scholarly journals 393. Prevalence of HIV in Patients Hospitalized for COVID-19 and Associated Mortality Outcomes: A Systematic Review and Meta-analysis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S266-S266
Author(s):  
Paddy Ssentongo ◽  
Anna E Ssentongo ◽  
Emily S Heilbrunn ◽  
Ping Du

Abstract Background As of June 3rd, 2020, the number of confirmed cases of novel SARS-CoV-2, the causative agent of COVID-19, was approximately 6,538,456, with 386,503 deaths globally. Individuals with pre-existing conditions are particularly susceptible to and more likely to die from Covid-19. However, individuals with human immunodeficiency virus (HIV) are unique due to their use of antiretroviral therapy, including protease inhibitors, which have been used to treat COVID-19. We aimed to conduct a systematic review and meta-analysis exploring the prevalence and prevalence of HIV in patients hospitalized for COVID-19 and delineating the mortality rates. Methods MEDLINE, SCOPUS, and Cochrane Library databases and medrxiv.org were searched from January 1st, 2020, to June 15th, 2020. Studies reporting on the prevalence of HIV among hospitalized COVID-19 patients among and outcome of mortality were extracted. Two reviewers independently extracted appropriate data of interest and assessed the risk of bias. All analyses were performed using random-effects models on log-transformed proportions and risk ratio estimates, and heterogeneity was quantified. Results A total of 144,795 hospitalized COVID-19 patients were identified from 14 studies (United States 8, Spain 3, China 1, Italy1, and Germany 1). The pooled prevalence of HIV in COVID-19 patients was 1.22 % [95% confidence interval (CI): 0.61%-2.43%)] translating to a 2-fold increase compared to the respective local-level pooled HIV prevalence in the general population of 0.65% (95% CI: 0.48%-0.89%. When we stratified the analysis by country, pooled HIV prevalence among COVID-19 patients in United States (1.43%, 95% CI: 0.98% -2.07%) was significantly higher compared to Spain (0.26%, 95% CI: 0.23%-0.29%) but not different from China (0.99 %, 95% CI: 0.25 %-3.85%). The pooled mortality rates in HIV-positive patients hospitalized for COVID-19 was 14.1 % 95% CI: 5.78%-30.50% and was substantially higher in the United States compared to other countries. Conclusion The prevalence of HIV among COVID-19 patients may be higher compared to the general population, suggesting higher susceptibility to COVID-19. The mortality rates are high but vary significantly across countries. Disclosures All Authors: No reported disclosures

2020 ◽  
Author(s):  
Paddy Ssentongo ◽  
Emily S Heilbrunn ◽  
Anna E Ssentongo ◽  
Shailesh Advani ◽  
Vernon M Chinchilli ◽  
...  

Objective To conduct a systematic review and meta-analysis of the prevalence of HIV in patients hospitalized for COVID-19 and delineating clinical outcomes including mortality. Design/Methods MEDLINE, SCOPUS, OVID, and Cochrane Library databases and medrxiv.org were searched from January 1st, 2020, to June 15th, 2020. Data were extracted from studies reporting the prevalence of HIV among hospitalized COVID-19 patients and their clinical outcomes. Analyses were performed using random-effects models on log-transformed proportions and risk ratio estimates, and heterogeneity was quantified. Results A total of 144,795 hospitalized COVID-19 patients were identified from 14 studies in North America, Europe, and Asia. Median age was 55 years, and 66% were male. The pooled prevalence of HIV in COVID-19 patients was 1.22% [95% confidence interval (CI): 0.61%-2.43%)] translating to a 2-fold increase compared to the respective local-level pooled HIV prevalence in the general population of 0.65% (95% CI: 0.48%-0.89%). When stratified by country, the pooled HIV prevalence among COVID-19 patients in United States (1.43%, 95% CI: 0.98%-2.07%) was significantly higher compared to Spain (0.26%, 95% CI: 0.23%-0.29%) but was not different from China (0.99%, 95% CI: 0.25%-3.85%). The pooled mortality rate in HIV-positive patients hospitalized for COVID-19 was 14.1% (95% CI: 5.78%-30.50%) and was substantially higher in the United States compared to other countries.


