Umifenovir in COVID-19 therapy: a systematic review and meta-analysis.

SARS-CoV-2 has infected more than 600 million people worldwide over the last 2.5 years. So far, there efficacy of many antiviral drugs against COVID-19 has been evaluated only in small studies conducted in different countries. Objective. To assess the efficacy of umifenovir in patients with COVID-19. Materials and methods. We performed systematic search of publications in the PubMed and Google Scholar databases. Sixteen studies with a total of 1,843 patients were included in the analysis. The following endpoints were evaluated: frequencies of negative PCR test on days 7 and 14;mortality in patients with mild, moderate, and severe disease;and frequency of fever resolution on day 7. Results. We found that patients receiving umifenovir demonstrated a significantly higher frequency of negative PCR test on day 7 than patients who received no causal therapy or other antiviral drugs (odds ratio (OR) 1.69, 95% confidence interval (CI): 1.09-2.62, p = 0.02, I2 = 13%). This difference was even more significant among patients with mild to moderate COVID-19 (OR: 2.03, 95% CI: 1.24-3.32, p = 0.005, I2 = 0%), as well as on day 14 (OR: 2.02, 95% CI: 1.35-3.94, p = 0.0007, I2 = 50%). We also observed a reduced risk of death in the studies that included only patients with mild and moderate disease (JR: 0.53, 95% CI: 0.33-0.83, p = 0.006, I2 = 0). Umifenovir therapy did not affect the frequency of fever resolution by day 7 (OR: 0.87, 95% CI: 0.49-1.56, p = 0.64, I2 = 0%). Conclusion. Umifenovir significantly accelerated virus elimination by days 7 and 14 among patients with mild to moderate COVID-19. Umifenovir also reduced the risk of death compared to other antiviral drugs.Copyright © 2022, Dynasty Publishing House. All rights reserved.

Adverse events following immunization associated with the ChAdOx1nCoV-19 and BBV152 vaccine-a cross-sectional study

COVID-19, an infectious disease, has become a leading cause of death in many people. The rapid emergence of the pandemic prompted the development of a vaccine to mitigate the disease's harmful consequences. Vaccination is the only effective way to prevent infection from spreading and build immunity to the virus. However, developing adverse effects has become a major problem for vaccine reluctance. Accordingly, the interest has been shifted towards identifying the adverse effects developed following immunization. The current study objective is to assess and compare the intensity of adverse effects following 1st and 2nd dose of COVID-19 vaccination and the medication administered to relieve the symptoms associated with vaccination. A cross-sectional study was performed in a community over six months. A total of 836 participants were involved in the study. All the data regarding the vaccination were collected through a specially designed questionnaire form and analyzed in all the participants within the study group. According to the study, at least 1 AEFI was developed in about 90% of the study population. The most common systemic and local effect developed in the study population was fever (59.42%) and pain at the injection site (69.82%), respectively. With both vaccines (ChAdOx1 nCoV-19 and BBV152), the incidence and severity of AEFIs were lower after the second dose than after the first dose, and most of the symptoms associated with vaccination were alleviated by taking home remedies and symptomatic treatment. The adverse effects reported after receiving the ChAdOx1 nCoV-19 and BBV152 vaccines are typical of most vaccines, and the majority of them were tolerated, and most subsided in less than 24 hours.

Influence of environmental and demographic factors on the transmission and mortality rate of COVID19 in India

COVID-2019 has been declared a Public Health Emergency of International Concern (PHEIC) by the World Health Organization due to the global spread of 2019-nCOV at an exponential rate (WHO). Scientists have hypothesized the reduction in transmission rate at warm and humid environment whereas facilitate rapid transmission at cold and dry environment. Hence in this work, we examine the combined impact of environmental and demographic factors along with the implementation of lockdown by the Government of India on the transmission rate of 2019-nCoV. Our analyses indicated a lower mortality rate in spite of higher population density in India compared to other countries and lower exponential growth factor after lockdown compared to before lockdown. The containment of transmission and mortality rate may be attributed to the favorable environment and median population age, respectively. Even though, to significantly reduce the outbreak, individuals, the media, and healthcare organizations are necessary to work together. © 2023 Author(s).

