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1.
Vaccine Research ; 8(2):93-101, 2021.
Article in English | CAB Abstracts | ID: covidwho-2207027

ABSTRACT

Introduction: Vaccine hesitancy is a global phenomenon and vaccination efforts against the Coronavirus Disease 2019 (COVID-19) pandemic may be hampered by it. This study assessed the acceptance rate of COVID-19 vaccination at different hypothetical efficacy and safety levels in Nigeria.

2.
Medical Journal of Tabriz University of Medical Sciences and Health Services ; 44(3):166-177, 2022.
Article in Persian | CAB Abstracts | ID: covidwho-2206183

ABSTRACT

Background. This systematic review evaluated the studies conducted on Guillain-Barre syndrome (GBS) due to COVID-19 vaccination to clarify any possible connections and the type of vaccines causing GBS. Methods. A comprehensive search was performed on July 2021 through MEDLINE (via PubMed), Scopus, Cochrane, and Web of Science databases to detect published and unpublished papers. Our PICO was all COVID-19 vaccinated individuals as the population, COVID-19 vaccines as the intervention, and patients experiencing GBS following COVID-19 vaccination as the outcome. Critical appraisal instruments from the Joanna Briggs Institute case series or case report were used to evaluate the quality of included studies. Results. In the present systematic review, 12 case reports and case series including 21 patients were assessed. More than half of the patients were male, and the mean age of male patients was lower than females. In terms of vaccine type, the most common kind of vaccine injected was Oxford/AstraZeneca, and all the cases except one patient had received only one dose of the vaccine. Regarding the interval between receiving the vaccine and the onset of GBS symptoms, the mean duration was 14 days. The lowest mean time interval between receiving the vaccine and the onset of symptoms of GBS was related to the unnamed vector-based COVID-19 vaccine, and the highest was associated with Oxford/AstraZeneca. Conclusion. Through this systematic review of case reports, we neither attempt to establish nor rule out a causal link between the COVID-19 vaccine and GBS, because such a link requires extensive case-control studies. However, we must highlight any events that may occur following the injection of existing vaccines. Practical Implications. The most common symptoms seen in patients experiencing GBS after vaccination included progressive bilateral lower limb weakness, paresthesia, numbness of limbs, generalized body aches, and back pain.

3.
Research in Molecular Medicine ; 9(4):229-244, 2021.
Article in English | CAB Abstracts | ID: covidwho-2205940

ABSTRACT

Background: Because of high genetic variation in human leukocyte antigen (HLA) alleles, epitope-based vaccines do not show equal efficacy in different human populations. Therefore, we proposed a multi-epitope vaccine against SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) for Iranian populations. Materials and Methods: For this purpose, the proteins without allergenicity and high antigenicity, as well as conservancy levels from SARS-CoV-2, were chosen for computational epitope mapping. The T-cell epitope mapping process was performed based on the most frequent human leukocyte antigen (HLA) alleles in Iran. The B- and T-cell epitopes were determined based on their allergenicity, antigenicity, and hemolytic potential. Then, the epitopes with acceptable features were subjected to the final construct. The screened epitopes were structured in the final vaccine sequence. The secondary and tertiary structures of the proposed vaccine were predicted, and its affinity to HLA-I, HLA-II, toll-like receptor (TLR)- 3, and TLR-4 were evaluated by the molecular docking method. Additionally, possible immune responses against the vaccine were predicted through immune simulation.

4.
Research in Molecular Medicine ; 9(4):221-228, 2021.
Article in English | CAB Abstracts | ID: covidwho-2205939

ABSTRACT

Background: ChAdOx1 nCov-19 vaccine is a viral vector-based vaccine with desirable protection (about 70.4%, two weeks after the second dose). Few reports were released on thrombocytopenia associated with thrombotic events shortly after the ChAdOx1 nCov-19 vaccination. However, the exact pathophysiologic mechanism of this vaccineinduced thrombotic complication has not yet been elucidated. Vaccine-induced thrombotic thrombocytopenia syndrome (VITTS) is associated with detecting anti-platelet factor 4 (PF4) antibodies that are not yet linked to previous exposure to heparin. Materials and Methods: In the current review, based on relevantly reported cases, possible mechanisms are suggested on the relationship between the anti-platelet factor 4 (anti-PF4) antibody assays, previous exposure to heparin, and the involved mechanisms of post-vaccination thrombocytopenia and thrombotic events, which might help the experts for selecting the appropriate therapeutic measures.

