scholarly journals Risks of and From SARS-CoV-2 Infection and COVID-19 in People With Diabetes: a Systematic Review of Reviews

2021 ◽  
Author(s):  
Jamie Hartmann-Boyce ◽  
Karen Rees ◽  
James C Perring ◽  
Sven A Kerneis ◽  
Elizabeth M. Morris ◽  
...  
Keyword(s):  
Risk Factor ◽  
Systematic Reviews ◽  
Data Extraction ◽  
Severe Disease ◽  
World Health ◽  
Glucose Levels ◽  
Study Selection ◽  
Increased Risk ◽  
Health Organization ◽  
The Impact

Background <p>This review was commissioned by the World Health Organization and presents a summary of the latest research evidence on the impact of COVID-19 in people with diabetes (PWD).</p> <p>Purpose </p> <p>To review the evidence regarding the extent to which PWD are at increased risk of SARS-CoV-2 infection, and/or of suffering its complications including associated mortality.</p> <p>Data sources</p> <p>We searched the Cochrane COVID-19 study register, Embase, MEDLINE, and LitCOVID on 3 December 2020.</p> <p>Study selection</p> <p>Systematic reviews synthesising data on PWD exposed to SARS-CoV-2 infection, reporting data on confirmed SARS-CoV-2 infection, admission to hospital and/or to ICU with COVID-19, death with COVID-19.</p> <p>Data extraction</p> <p>One reviewer appraised and extracted data; data were checked by a second.</p> <p>Data synthesis</p> <p>Data from 112 systematic reviews were narratively synthesised and displayed using effect direction plots. Reviews provided consistent evidence that diabetes is a risk factor for severe disease and death from COVID-19. There was less data available on ICU admission, but where available this data also signalled increased risk. Within PWD, higher blood glucose levels both prior to COVID-19 illness and during COVID-19 illness were associated with worse COVID-19 outcomes. Type 1 diabetes was associated with worse outcomes compared to type 2 diabetes. There was no appropriate data for discerning whether diabetes was a risk factor for acquiring SARS-CoV-2 infection.</p> <p>Limitations</p> <p>Due to the nature of the review questions, the majority of data contributing to included reviews come from retrospective observational studies. Reviews varied in the extent to which they assessed risk of bias.</p> <p>Conclusions</p> <p>There are no data on whether diabetes predisposes to infection with SARS-CoV-2. Data consistently show that diabetes increases risk of severe COVID-19. As both diabetes and worse COVID-19 outcomes are associated with socioeconomic disadvantage, their intersection warrants particular attention.</p>

scholarly journals Risks of and From SARS-CoV-2 Infection and COVID-19 in People With Diabetes: a Systematic Review of Reviews

2021 ◽  
Author(s):  
Jamie Hartmann-Boyce ◽  
Karen Rees ◽  
James C Perring ◽  
Sven A Kerneis ◽  
Elizabeth M. Morris ◽  
...  
Keyword(s):  
Risk Factor ◽  
Systematic Reviews ◽  
Data Extraction ◽  
Severe Disease ◽  
World Health ◽  
Glucose Levels ◽  
Study Selection ◽  
Increased Risk ◽  
Health Organization ◽  
The Impact

Background <p>This review was commissioned by the World Health Organization and presents a summary of the latest research evidence on the impact of COVID-19 in people with diabetes (PWD).</p> <p>Purpose </p> <p>To review the evidence regarding the extent to which PWD are at increased risk of SARS-CoV-2 infection, and/or of suffering its complications including associated mortality.</p> <p>Data sources</p> <p>We searched the Cochrane COVID-19 study register, Embase, MEDLINE, and LitCOVID on 3 December 2020.</p> <p>Study selection</p> <p>Systematic reviews synthesising data on PWD exposed to SARS-CoV-2 infection, reporting data on confirmed SARS-CoV-2 infection, admission to hospital and/or to ICU with COVID-19, death with COVID-19.</p> <p>Data extraction</p> <p>One reviewer appraised and extracted data; data were checked by a second.</p> <p>Data synthesis</p> <p>Data from 112 systematic reviews were narratively synthesised and displayed using effect direction plots. Reviews provided consistent evidence that diabetes is a risk factor for severe disease and death from COVID-19. There was less data available on ICU admission, but where available this data also signalled increased risk. Within PWD, higher blood glucose levels both prior to COVID-19 illness and during COVID-19 illness were associated with worse COVID-19 outcomes. Type 1 diabetes was associated with worse outcomes compared to type 2 diabetes. There was no appropriate data for discerning whether diabetes was a risk factor for acquiring SARS-CoV-2 infection.</p> <p>Limitations</p> <p>Due to the nature of the review questions, the majority of data contributing to included reviews come from retrospective observational studies. Reviews varied in the extent to which they assessed risk of bias.</p> <p>Conclusions</p> <p>There are no data on whether diabetes predisposes to infection with SARS-CoV-2. Data consistently show that diabetes increases risk of severe COVID-19. As both diabetes and worse COVID-19 outcomes are associated with socioeconomic disadvantage, their intersection warrants particular attention.</p>

