Comorbidity In COVID-19 Patients Research Articles

Role of ribosomal pathways and comorbidity in COVID-19: Insight from SARS-CoV-2 proteins and host proteins interaction network analysis

The COVID-19 pandemic has become a significant global issue in terms of public health. While it is largely associated with respiratory complications, recent reports indicate that patients also experience neurological symptoms and other health issues. The objective of this study is to examine the network of protein-protein interactions (PPI) between SARS-CoV-2 proteins and human host proteins, pinpoint the central genes within this network implicated in disease pathology, and assess their viability as targets for drug development.The study adopts a network-based approach to construct a network of 29 SARS-CoV-2 proteins interacting with 2896 host proteins, with 176 host genes being identified as interacting genes with all the viral proteins. Gene ontology and pathway analysis of these host proteins revealed their role in biological processes such as translation, mRNA splicing, and ribosomal pathways. We further identified EEF2, RPS3, RPL9, RPS16, and RPL11 as the top 5 most connected hub genes in the disease-causing network, with significant interactions among each other. These hub genes were found to be involved in ribosomal pathways and cytoplasmic translation. Further a disease-gene interaction was also prepared to investigate the role of hub genes in other disorders and to understand the condition of comorbidity in COVID-19 patients. We also identified 13 drug molecules having interactions with all the hub genes, and estradiol emerged as the top potential drug target for the COVID-19 patients. Our study provides valuable insights using the protein-protein interaction network of SARS-CoV-2 proteins with host proteins and highlights the molecular basis of manifestation of COVID-19 and proposes drug for repurposing.As the pandemic continues to evolve, it is anticipated that investigating SARS-CoV-2 proteins will remain a critical area of focus for researchers globally, particularly in addressing potential challenges posed by specific SARS-CoV-2 variants in the future.

Mortality and Comorbidities of Covid-19 Patients with Immune Thrombocytopenic Purpura - a Review of the National Database 2019-2020

Introduction: Immune thrombocytopenic purpura (ITP) is a diagnosis of exclusion that is characterized by isolated thrombocytopenia with a generalized purpuric rash. If there is a known case for the ITP, it is referred to as secondary ITP. Secondary ITP may often be caused by drugs, systemic immunologic, or infectious diseases. Covid-19 is a disease caused by the SARS-CoV-2 virus, which caused a pandemic in 2020, affecting hundreds of millions of people worldwide. There have been several different hematologic conditions associated with this viral infection, including deep vein thromboses, pulmonary emboli, and many patients with ITP induced by Covid-19. With several case reports and case series available on these patients, the specifics behind the strength of the association, mortality of the patients, and their comorbidities have not been previously explored. Methods: Using the national inpatient sample from the years 2019-2020, we analyzed adult hospitalized patients with ITP and Covid-19 based on their International Classification of Diseases - 10 clinical modification codes. We calculated the odds ratios for patients with Covid-19 being diagnosed with ITP compared to other hospitalized patients. Additionally, we calculated the odds of several complications, treatments, as well as concurrent conditions in patients with Covid-19 and ITP. The complications measured were epistaxis or hemoptysis, intracranial hemorrhage (ICH), non-intracranial hemorrhage (nICH), deep vein thrombosis (DVT), pulmonary embolism (PE), and death. Treatments measured were transfusion with either red blood cells (RBC) or platelets. The concurrent conditions evaluated were systemic lupus erythematosus (SLE), hepatitis C and heparin-induced thrombocytopenia (HIT). Results Out of the 115,150 hospitalized patients with ITP included in the database, 0.02% of them were diagnosed with Covid-19. The odds of a patient with Covid-19 being diagnosed with ITP were lower than those for other hospitalized patients (OR=0.860 [0.787-0.941], p=0.001). The mean age for patients with ITP diagnosed with Covid-19 was 64.1 compared to 60.9 in patients without Covid-19 (p=0.001). Hospitalized patients with ITP who were also diagnosed with Covid-19 were at a higher risk of developing epistaxis (OR: 1.45 [1.01-2.07], p=0.042), pulmonary embolism (OR: 2.22 [1.35-3.66], p=0.002), and death (OR: 4.39 [3.33-5.80], p<0.001) compared to those without Covid-19. They were not at higher odds of developing a DVT (OR: 1.25 [0.798-1.97], p=0.325), ICH (OR: 0.158 [0.0160-1.56], 0.114) or nICH (OR: 1.03 [0.678-1.55], p=0.905). They were not significantly more or less likely to get transfused with RBC (OR: 0.816 [0.585-1.14], p=0.231) or platelets (OR: 1.14 [0.865-1.53], p=0.337). The ITP patients with concurrent Covid-19 were also not more likely to suffer from SLE (OR: 0.737 [0.453-1.20], p= 0.222), Hepatitis C (OR: 0.760 [0.392-1.47], 0.416), or HIT (OR: 1.16 [0.181-7.49], p=0.872). Conclusion Hospitalized patients with Covid-19 were at a lower risk of being diagnosed with concurrent ITP than other hospitalized Covid-19 patients. Those with ITP who also had Covid 19 had significantly higher odds of complication of bleeding with epistaxis or hemoptysis as well as a higher risk of pulmonary embolism and death. However, they were not at higher risk of hemorrhage elsewhere or DVT. They were not treated with transfusions differently and having SLE, hepatitis C or HIT did not place hospitalized patients with ITP at a higher risk of developing Covid-19.

