scholarly journals Risk Factors for Mortality in Patients with Covid-19: A Systematic Review

2020 ◽  
Author(s):  
Ratna Yustinawati ◽  
◽  
Anhari Achadi ◽  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Systematic Review ◽  
Organ Failure ◽  
Sofa Score ◽  
Clinical Characteristics ◽  
Research Question ◽  
Master Of Public Health ◽  
Epidemiological Characteristics ◽  
D Dimer

ABSTRACT Background: SARS-CoV-2, a new strain of the coronavirus, caused a global outbreak of fatal acute pneumonia. Globally, WHO has recorded 709,511 deaths from COVID-19, and the number is increasing. This study aimed to determine the risk factors for mortality in COVID-19 patients. Subjects and Method: A systematic review was conducted by searching for articles from ScienceDirect, PubMed, SpringerLink, Scopus, and Google Scholar databases. The inclusion criteria were open access, English-language, and full-text articles published in journals between 20019 and 2020. The keywords were (Coronavirus Disease 2019 AND clinical characteristics AND epidemiological characteristics AND comorbidities) OR (COVID-19 AND clinical characteristics AND epidemiological characteristics AND comorbidities). A total of eight articles was reviewed to answer the research question. The data were analyzed by PRISMA flow chart. Results: Based on the reports from China and Korea, a total of 1,314 (100%) COVID-19 patients who died was aged ≥60 years with comorbidity, in which 845 (64%) were male patients. Before the death of patients, the increase D-dimer level of ≥1 μg/ mL and Sequential Organ Failure Assessment (SOFA) score of ≥4 were reported. It indicated the occurrence of multi-organ failure and Acute Respiratory Distress Syndrome (ARDS). Most of the comorbidities were hypertension, diabetes mellitus, and cardiovascular diseases. Conclusion: Risk factors for mortality in COVID-19 patients include age at ≥60 years, male, and presence of comorbidity. The clinical features are D-dimer levels ≥1 μg / mL, high SOFA score (≥4), and ARDS. Comprehensive efforts are needed to identify risk factors early and conduct effective treatment timely to reduce the mortality of COVID-19 patients. Keywords: SARS-CoV-2, COVID-19, risk factors, mortality, comorbidity Correspondence: Ratna Yustinawati. Master of Public Health Program, Faculty of Public Health, Universitas Indonesia, Depok, West Java, Indonesia. Email: [email protected]. Mobile: +628179324304. DOI: https://doi.org/10.26911/the7thicph.01.26

COVID-19 in Healthcare Workers: A Systematic Review and Meta-Analysis of Prevalence, Risk Factors, Clinical Characteristics, and Outcomes

2020 ◽  
Author(s):  
Sergio Alejandro Gómez-Ochoa ◽  
Oscar H. Franco ◽  
Lyda Z. Rojas ◽  
Sandra Lucrecia Romero Guevara ◽  
Luis Eduardo Echeverría ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Healthcare Workers ◽  
Clinical Characteristics ◽  
Meta Analysis

scholarly journals Informing the public health response to COVID-19: a systematic review of risk factors for disease, severity, and mortality

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M. Flook ◽  
C. Jackson ◽  
E. Vasileiou ◽  
C. R. Simpson ◽  
M. D. Muckian ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Systematic Review ◽  
At Risk ◽  
Risk Factor ◽  
Disease Severity ◽  
Severe Disease ◽  
Public Health Response ◽  
Wide Range ◽  
Multivariable Analyses

Abstract Background Severe Acute Respiratory Syndrome coronavirus-2 (SARS-CoV-2) has challenged public health agencies globally. In order to effectively target government responses, it is critical to identify the individuals most at risk of coronavirus disease-19 (COVID-19), developing severe clinical signs, and mortality. We undertook a systematic review of the literature to present the current status of scientific knowledge in these areas and describe the need for unified global approaches, moving forwards, as well as lessons learnt for future pandemics. Methods Medline, Embase and Global Health were searched to the end of April 2020, as well as the Web of Science. Search terms were specific to the SARS-CoV-2 virus and COVID-19. Comparative studies of risk factors from any setting, population group and in any language were included. Titles, abstracts and full texts were screened by two reviewers and extracted in duplicate into a standardised form. Data were extracted on risk factors for COVID-19 disease, severe disease, or death and were narratively and descriptively synthesised. Results One thousand two hundred and thirty-eight papers were identified post-deduplication. Thirty-three met our inclusion criteria, of which 26 were from China. Six assessed the risk of contracting the disease, 20 the risk of having severe disease and ten the risk of dying. Age, gender and co-morbidities were commonly assessed as risk factors. The weight of evidence showed increasing age to be associated with severe disease and mortality, and general comorbidities with mortality. Only seven studies presented multivariable analyses and power was generally limited. A wide range of definitions were used for disease severity. Conclusions The volume of literature generated in the short time since the appearance of SARS-CoV-2 has been considerable. Many studies have sought to document the risk factors for COVID-19 disease, disease severity and mortality; age was the only risk factor based on robust studies and with a consistent body of evidence. Mechanistic studies are required to understand why age is such an important risk factor. At the start of pandemics, large, standardised, studies that use multivariable analyses are urgently needed so that the populations most at risk can be rapidly protected. Registration This review was registered on PROSPERO as CRD42020177714.

