Factors Associated with COVID-19 Morbidity and Mortality: A Narrative Review

2021 ◽  
Author(s):  
Omid Dadras ◽  
Nazanin Shahrokhnia ◽  
Sarina Borran ◽  
Ali Asadollahi-Amin ◽  
SeyedAhmad SeyedAlinaghi
Keyword(s):  
Risk Factors ◽  
Severe Disease ◽  
Narrative Review ◽  
Morbidity And Mortality ◽  
Laboratory Findings ◽  
Factors Affecting ◽  
Impaired Liver ◽  
Duration Of Hospitalization ◽  
Poor Outcomes ◽  
Underlying Diseases

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It has been declared as a pandemic on March 11th 2020 by the WHO. Morbidity and mortality of COVID-19 has been shown to be high among patients with underlying diseases. In this narrative review, searching a number of electronic databases (PubMed, Google Scholar, Scopus, and Science Direct), 127 related articles written in English were retrieved and of which 73 articles related to risk factors affecting morbidity and mortality of COVID-19 were extracted and summarized. Factors such as old age, male gender and working in health setting were associated with higher morbidity and mortality. Hypertension was the most frequent reported condition among those with severe disease. It also appeared to increase the mortality and duration of hospitalization. Diabetes, respiratory chronic illnesses (COPD, asthma), impaired liver and renal function, and malignancies were also mentioned as the risk factors for severe disease, longer hospitalization, poor prognosis and outcome. Some laboratory findings such as elevated D-dimer, CRP, and LDH as well as severe lymphopenia were associated with severity, mortality and poor outcomes in hospitalized patients. All in all, a considerable number of comorbidities and biomarkers are associated with severity and presentations of COVID-19 disease, affecting its morbidity and mortality rates.

Studying the Birth Outcome in Tikrit Teaching Hospital

2018 ◽  
Vol 1 (1) ◽  
pp. 55-57
Author(s):  
Areej Noaman
Keyword(s):  
Risk Factors ◽  
Developing Countries ◽  
Teaching Hospital ◽  
Birth Outcome ◽  
Morbidity And Mortality ◽  
Healthy Baby ◽  
Factors Affecting ◽  
Neonatal Deaths ◽  
Healthy Mother

  Background : A successful birth outcome is defined as the birth of a healthy baby to a healthy mother. While relatively low in industrialized world, maternal and fetal morbidity and mortality and neonatal deaths occur disproportionately in developing countries. Aim of the Study: To assess birth outcome and identify some risk factors affecting it for achieving favorable birth outcome in Tikrit Teaching Hospital

scholarly journals Patient trajectories and risk factors for severe outcomes among persons hospitalized for COVID-19 in the Maryland/DC region

2020 ◽  
Author(s):  
Brian T. Garibaldi ◽  
Jacob Fiksel ◽  
John Muschelli ◽  
Matthew Robinson ◽  
Masoud Rouhizadeh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Respiratory Rate ◽  
Disease Severity ◽  
Clinical Features ◽  
Hospital Admissions ◽  
Severe Disease ◽  
Cohort Analysis ◽  
Ordinal Scale ◽  
Severe Illness ◽  
Poor Outcomes