Exploring disparities and novel insights into metabolic and cardiovascular comorbidities among COVID-19 patients in Mexico

IntroductionThe COVID-19 pandemic, especially its early stages, sparked extensive discussions regarding the potential impact of metabolic and cardiovascular comorbidities on the severity and fatality of SARS-CoV-2 infection, yielding inconclusive outcomes. In this study, we delve into the prevalence of metabolic and cardiovascular comorbidities within COVID-19 patients in Mexico.MethodsEmploying a retrospective observational study design, we collected data from official databases encompassing COVID-19 patients admitted to both public and private hospitals in Mexico City.ResultsOur investigation unveiled a noteworthy incongruity in the prevalence of metabolic and cardiovascular comorbidities among COVID-19 patients, with a particular emphasis on obesity, hypertension, and diabetes. This incongruity manifests as location-dependent phenomena, where the prevalence of these comorbidities among COVID-19 patients significantly deviates from the reported values for the general population in each specific location.DiscussionThese findings underscore the critical importance of screening for metabolic and cardiovascular comorbidities in COVID-19 patients and advocate for the necessity of tailored interventions for this specific population. Furthermore, our study offers insights into the intricate interplay between COVID-19 and metabolic and cardiovascular comorbidities, serving as a valuable foundation for future research endeavors and informing clinical practice.

Anosmia, Dysgeusia, and Comorbidity in COVID-19 Patients with Respiratory Tract Manifestations

Introduction: Olfactory and special sensory disturbances such as anosmia and dysgeusia have been found among COVID-19 patients. These manifestations may cause post-covid sequelae, disturbing patients' quality of life who have recovered from COVID-19. This study aimed to analyze the association between anosmia and dysgeusia with the comorbidities in adult COVID-19 patients admitted to Dr. Soetomo General Hospital, Surabaya, from 1 January 2020 to 30 September 2021. Methods: This was a cross-sectional retrospective analysis study based on the medical records of all patients who met the criteria (n = 158). The minimal age inclusion was 18 years old, and the patient must be positively diagnosed with COVID-19 (reverse transcription polymerase chain reaction/RT-PCR). Results: Out of 158 patients, all had a fever, and approximately 93% of patients showed respiratory signs and symptoms. There were 128 patients (81%) who suffered from anosmia, and 15 patients (9.5%) had dysgeusia. Significant associations were found between anosmia with dysgeusia (p = 0.049) and between anosmia with cough (p = 0.003) and dyspnea (p = 0.000). The predominant comorbidities reported were overweight (60%), hypertension (42%), and type-2 diabetes mellitus (37%). Conclusion: There were significant associations between anosmia with dysgeusia and the respiratory tract signs and symptoms instead of the comorbidities reported.

