Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive最新文献

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A review of adverse effects of COVID-19 vaccines. COVID-19疫苗不良反应综述
H. Mushtaq, Anwar Khedr, T. Koritala, B. Bartlett, Nitesh Kumar Jain, S. A. Khan
{"title":"A review of adverse effects of COVID-19 vaccines.","authors":"H. Mushtaq, Anwar Khedr, T. Koritala, B. Bartlett, Nitesh Kumar Jain, S. A. Khan","doi":"10.53854/liim-3001-1","DOIUrl":"https://doi.org/10.53854/liim-3001-1","url":null,"abstract":"The COVID-19 pandemic has led to unanticipated pressures on all aspects of human life. Multiple approaches to eliciting protective immunity must be rapidly evaluated. Numerous efforts have been made to develop an effective vaccine for this novel coronavirus, resulting in a race for vaccine development. To combat COVID-19, all nations must focus their efforts on widespread vaccination with an effective and safe vaccine. Globally, concerns about potential long-term adverse effects of vaccines have led to some apprehension about vaccine use. A vaccine's adverse effect has an integral role in the public's confidence and vaccine uptake. This article reviews the current primary literature regarding adverse effects associated with different COVID-19 vaccines in use worldwide.","PeriodicalId":17977,"journal":{"name":"Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78775550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 18
Awaiting a cure for COVID-19: therapeutic approach in patients with different severity levels of COVID-19. 等待COVID-19治愈:不同严重程度COVID-19患者的治疗方法
G. Alfano, Niccoló Morisi, M. Frisina, A. Ferrari, F. Fontana, R. Tonelli, E. Franceschini, Marianna Meschiari, G. Donati, G. Guaraldi
{"title":"Awaiting a cure for COVID-19: therapeutic approach in patients with different severity levels of COVID-19.","authors":"G. Alfano, Niccoló Morisi, M. Frisina, A. Ferrari, F. Fontana, R. Tonelli, E. Franceschini, Marianna Meschiari, G. Donati, G. Guaraldi","doi":"10.53854/liim-3001-2","DOIUrl":"https://doi.org/10.53854/liim-3001-2","url":null,"abstract":"COVID-19 is an unpredictable infectious disease caused by SARS-CoV-2. The development of effective anti-COVID-19 vaccines has enormously minimized the risk of severe illness in most immunocompetent patients. However, unvaccinated patients and non-responders to the COVID-19 vaccine are at risk of shortand long-term consequences. In these patients, the outcome of COVID-19 relies on an interplay of multiple factors including age, immunocompetence, comorbidities, inflammatory response triggered by the virus as well as the virulence of SARS-CoV-2 variants. Generally, COVID-19 is asymptomatic or mildly symptomatic in young people, but it may manifest with respiratory insufficiency requiring mechanical ventilation in certain susceptible groups of patients. Furthermore, severe SARS-CoV-2 infection induces multiorgan failure syndrome by affecting liver, kidney heart and nervous system. Since December 2019, multiple drugs have been tested to treat COVID-19, but only a few have been proven effective to mitigate the course of the disease that continues to cause death and comorbidity worldwide. Current treatment of COVID-19 patients is essentially based on the administration of supportive oxygen therapy and the use of specific drugs such as steroids, anticoagulants, antivirals, anti-SARS-CoV-2 antibodies and immunomodulators. However, the rapid spread of new variants and the release of new data coming from the numerous ongoing clinical trials have created the conditions for maintaining a continuous updating of the therapeutic management of COVID-19 patients. Furthermore, we believe that a well-established therapeutic strategy along with the continuum of medical care for all patients with COVID-19 is pivotal to improving disease outcomes and restoring healthcare care fragmentation caused by the pandemic. This narrative review, focusing on the therapeutic management of COVID-19 patients, aimed to provide an overview of current therapies for (i) asymptomatic or mildly/moderate symptomatic patients, (ii) hospitalized patients requiring low-flow oxygen, (iii) high-flow oxygen and (iv) mechanical ventilation.","PeriodicalId":17977,"journal":{"name":"Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79660609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Can food matrices be considered as a potential carrier for COVID-19? 食物基质可以被视为COVID-19的潜在载体吗?