2020 ◽  
Author(s):  
Mohammed G Alkhathami ◽  
Shailesh M Advani ◽  
Adil A Abalkhail ◽  
Fahad M Alkhathami ◽  
Mohammed K Alshehri ◽  
...  

AbstractBackgroundCOVID-19 infections are seen across all age groups but they have shown to have a predisposition for the elderly and those with underlying comorbidities. Patients with severe COVID-19 infections and comorbidities are more prone to respiratory distress syndrome (ARDS), mechanical ventilator use and ultimately succumb to these complications. Little evidence exists of the prevalence of underlying lung comorbidities among COVID-19 patients and associated mortality.MethodsWe performed a systematic review of the literature including PubMed (Medline), Embase (Ovid), Google Scholar and Cochrane Library. The last date for our search was 29th April 2020. We included all original research articles on COVID-19 and calculated prevalence of chronic lung disease patients among COVID-19 patients using random effects model. Further we assessed for mortality rates among COVID-19 patients associated with these lung comorbidities.ResultsThe authors identified 29 articles that reported prevalence of chronic lung conditions among COVID-19 patients. Among those, 26 were from China and 3 from the United States. The pooled prevalence of lung comorbidities including Asthma, COPD, and lung cancer was 3% (95% CI=0-14%), 2.2% (95% CI=0.02-0.03%) and 2.1% (95% CI=0.00-0.21%) respectively. Mortality rates associated with these comorbidities was 30% (41/137) for COPD and 19% (7/37) for lung cancer respectively. No mortality rates were reported for patients with asthma.ConclusionThis study offers latest evidence of prevalence of chronic lung conditions among patients with COVID-19. Asthma, followed by COPD and lung cancer, was the most common lung comorbidity associated with COVID-19, while the higher mortality rate was found in COPD. Future studies are needed to assess other lung comorbidities and associated mortality among patients diagnosed with COVID-19.


2022 ◽  
Vol 8 ◽  
Author(s):  
Shijie Zhang ◽  
Xiang Tong ◽  
Tianli Zhang ◽  
Dongguang Wang ◽  
Sitong Liu ◽  
...  

BackgroundSarcoidosis-associated pulmonary hypertension (SAPH) is associated with poor prognosis, conferring up to a 10-fold increase in mortality in patients with sarcoidosis, but the actual prevalence of SAPH is unknown.MethodsThe PubMed, Embase, and Cochrane Library databases were systematically searched for epidemiological studies reporting the prevalence of SAPH up to July 2021. Two reviewers independently performed the study selection, data extraction, and quality assessment. Studies were pooled using random-effects meta-analysis.ResultsThis meta-analysis included 25 high-quality studies from 12 countries, with a pooled sample of 632,368 patients with sarcoidosis. The prevalence of SAPH by transthoracic echocardiography in Europe, the United States and Asia was 18.8% [95% confidence interval (CI): 11.1–26.5%], 13.9% (95% CI: 5.4–22.4%) and 16.2% (95% CI: 7.1–25.4%) separately, and the overall pooled prevalence was 16.4% (95%CI: 12.2–20.5%). By right heart catheterization (RHC), the pooled prevalence of SAPH was 6.4% (95% CI: 3.6–9.1%) in general sarcoidosis population, and subgroup analyses showed that the prevalence of SAPH was 6.7% (95% CI: 2.4–11.0%) in Europe and 8.6% (95% CI: −4.1 to 21.3%) in the United States. Further, the prevalence of pre-capillary PH was 6.5% (95% CI: 2.9–10.2%). For the population with advanced sarcoidosis, the pooled prevalence of SAPH and pre-capillary PH by RHC was as high as 62.3% (95% CI: 46.9–77.6%) and 55.9% (95% CI: 20.1–91.7%), respectively. Finally, the pooled prevalence of SAPH in large databases with documented diagnoses (6.1%, 95% CI: 2.6–9.5%) was similar to that of RHC. Substantial heterogeneity across studies was observed for all analyses (I2 > 80%, P < 0.001).ConclusionsThe sarcoidosis population has a relatively low burden of PH, mainly pre-capillary PH. However, as the disease progresses to advanced sarcoidosis, the prevalence of SAPH increases significantly.


