Comorbidities in SARS-CoV-2 Patients: a Systematic Review and Meta-Analysis

Ng, Wern Hann; Tipih, Thomas; Aminake, Makoah N.; Vermeulen, Jan‐G; Goedhals, Dominique; Sempa, Joseph; Burt, Felicity J.; Taylor, Adam; Mahalingam, Suresh

doi:10.1128/mbio.03647-20

Cited by 249 publications

(246 citation statements)

References 98 publications

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“…Symptoms of COVID-19 can range from fever, cough, and fatigue to severe respiratory illness and death (25). Patient comorbidities increase the risk of hospitalization and severe COVID-19 (26,27). Using virus isolated from patients, the K18-hACE2 mouse model of SARS-CoV-2 infection has been shown to reproduce the features of severe COVID-19 (11).…”

Section: Discussionmentioning

confidence: 99%

Infectious Clones Produce SARS-CoV-2 That Causes Severe Pulmonary Disease in Infected K18-Human ACE2 Mice

Liu

Zaid

Freitas

et al. 2021

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Newly emerged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the ongoing coronavirus disease 2019 (COVID-19) pandemic, which has caused extensive mortality and morbidity and wreaked havoc on socioeconomic structures. The urgent need to better understand SARS-CoV-2 biology and enable continued development of effective countermeasures is aided by the production of laboratory tools that facilitate SARS-CoV-2 research. We previously created a directly accessible SARS-CoV-2 toolkit containing user-friendly reverse genetic (RG) infectious clones of SARS-CoV-2. Here, using K18-human ACE2 (hACE2) mice, we confirmed the validity of RG-rescued SARS-CoV-2 viruses to reproduce the infection profile, clinical disease, and pathogenesis already established in mice infected with natural SARS-CoV-2 isolates, often patient derived. RG-rescued SARS-CoV-2-infected K18-hACE2 mice developed substantial clinical disease and weight loss by day 6 postinfection. RG-rescued SARS-CoV-2 was recovered from the lungs and brains of infected K18-hACE2 mice, and infection resulted in viral pneumonia with considerable changes in lung pathology, as seen previously with natural SARS-CoV-2 infection. In mice infected with RG-rescued SARS-CoV-2-mCherry, mCherry was detected in areas of lung consolidation and colocalized with clinically relevant SARS-CoV-2-assocated immunopathology. RG-rescued SARS-CoV-2 viruses successfully recapitulated many of the features of severe COVID-19 associated with the K18-hACE2 model of SARS-CoV-2 infection. With utility in vivo, the RG-rescued SARS-CoV-2 viruses will be valuable resources to advance numerous areas of SARS-CoV-2 basic research and COVID-19 vaccine development. IMPORTANCE To develop COVID-19 countermeasures, powerful research tools are essential. We produced a SARS-COV-2 reverse genetic (RG) infectious clone toolkit that will benefit a variety of investigations. In this study, we further prove the toolkit’s value by demonstrating the in vivo utility of RG-rescued SARS-CoV-2 isolates. RG-rescued SARS-CoV-2 isolates reproduce disease signs and pathology characteristic of the K18-hACE2 mouse model of severe COVID-19 in infected mice. Having been validated as a model of severe COVID-19 previously using only natural SARS-CoV-2 isolated from patients, this is the first investigation of RG-rescued SARS-CoV-2 viruses in K18-hACE2 mice. The RG-rescued SARS-CoV-2 viruses will facilitate basic understanding of SARS-CoV-2 and the preclinical development of COVID-19 therapeutics.

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Section: Discussionmentioning

confidence: 99%

Infectious Clones Produce SARS-CoV-2 That Causes Severe Pulmonary Disease in Infected K18-Human ACE2 Mice

Liu

Zaid

Freitas

et al. 2021

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“…Residents of counties with high SVI may experience greater prevalence of chronic health conditions that have been identified as comorbidities increasing the risk of mortality following SARS-CoV-2 infection, 21 including cancer, respiratory illness, cardiovascular illness, and diabetes. 22,23,24 These populations may also have poorer access to health care, especially the sophisticated medical care that is often required to mitigate severe and mortal COVID-19 outcomes. Furthermore, we observed an association of even greater magnitude between SVI Theme 3 (Minority Status & Language) and CFR, suggesting that communities of color and/or immigrant communities affected by COVID-19 may face greater risks of severe illness and mortality than white communities.…”

Section: Discussionmentioning

confidence: 99%

Injustices in pandemic vulnerability: A spatial-statistical analysis of the CDC Social Vulnerability Index and COVID-19 outcomes in the U.S.

