Incidence Of COVID-19 In Patients Research Articles

The risk of COVID-19 in Cushing's disease is independently related to disease activity (hypercortisolism) and obesity.

To evaluate the cumulative incidence, risk factors, and outcomes of COVID-19 in patients with Cushing's disease (CD). In all, 60 patients with CD following up in our outpatient clinic answered via phone interview a questionnaire about the occurrence of COVID-19 infection documented by RT-PCR (including the diagnosis date and clinical outcome) and vaccination status. Clinical and biochemical data on disease activity (hypercortisolism) and comorbidities (obesity, diabetes mellitus, and hypertension) were obtained from the patients' electronic medical records. Risk ratios (RRs) of risk factors were obtained using univariate and multivariate analyses. The cumulative incidence of COVID-19 in patients with CD during the observation period was 31.7%, which was higher than that in the general reference population (9.5%). The cumulative incidence of COVID-19 was significantly higher in patients with hypercortisolism (57% versus 17% in those without hypercortisolism, p = 0.012) and obesity (54% versus 9% in those without obesity, p < 0.001) but not in patients with hypertension or diabetes mellitus. On multivariate analysis, hypercortisolism and obesity were each independent risk factors for COVID-19 (RR 2.18, 95% CI 1.06-4.46, p = 0.033 and RR 5.19, 95% CI 1.61-16.74, p = 0.006, respectively). The incidence of COVID-19 in patients with CD was associated with hypercortisolism, as expected, and obesity, a novel and unexpected finding. Thus, correction of hypercortisolism and obesity should be implemented in patients with CD during the current and future COVID-19 outbreaks.

TO ASSESS THE INCIDENCE AND SEVERITY OF COVID 19 INFECTION IN PATIENTS ALREADY ON HEPATITIS C TREATMENT

The COVID-19 pandemic has caused a significant impact worldwide, affecting almost every continent and every nation and causing economic challenges. Even patients who were undergoing antiviral therapy for chronic hepatitis were not spared from the deadly virus. The objective of this observational cross-sectional study was to evaluate the incidence of COVID-19 in patients already undergoing HCV treatment and to assess the severity and recovery of the disease in these patients. The study was conducted in the Department of Medicine and Gastroenterology at Fatima Memorial Hospital in Lahore and was approved by the ethical committee. The study lasted six months, and the sampling technique used was continuous non-probability sampling. The sample size was 100. The results showed that Sofosbuvir and Velpatasvir were prescribed to 91.4% of subjects, while 8.6% were taking triple therapy, including Ribavirin, Sofosbuvir, and Velpatasvir. The antiviral therapy (AVT) course lasted for three months for 95% of participants, while 5% took AVT for six months. Only 7.4% of the participants underwent COVID-19 testing; of those, 3.7% had positive results. 14.8% of participants had received the COVID-19 vaccine, and 4.9% had been in contact with someone who had tested positive for COVID-19. During the AVT period, 11.1% of participants had a history of fever, 80% had symptoms lasting for less than one week, and 20% had symptoms. These findings suggest that antiviral treatment may have a protective and preventive role in COVID-19 infection. However, further studies with a larger population will be required to strengthen these observations.

Assessing the Frequency of COVID-19 in Patients Undergoing Primary Percutaneous Coronary Intervention (PCI).

The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global health crisis with significant morbidity and mortality. The aim of this study was to investigate the incidence of COVID-19 in patients undergoing primary percutaneous coronary intervention (PCI) for myocardial infarction and identify associated demographic and clinical characteristics. In this study, a retrospective and descriptive cross-sectional design was used to examine all patients (a total of 85) who experienced acute myocardial infarction and underwent primary percutaneous coronary intervention (PCI). The study measured various parameters, such as COVID-19 status, age, sex, ethnicity, diabetes, and hypertension. Data analysis was conducted using SPSS version 25 software. Out of the 85 patients who underwent primary percutaneous coronary intervention (PCI) for myocardial infarction (MI), 14 patients (16.5%) were found to have COVID-19. COVID-19 diagnosis was confirmed through RT-PCR testing for 2 patients, while the remaining 12 patients were diagnosed using lung CT scans. Among the COVID-19 patients, 21.4% (n = 3) had background diabetes, and 7.1% (n = 1) had background hypertension. MI recurrence was observed in 14.3% of COVID-19 patients (2 cases). Unfortunately, 1 COVID-19 patient, a 70- year-old Persian woman with diabetes and hypertension, passed away. No significant differences were found in terms of age, sex, ethnicity, underlying diabetes, or underlying hypertension between the COVID-19 and non-COVID-19 groups. The high occurrence of COVID-19 among myocardial infarction (MI) patients undergoing primary percutaneous coronary intervention (PCI) is worth noting. Further investigation is recommended to explore the impact of demographic and contextual factors on the severity and outcomes of primary PCI in MI patients with COVID-19, as well as the underlying mechanisms involved.