AbstractBackgroundRisk factors for poor outcomes from COVID-19 are emerging among US cohorts, but patient trajectories during hospitalization ranging from mild-moderate, severe, and death and the factors associated with these outcomes have been underexplored.MethodsWe performed a cohort analysis of consecutive COVID-19 hospital admissions at 5 Johns Hopkins hospitals in the Baltimore/DC area between March 4 and April 24, 2020. Disease severity and outcomes were classified using the WHO COVID-19 disease severity ordinal scale. Cox proportional-hazards regressions were performed to assess relationships between demographics, clinical features and progression to severe disease or death.Results832 COVID-19 patients were hospitalized; 633 (76.1%) were discharged, 113 (13.6%) died, and 85 (10.2%) remained hospitalized. Among those discharged, 518 (82%) had mild/moderate and 116 (18%) had severe illness. Mortality was statistically significantly associated with increasing age per 10 years (adjusted hazard ratio (aHR) 1.54; 95%CI 1.28-1.84), nursing home residence (aHR 2.13, 95%CI 1.41-3.23), Charlson comorbidity index (1.13; 95% CI 1.02-1.26), respiratory rate (aHR 1.13; 95%CI 1.09-1.17), D-dimer greater than 1mg/dL (aHR 2.79; 95% 1.53-5.09), and detectable troponin (aHR 2.79; 95%CI 1.53-5.09). In patients under 60, only male sex (aHR 1.7;95%CI 1.11-2.58), increasing body mass index (BMI) (aHR1.25 1.14-1.37), Charlson score (aHR 1.27; 1.1-1.46) and respiratory rate (aHR 1.16; 95%CI 1.13-1.2) were associated with severe illness or death.ConclusionsA combination of demographic and clinical features on admission is strongly associated with progression to severe disease or death in a US cohort of COVID-19 patients. Younger patients have distinct risk factors for poor outcomes.

scholarly journals Potential Biomarkers, Risk Factors and their Associations with IgE-mediated Food Allergy in Early Life: A Narrative Review

2021 ◽  
Author(s):  
Caroline E Childs ◽  
Daniel Munblit ◽  
Laurien Ulfman ◽  
Carlos Gómez-Gallego ◽  
Liisa Lehtoranta ◽  
...  
Keyword(s):  
Public Health ◽  
Quality Of Life ◽  
Risk Factors ◽  
Food Allergy ◽  
Early Life ◽  
Financial Burden ◽  
Narrative Review ◽  
Morbidity And Mortality ◽  
Potential Biomarkers

Abstract Food allergy affects the quality of life of millions of people worldwide and presents a significant psychological and financial burden for both national and international public health. In the past few decades, the prevalence of allergic disease has been on the rise worldwide. Identified risk factors for food allergy include family history, mode of delivery, variations in infant feeding practices, prior diagnosis of other atopic diseases such as eczema, and social economic status. Identifying reliable biomarkers which predict the risk of developing food allergy in early life would be valuable in both preventing morbidity and mortality and by making current interventions available at the earliest opportunity. There is also the potential to identify new therapeutic targets. This narrative review provides details on the genetic, epigenetic, dietary and microbiome influences upon the development of food allergy and synthesizes the currently available data indicating potential biomarkers. While there is a large body of research evidence available within each field of potential risk factors, there are very limited number of studies which span multiple methodological fields, for example including immunology, microbiome, genetic/epigenetic factors and dietary assessment. We recommend that further collaborative research with detailed cohort phenotyping is required to identify biomarkers, and whether these vary between at-risk populations and the wider population. The low incidence of oral food challenge confirmed food allergy in the general population, and the complexities of designing nutritional intervention studies will provide challenges for researchers to address in generating high quality, reliable and reproducible research findings. Statement of significance Food allergy affects the quality of life of millions of people worldwide and presents a significant psychological and financial burden for both national and international public health. Identifying reliable biomarkers which predict the risk of developing food allergy would be valuable in both preventing morbidity and mortality and by making current interventions available at the earliest opportunity. This review provides details on the genetic, epigenetic, dietary and microbiome influences upon the development of food allergy. This helps in identifying reliable biomarkers to predict the risk of developing food allergy, which could be valuable in both preventing morbidity and mortality and by making interventions available at the earliest opportunity.

scholarly journals Study on clinical profile and risk factors associated with pneumonia

2019 ◽  
Vol 6 (5) ◽  
pp. 1926
Author(s):  
Gangina Sriram ◽  
Akula Satyanarayana
Keyword(s):  
Risk Factors ◽  
Economic Status ◽  
Significant Risk ◽  
Severe Pneumonia ◽  
Control Programme ◽  
Morbidity And Mortality ◽  
Prospective Clinical Study ◽  
Age Group ◽  
Factors Affecting ◽  
Medical College