5.
Journal of Global Health Reports ; 6(e2022047), 2022.
Article in English | CAB Abstracts | ID: covidwho-2205662

ABSTRACT

Among the many profound disruptions created by COVID-19 around the world, the pandemic has greatly tested community-based research endeavours that rely upon international collaboration and face-to-face interactions in rural communities. Our group of Kenyan and American investigators based on remote Mfangano Island on Lake Victoria experienced numerous challenges due to travel restrictions, safety guidelines, and funding interruptions, forcing us to rapidly adapt objectives as conditions evolved in real time. Here we describe our effort to adjust the priorities of the MOMENTUM study, a longitudinal maternal health study, to support a community-driven response to the initial COVID-19 surge in 2020 and the subsequent Delta wave in 2021. Through a dynamic participatory process, our group identified and implemented three COVID-19 engagement strategies including, (i) printed COVID-19 factsheets for local distribution, (ii) vernacular radio programming on a popular local radio station, and (iii) targeted COVID-19 vaccine promotion among key community opinion leaders. We provide a review of the strengths, challenges, and local perspectives regarding these strategies. Due to notable limitations, such as our inability to compare outcomes with similar control populations, and the nature of the specific strategies designed to address the unique needs of these island populations, this report is not intended to provide definitive or generalizable conclusions regarding the impact of a COVID-19 intervention. We present our experience as an illustrative example of how community-based research collaborations can utilize their embedded networks to develop adaptive responses to unexpected public health threats. Most notably, the transition to virtual collaboration facilitated a long-overdue recentering of operational and strategic leadership into the hands of our Kenyan team. This aligned reality on the ground with our long-stated rhetoric regarding North-South equity in design and implementation. Ultimately, our experience in Kenya suggests that amid ongoing disruptions created by a pandemic, there exists both a responsibility to respond to evolving community needs and an opportunity to remodel global health partnerships for improved equity and long-term impact.

6.
Journal of Global Health Reports ; 6(e2022048), 2022.
Article in English | CAB Abstracts | ID: covidwho-2205660

ABSTRACT

Background: In the wake of the coronavirus (COVID-19) pandemic, the development of the COVID-19 vaccine became a game-changing tool. However, the rapid development of the COVID-19 vaccine gave rise to various myths, misconceptions and hesitancies among people.

7.
Journal of Global Health Reports ; 6(e2022041), 2022.
Article in English | CAB Abstracts | ID: covidwho-2205658

ABSTRACT

Background: Healthcare workers play a vital role in vaccine promotion and acceptance through community dialogue, education, and myth-busting. Vaccinated healthcare workers will likely recommend the vaccine to their families and community.

8.
Journal of Health Promotion and Behavior ; 6(2):91-96, 2021.
Article in English | CAB Abstracts | ID: covidwho-2205581

ABSTRACT

Background: COVID-19 pandemic has certainly brought tremendous global impacts in various sectors of life, such as social activities that are becoming increasingly limited. In addition, another impact is the prohibition of the implementation of collective worship of Muslims in Indonesia. The government implements health protocols as the main capital to stop the expansion of the pandemic. In addition, the use of vaccines with great hope as one of the main weapons to control COVID-19. This study aims to analyze the relationship between vaccination status and behavior in the implementation of Ramadan worship during the COVID-19 pandemic in Indonesia. Subjects and Method: A cross-sectional study was conducted in Indonesia from April to May 2021, with the research subjects being members of the Muhammadiyah Disaster Management Center (MDMC). A sample of 746 study subjects was selected for this study. The dependent was worship behavior. The independent variable was vaccination status. The data were analyzed by Chi-square test.

9.
Texila International Journal of Public Health ; 10(3), 2022.
Article in English | CAB Abstracts | ID: covidwho-2204936

ABSTRACT

Since the vaccination against severe acute respiratory syndrome corona virus two (SARS-CoV-2) became accessible in Zambia, there has been limited uptake. The study aimed to determine social cognitive aspects linked with SARS-CoV-2 vaccination in Mongu. A descriptive quantitative Survey was conducted from December 2021 to April 2022. Cochrane single proportion formula was used to determined sample size of 369 respondents based on 60% herd immunity criterion. Stata version 14 was used to perform Chi square and binary logistic regression. Findings indicated that, vaccination level is still below average, and most non-vaccinated people were unwilling to be vaccinated because they "simply haven't gotten around to it". 'Views on Covid-19 news', 'worrying about getting sick/a household member getting sick from Covid-19," real financial effect of Covid-19 at personal level,' 'ages of household Members,' marital status, religion, academic qualification, and ages of respondents were associated with SAR-CoV-2 vaccination. Social cognitive predictors of vaccination were 30-49-year-old household members and worry about household members being sick. Misconceptions about SARS-CoV-2 vaccinations prevent vaccination. Therefore, there is need scale-up sensitisation, and sensitisation messages should address the need to protect household members and especially having the most mobile age groups (30-49 years) to be vaccinated to reduce on community spread of the infection. Future studies should analyze the proportions of AstraZeneca's one-dose recipients who did not return for the second dose and the willingness of the completely vaccinated to accept a booster shot.

