scholarly journals Connecting BCG Vaccination and COVID-19: Additional Data

2020 ◽  
Author(s):  
Devi Dayal ◽  
Saniya Gupta
Keyword(s):  
Disease Burden ◽  
Additional Data ◽  
Severe Disease ◽  
Case Fatality ◽  
Epidemiological Data ◽  
Vaccination Policy ◽  
Bcg Vaccination ◽  
Significant Difference ◽  
The Impact ◽  
High Disease Burden

AbstractThe reasons for a wide variation in severity of coronavirus disease 2019 (COVID-19) across the affected countries of the world are not known. Two recent studies have suggested a link between the BCG vaccination policy and the morbidity and mortality due to COVID-19. In the present study we compared the impact of COVID-19 in terms of case fatality rates (CFR) between countries with high disease burden and those with BCG revaccination policies presuming that revaccination practices would have provided added protection to the population against severe COVID-19. We found a significant difference in the CFR between the two groups of countries. Our data further supports the view that universal BCG vaccination has a protective effect on the course of COVID-19 probably preventing progression to severe disease and death. Clinical trials of BCG vaccine are urgently needed to establish its beneficial role in COVID-19 as suggested by the epidemiological data, especially in countries without a universal BCG vaccination policy.

scholarly journals Associations Between the Use of Renin–Angiotensin System Inhibitors and the Risks of Severe COVID-19 and Mortality in COVID-19 Patients With Hypertension: A Meta-Analysis of Observational Studies

2021 ◽  
Vol 8 ◽  
Author(s):  
Xiao-Ce Dai ◽  
Zhuo-Yu An ◽  
Zi-Yang Wang ◽  
Zi-Zhen Wang ◽  
Yi-Ren Wang
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Observational Studies ◽  
Meta Analysis ◽  
Severe Disease ◽  
Host Cells ◽  
Cochrane Library ◽  
Converting Enzyme ◽  
Significant Difference ◽  
Duration Of Hospitalization ◽  
The Impact

Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) share a target receptor with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The use of ACEIs/ARBs may cause angiotensin-converting enzyme 2 receptor upregulation, facilitating the entry of SARS-CoV-2 into host cells. There is concern that the use of ACEIs/ARBs could increase the risks of severe COVID-19 and mortality. The impact of discontinuing these drugs in patients with COVID-19 remains uncertain. We aimed to assess the association between the use of ACEIs/ARBs and the risks of mortality and severe disease in patients with COVID-19. A systematic search was performed in PubMed, EMBASE, Cochrane Library, and MedRxiv.org from December 1, 2019, to June 20, 2020. We also identified additional citations by manually searching the reference lists of eligible articles. Forty-two observational studies including 63,893 participants were included. We found that the use of ACEIs/ARBs was not significantly associated with a reduction in the relative risk of all-cause mortality [odds ratio (OR) = 0.87, 95% confidence interval (95% CI) = 0.75–1.00; I2 = 57%, p = 0.05]. We found no significant reduction in the risk of severe disease in the ACEI subgroup (OR = 0.95, 95% CI = 0.88–1.02, I2 = 50%, p = 0.18), the ARB subgroup (OR = 1.03, 95% CI = 0.94–1.13, I2 = 62%, p = 0.48), or the ACEI/ARB subgroup (OR = 0.83, 95% CI = 0.65–1.08, I2 = 67%, p = 0.16). Moreover, seven studies showed no significant difference in the duration of hospitalization between the two groups (mean difference = 0.33, 95% CI = −1.75 to 2.40, p = 0.76). In conclusion, the use of ACEIs/ARBs appears to not have a significant effect on mortality, disease severity, or duration of hospitalization in COVID-19 patients. On the basis of the findings of this meta-analysis, there is no support for the cessation of treatment with ACEIs or ARBs in patients with COVID-19.

scholarly journals Neurological diseases in Peru: a systematic analysis of the global burden disease study