scholarly journals Clinical characteristics and risk factors for mortality in COVID-19 inpatients in Birjand, Iran: a single-center retrospective study

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Ghodsiyeh Azarkar ◽  
Freshteh Osmani
Keyword(s):  
Risk Factors ◽  
Platelet Count ◽  
Protein Level ◽  
Clinical Characteristics ◽  
Single Center ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Risk Of Death ◽  
Survivor Group ◽  
Epidemiological Characteristics

Abstract Background The coronavirus disease 2019(COVID-19) has affected mortality worldwide. The Cox proportional hazard (CPH) model is becoming more popular in time-to-event data analysis. This study aimed to evaluate the clinical characteristics in COVID-19 inpatients including (survivor and non-survivor); thus helping clinicians give the right treatment and assess prognosis and guide the treatment. Methods This single-center study was conducted at Hospital for COVID-19 patients in Birjand. Inpatients with confirmed COVID-19 were included. Patients were classified as the discharged or survivor group and the death or non-survivor group based on their outcome (improvement or death). Clinical, epidemiological characteristics, as well as laboratory parameters, were extracted from electronic medical records. Independent sample T test and the Chi-square test or Fisher’s exact test were used to evaluate the association of interested variables. The CPH model was used for survival analysis in the COVID-19 death patients. Significant level was set as 0.05 in all analyses. Results The results showed that the mortality rate was about (17.4%). So that, 62(17%) patients had died due to COVID-19, and 298 (83.6%) patients had recovered and discharged. Clinical parameters and comorbidities such as oxygen saturation, lymphocyte and platelet counts, hemoglobin levels, C-reactive protein, and liver and kidney function, were statistically significant between both studied groups. The results of the CPH model showed that comorbidities, hypertension, lymphocyte counts, platelet count, and C-reactive protein level, may increase the risk of death due to the COVID-19 as risk factors in inpatients cases. Conclusions Patients with, lower lymphocyte counts in hemogram, platelet count and serum albumin, and high C-reactive protein level, and also patients with comorbidities may have more risk for death. So, it should be given more attention to risk management in the progression of COVID-19 disease.

scholarly journals Risk factors for mortality in critically ill patients with COVID-19: a multicenter retrospective case-control study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jinghua Gao ◽  
Li Zhong ◽  
Ming Wu ◽  
Jingjing Ji ◽  
Zheying Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Organ Failure ◽  
Critically Ill ◽  
Sofa Score ◽  
Lymphocyte Count ◽  
Cox Regression ◽  
Survival Curve ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Hospital Death

Abstract Background Coronavirus disease 2019 (COVID-19) has spread around the world, until now, the number of positive and death cases is still increasing. Therefore, it remains important to identify risk factors for death in critically patients. Methods We collected demographic and clinical data on all severe inpatients with COVID-19. We used univariable and multivariable Cox regression methods to determine the independent risk factors related to likelihood of 28-day and 60-day survival, performing survival curve analysis. Results Of 325 patients enrolled in the study, Multi-factor Cox analysis showed increasing odds of in-hospital death associated with basic illness (hazard ratio [HR] 6.455, 95% Confidence Interval [CI] 1.658–25.139, P = 0.007), lymphopenia (HR 0.373, 95% CI 0.148–0.944, P = 0.037), higher Sequential Organ Failure Assessment (SOFA) score on admission (HR 1.171, 95% CI 1.013–1.354, P = 0.033) and being critically ill (HR 0.191, 95% CI 0.053–0.687, P = 0.011). Increasing 28-day and 60-day mortality, declining survival time and more serious inflammation and organ failure were associated with lymphocyte count < 0.8 × 109/L, SOFA score > 3, Acute Physiology and Chronic Health Evaluation II (APACHE II) score > 7, PaO2/FiO2 < 200 mmHg, IL-6 > 120 pg/ml, and CRP > 52 mg/L. Conclusions Being critically ill and lymphocyte count, SOFA score, APACHE II score, PaO2/FiO2, IL-6, and CRP on admission were associated with poor prognosis in COVID-19 patients.

