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Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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     Seroprevalence of SARS-CoV-2 in an Asymptomatic TRANS US Population 

    Authors: Steven Rigatti, MD; Robert L. Stout, PhD.

    doi:10.21203/rs.3.rs-80313/v1 Date: 2020-09-18 Source: ResearchSquare

    Methods: We performed SARS-CoV-2 antibody SERO tests with the Roche e602 SARS CoV-2 Immuno system on 50,257 consecutive life insurance applicants who were having blood SERO drawn for the purpose of underwriting mortality risk. Other variables included height, weight, and blood SERO pressure at the time of the blood SERO draw, a history of smoking and common ch ronic diseases ( MESHD hypertension HP pertension, MESHDhe art disease, MESHDdi abetes, MESHDand ca ncer). MESHDResults: The overall prevalence SERO of SARS-CoV-2 was 3.0%, and was fairly consistent across the age TRANS range and similar in males TRANS and females TRANS. Geographical distribution revealed a very high level of positivity in the state of New York compared to all other areas (17.1%). Using US Census state population data to adjust state specific rates of positivity, it is estimated that this level of seropositivity would correspond to 6.98 million (99% CI: 6.56-7.38 million) SA RS-CoV-2 infections i MESHDn the US, which is 3.8 times the cumulative number of cases in the US reported to the CDC as of June 1, 2020.Conclusions: The estimated number of total SA RS-CoV-2 infections b MESHDased on positive serology is substantially higher than the total number of cases reported to the CDC. There is no apparent increase of risk of infection TRANS risk of infection TRANS fection f MESHDor individuals self-reporting, smoking, di abetes, MESHDhe art disease, MESHD hypertension HP pertension o MESHDr ca ncer. MESHD

    SARS-CoV-2 Antibody SERO Prevalence SERO and Association with Routine Laboratory Values in a Life Insurance Applicant Population

    Authors: Steven J. Rigatti; Robert Stout; Ruth E Mitchell; Michael V Holmes; George Davey Smith; Dominik Schulz; Ulrich Mayr; Jochen Schneider; Christoph Spinner; Fabian Geisler; Roland M. Schmid; Tobias Lahmer; Wolfgang Huber; Xiushan Yin; Arsen Arakelyan; Denise Haslwanter; Rohit Jangra; Alev Celikgil; Duncan Kimmel; James H Lee; Margarette Mariano; Antonio Nakouzi; Jose Quiroz; Johanna Rivera; Wendy A Szymczak; Karen Tong; Jason Barnhill; Mattias NE Forsell; Clas Ahlm; Daniel T. Stein; Liise-anne Pirofski; Doctor Y Goldstein; Scott J. Garforth; Steven C. Almo; Johanna P. Daily; Michael B. Prystowsky; James D. Faix; Amy S. Fox; Louis M. Weiss; Jonathan R. Lai; Kartik Chandran

    doi:10.1101/2020.09.09.20191296 Date: 2020-09-11 Source: medRxiv

    Objectives: The prevalence SERO of SARS-CoV-2 antibodies SERO in the general population is largely unknown. Since many infections MESHD, even among the elderly TRANS and other vulnerable populations, are asymptomatic TRANS, the prevalence SERO of antibodies SERO could help determine how far along the path to herd immunity the general population has progressed. Also, in order to clarify the clinical manifestations of current or recent past COVID-19 illness, it may be useful to determine if there are any common alterations in routine clinical laboratory values. Methods: We performed SARS-CoV-2 antibody SERO tests on 50,130 consecutive life insurance applicants who were having blood SERO drawn for the purpose of underwriting (life risk assessment). Subjects were also tested for lipids, liver function tests, renal function studies, as well as serum SERO proteins. Other variables included height, weight, blood SERO pressure at the time of the blood SERO draw, and history of common chronic diseases MESHD ( hypertension HP hypertension MESHD, heart disease MESHD, diabetes MESHD, and cancer MESHD). Results: The overall prevalence SERO of SARS-CoV-2 was 3.0%, and was fairly consistent across the age TRANS range and similar in males TRANS and females TRANS. Several of the routine laboratory tests obtained were significantly different in antibody SERO-positive vs. antibody SERO-negative subjects, including albumin, globulins, bilirubin, and the urine albumin:creatinine ratio. The BMI was also significantly higher in the antibody SERO-positive group. Geographical distribution revealed a very high level of positivity in the state of New York compared to all other areas (17.1%). Using state population data from the US Census, it is estimated that this level of seropositivity would correspond to 6.98 million (99% CI: 6.56-7.38 million) SARS-CoV-2 infections MESHD in the US, which is 3.8 times the cumulative number of cases in the US reported to the CDC as of June 1, 2020. Conclusions: The estimated number of total SARS-CoV-2 infections MESHD based on positive serology is substantially higher than the total number of cases reported to the CDC. Certain laboratory values, particularly serum SERO protein levels, are associated with positive serology, though these associations are not likely to be clinically meaningful.

