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Objective: We aimed to find the parameters that can change during herpes zoster infection and observe the relationship of these parameters throughout the disease. Material and Methods: We compared 40 herpes zoster patients and 2 separate control groups, who were healthy and had comorbidities similar in age and gender. Patient files were retrospectively analyzed, and laboratory parameters were compared between groups. The laboratory values of the patient group with herpes zoster were evaluated among themselves according to the duration of the symptoms. Results: Fasting glucose, creatinine, aspartate aminotransferase values, the percentage and the absolute number of monocytes, red blood cell distribution width-coefficient of variation, and C-reactive protein levels of the patients with herpes zoster were significantly higher, and the absolute number of lymphocytes, mean corpuscular volume and platelet distribution width levels were lower than the control groups. The percentage of monocytes in the first 5 days was significantly higher than in the following days, and hematocrit values were lower in the last days. Conclusion: Examining routine laboratory values during diseases may help diagnose the disease, especially in patients with faint clinical signs and zoster sine zoster. In addition, it may be useful to question patients with herpes zoster for renal dysfunction, rheumatological diseases, and malignancy.
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Background: COVID-19 has caused a considerable number of hospital admissions in China since December 2019. Many COVID-19 patients experience signs of acute respiratory distress syndrome, and some are even in danger of dying. Background: to measure the serum levels of D-dimer, Neutrophil-Lymphocyte count ratio (NLR), and neopterin in patients hospitalized with severe COVID-19 in Baghdad, Iraq. And to determine the cut-off values (critical values) of these markers for the distinction between the severe patients diagnosed with COVID-19 and the controls. Materials and methods: In this case-control study, we collect blood from 89 subjects, 45 were severe patients hospitalized in many Baghdad medical centers who were diagnosed with COVID-19 infection, and 44 were apparently healthy subjects as a control. The time of collection is from September 15 th to December 31 th, 2021. The optimal cut-off points (critical values) and prognostic relevance of D-dimer, Neutrophil-Lymphocyte count ratio (NLR), and neopterin were investigated using (ROC) curves analysis. Results: In severe patients hospitalized with COVID-19 the levels of D-dimer, NLR, and neopterin were statistically significantly higher than in control participants (P < 0.005). The D-dimer, NLR, and neopterin tests have areas under the receiver operating characteristic (ROC) curves of 0.920, 0.90, and 0.74 respectively, and their critical values for the differentiation between the severe patients and control were 0.22 micro g/ml, 2.56, and 3.02 nmol/L. Conclusions: D-dimer, NLR, and neopterin levels in sever COVID-19 patients were higher than control, with values of greater than 0.22 micro g/ml, 2.56 and 3.02 nmol/L respectively was linked to a severe COVID-19 infection with good sensitivity and selectivity.
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BACKGROUND: Determining the vaccine effectiveness (VE) is an important part of studying every new vaccine. Test-negative case-control (TNCC) studies have recently been used to determine the VE. However, the estimated VE derived from a TNCC design depends on the test sensitivity and specificity. Herein, a method for correction of the value of VE derived from a TNCC study is presented. METHODS: An analytical method is presented to compute the corrected VE based on the sensitivity and specificity of the diagnostic test utilized. To show the application of the method proposed, a hypothetical TNCC study is presented. In this in silico study, 100 000 individuals referring to a healthcare system for COVID-19-like illness were tested with diagnostic tests with sensitivities of 0.6, 0.8, and 1.0, and specificities ranging from 0.85 to 1.00. A vaccination coverage of 60%, an attack rate of 0.05 for COVID-19 in unvaccinated group, and a true VE of 0.70, were assumed. In this simulation, a COVID-19-like illness with an attack rate of 0.30 could also affect all the studied population regardless of their vaccination status. RESULTS: The observed VE ranged from 0.11 (computed for a test sensitivity of 0.60 and specificity of 0.85) to 0.71 (computed for a test sensitivity and specificity of 1.0). The mean computed corrected VE derived from the proposed method was 0.71 (the standard deviation of 0.02). CONCLUSIONS: The observed VE derived from TNCC studies can be corrected easily. An acceptable estimate for VE can be computed regardless of the diagnostic test sensitivity and specificity used in the study.
