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Most-read articles are from the articles published in 2020 during the last three month.

Review Article
COVID-19 Outbreak in Malaysia
Asita Elengoe
Osong Public Health Res Perspect. 2020;11(3):93-100.   Published online June 1, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.3.08
  • 65,535 View
  • 3,442 Download
  • 51 Citations
AbstractAbstract PDF

In 2020 a significant threat to public health emerged. The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic outbreak emerged in December 2019 from Wuhan City, Hubei Province, China and spread to the rest of the world. This disease was named COVID-19 by World Health Organization. To date (17th April 2020) a total of 2,230,439 cases of COVID-19; 150,810 cases of deaths and 564,210 recovered cases have been reported worldwide. In this review the SARS-CoV-2 morphology, pathogenic mechanism, similarities and differences between SARS-CoV and Middle East Respiratory Syndrome and severe acute respiratory syndrome, transmission mode, diagnosis, treatment, and preventive measures were investigated. The outbreak of COVID-19 from a Malaysian perspective was explored and mental health care during the COVID-19 outbreak was explored. To date, there is no vaccine or no specific treatment for COVID-19. Therefore, preventive measures are very important to prevent and control the rapid spread of the SARS-CoV-2 virus. Preparedness should be a priority for future pandemic outbreaks.

Original Article
Identification of Coronavirus Isolated from a Patient in Korea with COVID-19
Jeong-Min Kim, Yoon-Seok Chung, Hye Jun Jo, Nam-Joo Lee, Mi Seon Kim, Sang Hee Woo, Sehee Park, Jee Woong Kim, Heui Man Kim, Myung-Guk Han
Osong Public Health Res Perspect. 2020;11(1):3-7.   Published online February 28, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.1.02
  • 38,048 View
  • 1,160 Download
  • 244 Citations
AbstractAbstract PDF
Objectives

Following reports of patients with unexplained pneumonia at the end of December 2019 in Wuhan, China, the causative agent was identified as coronavirus (SARS-CoV-2), and the 2019 novel coronavirus disease was named COVID-19 by the World Health Organization. Putative patients with COVID-19 have been identified in South Korea, and attempts have been made to isolate the pathogen from these patients.

Methods

Upper and lower respiratory tract secretion samples from putative patients with COVID-19 were inoculated onto cells to isolate the virus. Full genome sequencing and electron microscopy were used to identify the virus.

Results

The virus replicated in Vero cells and cytopathic effects were observed. Full genome sequencing showed that the virus genome exhibited sequence homology of more than 99.9% with SARS-CoV-2 which was isolated from patients from other countries, for instance China. Sequence homology of SARS-CoV-2 with SARS-CoV, and MERS-CoV was 77.5% and 50%, respectively. Coronavirus-specific morphology was observed by electron microscopy in virus-infected Vero cells.

Conclusion

SARS-CoV-2 was isolated from putative patients with unexplained pneumonia and intermittent coughing and fever. The isolated virus was named BetaCoV/Korea/KCDC03/2020.

Short Communication
Contact Transmission of COVID-19 in South Korea: Novel Investigation Techniques for Tracing Contacts
Osong Public Health Res Perspect. 2020;11(1):60-63.   Published online February 28, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.1.09
  • 31,864 View
  • 987 Download
  • 97 Citations
AbstractAbstract PDF

In the epidemiological investigation of an infectious disease, investigating, classifying, tracking, and managing contacts by identifying the patient’s route are important for preventing further transmission of the disease. However, omissions and errors in previous activities can occur when the investigation is performed through only a proxy interview with the patient. To overcome these limitations, methods that can objectively verify the patient’s claims (medical facility records, Global Positioning System, card transactions, and closed-circuit television) were used for the recent ongoing coronavirus disease 2019 contact investigations in South Korea.