The Impact of COVID-19 on Africa: Health and Economic Implications

The novel coronavirus (2019-nCoV) presents a difficult journey ahead for public health sectors and economies of African. This chapter analyses Africa's public service infrastructure deficits while considering the health and macroeconomic implications of coronavirus for the continent. To assess Africa's national and continental disease outbreak preparedness, the available COVID-19 data is analyzed against several risk factors like physician availability, access to basic sanitation, and drinking water services derived from the World Health Organization and World Bank. The macroeconomic impact of the pandemic on the economies of African countries is explored with a focus on sectors such as merchandise trade, agriculture, tourism, and oil with current data. The analysis indicates serious gaps in access to adequate public health and how this has negative implications for economic stability. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Study of body composition analysis in the view of obesity prognosis

Chronic overweight is characterized by significant elevations in abdominal fat as well as changes in the composition of fat free mass, particularly total body fluids and its interstitial compartment. The applied in the real restrictions placed by morbid obesity, as well as changes in body content from those of healthy weight, provide enormous hurdles to fat percentage assessment. This research concentrates on some of the research and practice challenges connected with using popular fat percentage measures, and it finds available evidence on suitable approaches for use in extremely obese people. There is already little scientific literature on which body composition measures may be utilised confidently in very obese people. A typical 3 model that combines readings of body mass by air - assisted plethysmography and total body liquid by bio-electrical impedance could provide metrics of percentage body fat in the extremely obese that are significant compared to a conventional, technically skilled 3 storage area prototype that requires infrastructure including such isotopic ratios mass spectrometry as well as important technological knowledge. This study focuses on a few fundamental issues that investigators and physicians confront when doing anthropometric studies on highly obese individuals. A 3 basic framework that is efficient and simple to implement shows potential for usage in this community. Nonetheless, more study on this and other suitable techniques of fat percentage measurement in a broad sample of extremely overweight adults is required. © 2023 Author(s).

Epidemiological and clinics characteristics of 414 cases of oral lesions and sensorial functions of COVID-19 in Brazil

Introduction: Several studies have evaluated the occurrence of oral lesions and changes in sensory functions in patients positive for COVID-19. Objective(s): To evaluate the manifestations of COVID-19, emphasizing olfactory and gustatory changes, xerostomia, and oral lesions. Material(s) and Method(s): A cross-sectional and observational study was conducted. Approved by the Institutional Ethics Committee (#46151121.6.0000.5141). All patients were diagnosed by reverse transcription-polymerase chain reaction assay (RT-PCR) and considered to have mild symptoms, according to the latest WHO joint report. The patients were evaluated at a reference Service for COVID-19 in Minas Gerais, Brazil. The oral cavity was evaluated for each patient on the second and seventh days. Result(s): A total of 414 patients older than 18 years were evaluated. One hundred thirty-nine presented at least one of the studied conditions, oral lesions (19.08%) were the most frequently observed, followed by gustatory disorders (18.11%), xerostomia (14.25%), and olfactory dysfunction (14%). Among the oral lesions, there were various anatomical locations and clinical presentations. The occurrence involving lips and tongue represented 49 oral lesions, the most prevalent being, respectively, ulcerations (n=51), candidiasis (n=8), and erythema or red plaques (n=7). Fifty patients died. Conclusion(s): This study represents, to date, the largest case series of oral lesions in Brazilian patients with COVID-19, and oral alterations were observed in an expressive percentage of patients with COVID-19. However, it cannot be concluded that SARS-CoV-2 directly causes them.

