Evidence map›Paper›PMID 37319299›Full record

Observational studyPloS one2023

Targeting patients for early COVID-19 therapy; Pre-infection metabolic dysfunction, polycystic ovary syndrome and risk of severe disease in patients under 65: A Massachusetts community-based observational study.

Susan R Sama, Rebecca Gore, Ann Z Bauer, Lawrence Garber, Richard Rosiello, Devi Sundaresan, Anne McDonald, David Kriebel

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 39% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 citations in OpenAlex.

  1. Trial
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Susan R SamaDepartment of Public Health, University of Massachusetts Lowell, Lowell, Massachusetts, United States of America.ORCID 0000-0003-0182-598X
Rebecca GoreDepartment of Public Health, University of Massachusetts Lowell, Lowell, Massachusetts, United States of America.
Ann Z BauerDepartment of Public Health, University of Massachusetts Lowell, Lowell, Massachusetts, United States of America.
Lawrence GarberReliant Medical Group, Inc., Worcester, Massachusetts, United States of America.ORCID 0000-0003-1500-5421
Richard RosielloReliant Medical Group, Inc., Worcester, Massachusetts, United States of America.
Devi SundaresanReliant Medical Group, Inc., Worcester, Massachusetts, United States of America.
Anne McDonaldReliant Medical Group, Inc., Worcester, Massachusetts, United States of America.
David KriebelDepartment of Public Health, University of Massachusetts Lowell, Lowell, Massachusetts, United States of America.
Reliant Medical Group · USUniversity of Massachusetts Lowell · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe demographics of those developing severe coronavirus disease (COVID-19) outcomes are shifting to younger patients. In an observational study utilizing electronic health records from a Massachusetts group medical practice, we identified 5025 patients with confirmed COVID-19 from March 1 to December 18, 2020. Of these, 3870 were under 65 years of age. We investigated the hypothesis that pre-infection metabolic or immunologic dysregulation including polycystic ovary syndrome (PCOS) increased risk of serious COVID-19 outcomes in patients under 65 years of age. MATERIALS AND

methodsWe compared those with COVID-19 related hospitalization or mortality to all other COVID-19 patients, using a case control approach. Using logistic regression and propensity score modeling, we evaluated risk of developing severe COVID-19 outcomes (hospitalization or death) in those with pre-infection comorbidities, metabolic risk factors, or PCOS.

resultsOverall, propensity score matched analyses demonstrated pre-infection elevated liver enzymes alanine aminotransferase (ALT) >40, aspartate aminotransferase (AST) >40 and blood glucose ≥215 mg/dL were associated with more severe COVID-19 outcomes, OR = 1.74 (95% CI 1.31, 2.31); OR = 1.98 (95% CI 1.52, 2.57), and OR = 1.55 (95% CI 1.08, 2.23) respectively. Elevated hemoglobin A1C or blood glucose levels were even stronger risk factors for severe COVID-19 outcomes among those aged < 65, OR = 2.31 (95% CI 1.14, 4.66) and OR = 2.42 (95% CI 1.29, 4.56), respectively. In logistic regression models, women aged < 65 with PCOS demonstrated more than a four-fold increased risk of severe COVID-19, OR 4.64 (95% CI 1.98, 10.88).

conclusionIncreased risk of severe COVID-19 outcomes in those < age 65 with pre-infection indicators of metabolic dysfunction heightens the importance of monitoring pre-infection indicators in younger patients for prevention and early treatment. The PCOS finding deserves further investigation. Meanwhile women who suffer from PCOS should be carefully evaluated and prioritized for earlier COVID-19 treatment and vaccination.

Indexed as

COVID-19Polycystic Ovary SyndromeAgedBlood GlucoseComorbidityCOVID-19 Drug TreatmentFemaleHumansBlood Glucose

Identifiers

PMID37319299
PMCPMC10270632
OpenAlexW4380853507

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.