scholarly journals Communicating Risk Regarding Food Consumption: The Case of Processed Meat

Nutrients ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 400 ◽  
Author(s):  
Slavica Zec ◽  
Clara Minto ◽  
Carlo Agostoni ◽  
Carolina Fano ◽  
Honoria Ocagli ◽  
...  
Keyword(s):  
Risk Communication ◽  
Public Awareness ◽  
Real Data ◽  
World Health ◽  
International Agency ◽  
Processed Meat ◽  
Awareness Campaigns ◽  
Increased Risk ◽  
Health Organization ◽  
The Impact

The present research combines real data and parameters found in recent literature that were used to design realistic scenarios demonstrating the potential effects (benefits and costs) of the World Health Organization (WHO)’s risk communication regarding the consumption of processed meat, which was proven to be associated with an increased risk of colorectal cancer (CRC) in an International Agency for Research on Cancer (IARC)/WHO report. The impact of the risk communication of processed meat consumption was simulated using Monte Carlo microsimulation models. The results showed that a 1% reduction in the number of high-level processed meat consumers may lead to a yearly decrease in CRC cases of 406.43 (IC 95%: −243.94, 1056.81), while the more extreme scenario of a 15% reduction may lead to 2086.62 fewer cases (IC 95%: 1426.66, 2746.57). On the other hand, if demand contraction in the processed meat sector resulted in a 0.1% loss in employment, one could expect 27.23 all-cause mortalities attributable to job loss (IC 95%: 16.55, 37.80). This simulation study demonstrates that caution should be taken when implementing public awareness campaigns, particularly when the prevention message is not straightforward.

scholarly journals Extended use or reuse of single-use surgical masks and filtering face-piece respirators during the coronavirus disease 2019 (COVID-19) pandemic: A rapid systematic review

2020 ◽  
Vol 42 (1) ◽  
pp. 75-83 ◽  
Author(s):  
Elaine C. Toomey ◽  
Yvonne Conway ◽  
Chris Burton ◽  
Simon Smith ◽  
Michael Smalle ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Data Extraction ◽  
Evidence Base ◽  
World Health ◽  
Healthcare Organizations ◽  
Surgical Masks ◽  
Single Use ◽  
Current Guidance ◽  
The Impact

AbstractBackground:Shortages of personal protective equipment during the coronavirus disease 2019 (COVID-19) pandemic have led to the extended use or reuse of single-use respirators and surgical masks by frontline healthcare workers. The evidence base underpinning such practices warrants examination.Objectives:To synthesize current guidance and systematic review evidence on extended use, reuse, or reprocessing of single-use surgical masks or filtering face-piece respirators.Data sources:We used the World Health Organization, the European Centre for Disease Prevention and Control, the US Centers for Disease Control and Prevention, and Public Health England websites to identify guidance. We used Medline, PubMed, Epistemonikos, Cochrane Database, and preprint servers for systematic reviews.Methods:Two reviewers conducted screening and data extraction. The quality of included systematic reviews was appraised using AMSTAR-2. Findings were narratively synthesized.Results:In total, 6 guidance documents were identified. Levels of detail and consistency across documents varied. They included 4 high-quality systematic reviews: 3 focused on reprocessing (decontamination) of N95 respirators and 1 focused on reprocessing of surgical masks. Vaporized hydrogen peroxide and ultraviolet germicidal irradiation were highlighted as the most promising reprocessing methods, but evidence on the relative efficacy and safety of different methods was limited. We found no well-established methods for reprocessing respirators at scale.Conclusions:Evidence on the impact of extended use and reuse of surgical masks and respirators is limited, and gaps and inconsistencies exist in current guidance. Where extended use or reuse is being practiced, healthcare organizations should ensure that policies and systems are in place to ensure these practices are carried out safely and in line with available guidance.