10.
Universa Medicina ; 41(3):228-235, 2022.
Article in English | CAB Abstracts | ID: covidwho-2204464

ABSTRACT

Background Herd immunity is necessary to control the coronavirus disease 2019 (COVID-19) pandemic. Unfortunately, attaining herd immunity is a significant challenge for current healthcare systems worldwide, and the prevalence of hesitancy toward COVID-19 remains high. The aim of this study was to determine pandemic vaccine hesitancy, attitudes towards COVID-19 vaccine and COVID-19 vaccine literacy level in vaccination period among unvaccinated young adults. Methods This cross-sectional study was carried out in the province of Corum in Turkey. Unvaccinated young adults (n=860) between the ages of 18-30 studying medicine and non-medical sciences of a university were included in the study. Socio-demographic form, and the scales on Pandemic Vaccine Hesitancy, Attitudes towards the COVID-19 vaccine, COVID-19 vaccine literacy were used to collect the research data. The data were analyzed using percentages, median values, regression analysis. Results The study was completed with 860 participants. In the group, 73.8% were 18-24 years 67.7% were women and 68.0% were infected with the virus. The median scores from the pandemic vaccine hesitancy scale, vaccine literacy and vaccine attitudes were 33, 27 and 30 respectively. Use of social media in daily, vaccine literacy and COVID-19 vaccine attitude were effective factors on pandemic vaccine hesitancy (p<0.05). Negative attitude to vaccines was the most influenced risk factor of vaccine hesitancy (Beta = 0.248). Conclusion Pandemic vaccine hesitancy is a phenomenon that coincides with low vaccine literacy and negative attitudes towards vaccines. COVID-19 vaccination information campaigns should promote group strategies, focusing on emphasising the safety of the vaccine and offer reassurance.

11.
Canada Communicable Disease Report ; 48(7/8):292-302, 2022.
Article in English | CAB Abstracts | ID: covidwho-2204033

ABSTRACT

This study illustrates what may have happened, in terms of coronavirus disease 2019 (COVID-19) infections, hospitalizations and deaths in Canada, had public health measures not been used to control the COVID-19 epidemic, and had restrictions been lifted with low levels of vaccination, or no vaccination, of the Canadian population. The timeline of the epidemic in Canada, and the public health interventions used to control the epidemic, are reviewed. Comparisons against outcomes in other countries and counterfactual modelling illustrate the relative success of control of the epidemic in Canada. Together, these observations show that without the use of restrictive measures and without high levels of vaccination, Canada could have experienced substantially higher numbers of infections and hospitalizations and almost a million deaths.

12.
Journal of Applied Pharmaceutical Science ; 12(11):151-156, 2022.
Article in English | CAB Abstracts | ID: covidwho-2203103

ABSTRACT

The emergence of a confound virus in China has caused a new pandemic spread worldwide, and the disease was entitled "coronavirus disease-19 (COVID-19)." High incidence rates combined with an exponential increase in mortality numbers among infected persons have been reported by the ministries of health all over the world. Screening of IgG immunoglobulin against severe acute respiratory syndrome coronavirus (SARS-CoV-2) was implemented for the determination of the prevalence and durability of the disease among citizens throughout the pandemic. The objectives of this study were to determine the levels of IgG antibodies against COVID-19 in the serum of Jordanian citizens after the third corona wave and to highlight the correlation between both demographic and clinical factors and the levels of IgG immunoglobulin. A cross-sectional study was conducted between September 2021 and January 2022 including 412 Jordanian citizens. Total IgG antibodies were qualitatively assayed against SARS-CoV-2 using the enzyme-linked immunosorbent assay technique. The median age was 34 years, 59% were male, and 41% were female. The seroprevalence was 81.8% for the study population with a mean of 15.17 IU/ml. 45.4% of the positive participants reported a previous COVID-19 infection, whereas the rest of the study population were subjected to vaccine shots. There was no significant difference in IgG levels when the participants were grouped by gender. IgG antibody levels were significantly lower among smokers and those with O blood groups, whereas levels were higher among participants with the B blood groups or negative Rh groups. Demographic factors including gender, age, education, residence, vaccination, and vaccine type did not influence the immunoglobulin level, whereas smoking and blood group affected the levels negatively.

