Anemia as a Predictor of Poor Clinical Outcome in Patients Admitted for Covid-19

Background: In respiratory infections, anemia is both a consequence of acute inflammation [1] and a predictor [2] of poor clinical outcomes. There are few studies investigating the role of anemia in COVID-19, suggesting a potential role in predicting disease severity [3, 4]. In this study, we aimed to assess the association between the presence of anemia at admission and incidence of severe disease and death in patients hospitalized for COVID-19. Method(s): Data from all adult patients admitted for COVID-19 in University Hospital P. Giaccone (Palermo) and University Hospital of Bari, Italy, were retrospectively collected from 1st of September 2020 and 31 August 2022. The association between anemia (defined as Hb < 13 g/dl and < 12 g/dl in males and females, respectively), in-hospital mortality and severe COVID-19 was tested using a Cox's regression analysis. Severe COVID-19 forms were defined as admission to intensive or sub-intensive care unit or a qSOFAscore >=2 or CURB65scores >=3. P values were calculated using the Student's T-test for continuous variables and the Mantel-Haenszel Chi-square test for categorical ones. The association between anemia and the mortality was made using a Cox's regression analysis, adjusted, in two models, for the potential confounders and using a propensity score. Result(s): Among the 1562 patients included in the analysis, prevalence of anemia was 45.1% (95%CI 43-48%), and as shown in Table 1, were significantly older (p< 0.0001), reported more co- morbidities, and presented higher baseline levels of procalcitonin, CRP, ferritin and IL-6. As shown in Figure 1, patients with anemia reported a higher crude higher incidence of mortality compared to patients without this condition (Figure 1). Overall, the crude incidence of mortality was about four times higher in patients with anemia compared to those without. After adjusting for 17 potential confounders, the presence of anemia significantly increased the risk of death (HR=2.68;95%CI: 1.59-4.52) and of risk of severe COVID-19 (OR=2.31;95%CI: 1.65-3.24) (Table 2). The propensity score analysis substantially confirmed these analyses. Conclusion(s): Our study provides evidence that, in patients hospitalized for COVID-19, anemia is both associated with a more pronounced baseline proinflammatory profile and higher incidence of in-hospital mortality and severe disease.

COVID-19: Impact of Pandemic on Older People Health and Well-Being

Since March 2020 and the declaration of pandemic, we may consider that three categories of disease are striking worldwide, COVID-19, a surge of noncommunicable diseases which due to COVID-19 are less treated and considered, and agism. COVID-19 is known to be sever in frail older people, with poor outcomes and often our older patients are frail. Moreover, frailty and COVID-19 share a proinflammatory cytokines cascade which may lead to an increase of mortality in these patients. COVID-19 lockdown also has led and is leading to several psychological disorders, notably in older people and older people with cognitive impairment. Patients in rural settings, primary care, and nursing homes with frailty were severely affected with COVID-19, also in their social and familial relationship. It is a crucial task for both general practitioners and geriatricians to assess and treat their older patients even in this context, notwithstanding the obstacles and limitations, levering eventually on e-health and ICT. © 2022, Springer Nature Switzerland AG.

Social environmental impact of COVID-19 and erectile dysfunction: an explorative review.

BACKGROUND: To date, no attempt has been made to collate literature on the relationship between the social environmental impact of COVID-19 and erectile dysfunction. The aim of this explorative review was to assess and compare the prevalence of erectile dysfunction (ED) in male healthcare workers and males during the COVID-19 pandemic. METHODS: A systematic review of major databases from inception to February 2021 was conducted. Prevalence data were extracted, and a random-effects meta-analysis was undertaken. OUTCOMES: The pooled prevalence of ED amongst healthcare workers working in COVID-19 specific environments, and non-healthcare during the COVID-19 pandemic. RESULTS: Of 52 initial studies, six were included for the final analysis. The pooled prevalence of ED in healthcare workers working in a COVID-19 environment was 63.6% (95% CI 20.3-92.3%), and in non-healthcare workers during the COVID-19 pandemic was 31.9% (95% CI 19.5-47.6%). CONCLUSION: The prevalence of ED in healthcare workers working in COVID-19 environments was higher than representative samples and is of concern. Sexual health (and by extension, overall health), should be a priority when considering ways to care for this population. Considering the social environmental impact of COVID-19 on sexual health and in particular on ED, it is important to provide adequate psychological support systems and to promote quality of life with particular attention to sexual health.

Coronavirus diseases (COVID-19) current status and future perspectives: a narrative review

At the end of 2019 a novel virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing severe acute respiratory syndrome expanded globally from Wuhan, China. In March 2020 the World Health Organization declared the SARS-Cov-2 virus a global pandemic. We performed a narrative review to describe existing literature with regard to Corona Virus Disease 2019 (COVID-19) epidemiology, pathophysiology, diagnosis, management and future perspective. MEDLINE, EMBASE and Scopus databases were searched for relevant articles. Although only when the pandemic ends it will be possible to assess the full health, social and economic impact of this global disaster, this review represents a picture of the current state of the art. In particular, we focus on public health impact, pathophysiology and clinical manifestations, diagnosis, case management, emergency response and preparedness.