Original Articles
Factors influencing acceptance of the COVID-19 vaccine in Malaysia: a web-based survey
June Fei Wen Lau, Yuan Liang Woon, Chin Tho Leong, Hoon Shien Teh
Osong Public Health Res Perspect. 2021;12(6):361-373.   Published online November 25, 2021
DOI: https://doi.org/10.24171/j.phrp.2021.0085
  • 4,675 View
  • 324 Download
  • 1 Citations
AbstractAbstract PDFSupplementary Material
Objectives
The coronavirus disease 2019 (COVID-19) pandemic has set a precedent for the fastest-produced vaccine as a result of global collaboration and outreach. This study explored Malaysians’ acceptance of the COVID-19 vaccine and its associated factors.
Methods
A cross-sectional anonymous web-based survey was disseminated to Malaysian adults aged ≥18 years old via social media platforms between July 10, 2020 and August 31, 2020.
Results
In the analysis of 4,164 complete responses, 93.2% of participants indicated that they would accept the COVID-19 vaccine if it was offered for free by the Malaysian government. The median out-of-pocket cost that participants were willing to pay for a COVID-19 vaccine was Malaysian ringgit (MYR) 100 (interquartile range [IQR], 100) if it was readily available and MYR 150 (IQR, 200) if the supply was limited. Respondents with a low likelihood of vaccine hesitancy had 13 times higher odds of accepting the COVID-19 vaccine (95% confidence interval [CI], 8.69 to 19.13). High perceived risk and severity were also associated with willingness to be vaccinated, with adjusted odds ratios of 2.22 (95% CI, 1.44 to 3.41) and 2.76 (95% CI, 1.87 to 4.09), respectively. Age and ethnicity were the only independent demographic characteristics that predicted vaccine uptake.
Conclusion
Public health strategies targeting perceived risk, perceived susceptibility and vaccine hesitancy could be effective in enhancing vaccine uptake.
Generalized anxiety and sleep quality among health care professionals during the COVID-19 pandemic: a cross-sectional study from a tertiary healthcare institution in Eastern India
Bijaya Nanda Naik, Sanjay Pandey, Rajath Rao, Manisha Verma, Prashant Kumar Singh
Osong Public Health Res Perspect. 2022;13(1):51-61.   Published online February 8, 2022
DOI: https://doi.org/10.24171/j.phrp.2021.0316
  • 1,851 View
  • 38 Download
AbstractAbstract PDF
Objectives
With the emergence of the coronavirus disease 2019 (COVID-19) pandemic, healthcare professionals (HCPs) have experienced high levels of stress and anxiety because of the high risk of infection for themselves and their families. This has led to acute sleep problems for HCP. This study was designed to assess the anxiety and sleep quality of HCPs during the COVID-19 pandemic. Methods: This cross-sectional study analyzed 370 HCPs employed at All India Institute of Medical Sciences Patna over 3 months, using the standard Generalized Anxiety Disorder 7-item scale (GAD-7) for suspected GAD and the Pittsburgh Sleep Quality Index for sleep quality. Results were tabulated and multivariable binomial logistic regression analysis was done to determine the predictors of poor sleep. Significance was attributed to p<0.05. Results: Of the 370 HCPs screened, 52 (14.1%; 95% confidence interval [CI], 10.8%–18.1%) were found to have GAD and 195 (52.7%; 95% CI, 47.5%–57.9%) were found to be poor sleepers. The presence of any addictive habit (adjusted odds ratio [AOR], 1.833; 95% CI, 1.12–2.8), unprotected contact with COVID-19 cases (AOR, 1.902; 95% CI, 1.1–3.3), and the presence of GAD (AOR, 5.57; 95% CI, 2.5–12.4) were found to be predictors of poor sleep quality among HCPs. Conclusion: A significant proportion of HCPs were found to have suspected GAD and were poor sleepers. This highlights the need for measures to confront this problem.
Delays in the diagnosis and treatment of tuberculosis during the COVID-19 outbreak in the Republic of Korea in 2020
Jiyeon Yang, Yunhyung Kwon, Jaetae Kim, Yoojin Jang, Jiyeon Han, Daae Kim, Hyeran Jeong, Hyekyung Park, Eunhye Shim
Osong Public Health Res Perspect. 2021;12(5):293-303.   Published online September 23, 2021
