Smoking and Comorbidities in Covid-19: A Systematic Review

COVID-19 is highly contagious, causing pneumonia, respiratory failure, death, and becoming a pandemic. Patients with severe infections must be treated in the Intensive Care Unit (ICU) with a ventilator. Ventilator facilities in the ICU are limited; it must take precautions by knowing the characteristics of patients at high risk of severe disease in COVID-19, one of which was smoking or comorbidity. The purpose of this study was to assess the risk of comorbidity and smoking in COVID-19. This study used systematic review by searching for articles from the ScienceDirect and Medline databases with journals published on January 1, 2019 - March 31, 2020. The results of the study showed that there were 12 relevant articles full text in English and were analysed. The conclusion was that patients with COVID-19 who were smoking or had comorbidities were more susceptible to COVID-19 infection, more severe illness, and causing death.

Download Full-text

COVID-19 as cause of viral sepsis: A Systematic Review and Meta-Analysis

10.1101/2020.12.02.20242354 ◽

2020 ◽

Author(s):

Eleni Karakike ◽

Evangelos J. Giamarellos-Bourboulis ◽

Miltiades Kyprianou ◽

Carolin Fleischmann-Struzek ◽

Mathias W. Pletz ◽

...

Keyword(s):

Systematic Review ◽

Intensive Care Unit ◽

Intensive Care ◽

Organ Dysfunction ◽

Full Text ◽

Meta Analysis ◽

Hospitalized Patients ◽

Adult Patients ◽

Sensitivity Analyses ◽

Organ Dysfunctions

ABSTRACTImportanceCOVID-19 is a heterogenous disease most frequently causing respiratory tract infection but in its severe forms, respiratory failure and multiple organ dysfunction syndrome may occur, resembling sepsis. The prevalence of viral sepsis among COVID-19 patients is still unclear.ObjectiveWe aimed to describe this in a systematic review.Data sourcesMEDLINE(PubMed), Cochrane and Google Scholar databases were searched for studies reporting on patients hospitalized with confirmed COVID-19, diagnosed with sepsis or infection-related organ dysfunctions or receiving organ replacement therapy.Study selectionEligible were full-text English articles of randomized and non-randomized clinical trials and observational studies reporting on patients with confirmed COVID-19, who are diagnosed with sepsis or have infection-related organ dysfunctions. Systematic reviews, editorials, conference abstracts, animal studies, case reports, articles neither in English nor full-text, and studies with fewer than 30 participants were excluded.Data extraction and synthesisAll eligible studies were included in a narrative synthesis of results and after reviewing all included studies a meta-analysis was conducted. Separate sensitivity analyses were conducted per adult vs pediatric populations and per Intensive Care Unit (ICU) vs non-ICU populations.Main outcomes and measuresPrimary endpoint was the prevalence of sepsis using Sepsis-3 criteria among patients with COVID-19 and among secondary, new onset of infection-related organ dysfunction. Outcomes were expressed as proportions with respective 95% confidence interval (CI).ResultsOf 1,903 articles, 104 were analyzed. The prevalence of sepsis in COVID-19 was 39.9% (95% CI, 35.9-44.1; I2, 99%). In sensitivity analysis, sepsis was present in 25.1% (95% CI, 21.8-28.9; I2 99%) of adult patients hospitalized in non-Intensive-Care-Unit (ICU) wards (40 studies) and in 83.8 (95% CI, 78.1-88.2; I2,91%) of adult patients hospitalized in the ICU (31 studies). Sepsis in children hospitalized with COVID-19 was as high as 7.8% (95% CI, 0.4-64.9; I2, 97%). Acute Respiratory Distress Syndrome was the most common organ dysfunction in adult patients in non-ICU (27.6; 95% CI, 21.6-34.5; I2, 99%) and ICU (88.3%; 95% CI, 79.7-93.5; I2, 97%)Conclusions and relevanceDespite the high heterogeneity in reported results, sepsis frequently complicates COVID-19 among hospitalized patients and is significantly higher among those in the ICU. PROSPERO registration number: CRD42020202018. No funding.KEY POINTSQuestionWhat is the prevalence of viral sepsis by Sepsis-3 definition among hospitalized patients with COVID-19?FindingsIn this systematic review and meta-analysis, we systematically reviewed published literature for evidence of organ failure in COVID-19, to estimate the prevalence of viral sepsis in this setting, by means of SOFA score calculation. The prevalence of sepsis in COVID-19 was 39.9% (95% CI, 35.9-44.1; I2, 99%).MeaningThis is the first study to address the burden of viral sepsis in hospitalized patients with COVID-19, a highly heterogenous infection ranging from asymptomatic cases to severe disease leading to death, as reflected in the high heterogeneity of this study.

