Annals of medicine
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Emerging data suggest that coronavirus disease 2019 (COVID-19) has extrapulmonary manifestations but its renal manifestations are not clearly defined. We aimed to evaluate renal complications of COVID-19 and their incidence using a systematic meta-analysis. ⋯ Frequent renal complications reported among hospitalized COVID-19 patients are electrolyte disturbance, AKI and RRT. Aggressive monitoring and management of these renal complications may help in the prediction of favourable outcomes. Systematic review registration: PROSPERO 2020: CRD42020186873 KEY MESSAGES COVID-19 affects multiple organs apart from the respiratory system; however, its renal manifestations are not clearly defined. In this systematic meta-analysis of 22 observational cohort studies, the prevalence of pre-existing chronic kidney disease (CKD) in COVID-19 patients was 5.2%. The most frequent renal complication was electrolyte disturbance (particularly hyperkalaemia) with an incidence of 12.5% followed by acute kidney injury (AKI) with an incidence of 11.0%; US populations and groups with higher prevalence of CKD had higher incidence of AKI.
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Multicenter Study
Hypertension is a risk factor for adverse outcomes in patients with coronavirus disease 2019: a cohort study.
Comorbidities are commonly seen in patients with coronavirus disease 2019 (COVID-19), but the clinical implication is not yet well-delineated. We aim to characterize the prevalence and clinical implications of comorbidities in patients with COVID-19. ⋯ Hypertension is a common comorbidity in patients with COVID-19 and associated with adverse outcomes. KEY MESSAGES Hypertension was identified as the comorbidity associated with the prognosis of COVID-19 in this retrospective cohort. Patients with hypertension could experience an increased risk of the composite endpoint. Anti-hypertensive therapy did not affect patient outcomes.
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Early detection of disease progression associated with severe COVID-19, and access to proper medical care lowers fatality rates of severe cases. Currently, no studies had systematically examined the variables in detecting severe COVID-19. ⋯ To analysis 41 studies with 5064 patients were included.Patients who are elderly (SMD, 1.90; 95% CI, 1.01 to 2.8), male (OR, 1.71; 95% CI, 1.39 to 2.11) and have comorbidities or flu-like symptoms were significantly associated with the development to severe cases. Severe cases were associated with significant increased WBC (OR, 5.83; 95% CI, 2.76 to 12.32), CRP (OR, 3.62; 95% CI, 1.62 to 8.03), D-dimer (SMD, 1.69; 95% CI, 1.09 to 2.28), AST (OR, 4.64; 95% CI, 3.18 to 6.77) and LDH (OR, 7.94; 95% CI, 2.09 to 30.21). CT manifestation of bilateral lung involvement (OR, 4.55; 95% CI, 2.17 to 9.51) was associated with the severe cases. Conclusions and Relevance: Our findings offer guidance for a wide spectrum of clinicians to early identify severe COVID-19 patients, transport to specialised centres, and initiate appropriate treatment. Key Messages This systematic review and meta-analysis examined 41 studies including 5,064 patients with confirmed COVID-19. Severe cases were associated with age, male gender, and with fever, cough and respiratory diseases, increased WBC, CRP, D-dimer, AST and LDH levels. Furthermore, CT manifestation of bilateral lung involvement was associated with the severe cases. These findings provide guidance to health professionals with early identification of severe COVID-19 patients, transportation to specialised care and initiate appropriate supportive treatment.
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Meta Analysis
Is interleukin-2 an optimal marker for diagnosing tuberculosis infection? A systematic review and meta-analysis.
Latent tuberculosis infection (LTBI) is a huge reservoir for the deadlier TB disease. Accurate identification of LTBI is a key strategy to eliminate TB. Therefore, a systematic review and meta-analysis approach was used to assess diagnostic potential of IL-2 for LTBI. ⋯ These findings showed that IL-2 is a powerful marker for differentiating LTBI from non-TB controls and a good marker for differentiating ATB from LTBI individuals.