2020 ◽  
Vol 78 (5) ◽  
pp. 282-289
Author(s):  
Carlos ALVA-DÍAZ ◽  
Andrely HUERTA-ROSARIO ◽  
Kevin PACHECO-BARRIOS ◽  
Roberto A. MOLINA ◽  
Alba NAVARRO-FLORES ◽  
...  
Keyword(s):  
Disease Burden ◽  
Neurological Diseases ◽  
Age Groups ◽  
Epidemiological Data ◽  
Global Burden ◽  
Years Of Life Lost ◽  
Systematic Analysis ◽  
Life Years ◽  
Disease Study ◽  
The Impact

ABSTRACT Background: Disease burden indicators assess the impact of disease on a population. They integrate mortality and disability in a single indicator. This allows setting priorities for health services and focusing resources. Objective: To analyze the burden of neurological diseases in Peru from 1990-2015. Methods: A descriptive study that used the epidemiological data published by the Institute for Health Metrics and Evaluation of Global Burden of Diseases from 1990 to 2015. Disease burden was measured using disability-adjusted life years (DALY) and their corresponding 95% uncertainty intervals (UIs), which results from the addition of the years of life lost (YLL) and years lived with disability (YLD). Results: The burden of neurological diseases in Peru were 9.06 and 10.65%, in 1990 and 2015, respectively. In 2015, the main causes were migraine, cerebrovascular disease (CVD), neonatal encephalopathy (NE), and Alzheimer’s disease and other dementias (ADD). This last group and nervous system cancer (NSC) increased 157 and 183% of DALY compared to 1990, respectively. Young population (25 to 44 years old) and older (>85 years old) were the age groups with the highest DALY. The neurological diseases produced 11.06 and 10.02% of the national YLL (CVD as the leading cause) and YLD (migraine as the main cause), respectively. Conclusion: The burden of disease (BD) increased by 1.6% from 1990 to 2015. The main causes were migraine, CVD, and NE. ADD and NSC doubled the DALY in this period. These diseases represent a significant cause of disability attributable to the increase in the life expectancy of our population among other factors. Priority actions should be taken to prevent and treat these causes.

scholarly journals Correlation between immunity from BCG and the morbidity and mortality of COVID-19

2020 ◽  
Author(s):  
Dakshitha Wickramasinghe ◽  
Nilanka Wickramasinghe ◽  
Sohan Anjana Kamburugamuwa ◽  
Carukshi Arambepola ◽  
Dharmabandhu N Samarasekera
Keyword(s):  
Linear Regression Analysis ◽  
Univariate Analysis ◽  
Case Fatality ◽  
Income Level ◽  
Morbidity And Mortality ◽  
Vaccination Policy ◽  
Specific Data ◽  
Bcg Vaccination ◽  
Country Level ◽  
Country Specific

Abstract Background To investigate the association between parameters indicating immunity from BCG at country level (presence of BCG vaccination policy, BCG coverage, age-specific incidence of tuberculosis(TB)) and the morbidity and mortality of COVID-19. Methods Country-specific data for COVID-19 cases and deaths, demographic details, BCG coverage and policy, age-specific TB incidence and income level were obtained. The crude COVID-19 cases and deaths per 100,000 population were calculated and assessed against the parameters indicating immunity from BCG using linear regression analysis. Results Univariate analysis identified higher income level of a country to be significantly associated with COVID-19 cases (p<0.0001) and deaths (p<0.0001) but not with its case fatality rate. The association between COVID-19 and TB was strongest for TB incidence in patients >65-years (Cases(rs=-0.785,p=0.0001)) and deaths (rs=-0.647,p=0.0001).Multivariate analysis identified the higher income level of a country and not having a universal BCG vaccination policy to affect the COVID-19 cases. The deaths were inversely affected by the presence of BCG vaccination policy and coverage; and positively by the TB incidence in patients >65-years. Conclusion Significant inverse correlations observed between cases and deaths of COVID-19 and BCG related parameters highlights immunity from BCG as a likely explanation for the variation in COVID-19 across countries.

