bims-covirf 2021-04-11 papers

Issue of 2021–04–11
two papers selected by
Catherine Rycroft, BresMed

J Prim Care Community Health. 2021 Jan-Dec;12:12 21501327211008050

Analysis of Risk Factors in COVID-19 Adult Mortality in Russia.

Youri Kirillov, Sergei Timofeev, Ashot Avdalyan, Vladimir N Nikolenko, Leonid Gridin, Mikhail Y Sinelnikov.

BACKGROUND AND OBJECTIVE: Epidemiological data obtained during the ongoing SARS-CoV-2 pandemic suggests that COVID-19 mortality has specific age and gender associations. However, limited epidemiological studies explored specific populational risk factors, including comorbidities, and patient clinical characteristics. The main aim of our retrospective cohort study was to analyze associations between age, gender, and comorbidities in deceased COVID-19 patients.
MATERIALS AND METHODS: A retrospective cohort analysis was performed to assess significant risk factors in adult patients deceased from COVID-19 infection by evaluating Electronic Medical Records and post-mortem analysis in COVID-19 patients deceased between April 2020 to October 2020. All patients underwent post-mortem evaluation along with medical history analysis, including data on disease duration, hospitalization, and clinical peculiarities.
RESULTS: Medical records of 1487 COVID-19 patients revealed that the prevalence of males was higher (by 23%) than females; the median age for males was 71 years of age whereas for females it was 78. The most prevalent comorbid pathologies were: hypertension, obesity, diabetes, and cancer. Males are at significantly increased risk of lethal outcome, even in younger age groups, with comorbid conditions.
CONCLUSION: The study concluded that comorbidities, such as hypertension, obesity, diabetes, cancer are the most important risk factors for comorbid mortality in COVID-19 patients. In addition to lung damage, multiple organ dysfunctions may be a crucial reason for COVID-19 induced death. Special precautions, such as early hospitalization, increased monitoring, and preventative tactics should be taken for at-risk patients.

Keywords: COVID-19; SARS-COV-2; comorbidity; mortality rates

DOI: https://doi.org/10.1177/21501327211008050

Mediators Inflamm. 2021 ;2021 8812304

Hyperglycemia and Correlated High Levels of Inflammation Have a Positive Relationship with the Severity of Coronavirus Disease 2019.

Wen Zhang, Chuanwei Li, Yu Xu, Binfeng He, Mingdong Hu, Guoqiang Cao, Li Li, Shuang Wu, Xia Wang, Chun Zhang, Jianping Zhao, Jungang Xie, Zihui Xu, Qi Li, Guansong Wang.

Objective: Coronavirus disease 2019 (COVID-19) is a considerable global public health threat. This study sought to investigate whether blood glucose (BG) levels or comorbid diabetes are associated with inflammatory status and disease severity in patients with COVID-19.
Methods: In this retrospective cohort study, the clinical and biochemical characteristics of COVID-19 patients with or without diabetes were compared. The relationship among severity of COVID-19, inflammatory status, and diabetes or hyperglycemia was analyzed. The severity of COVID-19 in all patients was determined according to the diagnostic and treatment guidelines issued by the Chinese National Health Committee (7th edition).
Results: Four hundred and sixty-one patients were enrolled in our study, and 71.58% of patients with diabetes and 13.03% of patients without diabetes had hyperglycemia. Compared with patients without diabetes (n = 366), patients with diabetes (n = 95) had a higher leucocyte count, neutrophil count, neutrophil to lymphocyte ratio (NLR), and erythrocyte sedimentation rate (ESR). There was no association between severity of COVID-19 and known diabetes adjusted for age, sex, body mass index (BMI), known hypertension, and coronary heart disease. The leucocyte count, NLR, and C-reactive protein (CRP) level increased with increasing BG level. Hyperglycemia was an independent predictor of critical (OR 4.00, 95% CI 1.72-9.30) or severe (OR 3.55, 95% CI 1.47-8.58) COVID-19, and of increased inflammatory levels (high leucocyte count (OR 4.26, 95% CI 1.65-10.97), NLR (OR 2.76, 95% CI 1.24-6.10), and CRP level (OR 2.49, 95% CI 1.19-5.23)), after adjustment for age, sex, BMI, severity of illness, and known diabetes.
Conclusion: Hyperglycemia was positively correlated with higher inflammation levels and more severe illness, and it is a risk factor for the increased severity of COVID-19. The initial measurement of plasma glucose levels after hospitalization may help identify a subset of patients who are predisposed to a worse clinical course.

DOI: https://doi.org/10.1155/2021/8812304