Diabetes Mellitus and COVID-19: Prevalence, Severity, Management, and Mortality: A Secondary Study

Objective: This study aimed to conduct a systematic review about diabetes mellitus and COVID-19 severity, management, and mortality
 Materials and Methods: Thirteen studies were included in this review, comprising a total of 1155 COVID-19 patients with diabetes mellitus as a significant comorbidity. Data regarding patient demographics and the prevalence of comorbidities, including smoking, hypertension, cardiovascular disease, chronic kidney disease, and chronic liver disease, were collected.
 Results: Among COVID-19 patients with diabetes mellitus, the majority were male (57.1%) compared to females (42.9%). The prevalence of comorbidities in COVID-19 are varied, with smokers accounting for 1- 12.6%, hypertension ranging from 8-41.6%, diabetes mellitus ranging from 7.4-70.8%, cardiovascular disease ranging from 1.6-23.0%, chronic kidney disease ranging from 0.7-2.9%, and chronic liver disease ranging from 0.5-4.6%. In comparison to COVID-19 patients without diabetes, a higher proportion of patients with diabetes mellitus were admitted to the intensive care unit (36.8%). Among COVID-19 patients with diabetes mellitus, the survival rate was significantly higher at 62.2% compared to a lower rate of 13.4% observed among non-survivors with diabetes mellitus.
 Conclusion: This systematic review emphasizes the significance of diabetes mellitus as a comorbidity in COVID-19 patients, increasing the risk of ICU admission. These findings emphasize the importance of identifying and effectively managing diabetes mellitus as a comorbidity in COVID-19 patients to enhance overall outcomes.

Correlation of various co-morbidities of COVID-19 patients with persistent COVID-19 PCR positivity: A prospective study at Nishtar Hospital Multan.

Objective: To investigate the correlation between various co-morbidities of COVID-19 patients with persistent PCR positivity in hospitalized patients. Study Design: Prospective Observational. Setting: Nishtar Medical University, Multan COVID Isolation Wards, and ICU. Period: September 15 to September 14, 2020. Material & Methods: The study sample included 162 hospitalized patients who underwent COVID-19 PCR testing at admission, 4 weeks, and 8 weeks, and their comorbidities data were collected. Multiple regression analysis was performed to determine the relationship between co-morbidities and COVID-19 PCR positivity. Results: Among 162 patients, seventy-nine (48.8%) were male and the mean age of the patients was 53.46±15.81 years. Out of 162 patients, 70 (43.2%) tested positive for COVID-19, while 92 (56.8%) tested negative. Among 70 patients who had positive PCR, 45(64.28%) patients had prolonged positive PCR (at 4 weeks) and out of 45, 29 (64.45%) again remained positive at 8 weeks. While carrying out the multiple linear regression, the results indicated that the presence of hypertension, diabetes, and lung disease was positively associated with persistent COVID-19 PCR positivity (at 4 and 8 weeks). However, no significant association was found between persistent COVID-19 PCR positivity and liver disease, malignancy, and ischemic heart disease. Conclusion: The study highlights the importance of considering co-morbidities like diabetes, hypertension, and lung disease, in predicting persistent COVID-19 PCR positivity in hospitalized patients. Further research is needed to confirm these findings and investigate the underlying mechanisms of these associations.

Correlation Between IL-8, C-Reactive Proteins (CRP) and Neutrophil to Lymphocyte Ratio (NLR) as Predictor of Mortality in COVID-19 Patients with Diabetes Mellitus Comorbidity.

