ABSTRACT
(1) Background: Data on COVID-19 outcomes and disease course as a function of different medications used to treat cardiovascular disease and chronic kidney disease (CKD), as well as the presence of different comorbidities in primarily Black cohorts, are lacking. (2) Methods: We conducted a retrospective medical chart review on 327 patients (62.6% Black race) who were admitted to the Detroit Medical Center, Detroit, MI. Group differences (CKD vs. non-CKD) were compared using the Pearson χ2 test. We conducted univariate and multivariate regression analyses for factors contributing to death during hospitalization due to COVID-19 (primary outcome) and ICU admission (secondary outcome), adjusting for age, sex, different medications, and comorbidities. A sub-analysis was also completed for CKD patients. (3) Results: In the fully adjusted model, a protective effect of ACEi alone, but not in combination with ARB or CCB, for ICU admission was found (OR = 0.400, 95% CI [0.183–0.874]). Heart failure was significantly associated with the primary outcome (OR = 4.088, 95% CI [1.1661–14.387]), as was COPD (OR = 3.747, 95% CI [1.591–8.828]). (4) Conclusions: Therapeutic strategies for cardiovascular disease and CKD in the milieu of different comorbidities may need to be tailored more prudently for individuals with COVID-19, especially Black individuals. [ FROM AUTHOR] Copyright of COVID is the property of MDPI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
PURPOSE: There is scarce literature regarding genitourinary symptoms in COVID-19, especially post-acute disease otherwise known as Long COVID. We identified recovered COVID-19 patients presenting with new or worsening overactive bladder symptoms, known as COVID-19-associated cystitis (CAC). METHODS: We used the American Urological Association Urology Care Foundation Overactive Bladder (OAB) Assessment Tool to screen COVID-19 recovered patients presenting with urological complaints at our urban-located institution from 5/22/2020 to 12/31/2020. Patients 10-14 weeks post-discharge responded to 5 symptom and 4 quality-of-life (QoL) questions. We reported median symptom scores, as well as QoL scores, based on new or worsening urinary symptoms, and by sex. RESULTS: We identified 350 patients with de novo or worsening OAB symptoms 10-14 weeks after hospitalization with COVID-19. The median total OAB symptom score in both men and women was 18. The median total QoL score for both men and women was 19. Patients with worsening OAB symptoms had a median pre-COVID-19 symptom score of 8 (4-10) compared to post-COVID-19 median symptom score of 19 (17-21). Median age was 64.5 (range 47-82). Median hospital length-of-stay was 10 days (range 5-30). CONCLUSION: We report survey-based results of patients suffering from new or worsening OAB symptoms months after their hospitalization from COVID-19. Future studies with larger sample sizes and more extensive testing will hopefully elucidate the specific pathophysiology of OAB symptoms in the context of long COVID so urologists can timely and appropriately treat their patients.
Subject(s)
COVID-19/complications , Cystitis/etiology , Quality of Life , SARS-CoV-2 , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19/etiology , Cystitis/epidemiology , Female , Humans , Incidence , Male , Middle Aged , Pandemics , United States/epidemiology , Post-Acute COVID-19 SyndromeABSTRACT
Introduction COVID-19 pandemic has been one of the main global health concerns in 2020, and many aspects of the disease remain enigmatic. While some patients infected with the disease-causing virus SARS-CoV2 have no or mild symptoms, others experience severe symptoms requiring hospitalization. Of these more severe patients, some remain stable while others experience cytokine storm syndrome or an exaggerated immune response that has been correlated with disease severity and progression of acute respiratory deterioration. It is currently unknown why some patients with COVID-19 demonstrate this response and others do not. In light of the apparent prominent role of the inflammatory mediators (i.e. cytokines) in COVID-19 pathogenesis, the ability to identify screening tools not only for the SARS-CoV2 virus but also for cytokines is important. The present investigation was designed to identify the urinary cytokine signature in COVID-19 patients. Methods The study enrolled 17 COVID-19 patients and 10 control subjects (SARS-CoV-2 negative) 18 years or older with glomerular filtration rate of > 60mL/min. Urine samples were collected and cytokines quantitated using the Luminex multiplex assay. The cytokines analyzed were growth-regulated oncogene (GRO), interleukin-8 (IL-8), and interleukin-6 (IL-6). Results The levels of GRO and IL-6 were significantly elevated in urine samples obtained from COVID-19 patients compared to controls (mean 16.8 pg/ml vs. 9.2 pg/ml ± 2.39, p < 0.0171 and mean 16.8 pg/ml vs 9.2 pg/ml ± 2.42, p < 0.0157, respectively). Conversely, IL-8 level was similar between COVID-19 patients and controls (15.6 pg/ml vs 11.3 pg/ml ± 1.3, p<0.1833). Conclusion The present investigation found that the levels of urinary cytokines GRO and IL-6 were significantly elevated in COVID-19 patients compared to controls and may serve as urinary biomarkers of disease progression. Furthermore, IL-8 although elevated in COVID-19 patients, did not reach statistical significance in our population sample. The findings of this proof of concept study underscore that the urinary cytokines may serve as prognostic and diagnostic accessible biomarkers in COVID-19.