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  1. Article ; Online: Coronavirus disease 2019 (COVID-19) and the renin-angiotensin system: A closer look at angiotensin-converting enzyme 2 (ACE2).

    Zemlin, Annalise E / Wiese, Owen J

    Annals of clinical biochemistry

    2020  Volume 57, Issue 5, Page(s) 339–350

    Abstract: Since the first cases of atypical pneumonia linked to the Huanan Seafood Wholesale Market in Wuhan, China, were described in late December 2019, the global landscape has changed radically. In March 2020, the World Health Organization declared COVID-19 a ... ...

    Abstract Since the first cases of atypical pneumonia linked to the Huanan Seafood Wholesale Market in Wuhan, China, were described in late December 2019, the global landscape has changed radically. In March 2020, the World Health Organization declared COVID-19 a global pandemic, and at the time of writing this review, just over three million individuals have been infected with more than 200,000 deaths globally. Numerous countries are in 'lockdown', social distancing is the new norm, even the most advanced healthcare systems are under pressure, and a global economic recession seems inevitable. A novel coronavirus (SARS-CoV-2) was identified as the aetiological agent. From experience with previous coronavirus epidemics, namely the severe acute respiratory syndrome (SARS) and Middle East Respiratory Syndrome (MERS) in 2004 and 2012 respectively, it was postulated that the angiotensin-converting enzyme-2 (ACE2) receptor is a possible port of cell entry. ACE2 is part of the renin-angiotensin system and is also associated with lung and cardiovascular disorders and inflammation. Recent studies have confirmed that ACE2 is the port of entry for SARS-CoV-2. Male sex, advanced age and a number of associated comorbidities have been identified as risk factors for infection with COVID-19. Many high-risk COVID-19 patients with comorbidities are on ACE inhibitors and angiotensin receptor blockers, and this has sparked debate about whether to continue these treatment regimes. Attention has also shifted to ACE2 being a target for future therapies or vaccines against COVID-19. In this review, we discuss COVID-19 and its complex relationship with ACE2.
    MeSH term(s) Angiotensin-Converting Enzyme 2 ; Angiotensin-Converting Enzyme Inhibitors/pharmacology ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; Animals ; Betacoronavirus/drug effects ; Betacoronavirus/immunology ; Betacoronavirus/metabolism ; COVID-19 ; Coronavirus Infections/drug therapy ; Coronavirus Infections/immunology ; Coronavirus Infections/metabolism ; Humans ; Pandemics ; Peptidyl-Dipeptidase A/immunology ; Peptidyl-Dipeptidase A/metabolism ; Pneumonia, Viral/drug therapy ; Pneumonia, Viral/immunology ; Pneumonia, Viral/metabolism ; Renin-Angiotensin System/drug effects ; Renin-Angiotensin System/physiology ; SARS-CoV-2
    Chemical Substances Angiotensin-Converting Enzyme Inhibitors ; Peptidyl-Dipeptidase A (EC 3.4.15.1) ; ACE2 protein, human (EC 3.4.17.23) ; Angiotensin-Converting Enzyme 2 (EC 3.4.17.23)
    Keywords covid19
    Language English
    Publishing date 2020-06-02
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 390309-6
    ISSN 1758-1001 ; 0004-5632
    ISSN (online) 1758-1001
    ISSN 0004-5632
    DOI 10.1177/0004563220928361
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Molecules in pathogenesis: angiotensin converting enzyme 2 (ACE2).

    Wiese, Owen / Zemlin, Annalise E / Pillay, Tahir S

    Journal of clinical pathology

    2020  Volume 74, Issue 5, Page(s) 285–290

    Abstract: The renin-angiotensin system is mainly associated with the regulation of blood pressure, but recently many other functions of this system have been described. ACE2, an 805-amino acid monocarboxypeptidase type I transmembrane glycoprotein, was discovered ... ...