Download Full-text

Verpleegkundiges se kommunikasie-stimulsie van hoerisikobabas in die neonatale sorgeenheid

Health SA Gesondheid ◽

10.4102/hsag.v5i3.36 ◽

2000 ◽

Vol 5 (3) ◽

pp. 35-49

Author(s):

Elmien Kraamwinkel ◽

Brenda Louw

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

High Risk ◽

Neonatal Intensive Care Unit ◽

Full Text ◽

Neonatal Intensive Care ◽

Communication Intervention ◽

Early Communication ◽

Intervention Services

Early communication intervention services begin in the neonatal intensive care unit, where growing numbers of high-risk infections survive every day.OpsommingVroee kommmunikasie intervensie begin reeds in die neonatale sorgeenheid, waar toenemend meer hoerisikobabas oorleef en gevolglik 'n risiko tot 'n kommunikasie-agterstand vertoon (Clark, I989:lI; Rosseni, 1996:150). *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

Download Full-text

Systematic review and meta-analysis of predictive symptoms and comorbidities for severe COVID-19 infection

10.1101/2020.03.15.20035360 ◽

2020 ◽

Cited By ~ 18

Author(s):

V Jain ◽

J-M Yuan

Keyword(s):

Public Health ◽

Systematic Review ◽

Cardiovascular Disease ◽

High Risk ◽

Meta Analysis ◽

Severe Disease ◽

Clinical Severity ◽

Future Research ◽

Severe Illness ◽

Icu Admission

AbstractBackground/introductionCOVID-19, a novel coronavirus outbreak starting in China, is now a rapidly developing public health emergency of international concern. The clinical spectrum of COVID-19 disease is varied, and identifying factors associated with severe disease has been described as an urgent research priority. It has been noted that elderly patients with pre-existing comorbidities are more vulnerable to more severe disease. However, the specific symptoms and comorbidities that most strongly predict disease severity are unclear. We performed a systematic review and meta-analysis to identify the symptoms and comorbidities predictive of COVID-19 severity.MethodThis study was prospectively registered on PROSPERO. A literature search was performed in three databases (MEDLINE, EMBASE and Global Health) for studies indexed up to 5thMarch 2020. Two reviewers independently screened the literature and both also completed data extraction. Quality appraisal of studies was performed using the STROBE checklist. Random effects meta-analysis was performed for selected symptoms and comorbidities to identify those most associated with severe COVID-19 infection or ICU admission.ResultsOf the 2259 studies identified, 42 were selected after title and abstract analysis, and 7 studies (including 1813 COVID-19 patients) were chosen for inclusion. The ICU group were older (62.4 years) compared to the non-ICU group (46 years), with a significantly higher proportion of males (67.2% vs. 57.1%, p=0.04). Dyspnoea was the only significant symptom predictive for both severe disease (pOR 3.70, 95% CI 1.83 – 7.46) and ICU admission (pOR 6.55, 95% CI 4.28– 10.0). Notwithstanding the low prevalence of COPD in severe disease and ICU-admitted groups (4.5% and 9.7%, respectively), COPD was the most strongly predictive comorbidity for both severe disease (pOR 6.42, 95% CI 2.44 – 16.9) and ICU admission (pOR 17.8, 95% CI 6.56 – 48.2). Cardiovascular disease and hypertension were also strongly predictive for both severe disease and ICU admission. Those with CVD and hypertension were 4.4 (95% CI 2.64 – 7.47) and 3.7 (95% CI 2.22 – 5.99) times more likely to have an ICU admission respectively, compared to patients without the comorbidity.ConclusionsDyspnoea was the only symptom strongly predictive for both severe disease and ICU admission, and could be useful in guiding clinical management decisions early in the course of illness. When looking at ICU-admitted patients, who represent the more severe end of the spectrum of clinical severity, COPD patients are particularly vulnerable, and those with cardiovascular disease and hypertension are also at a high-risk of severe illness. To aid clinical assessment, risk stratification, efficient resource allocation, and targeted public health interventions, future research must aim to further define those at high-risk of severe illness with COVID-19.

Download Full-text

Disease severity related to VOC dominance in unvaccinated SARS-CoV-2 positive adults without risk factors in Sweden

10.1101/2021.12.23.21268040 ◽

2021 ◽

Author(s):

Erik Wahlstrom ◽

Daniel Bruce ◽

Anna M Bennet-Bark ◽

Sten Walther ◽

Hakan Hanberger ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Hospital Admission ◽

Severe Disease ◽

High Flow ◽

Severe Illness ◽

Economic Factors ◽

Increased Risk ◽

Socio Economic Factors

Although the emerging SARS-CoV-2 variants of concern (VOC) have shown increasing transmissibility, their role for causing severe disease has not been fully clarified. Here, we studied changes in rates of hospitalisation and severe illness (subjection to high-flow nasal oxygen or admission to an intensive care unit during hospital stay) among all (n=685 891) unvaccinated SARS-CoV-2 positive adults without risk factors in Sweden from November 2020 to September 2021. After adjustment for age, sex, and socio-economic factors, and with November 2020 (non-VOC period) as reference, the odds ratios (OR) for hospitalisation were 1.6-1.7 in March-May 2021 (Alpha VOC dominance) and 2.4-3.0 in June-September 2021 (Delta VOC dominance), and the ORs for severe illness were 1.8-2.1 in March-May 2021 and 3.1-4.7 in June-September 2021. This study shows that unvaccinated adults without risk factors, have had a gradually increased risk for hospital admission and severe illness when infected with the Alpha and Delta VOCs, respectively.