A. Abbasi, H. Kafil, M. A. Ozma, Narges Sangtarash, Sahar Sabahi
{"title":"Can food matrices be considered as a potential carrier for COVID-19?","authors":"A. Abbasi, H. Kafil, M. A. Ozma, Narges Sangtarash, Sahar Sabahi","doi":"10.53854/liim-3001-7","DOIUrl":"https://doi.org/10.53854/liim-3001-7","url":null,"abstract":"Humanity is currently facing a life-threatening challenge from the infectious and epidemic disease SARS-CoV-2. To date, the various modes of transmission of the virus have not been fully elucidated. In this regard, there is a possibility of transmission of the virus through food products. The COVID-19 pandemic disease, like those associated with SARS and MERS, is transmitted mainly through the respiratory tract and airborne aerosol particles, but the presence of fragments of the genetic virus (RNA) in the feces of numerous patients proposes that their fecal-oral pathway may be expanded. In addition, people with gastrointestinal disorders such as atrophic gastritis and metaplasia may be susceptible to COVID-19 infection. Accordingly, food may act as a potential carrier of COVID-19 due to environmental or cross-contamination. According to the available evidence, the spread and possibility of transmission of COVID-19 contamination from humans to food products are possible. Beyond that, there is some evidence that some food sources of animal origin, such as pigs and rabbits, can be contaminated by COVID-19. Therefore, the transmission of the virus through some meat products may be conceivable. Due to the rapid release rate of COVID-19 and its stability in various milieus, especially food manufacturing circumstances, it may enter the matrix during different stages of traditional or industrial food processing. Therefore, preventive measures are recommended to be utilized in the food manufacturing sector. The present study explored the risk of different food matrices, including dairy products, bread, meat and meat products, vegetables, fruits, and processed foods, as potential carriers for the transmission of COVID-19.","PeriodicalId":17977,"journal":{"name":"Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91040787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Epidemiology of respiratory virus before and during COVID-19 pandemic. COVID-19大流行之前和期间的呼吸道病毒流行病学。
M. Avolio, S. Venturini, Rita De Rosa, M. Crapis, G. Basaglia
{"title":"Epidemiology of respiratory virus before and during COVID-19 pandemic.","authors":"M. Avolio, S. Venturini, Rita De Rosa, M. Crapis, G. Basaglia","doi":"10.53854/liim-3001-12","DOIUrl":"https://doi.org/10.53854/liim-3001-12","url":null,"abstract":"The COVID pandemic has forcefully turned the spotlight on the importance of the diagnosis of respiratory virus infections. Viruses have always been a frequent and common cause of respiratory tract infections. Rapid molecular diagnostics applied to the diagnostics of respiratory virus infections has revolutionized microbiology laboratories only a few years ago. Few studies illustrate the epidemiology of respiratory viruses, and fewer still those that have compared the pre-pandemic to the pandemic period. During the first year of the pandemic (2020-2021) it was clear to everyone to witness a sudden disappearance of the circulation of all the other respiratory viruses, especially those typically isolated during the winter time, such as RSV and Influenza virus. In our study we wanted to verify this phenomenon and to study the epidemiology of our local reality, analyzing three consecutive flu seasons (2018-2019, 2019-2020, 2020-2021). The results lead us to note that the prevalence of positivity to respiratory virus infections went from 49.8% (2018-2019) and 39% (2019-2020) to 13.4% (2020-2021). This decrease is at least partly attributable to the security measures adopted (social distancing and mask), but it certainly opens up new scenarios when the restriction measures will be terminated. We believe such studies can provide real-world evidence of the effectiveness of public health interventions implemented during current and future pandemics.","PeriodicalId":17977,"journal":{"name":"Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83181700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Comparison of COVID-19 characteristics in Egyptian patients according to their Toll-Like Receptor-4 (Asp299Gly) polymorphism. 根据toll样受体-4 (Asp299Gly)多态性比较埃及患者COVID-19特征
