Critical complications of COVID-19: A descriptive meta-analysis study

Vakili, Kimia; Fathi, Mobina; Pezeshgi, Aiyoub; Ashraf, Muhammad; Hajiesmaeili, Mohammadreza; Rezaei‐Tavirani, Mostafa; Sayehmiri, Fatemeh

doi:10.31083/j.rcm.2020.03.129

Cited by 46 publications

(37 citation statements)

References 74 publications

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“…The most common complications in our study group were pneumonia and respiratory failure as this infection most commonly damages the walls and lining of air sacs of the lungs. 24,25 Thirty percent of the patients developed ARDS. AKI is also quite commonly seen in these patients.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Laboratory Characteristics of COVID-19 Infection in Patients Presenting to A Tertiary Care Hospital

Batool

Karamat²,

Waheed

et al. 2021

BioMedica

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Background and Objective: COVID-19 disease is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) having a wide variety of clinical features ranging from asymptomatic carriers to respiratory failure requiring mechanical ventilation. The objective of the study was to analyze the spectrum of different symptoms, laboratory findings and complications in patients who were admitted in either COVID ward or intensive care unit (ICU) of a local hospital. Methods: A retrospective cohort study of the medical records of 100 COVID-19 disease patients with PCR detected SARS-CoV-2 infection were collected. Participant information was retrospectively obtained from the hospital medical records which included clinical records and laboratory findings. All statistical analyses were done using Statistical Package for the Social Sciences (SPSS) version 21. Results: The mean age of the patients was 50.8 ±5.86 with male predominance (79%). Most frequent co-morbidities were diabetes mellitus (42%) and hypertension (36%). Most frequent symptoms were fever (95.9%) and fatigue (95.9%) followed by dry cough (86.5%), myalgia (85.1) and shortness of breath (70%). Amongst the patients admitted, leukocyte count was 10.95 x 103, C-reactive protein (CRP) was 12.8mg/dl, ferritin was 730.8ng/ml and Lactate Dehydrogenase (LDH) was found to be 1254.7 U/l. Hepatic and renal functions were borderline deranged. Conclusion: COVID-19 disease has a wide spectrum of clinical symptoms. Patients with raised inflammatory markers have severe disease and are more likely in need of an ICU care. By carefully observing these markers may help in better management of COVID-19 disease.

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Section: Discussionmentioning

confidence: 99%

Clinical and Laboratory Characteristics of COVID-19 Infection in Patients Presenting to A Tertiary Care Hospital

Batool

Karamat²,

Waheed

et al. 2021

BioMedica

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“…Apart from these diseases, general symptoms of COVID-19 such as, blood related abnormalities (Rank-3), fever / severe fever with thrombocytopenia syndrome (Rank-19) [5], pain (Rank-20) [18], lung/ pulmonary function (Rank-22) [96, 97], fatigue (Rank-24) [6], sleep disorder (Rank-24) [98], pneumonia [86], conjunctivitis (Rank-24) [99], skin diseases etc. are also enriched under top 25 child categories with occurrence cut off value of 4.…”

Section: Resultsmentioning

confidence: 99%

“…Recent systematic reviews and meta-analysis based studies show that the most common short-term clinical symptoms in COVID-19 include fever (81.2%-84.30%), cough (58.5%-63.01%), fatigue (34.22% - 38.5%), dyspnea (26.1% −37.16%), Sputum (25.8%), diarrhea (11.47%) [5, 6], myalgia (7.7%), nasal congestion (17%), abdominal pain (2.4%), and emotional disturbances (15.9%) [7]. However, in critical cases, the most common complications are acute respiratory distress syndrome (ARDS) (33.15%), arrhythmia (16.64%), acute cardiac injury (15.68%), heart failure (11.50%), and acute kidney injury (AKI) (9.87%) [6]. Mortality and severity of COVID-19 is associated with various factors including gender (male, OR:1.60), behaviour (current smoker, OR:2.06), and existing several comorbid conditions [8].…”

Section: Introductionmentioning

confidence: 99%

A novel multi-omics-based identification of symptoms, comorbid conditions, and possible long-term complications in COVID-19

