The risk of thrombosis after acute-COVID-19 infection.

Severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) has been associated with coagulation dysfunction which predisposes patients to an increased risk of both venous and arterial thromboembolism, increasing the short-term morbidity and mortality. Current data evidenced that the rate of post-discharge thrombotic events in COVID-19 patients is lower compared to that observed during hospitalization. Rather than 'true thrombotic events', these complications seem more probably 'immunothrombosis' consequent to the recent infection. Unfortunately, the absence of data from randomized controlled trials, large prospective cohorts and ambulatory COVID-19 patients, left unresolved the question regarding the need of post-discharge thromboprophylaxis due to the absence of strong-level recommendations.

Heart failure as a complication of COVID-19 infection: systematic review and meta-analysis

Background: The prevalence and prognostic implications of heart failure (HF), as a complication of COVID-19 infection remains unclear. Aims: We performed a systematic review and metanalysis aimed to evaluate the pooled incidence of acute HF as a cardiac complication of COVID- 19 disease and to estimate the related mortality risk in these patients. Methods: Data were obtained searching MEDLINE, Scopus and Web of Science for all investigations published any time to December 26, 2020. If statistical heterogeneity was 50%, the results were derived from the fixedeffects model otherwise the random-effects model. Results: Overall, 1064 patients [mean age 66 years, 618 males] were included in the final analysis reviewing six investigations. The cumulative in-hospital rate of COVID-19 patients complicated by acute HF ranged between 6.9 to 63.4% among the studies reviewed. A random effect model revealed a pooled incidence of COVID-19 patients complicated by acute HF in 20.2% of cases (95% CI: 11.1-33.9%, p<0.0001 I2=94.4%) (Figure 1, Panel A). A second pooled analysis, based on a random-effect model, confirmed a significant increased risk of death in COVID-19 patients complicated by acute HF during the infection (OR 9.36, 95% CI 4.76-18.4, p<0.0001, I2=56.6%) (Figure 1, Panel B). The Egger's tests revealed no evidence of publication bias in estimating both the primary and secondary outcome (t=0.058, p=0.956 and t=1.402, p=0.233, respectively). Meta-regression analysis, using age as moderator variable, failed in founding a statistically significant relationship with the incidence of acute HF onset as a complication of COVID-19 disease (p=0.062) or the mortality risk among the same subjects (p=0.053). Conclusions: Acute HF represents a frequent complication of COVID-19 infection associated with a higher risk of mortality in the short-term period.

COVID-19 patients with coronary artery disease have a higher mortality risk: A meta-analysis

Background: The prevalence and prognostic implications of coronary artery disease (CAD) in patients infected by the novel coronavirus 2019 disease (COVID-19) remain unclear. Purposes: We conducted a systematic review and meta-analysis to investigate the prevalence and mortality risk in COVID-19 patients with preexisting CAD. PRISMA. guidelines were followed in ing data and assessing validity. We searched Medline, Scopus and Web of Science to locate all articles published up to December 8, 2020 reporting data of COVID-19 survivors and non-survivors with pre-existing CAD. Data were pooled using the Mantel-Haenszel random effects models with odds ratio (OR) as the effect measure with the related 95% confidence interval (CI). Statistical heterogeneity between groups was measured using the Higgins I2 statistic. Results: Twenty-four studies, enrolling 22744 patients [mean age 58.2 and 70.9 years for survivors and non-survivors (p<0.0001), respectively], met the inclusion criteria and were included into the final analysis. The pooled prevalence of pre-existing CAD in COVID-19 patients was 11.5% (95% CI 0.097-0.136) and resulted significantly higher in non-survivors compared to survivors (16.7% vs 7.1%, respectively, p<0.0001). A randomeffect model confirmed a significant higher risk of death in COVID- 19 patients with pre-existing CAD in the short-term period (OR 2.96, 95% CI 2.18-4.03, p<0.0001, I2=79%) (Figure 1). A meta-regression, using age as moderator, did not identify any statistical significance (Coeff: -0.046, 95% CI -0.101-0.009, p=0.104). The Egger's regression test (t=0.596;p=0.06) confirmed that there were not statistically evidences of publication bias Conclusions: Pre-existing CAD in COVID-19 patients significantly increased the risk of death during the infection.

