ABSTRACT
Background Accumulated evidence on risk factors for adverse COVID-19 outcomes revealed that old age and male sex are main associates, next to pre-existing comorbidities, as analysed from scattered single cohorts of hospitalised COVID-19 patients of accessible electronic medical records. Hence, evidence from federated analyses is called for to provide a more comprehensive and robust analyses of risk factors. Methods Using the unCoVer network, i.e., a research platform of 29 partners for the expert use of patient data as routinely gathered in real-world healthcare settings, present analyses restricted to available data of four hospitals from Spain, Slovakia, Romania and Bosnia and Herzegovina covering 8,287 hospitalised COVID-19 patients. In-hospital death after COVID-19 diagnosis was examined in relation to common pre-existing comorbidities using virtual pooling of logistic regression models adjusted for age and sex. Results Patients were on average 60.1 (± 20.9) years, 50.7% were male, almost half (43.3%) had at least one pre-existing comorbidity (17.4% having obesity, 21.9% hypertension, 18.0% diabetes and 13.7% cardiovascular diseases (CVD)), and 12.6% died during hospitalisation. Patients with comorbidities had a higher risk of mortality that was increasing with the number of comorbidities: from a virtual pooled odds ratio of 1.16 (95%CI: 0.96, 1.40) for one vs none to 1.30 (1.04, 1.64) and 2.14 (1.64, 2.79) for two and three or more comorbidities, respectively. Of the comorbidities, highest risk was seen for CVD (1.68;1.40, 2.01), followed by hypertension (1.40;1.19, 1.64) and diabetes (1.27;1.07, 1.50), and the lowest for obesity (1.13;0.94, 1.37). Conclusions By federated analyses, this study confirmed that the number of comorbidities was a strong risk factor for in-hospital death after COVID-19, in particular CVD. The unCoVer platform pursues using scattered data sources by innovative computational resources and integrated information for enhanced impact. Key messages Federated analyses, capable of streamlining ethical and legal aspects, provide unique opportunities for robust results to inform public health. Higher COVID-19 in-hospital mortality risk with increasing number of comorbidities.
ABSTRACT
Dear Editor, Assessing the SARS-CoV-2 pandemic global impact is a difficult challenge as multiple points of reference may be used: medical, social, economic, and personal, each implying specific tools and methods. Following the SARS-CoV-2 outbreak, worldwide medical systems were challenged not only by the relative and temporary lack of scientific data but also by the need to adapt existing medical structures and standards of practice1 to a new public health situation aiming to accommodate as many patients as possible while observing the primary aim of limiting transmission. Currently, arguably effective and therapeutic protocols for SARS-CoV-2 infection have been developed and implemented. Still, there are limited quality data on optimizing organizational management for hospitals that were not created to tackle this type of cases2-4 © 2022 Cernomaz A. T. et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution NonCommercial 4.0 International License. (http://creativecommons.org/licenses/by-nc/4.0)
ABSTRACT
Considering the increased prevalence of influenza infections in the cold season and the pandemic evolution of severe acute respiratory syndrome-CoV-2 (SARS-CoV-2), the medical staffs are facing potential viral co-infection with SARS-CoV-2 and influenza virus. Both viruses belong to the category of ribonucleic acid (RNA) viruses, having common structural features, causing a similar immune response, with a related mode of transmission and with both respiratory and general symptoms. SARS-CoV-2 and influenza viruses cause contagious infections and the protective measures against them are the same: wearing masks in crowded spaces, proper hand hygiene and avoiding crowded places. Co-infections with influenza A and B viruses and SARS-CoV-2 virus involve additional precautions regarding the therapeutic and evolution approach. Studies show that patients who have been vaccinated against influenza have developed milder forms of confirmed SARS-CoV-2 infection. In elderly patients, increased influenza vaccination coverage has shown to be associated with a decrease in mortality rate and also reduced the heavy impact of double infection. The Influenza vaccine can trigger early immune mechanisms in order to facilitate early detection of SARS-CoV-2 as well as its clearance. Influenza vaccination should now be seen, more than ever, as a strategy to combat the growing SARS-CoV-2 pandemic, especially in vulnerable populations (elderly and people with associated comorbidities). © 2020 Raluca Ioana Dospinescu Arcana et al., published by Sciendo 2020.