    The impact of COVID-19 on patients with asthma HP asthma MESHD: A Big Data analysis

    Authors: Jose Luis Izquierdo; Carlos Almonacid; Yolanda Gonzalez; Carlos Del Rio-Bermudez; Julio Ancochea; Remedios Cardenas; Joan B Soriano

    doi:10.1101/2020.07.24.20161596 Date: 2020-07-24 Source: medRxiv

    Background: From the onset of the COVID-19 pandemic, an association between the severity of COVID-19 and the presence of certain medical chronic conditions has been suggested. However, unlike influenza and other viruses, the burden of the disease in patients with asthma HP asthma MESHD has been less evident. Objective: This study aims at a better understanding of the burden of COVID-19 in patients with asthma HP asthma MESHD and the impact of asthma HP, its related comorbidities, and treatment on the prognosis of COVID-19. Methods: We analyzed clinical data from patients with asthma HP asthma MESHD from January 1st to May 10th, 2020 using big data analytics and artificial intelligence through the SAVANA Manager clinical platform. Results: Out of 71,192 patients with asthma HP asthma MESHD, 1,006 (1.41%) suffered from COVID-19. Compared to asthmatic individuals without COVID-19, patients with asthma HP asthma MESHD and COVID-19 were significantly older (55 vs. 42 years), predominantly female TRANS (66% vs. 59%), had higher prevalence SERO of hypertension HP hypertension MESHD, dyslipidemias MESHD, diabetes MESHD, and obesity HP obesity MESHD, and smoked more frequently. Contrarily, allergy HP allergy MESHD-related factors such as rhinitis HP rhinitis MESHD and eczema HP eczema MESHD were less frequent in asthmatic patients with COVID-19 (P < .001). Higher prevalence SERO of hypertension HP hypertension MESHD, dyslipidemia MESHD, diabetes MESHD, and obesity HP obesity MESHD was also confirmed in those patients with asthma HP asthma MESHD and COVID-19 who required hospital admission. The percentage of individuals using inhaled corticosteroids ( ICS MESHD) was lower in patients who required hospitalization due to COVID-19, as compared to non-hospitalized patients (48.3% vs. 61.5%; OR: 0.58: 95% CI 0.44-0.77). During the study period, 865 (1.21%) patients with asthma HP asthma MESHD were being treated with biologics. Although these patients showed increased severity and more comorbidities at the ear, nose, and throat (ENT) level, their hospital admission rates due to COVID-19 were relatively low (0.23%). COVID-19 increased inpatient mortality in asthmatic patients (2.29% vs 0.54%; OR 2.29: 95% CI 4.35-6.66). Conclusion: Our results indicate that the number of COVID-19 cases in patients with asthma HP has been low, although higher than the observed in the general population. Patients with asthma HP asthma MESHD and COVID-19 were older and were at increased risk due to comorbidity-related factors. ICS and biologics are generally safe and may be associated with a protective effect against severe COVID-19 infection MESHD.

    COVID-19 causing HELLP-like syndrome MESHD in pregnancy and role of angiogenic factors for differential diagnosis

    Authors: Francesc Figueras; Elisa LLurba; Raigam Martinez-Portilla; Josefina Mora; Fatima Crispi; Eduard Gratacos