COVID-19 is caused by SARS-CoV-2 and has a wide range of symptoms. While Diabetes Mellitus (DM) is a common comorbidity in COVID-19 patients, it is the main comorbidity in non-surviving COVID-19 patients. Interleukin-8 (IL-8) is a cytokine that has been correlated with severity and mortality in COVID-19 patients, but its role in COVID-19 patients with DM comorbidity and its relationship with NLR and CRP as markers of inflammation are not yet fully understood. To investigate the correlation between IL-8, NLR, and CRP in COVID-19 patients with DM comorbidity. A cross-sectional study was conducted at the Integrated Infectious Disease Installation of Dr. Saiful Anwar Malang Hospital from June to November 2021 using consecutive sampling. IL-8 was measured using the ELISA method with Legendmax® Human IL-8. NLR was measured using flow cytometry, while CRP was measured using the immunoturbidimetric method with Cobas C6000®. Patient outcomes were obtained from medical records. A total of 124 research subjects participated in the study. IL-8 and CRP levels were significantly higher (p < 0.05) in COVID-19 patients with DM comorbidity, and were also significantly higher (p < 0.05) in non-surviving COVID-19 patients. Overall, there was a positive correlation between IL-8 and CRP (r = 0.58, p < 0.05). There was also a positive correlation between IL-8 (r = 0.58; p < 0.05), NLR (r = 0.45, p < 0.05), CRP (r = 0.54, p < 0.05) and mortality in COVID-19 patients with DM comorbidity. The presence of DM comorbidity increased IL-8 levels and aggravated inflammation in COVID-19 patients, thereby increasing the risk of mortality. IL-8, CRP and NLR levels were higher in non-surviving COVID-19 patients with DM comorbidity, indicating that they could serve as good predictors of poor outcomes in this patient population.

Occurrence of comorbid diseases in patients after COVID-19.

The COVID-19 pandemic has highlighted the potential impact of this disease on cardiovascular morbidity and mortality. Patients with established cardiovascular (CV) disease are at increased risk of severe infection and hospital-acquired adverse outcomes. This study aimed to investigate the prevalence and characteristics of comorbidities in COVID-19 patients. We analyzed data from 220 patients who previously contracted COVID-19. Statistical analysis was performed using SPSS software. The average age of the patients was 54.6 ± 11.4 years, and arterial hypertension (AH) was the most common comorbidity, affecting 55% of patients. Obesity was observed in one-third of patients, while coronary heart disease (CHD) and coronary heart failure (CHF) were reported in 17.7% and 11.8% of patients, respectively. Chronic kidney disease (CKD), atrial fibrillation (AF), and obstructive pulmonary disease (COPD) were less common. Cardiovascular diseases, particularly AH, were the most frequent comorbidities in COVID-19 patients. Understanding the prevalence and characteristics of comorbidities in COVID-19 patients is crucial for developing appropriate management strategies and improving clinical outcomes. Our findings highlight the importance of identifying and managing comorbidities in COVID-19 patients to reduce the risk of severe COVID-19 and improve clinical outcomes.

Nutritional Status and Number of Comorbid in Adult Patients With COVID-19

During the last two years, the death rate due to the COVID-19 pandemic in Indonesia has reached 157,000 people, with comorbid diseases being the most significant factor in the incidence of mortality in COVID-19 patients. Examining the nutritional status and number of comorbidities in COVID-19 patients was the study's main goal. This study is an analytic observational, quantitative study that uses survey research design and cross-sectional approach design. The research samples were taken by a purposive sampling approach, so that all samples that met the inclusion criteria were taken (N= 136) According to the study's findings, there was no linkage among nutritional status and the amount of comorbidities among adults and the elderly. (p value = 0.910 and p = 0.220) and based on gender (p value = 0.937 and p = 0.795). For these reasons, In order to obtain more precise results, there is a need for further research on additional variables that can affect the frequency of comorbidities in COVID-19 patients.

Correlation of mortality levels of COVID-19 comorbid Type 2 diabetes mellitus patients with severity level of thoracic radiography in RSUD Dr. Moewardi

COVID-19 has become a global health hazard and its high infectivity is worrying. This virus can infect anyone and can be more severe in people who have comorbid illnesses. One of the most common comorbidities in COVID-19 patients is type 2 diabetes mellitus. Chest radiography can be used to predict prognosis and mortality in COVID-19 patients. One of the scoring used is the Brixia score which serves to assess the severity of the lung based on certain indicators. There are not many studies that discuss the mortality rate of COVID-19 patients with comorbid diabetes mellitus based on the radiographic profile as measured by the Brixia score assessment. Therefore, this study aims to determine the correlation between the mortality rate of comorbid COVID-19 patients with type 2 diabetes mellitus with the severity of chest radiography using the Brixia score. This study used an analytic observational study with a cross-sectional approach. The subjects were 60 COVID-19 patients with type 2 diabetes mellitus who met the inclusion and exclusion criteria. Sampling was done by purposive sampling technique and the data obtained were analyzed using the contingency coefficient test. There was a significant relationship between the mortality rate of patients with COVID-19 comorbid type 2 diabetes mellitus and the severity of chest radiography using the Brixia score (p&lt;0.001; p&lt;0.05). There was a relationship between the mortality rate of COVID-19 patients with type 2 diabetes mellitus and the severity of chest radiography treated in the ICU of RSUD Dr. Moewardi, Surakarta