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AIM: The study aimed to assess the effectiveness of the ChAdOx1 nCoV-19 vaccine in preventing laboratory-confirmed COVID-19. METHODS: It was a test-negative, case-control study conducted at Sharda Hospital, Greater Noida, India, between March 2021 and May 2021. An equal number of cases and controls were included in the study after taking proper informed consent. The individuals with positive reverse transcriptase-polymerase chain reaction test reports were taken as cases, whereas those with negative reports were included as controls. Data were analyzed and the groups were compared using multivariable logistic regression to calculate the odds ratio (OR), with adjustment for gender and presence or absence of comorbidities. The effectiveness of vaccine was calculated by the formula (1-adjusted OR) x100%. RESULTS: On analyzing the data from 560 case-control pairs, the vaccine effectiveness was calculated as 57.46% (95% confidence interval [CI]: 53.85-61.02) and 60.09% (95% CI: 56.32-63.77) for single dose and two doses, respectively. The effectiveness of complete and single-dose vaccination against the moderate-to-severe disease was calculated as 63.79% (95% CI: 58.58-68.77) and 56.19% (95% CI: 51.30-61.0), respectively. CONCLUSION: The ChAdOx1 nCoV-19 vaccine was found to be effective against COVID-19, with protection after two doses being a little more than that after a single dose. It also proved effective in protecting against the severe form of the disease.
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Introduction Multiple studies have demonstrated the multi-systemic involvement of COVID-19, and among all of these systems, there is mounting evidence that COVID-19 is linked to neurocognitive impairment, particularly when neurological symptoms are present. Our aim is to study the concept of cognitive dysfunction post-COVID-19 among college students in Saudi Arabia and its potential effect on their academic performance. Methods A population-based, observational case-control study was conducted across the Kingdom of Saudi Arabia, from May 2022 to September 2022. A total of 2,150 eligible students have completed the study questionnaire. An exact 776 (36.1%) of them had COVID-19 infection (group 1), while 1,374 (63.9%) students had not (group 2). The sample population was college-enrolled students from 18 to 28 years old, with a mean age of 21.3 for group 1 and 20.8 for group 2. Both groups were handed the same data collection tool to establish whether the COVID-19 survivors had cognitive deficits more than the control group. Results There was no significant difference between the two groups regarding their bio-demographic data, study methods, or vaccination rate. However, both Neurological Fatigue and Big Five Inventory score were significantly higher among infected students, comparable to non-infected students. A negative relation was found between the infected students' neurological fatigue (rho=-0.14), cognitive failure (rho=-0.10), and depression and anxiety scale with their GPA (rho=0.03). Contrarily, infected students showed a positive relationship between their GPA and the Big Five Inventory (rho=0.13) and Short Grit Scale (rho=0.14). Also, there was a significant inverse relation between students' apathy motivation with their Big Five Inventory. Likewise, there was an inverse relation between their neurological fatigue, cognitive failure, and apathy motivation with their Short Grit Scale. Conclusion We demonstrated that college students who have survived COVID-19 infection mostly complain of cognitive impairment, even though most of them have no comorbidities or psychological disorders.
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Background: COVID-19 has spread rapidly around the world. It is necessary to study lung tissue of postmortem COVID19 patients to determine the molecular alteration particularly the role of IL-6 and IL-17 in causing fatality. Background: This study aims to determine the differences in the expressions of IL-6 and IL-17 in lung tissue of post-mortem COVID-19 patients compared to non-COVID-19 patients. This study also aimed to analyze the correlation between the expressions of IL-6 and IL-17 in lung tissue of post-mortem COVID-19 patients. Methods: This research is an observational analytic study with crosssectional approach. The samples were 15 paraffin blocks of post-mortem lung tissue biopsy of COVID-19 patients, and 15 paraffin blocks of inflammatory lung tissue biopsy or surgery of non-COVID-19 patients. IL-6 and IL-17 expressions were evaluated by immunohistochemical procedure. Result: There was a significant difference in the expression of IL-6 in the COVID-19 group and the non-COVID-19 group with a p-value = 0.001 (p < 0.05). There was a significant difference in the expression of IL-17 in the COVID-19 group and the non-COVID-19 group with p-value = 0.001 (p < 0.05). There was a significant correlation between the expressions of IL-6 and IL-17 in the COVID-19 group, with the Spearman coefficient value (rs) of 0.548 with p = 0.034 (p < 0.05). Conclusion: There are differences in the expression of IL-6 and IL-17 between COVID-19 and non-COVID-19 lung tissue. There is a significant correlation between the expressions of IL-6 and IL-17 in post-mortem lung tissue of COVID-19 patients.