Treatment of Novel Coronavirus (2019-nCoV) Using Hinokitiol (β-thujaplicin) Copper Chelate

Human Coronavirus (HCoV) or Novel Coronavirus (2019-nCoV) is probably a brand new version of coronavirus that belongs to Betacoronaviruses kind Human Coronaviruses, similar to the Severe Acute Respiratory Syndrome (SARS) coronavirus and Middle-East Respiratory Syndrome (MERS) coronavirus. China recorded the number one case of this virus in December 2019 at Wuhan, the capital town of Hubei province. By 27 March 2020, 10:00 CET, nearly 23,335 humans died out of 509,164 showed instances recorded throughout the world. By the give up of January 2020, China showed that the Novel Coronavirus (2019-nCoV) transmitted from one human to another. This studies pursuits to research a completely specific medicament called "Hinokitiol Copper Chelate” towards the large quantity 2019-nCoV Spike Glycoprotein with a unmarried receptor binding domain. This take a look at gives a super version for Hinokitiol Copper Chelate to be examined in silico towards 2019-nCoV Main Protease. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Investigation on anti-Corona viral potential of Yarrow tea.

Achillea millefolium (Yarrow) is a herbaceous plant of Greek origin noted to treat pneumonia, common cold, cough, and other respiratory disorders. The flowers and leaves are the core part used to prepare herbal tea that gains the world's recognition as medicinal tea. Coronavirus disease is spreading across the globe, and numerous approaches are lodged to treat virus-induced lung inflammation. Here, we used the network pharmacology, metabolite analysis, docking and molecular simulation and MM-PBSA analysis to comprehend the biochemical basis of the health-boosting impact of Yarrow tea. Next, we performed the microscopic and dynamic light scattering (DLS) analysis of yarrow-treated ChAdOx1 nCoV-19 to evaluate the virucidal activity of the Yarrow. The present study investigates the druggability, metabolites and potential interaction of the title tea with genes associated with Covid-19-induced pathogenesis. Towards this, 1022 gene hits were obtained, 30 are mutually shared. Network Pharmacology and microarray gene expression analysis find the connection of PTGS2 in relieving the virus-induced inflammation. Yarrow constituents Luteolin may inhibit or down-regulate the Cyclooxygenase II (PTGS2), a plausible mechanism underlying the Yarrow's anti-inflammatory actions. Further, the Yarrow's virucidal activity was assessed towards Transmission Electron Microscopic (TEM). The Yarrow treated SARS-nCoV-2 cell exhibits the disintegration of the virus membrane. This work provides a scientific basis for further elucidating the mechanism underlying Achillea millefolium's antiviral and anti-inflammatory properties.

Remitting Seronegative Symmetrical Synovitis with Pitting Oedema Following Administration of the Chadox1-S/NCOV-19 Coronavirus Vaccine.

Introduction: We describe a case of remitting seronegative symmetrical synovitis with pitting oedema (RS3PE) syndrome following administration of the ChAdOx1-S/nCoV-19 [recombinant] vaccine, suggesting a possible causal link. Case Description: A 72-year-old man presented to his general practitioner with swollen, oedematous hands and legs 2 weeks after receiving a coronavirus vaccine. He had raised inflammatory markers but remained systemically well. He was initially presumed to have cellulitis, but his symptoms persisted despite several courses of antibiotics. Deep vein thromboses, cardiac failure, renal failure and hypoalbuminaemia were ruled out. Upon Rheumatology review, he was diagnosed as having RS3PE syndrome with the Covid vaccine suspected of being an immunogenic trigger. Following initiation of steroid therapy, his symptoms improved dramatically, as is characteristic of RS3PE syndrome. Discussion: The pathophysiology of RS3PE is unclear. It is known to have various triggers and associations including infections, certain vaccines and malignancy. This case highlights that a coronavirus vaccine (ChAdOx1-S/nCoV-19 [recombinant] vaccine) is also a possible trigger. Factors that make the diagnosis likely include an acute onset of symptoms including pitting oedema in a typical distribution, age above 50, and unremarkable autoimmune serology. Other learning points from this case include the importance of antibiotic stewardship and the need to explore non-infectious causes of illness when antibiotics do not improve symptoms. Conclusion: The ChAdOx1-S/nCoV-19 [recombinant] vaccine is a possible trigger of RS3PE. However, the benefits of vaccines against coronavirus outweigh the risks in the majority of patients. LEARNING POINTS: This case demonstrates a possible link between the ChAdOx1-S/nCoV-19 [recombinant] vaccine and autoimmune conditions such as RS3PE.It is important to consider alternative diagnoses when antibiotic regimes fail to work.A barrier to accurate diagnosis includes an episodic approach, where a patient presents to multiple clinicians acutely rather than having a long-term, continuous relationship with a single multi-disciplinary team, where response to treatment can be monitored.