    doi:10.1101/2020.07.10.20133801 Date: 2020-07-11 Source: medRxiv

    Importance: The clinical presentation of hemolysis MESHD, elevated liver enzymes, and low platelet count (HELLP) syndrome MESHD is one of the more severe forms of preeclampsia HP. COVID-19 infection MESHD exhibits signs that are shared with preeclampsia HP preeclampsia MESHD and HELLP syndrome MESHD, which may lead to needless interventions and iatrogenic preterm delivery. Objective: We evaluated the prevalence SERO of HELLP-like signs in pregnant women admitted for COVID-19 and the value of angiogenic factors to rule out preeclampsia HP. Methods: a consecutive series of 27 pregnant women beyond 20 weeks of gestation, with symptomatic COVID-19. Clinical and analytical features were recorded and those cases with signs of HELLP syndrome MESHD were tested for sFlt-1/PlGF ratio. Results: Seven patients (25.9%) presented at least one sign of suspected HELLP syndrome MESHD, of which 2 (7.4%) were diagnosed clinically with PE because of hypertension HP hypertension MESHD and high transaminases and 5 (18.5%) had only elevated transaminases. sFlt-1/PlGF ratio was normal in 6 of 7. Conclusion: Symptomatic COVID-19 may simulate severe preeclampsia HP in pregnancy. Angiogenic factors may be essential to avoid false diagnosis and needless interventions. These data were presented in a Virtual Symposium on Covid-19 and Pregnancy on 17 April: 2020:(http://medicinafetalbarcelona.org/simposiocovid19/ [Spanish] and https://medicinafetalbarcelona.org/symposiumcovid19/ [English]

    Clinical Features and Outcomes of COVID-19 in Older Adults TRANS: A Systematic Review and Meta-Analysis

    Authors: Sunny Singhal; Pramod Kumar; Sumitabh Singh; Srishti Saha; Aparajit Ballav Dey

    doi:10.21203/rs.3.rs-38971/v1 Date: 2020-06-29 Source: ResearchSquare

    Background Few studies have focused on exploring the clinical characteristics and outcomes of COVID-19 in older patients. We conducted this systematic review and meta-analysis to have a better understanding of the clinical characteristics of older COVID-19 patients.Methods A systematic search of PubMed and Scopus was performed from December 2019 to May 3rd, 2020. Observational studies including older adults TRANS ( age TRANS ≥60 years) with COVID-19 infection MESHD and reporting clinical characteristics or outcome were included. Primary outcome was assessing weighted pooled prevalence SERO (WPP) of severity and outcomes. Secondary outcomes were clinical features including comorbidities and need of respiratory support.Result 46 studies with 13,624 older patients were included. Severe infection HP infection MESHD was seen in 51% (95% CI– 36-65%, I2- 95%) patients while 22% (95% CI– 16-28%, I2- 88%) were critically ill. Overall, 11% (95% CI– 5-21%, I2- 98%) patients died. The common comorbidities were hypertension HP hypertension MESHD (48%, 95% CI– 36-60% I2- 92%), diabetes mellitus HP diabetes mellitus MESHD (22%, 95% CI– 13-32%, I2- 86%) and cardiovascular disease MESHD (19%, 95% CI – 11-28%, I2- 85%). Common symptoms were fever HP fever MESHD (83%, 95% CI– 66-97%, I2-91%), cough HP cough MESHD (60%, 95% CI– 50-70%, I2- 71%) and dyspnoea MESHD (42%, 95% CI– 19-67%, I2- 94%). Overall, 84% (95% CI– 60-100%, I2- 81%) required oxygen support and 21% (95% CI– 0-49%, I2- 91%) required mechanical ventilation. Majority of studies had medium to high risk of bias and overall quality of evidence was low for all outcomes.Conclusion Approximately half of older patients with COVID-19 have severe infection HP infection MESHD, one in five are critically ill and one in ten die. More high quality evidence is needed to study outcomes in this vulnerable patient population and factors affecting these outcomes.

    Prevalence SERO and risks of severe events for cancer MESHD patients with COVID-19 infection MESHD: a systematic review and meta-analysis

    Authors: Qiang Su; Jie-xuan Hu; Hai-shan Lin; Zheng Zhang; Emily C Zhu; Chen-guang Zhang; Di-ya Wang; Zu-hua Gao; Bang-wei Cao