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Background and purpose: The Coronavirus Disease 2019 (COVID-19) pandemic, caused by severe respiratory syndrome coronavirus 2 (SARS-CoV-2) resulted in a worldwide emergency. Various studies show conflicting and diverse results on the role of inflammatory cytokines in predicting the severity and prognosis in patients with COVID-19. The aim of this study was to compare the serum levels of interleukin-6 (IL-6) and interleukin-8 (IL-8) in predicting the severity of COVID-19 and prognosis in patients admitted to Qaemshahr Razi Hospital. Materials and methods: In this cross-sectional prospective study, the serum levels of interleukin 8 and 6 were measured in 51 patients with COVID-19 and compared with 25 healthy individuals in Qaemshahr Razi Hospital, 2021. ELISA method was used to measure these cytokines and data analysis was performed in SPSS V25. Results: The serum levels of IL6 and IL8 in the patient group were about 4 times and 6 times higher than those of the control group, respectively. Average levels of IL-6 (P=0.004) and IL-8 (P<0.001) were significantly higher in patients with severe COVID-19 compared to moderate form and control group. There was no correlation between the duration of hospitalization and the level of IL-6 (P=0.1), while there was a significant correlation between the length of hospital stay and the level of IL-8 (P=0.012). Conclusion: IL-6 and IL-8 serum levels in patients with COVID-19 can be helpful in predicting the severity of disease and prognosis of patients.
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Background and Design: Systemic retinoids are commonly used medications in dermatology and indicated in various skin disorders such as acne vulgaris and psoriasis. Data about the risk of Coronavirus disease-2019 (COVID-19) in patients using systemic retinoids are limited. Thus, this study aimed to investigate the risk of COVID-19 in patients undergoing systemic retinoid therapy. Materials and Methods: A total of 186 patients who have undergone systemic isotretinoin and acitretin therapy were recruited. Patients who presented to the dermatology clinic for various skin diseases, such as eczema, vitiligo, tinea, etc., who were not on systemic retinoid therapy, and who received topical medications comprised the control group. The development of COVID-19 in the retinoid therapy group and the control group was retrospectively reviewed using hospital database. Results: The mean age of the patients in the retinoid therapy group was 25.72+or-0.67 and that in the control group was 25.4+or-0.62. Moreover,165 patients received isotretinoin, and 21 patients received acitretin treatment. The isotretinoin dosage ranged from 0.5 to 0.8 mg/kg wheras the acitretin dosage ranged between 10 and 25 mg/day. Two patients (1.07%) in the retinoid therapy group and 8 (4.3%) patients in the control group were diagnosed with COVID-19. None of the patients receiving acitretin was diagnosed with COVID-19. COVID-19 diagnosis was established in the 2nd and 3rd months of isotretinoin treatment, and lung involvement was not observed. No significant difference regarding the number of COVID-19 cases and disease severity was found between the two groups (p=0.105;p=0.258, respectively). Conclusion: Isotretinoin and acitretin use was not associated with increased COVID-19 risk or disease severity. Systemic retinoids appear to be a safe treatment modality in the COVID-19 era.
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Background: The severity of Coronavirus Disease-2019 (COVID-19) cases is associated with hyperinflammation. Patients with critical and severe COVID-19 have been observed to have high amounts of circulating cytokines. Neopterin, a crucial cytokine in the antiviral immune response that is released by macrophages upon stimulation with interferon-gamma, can be utilized to forecast the severity of illness in COVID-19 patients. Methods: The study included 185 patients with COVID-19. The patients with COVID-19 were divided into three groups according to disease severity as critical disease (n=51), severe disease (n=81), and moderate disease (n=53). All basic demographic and clinical data of the patients were recorded and blood samples were collected. Results: Neopterin levels were significantly higher in critical COVID-19 patients compared with severe and moderate COVID-19 patients (p < 0.0001). Further, neopterin showed significantly higher levels in the age group >50 years of patients with COVID-19 than in the age group <50 years. Neopterin levels were correlated with WBCs, Platelet, CRP, D-Dimer, Ferritin, Fibrinogen, IL-6, and Procalcitonin levels positively (ρ= 0.569, 0.474, 0.338, 0.696, 0.605, 0.77, 0.727, and 0.585;p < 0.01 respectively), and correlated with BMI, SpO2, and lymphocyte negatively (ρ= - 0.165;p < 0.05, p= - 0.754, - 0. 548;p < 0.01 respectively). A cutoff value of 23.62 nmol/L for neopterin predicted COVID-19 with a sensitivity of 95.7% and a specificity of 95.5% (AUC: 0.986;p < 0.0001). Conclusion: Neopterin may be a useful prognostic biomarker for assessing the severity of COVID-19.