    Abstract The renin-angiotensin system is mainly associated with the regulation of blood pressure, but recently many other functions of this system have been described. ACE2, an 805-amino acid monocarboxypeptidase type I transmembrane glycoprotein, was discovered in 2000 and has sequence similarity to two other proteins, namely ACE and collectrin. The ACE2 gene is located on Xp22 and is highly polymorphic. ACE2 is expressed in numerous tissues especially the lung alveolar epithelial cells, heart, kidney and gastrointestinal tract. Animal studies have found that ACE2 is central in diseases affecting almost all organ systems, among other cardiac, respiratory, renal and endocrine functions. ACE2 was identified as the cellular contact point for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of the global pandemic (COVID-19), and is a potential drug target. SARS-CoV-2 infection has several effects on the renin-angiotensin system and conversely, regulation of this receptor may affect the progress of infection. We describe the genetics and functions of ACE2, explore its various physiological functions in the renin-angiotensin system and discuss its role in the pathophysiology of disease. ACE2 opposes the vasopressor ACE pathway of the renin-angiotensin system by converting angiotensin (Ang) I to Ang (1-9) and Ang II to Ang (1-7) which initiates the vasodilatory pathway. ACE2 may have a protective effect in the lung and kidney as knockout mice display susceptibility to acute respiratory distress and hypertensive nephropathy. Binding of SARS-CoV-2 and the subsequent fusion and downregulation of this pathway during SARS-CoV-2 infection may explain some of the unusual sequelae seen in COVID-19.
    MeSH term(s) Angiotensin-Converting Enzyme 2/genetics ; Angiotensin-Converting Enzyme 2/metabolism ; Animals ; COVID-19/metabolism ; Humans ; Mice ; Mice, Knockout ; Renin-Angiotensin System/physiology
    Chemical Substances Angiotensin-Converting Enzyme 2 (EC 3.4.17.23)
    Keywords covid19
    Language English
    Publishing date 2020-08-05
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 80261-x
    ISSN 1472-4146 ; 0021-9746
    ISSN (online) 1472-4146
    ISSN 0021-9746
    DOI 10.1136/jclinpath-2020-206954
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Coronavirus disease 2019 (COVID-19) and the renin-angiotensin system: A closer look at angiotensin-converting enzyme 2 (ACE2)

    Zemlin, Annalise E / Wiese, Owen J

    Ann Clin Biochem

    Abstract: Since the first cases of atypical pneumonia linked to the Huanan Seafood Wholesale Market in Wuhan, China, were described in late December 2019, the global landscape has changed radically. In March 2020, the World Health Organization declared COVID-19 a ... ...

    Abstract Since the first cases of atypical pneumonia linked to the Huanan Seafood Wholesale Market in Wuhan, China, were described in late December 2019, the global landscape has changed radically. In March 2020, the World Health Organization declared COVID-19 a global pandemic, and at the time of writing this review, just over three million individuals have been infected with more than 200,000 deaths globally. Numerous countries are in 'lockdown', social distancing is the new norm, even the most advanced healthcare systems are under pressure, and a global economic recession seems inevitable. A novel coronavirus (SARS-CoV-2) was identified as the aetiological agent. From experience with previous coronavirus epidemics, namely the severe acute respiratory syndrome (SARS) and Middle East Respiratory Syndrome (MERS) in 2004 and 2012 respectively, it was postulated that the angiotensin-converting enzyme-2 (ACE2) receptor is a possible port of cell entry. ACE2 is part of the renin-angiotensin system and is also associated with lung and cardiovascular disorders and inflammation. Recent studies have confirmed that ACE2 is the port of entry for SARS-CoV-2. Male sex, advanced age and a number of associated comorbidities have been identified as risk factors for infection with COVID-19. Many high-risk COVID-19 patients with comorbidities are on ACE inhibitors and angiotensin receptor blockers, and this has sparked debate about whether to continue these treatment regimes. Attention has also shifted to ACE2 being a target for future therapies or vaccines against COVID-19. In this review, we discuss COVID-19 and its complex relationship with ACE2.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #176123
    Database COVID19

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  4. Article ; Online: Coronavirus disease 2019 (COVID-19) and the renin-angiotensin system

    Zemlin, Annalise E / Wiese, Owen J

    Annals of Clinical Biochemistry: International Journal of Laboratory Medicine

    A closer look at angiotensin-converting enzyme 2 (ACE2)

    2020  Volume 57, Issue 5, Page(s) 339–350

    Abstract: Since the first cases of atypical pneumonia linked to the Huanan Seafood Wholesale Market in Wuhan, China, were described in late December 2019, the global landscape has changed radically. In March 2020, the World Health Organization declared COVID-19 a ... ...