Pre-conceptual counselling in cardiology patients: still work to do and still missed opportunities. A comparison between 2015 and 2019 in women with cardiac disease attending combined obstetric cardiology clinics. Should the European Guidelines change anything?

2021 ◽  
pp. 1-7
Author(s):  
Chethan R. Kasargod Prabhakar ◽  
Daisy Pamment ◽  
Peter J. Thompson ◽  
Hsu Chong ◽  
Sara A. Thorne ◽  
...  
Keyword(s):  
World Health Organization ◽  
Cardiac Disease ◽  
Management Strategies ◽  
Reproductive Age ◽  
World Health ◽  
Modest Improvement ◽  
Increased Risk ◽  
Adverse Pregnancy ◽  
Health Organization ◽  
The Impact

Abstract Women with underlying cardiac conditions have an increased risk of adverse pregnancy outcomes. Counselling reproductive age women with heart disease is important to assist them in deciding whether to pursue pregnancy, to ensure their best cardiovascular status prior to pregnancy, and that they understand the risks of pregnancy for them and baby. This also provides an opportunity to explore management strategies to reduce risks. For this growing cohort of women, there is a great need for pre-conceptual counselling. This retrospective comparative audit assessed new referrals and pre-conceptual counselling of women attending a joint obstetric–cardiology clinic at a tertiary maternity centre in a 12-month period of 2015–2016 compared with 2018–2019. This reflected the timing of the introduction of a multidisciplinary meeting prior to clinics and assessed the impact on referrals with the introduction of the European Society of Cardiology guidelines. Data were reviewed from 56 and 67 patients in respective audit periods. Patient’s risk was stratified using modified World Health Organization classification. Less than 50% of women with pre-existing cardiac conditions had received pre-conceptual counselling, although half of them had risks clearly documented. The majority of patients had a recent electrocardiograph and echocardiogram performed prior to counselling, and there was a modest improvement in the number of appropriate functional tests performed between time points. One-third of patients in both cohorts were taking cardiac medications during pregnancy. There was a significant increase in the number of pregnant women with cardiac disease and in complexity according to modified World Health Organization risk classification. While there have been improvements, it is clear that further work to improve availability and documentation of pre-pregnancy counselling is needed.

scholarly journals Obesity as a risk factor for heart failure: overview of systematic reviews

2022 ◽  
Vol 11 (1) ◽  
pp. e0811124380
Author(s):  
Cleyton Oliveira Bezerra ◽  
Rafael Marinho de Lima Paiva ◽  
Thamires Lucena da Silva ◽  
Vinicius Soares Ribeiro ◽  
Cinthia Caldas Rios ◽  
...  
Keyword(s):  
Heart Failure ◽  
Risk Factor ◽  
Systematic Reviews ◽  
Data Extraction ◽  
Meta Analysis ◽  
Obesity Paradox ◽  
Overweight And Obesity ◽  
Risk Of Death ◽  
Increased Risk ◽  
Overview Of Systematic Reviews

The overweight and population with obesity has an increased risk of mortality from HF. However, some studies point to the existence of an "obesity paradox" where there could be a protective effect on the relative risk of death by HF in these populations with high BMI. In this way, the present study aimed to investigate obesity as a risk factor for heart failure. For this, an overview of systematic reviews was performed by selecting articles from the following databases: "Pubmed", "Scopus" and "SciElo”. A total of 615 articles were found from this initial search, leaving 59 articles for full-text reading, of which 22 articles were included for data extraction using the predefined inclusion criteria. From these 22 studies 73% were meta-analysis and 64% of the studies are of high methodological quality according to AMSTAR-2. Overweight and obesity have demonstrated a close relationship with the onset and increase of mortality by HF, studies have even been found that point to a gene interference in this relationship. In studies reporting on the obesity paradox, the results pointed to a momentary protection from mortality risk.

scholarly journals An IoT-Based Glucose Monitoring Algorithm to Prevent Diabetes Complications

2020 ◽  
Vol 10 (3) ◽  
pp. 921
Author(s):  
Francisco Valenzuela ◽  
Armando García ◽  
Erica Ruiz. ◽  
Mabel Vázquez ◽  
Joaquín Cortez ◽  
...  
Keyword(s):  
Critical Condition ◽  
Moving Average ◽  
Glucose Monitoring ◽  
Public Health Problem ◽  
World Health ◽  
Elderly Persons ◽  
Glucose Levels ◽  
Normal Limits ◽  
Health Organization ◽  
The Impact