Background: Modernization, industrialization and urbanization are now posed with the problem of increase in ARI morbidity and mortality. The epidemiological information regarding risk factors and management is scanty. A large gap exists in our knowledge about these factors, which needs to be fulfilled by systematic studies. The present study is designed to identify the risk factors of pneumonia in our area.Methods: This was a prospective clinical study of pneumonia conducted on 94 children who were admitted to Paediatric ward in GSL Medical College General Hospital, Rajahmundry in study duration. Epidemiological factors affecting the same were studied and bronchoscopy was done whenever it was needed. A detailed history of the relevant symptoms, such as fever, cough, rapid breathing, refusal of feeds, noisy breathing, bluish discolouration etc., was collected.Results: The most affected children belonged to the age group of 1 year to 3 years (64.9%). Bronchopneumonia (86.2%) was the most common clinical diagnosis made at admission. According to WHO ARI control programme, 28.7% had pneumonia, 54.3% had severe pneumonia and 17% very severe pneumonia. It was found that younger age group, malnutrition, kutcha house, crowding, poor sanitation facilities, cooking with fuel other than LPG (indoor pollution) and low socio economic status and high respiratory rate were significant risk factors for pneumonia in children.Conclusions: ARI, especially pneumonia is one of the major causes of morbidity and mortality in children. Bronchopneumonia is the predominant form of presentation in infants and preschool children.  

scholarly journals P0311INFECTION-RELATED GLOMERULONEPHRITIS IN ADULTS: TIME FOR A DEFINITIVE PARADIGM SHIFT?

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Chiara Salviani ◽  
Mattia Zappa ◽  
Guido Jeannin ◽  
Mario Gaggiotti ◽  
Regina Tardanico ◽  
...  
Keyword(s):  
Risk Factors ◽  
Interstitial Fibrosis ◽  
Severe Disease ◽  
Significant Proportion ◽  
Laboratory Findings ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background and Aims The recent decades have witnessed significant changes in the epidemiology and clinical course of infection-related glomerulonephritis (IRGN). We analyzed the clinicopathological features and long-term outcome of adult patients with biopsy-proven IRGN followed in a large Italian referral centre. Method We included patients with biopsy-proven IRGN diagnosed from 2000 to 2018. Clinical and laboratory findings, histological features, possible risk factors and therapy were assessed for both renal and patient outcome. Results Forty-one patients met the inclusion criteria (male:female ratio 3:1, mean age 61±16 years). Smoke habit (47.2%), alcoholism (30.6%), and diabetes (27.5%) were the most common risk factors. The most frequently identified sites of infection were skin, lung and heart (Table 1). Staphylococci spp. accounted for 76.5% of positive cultures (Figure 1). Hypocomplementaemia emerged in 48.5% of cases. The most frequent histologic patterns were diffuse proliferative (56.0%) and membranoproliferative (29.3%) glomerulonephritis. Haemodialysis was required by 22.5% of patients at inception. Two thirds of patients developed chronic kidney disease; half of them reached end-stage renal disease (ESRD). By multivariate analysis ESRD was associated with diabetes (HR 13.7; 95% CI, 1.6-121.0; p=0.018), crescents (HR 25.2; 95% CI, 2.7-235.7; p=0.005), and interstitial fibrosis (HR 31.0; 95% CI, 3.3-287.3; p=0.003). Male gender (HR 12.7; 95% CI, 10.8-14.6; p=0.008) hypertension (HR 40.8; 95% CI, 38.6-43.1; p=0.001), gross haematuria (HR 11.8; 95% CI, 9.4-14.2; p=0.047), need for haemodialysis at onset (HR 16.3; 95% CI, 14.7-17.8; p<0.0001), and interstitial infiltrate (HR 13.3; 95% CI, 11.6-15.0; p=0.003) significantly affected survival. Corticosteroids did not affect prognosis. Conclusion While traditionally considered a “benign” disease with a favorable course in children, IRGN is a potentially severe disease in adults, particularly when a background of major comorbidities and older age are present. A significant proportion of patients does not recover renal function, with a remarkable risk of ESRD.