    Abstract Since the first cases of atypical pneumonia linked to the Huanan Seafood Wholesale Market in Wuhan, China, were described in late December 2019, the global landscape has changed radically. In March 2020, the World Health Organization declared COVID-19 a global pandemic, and at the time of writing this review, just over three million individuals have been infected with more than 200,000 deaths globally. Numerous countries are in ‘lockdown’, social distancing is the new norm, even the most advanced healthcare systems are under pressure, and a global economic recession seems inevitable. A novel coronavirus (SARS-CoV-2) was identified as the aetiological agent. From experience with previous coronavirus epidemics, namely the severe acute respiratory syndrome (SARS) and Middle East Respiratory Syndrome (MERS) in 2004 and 2012 respectively, it was postulated that the angiotensin-converting enzyme-2 (ACE2) receptor is a possible port of cell entry. ACE2 is part of the renin-angiotensin system and is also associated with lung and cardiovascular disorders and inflammation. Recent studies have confirmed that ACE2 is the port of entry for SARS-CoV-2. Male sex, advanced age and a number of associated comorbidities have been identified as risk factors for infection with COVID-19. Many high-risk COVID-19 patients with comorbidities are on ACE inhibitors and angiotensin receptor blockers, and this has sparked debate about whether to continue these treatment regimes. Attention has also shifted to ACE2 being a target for future therapies or vaccines against COVID-19. In this review, we discuss COVID-19 and its complex relationship with ACE2.
    Keywords Clinical Biochemistry ; General Medicine ; covid19
    Language English
    Publisher SAGE Publications
    Publishing country us
    Document type Article ; Online
    ZDB-ID 390309-6
    ISSN 1758-1001 ; 0004-5632
    ISSN (online) 1758-1001
    ISSN 0004-5632
    DOI 10.1177/0004563220928361
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Coronavirus disease 2019 (COVID-19) and the reninangiotensin system

    Zemlin, Annalise E. / Wiese, Owen

    a closer look at angiotensin-converting enzyme 2 (ACE2)

    2020  

    Abstract: CITATION: Zemlin, A. & Wiese, O. 2020. Coronavirus disease 2019 (COVID-19) and ...

    Abstract CITATION: Zemlin, A. & Wiese, O. 2020. Coronavirus disease 2019 (COVID-19) and the reninangiotensin system : a closer look at angiotensin-converting enzyme 2 (ACE2). Annals of Clinical Biochemistry. doi:10.1177/0004563220928361.

    The original publication is available at https://journals.sagepub.com/home/acb

    ENGLISH ABSTRACT: Since the first cases of atypical pneumonia linked to the Huanan Seafood Wholesale Market in Wuhan, China were described in late December 2019, the global landscape has changed radically. In March 2020, the World Health Organization (WHO) declared COVID-19 a global pandemic, and at the time of writing this review just over 3 million individuals have been infected with more than 200 000 deaths globally. Numerous countries are in “lockdown”, social distancing is the new norm, even the most advanced healthcare systems are under pressure, and a global economic recession seems inevitable. A novel coronavirus (SARS-CoV-2) was identified as the aetiological agent. From experience with previous coronavirus epidemics, namely the Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) in 2004 and 2012 respectively, it was postulated that the angiotensin-converting enzyme-2 (ACE2) receptor is a possible port of cell entry. ACE2 is part of the renin-angiotensin system (RAS), and is also associated with lung and cardiovascular disorders and inflammation. Recent studies have confirmed that ACE2 is the port of entry for SARS-CoV-2. Male sex, advanced age, and a number of associated comorbidities have been identified as risk factors for infection with COVID-19. Many high-risk COVID-19 patients with comorbidities are on ACE inhibitors and angiotensin receptor blockers, and this has sparked debate about whether to continue these treatment regimes. Attention has also shifted to ACE2 being a target for future therapies or vaccines against COVID-19. In this review, we discuss COVID-19 and its complex relationship with ACE2.

    Pre-print
    Keywords COVID-19 (Disease) ; Coronavirus infections ; Glucagon-like peptide 1 ; Analytes ; covid19
    Subject code 610
    Language English
    Publishing date 2020-05-01
    Publisher Sage
    Publishing country za
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Molecules in pathogenesis

    Wiese, Owen / Zemlin, Annalise E / Pillay, Tahir S

    Journal of Clinical Pathology

    angiotensin converting enzyme 2 (ACE2)

    2020  , Page(s) jclinpath–2020–206954

    Abstract: The renin–angiotensin system is mainly associated with the regulation of blood pressure, but recently many other functions of this system have been described. ACE2, an 805-amino acid monocarboxypeptidase type I transmembrane glycoprotein, was discovered ... ...