COVID-19 pandemic: Psychological aspects, behavioral alterations and profile of habits. Results of a survey in the university environment one month after total confinement in Mendoza, Argentina

Introduction: COVID-19 pandemic has shaken the world from the human, health, scientific, socio-economic, and political. In this paper we present results of an online survey applied to a university population. Material and methods: Data such as age, sex, functions, career, dependents, cohabitants and psychological aspects, habits and preventive behaviors were obtained. Results: Validated 1488 responses: 63% corresponded to female sex (SF), average age = 29.5 years (DE12.9). 70% were students and 30% teachers, managers, and others. 87% had COVID-19 pandemic concern (CPC). 41% levels of anguish (ANG), 56% anxiety (ANX), all in moderate to severe degree. 79% sleep disturbances and 65% in eating habits. Future worries (PaF) related to economic/labor aspects was the most mentioned (74%). 67% reported over-information (SInf) related to epidemiological situation. Logistic regression showed the following positive statistical relationships with RR (CI): CPC with age = 2.22 (1.52–3.24) and SInF = 4.22 (2.93–6.07);ANG with sex F = 1.40 (1.13–1.76), relaxation activity = 0.71 (0.57–0.88) and SInF = 2.91 (2.01–4.22);ANX with age = 1.75 (1.39–2.20) sex F = 1.32 (1.06–1.65), physical activity = 0.78 (0.62–0.97) and SInF = 2.72 (1.96–3.79) and sleep disturbances with: student function: = 1.78 (1.36–2.35) and SInF = 2.81 (2.01–3.92). Conclusions: This study highlights the high prevalence of potentially risky alterations to physical and psychological health during the COVID-19 pandemic. There are also high levels of worries about the future, especially involving economic/labor aspects. Therefore, active measures should be adopted early to promote comprehensive health in the general population, especially in young people and women, avoiding over-information and promoting healthy habits.

Dyslipidaemia and mortality in COVID-19 patients: a meta-analysis.

BACKGROUND: The prevalence and prognostic implications of pre-existing dyslipidaemia in patients infected by the SARS-CoV-2 remain unclear. AIM: To assess the prevalence and mortality risk in COVID-19 patients with pre-existing dyslipidaemia. DESIGN: Systematic review and meta-analysis. METHODS: Preferred reporting items for systematic reviews and meta-analyses guidelines were followed in abstracting data and assessing validity. We searched MEDLINE and Scopus to locate all the articles published up to 31 January 2021, reporting data on dyslipidaemia among COVID-19 survivors and non-survivors. The pooled prevalence of dyslipidaemia was calculated using a random-effects model and presenting the related 95% confidence interval (CI), while the mortality risk was estimated using the Mantel-Haenszel random-effect models with odds ratio (OR) and related 95% CI. Statistical heterogeneity was measured using the Higgins I2 statistic. RESULTS: Of about 18 studies, enrolling 74 132 COVID-19 patients (mean age 70.6 years), met the inclusion criteria and were included in the final analysis. The pooled prevalence of dyslipidaemia was 17.5% of cases (95% CI: 12.3-24.3%, P < 0.0001), with high heterogeneity (I2 = 98.7%). Pre-existing dyslipidaemia was significantly associated with higher risk of short-term death (OR: 1.69, 95% CI: 1.19-2.41, P = 0.003), with high heterogeneity (I2 = 88.7%). Due to publication bias, according to the Trim-and-Fill method, the corrected random-effect ORs resulted 1.61, 95% CI 1.13-2.28, P < 0.0001 (one studies trimmed). CONCLUSION: Dyslipidaemia represents a major comorbidity in about 18% of COVID-19 patients but it is associated with a 60% increase of short-term mortality risk.