Incidence of COVID-19 in cancer patients in a teaching hospital faculty of medicine in Medan, Indonesia

The aim of this study was to determine the incidence of COVID-19 in cancer patients in the Teaching Hospital Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia. This descriptive study was conducted at H. Adam Malik Hospital and USU General Hospital, Medan, from March 2020 to August 2021. The main inclusion criteria for the participants were COVID-19 and confirmed cancer. A total sampling technique was used. Among the 3308 COVID-19 patients studied, the mean age was 44 years, ranging from 1 day to 92 years. Male participants were slightly more prevalent (51.8% vs 48.2%). Twenty-five of these patients (0.75%) had both COVID-19 and cancer, and thus met the inclusion criteria. The most common types of cancer were leukemia (20.0%), breast cancer (20.0%), ovarian cancer (16.0%), lymphoma (8.0%), and osteosarcoma (8.0%). The proportions of patients with mild, moderate, and severe degrees of COVID-19 where 48.0%, 24.0%, and 28.0%, respectively. Seven patients required intensive care, and five died. The incidence of COVID-19 in patients with cancer was relatively low. Nevertheless, almost a third of cancer patients with COVID-19 developed severe disease and had poor prognoses. Vaccination among cancer patients is important to protect them from poor outcomes if exposed to COVID-19.

Dva roky pandemie covidu-19 v populaci českých pacientů s idiopatickými střevními záněty léčenými bio­logickou léčbou – zkušenosti terciárního IBD centra

Summary: Background: Inflammatory bowel disease (IBD) may be associated with a more severe course of infections and a different response to vaccination, especially in complicated IBD course and in association with immune-modifying IBD treatment. The aim of this study was to describe COVID-19 pandemic during years 2020–2022 in IBD patients with long-term bio­logical therapy. Methods: A retrospective analysis of SARS-CoV-2 infection incidence in the population of 1,177 IBD (Crohn’s disease or ulcerative colitis) patients with long-term bio­logical therapy (IBD cohort) was performed. The incidence rate, crude incidence rate and standardized incidence ratio of COVID-19 in the IBD cohort, the odds ratio of infection depending on the type of bio­logic therapy administered, the dynamics of COVID-19 incidence depending on the predominant SARS-CoV-2 variant in the population and the current vaccination coverage of the IBD cohort were calculated. Results: From January 2020 to April 2022, 548 confirmed cases of COVID-19 (46.6%) were reported in the IBD cohort, with 39% share of PCR positivity in vaccinated individuals and with 95% occurrence of infection in unvaccinated part of the IBD cohort. Standardized incidence rate ratio of COVID-19 was 27% higher in the IBD cohort compared to the general Czech population. The dynamics of the development of the number of positive cases of COVID-19 in the IBD cohort was identical to the situation in the entire country. A higher odds ratio of the chances of infection was demonstrated in patients treated with tumor necrosis factor inhibitors, but not in patients treated with anti-integrins or monoclonal antibodies against interleukins. In the IBD cohort, 85.2% of patients were properly vaccinated, which was significantly more than the vaccination rate of the entire Czech population. Discussion and conclusion: During the two pandemic years, the incidence of COVID-19 in patients with severe IBD and long-term bio­logical treatment was higher compared to the general Czech population, despite the favorable vaccination coverage of this high-risk patients’ group. A higher risk was associated with tumor necrosis factor inhibitor therapy. Key words: inflammatory bowel disease – Crohn’s disease – ulcerative colitis – COVID-19 – SARS-CoV-2 – vaccination – bio­logical therapy

New coronavirus infection in patients with chronic non-communicable diseases in primary care