    Abstract The renin–angiotensin system is mainly associated with the regulation of blood pressure, but recently many other functions of this system have been described. ACE2, an 805-amino acid monocarboxypeptidase type I transmembrane glycoprotein, was discovered in 2000 and has sequence similarity to two other proteins, namely ACE and collectrin. The ACE2 gene is located on Xp22 and is highly polymorphic. ACE2 is expressed in numerous tissues especially the lung alveolar epithelial cells, heart, kidney and gastrointestinal tract. Animal studies have found that ACE2 is central in diseases affecting almost all organ systems, among other cardiac, respiratory, renal and endocrine functions. ACE2 was identified as the cellular contact point for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of the global pandemic (COVID-19), and is a potential drug target. SARS-CoV-2 infection has several effects on the renin–angiotensin system and conversely, regulation of this receptor may affect the progress of infection. We describe the genetics and functions of ACE2, explore its various physiological functions in the renin–angiotensin system and discuss its role in the pathophysiology of disease. ACE2 opposes the vasopressor ACE pathway of the renin–angiotensin system by converting angiotensin (Ang) I to Ang (1–9) and Ang II to Ang (1–7) which initiates the vasodilatory pathway. ACE2 may have a protective effect in the lung and kidney as knockout mice display susceptibility to acute respiratory distress and hypertensive nephropathy. Binding of SARS-CoV-2 and the subsequent fusion and downregulation of this pathway during SARS-CoV-2 infection may explain some of the unusual sequelae seen in COVID-19.
    Keywords Pathology and Forensic Medicine ; General Medicine ; covid19
    Language English
    Publisher BMJ
    Publishing country uk
    Document type Article ; Online
    ZDB-ID 80261-x
    ISSN 1472-4146 ; 0021-9746
    ISSN (online) 1472-4146
    ISSN 0021-9746
    DOI 10.1136/jclinpath-2020-206954
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: The association between acid-base status and clinical outcome in critically ill COVID-19 patients admitted to intensive care unit with an emphasis on high anion gap metabolic acidosis.

    Zemlin, Annalise E / Sigwadhi, Lovemore N / Wiese, Owen J / Jalavu, Thumeka P / Chapanduka, Zivanai C / Allwood, Brian W / Tamuzi, Jacques L / Koegelenberg, Coenraad F / Irusen, Elvis M / Lalla, Usha / Ngah, Veranyuy D / Yalew, Anteneh / Erasmus, Rajiv T / Matsha, Tandi E / Zumla, Alimuddin / Nyasulu, Peter S

    Annals of clinical biochemistry

    2022  Volume 60, Issue 2, Page(s) 86–91

    Abstract: Objective: The aim of this study was to identify arterial blood gas (ABG) abnormalities, with a focus on a high anion gap (AG) metabolic acidosis and evaluate outcomes in coronavirus disease 2019 (COVID-19) patients admitted to the ICU.: Methods: A ... ...

    Abstract Objective: The aim of this study was to identify arterial blood gas (ABG) abnormalities, with a focus on a high anion gap (AG) metabolic acidosis and evaluate outcomes in coronavirus disease 2019 (COVID-19) patients admitted to the ICU.
    Methods: A retrospective, observational study was conducted in a tertiary hospital in Cape Town during the first and second COVID-19 waves. Age, gender, sodium (Na), potassium (K), chloride (Cl), bicarbonate (HCO
    Results: This study included 465 patients, 226 (48%) of whom were female. The sample population's median (IQR) age was 54.2 (46.1-61.3) years, and 63% of the patients died. ABG analyses found that 283 (61%) of the 465 patients had alkalosis (pH ≥ 7.45), 65 (14%) had acidosis (pH ≤ 7.35) and 117 (25%) had normal pH (7.35-7.45). In the group with alkalosis, 199 (70.3%) had a metabolic alkalosis and in the group with acidosis, 42 (64%) had a metabolic acidosis with an increased AG of more than 17. Non-survivors were older than survivors (56.4 years versus 50.3 years,
    Conclusion: Most of the COVID-19 patients admitted to the ICU had an alkalosis, and those with acidosis had a much worse prognosis. Higher AG metabolic acidosis was not associated with patients' characteristics.
    MeSH term(s) Humans ; Female ; Middle Aged ; Male ; Acid-Base Equilibrium ; Retrospective Studies ; Critical Illness ; COVID-19 ; South Africa ; Acidosis ; Alkalosis ; Intensive Care Units
    Language English
    Publishing date 2022-11-07
    Publishing country England
    Document type Observational Study ; Journal Article
    ZDB-ID 390309-6
    ISSN 1758-1001 ; 0004-5632
    ISSN (online) 1758-1001
    ISSN 0004-5632
    DOI 10.1177/00045632221134687
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Correlating arterial blood gas, acid-base and blood pressure abnormalities with outcomes in COVID-19 intensive care patients.