HYPERTENSION AS A RISK FACTOR FOR COVID-19 SEVERITY AND MORTALITY: AN INTEGRATIVE REVIEW

The new coronavirus illness (COVID-19) produced by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has swiftly grown into a global epidemic. Hypertension has been identified as the most common cardiovascular comorbidity in COVID-19 patients, and it has been shown to increase the risk of hospitalization and mortality. Initial research suggested that renin-angiotensin-aldosterone system inhibitors might raise the likelihood of viral infection and worsen illness severity, generating concern considering the global prevalence of hypertension. Nonetheless, further research supported the use of antihypertensive medicines, noting that they do not worsen the severity of COVID-19 infection in hypertensive individuals, but may have a favorable impact. To yet, the specific mechanism through which hypertension predisposes to adverse outcomes in COVID-19 individuals is unclear. In this study, we discuss the incidence of SARS-CoV-2 infection and hypertension, as well as probable causes, with an emphasis on the dual roles of angiotensin-converting enzyme 2 in COVID-19 and hypertension. The effects of pro-inflammatory factors released by the immune system and gastrointestinal dysfunction in COVID-19 are also discussed, as well as how to manage hypertension with covid-19.

Hypertension in Associated with COVID-19

The novel coronavirus infection (COVID-19), now a worldwide public health concern is associated with varied fatality. Patients with chronic underlying conditions like hypertension have shown worst outcomes. Hypertension is a multifactorial disease and a public health burden, as it is a risk factor for diseases like stroke, coronary artery disease, and heart failure. As one of the most important public health problems in the 21st century, hypertension affects more than one billion individuals worldwide. Hypertension is a common comorbidity in COVID-19 patients. However, the association of hypertension with the severity and fatality of COVID-19 remain unclear. Hypertension is a major risk factor regarding the severity and fatality of COVID-19, and the RAAS plays an important role in COVID-19 infection since SARS-CoV-2 can lead to a dysregulation of the system by reducing the ACE2 expression. Hypertension may also affect the prognosis of COVID-19 illness. The severity rate of COVID-19 in hypertensive patients was much higher than in non-hypertensive cases. A systematic literature search was conducted using several databases on studies that assess hypertension and outcome in COVID-19. Composite of poor outcome, comprising of mortality, severe COVID-19, acute respiratory distress syndrome (ARDS), need for intensive care unit (ICU) care and disease progression were the outcomes of interest. Authors independently reviewed some titles, abstracts and read full-texts of articles to identify potentially eligible studies to decide about final inclusions. This systematic review was conducted based on the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) Statement. We used six different databases: Pubmed, Clinical Key, Science Direct, Cochrane Library, Springer Link and Oxford Academic. A total of 2731 articles from the databases were identified, we got three articles that fulfill the criteria. We excluded the other studies by reading the title, abstract, and full text assessment. Hypertension was associated with the severity and mortality of COVID-19 illness. Hypertension was also independently associated with a significantly increased risk of critical COVID-19 and inhospital mortality of COVID-19.