BACKGROUND: The pandemic of a new coronavirus infection, which began in the Chinese city of Wuhan in December 2019, has spread to more than 200 countries and territories. There are a number of studies, the results of which indicate that deaths are mainly registered among the middle-aged and elderly population with chronic non-communicable diseases. Most of these studies are based on the study of cases of COVID-19 with severe course or in hospitalized patients. At the same time, a greater number of patients, including those with chronic non-communicable diseases, carry COVID-19 to a mild degree and remain under the supervision of primary care physicians.&#x0D; AIM: To identify risk factors for the development of severe COVID-19 in patients with chronic non-communicable diseases who sought outpatient care during various periods of increased incidence of new coronavirus infection from March 2020 to February 2022.&#x0D; MATERIALS AND METHODS: The study was carried out on the basis of the Family Medicine Center of North-Western State Medical University named after I.I. Mechnikov, which provides primary health care to the population attached under compulsory health insurance. The design of the study was published earlier. A retrospective cohort study was conducted based on the analysis of outpatient records of patients who sought medical care at the Family Medicine Center during various periods of increased incidence of COVID-19: from 19.03.2020 to 30.06.2020 (group 1), from 1.10.2021 to 30.11.2021 (group 2) and from 18.01.2022 to 28.02.2022 (group 3).&#x0D; RESULTS: 343 patients were included in the study: 137 men (39.9%) and 206 women (60.1%). The number of patients with at least one chronic non-communicable disease was 232 (67.9%). It was found that the severity of COVID-19 is not affected by the presence of one or more chronic non-communicable diseases of mild severity in the patient. At the same time, grade II obesity and grade III hypertension are independent factors that significantly increase the risk of developing severe COVID-19 by 13.4 and 5.4 times, respectively (p 0.05). It should be noted that the combination of these diseases significantly increased the likelihood of developing severe COVID-19 by 11.9 times (p 0.05).&#x0D; CONCLUSIONS: Regardless of the period of morbidity, the clinical manifestations of COVID-19 in patients with chronic non-communicable diseases have their own characteristics: weakness, sweating, dry and wet cough are significantly more common (p 0.05). With each subsequent wave of increase in the incidence of COVID-19 in patients with chronic non-communicable diseases, there is a significant tendency to decrease the frequency of severe and very severe course of the disease, pneumonia and hospitalization, as in patients without chronic non-communicable diseases. It was found that the severity of the COVID-19 course is not affected by the presence of mild chronic non-communicable diseases in the patient. At the same time, grade II and higher obesity or grade III hypertension are independent factors that significantly increase the risk of developing severe COVID-19 by 11.9 and 5.4 times, respectively (p 0.05). The combination of these diseases significantly increased the probability of developing severe COVID-19 by 13.4 times (p 0.05).

Patients Receiving Correctional Assistance At Class 1 Rutan Clinic In Central Jakarta's Knowledge Of Covid-19 Prevention And Review From An Islamic Perspective

Background: A novel variety of coronavirus is what causes Coronavirus Sickness-2019 (Covid-19), a disease. Cough, fever, exhaustion, breathlessness, and lack of appetite are signs of the Covid-19 infection. In order to prevent the corona virus from spreading further, the WHO refers to physical separation as a physical distance regulation. To be able to stop the spread of COVID-19, research on COVID-19 awareness among patients receiving correctional assistance at the Class 1 Rutan Clinic in Central Jakarta is deemed crucial.Method: This kind of study employs cross-sectional research methodology and descriptive observation. 2,900 patients receiving correctional assistance made up the study's sample of 352 participants, who were seen at the Class 1 Rutan Clinic in the heart of Jakarta. Techniques for gathering data include surveys and one-on-one interviews with respondents. Bivariate and univariate analysis are the methods used in this study.Result: Features of the 352 respondents, including 89 (25.28%) respondents who were between the ages of 24 and 29. As many as 281 (79.8%) respondents reported that they had never heard of COVID-19. 66% of the 233 respondents have high knowledge and preventative skills. There is a correlation between the Knowledge Level of Prevention and the Incidence of COVID-19, according to the findings of the Chi-Square statistical test, which yielded the Continuity Correction value = 0.049 where p&gt;0.05.Conclusion: The Class 1 Central Jakarta Rutan Clinic classifies the level of COVID-19 prevention knowledge among patients receiving correctional assistance as "excellent." The incidence of COVID-19 in patients treated at the Class 1 Rutan Clinic in Central Jakarta is correlated with knowledge and prevention. According to the Islamic perspective, the Messenger of Allah discouraged people from entering areas where the plague was rife and from attempting to flee the plague.