    Bezuidenhout, Morne C / Wiese, Owen J / Moodley, Desiree / Maasdorp, Elizna / Davids, Mogamat R / Koegelenberg, Coenraad Fn / Lalla, Usha / Khine-Wamono, Aye A / Zemlin, Annalise E / Allwood, Brian W

    Annals of clinical biochemistry

    2020  Volume 58, Issue 2, Page(s) 95–101

    Abstract: Background: During the outbreak of coronavirus disease 2019 (COVID-19), many studies have investigated laboratory biomarkers in management and prognostication of COVID-19 patients, however to date, few have investigated arterial blood gas, acid-base and ...

    Abstract Background: During the outbreak of coronavirus disease 2019 (COVID-19), many studies have investigated laboratory biomarkers in management and prognostication of COVID-19 patients, however to date, few have investigated arterial blood gas, acid-base and blood pressure patterns. The aim of the study is to assess the arterial blood gas and acid-base patterns, blood pressure findings and their association with the outcomes of COVID-19 patients admitted to an intensive care unit.
    Methods: A single-centre retrospective, observational study in a dedicated COVID-19 intensive care unit in Cape Town, South Africa. Admission arterial blood gas, serum electrolytes, renal function and blood pressure readings performed on COVID-19 patients admitted between 26 March and 2 June 2020 were analysed and compared between survivors and non-survivors.
    Results: A total of 56 intensive care unit patients had admission arterial blood gas performed at the time of intensive care unit admission. An alkalaemia (pH > 7.45) was observed in 36 (64.3%) patients. A higher arterial pH (median 7.48 [interquartile range: 7.45-7.51] versus 7.46 [interquartile range: 7.40-7.48],
    Conclusions: The majority of the study population admitted to intensive care unit had an alkalaemia on arterial blood gas. A higher pH and lower partial pressure of oxygen in arterial blood on arterial blood gas analysis were significantly associated with survival.
    MeSH term(s) Acid-Base Equilibrium ; Adult ; Biomarkers/blood ; Blood Gas Analysis ; Blood Pressure ; COVID-19/blood ; COVID-19/mortality ; COVID-19/physiopathology ; COVID-19/therapy ; Critical Care ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Retrospective Studies ; SARS-CoV-2/metabolism
    Chemical Substances Biomarkers
    Keywords covid19
    Language English
    Publishing date 2020-11-20
    Publishing country England
    Document type Journal Article ; Observational Study
    ZDB-ID 390309-6
    ISSN 1758-1001 ; 0004-5632
    ISSN (online) 1758-1001
    ISSN 0004-5632
    DOI 10.1177/0004563220972539
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Global rural health disparities in Alzheimer's disease and related dementias: State of the science.

    Wiese, Lisa Ann Kirk / Gibson, Allison / Guest, Marc Aaron / Nelson, Amy R / Weaver, Raven / Gupta, Aditi / Carmichael, Owen / Lewis, Jordan P / Lindauer, Allison / Loi, Samantha / Peterson, Rachel / Radford, Kylie / Rhodus, Elizabeth K / Wong, Christina G / Zuelsdorff, Megan / Saidi, Ladan Ghazi / Valdivieso-Mora, Esmeralda / Franzen, Sanne / Pope, Caitlin N /
    Killian, Timothy S / Shrestha, Hom L / Heyn, Patricia C / Ng, Ted Kheng Siang / Prusaczyk, Beth / John, Samantha / Kulshreshtha, Ambar / Sheffler, Julia L / Besser, Lilah / Daniel, Valerie / Tolea, Magdalena I / Miller, Justin / Musyimi, Christine / Corkey, Jon / Yank, Veronica / Williams, Christine L / Rahemi, Zahra / Park, JuYoung / Magzamen, Sheryl / Newton, Robert L / Harrington, Candace / Flatt, Jason D / Arora, Sonakshi / Walter, Sarah / Griffin, Percy / Babulal, Ganesh M

    Alzheimer's & dementia : the journal of the Alzheimer's Association

    2023  Volume 19, Issue 9, Page(s) 4204–4225

    Abstract: Introduction: Individuals living in rural communities are at heightened risk for Alzheimer's disease and related dementias (ADRD), which parallels other persistent place-based health disparities. Identifying multiple potentially modifiable risk factors ... ...

