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The burden and outcomes of COVID-19 among patients with co-morbid disease in Africa: protocol for a systematic review and meta-analysis.

ABSTRACT: The coronavirus disease 2019 (COVID-19) outbreak is now a global public health concern and has had an enormous adverse impact in both developed and developing countries. In Africa, in August 2020, the total number of confirmed cases was 1 022 401 cases, with 704 704 recovered and 22 501 deaths. People with co-morbidities are at increased risk of complications and COVID-19-related death. Evidence on the burden and outcome among patients with co-morbid diseases has not been published in Africa, so this systematic review and meta-analysis aims to quantify these. Observational studies reporting on the burden and outcome of COVD-19 among patients with co-morbid diseases in Africa will be included and a search of online databases PubMed/MEDLINE, EMBASE, HINARI, Cochrane Library, World Health Organization COVID-19 database, Africa Wide Knowledge and Web of Science will be applied. Two independent authors will carry out data extraction and assess the risk of bias using a predetermined and structured method of data collection. Disagreements will be resolved by discussion after mutual consensus with a third reviewer who is an experienced researcher (AH) in meta-analysis studies. We will use random-effects to estimate the overall burden and outcome of COVID-19 among patients with co-morbid diseases in Africa. To assess possible publication bias, funnel plot test and Egger's test methods will be used. This systematic review and meta-analysis protocol will be reported based on the Preferred Reporting Items for Systematic reviews and Meta-Analysis protocol guidelines. Results will be stratified by the African geographic region, diagnostic methods and co-morbidity. COVID-19 distribution data will be shown by interest variables such as residence/geographic region, diagnostic methods, type of co-morbidity and outcomes of co-morbidity. The findings of this review will notify health-care professionals about the burden and outcome of COVID-19 among patients with co-morbid diseases while providing evidence to bring about the requisite improvements in clinical practice for these patients.

SUBMITTER: Aberhe W

PROVIDER: S-EPMC7786108 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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The burden and outcomes of COVID-19 among patients with co-morbid disease in Africa: protocol for a systematic review and meta-analysis.

Aberhe W W Mariye T T Hailay A A Zereabruk K K Mebrahtom G G Gebremedhn G G Haile T T Guesh T T

New microbes and new infections 20201030

The coronavirus disease 2019 (COVID-19) outbreak is now a global public health concern and has had an enormous adverse impact in both developed and developing countries. In Africa, in August 2020, the total number of confirmed cases was 1 022 401 cases, with 704 704 recovered and 22 501 deaths. People with co-morbidities are at increased risk of complications and COVID-19-related death. Evidence on the burden and outcome among patients with co-morbid diseases has not been published in Africa, so ...[more]

PMID: 33437493

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Project description:Background and Aim: Co-infection of COVID-19 with other respiratory pathogens which may complicate the diagnosis, treatment, and prognosis of COVID-19 emerge new concern. The overlap of COVID-19 and influenza, as two epidemics at the same time can occur in the cold months of the year. The aim of current study was to evaluate the rate of such co-infection as a systematic review and meta-analysis. Methods: A systematic literature search was performed on September 28, 2019 for original research articles published in Medline, Web of Science, and Embase databases from December 2019 to September 2020 using relevant keywords. Patients of all ages with simultaneous COVID-19 and influenza were included. Statistical analysis was performed using STATA 14 software. Results: Eleven prevalence studies with total of 3,070 patients with COVID-19, and 79 patients with concurrent COVID-19 and influenza were selected for final evaluation. The prevalence of influenza infection was 0.8% in patients with confirmed COVID-19. The frequency of influenza virus co-infection among patients with COVID-19 was 4.5% in Asia and 0.4% in the America. Four prevalence studies reported the sex of patients, which were 30 men and 31 women. Prevalence of co-infection with influenza in men and women with COVID-19 was 5.3 and 9.1%, respectively. Eight case reports and 7 case series with a total of 123 patients with COVID-19 were selected, 29 of them (16 men, 13 women) with mean age of 48 years had concurrent infection with influenza viruses A/B. Fever, cough, and shortness of breath were the most common clinical manifestations. Two of 29 patients died (6.9%), and 17 out of 29 patients recovered (58.6%). Oseltamivir and hydroxychloroquine were the most widely used drugs used for 41.4, and 31% of patients, respectively. Conclusion: Although a low proportion of COVID-19 patients have influenza co-infection, however, the importance of such co-infection, especially in high-risk individuals and the elderly, cannot be ignored. We were unable to report the exact rate of simultaneous influenza in COVID-19 patients worldwide due to a lack of data from several countries. Obviously, more studies are needed to evaluate the exact effect of the COVID-19 and influenza co-infection in clinical outcomes.