Shielding reduced incidence of COVID-19 in patients with inflammatory arthritis but vulnerability is associated with increased mortality.

ObjectivesInvestigate whether individuals with inflammatory arthritis (IA), their treatments and shielding status affect the risk of adverse outcomes from COVID-19 for the entire population of Wales, UK.MethodsRetrospective, population-based cohort study using linked, anonymized electronic health data from SAIL Databank, including primary/secondary care, rheumatology, Office for National Statistics Mortality and COVID-19 laboratory data. Individuals aged 18 years and over testing positive for COVID-19 between March 2020 and May 2021 with READ Codes present for rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis formed the study cases.ResultsA total of 1966 people with IA and 166 602 without tested positive for COVID-19. The incidence rate was 3.5% (1966/56 914) in IA, vs 6% in the general population (166 602/2 760 442), (difference: 2.5%, 95% CI: 2.4%, 2.7%, P ≤0.001). In an adjusted Cox proportional hazard model, IA was not associated with higher mortality (HR: 0.56, 95% CI: 0.18, 1.64, P=0.286). Significant risk factors included shielding (HR: 1.52, 95% CI: 1.40, 1.64, P ≤0.001), hospitalization for previous infections (HR: 1.20, 95% CI: 1.12, 1.28, P ≤0.001), hospitalizations one year pre-pandemic (HR: 1.34, 95% CI: 1.25, 1.44, P ≤0.001) and glucocorticoid use (HR: 1.17, 95% CI: 1.09, 1.25, P ≤0.001).ConclusionsIndividuals with IA had a lower incidence of COVID-19, probably due to shielding. IA was not associated with increased mortality following COVID-19 infection; being vulnerable (shielded), comorbidities and other factors were associated with increased risk. These key risk factors can identify individuals with IA at greater risk from COVID-19 and advised to shield during high community prevalence.

Prevalence and risk of COVID-19 in patients with rheumatic diseases: a systematic review and meta-analysis.

ObjectivesCOVID-19 pandemic has already had a tremendous impact on the process of human society; the survival of mankind and the healthy living environment deterioration with the influence will last for many years. This meta-analysis aims to assess the risk of COVID-19 in patients with rheumatic diseases.MethodsPubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), and Chinese Biomedical Database (CBM) were systematically searched with no language restriction up to July 5, 2021. The pooled rates were synthesized by fixed effect model or random effect model depending on heterogeneity.ResultsA total of 83 articles were included in this meta-analysis. The incidence of COVID-19 in patient with rheumatic diseases was 0.0190 (95% CI: 0.0136-0.0252), and the hospitalization rate, intensive care unit admission rate, mechanical ventilation rate, and case fatality rate of patients with rheumatic diseases infected with COVID-19 were 0.4396 (95% CI: 0.3899-0.4898), 0.0635 (95% CI: 0.0453-0.0836), 0.0461 (95% CI: 0.0330-0.0609), and 0.0346 (95% CI: 0.0218-0.0493), respectively.ConclusionsOur research shows that patients with rheumatic diseases have great risk of COVID-19. Differences in COVID-19 incidence, hospitalization rates, and mortality rates in regions were statistically significant. We still need to pay attention to the risk of COVID-19 in patients with rheumatic diseases.Key Points • Although the risk of COVID-19 in patients with rheumatic diseases has been discussed in previous meta-analysis, their research directions were inconsistent, and few studies focus on prevalence or serious outcomes of COVID-19 in patient with rheumatic diseases, while the quality of these articles was variable. • The incidence of COVID-19 and serious clinical outcomes in patients with rheumatic diseases were still high along with differential risks in most regions. • The use of glucocorticoids and conventional synthetic disease-modifying antirheumatic drugs did not affect the hospitalization rate and mortality in rheumatism patients with COVID-19. Supplementary InformationThe online version contains supplementary material available at 10.1007/s10067-022-06087-1.

