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1.
G Ital Cardiol (Rome) ; 22(5): 363-375, 2021 May.
Article in Italian | MEDLINE | ID: covidwho-1219383

ABSTRACT

In over a year, the COVID-19 pandemic caused 2.69 million deaths and 122 million infections. Social isolation and distancing measures have been the only prevention available for months. Scientific research has done a great deal of work, developing in a few months safe and effective vaccines against COVID-19. In the European Union, nowadays, four vaccines have been authorized for use: Pfizer-BioNTech, Moderna, ChAdOx1 (AstraZeneca/Oxford), Janssen (Johnson & Johnson), and three others are currently under rolling review.Vaccine allocation policy is crucial to optimize the advantage of treatment preferring people with the highest risk of contagion. These days the priority in the vaccination program is of particular importance since it has become clear that the number of vaccines is not sufficient for the entire Italian population in the short term. Cardiovascular diseases are frequently associated with severe COVID-19 infections, leading to the worst prognosis. The elderly population suffering from cardiovascular diseases is, therefore, to be considered a particularly vulnerable population. However, age cannot be considered the only discriminating factor because in the young-adult population suffering from severe forms of heart disease, the prognosis, if affected by COVID-19, is particularly ominous and these patients should have priority access to the vaccination program. The aim of this position paper is to establish a consensus on a priority in the vaccination of COVID-19 among subjects suffering from different cardiovascular diseases.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , Cardiovascular Diseases/complications , Consensus , Age Factors , Animals , COVID-19/epidemiology , COVID-19/mortality , Cardiology , Coronary Disease/complications , Disease Vectors , Heart Failure/complications , Heart Transplantation , Heart Valve Diseases/complications , Humans , Hypertension, Pulmonary/complications , Italy/epidemiology , Prognosis , Renal Insufficiency/complications , SARS-CoV-2/immunology , Societies, Medical , Vaccines, Synthetic/administration & dosage
2.
BMC Nephrol ; 22(1): 73, 2021 02 27.
Article in English | MEDLINE | ID: covidwho-1105701

ABSTRACT

BACKGROUND: Hemodialysis patients with COVID-19 have been reported to be at higher risk for death than the general population. Several prognostic factors have been identified in the studies from Asian, European or American countries. This is the first national Lebanese study assessing the factors associated with SARS-CoV-2 mortality in hemodialysis patients. METHODS: This is an observational study that included all chronic hemodialysis patients in Lebanon who were tested positive for SARS-CoV-2 from 31st March to 1st November 2020. Data on demographics, comorbidities, admission to hospital and outcome were collected retrospectively from the patients' medical records. A binary logistic regression analysis was performed to assess risk factors for mortality. RESULTS: A total of 231 patients were included. Mean age was 61.46 ± 13.99 years with a sex ratio of 128 males to 103 females. Around half of the patients were diabetics, 79.2% presented with fever. A total of 115 patients were admitted to the hospital, 59% of them within the first day of diagnosis. Hypoxia was the major reason for hospitalization. Death rate was 23.8% after a median duration of 6 (IQR, 2 to 10) days. Adjusted regression analysis showed a higher risk for death among older patients (odds ratio = 1.038; 95% confidence interval: 1.013, 1.065), patients with heart failure (odds ratio = 4.42; 95% confidence interval: 2.06, 9.49), coronary artery disease (odds ratio = 3.27; 95% confidence interval: 1.69, 6.30), multimorbidities (odds ratio = 1.593; 95% confidence interval: 1.247, 2.036), fever (odds ratio = 6.66; 95% confidence interval: 1.94, 27.81), CRP above 100 mg/L (odds ratio = 4.76; 95% confidence interval: 1.48, 15.30), and pneumonia (odds ratio = 19.18; 95% confidence interval: 6.47, 56.83). CONCLUSIONS: This national study identified older age, coronary artery disease, heart failure, multimorbidities, fever and pneumonia as risk factors for death in patients with COVID-19 on chronic hemodialysis. The death rate was comparable to other countries and estimated at 23.8%.