Diabetes mellitus (DM) is a metabolic disorder characterized by blood glucose levels above normal limits. The impact of this disease on the population has increased in recent years. It is already a public health problem worldwide and one of the leading causes of death. Recently, several proposals have been developed for better and regular monitoring of glucose. However, theses proposals do not discard erroneous readings and they are not able to anticipate a critical condition. In this work, we propose an algorithm based on the double moving average supported by an IoT architecture to prevent possible complications in elderly patients. The algorithm uses historical readings to construct a series. Given a number of periods, it is possible to calculate averages of different subsets and trends for the next periods and, in this way, the prognosis is obtained. With the prognosis, it is possible to notify the doctor and relatives in advance about a possible critical condition in the patient. The aim of our work is to validate the architecture and prognosis algorithm used for elderly persons. Tests of the algorithm and the architecture were performed with different readings and it was shown that the system generated corresponding notifications before the glucose values were higher than those defined by the WHO (World Health Organization), thus avoiding unnecessary alarms.

scholarly journals Nurses as Agents of Safety: Identifying unique contributors to falls in hospitalized Adult Hematology Patients: A Retrospective Study

2021 ◽  
pp. 1-4
Author(s):  
Catherine Mbango ◽  
Keyword(s):  
Safety Concern ◽  
Unintentional Injury ◽  
World Health ◽  
National Database ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Fall Incident ◽  
Increased Risk ◽  
Health Organization ◽  
The Impact

Falls continue to be a major safety concern in acute care settings and are the second cause of unintentional injury deaths globally [1].The World Health Organization defines a fall as an event that results in a person coming to a rest inadvertently on the ground or floor or other lower level. Prevention of a fall is a safety measure, which is significantly affected by nursing care according to the National Database of Nursing Quality Indicators (NDNQI) [2].This retrospective review of one hundred medical records was conducted to assess if there are unique contributors to falls in hospitalized adult hematology patients. The study sample was drawn from the parent study that examined the impact of video-based educational intervention on the occurrence of falls among hematology patients hospitalized for the management of cancer treatment and complications. Patients with cancer are at an increased risk of sustaining a fall related injury due to impaired functional status, low blood counts, treatment related fatigue, frailty, and poor nutritional status [3,4]. Simple logistic regression between continuous variables and dependent variable, and cross-tabulation between categorical variables and the dependent variable was used to analyze study results.The study revealed that there was a significant relationship between fall incident and fall risk assessment scores on admission; X2 (1) = 6.153, p = .013, Cramer’s V = .256.

scholarly journals Inflammatory bowel diseases during the coronavirus pandemic: potential risks and ways to reduce them

2020 ◽  
Vol 12 (1) ◽  
pp. 5-10
Author(s):  
Igor G. Bakulin ◽  
Maria I. Skalinskaya ◽  
Ekaterina V. Skazyvaeva ◽  
Maria S. Zhuravleva
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Severe Disease ◽  
World Health ◽  
Disease Course ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Potential Risks ◽  
Health Organization ◽  
Active Inflammation ◽  
The Impact

This review is devoted to the current issues on management of the patients with inflammatory bowel diseases during the new coronavirus SARS-CoV-2 pandemic. Since March 2020, the World Health Organization with the support of international gastroenterological associations has launched a project for monitoring and reporting outcomes of COVID-19 occurring in inflammatory bowel diseases patients SECURE-IBD aimed to define the impact of COVID-19 on patients with inflammatory bowel diseases and how factors such as age, comorbidities, and inflammatory bowel diseases treatments influence COVID outcomes (www.covidibd.org). According to the data of this Registry, no higher incidence of SARS-CoV-2 in patients with inflammatory bowel diseases compared to the general population has been reported. However, active inflammation, severe disease course, the induction period of immunosuppressive therapy and the use of systemic steroids are unfavorable predictors of severe COVID-19 infection course in case of inflammatory bowel diseases.

scholarly journals Increased prevalence and clinical impact of hypocalcaemia in severe COVID-19 distinguishes it from other forms of infective pneumonia

2021 ◽  
Author(s):  
Meera Mehta ◽  
Hakim Ghani ◽  
Felix Chua ◽  
Adrian Draper ◽  
Sam Calmonson ◽  
...  
Keyword(s):  
Disease Severity ◽  
Serum Calcium ◽  
Respiratory Infections ◽  
Severe Disease ◽  
Community Acquired Pneumonia ◽  
Host Cells ◽  
World Health ◽  
Level Of Care ◽  
Increased Risk ◽  
Health Organization

