The novel coronavirus infection , now a worldwide public health concern is associated with varied fatality. Patients with chronic underlying conditions like diabetes and hypertension have shown worst outcomes. The understanding of the association might be helpful in early vigilant monitoring and better management of COVID-19 patients at high risk. The aim of the meta-analysis was to assess the association of diabetes and hypertension with severity of disease.Methods: A literature search was conducted using the databases PubMed and Cochrane until March 31, 2020. Seven studies were included in the meta-analysis, including 2018 COVID-19 patients.
Introduction: Coronavirus disease 2019 (COVID-19) cases are increasing rapidly worldwide. Similar
to Middle East respiratory syndrome where cardiovascular diseases were present in nearly 30% of cases,
the increased presence of cardiovascular comorbidities remains true for COVID-19 as well. The mechanism
of this association remains unclear at this time. Therefore, we reviewed the available literature and tried
to find the probable association between cardiovascular disease with disease severity and mortality in
COVID-19 patients.
Methods: We searched Medline (via PubMed) and Cochrane Central Register of Controlled Trials for
articles published until Sept 5, 2020. Nineteen articles were included involving 6,872 COVID-19 patients.
Results: The random-effect meta-analysis showed that cardiovascular disease was significantly associated
with severity and mortality for COVID-19: odds ratio (OR) 2.89, 95% confidence interval (CI) 1.98–4.21
for severity and OR 3.00, 95% CI 1.67–5.39 for mortality, respectively. Risk of COVID-19 severity was
higher in patients having diabetes, hypertension, chronic obstructive pulmonary disease, malignancy,
cerebrovascular disease and chronic kidney disease. Similarly, patients with diabetes, hypertension, chronic
liver disease, cerebrovascular disease and chronic kidney disease were at higher risk of mortality.
Conclusion: Our findings showed that cardiovascular disease has a negative effect on health status of
COVID-19 patients. However, large prevalence studies demonstrating the consequences of comorbid
cardiovascular disease are urgently needed to understand the extent of these concerning comorbidities.
Keywords: Cardiovascular disease, COVID-19, SARS-CoV-2
Purpose
Coronavirus disease‐2019 (COVID‐19) may predispose to venous thromboembolism (VTE) and arterial thromboembolism because of excessive inflammation, hypoxia, immobilisation and diffuse intravascular coagulation. The understanding of the association might be helpful in early vigilant monitoring and better management of COVID‐19 patients at high risk. Thus, in this meta‐analysis, we aim to assess the association of VTE with the severity of COVID‐19 disease.
Methods
A literature search was conducted on PubMed and Cochrane Central Register of Controlled Trials using the keywords “COVID‐19 and thromboembolism” and “COVID‐19 and embolism,” till 20 February 2021. Thirteen studies including 6648 COVID‐19 patients were incorporated in this systematic review and exploratory meta‐analysis.
Results
The analysis revealed nearly three times more risk than intensive care unit (ICU) care in patients with VTE compared to non‐VTE patients (RR: 2.78; 95% CI: 1.75‐4.39;
P
< .001;
I
2
: 65.1%). Patients with pulmonary embolism and deep vein thrombosis are at increased risk of being admitted to ICU (RR: 2.21; 95% CI: 1.86‐2.61;
P
< .001;
I
2
: 41.2%) and (RR: 2.69; 95% CI: 2.37‐3.06;
P
< .001;
I
2
: 0.0%), respectively. The quality assessment indicated that the included studies were of fair quality.
Conclusions
Our findings suggest that VTE either deep vein thrombosis or pulmonary embolism may have a negative effect on the health status of COVID‐19 patients. This study highlights the need to consider measures for reducing thromboembolism risk amongst COVID‐19 patients.
PurposeTo identify the specific motivations that drive healthy volunteers to consent for their participation in clinical studies. Additionally, the study aimed to document the socio-demographic determinants of participation in the trial related solely to the intention of securing financial gains.Patients and methodsThis cross-sectional study was conducted among subjects who participated as healthy volunteers in clinical trials conducted by Contract Research Organizations (CROs) of Delhi. Pre-tested, validated semi-structured questionnaires were used to collect baseline socio-demographic data, information about factors motivating participation in clinical trials, and pattern of utilisation of money received against participation in the trial. Logistic regression analysis was done to determine the factors that influenced participation in the trial related purely to the motive of securing financial gains.ResultsA total of 400 participants were selected. The majority of the volunteers (77.5%) reported that their sole reason for participating in clinical trials was for monetary gain. Around a tenth of the volunteers participated with the intent to advance scientific knowledge and another 4.5% participated due to benefits of free medical check-ups. Participants in the age group of 29–38 years, those that were married, those residing in an urban slum, male participants, those with a high number of dependent family members (ie, 5 to 8), and those earning less than 5000 INR (71 USD) a month had higher odds of participating in a clinical trial purely for the financial benefits. Those educated till intermediate and above had lower odds of participation in the trial due to monetary benefits.ConclusionOur study shows that healthy volunteers in Delhi consider participation in clinical trials mainly because of the prospect of financial reward. More research is needed to inform judgments around the ethics of providing financial rewards and enrollment of healthy research volunteers.
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