Question Collective evidence for the bidirectional association between depression and autoimmune diseases (ADs) is scarce, especially for subgroups of patients with specific ADs. We conducted a meta-analysis to determine the incidence rates and relative risks (RRs) of depression among patients with ADs, and vice versa. Study selection and analysis PubMed, Embase, Web of Science, Ovid, PsycNet and Cochrane were searched up to 10 September 2024. Cohort studies evaluating longitudinal risks between ADs and depression were included. Incidence rates and RRs of depression among patients with ADs and vice versa were pooled. Findings The analysis included 47 studies, involving over 40.77 million participants. The pooled incidence rate of depression among patients with ADs was 6.71% (95% CI 5.10% to 8.77%), with an RR of 1.85 (95% CI 1.57 to 2.19), higher in patients aged over 45 (2.30; 95% CI 1.62 to 3.26) and females (1.88; 95% CI 1.61 to 2.20). Conversely, the pooled incidence rate of ADs among depression was 0.54% (95% CI 0.24% to 1.19%), with an RR of 1.84 (95% CI 1.10 to 3.09). The incidence rate and RRs also varied across subgroups with the highest incidence rate in the musculoskeletal system and connective tissue (1.36; 95% CI 0.50 to 3.63) and RR in the genitourinary system (2.23; 95% CI 1.98 to 2.51). Conclusions This study identified a bidirectional association between depression and ADs, with higher RRs among patients aged over 45 and females. Especially higher risks were also found for specific types of ADs including endocrine, nutritional, and metabolic diseases, genitourinary system, and skin and subcutaneous tissue. PROSPERO registration number CRD42024541053.

Numerous studies have shown that Helicobacter pylori (HP) infection may be involved in the development of carotid atherosclerosis (CAS), but this conclusion is still controversial. The aim of this study was to explore whether there is a positive association between HP infection and CAS occurrence. We collected data on demographic characteristics, lifestyle, and disease history of the participants by questionnaire. We obtained clinical anthropometric data and blood samples of the participants from clinical examinations and laboratory work. The ¹³C urea breath test (¹³C-UBT) was performed to assess the HP infection status, and carotid ultrasonography was used to diagnose the CAS and plaque types. Univariate analysis and multivariate logistic regression were used to identify the relationship between HP infection and CAS. A total of 1,424 participants were recruited for this study. A total of 740 HP-positive individuals and 684 HP-negative individuals were identified, and 345 participants were diagnosed with CAS. The prevalence of CAS was higher in the HP-positive group (26.4%) than in the HP-negative group (21.7%) (P < 0.05). A significantly higher prevalence of carotid intima-media thickening, carotid plaque, and carotid stenosis was identified in the HP-positive group than in the HP-negative group (P < 0.05). There was no significant difference in the detection rate of unstable plaques between the HP-positive and HP-negative groups (P > 0.05). In multivariate models adjusted for covariates, HP infection showed a positive association with CAS, independent of other risk factors (ORs range: 1.283–1.333, P < 0.05). HP infection independently accounted for approximately 5% of the CAS risk in the absence of other cardiovascular risk factors. A positive association between HP infection and CAS was demonstrated in this study. HP infection might be an independent risk factor for CAS. Although the effect of HP infection on CAS observed in our study was less than that of traditional risk factors, we believe that this is an indispensable advance in the etiological study of CAS. These results imply that the microbial population might play an essential role in CAS, which provides a new perspective for the primary prevention of CAS.

Background: The coronavirus disease 2019 (COVID-19) has affected approximately 2 million individuals worldwide; however, data regarding fatal cases have been limited. Objective: To report the clinical features of 162 fatal cases of COVID-19 from 5 hospitals in Wuhan between December 30, 2019 and March 12, 2020. Methods: The demographic data, signs and symptoms, clinical course, comorbidities, laboratory findings, computed tomographic (CT) scans, treatments, and complications of the patients with fatal cases were retrieved from electronic medical records. Results: The median patient age was 69.5 (interquartile range: 63.0–77.25) years, and 80% of the patients were over 61 years. A total of 112 (69.1%) patients were men. Hypertension (45.1%) was the most common comorbidity, while 59 (36.4%) patients had no comorbidity. At admission, 131 (81.9%) patients had severe or critical COVID-19, whereas 39 (18.1%) patients with hypertension or chronic lung disease had moderate COVID-19. In total, 126 (77.8%) patients received antiviral treatment, while 132(81.5%) patients received glucocorticoid treatment. A total of 116 (71.6%) patients were admitted to the intensive care unit (ICU), and 137 (85.1%) patients received mechanical ventilation. Most patients received mechanical ventilation before ICU admission. Approximately 93.2% of the patients developed respiratory failure or acute respiratory distress syndrome. There were no significant differences in the inhospital survival time among the hospitals (P=0.14). Conclusion: Young patients with moderate COVID-19 without comorbidity at admission could also develop fatal outcomes. The in-hospital survival time of the fatal cases was similar among the hospitals of different levels in Wuhan.