scholarly journals Mortality among the early cases of COVID-19 and its association with key comorbidities in a large state in South India

2020 ◽  
Vol 7 (10) ◽  
pp. 3882
Author(s):  
Suhas Bhat ◽  
Rohan Kolla ◽  
Shashank D. Shindhe ◽  
Surekha B. Munoli
Keyword(s):  
Case Fatality Rate ◽  
Severe Disease ◽  
Case Fatality ◽  
The Elderly ◽  
Median Number ◽  
Fatality Rate ◽  
Study Region ◽  
Large State ◽  
Death Time ◽  
The Impact

Background: The mortality associated with the pandemic COVID-19 is a subject of intense scrutiny as COVID-19 can cause severe disease leading to hospitalization in ICU and potentially death, especially in the elderly with comorbidities. A statistical analysis is carried out to study the impact of age, gender and comorbidities on deaths among early one lakh infected population of Karnataka, a large state in south India.Methods: Daily case fatality rate and adjusted case fatality rate (CFR) (adjusted to median death time) are estimated. The impacts of age, gender and comorbidities on mortality outcomes of COVID patients are studied.Results: The daily CFR on 27th July for Karnataka is estimated from the dataset to be 1.93%. However, the adjusted CFR based on the median number of days from diagnosis to death was found to be 2.15% (95% confidence interval 2%-2.3%) on that day. The deaths among male patients outnumber those in females. As far as age of the patients is concerned, more than 50% of the deaths occurred in the age group 50-60 and 60-70 years. Majority of deaths reported in the state were associated with at least one of the comorbidity. Diabetes mellitus and hypertension were the most significant comorbidities.Conclusions: The daily adjusted CFR for the study region is found to be lower than the CFR of the whole nation. Also the age, gender and comorbidities were found to be associated with the deaths as opposed to the infection alone. It was also deduced that, patients with a history of diabetes or hypertension or ischemic heart disease or a combination of any of these were most likely to experience severe outcomes of the infection. 

The impact of KRAS mutation on radioembolization in the treatment of unresectable liver predominant metastatic colorectal cancer.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 664-664
Author(s):  
Michael Schacht ◽  
Douglas M. Coldwell ◽  
Vivek Sharma
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Median Time ◽  
Metastatic Disease ◽  
Disease Burden ◽  
Hepatic Metastases ◽  
Time To Progression ◽  
Kras Status ◽  
Significant Difference ◽  
The Impact

664 Background: Radioembolization with either Yttrium-90 labeled resin or glass microspheres is an FDA approved treatment for hepatic metastases from primary colorectal cancer. Y-90 therapy is used almost exclusively in unresectable liver metastases. However, radioembolization is only an optional part of the treatment process along with first-line, second-line, and salvage chemotherapy. KRAS is a known proto-onco gene that has typically been studied as a negative prognostic factor in the chemotherapeutic treatment of metastatic colorectal cancer (mCRC). KRAS is a known marker for resistance to anti-EGFR antibodies and generally have a poorer prognosis. The aim of this study is to begin to shed light on the impact of KRAS status on the outcome of patients undergoing radioembolization for the treatment of unresectable liver predominant metastatic CRC, regardless of their chemotherapy regimens. Methods: This is a retrospective analysis of 18 subjects treated with radioembolization for liver predominant metastatic CRC. KRAS status and treatment outcomes were followed for each patient up to the study close date of 9/15/13. Statistical analysis was performed using the Mann-Whitney U test. Results: Of the 18 subjects included in the study, 5 were found to have KRAS mutant oncogene. The remaining 13 were found to have the KRAS wildtype. Overall, those subjects with KRAS mutant were found to have a statistically significant difference in median time to progression of intrahepatic metastatic disease burden when compared to KRAS wildtype even when liver-directed therapy was utilized (2.0 vs. 6.4 months). Differences in median time to progression of extrahepatic metastatic disease burden and overall survival were not found to be statistically significant at this time. Conclusions: KRAS mutant patients are exceedingly difficult to treat due to both intrahepatic and extrahepatic disease recurrence/progression.