13.
Health ; 14(6):675-683, 2022.
Article in English | CAB Abstracts | ID: covidwho-2202192

ABSTRACT

In this overview, we discuss the impact of antibiotic therapy on the COVID infection, the complications after vaccination, possible causes of adverse events, and ways to protect against pandemic infection, as well as try to dispel myths about COVID. Antibiotics are necessary only in case of secondary infection, but overlapping with bacterial infection mainly occurs after hospitalization, and the vast majority of infections were caused by the Acinetobacter baumannii strain. Commonly used antimicrobial disinfectants are chlorhexidine derivatives;due to their frequent use, microorganisms have become resistant to them, and in addition, chloroquine has no clinical benefit in the treatment of COVID-19. Virus escapes from the immune response due to multiple mutations in the receptor-binding domain, or the N-terminal end, which are the sites responsible for antibody binding and virus neutralization. The COVID infection itself is characterized by a rather powerful suppression of immunity. For this reason, the use of antibiotics in the absence of a secondary infection layer leads to greater suppression of the immune system and an aggravation of the process, which often ends up fatally. Immune dysregulation predisposes to the development of severe COVID-19. A decrease in the number of leukocytes gives an unfavorable prognosis for the severity of the COVID infection course. The main reason for the death cases after vaccination seems to be an increase in blood clotting, which is observed not only among the population over 60 years old, but also amid young people.

14.
Journal of Southern Agriculture ; 53(8):2077-2087, 2022.
Article in Chinese | CAB Abstracts | ID: covidwho-2201259

ABSTRACT

Object: To explore genetic evolution relationship of variant porcine epidemic diarrhea virus(PEDV)and antigenic differential sites among variant strain subtypes,so as to lay a foundation for the development of novel vaccines and diagnostic kits. Method: Three PEDV-positive porcine intestinal samples were inoculated on to confluent Vero cells to isolate PEDV. Virus identification was performed by indirect fluorescence assay(IFA), Western blotting,RT-PCR and whole genome sequencing and electron microscopic observation;virus titer was determined by TCID50and the in vitvo proliferation dynamin curve of the virus was drawn. The genome of the isolated strain was divided into 33 segments for RT-PCR amplification, and the SeqMan of Lasergene was used to splice sequences. Then the genetic evolution analysis was performed with MEGA 7.0, and the antigenicity analysis was performed with Jameson-Wolf algorithm in Protean. Result: Typical cytopathic effect appeared in one PEDV-positive porcine intestinal sample in Vero cells when it was blindly passaged to the 6thgeneration and the sample was designated as CH-HK-2021. IFA and Western blotting results showed that the strain CH-HK-2021 could react with PEDV N monoclonal antibody and expected reads were obtained through RT-PCR amplification, which demonstrated this virus was PEDV. Diameter of strain CH-HK-2021 was 80-120 nm and the surface of the virus particles were in spike-like shape, indicating it was coronavirus. The strain could be stably propagated in Vero cells, and it has been passaged to 100thgeneration. After 24 h of infecting the Vero cells, virus titer of strain CH-HK-2021 reached the highest,105.6TCID50/mL. The size whole genome of strain CH-HK-2021 not including poly(A)tail was 28034 bp, with a similarity of 96.0%-98.9% with nucleotide sequence of the PEDV reference strain and a similarity of 93.1%-99.0% with S-base nucleotide sequence of the reference strain. The strain had the highest similarity with nucleotide sequence of variant strain CH/JX/01(KX058031)and the lowest similarity with nucleotide sequence of classical strain AVCT12(LC053455). Strain CH-HK-2021 was a subtype of G2a and it is spreading in China. Strain G2a and variant strain G2b had 42 nucleotide differential sites in S gene and 6 antigenic differential sites;and main differential sites located in subunit S2.