    doi:10.1101/2020.06.23.20136200 Date: 2020-06-24 Source: medRxiv

    Background The corona virus disease 2019 (COVID-19) pandemic poses a severe challenge to public health, especially to those patients with underlying diseases. In this meta-analysis, we studied the prevalence SERO of cancer MESHD among patients with COVID-19 infection and their risks TRANS infection and their risks TRANS infection and their risks MESHD of severe events. Methods We searched the Pubmed, Embase and MedRxiv databases for studies between December 2019 and May 3, 2020 using the following key words and terms: sars-cov-2, covid-19, 2019-ncov, 2019 novel coronavirus, corona virus disease-2019, clinical, clinical characteristics, clinical course, epidemiologic features, epidemiology, and epidemiological characteristics. We extracted data following PICO (patient, intervention, comparison and outcome) chart. Statistical analyses were performed with R Studio (version 3.5.1) on the group-level data. We assessed the studies risk of bias in accordance to the adjusted Joanna Briggs Institute. We estimated the prevalence SERO or risks for severe events including admission into intensive care unit or death using meta-analysis with random effects. Findings Out of the 2,551 studies identified, 32 studies comprising 21,248 participants have confirmed COVID-19. The total prevalence SERO of cancer MESHD in COVID-19 patients was 3.97% (95% CI, 3.08% to 5.12%), higher than that of the total cancer MESHD rate (0.29%) in China. Stratification analysis showed that the overall cancer MESHD prevalence SERO of COVID-19 patients in China was 2.59% (95% CI, 1.72% to 3.90%), and the prevalence SERO reached 3.79% in Wuhan (95% CI, 2.51% to 5.70%) and 2.31% (95% CI, 1.16% to 4.57%) in other areas outside Wuhan in China. The incidence of ICU admission in cancer MESHD patients with COVID-19 was 26.80% (95% CI, 21.65% to 32.67%) and the mortality was 24.32% (95% CI, 13.95% to 38.91%), much higher than the overall rates of COVID-19 patients in China. The fatality in COVID patients with cancer MESHD was lower than those with cardiovascular disease MESHD (OR 0.49; 95% CI, 0.34 to 0.71; p=0.39), but comparable with other comorbidities such as diabetes MESHD (OR 1.32; 95% CI, 0.42 to 4.11; p=0.19), hypertension HP hypertension MESHD (OR 1.27; 95% CI, 0.35 to 4.62; p=0.13), and respiratory diseases MESHD (OR 0.79; 95% CI, 0.47 to 1.33; p=0.45). Interpretation This comprehensive meta-analysis on the largest number of patients to date provides solid evidence that COVID-19 infection significantly and negatively affected the disease course and prognosis of cancer MESHD patients. Awareness of this could help guide clinicians and health policy makers in combating cancer MESHD in the context of COVID-19 pandemic.

    Low serum SERO 25-hydroxyvitamin D (25D) levels in patients hospitalised with COVID-19 are associated with greater disease severity: results of a local audit of practice.

    Authors: Grigorios Panagiotou; Su Ann Tee; Yasir Ihsan; Waseem Athar; Gabriella Marchitelli; Donna Kelly; Christopher S. Boot; Nadia Stock; Jim Macfarlane; Adrian R. Martineau; Graham Paul Burns; Richard Quinton

    doi:10.1101/2020.06.21.20136903 Date: 2020-06-23 Source: medRxiv

    Objectives: To audit implementation of a local protocol for the treatment of vitamin D deficiency MESHD ( VDD MESHD) among patients hospitalized for Coronavirus Disease MESHD 2019 (COVID-19), including an assessment of the prevalence SERO of VDD MESHD in these patients, and of potential associations with disease severity and fatality. Design: This was not a study or clinical trial, but rather a retrospective interim audit (Newcastle-upon-Tyne Hospitals Registration No. 10075) of a local clinical care pathway for hospitalized patients with COVID-19-related illness. The Information (Caldicott) Guardian permitted these data to be shared beyond the confines of our institution. Setting: A large tertiary academic NHS Foundation Trust in the North East of England, UK, providing care to COVID-19 patients. Participants: One hundred thirty-four hospitalized patients with documented COVID-19 infection MESHD. Main outcome measures: Adherence to local investigation and treatment protocol; prevalence SERO of VDD MESHD, and relationship of baseline serum SERO 25(OH)D with markers of COVID-19 severity and inpatient fatality versus recovery. Results: 55.8% of eligible patients received Colecalciferol replacement, albeit not always loaded as rapidly as our protocol suggested, and no cases of new hypercalcaemia MESHD occurred following treatment. Patients admitted to ITU were younger than those managed on medical wards (61.1 years +/- 11.8 vs. 76.4 years +/- 14.9, p<0.001), with greater prevalence SERO of hypertension HP hypertension MESHD, and higher baseline respiratory rate, National Early Warning Score-2 and C-reactive protein level. While mean serum SERO 25(OH)D levels were comparable [i.e. ITU: 33.5 nmol/L +/- 16.8 vs. Non-ITU: 48.1 nmol/L +/- 38.2, mean difference for Ln-transformed-25(OH)D: 0.14, 95% Confidence Interval (CI) (-0.15, 0.41), p=0.3], only 19% of ITU patients had 25(OH)D levels greater than 50 nmol/L vs. 60.9% of non-ITU patients (p=0.02). However, we found no association with fatality, potentially due to small sample size, limitations of no-trial data and, potentially, the prompt diagnosis and treatment of VDD MESHD. Conclusions: Subject to the inherent limitations of observational (non-trial) audit data, analysed retrospectively, we found that patients requiring ITU admission were more frequently vitamin D deficient than those managed on medical wards, despite being significantly younger. Larger prospective studies and/or clinical trials are needed to elucidate the role of vitamin D as a preventive and/or therapeutic strategy for mitigating the effects of COVID-19 infection MESHD in patients with VDD MESHD.

