of Pediatrics, Division of Diabetes/Endocrinology, University of Washington School of Medicine, Seattle, WA, United States
| | - Chuan Zhou
- Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA, United States
- Department of Pediatrics, Division of General Pediatrics, School of Medicine, University of Washington, Seattle, WA, United States
| | - Abby R. Rosenberg
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, WA, United States
- Cambia Palliative Care Center of Excellence, University of Washington School of Medicine, Seattle, WA, United States
| | - Joyce P. Yi-Frazier
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, WA, United States
- *Correspondence: Joyce P. Yi-Frazier,
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Yuniarti L, Haerudin H, Triyani Y, Garna H, Dirgavarisya GB, Fernanda DR, Ramandhita AP, Karima H, Resa N, Tejasari M. SARS-CoV-2 Gene Expression as a Prognosis Predictor for COVID-19. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7667] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Introduction: Real time quantitative PCR is the gold standard for detection of SARS-CoV-2 which is specific, sensitive, and simple quantitative. The target of RT-qPCR is to assess the expression level of the SARS-CoV-2 gene through cycle threshold values (CT-value). The purpose of this study was to analyze the association of the level of SARS-CoV-2 gene expression and the severity of COVID-19 in patients hospitalized.
Method: This research is an analytic observational study with cross sectional method. While the research sample was taken using a consecutive sampling technique from the Medical Records of Sumedang Hospital and Cideres Hospital, West Java, Indonesia from December 2020 to March 2021. Patient parameters include analysis of age, sex, comorbidity, and disease severity. The severity of the patient is classified based on complaints and oxygen saturation. The expression level of the SARS-CoV-2 N gene and E gene were assessed by calculating the relative quantification by comparing the expression of the E and N gene with the expression of the internal control gene by Livak formula (2-ΔΔCT Formula).
Result: The Spearman correlation test showed that there was a relationship between the expression of SARS-CoV-2 genes E and N genes with the severity of COVID-19 patients (with r=0.374 and p<0.0001) and (with r=0.452 and p<0.0001).
Conclusions: There is an correlation between the level of expression of genes E and gene N with the severity of patients.
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