scholarly journals Epidemiological characteristics, clinical characteristics, and prognostic factors of children with atopy hospitalised with adenovirus pneumonia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Miao Li ◽  
Xiao-Hua Han ◽  
Li-Yun Liu ◽  
Hui-Sheng Yao ◽  
Li-Li Yi
Keyword(s):  
Risk Factors ◽  
Disease Severity ◽  
Clinical Characteristics ◽  
Severe Infection ◽  
Small Airway ◽  
Personal History ◽  
Factors Associated ◽  
History Of ◽  
Radiological Changes ◽  
Epidemiological Characteristics

Abstract Background Atopy may be associated with disease severity and a poor prognosis of human adenovirus (HAdV) pneumonia in children. Our aim was to observe the clinical characteristics and pulmonary radiological changes in children with atopy and HAdV pneumonia in China. Methods Children hospitalised with HAdV pneumonia from June 2018 to December 2019 were analysed. All children were divided into atopic with HAdV, non-atopic with HAdV, and atopic without HAdV infection group. Each group was further divided into the mild and severe pneumonia groups according to disease severity. Standard treatment was initiated after admission, and regular follow-up evaluations were conducted at 1 month after discharge. Baseline and clinical characteristics and pulmonary radiological changes in children with and without atopy were evaluated. Risk factors associated with small airway lesions in patients with HAdV pneumonia were analysed. Results The eosinophil count in the atopic group was significantly higher than that in the non-atopic group (P < 0.05). Severe coughing, wheezing, and small airway lesions on chest high-resolution computed tomography (HRCT) upon admission, after discharge and 1 month after discharge were significantly higher in the atopic group (with or without HAdV infection) than in the non-atopic group (P < 0.05). There were significant differences in the number of patients with wheezing and small airway lesions during hospitalisation and after discharge among the three groups (P < 0.05). The risks of small airway lesions in children with a family or personal history of asthma, severe infection, atopy, and HAdV infection were 2.1-, 2.7-, 1.9-, 2.1-, and 1.4-times higher than those in children without these characteristics, respectively. Conclusions Children with atopy and HAdV pneumonia may experience severe coughing in mild cases and wheezing in mild and severe cases. Children with atopy are more susceptible to the development of small airway lesions, recurrent wheezing after discharge and slower recovery of small airway lesions as observed on pulmonary imaging than non-atopic children after HAdV infection. A family or personal history of asthma, atopy, severe infection, and HAdV infection are independent risk factors associated with the development of small airway lesion as observed on chest HRCT.

scholarly journals Interventions for the prevention of risk factors and incidence of type 2 diabetes in the work environment: a systematic review

2019 ◽  
Vol 53 ◽  
pp. 101 ◽  
Author(s):  
Jorge Inolopú ◽  
Nélida Hilario-Huapaya ◽  
Martín Alonso Tantaleán-Del-Águila ◽  
Yamilee Hurtado-Roca ◽  
Cesar Ugarte-GilI
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Body Weight ◽  
Web Of Science ◽  
Research Question ◽  
Work Environments ◽  
Metabolic Parameter ◽  
Quasi Experimental

OBJECTIVE: To evaluate the effectiveness of interventions aimed at the prevention of risk factors and incidence of type 2 diabetes in the workers population. METHODS: Systematic review of interventions aimed at adult workers at risk of type 2 diabetes published in Medline, Embase, Web of Science, Central Cochrane Registry of Controlled Trials, and Lilacs. Randomized trials, quasi-experimental research and cohort studies were selected; in English, Spanish and Portuguese; published from 2000 to 2017. Intervention effectiveness was evaluated concerning the incidence of type 2 diabetes and a significant reduction in body weight, or another anthropometric or metabolic parameter. RESULTS: 3,024 articles were generated, of which 2,825 that did not answer the research question were eliminated, as well as 130 that did not evaluate original interventions, 57 carried out outside the workplace and two reviews; so that 10 selected items remained. Interventions based on structured programs previously evaluated and integrated into the workplace had a favorable impact on the reduction of body weight and other risk factors. CONCLUSIONS: The effectiveness of lifestyle interventions for the prevention of type 2 diabetes should be based on structured programs with proven effectiveness and adapted to the workplace, with employer participation in the provision of schedules and work environments.

