The clinical course, biochemical markers, and clinical outcomes of COVID-19 positive patients from the third wave in Pakistan: A retrospective cohort study

Alam, Muhammad Tanveer; Mehdi, Asad; Timsaal, Yumna; Rehan, Muhammad; Kumar, Amod; Shaikh, Imran Sarwar; Yasmin, Farah; Memon, Gul Muhammad; Ahmed, Nisar; Asghar, Muhammad Sohaib

doi:10.1016/j.amsu.2022.103599

Cited by 4 publications

(5 citation statements)

References 31 publications

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“…After that, 300 articles were evaluated for full-text eligibility, and 197 articles with available data but not Asian were excluded. Ultimately, 103 studies conducted in Asia were enrolled in this meta-analysis [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 ,…”

Section: Resultsmentioning

confidence: 99%

Comorbid Asthma Increased the Risk for COVID-19 Mortality in Asia: A Meta-Analysis

et al. 2022

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We aimed to explore the influence of comorbid asthma on the risk for mortality among patients with coronavirus disease 2019 (COVID-19) in Asia by using a meta-analysis. Electronic databases were systematically searched for eligible studies. The pooled odds ratio (OR) with 95% confidence interval (CI) was estimated by using a random-effect model. An inconsistency index (I2) was utilized to assess the statistical heterogeneity. A total of 103 eligible studies with 198,078 COVID-19 patients were enrolled in the meta-analysis; our results demonstrated that comorbid asthma was significantly related to an increased risk for COVID-19 mortality in Asia (pooled OR = 1.42, 95% CI: 1.20–1.68; I2 = 70%, p < 0.01). Subgroup analyses by the proportion of males, setting, and sample sizes generated consistent findings. Meta-regression indicated that male proportion might be the possible sources of heterogeneity. A sensitivity analysis exhibited the reliability and stability of the overall results. Both Begg’s analysis (p = 0.835) and Egger’s analysis (p = 0.847) revealed that publication bias might not exist. In conclusion, COVID-19 patients with comorbid asthma might bear a higher risk for mortality in Asia, at least among non-elderly individuals.

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Section: Resultsmentioning

confidence: 99%

Comorbid Asthma Increased the Risk for COVID-19 Mortality in Asia: A Meta-Analysis

et al. 2022

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“…A large body of literature is emerging on the effectiveness of continuous positive airway pressure (CPAP) and non-invasive ventilation (NIV) therapy interventions during both the first and second waves of the COVID-19 pandemic. While several studies report consistent and coherent positivity within the CPAP/NIV outcome results1–5 others found CPAP associated with higher mortality or not associated with improved survival 6 7. In comparison with conventional oxygen therapy, preliminary data from the Recovery-RS Randomised Clinical Trial (1273 patients from UK and Jersey),8 demonstrated the superiority of CPAP in managing COVID-19 over conventional oxygen therapy, by reducing the requirement of intubation or mortality within 30 days.…”

Section: Introductionmentioning

confidence: 95%

“…While several studies report consistent and coherent positivity within the CPAP/NIV outcome results 1–5 others found CPAP associated with higher mortality or not associated with improved survival. 6 7 In comparison with conventional oxygen therapy, preliminary data from the Recovery-RS Randomised Clinical Trial (1273 patients from UK and Jersey), 8 demonstrated the superiority of CPAP in managing COVID-19 over conventional oxygen therapy, by reducing the requirement of intubation or mortality within 30 days. However, this primary outcome was mostly driven by a reduction in the need of intubation instead of mortality, which large CIs preclude from a definite conclusion.…”

Section: Introductionmentioning

confidence: 99%

Comparison of COVID-19 survival in relation to CPAP length of treatment and by comorbidity and transmission setting (community or hospital acquired) in a medium-sized UK hospital in 2020: a retrospective study