Project description:IntroductionMeasures of epidemiological burdens are an important contribution to estimating disease severity and determining the at-risk populations for seasonal influenza. In the absence of these data, it is extremely difficult for policy-makers to decide on how to distribute limited resources. This systematic review will synthesise the literature on reported burden of seasonal influenza (eg, morbidity and mortality) in sub-Saharan Africa.Method and analysisWe will include published epidemiological studies that capture the burden estimation of seasonal influenza between 1 January 2000 and 31 August 2018. Studies that have reported disease burden estimates associated to influenza-like illness, acute respiratory illness, acute lower respiratory illness, severe acute respiratory illness and severe or very severe pneumonia using laboratory-confirmed influenza cases will be included. We will perform a multiple electronic database search in PubMed, Embase, African Journals Online, Cochrane, Web of science, CINAHL and Google scholar for eligible studies. The reference lists of relevant studies will also be hand-searched for potentially eligible studies. The titles and abstracts of identified records will be screened independently by two authors. The full-text articles of potentially eligible studies will be assessed independently by two authors. Discrepancies will be resolved by discussion, and by a third author if the first two authors fail to come to a consensus. The measures of the burden of influenza will be aggregated using a meta-analysis for homogeneous studies and narrative synthesis if the studies are heterogeneous. The strength of the evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach.Ethics and disseminationThis systematic review will use publicly available data; and as such, no formal ethical review is required. Our findings will be published in a peer-reviewed journal and also disseminated through conferences and stakeholder meetings.Prospero registration numberCRD42017074091.

Project description:OBJECTIVE:To evaluate association between biomarkers and outcomes in COVID-19 hospitalised patients. COVID-19 pandemic has been a challenge. Biomarkers have always played an important role in clinical decision making in various infectious diseases. It is crucial to assess the role of biomarkers in evaluating severity of disease and appropriate allocation of resources. DESIGN AND SETTING:Systematic review and meta-analysis. English full text observational studies describing the laboratory findings and outcomes of COVID-19 hospitalised patients were identified searching PubMed, Web of Science, Scopus, medRxiv using Medical Subject Headings (MeSH) terms COVID-19 OR coronavirus OR SARS-CoV-2 OR 2019-nCoV from 1 December 2019 to 15 August 2020 following Meta-analyses Of Observational Studies in Epidemiology (MOOSE) guidelines. PARTICIPANTS:Studies having biomarkers, including lymphocyte, platelets, D-dimer, lactate dehydrogenase (LDH), C reactive protein (CRP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine, procalcitonin (PCT) and creatine kinase (CK), and describing outcomes were selected with the consensus of three independent reviewers. MAIN OUTCOME MEASURES:Composite poor outcomes include intensive care unit admission, oxygen saturation <90%, invasive mechanical ventilation utilisation, severe disease, in-hospital admission and mortality. The OR and 95%?CI were obtained and forest plots were created using random-effects models. Publication bias and heterogeneity were assessed by sensitivity analysis. RESULTS:32 studies with 10?491 confirmed COVID-19 patients were included. We found that lymphopenia (pooled-OR: 3.33 (95% CI: 2.51-4.41); p<0.00001), thrombocytopenia (2.36 (1.64-3.40); p<0.00001), elevated D-dimer (3.39 (2.66-4.33); p<0.00001), elevated CRP (4.37 (3.37-5.68); p<0.00001), elevated PCT (6.33 (4.24-9.45); p<0.00001), elevated CK (2.42 (1.35-4.32); p=0.003), elevated AST (2.75 (2.30-3.29); p<0.00001), elevated ALT (1.71 (1.32-2.20); p<0.00001), elevated creatinine (2.84 (1.80-4.46); p<0.00001) and LDH (5.48 (3.89-7.71); p<0.00001) were independently associated with higher risk of poor outcomes. CONCLUSION:Our study found a significant association between lymphopenia, thrombocytopenia and elevated levels of CRP, PCT, LDH, D-dimer and COVID-19 severity. The results have the potential to be used as an early biomarker to improve the management of COVID-19 patients, by identification of high-risk patients and appropriate allocation of healthcare resources in the pandemic.

Dataset Information

The burden and outcomes of COVID-19 among patients with co-morbid disease in Africa: protocol for a systematic review and meta-analysis.

Publications

The burden and outcomes of COVID-19 among patients with co-morbid disease in Africa: protocol for a systematic review and meta-analysis.

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