Preexisting Comorbidities Predicting Severe Covid-19 in Older Adults in the UK Biobank Community Cohort

Atkins, Janice L.; Masoli, Jane; Delgado, João; Pilling, Luke C.; Kuo, Chia‐Ling; Kuchel, George A.; Melzer, David

doi:10.1101/2020.05.06.20092700

Cited by 58 publications

(44 citation statements)

References 21 publications

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“…Data from the UK Biobank [37], in a prospective case-control study, showed an asthma prevalence of 17.9% in 605 COVID-19 hospitalized patients, most of them adults (the asthma prevalence was of 13.5% in the control population) but the disease was not identified as an independent risk factor for COVID-19 hospitalization/severity, in contrast with hypertension and COPD. In the oldest population (age ≥65 years) included in the UK Biobank [38], the same tendency of asthma prevalence was found between hospitalized COVID-19 patients versus controls (18.2 vs. 13.0%), but again asthma was not identified as an independent risk factor for severity.…”

Section: Methodsmentioning

confidence: 85%

Asthma and the Coronavirus Disease 2019 Pandemic: A Literature Review

Morais‐Almeida

Pité

Aguiar

et al. 2020

Int Arch Allergy Immunol

106

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Even though respiratory viruses are one of the most common triggers for asthma exacerbations, not all of these viruses affect patients equally. There is no strong evidence supporting that patients with asthma have a higher risk of becoming seriously ill from coronavirus disease 2019 (CO-VID-19), although recent reports from the USA and the UK suggest that asthma is much more common in children and adults with mild to severe COVID-19 than has previously been reported in Asia and in Europe. As in previous severe acute respiratory syndrome (SARS) outbreaks, patients with asthma, especially children, appear to be less susceptible to the coronavirus with a low rate of asthma exacerbations. A different expression of viral receptors and T2 inflammation can be responsible for different outcomes. Future studies focused on asthma and on other allergic disorders are needed to provide a greater understanding of the impact of underlying asthma and allergic inflammation on COVID-19 susceptibility and disease severity. However, for the moment, it is crucial that asthmatic patients maintain their controller medication, from inhaled corticosteroids to biologics, without making any dose adjustments on their own or stopping the medication. New data are emerging daily, rapidly updating our understanding of this novel coronavirus.

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Section: Methodsmentioning

confidence: 85%

Asthma and the Coronavirus Disease 2019 Pandemic: A Literature Review

Morais‐Almeida

Pité

Aguiar

et al. 2020

Int Arch Allergy Immunol

106

View full text Add to dashboard Cite

show abstract

“…To deploy this approach, clinical registries and linked biobanks are a helpful source of information on COVID-19 phenotype variability. The UK Biobank (UKB) has already provided pieces of evidence on COVID-19 [91], and one study matched the inclusion criteria of the present review. By interrogating the UKB, Kuo and coworkers found that ApoE ε4 homozygous individuals are more likely to be COVID-19 test positives compared with ε3 homozygotes, independently from dementia [57].…”

Section: Methodological Issuesmentioning

confidence: 99%

Genetic variants of the human host influencing the coronavirus-associated phenotypes (SARS, MERS and COVID-19): rapid systematic review and field synopsis

et al. 2020

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The COVID-19 pandemic has strengthened the interest in the biological mechanisms underlying the complex interplay between infectious agents and the human host. The spectrum of phenotypes associated with the SARS-CoV-2 infection, ranging from the absence of symptoms to severe systemic complications, raised the question as to what extent the variable response to coronaviruses (CoVs) is influenced by the variability of the hosts’ genetic background. To explore the current knowledge about this question, we designed a systematic review encompassing the scientific literature published from Jan. 2003 to June 2020, to include studies on the contemporary outbreaks caused by SARS-CoV-1, MERS-CoV and SARS-CoV-2 (namely SARS, MERS and COVID-19 diseases). Studies were eligible if human genetic variants were tested as predictors of clinical phenotypes. An ad hoc protocol for the rapid review process was designed according to the PRISMA paradigm and registered at the PROSPERO database (ID: CRD42020180860). The systematic workflow provided 32 articles eligible for data abstraction (28 on SARS, 1 on MERS, 3 on COVID-19) reporting data on 26 discovery cohorts. Most studies considered the definite clinical diagnosis as the primary outcome, variably coupled with other outcomes (severity was the most frequently analysed). Ten studies analysed HLA haplotypes (1 in patients with COVID-19) and did not provide consistent signals of association with disease-associated phenotypes. Out of 22 eligible articles that investigated candidate genes (2 as associated with COVID-19), the top-ranked genes in the number of studies were ACE2, CLEC4M (L-SIGN), MBL, MxA (n = 3), ACE, CD209, FCER2, OAS-1, TLR4, TNF-α (n = 2). Only variants in MBL and MxA were found as possibly implicated in CoV-associated phenotypes in at least two studies. The number of studies for each predictor was insufficient to conduct meta-analyses. Studies collecting large cohorts from different ancestries are needed to further elucidate the role of host genetic variants in determining the response to CoVs infection. Rigorous design and robust statistical methods are warranted.

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“…In older individuals, comorbidities, such as hypertension, diabetes, obesity, and heart disease, are more likely to promote a cytokine storm resulting in life-threatening respiratory failure and multi-organ damage. 38 42 43 44 Also, respiratory distress is common among most late-stage Alzheimer's disease (AD) patients. 45 Bauer claims that individuals with dementia are more likely to have cardiovascular disease, diabetes, and pneumonia compared to individuals of the same age without dementia.…”

Section: Impact Of Covid-19 On Patients With Cognitive Impairmentmentioning

confidence: 99%

Coping with Dementia in the Middle of the COVID-19 Pandemic

et al. 2020

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Multiple neurological complications have been associated with the coronavirus disease-19 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2. This is a narrative review to gather information on all aspects of COVID-19 in elderly patients with cognitive impairment. First, the following three mechanisms have been proposed to underlie the neurological complications associated with COVID-19: 1) direct invasion, 2) immune and inflammatory reaction, and 3) hypoxic brain damage by COVID-19. Next, because the elderly dementia patient population is particularly vulnerable to COVID-19, we discussed risk factors and difficulties associated with cognitive disorders in this vulnerable population. We also reviewed the effects of the patient living environment in COVID-19 cases that required intensive care unit (ICU) care. Furthermore, we analyzed the impact of stringent social restrictions and COVID-19 pandemic-mediated policies on dementia patients and care providers. Finally, we provided the following strategies for working with elderly dementia patients: general preventive methods; dementia care at home and nursing facilities according to the activities of daily living and dementia characteristics; ICU care after COVID-19 infection; and public health care system and government response. We propose that longitudinal follow-up studies are needed to fully examine COVID-19 associated neurological complications, such as dementia, and the efficacy of telemedicine/telehealth care programs.

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Preexisting Comorbidities Predicting Severe Covid-19 in Older Adults in the UK Biobank Community Cohort

Cited by 58 publications

References 21 publications

Asthma and the Coronavirus Disease 2019 Pandemic: A Literature Review

Asthma and the Coronavirus Disease 2019 Pandemic: A Literature Review

Genetic variants of the human host influencing the coronavirus-associated phenotypes (SARS, MERS and COVID-19): rapid systematic review and field synopsis

Coping with Dementia in the Middle of the COVID-19 Pandemic

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