ABSTRACT
Background: This study aimed to investigate the clinical indicators and outcomes of COVID-19-positive patients with inflammatory bowel disease (IBD), focusing on age, sex, socioeconomic status, and geographic location. The objective of this study was to fill the knowledge gap regarding determinants influencing outcomes in individuals with and without IBD who contracted COVID-19, thus impacting healthcare provision.Methods: This study utilized the nationwide inpatient sample (NIS) database for the period from January to December 2020. Patients were categorized into those with COVID-19 alone (controls) and those with both COVID-19 and IBD (cases). Demographic, clinical, and hospital-related variables were analyzed using statistical methods, including t tests and chi-square tests. Logistic and multivariate regression analyses were performed to assess factors affecting mortality.Results: Among COVID-19 patients with IBD, a sex disparity was observed, with more females in the IBD group than in the non-IBD group. The mean age was similar in both groups. Hospitalizations were concentrated in the age group of 65–84 years. Ethnically, Caucasians dominated both cohorts, and Medicare was the primary payer for a greater proportion of hospitalizations in the IBD group. Hospitalizations were prevalent in urban teaching hospitals, primarily in the southern and mid-western regions of the US. There were no significant differences in mortality rates, and clinical symptoms were comparable between the two groups. Factors associated with mortality included sex, age, and specific existing health conditions.Conclusion: Contrary to the initial hypothesis, the presence of IBD among COVID-19 patients did not significantly impact mortality rates. However, certain clinical indicators and outcomes are influenced by individual factors such as age, sex, and underlying health conditions. This study emphasizes the need for careful monitoring of COVID-19 patients with IBD, particularly those with additional risk factors. Further research is necessary to fully understand the biochemical interactions and implications of IBD in the context of COVID-19. This comprehensive study contributes valuable insights to healthcare authorities, aiding in patient management and outcome optimization.
Subject(s)
Inflammatory Bowel Diseases , COVID-19ABSTRACT
Background As the COVID-19 pandemic rages on, reports on disparities in vaccine roll out alongside reinfection and reactivation from previously recovered cases have been emerging. With newer waves and variants of COVID-19, we conducted a systematic review to assess the determinants and disease spectrum of COVID-19 reinfection. Methods A comprehensive search covering relevant databases was conducted for observational studies reporting Polymerase Chain Reaction (PCR) confirmed infection and reinfection cases. Quality assessment tool developed by the National Institute of Health (NIH) for assessment of case series was used. Meta-analyses were performed using RevMan 5.3 for pooled proportions of findings in first infection and reinfection with 95% confidence interval (CI). Results Eighty-one studies reporting 577 cases were included from 22 countries. The mean age of patients was 46.2±18.9 years with males accounting for 45.8% of the study population while 179 (31.0%) cases of comorbidities were reported. The average time duration between first infection and reinfection was 63.6±48.9 days. During first infection and reinfection, fever was the most common symptom (41.4% and 36.4%, respectively) whilst anti-viral therapy was the most common treatment regimen administered (44.5% and 43.0%, respectively). Overall, comparable odds of symptomatic presentation and management were reported in the two infections. However, a higher Intensive Care Unit (ICU) admission rate was observed in reinfection compared to first infection (10 vs 3). Ten deaths were reported with 565 patients fully recovering. Respiratory failure was the most common cause of death (7/10 deaths). Seventy-two studies were determined to be of good quality whilst nine studies were of fair quality. Conclusion As the first global-scale systematic review of its kind, our findings support immunization practices given increased ICU admissions and mortality in reinfections. Our cohort serves as a guide for clinicians and authorities for devising an optimal strategy for controlling the pandemic.
Subject(s)
COVID-19 , Respiratory InsufficiencyABSTRACT
Background: The Novel Coronavirus Disease (COVID-19) has created havoc globally as countries worldwide struggle to combat this pandemic. Since prevention and social isolation are known to be the only ways to prevent the spread of COVID-19, this has created challenges among the lower-middle income countries (LMIC) including Pakistan, as it battles between an under-resourced healthcare, an economic shutdown, and widespread myths and misconceptions. Therefore, we conducted a study to evaluate the knowledge, attitude and perceptions regarding COVID-19 as public understanding is vital to help facilitate the control of this outbreak. Methods: : A pre-validated online questionnaire was distributed among the general population of Pakistan from 1 st to 12 th June 2020. Descriptive statistics were analyzed using SPSS v25. Adequate knowledge was assigned as a score of >4 (range: 0-8) and good perception as a score of >3 (range: 0-5). Chi‑square test was used to determine the significance of difference in knowledge and perception of COVID-19 among socio-demographics. Logistic regression analysis was run to identify factors associated with adequate knowledge and perception. P < 0.05 was considered as significant. Results: : A total of 1200 respondents participated in this study with a wide range of age groups and education. Majority of the respondents had adequate knowledge (93.3%) with a mean score of 6.59 ± 1.35, and good perception (85.6%) with a mean score of 4.29 ± 0.82. Significant differences in knowledge and perception were observed among genders, age groups, education and between students and employees in the healthcare and non-healthcare department. A multivariable analysis revealed an advanced degree and a female gender to be significant predictors of adequate knowledge and perception. Conclusions: : Albeit the surge of COVID-19 cases in Pakistan, the participants demonstrated an overall adequate knowledge and good perception towards COVID-19. Perhaps, a potential hint towards noncompliance practices in following preventive protocols requires further educational interventions that target safe health practices and complications of this infection.