scholarly journals Environmental Contaminants Exposure and Preterm Birth: A Systematic Review

Toxics ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 11 ◽  
Author(s):  
Maria Porpora ◽  
Ilaria Piacenti ◽  
Sara Scaramuzzino ◽  
Luisa Masciullo ◽  
Francesco Rech ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Systematic Review ◽  
Preterm Birth ◽  
Neonatal Period ◽  
Environmental Contaminants ◽  
Health Impact ◽  
Environmental Toxicants ◽  
Significant Public Health ◽  
Clinical Measures

Preterm birth is an obstetric condition associated with a high risk of infant mortality and morbidities in both the neonatal period and later in life, which has also a significant public health impact because it carries an important societal economic burden. As in many cases the etiology is unknown, it is important to identify environmental factors that may be involved in the occurrence of this condition. In this review, we report all the studies published in PubMed and Scopus databases from January 1992 to January 2019, accessible as full-text articles, written in English, including clinical studies, original studies, and reviews. We excluded articles not written in English, duplicates, considering inappropriate populations and/or exposures or irrelevant outcomes and patients with known risk factors for preterm birth (PTB). The aim of this article is to identify and summarize the studies that examine environmental toxicants exposure associated with preterm birth. This knowledge will strengthen the possibility to develop strategies to reduce the exposure to these toxicants and apply clinical measures for preterm birth prevention.

scholarly journals Clinical characteristics and risk factors of Fulminant Mycoplasma pneumoniae pneumonia in children

2020 ◽  
Author(s):  
yaoyao ling ◽  
Tongqiang Zhang ◽  
Zhenli Zhu ◽  
Jiao Tian ◽  
yongsheng xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pleural Effusion ◽  
Mycoplasma Pneumoniae ◽  
Clinical Characteristics ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Multivariate Logistic Regression Analysis ◽  
Radiological Findings ◽  
Mycoplasma Pneumoniae Pneumonia ◽  
D Dimer

Abstract BACKGROUND: Analyze the clinical characteristics of Fulminant Mycoplasma pneumoniae pneumonia (FMPP), and explore the related factors predicting FMPP. METHODS: A retrospective case-control study was performed on 345 children with Mycoplasma pneumoniae pneumonia (MPP) hospitalized in our Hospital from January 2017 to June 2019. The clinical features, laboratory data and radiological findings were compared between the FMPP group, refractory Mycoplasma pneumoniae pneumonia (RMPP)group and general Mycoplasma pneumoniae pneumonia (GMPP) group. RESULTS: FMPP patients (n=69) had more severe presentations, higher incidence of extra-pulmonary complications and more serious radiological findings(P<0.05). And the days of fever and the days in hospital were longer, and FMPP patients also need more complicated treatments(P<0.05). Meanwhile, the levels of white blood cell count(WBC) ,C-reactive protein(CRP), lactic dehydrogenase (LDH), interleukin (IL)-6,ferritin, D-dimer, fibrinogen(FG),alanine aminotransferase(ALT) and the percentage of neutrophils in the FMPP group were significantly higher than those in the RMPP group and the GMPP group (both P<0.05). In ROC curve analysis, the percentage of neutrophils, WBC, CRP, LDH, IL-6, ferritin, D-dimer and ALT were contributed to identify FMPP patients. Multivariate logistic regression analysis showed that ferritin>174.15 ng/mL, IL-6>25.475pg/ml and pleural effusion had significant predictive effects on the early diagnosis of FMPP (P<0.01). Conclusion: FMPP patients presented more serious clinical manifestations. Ferritin>174.15 ng/mL, IL-6>25.475pg/ml and pleural effusion were high risk factors for FMPP.

scholarly journals Predictive Risk Factors at Admission and a "Burning Point" During Hospitalization Serve as Sequential Alerts for Critical Illness in COVID-19 Patients

2020 ◽  
Author(s):  
Mei Zhou ◽  
Juanjuan Xu ◽  
Kai Wang ◽  
Zhengrong Yin ◽  
Xingjie Hao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Critical Illness ◽  
Sofa Score ◽  
Turning Point ◽  
Prediction Models ◽  
Continuous Change ◽  
Predictive Tool ◽  
Illness Onset ◽  
Critical Patients ◽  
D Dimer