Sara I. Taha, A. Shata, E. El-Sehsah, M. Mohamed, Nouran M. Moustafa, Mariam K. Youssef
{"title":"Comparison of COVID-19 characteristics in Egyptian patients according to their Toll-Like Receptor-4 (Asp299Gly) polymorphism.","authors":"Sara I. Taha, A. Shata, E. El-Sehsah, M. Mohamed, Nouran M. Moustafa, Mariam K. Youssef","doi":"10.53854/liim-3001-11","DOIUrl":"https://doi.org/10.53854/liim-3001-11","url":null,"abstract":"Background\u0000Toll-like receptor (TLR)-4 plays a vital role in recognizing viral particles, activating the innate immune system, and producing pro-inflammatory cytokines.\u0000\u0000\u0000Objectives\u0000This cross-sectional study aimed to compare COVID-19 severity, progression, and fate according to TLR-4 (Asp299Gly) polymorphism in Egyptian patients.\u0000\u0000\u0000Methods\u0000A total of 145 COVID-19 patients were included in this study. TLR-4 (Asp299Gly) genotyping was done using the PCR restriction fragment length polymorphism (PCR-RFLP) approach.\u0000\u0000\u0000Results\u0000The most commonly encountered TLR-4 genotype in relation to the amino acid at position 299 was the wild-type AA (73.1%); meanwhile, the homozygous mutant GG genotype (8.3%) was the least encountered. At hospital admission, 85.8% of the AA group had free (with no ground glass opacities) chest computed tomography (CT) examination, and 16.0% were asymptomatic. On the other hand, of the AG and GG groups, 81.5% and 83.3%, respectively showed bilateral ground-glass opacities in chest CT, as well as 25.9% and 75.0%, respectively were dyspneic. Values of the total leucocytic count, C-reactive protein (CRP), ferritin, and D dimer increased in the AAAG>GG sequence. ICU admission (83.3%) and in-hospital death (33.3%) rates were significantly higher in the GG group.\u0000\u0000\u0000Conclusions\u0000In COVID-19 patients, the TLR-4 mutant G allele may be associated with a more aggressive disease course and in-hospital death. New therapeutic alternatives could be aimed at this area.","PeriodicalId":17977,"journal":{"name":"Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90720830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Spondylodiscitis associated with skin lesions caused by Rhizopus in a patient with systemic lupus erythematosus. 系统性红斑狼疮患者根霉引起的与皮肤病变相关的脊椎椎间盘炎。
Larissa Silva de Saboya, Moara Borges, Diego Gonçalves Camargo, Maria Auxiliadora de Paula Carneiro Cysneiros, M. E. Oliveira, A. Guilarde
{"title":"Spondylodiscitis associated with skin lesions caused by Rhizopus in a patient with systemic lupus erythematosus.","authors":"Larissa Silva de Saboya, Moara Borges, Diego Gonçalves Camargo, Maria Auxiliadora de Paula Carneiro Cysneiros, M. E. Oliveira, A. Guilarde","doi":"10.53854/liim-3001-17","DOIUrl":"https://doi.org/10.53854/liim-3001-17","url":null,"abstract":"Mucormycosis is a serious and rare fungal disease caused by opportunistic fungi of the zygomycete class, order Mucorales. The main clinical presentations are rhinocerebral, pulmonary, cutaneous, gastrointestinal, and disseminated infections. There are few reports in the literature of spondylodiscitis caused by mucormycosis. We report a 53-year-old male patient presenting with subcutaneous nodules and severe low back pain radiating to the lower limbs. The patient had systemic lupus erythematosus (SLE) for 8 years and corticoid-induced diabetes. He had been using 60 mg/day of prednisone in the last year, with a recent pulse therapy regimen with methylprednisolone and cyclophosphamide to control the renal dysfunction. Nuclear magnetic resonance (NMR) of the spine showed spondylodiscitis. The patient underwent spinal arthrodesis and lesion biopsy. The histopathological study of the vertebra reported a necro suppurative inflammation with numerous fungal structures described as a wide range of hyaline hyphae. The histopathology of the cutaneous nodule exhibited an extensive suppurative lesion centered on the subcutaneous tissue, associated with a large amount of hyphae, similar to that found in the spinal lesion, suggestive of mucormycosis. The fungal culture showed the growth of Rhizopus spp. Treatment was performed with amphotericin B lipid complex 5 mg/kg/day for 60 days. After antifungal treatment, there was a progressive reduction