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The COVID-19 pandemic has focused attention on issues of epidemiology, public health, and vaccine design. I submit that attention to COVID-19 pharmacologic therapy needs similar emphasis, including identifying any existing medications that can be repurposed to treat COVID-19 patients.
Subject(s)
Coronavirus Infections/drug therapy , Drug Repositioning , Pneumonia, Viral/drug therapy , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Drug Therapy/trends , Humans , Pandemics , Pneumonia, Viral/epidemiology , Public Health , SARS-CoV-2 , COVID-19 Drug TreatmentABSTRACT
BACKGROUND: Disease and treatment-associated immune system abnormalities may confer higher risk of Coronavirus disease 2019 (COVID-19) to people with multiple sclerosis (PwMS). We assessed modifiable risk factors associated with COVID-19 in PwMS. METHODS: Among patients referring to our MS Center, we retrospectively collected epidemiological, clinical and laboratory data of PwMS with confirmed COVID-19 between March 2020 and March 2021 (MS-COVID, n = 149). We pursued a 1:2 matching of a control group by collecting data of PwMS without history of previous COVID-19 (MS-NCOVID, n = 292). MS-COVID and MS-NCOVID were matched for age, expanded disability status scale (EDSS) and line of treatment. We compared neurological examination, premorbid vitamin D levels, anthropometric variables, life-style habits, working activity, and living environment between the two groups. Logistic regression and Bayesian network analyses were used to evaluate the association with COVID-19. RESULTS: MS-COVID and MS-NCOVID were similar in terms of age, sex, disease duration, EDSS, clinical phenotype and treatment. At multiple logistic regression, higher levels of vitamin D (OR 0.93, p < 0.0001) and active smoking status (OR 0.27, p < 0.0001) emerged as protective factors against COVID-19. In contrast, higher number of cohabitants (OR 1.26, p = 0.02) and works requiring direct external contact (OR 2.61, p = 0.0002) or in the healthcare sector (OR 3.73, p = 0.0019) resulted risk factors for COVID-19. Bayesian network analysis showed that patients working in the healthcare sector, and therefore exposed to increased risk of COVID-19, were usually non-smokers, possibly explaining the protective association between active smoking and COVID-19. CONCLUSIONS: Higher Vitamin D levels and teleworking may prevent unnecessary risk of infection in PwMS.
Subject(s)
COVID-19 , Multiple Sclerosis , Humans , Multiple Sclerosis/complications , Multiple Sclerosis/epidemiology , Multiple Sclerosis/drug therapy , Case-Control Studies , Retrospective Studies , Bayes Theorem , Vitamin D/therapeutic use , Risk FactorsABSTRACT
Background: Early identification of COVID-19-associated pulmonary aspergillosis (CAPA) is particularly challenging in low- middle-income countries where diagnostic capabilities are limited, and risk factors for CAPA have not been identified. It is also essential to recognise CAPA patients who are likely to have a poorer outcome to decide on aggressive management approaches. Therefore, this study aimed to identify risk factors and outcomes for CAPA among admitted moderate to critical COVID-19 patients at our centre in Pakistan. Methods: An unmatched case–control study with ratio of 1:2 was conducted on hospitalised adult patients with COVID-19 from March 2020–July 2021. Cases were defined according to European Confederation of Medical Mycology and the International Society for Human and Animal Mycology consensus criteria. Controls were defined as patients hospitalised with moderate, severe or critical COVID-19 without CAPA. Results: A total of 100 CAPA cases (27 probable CAPA;73 possible CAPA) were compared with 237 controls. Critical disease at presentation (aOR 5.04;95% CI 2.18–11.63), age ≥ 60 years (aOR 2.00;95% CI 1.20–3.35) and underlying co-morbid of chronic kidney disease (CKD) (aOR 3.78;95% CI 1.57–9.08) were identified as risk factors for CAPA. Patients with CAPA had a significantly greater proportion of complications and longer length of hospital stay (p-value <.001). Mortality was higher in patients with CAPA (48%) as compared to those without CAPA (13.5%) [OR = 6.36(95% CI 3.6–11)]. Conclusions: CAPA was significantly associated with advanced age, CKD and critical illness at presentation, along with a greater frequency of complications and higher mortality. © 2022 Wiley-VCH GmbH.