Song

Wiebe

Solomon

et al. 2021

Preprint

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Background: The COVID-19 pandemic has exacerbated health injustices in the U.S. driven by racism and other forms of structural violence. Research has shown the disproportionate impacts of COVID-19 morbidity and mortality in the most marginalized communities. Objectives: We examined the associations between COVID-19 cumulative incidence (CI) and case-fatality risk (CFR) and the CDC's Social Vulnerability Index (SVI), a composite score assessing historical marginalization and thus vulnerability to disaster events. Methods: Using county-level data from national databases, we used population density, Gini index, percent uninsured, and average annual temperature as covariates, and employed negative binomial regression to evaluate relationships between SVI and COVID-19 outcomes. Optimized hot spot analysis identified hot spots of COVID-19 CI and CFR, which were compared in terms of SVI using logistic regression. Results: As of 2/3/21, 26,452,031 cases of and 448,786 deaths from COVID-19 had been reported in the U.S. Negative binomial regression showed that counties in the top SVI quintile reported 13.7% higher CI (p<0.001) than those in the bottom SVI quintile. Additionally, each unit increase in a county's SVI score was associated with a 0.2% increase in CFR (p<0.001). Logistic regression analysis showed that counties in the lowest SVI quintile had significantly greater odds of being in a CI hot spot than all other counties, yet counties in the highest SVI quintile had 63% greater odds (p=0.008) of being in a CFR hot spot than counties in the lowest SVI quintile. Conclusion: We demonstrated a significant relationship between SVI and CFR, but the relationship between SVI and CI is complex and warrants further investigation. SVI may help elucidate unequal impacts of COVID-19 and guide prioritization of vaccines to communities most impacted by structural injustices.

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“…Studies conducted in similar settings reported hypertension and diabetes as the commonly comorbid conditions among the hospitalized patients; for example, a nationwide analysis in China (Guan et al 2020) reported hypertension (19.9%), diabetes (8.2%). Additional to the single study, systematic reviews (Ng et al 2021; Sanyaolu et al 2020) and meta-analysis reported hypertension and diabetes as the common comorbid conditions among people infected by the virus.…”

Section: Discussionmentioning

confidence: 99%

Clinical manifestations of hospitalized COVID-19 patients in Bangladesh: a 14-day observational study

Shaha

Islam²,

Huq³

et al. 2021

Preprint

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Objectives: Severe acute respiratory coronavirus-2 (SARS-CoV-2) is currently a significant public health concern and causing a pandemic in the world. Despite of immense attention to the coronavirus disease-2019 (COVID-19), very little attention has been given to the kinetics of disease progression in infected patients. Therefore, in this study, we present a 14-day clinical observation of hospital-admitted COVID-19 patients. Methods: After recording the demography of 42 COVID-19 patients on day 1, we observed the clinical progression for 14 days by investigating the hematological and biochemical responses of patients blood and serum, respectively. Results: Approximately 62% of the hospital-admitted COVID-19 patients presented cough, followed by fever (approximately 52%). The top comorbidities of these patients were hypertension (30%) and diabetes mellitus (19%). The average blood hemoglobin level was slightly low among the patients in early days of infection and went up to the normal level on the latter days. A substantial increase in the level of ALT/SGPT (up to 106 units/L; SEM: 12.64) and AST/SGOT (up to 64.35 units/L; SEM: 5.013) in COVID-19 patients was observed, which may suggest that infection with CoV-2019 is associated with the functionality of other organs of COVID-19 patients. Conclusion: This 14-day observational study may help clinicians to decide the choice of treatment of COVID-19 patients.

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Comorbidities in SARS-CoV-2 Patients: a Systematic Review and Meta-Analysis

Cited by 249 publications

References 98 publications

Infectious Clones Produce SARS-CoV-2 That Causes Severe Pulmonary Disease in Infected K18-Human ACE2 Mice

Infectious Clones Produce SARS-CoV-2 That Causes Severe Pulmonary Disease in Infected K18-Human ACE2 Mice

Injustices in pandemic vulnerability: A spatial-statistical analysis of the CDC Social Vulnerability Index and COVID-19 outcomes in the U.S.

Clinical manifestations of hospitalized COVID-19 patients in Bangladesh: a 14-day observational study

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