Subject(s)
COVID-19/mortality , Multimorbidity , Renal Dialysis , Age Factors , Aged , COVID-19/complications , Coronary Disease/complications , Critical Care , Dementia/complications , Female , Fever/complications , Heart Failure/complications , Hospitalization , Humans , Lebanon/epidemiology , Male , Middle Aged , Prognosis , Retrospective Studies , Risk Factors , SARS-CoV-2 , Stroke/complications
3.
Diabetes Obes Metab ; 23(1): 258-262, 2021 01.
Article in English | MEDLINE | ID: covidwho-793166

ABSTRACT

Obesity is associated with severe COVID-19 outcomes, yet, it is unclear whether the risk of COVID-19 mortality associated with obesity is similar between the sexes. We used data from the UK Biobank to assess the risk of COVID-19 mortality associated with various anthropometric measures in women and men. To put these results in context, we also compared these estimates with those for mortality from influenza/pneumonia and coronary heart disease (CHD). The analyses included 502 493 individuals (54% women), of whom 410 (36% women) died from COVID-19, 549 (36% women) died from influenza/pneumonia and 3355 (19% women) died from CHD. A higher body mass index (BMI), waist circumference, waist-to-hip ratio and waist-to-height ratio were each associated with a greater risk of death from COVID-19, influenza/pneumonia and CHD in both sexes, with the exception of the association between higher BMI and the risk of influenza/pneumonia death in men. A higher BMI was associated with a stronger risk of COVID-19 mortality in women than men; the women-to-men ratio of hazard ratios was 1.20 (95% confidence interval 1.00; 1.43). This study demonstrates the role of obesity in COVID-19 mortality and shows that the relative effects of a higher BMI on COVID-19 mortality may be stronger in women than men.


Subject(s)
COVID-19 , Coronary Disease , Influenza, Human , Obesity , Adult , Aged , Body Mass Index , COVID-19/complications , COVID-19/epidemiology , COVID-19/mortality , Cohort Studies , Coronary Disease/complications , Coronary Disease/epidemiology , Databases, Factual , Female , Humans , Influenza, Human/complications , Influenza, Human/epidemiology , Male , Middle Aged , Obesity/complications , Obesity/epidemiology , Pandemics , Risk Factors , SARS-CoV-2 , United Kingdom
5.
Eur Rev Med Pharmacol Sci ; 24(14): 7855-7860, 2020 07.
Article in English | MEDLINE | ID: covidwho-693645

ABSTRACT

We present the case details of seven patients diagnosed with severe novel coronavirus disease 2019 (2019-nCoV, hereafter COVID-19) with hepatic injury. Most of these patients were elderly and had hypertension, diabetes mellitus, coronary heart disease, and other underlying health conditions prior to admission for COVID-19. Liver injury occurred in all seven cases during the course of the disease. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels initially increased (1.2-times to 2.0-times the normal value, respectively) in the second week. The liver function recovered in all patients within one week of conventional liver protection treatment. Elevated serum transaminase levels in these patients were due to the COVID-19 infection but could also be related to systemic immune response caused by cytokine storm syndrome (CSS) and hepatocyte damage caused by ischemia and hypoxia. COVID-19 is highly infectious and mainly affects the lungs. In some cases, especially in patients with severe disease type, COVID-19 may also cause liver injury. The liver function of patients with severe COVID-19 should be very carefully monitored, especially if the patients are elderly and have underlying comorbidities.


Subject(s)
Coronavirus Infections/pathology , Liver Diseases/diagnosis , Pneumonia, Viral/pathology , Aged , Alanine Transaminase/blood , Aspartate Aminotransferases/blood , Betacoronavirus/isolation & purification , COVID-19 , Coronary Disease/complications , Coronavirus Infections/complications , Coronavirus Infections/immunology , Coronavirus Infections/virology , Female , Humans , Hypertension/complications , Liver Diseases/etiology , Lung/diagnostic imaging , Male , Middle Aged , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/immunology , Pneumonia, Viral/virology , SARS-CoV-2 , Severity of Illness Index , Tomography, X-Ray Computed
7.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(3): 420-424, 2020 Jun 18.
Article in Chinese | MEDLINE | ID: covidwho-599891