scholarly journals The severe acute respiratory syndrome epidemic in mainland China dissected

2011 ◽  
Vol 3 (1) ◽  
pp. 2 ◽  
Author(s):  
Wuchun Cao ◽  
Sake J. De Vlas ◽  
Jan H. Richardus
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Mainland China ◽  
Emerging Infectious Diseases ◽  
Case Fatality ◽  
Epidemiological Data ◽  
Control Measures ◽  
Political Commitment ◽  
Younger Age ◽  
Surrounding Areas ◽  
The Impact

This paper provides a review of a recently published series of studies that give a detailed and comprehensive documentation of the severe acute respiratory syndrome (SARS) epidemic in mainland China, which severely struck the country in the spring of 2003. The epidemic spanned a large geographical extent but clustered in two areas: first in Guangdong Province, and about 3 months later in Beijing with its surrounding areas. Reanalysis of all available epidemiological data resulted in a total of 5327 probable cases of SARS, of whom 343 died. The resulting case fatality ratio (CFR) of 6.4% was less than half of that in other SARS-affected countries or areas, and this difference could only partly be explained by younger age of patients and higher number of community acquired infections. Analysis of the impact of interventions demonstrated that strong political commitment and a centrally coordinated response was the most important factor to control SARS in mainland China, whereas the most stringent control measures were all initiated when the epidemic was already dying down. The long-term economic consequence of the epidemic was limited, much consumption was merely postponed, but for Beijing irrecoverable losses to the tourist sector were considerable. An important finding from a cohort study was that many former SARS patients currently suffer from avascular osteo­necrosis, as a consequence of the treatment with corticosteroids during their infection. The SARS epidemic provided valuable information and lessons relevant in controlling outbreaks of newly emerging infectious diseases, and has led to fundamental reforms of the Chinese health system. In particular, a comprehensive nation-wide internet-based disease reporting system was established.

scholarly journals Rotavirus disease burden pre-vaccine introduction in young children in Rural Southern Mozambique, an area of high HIV prevalence

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249714
Author(s):  
Sozinho Acácio ◽  
Tacilta Nhampossa ◽  
Llorenç Quintò ◽  
Delfino Vubil ◽  
Marcelino Garrine ◽  
...  
Keyword(s):  
Risk Factors ◽  
Disease Burden ◽  
Conditional Logistic Regression ◽  
Epidemiological Data ◽  
Daily Basis ◽  
African Countries ◽  
Severe Diarrhea ◽  
Vaccine Introduction ◽  
Rotavirus Vaccines ◽  
The Impact

Background Rotavirus vaccines have been adopted in African countries since 2009, including Mozambique (2015). Disease burden data are needed to evaluate the impact of rotavirus vaccine. We report the burden of rotavirus-associated diarrhea in Mozambique from the Global Enteric Multicenter Study (GEMS) before vaccine introduction. Methods A case-control study (GEMS), was conducted in Manhiça district, recruiting children aged 0–59 months with moderate-to-severe diarrhea (MSD) and less-severe-diarrhea (LSD) between December 2007 and November 2012; including 1–3 matched (age, sex and neighborhood) healthy community controls. Clinical and epidemiological data and stool samples (for laboratory investigation) were collected. Association of rotavirus with MSD or LSD was determined by conditional logistic regression and adjusted attributable fractions (AF) calculated, and risk factors for rotavirus diarrhea assessed. Results Overall 915 cases and 1,977 controls for MSD, and 431 cases and 430 controls for LSD were enrolled. Rotavirus positivity was 44% (217/495) for cases and 15% (160/1046) of controls, with AF = 34.9% (95% CI: 32.85–37.06) and adjusted Odds Ratio (aOR) of 6.4 p< 0.0001 in infants with MSD compared to 30% (46/155) in cases and 14% (22/154) in controls yielding AF = 18.7%, (95% CI: 12.02–25.39) and aOR = 2.8, p = 0.0011 in infants with LSD. The proportion of children with rotavirus was 32% (21/66) among HIV-positive children and 23% (128/566) among HIV-negative ones for MSD. Presence of animals in the compound (OR = 1.9; p = 0.0151) and giving stored water to the child (OR = 2.0, p = 0.0483) were risk factors for MSD; while animals in the compound (OR = 2.37, p = 0.007); not having routine access to water on a daily basis (OR = 1.53, p = 0.015) and washing hands before cooking (OR = 1.76, p = 0.0197) were risk factors for LSD. Conclusion The implementation of vaccination against rotavirus may likely result in a significant reduction of rotavirus-associated diarrhea, suggesting the need for monitoring of vaccine impact.