Этиопатогенетические аспекты влияния анемического синдрома на возникновение, течение и исход коронавирусной инфекции COVID-19

We consider relevant to modern realities coronavirus infection, which most of us, if not all of us, have encountered. And no less common among the population of the clinical and hematological syndrome is anemia. Anemia in coronavirus infection can be both a contributing factor to its development and a direct consequence of infection. We consider dyserythropoietic “deficiency” anemia – iron deficiency and anemia of chronic diseases characterized by a decrease in serum iron levels. In turn, iron is an active participant in tissue respiration and ensures the normal functioning of the immune system. Data were collected on the incidence of COVID-19 in patients with pre-existing anemia, we consider and analyze the incidence of anemia as a complication of coronavirus infection, and the overall impact of anemia on the severity of COVID-19 and its outcomes, the role of anemia in the necessity for artificial lung ventilation in patients, the development of complications associated with suppression of the immune system and oxygen starvation .The study revealed a significant negative impact of anemia on the course and outcome of coronavirus infection, as well as a its significant role in development of such severe conditions as hypoxic coma, acute respiratory distress syndrome and cytokine storm.

Cardiac rehabilitation in COVID-19 pandemic period

BackgroundCOVID-19 pandemic constitutes a challenge in cardiovascular disease management. Little is known about COVID-19 prevalence and incidence in cardiac rehabilitation (CR) programs.AimTo evaluate the prevalence and incidence of COVID-19 in patients undergoing CR in ambulatory setting.MethodsFrom august to October 2020, all patients admitted in a single ambulatory CR program were screened for COVID-19 infection before and after CR, through naso-pharyngeal RT-PCR and serology assays before and after the CR. Number of patients was reduced from 9 to 4 in each group, 2 meters distancing respected, and all patients and staff had to wear surgical mask during sessions. Hand washing and material disinfection were systematic before and after each session for both patients and health professionals.ResultsAmong the 81 patients included, 63 (76%) were male, mean age was 57 ± 11 years (Table 1). None (0%) had positive RT-PCR before entering CR and only 2 (2.7%) were tested positive after CR. These two patients were asymptomatic. After serological analysis, 3 patients (3.8%) had anti-bodies against SARS-COV-2 before and after participating CR (Fig. 1). These 3 patients were negative on nasal swab before and after CR. No seroconversion was observed. In total (before and after CR), 5 patients (6.0%) were tested positive with COVID-19. Those 5 patients were younger (mean age 51 years old versus 58, P = 0.02), with better functional capacity before and after CR: respectively 7.1 METs (versus 5.2 METs, P = 0.01) and 8.3 METs (versus 6.3 METs, P = 0.03). In COVID+ patients, improvement of functional capacity was similar to COVID–patients: respectively 0.8 METs (P = 0.9) and 15 Watts (P = 0.9).ConclusionCR is not associated with risk of infection with SARS-COV-2, provided that basic sanitary measures are stricly applied. It is also associated with functional capacity improvement, even in patients who previously had COVID-19.

No COVID-19 in Patients With Sudden Sensorineural Hearing Loss (SSNHL).

Various case reports have described sudden sensorineural hearing loss (SSNHL) in patients with the 2019 novel coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Our aim was to determine the incidence of COVID-19 in patients with SSNHL. All consecutive patients with audiometric confirmed SSNHL between November 2020 and March 2021 in a Dutch large inner city teaching hospital were included. All patients were tested for COVID-19 by polymerase-chain-reaction (PCR) and awaited the results in quarantine. Out of 25 patients, zero (0%) tested positive for COVID-19. Two patients had previously tested positive for COVID-19: at three and eight months prior to the onset of hearing loss. This is the largest series to date investigating COVID-19 in SSNHL patients. In this series there is no apparent relationship between SSNHL and COVID-19.

Incidence of COVID-19 in patients treated with infliximab compared with patients treated with rituximab

ObjectiveTo determine whether patients with inflammatory autoimmune diseases treated with rituximab (RTX) have more severe forms of COVID-19 compared with patients treated with anticytokine therapies, such as Tumour Necrosis Factor...