A case report of vaccine-induced immune thrombotic thrombocytopenia (VITT) with genetic analysis.

The emergence of the rare syndrome called vaccine-induced immune thrombocytopenia and thrombosis (VITT) after adenoviral vector vaccines, including ChAdOx1 nCov-19, raises concern about one's predisposing risk factors. Here we report the case of a 56-year-old white man who developed VITT leading to death within 9 days of symptom onset. He presented with superior sagittal sinus thrombosis, right frontal intraparenchymal hematoma, frontoparietal subarachnoid and massive ventricular hemorrhage, and right lower extremity arterial and venous thrombosis. His laboratory results showed elevated D-dimer, C-reactive protein, tissue factor, P-selectin (CD62p), and positive anti-platelet factor 4. The patient's plasma promoted higher CD62p expression in healthy donors' platelets than the controls. Genetic investigation on coagulation, thrombophilia, inflammation, and type I interferon-related genes was performed. From rare variants in European or African genomic databases, 68 single-nucleotide polymorphisms (SNPs) in one allele and 11 in two alleles from common SNPs were found in the patient genome. This report highlights the possible relationship between VITT and genetic variants. Additional investigations regarding the genetic predisposition of VITT are needed.

Effectiveness of RCTs Pooling Evidence on Mesenchymal Stem Cell (MSC) Therapeutic Applications During COVID-19 Epidemic: A Systematic Review.

Background: Global pandemic identified as coronavirus disease 2019 (COVID-19) has resulted in a variety of clinical symptoms, from asymptomatic carriers to those with severe acute respiratory distress syndrome (SARS) and moderate upper respiratory tract symptoms (URTS). This systematic review aimed to determine effectiveness of stem cell (SC) applications among COVID-19 patients. Methods: Multiple databases of PubMed, EMBASE, Science Direct, Google Scholar, Scopus, Web of Science, and Cochrane Library were used. Studies were screened, chosen, and included in this systematic review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 flowchart diagram and PRISMA checklist. Included studies' quality was assessed employing Critical Appraisal Skills Programme (CASP) quality evaluation criteria for 14 randomized controlled trials (RCTs). Results: Fourteen RCTs were performed between the years of 2020 to 2022, respectively, with a sample size n = 574 (treatment group (n = 318); control group (n = 256)) in multiple countries of Indonesia, Iran, Brazil, Turkey, China, Florida, UK, and France. The greatest sample size reported from China among 100 COVID-19 patients, while the lowest sample of 9 COVID-19 patients from Jakarta, Indonesia, and the patient's age ranges from 18 to 69 years. Studies applied to the type of SC were "Umbilical cord MSCs, MSCs secretome, MSCs, Placenta-derived MSCs, Human immature dental pulp SC, DW-MSC infusion, Wharton Jelly-derived MSCs". The injected therapeutic dose was 1 × 106 cells/kg, 1 × 107 cells/kg, 1 × 105 cells/kg, and 1 million cells/kg as per the evidence from the different studies. Studies focused on demographic variables, clinical symptoms, laboratory tests, Comorbidities, respiratory measures, concomitant therapies, Sequential Organ Failure Assessment score, mechanical ventilation, body mass index, adverse events, inflammatory markers, and PaO2/FiO2 ratio were all recorded as study characteristics. Conclusion: Clinical evidence on MSC's therapeutic applications during COVID-19 pandemic has proven to be a promising therapy for COVID-19 patient recovery with no consequences and applied as a routine treatment for challenging ailments.

