Introduction The novel severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has caused a pandemic. Many studies have shown that several laboratory parameters are related to disease severity and mortality in SARS‐CoV‐2 cases. This meta‐analysis aimed to determine the relationship of a prognostic factor, D‐dimer, with disease severity, need for intensive care unit (ICU) care, and mortality in SARS‐CoV‐2 patients. Methods A systematic search for all observational studies and trials involving adult patients with SARS‐CoV‐2 that had any data related to D‐dimer on admission was conducted using PubMed, Science Direct, Scopus, ProQuest, and MedRxiv databases. We performed random‐effects inverse‐variance weighting analysis using mean difference (MD) of D‐dimer values for outcomes such as disease severity, mortality, and need for ICU care. Results A total of 29 studies (4,328 patients) were included in this meta‐analysis, which revealed a higher mean of D‐dimer levels on admission in severe patients than in nonsevere patients (MD = 0.95, [95% confidence interval (CI): 0.61‐1.28], P < .05; I2 = 90%). The nonsurvivor group had a higher pooled MD of D‐dimer values on admission (MD = 5.54 [95% CI: 3.40‐7.67], P < .05; I2 = 90%). Patients who needed ICU admission had insignificantly higher D‐dimer values than patients who did not need ICU admission (MD = 0.29, [95% CI: −0.05 to 0.63], P = .10; I2 = 71%). Conclusion Elevated D‐dimer levels on admission were associated with an increased risk of disease severity and mortality in patients with SARS‐CoV‐2 infection.
INTRODUCTION: COVID-19 is a systemic infection with a significant impact on coagulation which manifests in thromboembolism. There is an unknown relationship of which coagulation profile parameter at presentation has an association with poor outcome in COVID-19. OBJECTIVE: This meta-analysis aimed to determine the relationship between fibrinogen and FDP with poor outcome in COVID-19 patients. METHODS: A systematic search of all observational studies or trials involving adult patients with COVID-19 that had any data fibrinogen or FDP on admission was carried out using the PubMed, Science Direct, Scopus, ProQuest, and MedRxiv databases. We assessed the methodological quality assessment using the NIH Quality Assessment Tool. We performed random-effects inverse-variance weighting analysis using mean difference (MD). RESULTS: A total of 17 studies (1,654 patients) were included in this meta-analysis. It revealed a higher mean of fibrinogen levels on admission in patients with severe case compared to those with non-severe case (MD = 0.69, [95% CI: 0.44 to 0.94], p < 0.05; I2 = 72%, p < 0.05). Non-survivor group had a pooled higher mean difference of fibrinogen values on admission (MD = 0.48 [95% CI: 0.13 to 0.83], p < 0.05; I2 = 38%, p = 0.18). Higher FDP on admission was found in poor outcome (composite of severity, critically ill, and mortality) compared to good outcome (4 studies, MD = 4.84 [95% CI: 0.75 to 8.93], p < 0.05; I2 = 86%, p < 0.05). CONCLUSION: Elevated fibrinogen and FDP level on admission were associated with an increase risk of poor outcome in COVID-19 patients.
Aims This meta-analysis aims to analyze the association of calcium channel blocker (CCB) use with COVID-19 clinical outcomes. Methods PubMed, ProQuest, Science Direct, Scopus, and medRxiv databases were searched systematically in a limited period. The primary outcome was mortality. Results A total of 119,298 patients from 31 eligible studies were included. Pooled analysis of the random-effect model revealed CCB was not associated with reduced mortality (OR = 1.21 [95%CI: 0.98–1.49], p = 0.08). Interestingly, subgroup analysis in hypertensive patients revealed significantly reduced mortality (OR = 0.69 [95%CI: 0.52–0.91], p = 0.009). Conclusion CCB usage was not associated with the outcome of COVID-19. However, CCB was associated with a decreased mortality rate in hypertensive COVID-19 patients.
The coronavirus disease (COVID-19) has become a global pandemic with a high mortality rate. There has been emerging evidence regarding the presence of thrombosis in patients with severe COVID-19 infection. In addition, prognosis of COVID patients, once they are complicated with DVT or fatal pulmonary emboli, will also significantly decline. Hence, understanding the pathomechanism and prompt treatment of thromboembolism is important in improving the outcome in COVID-19 patients. Prophylaxis anticoagulant was proposed for all hospitalized COVID-19 patients. The aim of this article is to review the current literature regarding pathomechanism, risk assessment, diagnosis, and management of VTE.
Although remarkable progress in percutaneous coronary intervention (PCI) has been achieved over the last decade, the success rate of chronic total occlusion (CTO) recanalization varies greatly. Coronary angiography characteristics may affect the success rate of CTO recanalization. This study sought to establish a scoring model to predict successful CTO recanalization based on coronary angiography characteristics. We analyze 287 angiography data from patients who underwent elective PCI. Angiography characteristics being measured were lesion location, blunt stump, calcification, ostial lesion, bridging collateral, bending, side branch, tortuosity, previous stent attempt, and lesion length of >20 mm. Data were analyzed using SPSS 25.0. Multivariate analysis shows that side branch lesion (p = 0.000), proximal vessels tortuosity (p = 0.015), calcified lesion (p = 0.000), lesion length of >20 mm (p = 0.000), and blunt stump (p = 0.000) can predict the successful PCI in the CTO. ROC curve analysis of the score ability to predict successful PCI in the CTO showed area under curve of 0.89 (confidence interval 95%), the cutoff point of ≤2 with a sensitivity of 93.33%, and specificity of 88.23%. We concluded that the five angiography characteristics that strongly associate with successful PCI in the CTO are calcified lesion, blunt stump, lesion length >20 mm, proximal vessel tortuosity, and side branch lesion. This score may help cardiologists to predict the success probability of PCI in the CTO.
BACKGROUND: Hypertension is the major risk factor for cardiovascular disease, a leading cause of premature death and disability. Interactive education and training are potentially used to improve hypertension knowledge. AIM: This study aimed to identify the impact of training and education programs toward knowledge in hypertension for women cadres. METHODS: This quasi-experimental study was conducted in Surabaya, Indonesia, involving 100 women cadre. The data were collected through interviews, pre- and post-training using a validated researcher-made questionnaire of demographic characteristics, and knowledge tests of hypertension. Data were analyzed using SPSS 21. RESULTS: Knowledge of cadre was significantly increased by 50% after the training and education program (p < 0.001). The median score of the pre-test and post-test was 40.00 (30.00–50.00) and 60.00 (50.00–70.00), respectively. The level of education found to have a negative correlation with the post-test score (p = 0.008). There was no difference in knowledge increment after training among age groups (p = 0.261), marital status (p = 0.849), or occupations type (p = 0.827). CONCLUSION: Training and education programs significantly improve the hypertension knowledge of woman cadre. This method can be a preferable early public health intervention to tackle hypertension.
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