RISK FACTORS ASSOCIATED WITH THE INFECTIVITY AND SEVERITY OF COVID-19 INFECTION
Main Article Content
Keywords
Coronavirus Disease 2019, Diabetes, Hypertension, Pre-morbidities, Risk Factors
Abstract
Background: The COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, has had a profound impact on the world, causing widespread illness and death, as well as major disruptions to economies, societies, and daily life. The virus spreads easily from person to person, particularly through respiratory droplets produced when an infected person talks, coughs, or sneezes. Early symptoms of COVID-19 include fever, fatigue, dry cough, and shortness of breath, but the disease can range from mild to severe, with severe cases leading to pneumonia and acute respiratory distress syndrome.
Objective: Pakistan is facing the COVID-19 situation like the rest of the world. However, the data is restricted to address the epidemiological features and concomitant complications in symptomatic and asymptomatic COVID-19 patients. The present study aimed to focus on the symptomatology, infectivity, and severity of COVID-19 in Pakistani population with pre-existing co-morbidities.
Methodology: This cross-sectional study was designed to collect data and swab samples from suspected patients to confirm the disease prevalence and its correlation with different comorbidities. Patients were interviewed by trained health professionals about the presence and absence of symptoms and pre-morbid conditions. Detection of COVID-19 was carried out by Real time Polymerase Chain Reaction test from nasopharyngeal swabs.
Results: The overall prevalence COVID-19 was 55.4%, out of which 68% were males and 32% were females. Out of total 277 positive cases, 9.7% reported to have a close contact with a confirmed COVID-19 positive patient. Moreover, 24 out of total 26 diabetic patients (92%, p < 0.05) and 20 out of 21 hypertensive patients (95%, p < 0.05) were presented with symptoms pointing towards presentation of severity of COVID-19. The severity of COVID-19 was also found to be increased in patients with cardiovascular disease, chronic kidney disease and chronic chest infection, though the results were not statistically significant.
Conclusion: The study concluded a greater risk of COVID-19 severity in DM and HTN patients, notably in the age range of 41 to 80 years. The data contributed can potentially help in the effective management and prevention of COVID-19 infection in the future.
References
2. Zhang J, Wang X, Jia X, et al. Risk factors for disease severity, unimprovement, and mortality in COVID-19 patients in Wuhan, China. Clinical microbiology and infection. 2020;26(6):767-772.
3. Cucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed. 2020;91(1):157-160. doi:10.23750/ABM.V91I1.9397
4. WHO. WHO Coronavirus (COVID-19) Dashboard | WHO Coronavirus (COVID-19) Dashboard With Vaccination Data. World Health Organization. Published 2021. Accessed December 28, 2021. https://covid19.who.int/
5. Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC, Joost Wiersinga W. Pathophysiology, Transmission, Diagnosis, and Treatmentof Coronavirus Disease 2019 (COVID-19) A Review. JAMA. 2020;324(8):782-793. doi:10.1001/jama.2020.12839
6. Team E. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19)—China, 2020. China CDC Wkly. 2020;2(8):113.
7. al Mutair A, Elhazmi A, Alhumaid S, et al. Examining the Clinical Prognosis of Critically Ill Patients with COVID-19 Admitted to Intensive Care Units: A Nationwide Saudi Study. Medicina (B Aires). 2021;57(9). doi:10.3390/MEDICINA57090878
8. Arshad S, Tahir S, Tahir B, et al. Risk factors associated with diabetes mellitus in local population of Lahore, Pakistan. Global Journal of Health Science. 2017;9(9):42.
9. Ussaid A, Riaz B, Rafai W, et al. Clinical Characteristics of 47 Death Cases With COVID-19: A Retrospective Study at a Tertiary Center in Lahore. Cureus. 2020;12(12).
10. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The lancet. 2020;395(10229):1054-1062.
11. Gesesew HA, Koye DiN, Fetene DM, et al. Risk factors for COVID-19 infection, disease severity and related deaths in Africa: a systematic review. BMJ Open. 2021;11(2):e044618. doi:10.1136/BMJOPEN-2020-044618
12. Li J, Huang DQ, Zou B, et al. Epidemiology of COVID-19: A systematic review and meta-analysis of clinical characteristics, risk factors, and outcomes. Journal of Medical Virology. 2021;93(3):1449-1458. doi:10.1002/JMV.26424
13. Peña JE de la, Rascón-Pacheco RA, Ascencio-Montiel I de J, et al. Hypertension, Diabetes and Obesity, Major Risk Factors for Death in Patients with COVID-19 in Mexico. Archives of Medical Research. 2021;52(4):443-449. doi:10.1016/J.ARCMED.2020.12.002
14. Araf Y, Faruqui NA, Anwar S, Hosen MJ. SARS-CoV-2: a new dimension to our understanding of coronaviruses. International Microbiology. Published online 2020:1-6.