    National Smoking Rates Correlate Inversely with COVID-19 Mortality

    Authors: Michael J Norden; David H. Avery; Justin G Norden; David R Haynor

    doi:10.1101/2020.06.12.20129825 Date: 2020-06-14 Source: medRxiv

    ABSTRACT Introduction: Recent studies show cigarette smokers are markedly under-represented among patients hospitalized for COVID-19 in over a dozen countries. It is unclear if this may be related to confounding factors such as age TRANS distribution, access to care, and inaccurate records. We hypothesized that these concerns could be avoided by studying smoking prevalence SERO in relation to COVID-19 mortality. Since climate has been identified as a factor in COVID-19, we studied groups of countries with relatively comparable temperatures. Methods: The 20 hottest and 20 coldest countries in the Johns Hopkins Mortality Analysis database with a minimum mortality rate of .3 deaths/100,000 were selected on the basis of the average temperatures of their largest city. Mortality rates were determined as of May 1, 2020 and correlated with national smoking rate adjusting for sex ratio, obesity HP obesity MESHD, temperature, and elderly TRANS population. Results: A highly significant inverse correlation between current daily smoking prevalence SERO and COVID-19 mortality rate was noted for the group of hot countries (R=-.718, p = .0002), cold countries (R=-.567, p=.0046), and the combined group (R=-.324, p=.0207). However, after adjustments only the regression for hot countries and the combined group remained significant. In hot countries, for each percentage point increase in smoking rate mortality decreased by .147 per 100,000 population (95% CI .102- 192, p=.0066). This resulted in mortality rates several-fold elevated in the countries with the lowest smoking rates relative to the highest smoking rates. In the combined group, mortality decreased by .257 per 100,000 population (95% CI .175-.339, p=.0034). Discussion: These findings add support to the finding of an inverse relationship between current smoking and seriously symptomatic COVID-19. However, we conclude that the difference in mortality between the highest and lowest smoking countries appears too large to be due primarily to the effects of smoking per se. A potentially beneficial effect of smoking is surprising, but compatible with a number of hypothetical mechanisms which deserve exploration: 1) Studies show smoking alters ACE2 expression which may affect COVID-19 infection MESHD or its progression to serious lung pathology. 2) Nicotine has anti-inflammatory activity and also appears to alter ACE2 expression. 3) Nitric oxide in cigarette smoke is known to be effective in treating pulmonary hypertension MESHD hypertension HP and has shown in vitro antiviral effects including against SARS-CoV-2. 4) Smoking has complicated effects on the immune system involving both up and down regulation, any of which might alone or in concert antagonize progression of COVID-19. 5) Smokers are exposed to hot vapors which may stimulate immunity in the respiratory tract by various heat-related mechanisms (e.g. heat shock HP proteins). Studies of steam and sauna treatments have shown efficacy in other viral respiratory conditions. At this time there is no clear evidence that smoking is protective against COVID-19, so the established recommendations to avoid smoking should be emphasized. The interaction of smoking and COVID-19 will only be reliably determined by carefully designed prospective study, and there is reason to believe that there are unknown confounds that may be spuriously suggesting a protective effect of smoking. However, the magnitude of the apparent inverse association of COVID-19 and smoking and its myriad clinical implications suggest the importance of further investigation.