ABSTRACT

OBJECTIVE: The pathogenesis of myocardial injury upon corona virus disease 2019 (COVID-19) infection remain unknown,evidence of impact on outcome is insufficient, therefore, we aim to investigate the risk factors for death among COVID-19 patients combined with hypertension, coronary heart disease or diabetes in this study. METHODS: This was a single-centered, retrospective, observational study. Patients of Sino-French Eco-City section of Tongji Hospital, Wuhan, China attended by Peking University Supporting Medical Team and admitted from Jan. 29, 2020 to Mar. 20, 2020 were included. The positive nucleic acid of COVID-19 virus and combination with hypertension, coronary heart disease or diabetes were in the standard. We collected the clinical data and laboratory examination results of the eligible patients to evaluate the related factors of death. RESULTS: In the study, 94 COVID-19 patients enrolled were divided into the group of death (13 cases) and the group of survivors (81 cases), the average age was 66.7 years. Compared with the survival group, the death group had faster basal heart rate(103.2 beats/min vs. 88.4 beats /min, P=0.004), shortness of breath(29.0 beats /min vs. 20.0 beats /min, P<0.001), higher neutrophil count(9.2×109/L vs. 3.8×109/L, P<0.001), lower lymphocyte count(0.5×109/L vs. 1.1×109/L, P<0.001), creatine kinase MB(CK-MB, 3.2 µg/L vs. 0.8 µg/L, P<0.001), high sensitivity cardiac troponin Ⅰ(hs-cTnⅠ, 217.2 ng/L vs. 4.9 ng/L, P<0.001), N-terminal pro brain natriuretic peptide(NT-proBNP; 945.0 µg/L vs. 154.0 µg/L, P<0.001), inflammatory factor ferritin(770.2 µg/L vs. 622.8 µg/L , P=0.050), interleukin-2 recepter(IL-2R, 1 586.0 U/mL vs. 694.0 U/mL, P<0.001), interleukin-6(IL-6, 82.3 ng/L vs. 13.0 ng/L, P<0.001), interleukin-10(IL-10, 9.8 ng/L vs. 5.0 ng/L, P<0.001)were higher than those in the survival group. Univariate logistic regression analysis showed that the risk factors for death were old age, low non oxygen saturation, low lymphocyte count, myocardial injury, abnormal increase of IL 2R, IL-6, and IL-10. Multivariate regression showed that old age (OR=1.11, 95%CI=1.03-1.19, P=0.026), low non oxygen saturation(OR=0.85, 95%CI=0.72-0.99, P=0.041), and abnormal increase of IL-10(>9.1 ng/L, OR=101.93, 95%CI=4.74-2190.71, P=0.003)were independent risk factors for COVID-19 patients combined with hypertension, coronary heart disease or diabetes. CONCLUSION: In COVID-19 patients combined with hypertension, coronary heart disease or diabetes, the risk factors for death were old age, low non oxygen saturation, low lymphocyte count, myocardial injury, and abnormal increase of IL-2R, IL-6, and IL-10. Old age, low non oxygen saturation and abnormal increase of IL-10 were independent risk factors.


Subject(s)
Coronary Disease , Coronavirus Infections , Diabetes Mellitus , Hypertension , Pandemics , Pneumonia, Viral , Aged , Betacoronavirus , COVID-19 , China/epidemiology , Coronary Disease/complications , Coronavirus Infections/complications , Coronavirus Infections/epidemiology , Coronavirus Infections/mortality , Humans , Hypertension/complications , Pneumonia, Viral/complications , Pneumonia, Viral/epidemiology , Pneumonia, Viral/mortality , Retrospective Studies , Risk Factors , SARS-CoV-2
8.
J Clin Virol ; 128: 104431, 2020 07.
Article in English | MEDLINE | ID: covidwho-245358