15.
PLoS Global Public Health ; 2(12), 2022.
Article in English | CAB Abstracts | ID: covidwho-2196847

ABSTRACT

There is an increased need for COVID-19 vaccination since the world is gradually returning to normal. Current evidence supports vaccination activity more towards viral suppression than COVID-19 prevention. This has led to divergent views regarding vaccination which may influence anti-vaccine attitudes and vaccine hesitancy. The study examined the role of personality traits, anti-vaccine attitudes and illness perceptions on vaccine hesitancy. The study was a cross-sectional survey using snowball and convenience sampling to recruit 492 participants via social media platforms. Multivariate analysis of variance and regression analysis were used to test the hypotheses. The study found that some facets of illness perception (identity, concern, emotional representation and treatment control), extraversion, experience with COVID-19 and anti-vaccine attitudes (mistrust, profiteering, worries about unforeseen effects of vaccine) predicted vaccine hesitancy. The outcomes from this study have implications for achieving public health goals and developing strategies for reaching optimal vaccination targets and attaining herd immunity. Health-promoting programs need to be intensified and could include psychosocial perspectives on vaccine hesitancy so that specific target groups can be reached to be vaccinated.

16.
PLoS Global Public Health ; 2(12), 2022.
Article in English | CAB Abstracts | ID: covidwho-2196842

ABSTRACT

Despite COVID-19 vaccines being available to pregnant women in India since summer 2021, little is known about vaccine uptake among this high need population. We conducted mixed methods research with pregnant and recently delivered rural women in northern India, consisting of 300 phone surveys and 15 in-depth interviews, in November 2021. Only about a third of respondents were vaccinated, however, about half of unvaccinated respondents reported that they would get vaccinated now if they could. Fears of harm to the unborn baby or young infant were common (22% of unvaccinated women). However, among unvaccinated women who wanted to get vaccinated, the most common barrier reported was that their health care provider refused to provide them the vaccine. Gender barriers and social norms also played a role, with family members restricting women's access. Trust in the health system was high, however, women were most often getting information about COVID-19 vaccines from sources that they did not trust, and they knew they were getting potentially poor-quality information. Qualitative data shed light on the barriers women faced from their family and health care providers but described how as more people got the vaccine that norms were changing. These findings highlight how pregnant women in India have lower vaccination rates than the general population, and while vaccine hesitancy does play a role, structural barriers from the health care system also limit access to vaccines. Interventions must be developed that target household decision-makers and health providers at the community level, and that take advantage of the trust that rural women already have in their health care providers and the government. It is essential to think beyond vaccine hesitancy and think at the system level when addressing this missed opportunity to vaccinate high risk pregnant women in this setting.

17.
PLoS Global Public Health ; 2(12), 2022.
Article in English | CAB Abstracts | ID: covidwho-2196841

ABSTRACT

The COVAX program aims to provide global equitable access to life-saving vaccines. Despite calls for increased sharing, vaccine protectionism has limited progress towards vaccine sharing goals. For example, as of April 2022 only ~20% of the population in Africa had received at least one COVID-19 vaccine dose. Here we use a two-nation coupled epidemic model to evaluate optimal vaccine-sharing policies given a selfish objective: in which countries with vaccine stockpiles aim to minimize fatalities in their own population. Computational analysis of a suite of simulated epidemics reveal that it is often optimal for a donor country to share a significant fraction of its vaccine stockpile with a recipient country that has no vaccine stockpile. Sharing a vaccine stockpile reduces the intensity of outbreaks in the recipient, in turn reducing travel-associated incidence in the donor. This effect is intensified as vaccination rates in a donor country decrease and epidemic coupling between countries increases. Critically, vaccine sharing by a donor significantly reduces transmission and fatalities in the recipient. Moreover, the same computational framework reveals the potential use of hybrid sharing policies that have a negligible effect on fatalities in the donor compared to the optimal policy while significantly reducing fatalities in the recipient. Altogether, these findings provide a self-interested rationale for countries to consider sharing part of their vaccine stockpiles.