DOI: https://doi.org/10.24171/j.phrp.2021.0063
  • 3,035 View
  • 127 Download
  • 1 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
We investigated the impact of the coronavirus disease 2019 (COVID-19) pandemic on tuberculosis (TB) management in the Republic of Korea (ROK).
Methods
This retrospective cross-sectional study used nationwide ROK TB notification data (98,346 cases) from 2017 to 2020. The median time from the onset of TB symptoms to treatment initiation and the compliance rates with the required timing for notification and individual case investigations were measured and compared across periods and regions affected by the COVID-19 epidemic.
Results
TB diagnosis during the COVID-19 pandemic was delayed. The median time to TB treatment initiation (25 days) in 2020 increased by 3 days compared to that of the previous 3 years (22 days) (p<0.0001). In the outbreak in Seoul, Incheon, and Gyeonggi province during August, the time to TB diagnosis was 4 days longer than in the previous 3 years (p=0.0303). In the outbreak in Daegu and Gyeongbuk province from February to March 2020, the compliance rate with the required timing for individual case investigations was 2.2%p points lower than in other areas in 2020 (p=0.0148). For public health centers, the rate was 13%p lower than in other areas (80.3% vs. 93.3%, p=0.0003).
Conclusion
TB diagnoses during the COVID-19 pandemic in the ROK were delayed nationwide, especially for patients notified by public-private mix TB control hospitals. TB individual case investigations were delayed in regional COVID-19 outbreak areas (Daegu and Gyeongbuk province), especially in public health centers. Developing strategies to address this issue will be helpful for sustainable TB management during future outbreaks.
Review Article
Points to consider for COVID-19 vaccine quality control and national lot release in Republic of Korea: focus on a viral vector platform
Jung Hun Ju, Naery Lee, Sun-hee Kim, Seokkee Chang, Misook Yang, Jihyun Shin, Eunjo Lee, Sunhwa Sung, Jung-Hwan Kim, Jin Tae Hong, Ho Jung Oh
Osong Public Health Res Perspect. 2022;13(1):4-14.   Published online February 8, 2022
DOI: https://doi.org/10.24171/j.phrp.2021.0311
  • 1,572 View
  • 102 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Due to the global public health crisis caused by the coronavirus disease 2019 (COVID-19) pandemic, the importance of vaccine development has increased. In particular, a rapid supply of vaccines and prompt deployment of vaccination programs are essential to prevent and overcome the spread of COVID-19. As a part of the vaccine regulations, national lot release is regulated by the responsible authorities, and this process involves the assessment of the lot before a vaccine is marketed. A lot can be released for use when both summary protocol (SP) review and quality control testing are complete. Accelerated lot release is required to distribute COVID-19 vaccines in a timely manner. In order to expedite the process by simultaneously undertaking the verification of quality assessment and application for approval, it is necessary to prepare the test methods before marketing authorization. With the prolonged pandemic and controversies regarding the effectiveness of the COVID-19 vaccine against new variants, public interest for the development of a new vaccine are increasing. Domestic developers have raised the need to establish standard guidance on the requirements for developing COVID-19 vaccine. This paper presents considerations for quality control in the manufacturing process, test items, and SP content of viral vector vaccines.
Original Article
Cross-Country Comparison of Case Fatality Rates of COVID-19/SARS-COV-2
Morteza Abdullatif Khafaie, Fakher Rahim
Osong Public Health Res Perspect. 2020;11(2):74-80.   Published online April 30, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.2.03
  • 14,836 View
  • 640 Download
  • 110 Citations
AbstractAbstract PDFSupplementary Material
Objectives