in the number of subcutaneous nodules and total improvement of the patient's low back pain, with recovery of his gait. At the 18-month outpatient visit follow-up, the patient was stable and without recurrence. In our case, timely diagnosis enabled the removal of the osteoarticular focus and the targeted therapy resulted in a satisfactory clinical response, without sequelae or complications, despite the patient's underlying immunosuppressed status.","PeriodicalId":17977,"journal":{"name":"Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84933089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Recurrent erysipelas led to diagnosis of hereditary hemorrhagic telangiectasia. 复发丹毒导致遗传性出血性毛细血管扩张的诊断。
Mari Yamaoka, Y. Kanzawa, Shun Tatehara, K. Sasaki, Shimpei Mizuki, J. Ohnishi, Takahiro Nakajima, Naoto Ishimaru, Saori Kinami
{"title":"Recurrent erysipelas led to diagnosis of hereditary hemorrhagic telangiectasia.","authors":"Mari Yamaoka, Y. Kanzawa, Shun Tatehara, K. Sasaki, Shimpei Mizuki, J. Ohnishi, Takahiro Nakajima, Naoto Ishimaru, Saori Kinami","doi":"10.53854/liim-3001-16","DOIUrl":"https://doi.org/10.53854/liim-3001-16","url":null,"abstract":"Hereditary hemorrhagic telangiectasia (HHT) is a risk of infection, such as by brain abscess associated with pulmonary arteriovenous malformations. However, association between HHT and recurrent erysipelas is not well described. HHT can cause vessel malformations in organs, leading to various serious outcomes. Prophylactic treatment is effective, but many people with HHT are undiagnosed. HHT is not described as a risk factor for soft tissue infection, but may increase the risk of serious infections requiring hospitalization. Our 72-year-old female patient was admitted for recurrent erysipelas. Pulmonary nodules indicated pulmonary arteriovenous fistula on chest computed tomography. By recognizing this combination, although seemingly unrelated problems, we could diagnose HHT and the patient could receive adequate treatment to prevent life-threatening events. The recurrent erysipelas was likely associated with HHT. Recurrent erysipelas is an important presentation which may facilitate early diagnosis of HHT.","PeriodicalId":17977,"journal":{"name":"Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84055299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Whipple's disease: a case report in Santa Catarina, Brazil. 惠普尔病:巴西圣卡塔琳娜的一例报告。
Camila Kleber Stroher, A. Santos, Leandra Ceron, Liandra Luisa Fabrin
{"title":"Whipple's disease: a case report in Santa Catarina, Brazil.","authors":"Camila Kleber Stroher, A. Santos, Leandra Ceron, Liandra Luisa Fabrin","doi":"10.53854/liim-3001-18","DOIUrl":"https://doi.org/10.53854/liim-3001-18","url":null,"abstract":"Whipple's disease is a rare systemic infection caused by a diastase-resistant and Gram-positive bacillus called Tropheryma whipplei. The diagnosis of the disease is difficult and often late due to the variety of the symptoms. The objective of this study was to report a rare case of Whipple's disease treated at the Internal Medicine service of a hospital in the Midwest of Santa Catarina, Brazil. The patient was invited for an interview to describe the history of symptoms and previous treatments. Additionally, test results and treatments performed during hospitalization were assessed through the medical records. The case report describes a 39-year-old white male who presented, at the time of diagnosis, severe diarrhea, hematochezia, weight loss, fever, and inguinal adenomegaly, in addition to preceding migratory polyarthritis. After investigation, the diagnosis of Whipple's disease was achieved in conjunction with antibiotic treatment, with improvement of clinical and laboratory symptoms after 15 days. This case highlights the broad array of symptoms and the non-specific features of the Whipple's disease. Establishing an early diagnosis is essential for the success of the treatment, avoiding a long-lasting escalation of symptoms, which lead to cachexia and a devastating loss of the patient's quality of life.","PeriodicalId":17977,"journal":{"name":"Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83404055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Trueperella bernardiae bloodstream infection following onco-gynaecologic surgery and literature review. 妇科肿瘤手术后伯纳真鞭毛虫血流感染及文献复习。