S3417 Incidence of COVID-19 in Patients With Chronic Hepatitis C in an Outpatient Clinic

Introduction: The Centers for Disease Control and Prevention has reported an increased risk for severe COVID-19 in certain patient groups including those older than 65 years and individuals with diabetes, cardiovascular disease, and liver disease. However, there remains minimal evidence to support that patients with chronic hepatitis C virus (HCV) are more prone for COVID-19 infection or its complications. Methods: We conducted a retrospective chart review of electronic medical records of 107 patients with chronic hepatitis C seen in Infectious Disease clinic from January 1, 2020 to July1, 2020 to evaluate the incidence of COVID-19 in this population. Results: 17 out of 107 patients with hepatitis C had any symptoms that required testing for COVID-19 and only 1 of them tested positive for SARS-Cov-2 by PCR, with an incidence rate of 0.93%. She is a 61-year-old with history of diabetes mellitus, COPD, BMI of 42.14 who presented with fever, cough, chest tightness, weakness and shortness of breath. On presentation she was afebrile, tachycardic, did not require any supplemental oxygen. Lungs were clear to auscultation. Chest X-ray showed no acute abnormality. She was discharged home from emergency room and was instructed to isolate at home for 14 days. Her symptoms improved without any treatment for COVID-19 pneumonia. Conclusion: A meta-analysis of reports from China to study the prevalence of COVID-19 in patients with chronic liver disease, reported a prevalence of 3% with no specific data of Hepatitis C patients. COVID-19 has been reported even more infrequently in patients HCV infections in the United States. In a large series of 5700 hospitalized patients with COVID-19 in the northeastern United States, HCV infections were encountered in < 0.1% of patients which is similar to our reported incidence of 0.93%. Even in our reported case, diabetes, obesity and COPD might have predisposed her to COVID-19 infection rather than Hepatitis C. Further studies are needed to assess the risk of COVID-19 in patients with hepatitis C .

S413 The Interaction Effect of Gender and Socio-Economic Status on the Incidence of COVID-19 in Patients With Gastroesophageal Reflux Disease: A Population-Based Study

Introduction: Reports on COVID-19 have shown gender and racial differences in health outcomes. Our aim was to examine the relationship between social determinants of health and risk of COVID-19 in patients with gastroesophageal reflux disease (GERD). Methods: We analyzed medical records from a large population database (Explorys, IBM) pooled from 26 major healthcare systems across US. Only adult patients with diagnosis of GERD from January 1999-May 2021 and COVID-19 from December 2019-May 2021 were included. Data on gender, race/ethnicity, insurance status and PPI use were collected. Univariable and multivariable analyses were used for statistical analysis. Model was stratified by gender. Effect modification by PPI use was examined. Results: We identified 6215670 GERD patients of which 4057825 (65%) used PPI, 2409175 (59%) were females and 1648650 (41%) were males. A total of 3605950 (58%) were uninsured. Cumulative incidence of COVID-19 among PPI users and non-users was 0.11% vs 0.04% (P< 0.001). In univariate analysis, odds (OR) of COVID-19 was highest among whites 3.35 [3.11-3.6, P< 0.05], African Americans OR 2.9 [2.7-3.12, P< 0.05] and Hispanics OR 2.8 [2.6-3.0, P< 0.05]. Risk of COVID-19 was modified across all races if they were PPI users: whites OR 2.83 [2.6-3.14, P< 0.001], African Americans OR 3.11 [2.8-3.5, P< 0.05] and Hispanics OR 1.9 [1.4-2.5, p< 0.05]. Lack of insurance was significantly associated with COVID-19 diagnosis OR 3.1 [2.9-3.3, P < 0.001]. In the multivariate model, after adjusting for covariates, African American race was the strongest independent risk factor for COVID-19 OR 4.8 [4.3-5.2], P< 0.001) followed by PPI use OR 2.9 [2.7-3.1, P< 0.001]. There was no clear association between Hispanic or white race and COVID-19 OR 0.99 [0.87-1.1, P=0.6] and OR 0.94 [0.86-1.0, P=0.2], respectively. When the model was stratified by gender, being female reduced the risk of COVID-19 in Hispanics OR 0.55 [0.2-0.7, P< 0.001]. Female gender did not modify COVID-19 risk in African Americans (OR 1.2 [1.0-1.4, P=0.53] or whites OR 1.2 [1.0-1.4, P=0.9]. Patients with GERD who had public insurance such as Medicare OR 0.3 [0.2-0.31, P < 0.001] or Medicaid OR 0.4 [0.4-0.48, P< 0.001] had reduced risk of COVID-19 diagnosis compared to the uninsured. Conclusion: In GERD patients, COVID-19 diagnosis was highest among African Americans and PPI users. Female Hispanics were least likely to be diagnosed with COVID-19. Insurance status may indirectly influence susceptibility to COVID-19.Figure 1.: Multivariable regression analysis. A forest plot of gender differences for odds of COVID-19 diagnosis in patients with gastroesophageal reflux disease (GERD) based on race/ethnicity and public insurance type. Abbreviation: PPI, proton pump inhibitors.Table 1.: Baseline Characteristics of Patients with Gastroesophageal Reflux Disease (GERD) Included in the Study. Abbreviations: PPI, proton pump inhibitors; CI, confidence interval.

