A new international study has shown that contrary to some previous research, being male and increasing body mass index (BMI) are not associated with increased mortality in COVID-19 in patients admitted into an intensive care unit (ICU).
The study, led by Professor Bruce M Biccard, professor and second chair in the Department of Anaesthesia and Perioperative Medicine at the University of Cape Town (UCT), was published in the journal Anaesthesia and provided an analysis of 58 studies and 44 305 patients.
Patients with COVID-19 in ICU were 40% more likely to die with a history of smoking, 54% more likely with high blood pressure, 41% more likely with diabetes, 75% more likely with respiratory disease, around twice as likely with cardiovascular disease or cancer, and 2.4 times more likely to die with kidney disease, than patients without these risk factors.
“The findings confirm the association between diabetes, cardiovascular and respiratory comorbidities with mortality in COVID-19 patients. However, the reported associations between male sex and increasing BMI worsening outcomes are not supported by this meta-analysis of patients admitted to ICU,” said Professor Biccard.
“This meta-analysis provides a large sample size with respect to these risk factors and is a robust estimate of risk associated with male sex and BMI in critically ill COVID-19 patients.”
“The risk factors of hypertension, smoking and respiratory disease may be linked by their association with angiotensin-converting enzyme ... receptors in the body.”
Other factors associated with an increased risk of death were the severity of organ failure, needing mechanical ventilation (by 2.5 times compared with non-ventilated ICU patients), and elevated white blood cell counts and other markers of inflammation.
Analysing the reasons for the associations, the study found age may effectively represent frailty in COVID-19 patients which impacts on a person’s physiological reserve to overcome a critical illness.
The risk factors of hypertension, smoking and respiratory disease may be linked by their association with angiotensin-converting enzyme (ACE) receptors in the body, as seen by the increased expression of ACE-2 receptors among smokers and patients with chronic obstructive pulmonary disease.
“The association between hypertension and cardiovascular disease and increased mortality may be linked to the risk of cardiac injury associated with the systemic inflammatory response to COVID-19 infection,” added Biccard.
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COVID-19 is a global pandemic that caused President Cyril Ramaphosa to declare a national disaster in South Africa on 15 March 2020 and to implement a national lockdown from 26 March 2020. UCT is taking the threat of infection in our university community extremely seriously, and this page will be updated with the latest COVID-19 information. Please note that the information on this page is subject to change depending on current lockdown regulations.
Minister of Health, Dr Joe Phaahla, has in June 2022 repealed some of South Africa’s remaining COVID-19 regulations: namely, sections 16A, 16B and 16C of the Regulations Relating to the Surveillance and the Control of Notifiable Medical Conditions under the National Health Act. We are now no longer required to wear masks or limit gatherings. Venue restrictions and checks for travellers coming into South Africa have now also been removed.
“After almost a year of operation, the University of Cape Town’s (UCT) Community of Hope Vaccination Centre, located at the Forest Hill residence complex in Mowbray, will close on Friday, 29 July 2022. I am extremely grateful and proud of all staff, students and everyone involved in this important project.”
– Vice-Chancellor Prof Mamokgethi Phakeng
With the closure of the UCT Community of Hope Vaccination Centre, if you still require access to a COVID-19 vaccination site please visit the CovidComms SA website to find an alternative.
UCT’s Institute of Infectious Disease and Molecular Medicine (IDM) collaborated with Global Citizen, speaking to trusted experts to dispel vaccine misinformation.
If you have further questions about the COVID-19 vaccine check out the FAQ produced by the Desmond Tutu Health Foundation (DTHF). The DTHF has developed a dedicated chat function where you can ask your vaccine-related questions on the bottom right hand corner of the website.
“As a contact university, we look forward to readjusting our undergraduate and postgraduate programmes in 2023 as the COVID-19 regulations have been repealed.”
– Prof Harsha Kathard, Acting Deputy Vice-Chancellor: Teaching and Learning
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