Case fatality rates (CFR) and recovery rates are important readouts during epidemics and pandemics. In this article, an international analysis was performed on the ongoing coronavirus disease 2019 (COVID-19) pandemic.

Methods

Data were retrieved from accurate databases according to the user’s guide of data sources for patient registries, CFR and recovery rates were calculated for each country. A comparison of CFR between countries with total cases ≥ 1,000 was observed for 12th and 23rd March.

Results

Italy’s CFR was the highest of all countries studied for both time points (12th March, 6.22% versus 23rd March, 9.26%). The data showed that even though Italy was the only European country reported on 12rd March, Spain and France had the highest CFR of 6.16 and 4.21%, respectively, on 23rd March, which was strikingly higher than the overall CFR of 3.61%.

Conclusion

Obtaining detailed and accurate medical history from COVID-19 patients, and analyzing CFR alongside the recovery rate, may enable the identification of the highest risk areas so that efficient medical care may be provided. This may lead to the development of point-of-care tools to help clinicians in stratifying patients based on possible requirements in the level of care, to increase the probabilities of survival from COVID-19 disease.

Review Article
Yersinia pestis antibiotic resistance: a systematic review
Chen Lei, Suresh Kumar
Osong Public Health Res Perspect. 2022;13(1):24-36.   Published online February 18, 2022
DOI: https://doi.org/10.24171/j.phrp.2021.0288
  • 1,074 View
  • 63 Download
AbstractAbstract PDF
Yersinia pestis, the cause of plague and a potential biological weapon, has always been a threatening pathogen. Some strains of Y. pestis have varying degrees of antibiotic resistance. Thus, this systematic review was conducted to alert clinicians to this pathogen’s potential antimicrobial resistance. A review of the literature was conducted for experimental reports and systematic reviews on the topics of plague, Y. pestis, and antibiotic resistance. From 1995 to 2021, 7 Y. pestis isolates with 4 antibiotic resistance mechanisms were reported. In Y. pestis 17/95, 16/95, and 2180H, resistance was mediated by transferable plasmids. Each plasmid contained resistance genes encoded within specific transposons. Strain 17/95 presented multiple drug resistance, since plasmid 1202 contained 10 resistance determinants. Strains 16/95 and 2180H showed single antibiotic resistance because both additional plasmids in these strains carried only 1 antimicrobial determinant. Strains 12/87, S19960127, 56/13, and 59/13 exhibited streptomycin resistance due to an rpsl gene mutation, a novel mechanism that was discovered recently. Y. pestis can acquire antibiotic resistance in nature not only via conjugative transfer of antimicrobial-resistant plasmids from other bacteria, but also by gene point mutations. Global surveillance should be strengthened to identify antibiotic-resistant Y. pestis strains by whole-genome sequencing and drug susceptibility testing.
Brief Report
COVID-19 vaccine safety monitoring in Republic of Korea from February 26, 2021 to October 31, 2021
Insob Hwang, Kyeongeun Park, Tae Eun Kim, Yunhyung Kwon, Yeon-Kyeng Lee
Osong Public Health Res Perspect. 2021;12(6):396-402.   Published online December 21, 2021
DOI: https://doi.org/10.24171/j.phrp.2021.0310
  • 2,178 View
  • 104 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Objectives
This study aimed to present data on reported adverse events following coronavirus disease 2019 (COVID-19) vaccination in Republic of Korea from February 26 to October 31, 2021, and to determine whether any significant patterns emerged from an analysis of the characteristics of suspected adverse event cases for each type of vaccine.
Methods
Adverse events following COVID-19 vaccination reported by medical doctors and forensic pathologists were analyzed. Cases of suspected anaphylaxis were classified using the Brighton Collaboration definition.
Results
By October 31, 2021, a total of 353,535 (0.45%) adverse events were reported after 78,416,802 COVID-19 vaccine doses. Of the adverse events, 96.4% were non-serious and 3.6% were serious. The most frequently reported adverse events were headache, myalgia, and dizziness. Of the 835 reported deaths after COVID-19 vaccination, 2 vaccine-related deaths were confirmed. Suspected anaphylaxis was confirmed in 454 cases using the Brighton Collaboration definition.
Conclusion
The commonly reported symptoms were similar to those described in clinical trials. Most reported adverse events were non-serious, and the reporting rate of adverse events following COVID-19 vaccination was higher in women than in men (581 vs. 315 per 100,000 vaccinations). Confirmed anaphylaxis was reported in 5.8 cases per 1,000,000 vaccinations.
Original Articles
Perceptions of the COVID-19 vaccine and willingness to receive vaccination among health workers in Nigeria
Oluseyi Ademola Adejumo, Olorunfemi Akinbode Ogundele, Cynthia Roli Madubuko, Rosena Olubanke Oluwafemi, Ogochukwu Chinedum Okoye, Kenechukwu Chukwuemeka Okonkwo, Sunday Samson Owolade, Oladimeji Adedeji Junaid, Olutoyin Morenike Lawal, Adenike Christianah Enikuomehin, Maureen Iru Ntaji, Aisha Sokunbi, Aina Omodele Timothy, Olatunji Sunday Abolarin, Emmanuel Olalekan Ali, John Oghenevwirhe Ohaju-Obodo
Osong Public Health Res Perspect. 2021;12(4):236-243.   Published online July 19, 2021
DOI: https://doi.org/10.24171/j.phrp.2021.0023
  • 5,030 View
  • 354 Download
  • 9 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
The study aimed to examine health workers’ perceptions of the coronavirus disease 2019 (COVID-19) vaccine in Nigeria and their willingness to receive the vaccine when it becomes available.
Methods
This multi-center cross-sectional study used non-probability convenience sampling to enroll 1,470 hospital workers aged 18 and above from 4 specialized hospitals. A structured and validated self-administered questionnaire was used for data collection. Data entry and analysis were conducted using IBM SPSS ver. 22.0.
Results
The mean age of respondents was 40±6 years. Only 53.5% of the health workers had positive perceptions of the COVID-19 vaccine, and only slightly more than half (55.5%) were willing to receive vaccination. Predictors of willingness to receive the COVID-19 vaccine included having a positive perception of the vaccine (adjusted odds ratio [AOR], 4.55; 95% confidence interval [CI], 3.50−5.69), perceiving a risk of contracting COVID-19 (AOR, 1.50; 95% CI, 1.25–3.98), having received tertiary education (AOR, 3.50; 95% CI, 1.40−6.86), and being a clinical health worker (AOR, 1.25; 95% CI, 1.01−1.68).
Conclusion
Perceptions of the COVID-19 vaccine and willingness to receive the vaccine were sub-optimal among this group. Educational interventions to improve health workers' perceptions and attitudes toward the COVID-19 vaccine are needed.
Early Epidemiological and Clinical Characteristics of 28 Cases of Coronavirus Disease in South Korea
Osong Public Health Res Perspect. 2020;11(1):8-14.   Published online February 28, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.1.03
  • 18,432 View
  • 721 Download
  • 75 Citations
AbstractAbstract PDF
Objectives