Barh

Tiwari

Andrade

et al. 2020

Preprint

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Till date the comprehensive clinical pictures, comorbid conditions, and long-term complications of COVID-19 are not known. Recently using a multi-omics-based strategy, we have predicted the drugs for COVID-19 management with ∼70% accuracy. Here, using a similar multi-omics-based bioinformatics approach and three-ways of analysis, we identified the symptoms, comorbid conditions, and short, mid and possible long-term complications of COVID-19 with ∼90% precision. In our analysis (i) we identified 27 parent, 170 child, and 403 specific conditions associated with COVID-19. (ii) Among the specific conditions, 36 are viral and 53 short-term, 62 short to mid to long-term, 194 mid to long-term, and 57 are congenital conditions. (iii) At a cut off “count of occurrence” of 4, we found ∼ 90% of the enriched conditions are associated with COVID-19. (iv) Except the dry cough and loss of taste, all other COVID-19 associated mild and severe symptoms are enriched. (v) Cardiovascular, pulmonary, metabolic, musculoskeletal, neuropsychiatric, kidney, liver, and immune system disorders are found as top comorbid conditions. (vi) Specific diseases such as myocardial infarction, hypertension, COPD, lung injury, diabetes, cirrhosis, mood disorders, dementia, macular degeneration, chronic kidney disease, lupus, arthritis etc. along with several other diseases are also enriched as top candidates. (vii) Interestingly, many cancers and congenital disorders associated with COVID-19 severity are also identified. (viii) Arthritis, dermatomyositis, glioma, diabetes, psychiatric disorder, cardiovascular diseases having bidirectional relationship with COVID-19 are also found as top ranked conditions. Based on the accuracy (∼90%) of this analysis, long presence of SARS-CoV-2 RNA in human, and our previously proposed “genetic remittance” assumption, we hypothesize that all the identified comorbid conditions including the short-long-mid and mid-long non-communicable diseases (NCDs) could also be long-term consequences in COVID-19 survivors and warrants long-term observational studies.

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“…The clinical setting of COVID-19 infection could be diverse, affecting multiple organs and provoking various symptoms and signs, making it more difficult to enable an appropriate risk stratification of these patients [ 18 ]. Also, the clinical course of the disease in terms of different pathophysiological mechanisms and complications, including acute respiratory distress syndrome, superinfection, shock, acute heart, liver, and kidney injury, is unpredictable and is leaving a limited timespan to bring the right treatment decision in a real clinical scenario [ 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of a Multivariable Predictive Model for Mortality of COVID‐19 Patients Demanding High Oxygen Flow at Admission to ICU: AIDA Score

Zdravković

Popadić

Klašnja

et al. 2021

Oxidative Medicine and Cellular Longevity

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Introduction. Risk stratification is an important aspect of COVID-19 management, especially in patients admitted to ICU as it can provide more useful consumption of health resources, as well as prioritize critical care services in situations of overwhelming number of patients. Materials and Methods. A multivariable predictive model for mortality was developed using data solely from a derivation cohort of 160 COVID-19 patients with moderate to severe ARDS admitted to ICU. The regression coefficients from the final multivariate model of the derivation study were used to assign points for the risk model, consisted of all significant variables from the multivariate analysis and age as a known risk factor for COVID-19 patient mortality. The newly developed AIDA score was arrived at by assigning 5 points for serum albumin and 1 point for IL-6, D dimer, and age. The score was further validated on a cohort of 304 patients admitted to ICU due to the severe form of COVID-19. Results. The study population included 160 COVID-19 patients admitted to ICU in the derivation and 304 in the validation cohort. The mean patient age was 66.7 years (range, 20–93 years), with 68.1% men and 31.9% women. Most patients (76.8%) had comorbidities with hypertension (67.7%), diabetes (31.7), and coronary artery disease (19.3) as the most frequent. A total of 316 patients (68.3%) were treated with mechanical ventilation. Ninety-six (60.0%) in the derivation cohort and 221 (72.7%) patients in the validation cohort had a lethal outcome. The population was divided into the following risk categories for mortality based on the risk model score: low risk (score 0–1) and at-risk ( score > 1 ). In addition, patients were considered at high risk with a risk score > 2 . By applying the risk model to the validation cohort ( n = 304 ), the positive predictive value was 78.8% (95% CI 75.5% to 81.8%); the negative predictive value was 46.6% (95% CI 37.3% to 56.2%); the sensitivity was 82.4% (95% CI 76.7% to 87.1%), and the specificity was 41.0% (95% CI 30.3% to 52.3%). The C statistic was 0.863 (95% CI 0.805-0.921) and 0.665 (95% CI 0.598-0.732) in the derivation and validation cohorts, respectively, indicating a high discriminative value of the proposed score. Conclusion. In the present study, AIDA score showed a valuable significance in estimating the mortality risk in patients with the severe form of COVID-19 disease at admission to ICU. Further external validation on a larger group of patients is needed to provide more insights into the utility of this score in everyday practice.

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Critical complications of COVID-19: A descriptive meta-analysis study

Cited by 46 publications

References 74 publications

Clinical and Laboratory Characteristics of COVID-19 Infection in Patients Presenting to A Tertiary Care Hospital

Clinical and Laboratory Characteristics of COVID-19 Infection in Patients Presenting to A Tertiary Care Hospital

A novel multi-omics-based identification of symptoms, comorbid conditions, and possible long-term complications in COVID-19

Development and Validation of a Multivariable Predictive Model for Mortality of COVID‐19 Patients Demanding High Oxygen Flow at Admission to ICU: AIDA Score

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