Background: Hypocalcaemia has been reported in the context of acute COVID-19, where it has been associated with an increased risk of hospitalisation and disease severity. Calcium is an important intracellular messenger that controls diverse cellular processes. Two other clinically important coronaviruses, SARS-CoV-1 and Middle East respiratory syndrome (MERS)-CoV, can use calcium ions to enter and replicate within host cells. Calcium may therefore be important in the pathophysiology of COVID-19 infection. We sought to investigate whether calcium derangement was a specific feature of COVID-19 that distinguishes it from other infective pneumonias, and its association with disease severity. Methods: We conducted a single centre retrospective study of albumin-corrected serum calcium on adult patients with COVID-19 who presented between March 1st and May 16th 2020. The primary outcome was maximal level of care based on the World Health Organization Clinical Progression Scale for COVID-19. Cases with community acquired pneumonia (CAP) and viral pneumonia (VP) were identified through a clinical database over three intervals (January to February 2018, January to February 2019 and September to December 2019). Results: We analysed data from 506 patients with COVID-19, 95 patients with CAP and 152 patients with VP. Hypocalcaemia (serum calcium <2.2mmol/L) was a specific and common clinical finding in patients with COVID-19 that was not present in other respiratory infections. Calcium levels were significantly lower in those with severe disease. Ordinal regression of risk estimates for categorised care levels showed that baseline hypocalcaemia was incrementally associated with odds ratio of 2.33 for higher level of care, superior to other variables that have previously been shown to predict worse COVID-19 outcome. Serial calcium levels showed improvement by day 7-9 of admission, only in in survivors of COVID-19. Conclusion: Hypocalcaemia may independently predict not only more severe but more progressive disease and warrants detailed prognostic investigation. The fact that decreased serum calcium is observed at the time of clinical presentation in COVID-19, but not other infective pneumonias, suggests that its early derangement is pathophysiological and may influence the deleterious evolution of this disease. If calcium is ultimately shown to be critical to the entry and replication of SARS-CoV-2 in host cells, unravelling how this mechanism could be therapeutically targeted deserves more intensive examination. Trial registration HRA: 20/HRA/2344.

scholarly journals Extended use or re-use of single-use surgical masks and filtering facepiece respirators: A rapid evidence review

2020 ◽  
Author(s):  
Elaine Toomey ◽  
Yvonne Conway ◽  
Christopher Burton ◽  
Simon Smith ◽  
Michael Smalle ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Data Extraction ◽  
Evidence Base ◽  
Open Science ◽  
World Health ◽  
Limited Evidence ◽  
Surgical Masks ◽  
Guidance Documents ◽  
Single Use ◽  
The Impact

Background The COVID-19 pandemic has led to unprecedented demand for personal protective equipment. Shortages of surgical masks and filtering facepiece respirators has led to the extended use or re-use of single-use respirators and surgical masks by frontline healthcare workers. The evidence base underpinning such practices has been questioned. Objectives To summarise guidance and synthesise systematic review evidence on extended use, re-use or reprocessing of single-use surgical masks or filtering facepiece respirators. Methods A targeted search of the World Health Organization, European Centre for Disease Prevention and Control, the US Centers for Disease Control and Prevention, and Public Health England websites was conducted to identify guidance. Four databases (Medline, Pubmed, Epistemonikos, Cochrane Database of Systematic Reviews) and three preprint repositories (Litcovid, MedRxiv and Open Science Framework) were searched for relevant systematic reviews. Record screening and data extraction was conducted by two reviewers. Quality of included systematic reviews was appraised using the AMSTAR-2 checklist. Findings were integrated and narratively synthesised to highlight the extent to which key claims in guidance documents were supported by research evidence. Results Six guidance documents were identified. All note that extended use or re-use of single-use surgical masks and respirators (with or without reprocessing) should be considered only in situations of critical shortage. Extended use was generally favoured over re-use because of reduced risk of contact transmission. Four high-quality systematic reviews were included: three focused on reprocessing (decontamination) of N95 respirators and one focused on reprocessing of surgical masks. There was limited evidence on the impact of extended use on masks and respirators. Vaporised hydrogen peroxide and ultraviolet germicidal irradiation were highlighted as the most promising reprocessing methods, but evidence on the relative efficacy and safety of different methods was limited. We found no well-established methods for reprocessing respirators at scale. Conclusions: There is limited evidence on the impact of extended use and re-use of surgical masks and respirators. Where extended use or re-use is being practiced, healthcare organisations should ensure that policies and systems are in place to ensure these practices are carried out safely and in line with available guidance.

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