The first confirmed case of coronavirus disease 2019 (COVID-19) in South Korea was reported in January 2020, with 28 confirmed cases reported as of February 14th, 2020. The epidemiological and clinical characteristics of all 28 cases were analyzed in response to this disease.

Methods

The epidemiological characteristics and early clinical features of the 28 patients from Korea with confirmed COVID-19 were analyzed using COVID-19 reporting and surveillance data and the epidemiological investigation reports prepared by the rapid response team.

Results

There were 16 patients that entered Korea from foreign countries: Wuhan, China (11 patients), Zhuhai, China, (1 patient), Singapore (2 patients), Japan (1 patient), and Thailand (1 patient). The early symptoms were fever, sore throat, cough or sputum production, chills, and muscle ache. Three patients were asymptomatic, however, 18 developed pneumonia. Of the 28 cases, 16 were index cases imported from abroad, with 10 cases of secondary infection originating in Korea, and the route of transmission still under investigation for 2 patients. The 10 patients with secondary infection were infected from contact with family members or acquaintances of primary patients, and the suspected sites of transmission were mostly at home.

Conclusion

COVID-19 in Korea was spread by 16 infected individuals traveling from other countries, leading to second-generation cases. The initial symptoms were mostly minor, but the disease was infectious at this stage, resulting from close contact, particularly at home. Establishing an early detection strategy for COVID-19 is crucial for managing the transmission of the disease.

Genome-Wide Identification and Characterization of Point Mutations in the SARS-CoV-2 Genome
Jun-Sub Kim, Jun-Hyeong Jang, Jeong-Min Kim, Yoon-Seok Chung, Cheon-Kwon Yoo, Myung-Guk Han
Osong Public Health Res Perspect. 2020;11(3):101-111.   Published online May 14, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.3.05
  • 10,130 View
  • 481 Download
  • 46 Citations
AbstractAbstract PDF
Objectives

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China, in December 2019 and has been rapidly spreading worldwide. Although the causal relationship among mutations and the features of SARS-CoV-2 such as rapid transmission, pathogenicity, and tropism, remains unclear, our results of genomic mutations in SARS-CoV-2 may help to interpret the interaction between genomic characterization in SARS-CoV-2 and infectivity with the host.

Methods

A total of 4,254 genomic sequences of SARS-CoV-2 were collected from the Global Initiative on Sharing all Influenza Data (GISAID). Multiple sequence alignment for phylogenetic analysis and comparative genomic approach for mutation analysis were conducted using Molecular Evolutionary Genetics Analysis (MEGA), and an in-house program based on Perl language, respectively.

