ABSTRACT
Context: Hepatic manifestations of Coronavirus Disease 2019 (COVID-19) are common among people living with Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV). Objectives: This systematic review aimed to summarize the evidence on COVID-19 patients living with HBV or HCV co-infections. Data Sources: We searched multiple electronic databases and preprint servers from December 1, 2019, to August 9, 2020. Study Selection: Studies were included if they reported quantitative empirical data on COVID-19 patients living with HBV or HCV co-infections. Data Extraction: Descriptive analyses were reported, and data were synthesized narratively. The quality assessment was completed using the Joanna Briggs Institute critical appraisal tools. Results: Out of the 941 uniquely identified records, 27 studies were included. Of the eligible studies, 232 COVID-19 patients were living with HBV and 22 were living with HCV. Most patients were male, and the mean age was 49.8 and 62.8 years in patients living with HBV and HCV, respectively. Among the reported cases of SARS-CoV-2-HBV co-infection, the proportions of death were 4.7% and 15% in cross-sectional and case series/report studies, respectively. The death proportion was 8.3% among the reported cases of SARS-CoV2-HCV co-infection. Among COVID-19 patients, 34.1% and 76.2% reported at least one comorbidity besides HBV and HCV infections, mainly hypertension and type 2 diabetes mellitus. The most common COVID-19-related symptoms in both HBV and HCV groups were fever, cough, dyspnea, fatigue, and gastrointestinal symptoms. Conclusions: While understanding the pathogenesis of SARS-CoV-2 requires further investigations, the careful assessment of hepatic manifestations and chronic infections, such as HBV and HCV upon the admission of COVID-19 patients could help reduce multimorbidity among HBV or HCV patients and lead to more favorable health outcomes among them.
ABSTRACT
Introduction: Following the widespread pandemic of the novel coronavirus diseases (COVID-19), this study has reported demographic and laboratory findings and clinical outcomes of patients with COVID-19 admitted to a tertiary educational hospital in 99 days in Iran. Objective: We aimed to investigate in-hospital death risk factors including underlying diseases and describe the signs, symptoms, and demographic features of COVID-19 patients. Methods: All confirmed COVID-19 cases admitted from 22 February to 30 May 2020 were extracted from hospital records. A follow-up telephone survey was conducted 30 days after discharge to acquire additional data such as survival status. Distribution of demographic and clinical characteristics was presented based on survival status during hospitalization. All analyses were performed using STATA version 14 with a level of significance below 5%. Results: Among 1083 recorded patients, the rate of survival and death was 89.2% (n=966) and 10.8% (n=117), respectively. 62% of the cases (n=671) were male. The mean recovery time was 1.90 (3.4) days in survived cases, which was significantly lower than that in deceased cases 4.5 (5.2) days, p<0.001). A significantly higher rate of death was observed among patients above the age of 60 years (24.8%, p<0.001), cases with hypertension (25.4%, P<0.001) and cases without cough ( 17 %, p=0.002) but with shortness of breath (16.5%, p=0.001). Conclusions: Our study emphasized the significant effect of different underlying conditions as mortality factors among COVID-19 patients, namely older age spectrum, hypertension, and ischemic heart disease. By acknowledging the epidemiologic pattern and mortality factors, we have more tools to prioritize and make better judgments, and more lives can be saved.
ABSTRACT
Background and Objectives: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was first de-scribed during a pneumonia outbreak in Wuhan, has attracted tremendous attention in a short period of time as the death toll and the number of confirmed cases is growing unceasingly. Although molecular testing is the gold standard method of SARS-CoV-2 detection, the existence of the false-negative results presents a major limitation to this method. Materials and Methods: This retrospective Double-Centre study was conducted on 1320 COVID-19 patients recruited at Taleghani and Shohadae Tajrish Hospitals in Tehran, Iran. We analyzed the leukocyte, lymphocyte and neutrophil counts of hospitalized cases both on admission and at discharge. We also evaluated the alteration of these parameters within a sev-en-day follow-up. Results: Of the whole, 1077 (81.6%) neither were admitted to intensive care unit (ICU) nor experienced death, and were defined as the mild-moderate group. Of 243 severe cases, while 59 (24.3%) were admitted to ICU and cured with the intensive care services, 184 (75.7%) patients died of the disease, either with or without ICU admission. Calculation of neu-trophil-to-lymphocyte ratio (NLR) revealed that the mild-moderate cases had a lower ratio at discharge. On the other hand, the ratio was significantly higher in the death group as compared to the ICU group;highlighting the fact that patients with a higher degree of neutrophilia and a greater level of lymphopenia have a poor prognosis. Conclusion: We suggest that NLR greater than 6.5 may reflect the progression of the disease towards an unfavorable clinical outcome, with this notion that the ratios higher than 9 may strongly result in death.