scholarly journals H1N1 2009 pandemic influenza in Indigenous Australians

2011 ◽  
Vol 32 (1) ◽  
pp. 36 ◽  
Author(s):  
Peter Markey ◽  
Jiunn-Yih Su ◽  
Andre Wattiaux ◽  
James Trauer ◽  
Vicki Krause
Keyword(s):  
Risk Factors ◽  
Access To Health Care ◽  
Indigenous Population ◽  
Influenza Pandemic ◽  
Influenza Infection ◽  
Severe Disease ◽  
Population Level ◽  
Indigenous Australians ◽  
Poor Outcomes ◽  
The Impact

Given the known prevalence of chronic disease in the Australian Indigenous population, and the known risk factors for severe disease from influenza infection, it is not surprising that Indigenous Australians carried a higher burden of disease during the influenza pandemic of 2009. However, other determinants apart from comorbidities might also have affected influenza morbidity in Indigenous Australia. Factors such as overcrowding, sanitation infrastructure, remoteness, access to health care and availability of the specific hardware of the pandemic (such as personal protective equipment ? PPE? and antivirals) may also have been risk factors for poor outcomes at the population level. This article summarises the impact of the 2009 influenza pandemic on Australia?s Indigenous population, with particular emphasis on those living remotely in the Northern Territory (NT).

scholarly journals High Fibrosis-4 Index Is Related with Worse Clinical Outcome in Patients with Coronavirus Disease 2019 and Diabetes Mellitus: A Multicenter Observational Study

2021 ◽  
Vol 36 (4) ◽  
pp. 800-809
Author(s):  
Sung-Woo Kim ◽  
Jae-Han Jeon ◽  
Jun Sung Moon ◽  
Mi Kyung Kim
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Observational Study ◽  
Severe Disease ◽  
University Hospitals ◽  
Laboratory Findings ◽  
Multicenter Observational Study ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Additive Risk

Background: Based on recent evidence on the importance of the presence of diabetes mellitus (DM) and fibrosis-4 (FIB-4) index in coronavirus disease 2019 (COVID-19) mortality, we analyzed whether these factors could additively predict such mortality.Methods: This multicenter observational study included 1,019 adult inpatients admitted to university hospitals in Daegu. The demographic and laboratory findings, mortality, prevalence of severe disease, and duration of quarantine were compared between patients with and without DM and/or a high FIB-4 index. The mortality risk and corresponding hazard ratio (HR) were analyzed using the Kaplan-Meier method and Cox proportional hazard models.Results: The patients with DM (n=217) exhibited significantly higher FIB-4 index and mortality compared to those without DM. Although DM (HR, 2.66; 95% confidence interval [CI], 1.63 to 4.33) and a high FIB-4 index (HR, 4.20; 95% CI, 2.21 to 7.99) were separately identified as risk factors for COVID-19 mortality, the patients with both DM and high FIB-4 index had a significantly higher mortality (HR, 9.54; 95% CI, 4.11 to 22.15). Higher FIB-4 indices were associated with higher mortality regardless of DM. A high FIB-4 index with DM was more significantly associated with a severe clinical course with mortality (odds ratio, 11.24; 95% CI, 5.90 to 21.41) than a low FIB-4 index without DM, followed by a high FIB-4 index alone and DM alone. The duration of quarantine and hospital stay also tended to be longer in those with both DM and high FIB-4 index.Conclusion: Both DM and high FIB-4 index are independent and additive risk factors for COVID-19 mortality.

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