scholarly journals The impact of malaria coinfection on Ebola virus disease outcomes: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251101
Author(s):  
Hannah M. Edwards ◽  
Helen Counihan ◽  
Craig Bonnington ◽  
Jane Achan ◽  
Prudence Hamade ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ebola Virus ◽  
Virus Disease ◽  
Meta Analysis ◽  
Case Fatality ◽  
The Body ◽  
Diagnostic Methods ◽  
Ebola Virus Disease ◽  
Significant Difference ◽  
The Impact

Introduction Viral outbreaks present a particular challenge in countries in Africa where there is already a high incidence of other infectious diseases, including malaria which can alter immune responses to secondary infection. Ebola virus disease (EVD) is one such problem; understanding how Plasmodium spp. and Ebolavirus (EBOV) interact is important for future outbreaks. Methods We conducted a systematic review in PubMed and Web of Science to find peer-reviewed papers with primary data literature to determine 1) prevalence of EBOV/Plasmodium spp. coinfection, 2) effect of EBOV/Plasmodium spp. coinfection on EVD pathology and the immune response, 3) impact of EBOV/Plasmodium spp. coinfection on the outcome of EVD-related mortality. Random effects meta-analyses were conducted with the R package meta to produce overall proportion and effect estimates as well as measure between-study heterogeneity. Results From 322 peer-reviewed papers, 17 were included in the qualitative review and nine were included in a meta-analysis. Prevalence of coinfection was between 19% and 72%. One study reported significantly lower coagulatory response biomarkers in coinfected cases but no difference in inflammatory markers. Case fatality rates were similar between EBOV(+)/Pl(+) and EBOV(+)/Pl(-) cases (62.8%, 95% CI 49.3–74.6 and 56.7%, 95% CI 53.2–60.1, respectively), and there was no significant difference in risk of mortality (RR 1.09, 95% CI 0.90–1.31) although heterogeneity between studies was high. One in vivo mouse model laboratory study found no difference in mortality by infection status, but another found prior acute Plasmodium yoeli infection was protective against morbidity and mortality via the IFN-γ signalling pathway. Conclusion The literature was inconclusive; studies varied widely and there was little attempt to adjust for confounding variables. Laboratory studies may present the best option to answer how pathogens interact within the body but improvement in data collection and analysis and in diagnostic methods would aid patient studies in the future.

scholarly journals Correlation between immunity from BCG and the morbidity and mortality of COVID-19

2020 ◽  
Author(s):  
Dakshitha Wickramasinghe ◽  
Nilanka Wickramasinghe ◽  
Sohan Anjana Kamburugamuwa ◽  
Carukshi Arambepola ◽  
Dharmabandhu N Samarasekera
Keyword(s):  
Linear Regression Analysis ◽  
Univariate Analysis ◽  
Case Fatality ◽  
Income Level ◽  
Morbidity And Mortality ◽  
Vaccination Policy ◽  
Specific Data ◽  
Bcg Vaccination ◽  
Country Level ◽  
Country Specific