Download Full-text

Stress and stressors experienced by the high-risk neonates admitted in Neonatal Intensive Care Unit and their parents: Protocol for a systematic review of available evidence from India

10.21203/rs.3.rs-961644/v1 ◽

2021 ◽

Author(s):

Siva N ◽

Tenzin Phagdol ◽

Baby S Nayak ◽

Edlin Glane Mathias ◽

Leslie Edward S Lewis ◽

...

Keyword(s):

Systematic Review ◽

Intensive Care Unit ◽

Intensive Care ◽

High Risk ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Parental Behavior ◽

Grey Literature ◽

Cross Sectional

Abstract Background Hospitalization of a neonate is a significant stressor for the parents as well as family members especially when a high-risk neonate is admitted to the Neonatal Intensive Care Unit (NICU) requiring continued intensive care. This prolonged physical separation from parent can have a negative psychological effect on both the neonate and the parent. These adverse health effects may last beyond hospitalization, impacting parental behavior and causing long-term emotional complications and health alteration. The neonatal period is crucial for initiating interaction and bonding between mother and child. Undue stress during this period can compromise the establishment and maintenance of a healthy mother-child bonding, which may negatively impact their long-term relationship. Methods The systematic review will include hospital-based observational studies, cross-sectional surveys, descriptive studies, qualitative studies, and mixed-method studies from India. Studies will be retrieved from global databases like CINAHL via EBSCO host, MEDLINE via PubMed, EMBASE, SCOPUS, Ovid, Web of Science, ProQuest Medical Library, Microsoft academic, DOAJ, and Indian databases like Indian Citation Index, J-Gate, and Neonatal Database (JCDR) using database-specific keywords. Additionally, online hand searching will be done on Indian websites of relevant institutions, women and child welfare departments, NGOs, repositories, registries, search engines, pediatric journals, and grey literature. All the primary studies reference lists will be scrutinized for additional references. Two review authors will independently screen, extract data, and critically appraise included studies. In case of any disagreements, it will be resolved in consultation with a third reviewer. Results will be reported as per the PRISMA-P guidelines. Discussion This systematic review will identify and highlight the stress and stressors among high-risk neonates admitted to NICU and their parents, which will guide the health care team in planning and developing comprehensive family-centered programs or interventions to reduce stress and stressors among high-risk neonates and their parents. Registration of systematic review: Protocol is registered in PROSPERO (International prospective register of systematic reviews), Reg ID: CRD42021272323.

Download Full-text

Early mechanical ventilation in patients with Guillain-Barré syndrome at high risk of respiratory failure: a randomized trial

Annals of Intensive Care ◽

10.1186/s13613-020-00742-z ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Marie-Anne Melone ◽

Nicholas Heming ◽

Paris Meng ◽

Dominique Mompoint ◽

Jerôme Aboab ◽

...

Keyword(s):

Intensive Care Unit ◽

Mechanical Ventilation ◽

Intensive Care ◽

Respiratory Failure ◽

High Risk ◽

Guillain Barre Syndrome ◽

Hospital Death ◽

Significant Difference ◽

Guillain Barré Syndrome ◽

Guillain Barré

Abstract Introduction About 30% of patients with Guillain-Barré syndrome become ventilator dependent, of whom roughly 75% develop pneumonia. This trial aimed at assessing the impact of early mechanical ventilation (EMV) on pneumonia occurrence in GBS patients. We hypothesize that EMV will reduce the incidence of pneumonia. Methods This was a single centre, open-label, randomized controlled trial performed on two parallel groups. 50 intensive care unit adults admitted for Guillain-Barré syndrome and at risk for acute respiratory failure. Patients were randomized to early mechanical ventilation via face-mask or endotracheal intubation owing to the presence or absence of impaired swallowing (experimental arm), or to conventional care (control arm). The primary outcome was the incidence of pneumonia up to intensive care unit discharge (or 90 days, pending of which occurred first). Findings Twenty-five patients were randomized in each group. There was no significant difference between groups for the incidence of pneumonia (10/25 (40%) vs 9/25 (36%), P = 1). There was no significant difference between groups for the time to onset of pneumonia (P = 0.50, Gray test). During follow-up, there were 16/25 (64%) mechanically ventilated patients in the control group, and 25/25 (100%) in the experimental arm (P < 000·1). The time on ventilator was non-significantly shorter in the experimental arm (14 [7; 29] versus 21.5 [17.3; 35.5], P = 0.10). There were no significant differences between groups for length of hospital stay, neurological scores, the proportion of patients who needed tracheostomy, in-hospital death, or any serious adverse events. Conclusions In the present study including adults with Guillain-Barré syndrome at high risk of respiratory failure, we did not observe a prevention of pneumonia with early mechanical ventilation. Trial registration: ClinicalTrials.gov under the number NCT00167622. Registered 9 September 2005, https://clinicaltrials.gov/ct2/show/NCT00167622?cond=Guillain-Barre+Syndrome&cntry=FR&draw=2&rank=1

Download Full-text