ABSTRACT

BACKGROUND: Despite the death rate of COVID-19 is less than 3%, the fatality rate of severe/critical cases is high, according to World Health Organization (WHO). Thus, screening the severe/critical cases before symptom occurs effectively saves medical resources. METHODS AND MATERIALS: In this study, all 336 cases of patients infected COVID-19 in Shanghai to March 12th, were retrospectively enrolled, and divided in to training and test datasets. In addition, 220 clinical and laboratory observations/records were also collected. Clinical indicators were associated with severe/critical symptoms were identified and a model for severe/critical symptom prediction was developed. RESULTS: Totally, 36 clinical indicators significantly associated with severe/critical symptom were identified. The clinical indicators are mainly thyroxine, immune related cells and products. Support Vector Machine (SVM) and optimized combination of age, GSH, CD3 ratio and total protein has a good performance in discriminating the mild and severe/critical cases. The area under receiving operating curve (AUROC) reached 0.9996 and 0.9757 in the training and testing dataset, respectively. When the using cut-off value as 0.0667, the recall rate was 93.33 % and 100 % in the training and testing datasets, separately. Cox multivariate regression and survival analyses revealed that the model significantly discriminated the severe/critical cases and used the information of the selected clinical indicators. CONCLUSION: The model was robust and effective in predicting the severe/critical COVID cases.


Subject(s)
Coronary Disease/diagnosis , Coronavirus Infections/diagnosis , Diabetes Complications/diagnosis , Diabetes Mellitus/diagnosis , Disease Outbreaks , Hypertension/diagnosis , Pneumonia, Viral/diagnosis , Adult , Age Factors , Aged , Area Under Curve , Betacoronavirus , Biomarkers/blood , CD3 Complex/blood , COVID-19 , Cohort Studies , Coronary Disease/blood , Coronary Disease/complications , Coronary Disease/mortality , Coronavirus Infections/blood , Coronavirus Infections/complications , Coronavirus Infections/mortality , Diabetes Complications/blood , Diabetes Complications/mortality , Diabetes Mellitus/blood , Diabetes Mellitus/mortality , Female , Glutathione/blood , Humans , Hypertension/blood , Hypertension/complications , Hypertension/mortality , Male , Middle Aged , Pandemics , Pneumonia, Viral/blood , Pneumonia, Viral/complications , Pneumonia, Viral/mortality , Prognosis , ROC Curve , SARS-CoV-2 , Severity of Illness Index , Support Vector Machine , Survival Analysis , Thyroxine/blood
9.
Ann Cardiol Angeiol (Paris) ; 69(3): 107-114, 2020 May.
Article in French | MEDLINE | ID: covidwho-78184

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects host cells with angiotensin receptors, leading to pneumonia linked to COVID-19. The virus has a double impact on the cardiovascular system, the infection will be more intense if the host has cardiovascular co-morbidities and the virus can cause life-threatening cardiovascular lesions. Therapies associated with COVID-19 may have adverse cardiovascular effects. Therefore, special attention should be given to cardiovascular protection during COVID-19 infection.


Subject(s)
Betacoronavirus/pathogenicity , Cardiovascular Diseases/complications , Coronavirus Infections/complications , Pneumonia, Viral/complications , Antimalarials/adverse effects , Antimalarials/therapeutic use , Antiviral Agents/adverse effects , Antiviral Agents/therapeutic use , Azithromycin/adverse effects , Azithromycin/therapeutic use , Betacoronavirus/immunology , COVID-19 , Cardiomyopathies/virology , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/etiology , Cardiovascular Diseases/prevention & control , Cerebrovascular Disorders/complications , Cerebrovascular Disorders/prevention & control , Cerebrovascular Disorders/virology , Chloroquine/adverse effects , Chloroquine/therapeutic use , Comorbidity , Coronary Disease/complications , Coronary Disease/prevention & control , Coronary Disease/virology , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Drug Interactions , Drug Therapy, Combination/adverse effects , Female , Humans , Hydroxychloroquine/adverse effects , Hydroxychloroquine/therapeutic use , Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects , Male , Methylprednisolone/adverse effects , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Risk Factors , SARS-CoV-2 , Virus Internalization/drug effects
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