    Abstract Introduction: Individuals living in rural communities are at heightened risk for Alzheimer's disease and related dementias (ADRD), which parallels other persistent place-based health disparities. Identifying multiple potentially modifiable risk factors specific to rural areas that contribute to ADRD is an essential first step in understanding the complex interplay between various barriers and facilitators.
    Methods: An interdisciplinary, international group of ADRD researchers convened to address the overarching question of: "What can be done to begin minimizing the rural health disparities that contribute uniquely to ADRD?" In this state of the science appraisal, we explore what is known about the biological, behavioral, sociocultural, and environmental influences on ADRD disparities in rural settings.
    Results: A range of individual, interpersonal, and community factors were identified, including strengths of rural residents in facilitating healthy aging lifestyle interventions.
    Discussion: A location dynamics model and ADRD-focused future directions are offered for guiding rural practitioners, researchers, and policymakers in mitigating rural disparities.
    Highlights: Rural residents face heightened Alzheimer's disease and related dementia (ADRD) risks and burdens due to health disparities. Defining the unique rural barriers and facilitators to cognitive health yields insight. The strengths and resilience of rural residents can mitigate ADRD-related challenges. A novel "location dynamics" model guides assessment of rural-specific ADRD issues.
    MeSH term(s) Humans ; Alzheimer Disease/epidemiology ; Rural Population ; Rural Health ; Risk Factors
    Language English
    Publishing date 2023-05-23
    Publishing country United States
    Document type Journal Article ; Review ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
    ZDB-ID 2211627-8
    ISSN 1552-5279 ; 1552-5260
    ISSN (online) 1552-5279
    ISSN 1552-5260
    DOI 10.1002/alz.13104
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: EXPRESS: Correlating arterial blood gas, acid-base and blood pressure abnormalities with outcomes in COVID-19 intensive care patients

    Bezuidenhout, Morne C / Wiese, Owen J / Moodley, Desiree / Maasdorp, Elizna / Davids, Mogamat Razeen / Koegenlenberg, Coenraad Fn / Lalla, Usha / Khine-Wamono, Aye Aye / Zemlin, Annalise E / Allwood, Brian W

    Ann Clin Biochem

    Abstract: BACKGROUND: During the outbreak of coronavirus disease 2019 (COVID-19) many studies have investigated laboratory biomarkers in management and prognostication of COVID-19 patients, however to date, few have investigated arterial blood gas (ABG), acid-base ...

    Abstract BACKGROUND: During the outbreak of coronavirus disease 2019 (COVID-19) many studies have investigated laboratory biomarkers in management and prognostication of COVID-19 patients, however to date, few have investigated arterial blood gas (ABG), acid-base and blood pressure (BP) patterns. The aim of the study is to assess the ABG and acid-base patterns, BP findings and their association with the outcomes of COVID-19 patients admitted to an intensive care unit (ICU). METHODS: A single-centre retrospective, observational study in a dedicated COVID-19 ICU in Cape Town, South Africa. Admission ABG, serum electrolytes, renal function and BP readings performed on COVID-19 patients admitted between 26 March and 2 June 2020 were analysed and compared between survivors and non-survivors. RESULTS: A total of 56 ICU patients had admission ABG performed at the time of ICU admission. An alkalaemia (pH > 7.45) was observed in 36 (64.3%) patients. A higher arterial pH [median 7.48 (IQR: 7.45-7.51 vs. 7.46 (IQR: 7.40-7.48), p=0.049] and partial pressure of oxygen in arterial blood [PaO2; median 7.9kPa (IQR 7.3- 9.6) vs. 6.5kPa (IQR: 5.2-7.3), p=<0.001] were significantly associated with survival. Survivors also tended to have a higher systolic BP [median: 144mmHg (IQR: 134- 152) vs. 139mmHg (IQR: 125-142), p=0.078] and higher arterial HCO3 [median: 28.0mmol/L (IQR: 25.7- 28.8) vs. 26.3mmol/L (IQR: 24.3-27.9); p=0.059). CONCLUSIONS: The majority of the study population admitted to ICU had an alkalaemia on ABG. A higher pH and lower PaO2 on ABG analysis were significantly associated with survival.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #890020
    Database COVID19

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