Serum Procalcitonin Level and Comorbidity in Covid-19 Patients in UAE

Background: Most COVID-19 patients experience a mild form of the disease, but there is a certain percentage of patients who progress to a very severe disease state that requires intensive care and invasive ventilation. In order to ensure better patient management and improved outcomes, early identification of patients who may be at a higher risk of severe infection can play an important role. The aim of this study was to assess the association between the mean procalcitonin (PCT) level and comorbidity in hospitalized patients with COVID-19. Methods and Results: A total of 231 COVID-19-positive patients aged between 20 and 82 years (170[73.6 %] males and 61[26.4%] females) were included in this study. Serum PCT was accessed by procalcitonin assay using the Beckman Coulter UniCel DxI 800 instrument. Eighty-seven (37.7%) patients had no chronic disease, while 144(62.3%) had comorbidities: hypertension (37[16.0%]), diabetes mellitus (44[19.0%]), a combination of diabetes mellitus with hypertension (32[13.9%]), asthma (6[2.6%]), hyperlipidemia (4[1.7%]), renal disease (1[0.4%]), and COPD (1[0.4%]). COVID-19 patients with diabetes in combination with hypertension had a statistically greater PCT level than COVID-19 patients without comorbidities (P=0.0273). However, there were no statistically significant differences in the mean PCT level between different age categories (P=0 .7390). The serum PCT measurement could evaluate the prognosis of the disease in some COVID-19 patients.

Primary hypertension, anti-hypertensive medications and the risk of severe COVID-19 in UK Biobank.

Hypertension appears to be one of the commonest comorbidities in COVID-19 patients, although whether hypertensive individuals have a higher risk of severe COVID-19 compared with non-hypertensives is unclear. It is also unclear whether the absolute level of systolic blood pressure, or the type of anti-hypertensive medication is related to this risk. Analyses were conducted using data from the UK Biobank and linked health records. Logistic regression models were fitted to assess the impact of hypertension, systolic blood pressure (SBP) and medications on the risk of severe COVID-19. 16,134 individuals tested positive for severe acute respiratory syndrome-coronavirus, 22% (n = 3,584) developed severe COVID-19 and 40% (n = 6,517) were hypertensive. Hypertension was associated with 22% higher odds of severe COVID-19 (Odds ratio (OR) 1.22; 95% confidence interval (CI) 1.12, 1.33), compared with normotension after adjusting for confounding variables. In those taking anti-hypertensive medications, elevated SBP showed a dose-response relationship with severe COVID-19 (150-159mmHg versus 120-129mmHg (OR 1.91; 95% CI 1.44, 2.53), &gt;180+mmHg versus 120-129mmHg (OR 1.93; 95% CI 1.06, 3.51)). SBP &lt;120mmHg was associated with greater odds of severe COVID-19 (OR 1.40; 95% CI 1.11, 1.78). Angiotensin-converting enzyme inhibitors or angiotensin-II receptor blockers were not associated with altered risk of severe COVID-19. Hypertension is an important risk factor for COVID-19. A better understanding of the underlying mechanisms is warranted in case of more severe strains or other viruses in the future.

Clinical characteristics and mortality associated with COVID-19 in islamic hospital of Jemursari, Surabaya, Indonesia: A hospital-based retrospective cohort study

Introduction: According to WHO, the COVID-19 epidemic a public health emergency came to international attention in March 2020, and the pandemic quickly spread around the world. This disease is caused by the novel coronavirus SARS-CoV-2, which may enter human target cells via angiotensin-converting enzyme 2 (ACE2). This study aimed to assess the risk factors associated with poor prognosis among COVID-19 patients in the Islamic Hospital of Jemursari, Surabaya, Indonesia. Methods: This study was a retrospective cohort study that used patients hospitalized with COVID-19 at the Islamic Hospital of Jemursari, Surabaya as a study subject. Patients of all ages who enter the hospital and were confirmed with a positive real-time polymerase chain reaction (RT-PCR) result for SARS-CoV-2 were inclusion criteria of this study. Results: We included 554 COVID-19-positive patients with the highest age at 26-35 years old as much as 26.72%, followed by the second highest at 36-45 years old at 20.86%. In addition, from all the patients in this study, it was found that the most patients were 281 male and 273 female. Characteristics of comorbidities in COVID-19 patients, where type 2 diabetes mellitus is the most comorbid factor 88.89% in recovered COVID-19 patients and 11.11% in patients who have died. In addition, hypertension is also the second most comorbid 96.55% of Covid-19 patients. Conclusion: Based on this study, the independent risk factors related to critical outcomes among COVID-19 cases include old age, males, diabetes mellitus, cardiac-related disease history, and the presence of two or more comorbidities. In future research, we suggest designing a unique multi-item scale system to prognosticate COVID-19 patients.

