Over 60 years of age as an independent prognostic factor of in-hospital mortality among COVID-19 patients: a cohort study in an Iranian high-incidence area

Objectives

COVID-19 continues to cause devastation throughout the world. Various factors influence the perioperative course and prognosis of COVID-19. This study aims to collate the independent prognostic factors among hospitalised COVID-19 patients in east Iran.

Study design

In this cohort study, all patients with a confirmed diagnosis of COVID-19 between 19 February 2020 and 1 August 2020 who were admitted to nine public hospitals of South Khorasan province, Iran, were enrolled.

Methods

Univariate analysis (chi-square [χ²], and Mann–Whitney U test) and multiple logistic regression were performed.

Results

This study included 1290 participants; 676 patients (52.4%) were male. A total of 1189 (92.2%) recovered, and 101 (7.8%) died. The results show that in-hospital mortality increases with advanced age (the optimal cut-off point = 62 years). The following three variables were shown to have the most significant role in in-hospital mortality: age >60 years (odds ratio [OR] = 8.01, 95% confidence interval [CI] 4.8–13.35), shortness of breath (OR = 2.65, 95% CI: 1.4–69.17) and atypical radiological manifestations in a chest X-ray on admission (OR = 2.16, 95% CI: 1.3–28.64). In the univariate analysis, associated comorbidities, such as cardiovascular diseases, influenced the in-hospital mortality rate, while the same could not be replicated in the multiple variable analysis.

Conclusions

This study revealed the potential predictors of COVID-19 and highlighted the need to be cautious with advanced age and heightened clinical symptoms at the time of admission.

The efficacy of probiotics in experimental autoimmune encephalomyelitis (an animal model for MS): a systematic review and meta-analysis

Probiotics immunomodulatory properties and their beneficial effects for diseases such as multiple sclerosis (MS) are reported by several studies. The current systematic review and meta-analysis aimed to investigate the favourable effects of probiotics in improving experimental autoimmune/allergic encephalomyelitis (EAE) as an animal model of MS. We systematically searched Scopus, Web of Sciences (ISI), and PubMed databases to identify relevant studies from the inception of these databases to December 2019. A total of 15 animal studies met the inclusion criteria, while no human study met the inclusion criteria. The association between consumption of probiotics and each sign was calculated using the producing pooled odd ratios (95% confidence interval [95% CI]) in a random effect model. The meta-analysis revealed the significant effect of probiotics on the incidence of EAE, weight gain, and clinical symptoms. However, the effects of probiotics on the duration of the disease varied by probiotic strain. The administration of probiotics was associated with a significant reduction in the risk of mortality only in female animals. Moreover, the meta-analysis revealed the promising effects of probiotics on the prevention and management of EAE.

Global prevalence of latent toxoplasmosis in pregnant women: a systematic review and meta-analysis

BACKGROUND

Toxoplasma gondii infection, if acquired as an acute infection during pregnancy, can have substantial adverse effects on mothers, fetuses and newborns. Latent toxoplasmosis also causes a variety of pathologies and has been linked to adverse effects on pregnancy.

OBJECTIVE

Here, we present results of a comprehensive systematic review and meta-analysis of the global prevalence of latent toxoplasmosis in pregnant women.

DATA SOURCE

We searched PubMed, EMBASE, Web of Science, SciELO and Scopus databases for relevant studies that were published between 1 January 1988 and 20 July 2019.

STUDY ELIGIBILITY CRITERIA

All population-based, cross-sectional and longitudinal studies reporting the prevalence of latent toxoplasmosis in healthy pregnant women were considered for inclusion.

PARTICIPANTS

Pregnant women who were tested for prevalence of latent toxoplasmosis.

INTERVENTIONS

There were no interventions.

METHOD

We used a random effects model to calculate pooled prevalence estimates with 95% confidence intervals (CIs). We grouped prevalence data according to the geographic regions defined by the World Health Organization (WHO). Multiple subgroup and meta-regression analyses were performed.

RESULTS

In total, 311 studies with 320 relevant data sets representing 1 148 677 pregnant women from 91 countries were eligible for inclusion in the meta-analysis. The global prevalence of latent toxoplasmosis in pregnant women was estimated at 33.8% (95% CI, 31.8-35.9%; 345 870/1 148 677). South America had the highest pooled prevalence (56.2%; 50.5-62.8%) of latent toxoplasmosis in pregnant women, whereas the Western Pacific region had the lowest prevalence (11.8%; 8.1-16.0%). A significantly higher prevalence of latent toxoplasmosis was associated with countries with low income and low human development indices (p < 0.001).

CONCLUSION

Our results indicate a high level of latent toxoplasmosis in pregnant women, especially in some low- and middle-income countries of Africa and South America, although the local prevalence varied markedly. These results suggest a need for improved prevention and control efforts to reduce the health risks to women and newborns.