Results

Phylogenetic analysis of SARS-CoV-2 strains indicated that there were 3 major clades including S, V, and G, and 2 subclades (G.1 and G.2). There were 767 types of synonymous and 1,352 types of non-synonymous mutation. ORF1a, ORF1b, S, and N genes were detected at high frequency, whereas ORF7b and E genes exhibited low frequency. In the receptor-binding domain (RBD) of the S gene, 11 non-synonymous mutations were observed in the region adjacent to the angiotensin converting enzyme 2 (ACE2) binding site.

Conclusion

It has been reported that the rapid infectivity and transmission of SARS-CoV-2 associated with host receptor affinity are derived from several mutations in its genes. Without these genetic mutations to enhance evolutionary adaptation, species recognition, host receptor affinity, and pathogenicity, it would not survive. It is expected that our results could provide an important clue in understanding the genomic characteristics of SARS-CoV-2.

Review Article
Worldwide prevalence of fungal coinfections among COVID-19 patients: a comprehensive systematic review and meta-analysis
Saber Soltani, Milad Zandi, Samireh Faramarzi, Ramin Shahbahrami, Mohebat Vali, Sara Akhavan Rezayat, Reza Pakzad, Pooneh Malekifar, Iraj Pakzad, Neda Jahandoost, Jalal Moludi
Osong Public Health Res Perspect. 2022;13(1):15-23.   Published online February 8, 2022
DOI: https://doi.org/10.24171/j.phrp.2021.0293
  • 4,329 View
  • 59 Download
AbstractAbstract PDFSupplementary Material
Microbial coinfections can increase the morbidity and mortality rates of viral respiratory diseases. Therefore, this study aimed to determine the pooled prevalence of fungal coinfections in coronavirus disease 2019 (COVID-19) patients. Web of Science, Medline, Scopus, and Embase were searched without language restrictions to identify the related research on COVID-19 patients with fungal coinfections from December 1, 2019, to December 30, 2020. A random-effects model was used for analysis. The sample size included 2,246 patients from 8 studies. The pooled prevalence of fungal coinfections was 12.60%. The frequency of fungal subtype coinfections was 3.71% for Aspergillus, 2.39% for Candida, and 0.39% for other. The World Health Organization’s Regional Office for Europe and Regional Office for Southeast Asia had the highest (23.28%) and lowest (4.53%) estimated prevalence of fungal coinfection, respectively. Our findings showed a high prevalence of fungal coinfections in COVID-19 cases, which is a likely contributor to mortality in COVID-19 patients. Early identification of fungal pathogens in the laboratory for COVID-19 patients can lead to timely treatment and prevention of further damage by this hidden infection.
Original Article
Associations of pre-existing cardiovascular morbidity with severity and the fatality rate in COVID-19 patients: a systematic review and meta-analysis
Foad Alzoughool, Suhad Abumweis, Lo’ai Alanagreh, Manar Atoum
Osong Public Health Res Perspect. 2022;13(1):37-50.   Published online February 18, 2022
DOI: https://doi.org/10.24171/j.phrp.2021.0186
  • 965 View
  • 60 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Objectives
The aim of this study was to evaluate the association of pre-existing cardiovascular comorbidities, including hypertension and coronary heart disease, with coronavirus disease 2019 (COVID-19) severity and mortality. Methods: PubMed, ScienceDirect, and Scopus were searched between January 1, 2020, and July 18, 2020, to identify eligible studies. Random-effect models were used to estimate the pooled event rates of pre-existing cardiovascular disease comorbidities and odds ratio (OR) with 95% confidence intervals (95% CIs) of disease severity and mortality associated with the exposures of interest. Results: A total of 34 studies involving 19,156 patients with COVID-19 infection met the inclusion criteria. The prevalence of pre-existing cardiovascular disease in the included studies was 14.0%. Pre-existing cardiovascular disease in COVID-19 patients was associated with severe outcomes (OR, 4.1; 95% CI, 2.9 to 5.7) and mortality (OR, 6.1; 95% CI, 2.9 to 12.7). Hypertension and coronary heart disease increased the risk of severe outcomes by 2.6 times (OR, 2.6; 95% CI, 1.9 to 3.6) and 2.5 times (OR, 2.5; 95% CI, 1.7 to 3.8), respectively. No significant publication bias was indicated. Conclusion: COVID-19 patients with pre-existing cardiovascular comorbidities have a higher risk of severe outcomes and mortality. Awareness of pre-existing cardiovascular comorbidity is important for the early management of COVID-19.

PHRP : Osong Public Health and Research Perspectives