One year safety and immunogenicity of AZD1222 (ChAdOx1 nCoV-19): Final analysis of a randomized, placebo-controlled phase 1/2 trial in Japan.

BACKGROUND: Long duration trial data for two-dose COVID-19 vaccines primary series' are uncommon due to unblinding and additional doses. We report one-year follow-up results from a phase 1/2 trial of AZD1222 (ChAdOx1 nCoV-19) in Japan. METHODS: Adults (n = 256) seronegative for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) were stratified by age, 18-55 (n = 128), 56-69 (n = 86) and ≥70-year-old (n = 42), and randomized 3:1 to AZD1222 or placebo. Safety, immunogenicity, and exploratory efficacy data were collected until study Day 365. RESULTS: Safety was consistent with previous reports. In AZD1222 vaccinees, humoral responses against SARS-CoV-2 steadily declined over time. By Day 365, anti-SARS-CoV-2 spike-binding (spike) and receptor-binding domain (RBD) mean antibody titers remained above Day 15 levels and pseudovirus neutralizing antibodies were undetectable in many participants. CONCLUSIONS: AZD1222 is immunogenic and well tolerated in Japanese adults. Expected waning in anti-SARS-CoV-2 humoral responses was observed; spike and RBD antibody titers remained elevated. (ClinicalTrials.gov: NCT04568031).

Vogt-Koyanagi-Harada disease following ChAdOx1 nCoV-19 and mRNA-1273 vaccination.

Almost all vaccines have been reported to be associated with ocular inflammation, which has caused some concern regarding global mass COVID-19 vaccination efforts. Vogt-Koyanagi-Harada disease (VKHD) is a granulomatous inflammation caused by an autoimmune response against antigens in melanocytes, including those in the eyes. The mechanism by which COVID-19 vaccines are associated with VKHD is still unclear. Here, we report two cases of VKHD following COVID-19 vaccination. The first is a case of probable VKHD that presented with bilateral vision loss after administration of the adenovirus-vectored vaccine ChAdOx1 nCoV-19 (AstraZeneca). The condition improved after intravenous methylprednisolone 1g daily for 3days, followed by oral methotrexate and a slow taper of oral corticosteroids. The second case is a patient with an established diagnosis of well-controlled VKHD who developed a reactivation of the disease after receiving the mRNA-based vaccine (mRNA-1273, Moderna). VKHD is a potential ocular event that could follow COVID-19 vaccination. Awareness of this association is key to early detection and treatment to prevent loss of vision.

Humoral Immune Response to Sars-Cov-2 Third Vaccine in Patients with Autoimmune Rheumatic Diseases without Seroconversion after the Initial 2-Dose Regimen