Complications and Comorbidities in COVID-19 Patients: A Comparative study.

BackgroundCOVID-19 has rapidly spread across the world at an unprecedented rate. The outbreak of COVID-19 infection has led to a significant health burden on infected patients, especially those with existing comorbidities. The aim of this study is to find the most prevalent symptoms, comorbidities, and complications developed during the course of the disease and outline the most prevalent symptoms among the baseline and clinical characteristics of the patients.MethodsThis is a retrospective study that was performed on the data obtained from medical records of 3999 COVID-19 patients from Prince Mohammed Bin Abdulaziz Hospital in Riyadh, Saudi Arabia. Demographic data, clinical symptoms, and comorbidities were noted on the day of hospital admission. Complications developed during the COVID -19 infection were also observed.ResultsThe average age was 49.55 ± 14.75 years and 73.77% of the study population were male patients. The average Body Mass Index (BMI) of the patients was 29.48 ± 6.94. Fever and cough were the most common symptoms (85.85%) followed by shortness of breath (83.25%). Other reported symptoms were diarrhoea (17.43%), fatigue (16.2%), vomiting (15.38%), headache (15.23%), sore throat (9.3%), and nausea (8.5%) The most common comorbidity recorded was diabetes mellitus (DM) (39.51%), followed by hypertension (HTN) (33.91%), and asthma (9.45%). In COVID-19 patients with comorbidities, 61.90% developed complications of pneumonia, 8.73% had Acute Respiratory Distress Syndrome (ARDS), 7.25% developed pneumonia and ARDS concurrently, while 0.4% of the total patients had septic shock.ConclusionThe symptoms of fever, cough, and shortness of breath were higher in individuals with hypertension and diabetes mellitus, and more prevalent in complications of pneumonia, acute respiratory illness, and septic shock.

Higher Adherence to the Mediterranean Dietary Pattern Is Inversely Associated With Severity of COVID-19 and Related Symptoms: A Cross-Sectional Study.

Background and AimsAdherence to the Mediterranean diet (MD) has been associated with a decreased risk of developing a variety of chronic diseases that are comorbidities in COVID-19 patients. However, its association to the severity and symptoms of COVID-19 are still unknown. This study aimed to examine the association between adherence to the MD pattern and COVID-19 severity and symptoms in Iranian hospitalized patients.MethodsIn this cross-sectional study, 250 COVID-19 patients aged 18 to 65 were examined. We employed a food frequency questionnaire (FFQ) to obtain data on dietary intake of participants in the year prior to their COVID-19 diagnosis. COVID-19 severity was determined using the National Institutes of Health's Coronavirus Disease 2019 report. Additionally, symptoms associated with COVID-19, inflammatory markers, and other variables were evaluated. The scoring method proposed by Trichopoulou et al. was used to assess adherence to the MD.ResultsThe participants' mean age was 44.1 ± 12.1 years, and 46% of them had severe COVID-19. Patients who adhered more closely to the MD had lower serum C-reactive protein levels (7.80 vs. 37.36 mg/l) and erythrocyte sedimentation rate (14.08 vs. 42.65 mm/h). Those with the highest MD score were 77% less likely to have severe COVID-19 after controlling for confounding variables. The MD score was also found to be inversely associated with COVID-19 symptoms, including dyspnea, cough, fever, chills, weakness, myalgia, nausea and vomiting, and sore throat.ConclusionHigher adherence to the MD was associated with a decreased likelihood of COVID-19 severity and symptoms, as well as a shorter duration of hospitalization and convalescence, and inflammatory biomarkers.

Clinical Phenotypes and Mortality Biomarkers: A Study Focused on COVID-19 Patients with Neurological Diseases in Intensive Care Units.