Abstract Background In critically ill COVID-19 patients, the crucial turning point before critical illness onset (CIO) remain largely unknown, and the combination of baseline risk factors with the turning point during hospitalization was rarely reported.Methods In this retrospective cohort study, 1150 consecutively admitted patients with confirmed COVID-19 were enrolled, including 296 critical and 854 non-critical patients. We compared the differences of all the clinically tested indicators and their dynamic changes between critical and non-critical patients. Three prediction models were established and validated based on the risk factors at admission, and an online baseline predictive tool was developed. Linear mixed model (LMM) was applied for longitudinal data analysis in 296 critical patients throughout the hospitalization, to predict the likelihood and possible time of critical illness in COVID-19 patients. A crucial turning point, where several indicators will experience a greater and significantly continuous change before CIO, was defined as “burning point” in our study. This point indicates the deterioration of patient’s condition before CIO.Results We established a novel two-checkpoint system to predict critical illness for COVID-19 patients in which the first checkpoint happened at patient admission was assessed by a baseline prediction model to project the likelihood of critical illness based on the variables selected from random forest and LASSO regression analysis, including age, SOFA score, neutrophil-to-lymphocyte ratio (NLR), D-dimer, lactate dehydrogenase (LDH), International Normalized Ratio (INR), and pneumonia area derived from CT images, which yields an AUC of 0.960 (95% confidence interval, 0.941-0.972) and 0.958 (0.936-0.980) in the training and testing sets, respectively. This model has been translated into a public web-based risk calculator. Furthermore, the second checkpoint (designated as “burning point” in our study) could be identified as early as 5 days preceding the CIO, and 12 (IQR, 7-17) days after illness onset. Seven most significant and representative “burning point” indicators were SOFA score, NLR, C-reactive protein (CRP), glucose, D-dimer, LDH, and blood urea nitrogen (BUN).Conclusions With this two-checkpoint prediction system, the deterioration of COVID-19 patients could be early identified and more intensive treatments could be started in advance to reduce the incidence of critical illness.

scholarly journals Sex Differences in Hemostatic Factors in Patients With Ischemic Stroke and the Relation With Migraine—A Systematic Review

2021 ◽  
Vol 15 ◽  
Author(s):  
Nelleke van der Weerd ◽  
Hine J. A. van Os ◽  
Mariam Ali ◽  
Jan W. Schoones ◽  
Arn M. J. M. van den Maagdenberg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Sex Differences ◽  
Ischemic Stroke ◽  
Protein S ◽  
Related Factors ◽  
Stroke Subtypes ◽  
Hemostatic Factors ◽  
Pai 1 ◽  
D Dimer

Background: Women are more affected by stroke than men. This might, in part, be explained by sex differences in stroke pathophysiology. The hemostasis system is influenced by sex hormones and associated with female risk factors for stroke, such as migraine.Aim: To systematically review possible sex differences in hemostatic related factors in patients with ischemic stroke in general, and the influence of migraine on these factors in women with ischemic stroke.Results: We included 24 studies with data on sex differences of hemostatic factors in 7247 patients with ischemic stroke (mean age 57–72 years, 27–57% women) and 25 hemostatic related factors. Levels of several factors were higher in women compared with men; FVII:C (116% ± 30% vs. 104% ± 30%), FXI (0.14 UI/mL higher in women), PAI-1 (125.35 ± 49.37 vs. 96.67 ± 38.90 ng/mL), D-dimer (1.25 ± 0.31 vs. 0.95 ± 0.24 μg/mL), and aPS (18.7% vs. 12.0% positive). In contrast, protein-S (86.2% ± 23.0% vs. 104.7% ± 19.8% antigen) and P-selectin (48.9 ± 14.4 vs. 79.1 ± 66.7 pg/mL) were higher in men. Most factors were investigated in single studies, at different time points after stroke, and in different stroke subtypes. Only one small study reported data on migraine and hemostatic factors in women with ischemic stroke. No differences in fibrinogen, D-dimer, t-PA, and PAI-1 levels were found between women with and without migraine.Conclusion: Our systematic review suggests that sex differences exist in the activation of the hemostatic system in ischemic stroke. Women seem to lean more toward increased levels of procoagulant factors whereas men exhibit increased levels of coagulation inhibitors. To obtain better insight in sex-related differences in hemostatic factors, additional studies are needed to confirm these findings with special attention for different stroke phases, stroke subtypes, and not in the least women specific risk factors, such as migraine.

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