Hypertension and Diabetes Delay the Viral Clearance in COVID-19 Patients

Abstract

2 6 Sweden 2 7 2 8 Abstract = 186 words, Main text = 1722 words, Figures =2. Abstract 3 0 Objectives: Comorbidities have significant indications for the disease outcome of COVID-19, 3 1 however which underlying diseases that contribute the most to aggravate the conditions of 3 2 COVID-19 patients is still largely unknown. SARS-CoV-2 viral clearance is a golden standard 3 3 for defining the recovery of COVID-19 infections. To dissect the underlying diseases that 3 4 could impact on viral clearance, we enrolled 106 COVID-19 patients who were hospitalized in 3 5 Methodology: We comprehensively analyzed demographic, clinical and laboratory data, as 3 8 well as patient treatment records. Survival analyses with Kaplan-Meier and Cox regression 3 9 modelling were employed to identify factors influencing the viral clearance negatively. 4 0 Results: We found that increasing age, male gender, and angiotensin-converting enzyme 2 4 1 (ACE2) associated factors (including hypertension, diabetes, and cardiovascular diseases) 4 2 adversely affected the viral clearance. Furthermore, analysis by a random forest survival 4 3 model pointed out hypertension, cortisone treatment, gender, and age as the four most 4 4 important variables. 4 5 Conclusions: We conclude that patients at old age, males, and/or having diseases 4 6 associated with high expression of ACE2 will have worse prognosis during a COVID-19 4 7 infections. 4 8 4 9

Associations of clinical characteristics and antiviral drugs with viral RNA clearance in patients with COVID-19 in Guangzhou, China: a retrospective cohort study

“…In this study, only 10% of patients received corticosteroid treatment compared to 50%-79% as reported in patients from Wuhan [7,9]. Our analysis indicated that corticosteroid use was associated with delayed viral RNA clearance, in line with a recent report from Wuhan [18].…”

Elevated serum ferritin level effectively discriminates severity illness and predicts prognosis of COVID-19 patients

“…In addition, we compared the viral clearance rate and in-hospital length between elevation ferritin group and normal group, nding that ferritin was also a discriminated indictor for prognosis of COVID-19 patients. Viral clearance is the golden standard for de ning the recovery of COVID-19 infections and predicting inhospital length is extremely vital in COVID-19 pandemic due to the lack of medical resource [15]. Thus, we suppose ferritin could act as both an effective discriminator for severity illness and a predictor for prognosis.…”

Predicting mortality due to SARS-CoV-2: A mechanistic score relating obesity and diabetes to COVID-19 outcomes in Mexico

“…The relationship between increased risk of mortality attributable to acute severe respiratory infections in patients with diabetes mellitus has been extensively reported, particularly for the Italy [5,23,24]. Increased susceptibility for COVID-19 in patients with diabetes may be explained for several potential mechanisms including an increased lung ACE2 expression and elevated circulating levels of furin, a protease involved in viral entry to cells, and a decreased clearance of SARS-CoV-2 viral particles in subjects with diabetes and/or hypertension associated with ACE2 expression [25][26][27][28]. Impairments in immunity observed in patients with diabetes are characterized by initial delay in activation of Th1 cell-mediated immunity and late hyper-inflammatory response and are consistent with the increased risk associated with additional immunosuppression observed with our data [29].…”