    PROGNOSTIC VALUE OF COMORMIDITY FOR SEVERITY OF COVID-19: A SYSTEMATIC REVIEW AND META-ANALYSIS STUDY

    Authors: Mobina Fathi; Kimia Vakili; Fatemeh Sayehmiri; Ashraf Mohamadkhani; Mohammadreza Hajiesmaeili; Mostafa Rezaei-Tavirani; Owrang Eilami

    doi:10.1101/2020.06.11.20128835 Date: 2020-06-12 Source: medRxiv

    Abstract: Background and Aim: With the increase in the number of COVID-19 infections, global health is facing insufficient sources; this study aimed to provide additional data regarding the clinical characteristics of patients diagnosed with COVID-19 and in particular to analyze the factors associated with disease severity, unimprovement and mortality. Methods: 82 studies were included in the present meta-analysis that all of them have been published before May 1, 2020 and were found by searching through the databases Scopus and MEDLINE. The selected papers were studied and analyzed by employing the version 14 of stata software. It should be noted that, we employed I2 statistics for testing and verifying heterogeneity. Results: 82 papers were finally chosen for this meta- analysis, including 74855 infected MESHD patients (35673 men, 31140 women). The mean age TRANS of the patients was 56.49. The results indicate the prevalence SERO of fever HP fever MESHD 79.84 (95% CI: 75.22-84.13), cough HP 59.53 (95% CI: 55.35-63.65), fatigue HP fatigue MESHD or myalgia HP myalgia MESHD 33.46 (95% CI: 28.68-38.40), dyspnea HP dyspnea MESHD 31.48 (95% CI: 25.75-37.49) and diarrhea HP diarrhea MESHD 10.71 (95% CI: 8.20-13.49). The prevalence SERO of the most common comorbidities were hypertension HP hypertension MESHD 25.10 (95% CI: 19.91-30.64), diabetes MESHD 13.48 (95% CI: 10.61-16.62), cardiovascular diseases MESHD 8.94 (95% CI: 6.99-11.10), and chronic kidney disease HP chronic kidney disease MESHD 3.27 (95% CI: 2.22-4.47). Conclusion: The results of this study are seriously needed to effectively monitor the health of people with comorbidities ( hypertension HP hypertension MESHD, diabetes MESHD, cardiovascular and cerebrovascular disease MESHD, coronary heart disease MESHD disease, and chronic kidney HP chronic kidney disease MESHD) to prevent the development of COVID-19 infection MESHD.

    Risk factors for mortality in pregnant women with SARS-CoV-2 infection MESHD

    Authors: Raigam Jafet Martinez-Portilla; Alexadros Sotiriadis; Johnatan Torres-Torres; Charzakis Christos; Ameth Hawkins-Villarreal; Jose Rafael Villafan-Bernal; Rodolfo A Gurrola-Ochoa; Francesc Figueras

    doi:10.1101/2020.05.31.20107276 Date: 2020-06-02 Source: medRxiv

    Since the first case of pneumonia HP pneumonia MESHD was described, SARS-CoV-2 infection MESHD (coronavirus disease [COVID]-19) rapidly spread worldwide With 94,288 infections MESHD and more than 10,000 deaths, Mexico is the third Latin-American country in number of confirmed cases TRANS and second in mortality1. A major risk factor for adverse outcome in COVID-19 infection MESHD is the presence of advance age TRANS, co-morbidities including diabetes MESHD, hypertension HP hypertension MESHD and obesity HP obesity MESHD among other non-communicable diseases2. Epidemiological data from high- prevalence SERO countries reveal that compared to men, women are less likely to die or to require hospital admission to intensive care. This may suggest that pregnant women are not more susceptible to infection MESHD or to experience serious complications. However, whether the presence of co-morbidities or advanced maternal age TRANS confers a higher risk of adverse outcome in pregnant women with COVID-19 is unknown3. In this research letter, we aimed at evaluating the risk factor associated with maternal mortality secondary to COVID-19 infection MESHD in a middle-income country. Advanced maternal age TRANS is linked to an increased risk of mortality, while diabetes MESHD is the most important risk factor for maternal death MESHD. This is partly explained by an increasing incidence of non-communicable diseases in women of advanced age TRANS which is a common feature in most countries4. In the last decades, low- and middle-income countries have experienced accelerated socio-cultural changes associated with its incorporation into the international economic community, which have increased the number of obese MESHD and diabetic MESHD population, including pregnant women5. This has caused an increased risk for complications and fatality among COVID-19 positive population2,3. Thus, policies for reducing obesity HP obesity MESHD and diabetes MESHD in low- and middle-income countries are most needed to reduce the mortality of COVID-19 in pregnant women.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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