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Background The COVID-19 pandemic seriously affects human health and life. COVID-19 has been reportedly associated with a high risk of thrombotic events, which are closely associated with stroke. Objective To assess the effect and possible mechanism of COVID-19 on stroke morbidity, providing a reliable theoretical basis for scientific prevention and treatment of COVID-19 in stroke. Methods We searched databases of Web of Science, PubMed, EmBase, Cochrane Library, CNKI and Wanfang Data for cohort studies and case-control studies related to COVID-19 and stroke published from December 2019 to January 2022. Two researchers conducted literature screening and data extraction separately. The Newcastle-Ottawa Scale was used to assess the quality of included studies. Meta-analysis was used to evaluate the impact of COVID-19 on stroke mortality. Funnel plot was used to evaluate the potential publication bias. Results A total of 18 studies were included, 12 of them were of good quality, and other 6 were of fair quality. Meta-analysis showed that stroke patients with COVID-19 had higher mortality 〔RR=4.16, 95%CI(2.82, 6.13), P<0.000 01〕, prolonged prothrombin time (PT) 〔MD=0.78, 95%CI (0.35, 1.20), P=0.000 3〕, higher D-dimer level 〔MD=1.34, 95%CI(0.83, 1.84), P<0.000 01〕 and higher NIHSS score 〔MD=6.66, 95%CI (4.54, 8.79), P<0.000 01〕, as well as younger age 〔MD=-2.04, 95%CI(-3.48, -0.61), P=0.005〕 than those without COVID-19. There was no statistically significant difference in activated partial thromboplastin time between stroke patients with and without COVID-19 〔MD=2.51, 95%CI(-2.69, 7.71), P=0.34〕. Funnel plot assessing potential publication bias in the impact of COVID-19 on stroke mortality was basically symmetrical. Conclusion COVID-19 could increase the risk of stroke mortality, which may be related to alterations in the coagulation system manifested by abnormal PT and D-dimer level and so on. And the outcomes of stroke patients with COVID-19 were associated with age and NIHSS score at admission. © 2023 Chinese General Practice. All rights reserved.
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Background The worldwide COVID-19 pandemic has turned into a global catastrophic public health crisis，and the conclusion about the risk factors of hospital death in COVID-19 patients is not uniform. Objective To explore risk factors of in-hospital death in patients with COVID-19 by a meta-analysis. Methods Case-control studies about risk factors of in-hospital death in COVID-19 patients were searched from databases of the Cochrane Library，ScienceDirect，PubMed，Medline，Wanfang Data，CNKI and CQVIP from inception to October 1，2021. Literature screening，data extraction and methodological quality assessment were conducted. Meta-analysis was performed using Stata 15.1. Meta-regression was used to explore the potential sources of heterogeneity. Results Eighty studies were included which involving 405 157 cases〔349 923 were survivors（86.37%），and 55 234 deaths（13.63%）〕，that were rated as being of high quality by the Newcastle-Ottawa Scale. Meta-analysis showed that being male〔OR=1.49，95%CI（1.41，1.57），P<0.001），older age〔WMD=10.44，95%CI（9.79，11.09），P<0.001〕，dyspnoea〔OR=2.09，95%CI（1.80，2.43），P<0.001〕，fatigue〔OR=1.49，95%CI（1.31，1.69），P<0.001〕，obesity〔OR=1.46，95%CI（1.43，1.50），P<0.001〕，smoking〔OR=1.18，95%CI （1.14，1.23），P<0.001〕，stroke〔OR=2.26，95%CI（1.41，3.62），P<0.001〕，kidney disease〔OR=3.62，95%CI （3.26，4.03），P<0.001〕，cardiovascular disease〔OR=2.34，95%CI（2.21，2.47），P<0.001〕，hypertension〔OR=2.23，95%CI（2.10，2.37），P<0.001〕，diabetes〔OR=1.84，95%CI（1.74，1.94），P<0.001〕，cancer〔OR=1.86，95%CI （1.69，2.05），P<0.001〕，pulmonary disease〔OR=2.38，95%CI（2.19，2.58），P<0.001〕，liver disease〔OR=1.65，95%CI（1.36，2.01），P<0.001〕，elevated levels of white blood cell count〔WMD=2.03，95%CI（1.74，2.32），P<0.001〕，neutrophil count〔WMD=1.77，95%CI（1.49，2.05），P<0.001〕，total bilirubin〔WMD=3.19，95%CI（1.96，4.42），P<0.001〕，aspartate transaminase〔WMD=13.02，95%CI（11.70，14.34），P<0.001〕，alanine transaminase 〔WMD=2.76，95%CI（1.68，3.85），P<0.001〕，lactate dehydrogenase〔WMD=166.91，95%CI（150.17，183.64），P<0.001〕，blood urea nitrogen〔WMD=3.11，95%CI（2.61，3.60），P<0.001〕，serum creatinine〔WMD=22.06，95%CI （19.41，24.72），P<0.001〕，C-reactive protein〔WMD=76.45，95%CI （71.33，81.56），P<0.001〕，interleukin-6 〔WMD=28.21，95%CI（14.98，41.44），P<0.001〕，and erythrocyte sedimentation rate〔WMD=8.48，95%CI（5.79，11.17），P<0.001〕were associated with increased risk of in-hospital death for patients with COVID-19，while myalgia〔OR=0.73，95%CI（0.62，0.85），P<0.001〕，cough〔OR=0.87，95%CI（0.78，0.97），P=0.013〕，vomiting〔OR=0.73，95%CI （0.54，0.98），P=0.030〕，diarrhoea〔OR=0.79，95%CI（0.69，0.92），P=0.001〕，headache〔OR=0.55，95%CI（0.45，0.68），P<0.001〕，asthma〔OR=0.73，95%CI（0.69，0.78），P<0.001〕，low body mass index〔WMD=-0.58，95%CI （-1.10，-0.06），P=0.029〕，decreased lymphocyte count〔WMD=-0.36，95%CI（-0.39，-0.32），P<0.001〕，decreased platelet count 〔WMD=-38.26，95%CI（-44.37，-32.15），P<0.001〕，increased D-dimer〔WMD=0.79，95%CI（0.63，0.95），P<0.001〕，longer prothrombin time〔WMD=0.78，95%CI（0.61，0.94），P<0.001〕，lower albumin〔WMD =-1.88，95%CI（-2.35，-1.40），P<0.001〕，increased procalcitonin〔WMD=0.27，95%CI（0.24，0.31），P<0.001〕，and increased cardiac troponin〔WMD=0.04，95%CI（0.03，0.04），P<0.001〕were associated with decreased risk of in-hospital death due to COVID-19. According to the meta-regression result，the heterogeneity in gender，renal disease，cardiovascular diseases，asthma，white blood cell count，neutrophil count，platelet count，hemoglobin，and urea nitrogen differed siangificnatly by country（P<0.05）. Conclusion The risk of in-hospital death due to COVID-19 may be increased by 25 factors（including being male，older age，dyspnoea，fatigue，obesity，smoking，stroke，kidney disease，cardiovascular disease，hypertension，diabetes，cancer，pulmonary disease，liver disease，elevated levels of white blood cells，neutrophil count，total bilirubin，aspartate transaminase，alanine transaminase，lactate dehydrogenase，blood urea nitrogen，serum creatinine，C-reactive protein，interleukin-6，and erythrocyte sedimentation rate），and may be decreased by 13 factors（including myalgia，cough，vomiting，diarrhoea，headache，asthma，low body mass index，decreased lymphocyte count and platelet count，increased D-dimer，longer prothrombin time，lower albumin，increased procalcitonin and cardiac troponin）. The conclusion drawn from this study needs to be further confirmed by high-quality，multicenter，large-sample，real-world studies. © 2023 Chinese General Practice. All rights reserved.
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Background The worldwide COVID-19 pandemic has turned into a global catastrophic public health crisis，and the conclusion about the risk factors of hospital death in COVID-19 patients is not uniform. Objective To explore risk factors of in-hospital death in patients with COVID-19 by a meta-analysis. Methods Case-control studies about risk factors of in-hospital death in COVID-19 patients were searched from databases of the Cochrane Library，ScienceDirect，PubMed，Medline，Wanfang Data，CNKI and CQVIP from inception to October 1，2021. Literature screening，data extraction and methodological quality assessment were conducted. Meta-analysis was performed using Stata 15.1. Meta-regression was used to