Purpose: To identify clinical phenotypes and biomarkers for best mortality prediction considering age, symptoms and comorbidities in COVID-19 patients with chronic neurological diseases in intensive care units (ICUs). Subjects and Methods: Data included 1252 COVID-19 patients admitted to ICUs in Cuba between January and August 2021. A k-means algorithm based on unsupervised learning was used to identify clinical patterns related to symptoms, comorbidities and age. The Stable Sparse Classifiers procedure (SSC) was employed for predicting mortality. The classification performance was assessed using the area under the receiver operating curve (AUC). Results: Six phenotypes using a modified v-fold cross validation for the k-means algorithm were identified: phenotype class 1, mean age 72.3 years (ys)—hypertension and coronary artery disease, alongside typical COVID-19 symptoms; class 2, mean age 63 ys—asthma, cough and fever; class 3, mean age 74.5 ys—hypertension, diabetes and cough; class 4, mean age 67.8 ys—hypertension and no symptoms; class 5, mean age 53 ys—cough and no comorbidities; class 6, mean age 60 ys—without symptoms or comorbidities. The chronic neurological disease (CND) percentage was distributed in the six phenotypes, predominantly in phenotypes of classes 3 (24.72%) and 4 (35,39%); χ² (5) 11.0129 p = 0.051134. The cerebrovascular disease was concentrated in classes 3 and 4; χ² (5) = 36.63, p = 0.000001. The mortality rate totaled 325 (25.79%), of which 56 (17.23%) had chronic neurological diseases. The highest in-hospital mortality rates were found in phenotypes 1 (37.22%) and 3 (33.98%). The SSC revealed that a neurological symptom (ageusia), together with two neurological diseases (cerebrovascular disease and Parkinson’s disease), and in addition to ICU days, age and specific symptoms (fever, cough, dyspnea and chilliness) as well as particular comorbidities (hypertension, diabetes and asthma) indicated the best prediction performance (AUC = 0.67). Conclusions: The identification of clinical phenotypes and mortality biomarkers using practical variables and robust statistical methodologies make several noteworthy contributions to basic and experimental investigations for distinguishing the COVID-19 clinical spectrum and predicting mortality.

Factors Affecting the Outcomes of COVID-19 Patients Treated at Dr. M. Djamil Padang General Hospital

Background: COVID-19 has spread rapidly throughout the world with high morbidity and mortality. This study aimed to determine the factors that influenced the outcomes of COVID-19 patients treated at RSUP. Dr. M. Djamil Padang.Methods: This was an observational analytic study conducted with a retrospective cohort design on COVID-19 patients at RSUP Dr. M. Djamil Padang. Data were taken from medical records from January to March 2021. Association between comorbidities and the outcome of COVID-19 patients were analyzed using Chi- Square/Fisher Exact Test.Results: Majority of the patients were female (56.4%) and aged above 50 years (64.3%). Hypertension was the most common comorbidity (41.1%). Diabetes mellitus affected the final outcome of treatment. The number of comorbidities the patients had was associated with a worse outcome for COVID-19.Conclusion: Most of COVID-19 patients at RSUP Dr. M. Djamil Padang were male and more than 50 years old. There was a correlation between age, gender, and comorbidities in COVID-19 patients with the outcomes.

C-peptide levels and glycemic indices in COVID-19 patients

Type 2 diabetes (T2DM) is a common comorbidity in COVID-19 patients, which could favor disease progression. Our study aimed to evaluate the impact of some glycemic biomarkers on characteristic features of COVID-19. Electronic medical records of patients consecutively admitted to a COVID-19 ward were analyzed. Demographic and anthropometric as well as clinical and laboratory parameters were obtained. T2DM was present in 47% of the patients, with 22.58% of diabetic patients being newly diagnosed at admission. The most important predictors of severe COVID-19 were age (OR 1.214 [1.078-1.366], p = 0.001), creatinine levels (OR 1.018 [1.003-1.034], p = 0.017), glucose above 7.0 mmol/L at admission (OR 7.800 [2.232-27.255], p = 0.001) and HbA1c ≥ 6.5% (OR 4.840 [1.428-16.405], p = 0.011) irrespective of the presence of DM. C-peptide levels correlated positively with age, creatinine level, the severity of hypoxia and ferritin levels of patients (p < 0.05 for all) and appeared to be a significant predictor of leukocytosis. Suboptimal glycemic indices and impaired kidney function might predict COVID-19 disease worsening. Early detection of DM and optimization of glycemic control in diabetic patients should be among the priorities of the public health systems during COVID-19 pandemics.