COVID-19 in patients with tuberculosis: epidemiological and clinical features

Aim. To study the epidemiological and clinical features of COVID-19 among patients with tuberculosis.Materials and Methods. We studied the incidence of COVID-19 in various population groups in Kemerovo Region in 2020 (from March, 13 to December, 31). The study cohort consisted of 3929 tuberculosis patients, including 113 with a verified COVID-19 diagnosis. The control cohort included tuberculosis-free subjects with COVID-19 (25,774 individuals). Out of these subjects, we enrolled 71 patients with tuberculosis and 71 age- and gender-matched controls. All patients underwent complete blood count, urinalysis, biochemical analysis, and coagulation testing.Results. The incidence of COVID-19 in patients with tuberculosis was 2.96-fold higher than in the tuberculosis-free population (2876.05 and 971.17 per 100,000 population, respectively). In patients with tuberculosis, the highest incidence of COVID-19 was recorded in two age categories: from 18 to 29 years and ≥ 65 years of age. In tuberculosis patients, COVID-19 was mostly mild, was characterised by a 9.2-fold lower frequency of pneumonia, 11.8-fold less use of antibiotics, and oxygen therapy was required only in 1.41% of cases in comparison with 16.9% in the tuberculosis-free subjects. In addition, patients with tuberculosis less often suffered from hyperthermia, cough and weakness. Regarding the comorbid conditions, patients with tuberculosis showed lower prevalence of arterial hypertension, chronic heart failure, peripheral artery disease, and obesity. Further, patients with tuberculosis generally had higher glomerular filtration rate and rarely had neutrophilia or lymphopenia when compared with the control individuals with COVID-19, although having higher fibrinogen and aspartate aminotransferase serum levels.Conclusion. Tuberculosis is a risk factor of COVID-19 but not a predictor of morbidity and mortality from this disease.

Bendopnea as a risk factor for the incidence of COVID-19 in patients with CHF

Purpose. Analysis of the incidence of COVID-19 in patients from the register «Management of chronic patients with multiple diseases» with a previously established CHF diagnosis, depending on the presence or absence of a symptom of bendopnea. Materials and methods. Retrospective analysis of electronic outpatient records of 121 patients with CHF with and without bendopnea symptom, with an assessment of the incidence of COVID-19. For statistical processing of the data obtained, we used the R language and the RStudio software environment. Results. The average age of the patients was 74.38±9.83 years. Bendopnea symptom occurred in 60,3% (n = 73) of the studied patients. The incidence of COVID-19 was 14% (n = 17), of which 88% were patients with the symptom of bendopnea (p-value = 0.023, Х2 = 5.17). The chance of COVID-19 in patients with bendopnea was higher than in patients without symptom of bendopnea (OR 5.8 (1.2; 26.7), p = 0.013). Conclusion. The presence of a symptom of bendopnea in patients with CHF increases the risk of COVID-19. A statistically significant relationship was established between the presence of a symptom of bendopnea, the level of left ventricular ejection fraction and the incidence of COVID-19.