Abstract Purpose To investigate the association between parameters indicating immunity from BCG at country level (presence of BCG vaccination policy, BCG coverage, age-specific incidence of tuberculosis (TB)) and the morbidity and mortality of COVID-19. Methods Country-specific data for COVID-19 cases and deaths, demographic details, BCG coverage and policy, age-specific TB incidence and income level were obtained. The crude COVID-19 cases and deaths per 100,000 population were calculated and assessed against the parameters indicating the immunity from BCG using linear regression analysis. Results Univariate analysis identified higher income level of a country to be significantly associated with COVID-19 cases (p<0.0001) and deaths (p<0.0001) but not with its case fatality rate. The association between COVID-19 and TB was strongest for TB incidence in patients >65-years (Cases(r s =-0.785,p=0.0001)) and deaths (r s =-0.647,p=0.0001). Multivariate analysis identified the higher income level of a country and not having a universal BCG vaccination policy to affect the COVID-19 cases. The deaths were affected negatively by the presence of BCG vaccination policy and coverage; and positively by the TB incidence in patients >65-years. Conclusion Significant negative correlations observed between cases and deaths of COVID-19 and parameters indicating immunity from BCG highlight a likely explanation for the variation in COVID-19 across countries.

scholarly journals COVID-19 pandemic: examining the faces of spatial differences in the morbidity and mortality in sub-Saharan Africa, Europe and USA

2020 ◽  
Author(s):  
Adebayo A. Otitoloju ◽  
Ifeoma P. Okafor ◽  
Mayowa Fasona ◽  
Kafilat A. Bawa-Allah ◽  
Chukwuemeka Isanbor ◽  
...  
Keyword(s):  
Critical Evaluation ◽  
Developed Countries ◽  
Sub Saharan Africa ◽  
Mean Annual Temperature ◽  
Vaccination Policy ◽  
African Countries ◽  
Bcg Vaccination ◽  
Malaria Burden ◽  
Geographical Regions ◽  
Significant Difference

AbstractBackgroundCOVID-19, the disease associated with the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is currently a global pandemic with several thousands of confirmed cases of infection and death. However, the death rate across affected countries shows variation deserving of critical evaluation.MethodsIn this study, we evaluated differentials in COVID-19 confirmed cases of infection and associated deaths of selected countries in Sub-Sahara Africa (Nigeria and Ghana), South Africa, Europe (Italy, Spain, Sweden and UK) and USA. Data acquired for various standard databases on mutational shift of the SARS-CoV-2 virus based on geographical location, BCG vaccination policy, malaria endemicity, climatic conditions (temperature), differential healthcare approaches were evaluated over a period of 45 days from the date of reporting the index case.ResultsThe number of confirmed cases of infection and associated deaths in Sub-Sahara Africa were found to be very low compared to the very high values in Europe and USA over the same period. Recovery rate from COVID-19 is not correlated with the mutational attributes of the virus with the sequenced strain from Nigeria having no significant difference (p>0.05) from other geographical regions. Significantly higher (p<0.05) infection rate and mortality from COVID-19 were observed in countries (Europe and USA) without a current universal BCG vaccination policy compared to those with one (Sub-Sahara African countries). Countries with high malaria burden had significantly lower (p<0.05) cases of COVID-19 than those with low malaria burden. A strong negative correlation (−0.595) between mean annual temperature and COVID-19 infection and death was observed with 14.8% variances between temperature and COVID-19 occurrence among the countries. A clear distinction was observed in the COVID-19 disease management between the developed countries (Europe and USA) and Sub-Sahara Africa.ConclusionsThe study established that the wide variation in the outcome of the COVID-19 disease burden in the selected countries are attributable largely to climatic condition (temperature) and differential healthcare approaches to management of the disease. We recommend consideration and mainstreaming of these findings for urgent intervention and management of COVID-19 across these continents.

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