Association of hypertension with the severity and fatality of SARS-CoV-2 infection: A meta-analysis.
高血压与SARS-CoV-2 感染严重程度和病死率的关系: 一项荟萃分析.
- 作者列表："Zhang J","Wu J","Sun X","Xue H","Shao J","Cai W","Jing Y","Yue M","Dong C
:Hypertension is a common comorbidity in COVID-19 patients. However, the association of hypertension with the severity and fatality of COVID-19 remain unclear. In the present meta-analysis, relevant studies reported the impacts of hypertension on SARS-CoV-2 infection were identified by searching PubMed, Elsevier Science Direct, Web of Science, Wiley Online Library, Embase and CNKI up to 20 March 2020. As the results shown, 12 publications with 2389 COVID-19 patients (674 severe cases) were included for the analysis of disease severity. The severity rate of COVID-19 in hypertensive patients was much higher than in non-hypertensive cases (37.58% vs 19.73%, pooled OR: 2.27, 95% CI: 1.80-2.86). Moreover, the pooled ORs of COVID-19 severity for hypertension vs. non-hypertension was 2.21 (95% CI: 1.58-3.10) and 2.32 (95% CI: 1.70-3.17) in age <50 years and ⩾50 years patients, respectively. Additionally, six studies with 151 deaths of 2116 COVID-19 cases were included for the analysis of disease fatality. The results showed that hypertensive patients carried a nearly 3.48-fold higher risk of dying from COVID-19 (95% CI: 1.72-7.08). Meanwhile, the pooled ORs of COVID-19 fatality for hypertension vs. non-hypertension was 6.43 (95% CI: 3.40-12.17) and 2.66 (95% CI: 1.27-5.57) in age <50 years and ⩾50 years patients, respectively. Neither considerable heterogeneity nor publication bias was observed in the present analysis. Therefore, our present results provided further evidence that hypertension could significantly increase the risks of severity and fatality of SARS-CoV-2 infection.
: 高血压是新型冠状病毒肺炎患者常见的共病。然而，高血压与新型冠状病毒肺炎的严重程度和病死率的关系仍不清楚。在本荟萃分析中，通过检索PubMed、Elsevier Science Direct、Web of Science、Wiley在线图书馆，确定了高血压对SARS-CoV-2 感染的影响。embase和CNKI截至 2020 年 3 月 20 日。如结果所示，纳入了 12 篇出版物，包括 2389 例新型冠状病毒肺炎患者 (674 例重症病例)，用于分析疾病严重程度。高血压患者的新型冠状病毒肺炎严重程度率远高于非高血压患者 (37.58% vs 19.73%，合并OR: 2.27，95% CI: 1.80-2.86)。此外，合并or新型冠状病毒肺炎严重程度为高血压vs.在年龄 <50 岁和 50 岁的患者中，非高血压分别为 2.21 (95% CI: 1.58-3.10) 和 2.32 (95% CI: 1.70-3.17)。此外，还纳入了 6 项研究，其中 151 例死亡，2116 例新型冠状病毒肺炎病例，用于分析疾病病死率。结果显示，高血压患者死于新型冠状病毒肺炎的风险高出近 3.48 倍 (95% CI: 1.72-7.08)。同时，合并or的新型冠状病毒肺炎高血压病死率vs.在年龄 <50 岁和 50 岁的患者中，非高血压分别为 6.43 (95% CI: 3.40-12.17) 和 2.66 (95% CI: 1.27-5.57)。在本分析中均未观察到相当大的异质性和发表偏倚。因此，我们的研究结果进一步证明了高血压可显著增加SARS-CoV-2 感染的严重程度和病死率。
METHODS::Since mid-December of 2019, coronavirus disease 2019 (COVID-19) infection has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 infection in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.
METHODS::In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oral-fecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral-fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes.
METHODS::There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.