COVID-19 Vaccination Is Safe and Effective in Patients With Inflammatory Bowel Disease: Analysis of a Large Multi-institutional Research Network in the United States

COVID-19 Vaccination Is Safe and Effective in Patients With Inflammatory Bowel Disease: Analysis of a Large Multi-institutional Research Network in the United States

P612 Lower incidence of COVID-19 in patients with Inflammatory Bowel Diseases treated with non-gut-selective biologic therapy: an observational multicentre study

BackgroundSince the outbreak of COVID-19, concerns have been raised as to whether IBD patients under biologic therapy might be more susceptible to the disease and its complications. This study aimed to determine the incidence and outcomes of COVID-19 in a large cohort of IBD patients on biologic therapy in Lombardy, the hardest-hit Italian region by the pandemic.MethodsThis is an observational retrospective multicentre study collecting data about COVID-19 in IBD patients on biologic therapy in regular clinical follow-up at 11 IBD referral units in Lombardy, between February 20th and May 20th, 2020. The main endpoints were to assess the cumulative incidence of COVID-19 and its outcome (hospitalization/death) among IBD patients on biologic therapy and to identify any variations among the different classes of biologic agents. Secondarily, we compared the results with the incidence of COVID-19 in the general population of Lombardy in the same period and the incidence of symptoms suggestive of COVID-19 in our study population compared with those of a second cohort of IBD patients undergoing non-biological therapies and coming from the same geographic area.ResultsOverall, 1816 IBD patients on biologic therapy were enrolled. The cumulative incidence of COVID-19 was 3.9 per 1000 (7/1816) with a hospitalization rate of 57% and a case-fatality rate (CFR) of 29%. In our Cohort, the gut-selective therapy (Vedolizumab and Etrolizumab) was the only risk factor of developing symptomatic COVID-19 (OR 8.7, 95% CI 1.7–45.0, p = 0.01). Conversely, non-gut selective anti-cytokine agents were associated with a lower incidence of infection (OR 0.13, 95%CI 0.02–0.74) and development of symptoms (OR 0.60, 95%CI 0.37–0.98). Compared to the general population of Lombardy, a lower incidence of COVID-19 was observed (3.9 vs 8.5 per 1000 with a RR 0.45, 95%CI 0.21–0.95); conversely, in terms of hospitalization rate and CFR, the clinical outcome was not statistically different. Finally, compared to a second cohort of 565 IBD patients treated with non-biologic conventional therapies, a significantly lower risk of symptomatic disease was observed in patients on biologic agents (OR 0.3, 95%CI 0.2–0.4, p<0.01).ConclusionCompared to the general population, IBD patients on biologic therapy are not exposed to a higher risk of COVID-19; compared to gut-selective agents, cytokine blockers are associated with a lower incidence of symptomatic infection, supporting the decision of maintaining the ongoing treatment.

Effect of hydroxychloroquine on COVID-19 prevention in cancer patients undergoing treatment: study protocol for a randomized controlled trial

ObjectivesIn this study, we will investigate the effect of hydroxychloroquine on the prevention of novel coronavirus disease (COVID-19) in cancer patients being treated.Trial designThis is a two-arm, parallel-group, triple-blind, phase 2–3 randomized controlled trial.ParticipantsAll patients over the age of 15 years from 5 types of cancer will be included in the study. Patients with acute lymphoid and myeloid leukemias in the first line treated with curative intent, patients with high-grade non-Hodgkin’s lymphoma treated with leukemia regimens, and patients with non-metastatic breast and colon cancer in the first line of treatment will enter the study.Intervention and comparatorPatients are randomly assigned to two groups: one being given hydroxychloroquine and the other is given placebo. During 2 months of treatment, the two groups will be treated with hydroxychloroquine every other day with a single 200-mg tablet (Amin® Pharmaceutical Company, Isfahan, Iran) or placebo (identical in terms of shape, color, and smell). Patients will be monitored for COVID-19 symptoms during follow-up period.If any COVID-19-related signs or symptoms occur, they will be examined, thoroughly, investigated with a high resolution computerize tomography (CT) scan of the lungs and nasopharyngeal swab assessed by RT-PCR for SARS-CoV-2 virus. This study will be performed in five centers affiliated to Mashhad University of Medical Sciences, Mashhad, Iran.Main outcomesThe primary end point of this study is to investigate the incidence of COVID-19 in patients being treated for their cancer and receiving prophylactic Hydroxychloroquine.RandomizationRandomization will be performed using random permuted blocks. By using online website (www.randomization.com), the randomization sequence will be produced by quadruple blocks. The allocation ratio in intervention and control groups is 1:1.Blinding (masking)Participants and caregivers do not know whether the patient is in the intervention or the control group. Those assessing the outcomes and data analyzer are also blinded to group assignment.Sample sizeThe calculated total sample size is 60 patients, with 30 patients in each group.