Objectives: To evaluate the humoral immune response to the third dose (booster) of vaccine against SARS-CoV-2 in patients with autoimmune rheumatic diseases who were seronegative after a two-dose regimen. Method(s): Observational study. Patients with autoimmune rheumatic diseases who had not achieved seroconversion after a two-dose vaccine schedule against SARS-CoV-2 were included. To assess the humoral immune response, anti-RBD IgG (S protein receptor binding domain) neutralizing antibody titers were determined by ELISA (cutoff titer 200). The determination was made between 30 to 45 days after the third dose. Result(s): From 66 patients who received SARS-CoV-2 vaccination, 18 patients (29.5%) were seronegative after a two-dose schedule. 61% had SLE, 77% had comorbidities (61% with hypertension, p = 0.03). Patients were on treatment: 10 with prednisone (8 with doses greater than 10 mg/d, p = 0.01), 10 with hydroxychloroquine, one with methotrexate, one with leflunomide, four with azathioprine, five with my cophenolatemofetil and five with rituximab (they are the total number of non-responders on biological treatment, p = 0.03). Regarding the primary vaccination regimen, 11 received BBIBP-CorV (p = 0.01), 5 AZD1222, 1 Gam-COVID-Vac and 1 mRNA1273/Gam-COVID-Vac heterologous scheme. Of these 18 non-responders, 14 received a third dose;nine patients (62%) presented anti-RBD IgG detectable. Of the five patients who did not respond to the booster vaccination, three had received BBIBP-CorV as the initial schedule and the vaccines applied as a third dose were Ad5-nCoV (1), BNT162b2 (1), AZD 1222 (2) and Gam-COVID-Vac (1). They were being treated with: rituximab (2), azathioprine (2) and mycophenolate mofetil (1). Treatment with higher doses of prednisone was the only factor associated with non-seroconversion to the third dose (8 +/- 4.5;p 0.02). Conclusion(s): The third dose of SARS-CoV-2 vaccine allowed to improve the serological response to vaccination, achieving a seroconversion of 62% in this group of patients.

Sars-Cov-2 Vaccination Coverage in a Mexican Population with Rheumatic Disease

Objectives: Latest recommendation on SARS-CoV-2 vaccination in patients with systemic rheumatic diseases (SRD) by the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) is 3 doses while the Centers for Diseases Control and Prevention (CDC) recommends 5 doses. Method(s): We performed a cross-sectional study from April to November 2022 about SARS-CoV-2 vaccination in an outpatient rheumatology clinic in northeast Mexico. Consecutive SRD patients with a history of COVID-19 vaccination were invited to participate. Patients without SRD were excluded. Eligible participants completed a survey that included demographic data (age, sex, rheumatic disease diagnosis) and SARS-CoV-2 vaccination history (number of doses, and type of vaccine). Result(s): We recruited 252 patients.Vaccine types administered were: BNT162b2 (Pfizer-BioNTech) 55 (23.11%);ChAdOx1 nCoV-19/AZD1222 (Oxford-AstraZeneca) 130 (54.62%);Ad5-nCoV (CanSinoBIO) 31 (13.03%);Coronavac (Sinovac) 9 (3.78%);mRNA-1273 (Moderna)13 (5.46%). (See Table 1 and Table 2) Conclusion(s): Two thirds of our patients met SARS-CoV-2 vaccination recommendations by ACR and EULAR and 5.95% met CDC criteria. Population without any dose represents 6.74%. SARS-CoV-2 infection in vaccinated patients with SRD is associated with a better outcome compared with unvaccinated. Efforts to increase vaccination coverage need to be done.

Antibody Response to SARS-COV-2 Vaccination in Healthcare Workers of Uttarakhand: A Prospective Follow-up Study

Background: Countries around the world are now racing to vaccinate people against SARS-CoV-2, the virus that causes COVID-19. The Government of India also rolled out its vaccination drive from 16th January '2021. Aims: To estimate the antibody response of the COVID-19 vaccine in the form of SARS-COV-2 IgG antibodies in vaccinated healthcare workers.Methods: Prospective follow-up was study conducted on healthcare workers (HCWs) of a Medical college in Dehradun, Uttarakhand. Healthcare workers who have been vaccinated for COVID-19 were tested for SARS-CoV-2-IgG antibodies at regular intervals i.e at 4 weeks after the 1st dose and then again at 4 weeks after the 2nd dose. The third sample was taken 6 months after the 2nd dose. Results: A total of 302 HCWs were enrolled in the study who gave their samples for IgG antibody estimation after the Covishield vaccine. After 4 weeks of completion of both doses, 96% HCWs formed SARS-COV-2 IgG antibodies, whereas 4% didn't. Then after 6 months of follow-up, 14% HCWs have become negative for antibodies and better immunity is seen in people who also got infected with COVID-19 during this time.Conclusion: This study concludes that the immunity gained after vaccination is waning off in around 6 months and there is a need for a booster dose, especially for people at high risk. The infection control practices still play a crucial role in the prevention of this deadly disease.