Roberto Casale, G. Bianco, Stefano Cosma, L. Micheletti, S. Comini, M. Iannaccone, M. Boattini, R. Cavallo, C. Benedetto, C. Costa
{"title":"Trueperella bernardiae bloodstream infection following onco-gynaecologic surgery and literature review.","authors":"Roberto Casale, G. Bianco, Stefano Cosma, L. Micheletti, S. Comini, M. Iannaccone, M. Boattini, R. Cavallo, C. Benedetto, C. Costa","doi":"10.53854/liim-3001-15","DOIUrl":"https://doi.org/10.53854/liim-3001-15","url":null,"abstract":"Trueperella bernardiae is a Gram-positive commensal bacillus of the human skin and oropharynx. It is known as an opportunistic human pathogen causing surgical wound, skin, and soft tissue, osteoarticular, and bloodstream infections (BSIs) with severe complications. We report a case of surgical wound related T. bernardiae BSI following onco-gynaecologic surgery together with a comprehensive literature review of T. bernardiae infections to alert clinicians about this emerging pathogen.","PeriodicalId":17977,"journal":{"name":"Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87489452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
Differential mortality with COVID-19 and invasive mechanical ventilation between high-income and low-and middle-income countries: a systematic review, meta-analysis, and meta-regression. 高收入国家与中低收入国家之间COVID-19和有创机械通气死亡率的差异:系统评价、荟萃分析和元回归
Anwar Khedr, Hussam Al Hennawi, Ibtisam Rauf, M. K. Khan, H. Mushtaq, Hana Sultana Lodhi, J. P. Garces, Nitesh Kumar Jain, T. Koritala, S. A. Khan
{"title":"Differential mortality with COVID-19 and invasive mechanical ventilation between high-income and low-and middle-income countries: a systematic review, meta-analysis, and meta-regression.","authors":"Anwar Khedr, Hussam Al Hennawi, Ibtisam Rauf, M. K. Khan, H. Mushtaq, Hana Sultana Lodhi, J. P. Garces, Nitesh Kumar Jain, T. Koritala, S. A. Khan","doi":"10.53854/liim-3001-6","DOIUrl":"https://doi.org/10.53854/liim-3001-6","url":null,"abstract":"The COVID-19 pandemic has markedly affected the health care of patients in low- and middle-income countries (LMICs), but no systematic study to corroborate this effect has been undertaken. In addition, the survival outcomes of patients with COVID-19 who received invasive mechanical ventilation (IMV) have not been well established. We pooled evidence from all available studies and did a systematic review and meta-analysis to assess and compare mortality outcomes between LMICs and high-income countries (HICs). We searched MEDLINE and the University of Michigan Library according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines from December 1, 2019, to July 15, 2021, for case-control studies, cohort studies, and brief reports that discussed mortality ratios and survival outcomes among patients with SARS-CoV-2 who received IMV. We excluded studies and case reports without comparison groups, narrative reviews, and preprints. A random-effects estimate of the arcsine square root transformation (PAS) of each outcome was generated with the DerSimonian-Laird method. Seven eligible studies, consisting of 243,835 patients with COVID-19, were included. We identified a significantly higher mortality rate (i.e., a larger PAS) among the patients receiving IMV in LMICs (PAS, 0.754; 95% CI, 0.569-0.900; P<.001) compared to patients in HICs (PAS, 0.588; 95% CI, 0.263-0.876; P<.001). Considerable heterogeneity was present within the individual subgroups possibly because of the extent of the included studies, which had data from specific countries and states but not from individual hospitals or health care centers. Moreover, the sample population in each study was diverse. Meta-regression showed that a higher mortality rate among patients with COVID-19 who received IMV in both HICs (P<.001) and LMICs (P=.04) was associated with chronic pulmonary disease. Our study suggests that chronic pulmonary diseases and poor demographics lead to a worse prognosis among patients with COVID-19 who received IMV. Moreover, the survival outcome is worse in LMICs, where health care systems are usually understaffed and poorly financed.","PeriodicalId":17977,"journal":{"name":"Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86424562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
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