15. Shi Q, Zhang X, Jiang F, et al. Clinical Characteristics and Risk Factors for Mortality of COVID-19 Patients With Diabetes in Wuhan, China: A Two-Center, Retrospective Study. Diabetes Care. 2020;43(7):1382-1391. doi:10.2337/DC20-0598
16. Kulcsar KA, Coleman CM, Beck SE, Frieman MB. Comorbid diabetes results in immune dysregulation and enhanced disease severity following MERS-CoV infection. JCI Insight. 2019;4(20). doi:10.1172/JCI.INSIGHT.131774
17. Wang A, Zhao W, Xu Z, Diabetes JG, 2020 undefined. Timely blood glucose management for the outbreak of 2019 novel coronavirus disease (COVID-19) is urgently needed. diabetesresearchclinicalpractice …. Published online 2020. doi:10.1016/j.diabres.2020.108118
18. Rahman A, Tabassum T, Araf Y, al Nahid A, Ullah MA, Hosen MJ. Silent hypoxia in COVID-19: pathomechanism and possible management strategy. Molecular Biology Reports. 2021;48(4):3863-3869. doi:10.1007/S11033-021-06358-1
19. Henry B, Vikse J, Benoit S, Favaloro E, Lippi G. Hyperinflammation and derangement of renin-angiotensin-aldosterone system in COVID-19: a novel hypothesis for clinically suspected hypercoagulopathy. Clinica Chimica Acta. Published online 2020. Accessed December 20, 2021. https://www.sciencedirect.com/science/article/pii/S0009898120301832?casa_token=D74mJR3D8sMAAAAA:ZGobhcH7TfVkMSRgAQD3ksahL9G67sfdeQTvtKGdztxiaDNlljyRoLlByONDLpW-GXYxy1BwDQ
20. Morra ME, le Van Thanh |, Kamel MG, et al. Clinical outcomes of current medical approaches for Middle East respiratory syndrome: a systematic review and meta‐analysis. Wiley Online Library. 2018;28(3). doi:10.1002/rmv.1977
21. Mahamat-Saleh Y, Fiolet T, Rebeaud M, Mulot M. Diabetes, hypertension, body mass index, smoking and COVID-19-related mortality: a systematic review and meta-analysis of observational studies. BMJ Open. Published online 2021. Accessed December 20, 2021. https://bmjopen.bmj.com/content/11/10/e052777.abstract
22. Schiffrin EL, Flack JM, Ito S, Muntner P, Webb RC. Hypertension and COVID-19. American Journal of Hypertension. 2020;33(5):373-374. doi:10.1093/AJH/HPAA057
23. Ran J, Song Y, Zhuang Z, et al. Blood pressure control and adverse outcomes of COVID-19 infection in patients with concomitant hypertension in Wuhan, China. Hypertension Research 2020 43:11. 2020;43(11):1267-1276. doi:10.1038/s41440-020-00541-w
24. Zhou P, Yang X lou, Wang XG, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020 579:7798. 2020;579(7798):270-273. doi:10.1038/s41586-020-2012-7
25. Wu Z, Hu R, Zhang C, Ren W, Yu A, Zhou X. Elevation of plasma angiotensin II level is a potential pathogenesis for the critically ill COVID-19 patients. Critical Care. Published online 2020. doi:10.1186/s13054-020-03015-0
26. Liu N, Hong Y, Chen R, Zhu H. High rate of increased level of plasma Angiotensin II and its gender difference in COVID-19: an analysis of 55 hospitalized patients with COVID-19 in a single hospital. medrxiv. Published online 2020. doi:10.1101/2020.04.27.20080432
27. Hoffmann M, Kleine-Weber H, Schroeder S, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. cell. 2020;181(2):271-280.
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Ibrar Ahmad
Faculty of Rehabilitation and Allied Health Sciences, Riphah International University Islamabad Postal Code 45320
Muhammad Salman Munir Malik
University of Campania “Luigi Vanvitelli” Naples, Italy
Saba Kabir
Department of Microbiology University of Central Punjab, Lahore
Ammar Ahmed
Assistant Professor/Head of Department, Ibadat International University Islamabad
Iram Yousaf Malik
Assistant professor Microbiology Central park Medical College, Lahore
Rafi Ullah
Faculty of Rehabilitation and Allied Health Sciences, Riphah International University Islamabad Postal Code 45320
Muhammad Afzal
University of Lahore (UOL), Lahore, Pakistan
Aroma Mustafa
Department of Clinical Psychology, University of Management and Technology, Lahore, Pakistan
Tabinda Ijaz
Department: Clinical and Molecular Medicine University of Palermo, Italy
Rehmat Younas
Seychelles Medical Services, Victoria, Mahe Island, Seychelles.
Hafiz Sohail Imran
Department of Chemistry, Govt Degree College Madyan Swat, Postal Code 19020.
Khushbakht
Khyber Teaching Hospital MTI
Sibghat Ullah
Faculty of Rehabilitation and Allied Health Sciences, Riphah International University Islamabad Postal Code 45320