explore the potential sources of heterogeneity. Results Eighty studies were included which involving 405 157 cases〔349 923 were survivors（86.37%），and 55 234 deaths（13.63%）〕，that were rated as being of high quality by the Newcastle-Ottawa Scale. Meta-analysis showed that being male〔OR=1.49，95%CI（1.41，1.57），P<0.001），older age〔WMD=10.44，95%CI（9.79，11.09），P<0.001〕，dyspnoea〔OR=2.09，95%CI（1.80，2.43），P<0.001〕，fatigue〔OR=1.49，95%CI（1.31，1.69），P<0.001〕，obesity〔OR=1.46，95%CI（1.43，1.50），P<0.001〕，smoking〔OR=1.18，95%CI （1.14，1.23），P<0.001〕，stroke〔OR=2.26，95%CI（1.41，3.62），P<0.001〕，kidney disease〔OR=3.62，95%CI （3.26，4.03），P<0.001〕，cardiovascular disease〔OR=2.34，95%CI（2.21，2.47），P<0.001〕，hypertension〔OR=2.23，95%CI（2.10，2.37），P<0.001〕，diabetes〔OR=1.84，95%CI（1.74，1.94），P<0.001〕，cancer〔OR=1.86，95%CI （1.69，2.05），P<0.001〕，pulmonary disease〔OR=2.38，95%CI（2.19，2.58），P<0.001〕，liver disease〔OR=1.65，95%CI（1.36，2.01），P<0.001〕，elevated levels of white blood cell count〔WMD=2.03，95%CI（1.74，2.32），P<0.001〕，neutrophil count〔WMD=1.77，95%CI（1.49，2.05），P<0.001〕，total bilirubin〔WMD=3.19，95%CI（1.96，4.42），P<0.001〕，aspartate transaminase〔WMD=13.02，95%CI（11.70，14.34），P<0.001〕，alanine transaminase 〔WMD=2.76，95%CI（1.68，3.85），P<0.001〕，lactate dehydrogenase〔WMD=166.91，95%CI（150.17，183.64），P<0.001〕，blood urea nitrogen〔WMD=3.11，95%CI（2.61，3.60），P<0.001〕，serum creatinine〔WMD=22.06，95%CI （19.41，24.72），P<0.001〕，C-reactive protein〔WMD=76.45，95%CI （71.33，81.56），P<0.001〕，interleukin-6 〔WMD=28.21，95%CI（14.98，41.44），P<0.001〕，and erythrocyte sedimentation rate〔WMD=8.48，95%CI（5.79，11.17），P<0.001〕were associated with increased risk of in-hospital death for patients with COVID-19，while myalgia〔OR=0.73，95%CI（0.62，0.85），P<0.001〕，cough〔OR=0.87，95%CI（0.78，0.97），P=0.013〕，vomiting〔OR=0.73，95%CI （0.54，0.98），P=0.030〕，diarrhoea〔OR=0.79，95%CI（0.69，0.92），P=0.001〕，headache〔OR=0.55，95%CI（0.45，0.68），P<0.001〕，asthma〔OR=0.73，95%CI（0.69，0.78），P<0.001〕，low body mass index〔WMD=-0.58，95%CI （-1.10，-0.06），P=0.029〕，decreased lymphocyte count〔WMD=-0.36，95%CI（-0.39，-0.32），P<0.001〕，decreased platelet count 〔WMD=-38.26，95%CI（-44.37，-32.15），P<0.001〕，increased D-dimer〔WMD=0.79，95%CI（0.63，0.95），P<0.001〕，longer prothrombin time〔WMD=0.78，95%CI（0.61，0.94），P<0.001〕，lower albumin〔WMD =-1.88，95%CI（-2.35，-1.40），P<0.001〕，increased procalcitonin〔WMD=0.27，95%CI（0.24，0.31），P<0.001〕，and increased cardiac troponin〔WMD=0.04，95%CI（0.03，0.04），P<0.001〕were associated with decreased risk of in-hospital death due to COVID-19. According to the meta-regression result，the heterogeneity in gender，renal disease，cardiovascular diseases，asthma，white blood cell count，neutrophil count，platelet count，hemoglobin，and urea nitrogen differed siangificnatly by country（P<0.05）. Conclusion The risk of in-hospital death due to COVID-19 may be increased by 25 factors（including being male，older age，dyspnoea，fatigue，obesity，smoking，stroke，kidney disease，cardiovascular disease，hypertension，diabetes，cancer，pulmonary disease，liver disease，elevated levels of white blood cells，neutrophil count，total bilirubin，aspartate transaminase，alanine transaminase，lactate dehydrogenase，blood urea nitrogen，serum creatinine，C-reactive protein，interleukin-6，and erythrocyte sedimentation rate），and may be decreased by 13 factors（including myalgia，cough，vomiting，diarrhoea，headache，asthma，low body mass index，decreased lymphocyte count and platelet count，increased D-dimer，longer prothrombin time，lower albumin，increased procalcitonin and cardiac troponin）. The conclusion drawn from this study needs to be further confirmed by high-quality，multicenter，large-sample，real-world studies. © 2023 Chinese General Practice. All rights reserved.