et al. 2022

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ObjectiveTo estimate continuous positive airway pressure (CPAP) length of treatment effect on survival of hospitalised COVID-19 patients in a medium-sized UK Hospital, and how this effect changes according to the patient’s comorbidity and COVID-19 route of acquisition (community or nosocomial) during the two waves in 2020.SettingThe acute inpatient unit in Wrightington, Wigan and Leigh Teaching Hospitals National Health Service (NHS) Foundation Trust (WWL), a medium-sized NHS Trust in north-west of England.DesignRetrospective cohort of all confirmed COVID-19 patients admitted in WWL during 2020.Participants1830 patients (568 first wave, 1262 s wave) with antigen confirmed COVID-19 disease and severe acute respiratory syndrome admitted between 17 March 2020 (first confirmed COVID-19 case) and 31 December 2020.Outcome measureCOVID-19 survival rate in all patients and survival rate in potentially hospital-acquired COVID-19 (PHA) patients were modelled using a predictor set which include comorbidities (eg, obesity, diabetes, chronic ischaemic heart disease (IHD), chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD)), wave, age, sex and care home residency, and interventions (remdesivir, dexamethasone, CPAP, intensive care unit (ICU), intubation). Secondary outcome measure was CPAP length, which was modelled using the same predictors of the survival rate.ResultsMortality rate in the second wave was significantly lower than in the first wave (43.4% vs 28.1%, p<0.001), although for PHA COVID-19 patients mortality did not reduce, remaining at very high levels independently of wave and CPAP length. For all cohort, statistical modelling identified CPAP length (HR 95% CI 0.86 to 0.96) and women (HR 95% CI 0.71 to 0.81) were associated with improved survival, while being older age (HR 95% CI 1.02 to 1.03) admitted from care homes (HR 95% CI 2.22 to 2.39), IHD (HR 95% CI 1.13 to 1.24), CKD (HR 95% CI 1.14 to 1.25), obesity (HR 95% CI 1.18 to 1.28) and COPD-emphysema (HR 95% CI 1.18 to 1.57) were associated with reduced survival. Despite the detrimental effect of comorbidities, patients with CKD (95% CI 16% to 30% improvement in survival), IHD (95% CI 1% to 10% improvement in survival) and asthma (95% CI 8% to 30% improvement in survival) benefitted most from CPAP length, while no significant survival difference was found for obese and patients with diabetes.ConclusionsThe experience of an Acute Trust during the COVID-19 outbreak of 2020 is documented and indicates the importance of care home and hospitals in disease acquisition. Death rates fell between the first and second wave only for community-acquired COVID-19 patients. The fall was associated to CPAP length, especially for some comorbidities. While uncovering some risk and protective factors of mortality in COVID-19 studies, the study also unravels how little is known about PHA COVID-19 and the interaction between CPAP and some comorbidities.

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“…Consequently, vaccination rates remained low in the country, and in 2021, the country underwent the third and fourth waves of SARS-CoV-2, which were characterized by more transmissible SARS-CoV-2 variants such as Delta and Omicron. The Delta variant led to high hospitalization rates, severe illness, increased admission to intensive care units, and fatalities in the country [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Exploring the Clinical Features, Management of Hypertension, and Predictors of Severity in Hospitalized Hypertensive COVID-19 Patients

Kumar,

Syed Sulaiman,

Hashmi

et al. 2024

Cureus

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BackgroundHypertension significantly contributes to the severity, prolonged hospitalization, the need for intensive care, and mortality of COVID-19 patients. However, the data is still evolving. This study investigated the predictors of severity among hypertensive COVID-19 patients. MethodologyThis cohort study included 333 hospitalized hypertensive COVID-19 patients at the Indus Hospital, Karachi, Pakistan, from April 2021 to October 2021. The study evaluated the clinical features, antihypertensive therapy, and predictors of severity. A multivariable binary logistic regression model was used to determine severity predictors using IBM SPSS Statistics for Windows, Version 27.0 (Released 2020; IBM Corp., Armonk, NY, USA). ResultsThe majority of hypertensive COVID-19 patients were females (54.7%), aged <65 years (55.8%), and coexisted with diabetes mellitus (56.5%). The independent predictors of severity were male (aOR 2.65, 95%

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The clinical course, biochemical markers, and clinical outcomes of COVID-19 positive patients from the third wave in Pakistan: A retrospective cohort study

Cited by 4 publications

References 31 publications

Comorbid Asthma Increased the Risk for COVID-19 Mortality in Asia: A Meta-Analysis

Comorbid Asthma Increased the Risk for COVID-19 Mortality in Asia: A Meta-Analysis

Comparison of COVID-19 survival in relation to CPAP length of treatment and by comorbidity and transmission setting (community or hospital acquired) in a medium-sized UK hospital in 2020: a retrospective study

Exploring the Clinical Features, Management of Hypertension, and Predictors of Severity in Hospitalized Hypertensive COVID-19 Patients

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