Objective: To investigate risk factors for mortality in dengue. Methods: We performed a systematic review and meta-analysis searching MEDLINE, Embase, SciELO, LILACS Bireme, and OpenGrey databases to identify eligible observational studies of patients with dengue, of both genders, aged 14 years or older, that analysed risk factors associated with mortality and reported adjusted risk measures with their respective confidence intervals (CIs). We estimated the pooled weighted mean difference and 95% CIs with a DerSimonian and Laird random-effects model. We assessed the methodological quality using the Newcastle-Ottawa Scale. Results: Of 1,170 citations reviewed, 18 papers, with a total of 25,851 patients, were included in the systematic review and 12 in the meta-analysis. Severe hepatitis (OR 29.222, 95% CI 3.876-220.314), dengue shock syndrome (OR 23.575, 95% CI 3.664-151.702), altered mental status (OR 3.76, 95% CI 1.67-8.42), diabetes mellitus (OR 3.698,, and higher pulse rate (OR 1.039, 95% CI 1.011-1.067) are associated with mortality in patients with dengue. All studies included were classified as having a high quality. Conclusions: Proper identification and management of these risk factors should be considered to improve patient outcomes and reduce the hidden burden of this neglected tropical disease. Future well-designed studies are needed to investigate the association of other clinical, radiological, and laboratorial findings with mortality in dengue, as well as to develop prognostic models based on the risk factors found in our study.

COVID-19 is a pandemic associated with systemic clinical manifestations. In this study, we aimed to present a narrative review on kidney involvement in COVID-19. Kidney involvement could be derived from direct cytopathic effects, immunological mechanisms, indirect effects on renal tissue through other mediators, and dysfunction or injury of other organs. The evolution of COVID-19 may be complicated with acute kidney injury (AKI) in a significant percentage of patients, and renal dysfunction seems to be associated with worse prognosis. Patients with chronic kidney disease (CKD) seem to be more susceptible to the severe forms of COVID-19. Patients with renal replacement therapy (RRT) are also a vulnerable population as consequence of their advanced age, underlying comorbidities, impaired immune response, and clustering in hemodialysis centers, with requirements for frequent contact with healthcare services. Kidney transplant patients may be at high-risk due to long-term immunosuppression and comorbidities, hence, managing immunosuppression is imperative. Lastly, renal replacement therapy may be required during COVID-19, and different modalities are discussed based on clinical findings and laboratorial aspects. Therefore, COVID-19 seems to affect kidney by different mechanisms, which contributes for AKI development and increases the severity of the disease. Also, patients with CKD and kidney transplant recipients are at higher risk for COVID-19 and mortality.

In December 2019, a novel coronavirus was discovered and associated with a cluster of pneumonia of unknown cause in China. SARS-CoV-2 rapidly spread and is now characterized as a pandemic. The objective of this study is to discuss COVID-19 general features, including epidemiology, transmission, control measures, virology, diagnosis, clinical characteristics and radiological and laboratory results. In this context, literature was assessed to compare the three most affected countries in Asia, Europe and Americas on March 31, 2020. The main form of transmission is human-to-human by respiratory secretions, and studies indicated substantial involvement of asymptomatic patients in this process. COVID-19 patients are predominantly men and may present multiple symptoms, especially fever and cough. Arterial hypertension and diabetes mellitus were the most common comorbidities. Worse outcomes are associated with increased age, comorbidities, and complications. Abnormalities in computed tomography of the chest are frequent, with pulmonary ground-glass opacity and bilateral patchy shadowing as the most common patterns, but a significant percentage of patients do not present any findings at time of admission. Laboratory results often present lymphocytopenia, increased neutrophils and platelet counts, erythrocyte sedimentation rate, lactate dehydrogenase, C-reactive protein, ferritin, total bilirubin, aspartate aminotransferase, alanine aminotransferase, creatinine, creatine phosphokinase, myoglobin, glucose and cytokines. Although radiological findings and laboratory results presented similarities in China, Italy and USA, case-fatality rates can be conflicting suggesting, therefore, the need for studies according to each region.