Thrombosis is a detrimental sequala of COVID-19 infection; thus, prophylactic anti-coagulant therapy has been deemed mandatory in treatment unless serious contraindications are present. ...Susceptibility to thromboembolic events in COVID-19, or following COVID-19 vaccination, is likely attributable to an interplay of factors, including a patient's baseline clinical status and comorbidities, alongside genetic risk factors. In Europe, 8-20% of the population are homozygous for the MTHFR (methylene tetrahydrofolate reductase) variant, which compromises folate metabolism and elevates homocysteine levels. While heightened homocysteine levels are considered a risk factor for thromboembolic events, the precise clinical significance remains a contentious issue. However, recent research suggests elevated homocysteine levels may predict the course and severity of COVID-19 infection. Given the lack of reliable biomarkers predictive of COVID-19 thrombotic risk existing in practice, and the accessibility of MTHFR screening, we established two main outcomes for this study: (1) to determine the association between hereditary MTHFR mutations and COVID-19 severity and thromboembolic events and (2) to determine the link between MTHFR variants and adverse thrombotic events following COVID-19 vaccination.
The review was conducted in accordance with PRISMA guidelines. Medline, Scopus, and Web of Science databases were searched from pandemic inception (11 March 2020) to 30 October 2023. Eligibility criteria were applied, and data extraction performed.
From 63 citations identified, a total of 14 articles met the full inclusion criteria (8 of which were cross-sectional or observational studies, and 6 were case studies or reports). Among the eight observational and cross-sectional studies evaluating the relationship between MTHFR variants (C667T; A1298C) and thromboembolic events in COVID-19 infection, four studies established a connection (
= 2200), while the remaining four studies failed to demonstrate any significant association (
= 38).
This systematic review demonstrated a possible association between the MTHFR gene variants and COVID-19 severity, thromboembolic events, and adverse events following vaccination. However, the paucity of robust data precluded any firm conclusions being drawn. Further prospective trials are required to determine the connection between the MTHFR gene variant and COVID-19 infection and vaccination outcomes.
Cilj ovoga istraživanja bio je prikazati epidemiološke karakteristike tuberkuloze u Splitsko-dalmatinskoj županiji u razdoblju od 2003. do 2016. godine. Retrospektivno smo analizirali sve ...tuberkulozne bolesnike prijavljene Službi za epidemiologiju Nastavnog zavoda za javno zdravstvo Splitsko-dalmatinske županije od 2003. do 2016. godine, što ukupno čini 926 ispitanika. Rezultati su pokazali da županijska incidencija tuberkuloze kontinuirano pada te sa zadnjom zabilježenom stopom od 8,6/100 000 pripada područjima niske incidencije. Iako su na početku najviše stope bile zabilježene u zaobalju, a najniže na otocima, tijekom posljednjih 6 godina (2011. – 2016.) došlo je do izjednačavanja stopa u zaobalju i na otocima (najviše zbog izraženog pada stopa u zaobalju), a najniže su postale u priobalju. Stope incidencije rastu s porastom dobi. Muškarci obolijevaju dvostruko češće od žena. Najčešća lokalizacija tuberkuloze su pluća (85,1% oboljelih). Bakteriološki potvrđenih tuberkuloza bilo je 71,92%. Ukupno 40,82% bolesnika imalo je mikroskopski pozitivne iskašljaje, što ih čini najzaraznijim tuberkuloznim bolesnicima. Rezistencija je zabilježena u 4,35% slučajeva i najčešće se radilo o monorezistenciji na izoniazid. Zabilježena su dva slučaja multirezistentne tuberkuloze. Rezultati ovoga istraživanja pokazuju da je epidemiološka situacija povezana s tuberkulozom u Splitsko-dalmatinskoj županiji pod nadzorom. Kontinuirani pad stopa incidencije pokazuje da smo na dobrom putu, ali bez obzira na povoljne epidemiološke prilike, protutuberkulozne aktivnosti treba nastaviti provoditi kako su zakonski zadane, jer bilo kakvi propusti mogu uništiti sve dosad postignute uspjehe.