Aortic thrombosis and acute limb ischemia after ChAdOx1 nCov-19 (Oxford-AstraZeneca) vaccination: a case of vaccine-induced thrombocytopenia and thrombosis (VITT).

INTRODUCTION: Vaccine-induced thrombocytopenia and thrombosis (VITT) is a rare but devastating adverse event associated with the ChAdOx1 nCoV-19 (Oxford-AstraZeneca) adenoviral vaccine against the Severe Acute Respiratory Syndrome CoronaVirus-2 (SARS-CoV-2). METHODS: A 49-year-old man presented to the emergency department with acute right limb ischemia (Rutherford IIB) nine days after his ChAdOx1 nCoV-19 (Oxford-AstraZeneca) vaccination. CT angiography revealed significant aortic thrombosis and right femoral artery occlusion. Severe thrombocytopenia (platelet count of 23 × 103/µL), promptly elevated D-dimers (37937 ng/mL) and a reduced fibrinogen level (176 mg/dL) were remarkable. ELISA testing for anti-PF4 antibodies confirmed the diagnosis of VITT. RESULTS: An emergency revascularization of the right leg was provided via thrombectomy. High-dose intravenous immunoglobulins were administered whereafter the platelet count restored gradually. Therapeutic anticoagulation was progressively started. The postoperative course was uneventful and follow-up imaging after four weeks showed an almost complete resolution of the significant aortic thrombosis. CONCLUSION: Early recognition and appropriate counseling of VITT is advocated to pursue a good clinical outcome. Our patient presenting with severe aortic thrombosis and acute limb ischemia was successfully treated by a vascular thrombectomy along with intravenous immunoglobulins and anticoagulation therapy as the mainstay therapy.

Risk Factors and Clinical Characteristics of Acute Kidney Injury in Patients with COVID-19: A Systematic Review and Meta-Analysis.

Acute kidney injury (AKI) is associated with a worse prognosis in coronavirus disease 2019 (COVID-19) patients. Identification of AKI, particularly in COVID-19 patients, is important for improving patients' management. The study aims to assess risk factors and comorbidities of AKI in COVID-19 patients. We systematically searched PubMed and DOAJ databases for relevant studies involving confirmed COVID-19 patients with data on risk factors and comorbidities of AKI. The risk factors and comorbidities were compared between AKI and non-AKI patients. A total of 30 studies involving 22385 confirmed COVID-19 patients were included. Male (OR: 1.74 (1.47, 2.05)), diabetes (OR: 1.65 (1.54, 1.76)), hypertension (OR: 1.82 (1.12, 2.95)), ischemic cardiac disease (OR: 1.70 (1.48, 1.95)), heart failure (OR: 2.29 (2.01, 2.59)), chronic kidney disease (CKD) (OR: 3.24 (2.20, 4.79)), chronic obstructive pulmonary disease (COPD) (OR: 1.86 (1.35, 2.57)), peripheral vascular disease (OR: 2.34 (1.20, 4.56)), and history of nonsteroidal anti-inflammatory drugs (NSAID) (OR: 1.59 (1.29, 1.98)) were independent risk factors associated with COVID-19 patients with AKI. Patients with AKI presented with proteinuria (OR: 3.31 (2.59, 4.23)), hematuria (OR: 3.25 (2.59, 4.08)), and invasive mechanical ventilation (OR: 13.88 (8.23, 23.40)). For COVID-19 patients, male gender, diabetes, hypertension, ischemic cardiac disease, heart failure, CKD, COPD, peripheral vascular disease, and history of use of NSAIDs are associated with a higher risk of AKI.