2021 ◽  
pp. 112070002110126
Author(s):  
Raman Mundi ◽  
Harman Chaudhry ◽  
Seper Ekhtiari ◽  
Prabjit Ajrawat ◽  
Daniel M Tushinski ◽  
...  

Introduction: In the United States, over 1,000,000 total joint arthroplasty (TJA) surgeries are performed annually and has been forecasted that this number will exceed 4,000,000 by the year 2030. Many different types of dressing exist for use in TJA surgery, and it is unclear if any of the newer, hydrofibre dressings are superior to traditional dressings at reducing rates of infections or improving wound healing. Thus, the aim of this systematic review and meta-analysis was to assess the impact of hydrofiber dressings on reducing complications. Methods: A systematic review and meta-analysis was performed using the online databases MEDLINE and the Cochrane Library. Randomized controlled trials (RCTs) comparing hydrofibre dressings to a standard dressing were included. Summary measures are reported as odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs). Our primary outcome was prosthetic joint infection (PJI). Secondary outcomes included blisters, dressing changes and wound irritation. Results: 5 RCTs were included. Hydrofibre dressing had no observable effect on PJI or wound irritation (OR 0.53; 95% CI, 0.14–1.98; p = 0.35). Hydrofibre dressings reduced the rate of blisters (OR 0.36; 95% CI, 0.14–0.90; p = 0.03) and number of dressing changes (MD -1.89; 95% CI, -2.68 to -1.11). Conclusions: In conclusion, evidence suggests hydrofibre dressings have no observable effect on PJI and wound irritation. Evidence for reduction in blisters and number of dressings is modest given wide CIs and biased trial methodologies. Use of hydrofibre dressings should be considered inconclusive for mitigating major complications in light of current best evidence.


2014 ◽  
Vol 18 (4) ◽  
pp. 695-704 ◽  
Author(s):  
Rosana Poggio ◽  
Laura Gutierrez ◽  
María G Matta ◽  
Natalia Elorriaga ◽  
Vilma Irazola ◽  
...  

AbstractObjectiveThe purpose of the present study was to determine whether elevated dietary Na intake could be associated with CVD mortality.DesignWe performed a systematic review and meta-analysis of prospective studies representing the general population. The adjusted relative risks and their 95 % confidence intervals were pooled by the inverse variance method using random-effects models. Heterogeneity, publication bias, subgroup and meta-regression analyses were performed.SettingsMEDLINE (since 1973), Embase (since 1975), the Cochrane Library (since 1976), ISI Web of Science, Google Scholar (until September 2013) and secondary referencing were searched for inclusion in the study.SubjectEleven prospective studies with 229 785 participants and average follow-up period of 13·37 years (range 5·5–19 years).ResultsHigher Na intake was significantly associated with higher CVD mortality (relative risk=1·12; 95 % CI 1·06, 1·19). In the sensitivity analysis, the exclusion of studies with important relative weights did not significantly affect the results (relative risk=1·08; 95 % CI 1·01, 1·15). The meta-regression analysis showed that for every increase of 10 mmol/d in Na intake, CVD mortality increased significantly by 1 % (P=0·016). Age, hypertensive status and length of follow-up were also associated with increased CVD mortality.ConclusionsHigher Na intake was associated with higher CVD mortality in the general population; this result suggests a reduction in Na intake to prevent CVD mortality from any cause.


2017 ◽  
Vol 107 (8) ◽  
pp. e13-e21 ◽  
Author(s):  
David Burnes ◽  
Charles R. Henderson ◽  
Christine Sheppard ◽  
Rebecca Zhao ◽  
Karl Pillemer ◽  
...  

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