18.
PLoS Global Public Health ; 2(12), 2022.
Article in English | CAB Abstracts | ID: covidwho-2196840

ABSTRACT

Fractional dosing of COVID-19 vaccines could accelerate vaccination rates in low-income countries. Dose-finding studies of the mRNA vaccine BNT162b2 (Pfizer-BioNTech) suggest that a fractional dose induces comparable antibody responses to the full dose in people <55 years. Here, we report the safety and immunogenicity of a fractional dose regimen of the BNT162b2 vaccine. REDU-VAC is a participant-blinded, randomised, phase 4, non-inferiority study. Adults 18-55 years old, either previously infected or infection naive, were randomly assigned to receive 20g/20g (fractional dose) or 30g/30g (full dose) of BNT162b2. The primary endpoint was the geometric mean ratio (GMR) of SARS-CoV-2 anti-RBD IgG titres at 28 days post second dose between the reduced and full dose regimens. The reduced dose was considered non-inferior to the full dose if the lower limit of the two-sided 95% CI of the GMR was >0.67. Primary analysis was done on the per-protocol population, including infection naive participants only. 145 participants were enrolled and randomized, were mostly female (69.5%), of European origin (95%), with a mean age of 40.4 years (SD 7.9). At 28 days post second dose, the geometric mean titre (GMT) of anti-RBD IgG of the reduced dose regimen (1,705 BAU/mL) was not non-inferior to the full dose regimen (2,387 BAU/mL), with a GMR of 0.714 (two-sided 95% CI 0.540-0.944). No serious adverse events occurred. While non-inferiority of the reduced dose regimen was not demonstrated, the anti-RBD IgG titre was only moderately lower than that of the full dose regimen and, importantly, still markedly higher than the reported antibody response to the licensed adenoviral vector vaccines. These data suggest that reduced doses of the BNT162b2 mRNA vaccine may offer additional benefit as compared to the vaccines currently in use in most low and middle-income countries, warranting larger immunogenicity and effectiveness trials.

19.
PLoS Global Public Health ; 2(11), 2022.
Article in English | CAB Abstracts | ID: covidwho-2196834

ABSTRACT

In August 2021, a major wave of the SARS-CoV-2 Delta variant erupted in the highly vaccinated population of Israel. The transmission advantage of the Delta variant enabled it to replace the Alpha variant in approximately two months. The outbreak led to an unexpectedly large proportion of breakthrough infections (BTI)-a phenomenon that received worldwide attention. Most of the Israeli population, especially those aged 60+, received their second dose of the vaccination four months before the invasion of the Delta variant. Hence, either the vaccine induced immunity dropped significantly or the Delta variant possesses immunity escaping abilities, or both. In this work, we model data obtained from the Israeli Ministry of Health, to help understand the epidemiological factors involved in the outbreak. We propose a mathematical model that captures a multitude of factors, including age structure, the time varying vaccine efficacy, time varying transmission rate, BTIs, reduced susceptibility and infectivity of vaccinated individuals, protection duration of the vaccine induced immunity, and the vaccine distribution. We fitted our model to COVID-19 cases among the vaccinated and unvaccinated, for <60 and 60+ age groups, and quantified the transmission rate, the vaccine efficacy over time and the impact of the third dose booster vaccine. The peak transmission rate of the Delta variant was found to be 2.14 times higher than that of the Alpha variant. The two-dose vaccine efficacy against infection dropped significantly from >90% to ~40% over 6 months. We further performed model simulations and quantified counterfactual scenarios examining what would happen if the booster had not been rolled out. We estimated that approximately 4.03 million infective cases (95%CI 3.19, 4.86) were prevented by vaccination overall, and 1.22 million infective cases (95%CI 0.89, 1.62) averted by the booster.

20.
PLoS Global Public Health ; 2(11), 2022.
Article in English | CAB Abstracts | ID: covidwho-2196832

ABSTRACT

The literature remains scarce regarding the varying point estimates of risk factors for COVID-19 associated mortality and hospitalization. This meta-analysis investigates risk factors for mortality and hospitalization, estimates individual risk factor contribution, and determines drivers of published estimate variances. We conducted a systematic review and meta-analysis of COVID-19 related mortality and hospitalization risk factors using PRISMA guidelines. Random effects models estimated pooled risks and meta-regression analyses estimated the impact of geographic region and study type. Studies conducted in North America and Europe were more likely to have lower effect sizes of mortality attributed to chronic kidney disease (OR: 0.21, 95% CI: 0.09-0.52 and OR: 0.25, 95% CI: 0.10-0.63, respectively). Retrospective studies were more likely to have decreased effect sizes of mortality attributed to chronic heart failure compared to prospective studies (OR: 0.65, 95% CI: 0.44-0.95). Studies from Europe and Asia (OR: 0.42, 95% CI: 0.30-0.57 and OR: 0.49, 95% CI: 0.28-0.84, respectively) and retrospective studies (OR: 0.58, 95% CI: 0.47-0.73) reported lower hospitalization risk attributed to male sex. Significant geographic population-based variation was observed in published comorbidity related mortality risks while male sex had less of an impact on hospitalization among European and Asian populations or in retrospective studies.

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