ABSTRACT
Background: SARS-CoV-2, an enveloped, positive-sense single-stranded RNA virus, was the cause of the pandemic COVID-19. It enters the host cells via the angiotensin-converting enzyme 2 (ACE2) receptor and causes diffuse alveolar damage, pulmonary capillary congestion, and a cytokine storm, which leads to respiratory failure and the deadly acute respiratory distress syndrome (ARDS). Asthma affects a sizable majority of COVID-19 patients. The effects of asthma on COVID-19 progression are still unknown, but a moderating effect is conceivable because respiratory viruses are known to be a significant cause of asthma attacks, and another factor, possibly SCF (stem cell factor and its receptor), is a pleiotropic cytokine that affects immune response activation and survival at various stages of bone marrow development. Therefore, the study's case control objective was to assess the blood levels of c-KIT and the gene expression of stem cell factors in various age groups (asthmatics, people infected with Covid-19, and asthmatics and infected patients compared to healthy subjects). Methods: A case-control investigation was carried out on This study included one handicapped patient who visited Al-Kadhimya Hospital, Medical City, and private clinics in Baghdad, Iraq. The study also included 50 control subjects (without asthma or covid 19). For all groups indicated, the serum level of C-Kit was calculated using ELISA methods. SCF's gene expression was evaluated using the Ct value and folding (2-ΔΔCt) and standardized to the level of a housekeeping gene (GAPDH). Results: The expression of c-KIT and SCF significantly increased in the aforementioned groups (p < 0.001 and p <0.05, respectively). Conclusion: Serum concentrations of SCF and its soluble receptor c-kit appear to be prospective diagnostic targets for asthma and Covid-19 severity, indicating a function for these molecules in asthmatic inflammation as well as a potential treatment target for Covid-19 pathogenesis.
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Background The COVID-19 pandemic seriously affects human health and life. COVID-19 has been reportedly associated with a high risk of thrombotic events, which are closely associated with stroke. Objective To assess the effect and possible mechanism of COVID-19 on stroke morbidity, providing a reliable theoretical basis for scientific prevention and treatment of COVID-19 in stroke. Methods We searched databases of Web of Science, PubMed, EmBase, Cochrane Library, CNKI and Wanfang Data for cohort studies and case-control studies related to COVID-19 and stroke published from December 2019 to January 2022. Two researchers conducted literature screening and data extraction separately. The Newcastle-Ottawa Scale was used to assess the quality of included studies. Meta-analysis was used to evaluate the impact of COVID-19 on stroke mortality. Funnel plot was used to evaluate the potential publication bias. Results A total of 18 studies were included, 12 of them were of good quality, and other 6 were of fair quality. Meta-analysis showed that stroke patients with COVID-19 had higher mortality 〔RR=4.16, 95%CI(2.82, 6.13), P<0.000 01〕, prolonged prothrombin time (PT) 〔MD=0.78, 95%CI (0.35, 1.20), P=0.000 3〕, higher D-dimer level 〔MD=1.34, 95%CI(0.83, 1.84), P<0.000 01〕 and higher NIHSS score 〔MD=6.66, 95%CI (4.54, 8.79), P<0.000 01〕, as well as younger age 〔MD=-2.04, 95%CI(-3.48, -0.61), P=0.005〕 than those without COVID-19. There was no statistically significant difference in activated partial thromboplastin time between stroke patients with and without COVID-19 〔MD=2.51, 95%CI(-2.69, 7.71), P=0.34〕. Funnel plot assessing potential publication bias in the impact of COVID-19 on stroke mortality was basically symmetrical. Conclusion COVID-19 could increase the risk of stroke mortality, which may be related to alterations in the coagulation system manifested by abnormal PT and D-dimer level and so on. And the outcomes of stroke patients with COVID-19 were associated with age and NIHSS score at admission. © 2023 Chinese General Practice. All rights reserved.
ABSTRACT
Introduction: From January 2020 to December 31st, 2021, an estimated 5,940,000 people have died from COVID-19 worldwide. Case fatality rates vary by country, study setting and time. The objective of the present study was to determine the epidemiological and clinical factors associated with COVID-19 deaths in our department. Material and methods: This was a retrospective, descriptive and analytical case-control study of patients hospitalized in the Pulmonology Department of University Teaching Hospital Joseph Raseta Befelatanana in Antananarivo Madagascar, during the first two waves of COVID-19 in the country, from March to September 2020 and from March to June 2021.
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Objective: To analyze the risk factors of COVID-19 infection in Danzhou, Hainan province.
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Objective: To compare the characteristics of COVID-19 patients and healthy people, including living habits, living environment etc. so as to provide evidence for policy making in disease control.