Displaying publications 21 - 37 of 37 in total

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  1. Wan Yahaya WA, Azman NAM, Adam F, Subramaniam SD, Abd Hamid KH, Almajano MP
    Polymers (Basel), 2023 Jun 29;15(13).
    PMID: 37447534 DOI: 10.3390/polym15132884
    Biodegradable films made from biopolymer materials have the potential to replace conventional plastics, which can reduce waste disposal problems. This study aims to explore the potential of different seaweed derivate films consisting of 2% (w/w) of kappaphycus alverezi (KA), kappa carrageenan (KC), refined carrageenan (RC) and semi-refined carrageenan (SRC) as bio-based materials with 0.9% (w/w) glycerol (G), and reinforced with different concentrations of cellulose nanofibers (CNFs) derived from palm waste. A characterization of the glycerol-plasticized seaweed derivatives containing 0, 5, 10, and 15% (v/w) cellulose nanofiber is carried out. The CNFs were studied based on their mechanical, physical and thermal properties including mechanical properties, thickness, moisture content, opacity, water solubility, water vapor permeability and thermal stability. The hydrogen bonding was determined using the DFT calculation generated by Gauss view software version 9.6. The KA + G + 10%CNF film exhibited a surface with slight cracks, roughness, and larger lumps and dents, resulting in inferior mechanical properties (18.50 Mpa), making it unsuitable for biofilm production. The KC + G + 10%CNF film exhibited mechanical properties 24.97 Mpa and water vapor permeability of 1.42311 × 10-11 g s-1 m-1 Pa-1. The RC/G/10%CNF film displayed the highest TS (48.23 MPa) and water vapor permeability (1.4168 × 10-11 g s-1 m-1 Pa-1), but it also had higher solubility in water (66%). In contrast, the SRC + G + 10%CNF film demonstrated excellent mechanical properties (45.98 MPa), low water solubility (42.59%), low water vapor permeability (1.3719 × 10-11 g s-1 m-1 Pa-1), and a high decomposition temperature (250.62 °C) compared to KA, KC and RC. These attributes develop films suitable for various applications, including food packaging with enhanced properties and stability.
  2. Hanafiah M, Johari B, Abdul Kadir RF, Bakar NS, Baharuddin H
    Clin Case Rep, 2020 Dec;8(12):3565-3566.
    PMID: 33363980 DOI: 10.1002/ccr3.3206
    Cysts are a common finding of lymphocytic interstitial pneumonia (LIP) on imaging. Usually, they are limited in number and size. Tiny and numerous cysts of peribronchovascular distribution are less typical but a recognized appearance in LIP.
  3. Lambuk F, Nordin NA, Mussa A, Lambuk L, Ahmad S, Hassan R, et al.
    Immunology, 2024 Aug 27.
    PMID: 39191474 DOI: 10.1111/imm.13855
    Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by inflammation of the synovium and progressive joint destruction which significantly affects both quality of life and socioeconomic status. Admittedly, various treatments are available, but they are usually accompanied by various side effects, from mild to severe, and potentially with adverse events. Tumour necrosis factor-alpha (TNF-α) plays a crucial role in the pathophysiology of RA. It promotes inflammatory, apoptosis and necroptosis via TNF receptor-1 (TNFR1) but elicit anti-inflammatory effects via TNFR2. Herein, targeting TNFR2 has gained attention in RA studies. Understanding the role of nanomedicine in modulating TNFR2 signalling may be the instrument in development of RA therapies. Nanotechnology has made a significant progress in treating various conditions of diseases since its inception. Due to this, nanomedicine has emerged as a promising therapeutics approach for RA. Recent studies have demonstrated the potential of nanomedicine in RA theranostics, combining therapy and diagnostics for improved treatment outcomes. Owing to the challenges and advancements in the field of nanotechnology, nanoparticles are seen as an applicable candidate in the treatment of RA. In this review, we provide an overview of the role of nanomedicine in targeting TNFR2 for the treatment of RA and highlight the limitations of current therapies as well as the potential of nanocarriers with controlled drug release and active targeting abilities.
  4. Mohd Nazri MN, Khairil Anwar NA, Mohd Zaidi NF, Fadzli Mustaffa KM, Mokhtar NF
    Bioorg Med Chem Lett, 2024 Aug 31;112:129943.
    PMID: 39222892 DOI: 10.1016/j.bmcl.2024.129943
    Increased expression and activity of the PD-L1/PD-1 pathway suppresses the activation of cytotoxic T cells, which is vital in anti-tumour defence, allowing tumours to rise, expand and progress. Current strategies using antibodies to target PD-1/PD-L1 have been very effective in cancer therapeutics and companion diagnostics. Aptamers are a new class of molecules that offer an alternative to antibodies. Herein, the systematic evolution of ligands by exponential enrichment (SELEX) using agarose slurry beads was conducted to isolate DNA aptamers specific to recombinant human PD-L1 (rhPD-L1). Isolated aptamers were sequenced and analysed using MEGA X and structural features were examined using mFold. Three aptamer candidates (P33, P32, and P12) were selected for evaluation of binding affinity (dissociation constant, Kd) using ELONA and specificity and competitive inhibition assessment using the potentiostat-electrochemical method. Among those three, P32 displayed the highest specificity (8 nM) against PD-L1. However, P32 competes for the same binding site with the control antibody, 28-8. This study warrants further assessment of P32 aptamer as a potential, cost-effective alternative tool for targeting PD-L1.
  5. Mohd Nasir MZ, Malek KA, Isa MR, Hamdan MF, Abdul Kadir RF, Ahmad F, et al.
    Int J Clin Pract, 2021 Sep;75(9):e14445.
    PMID: 34105862 DOI: 10.1111/ijcp.14445
    AIMS: Our study aimed to investigate the association between elevated carotid-intima media thickness (CIMT) and serum uric acid (SUA) levels in hypertensive patients attending primary care clinics in Sungai Buloh, Malaysia.

    METHODS: We conducted a cross-sectional study on 140 hypertensive patients attending outpatient follow-up in two primary care clinics in Sungai Buloh, Malaysia, using a convenient sampling method. SUA levels were measured and divided into four quartiles. Two radiologist specialists performed B mode ultrasonography to assess the thickness of the right and left carotid intima media in all participants.

    RESULTS: Participants' mean SUA level was 355.75 ± 0.13. Their mean age was 53.44 (± 9.90), with a blood pressure control of 137.09 ± 13.22/81.89 ± 8.95. Elevated CIMT taken at ≥75th percentile was 0.666 for the left and 0.633 for the right common carotid arteries. By using a hierarchical method of multiple logistic regression, compared with the first quartile of the SUA level as reference group, the odd of elevated CIMT in quartile 4 in the common carotid artery was (OR = 2.00; 95% CI = 0.64-6.27, P = .576) for the right and (OR = 0.62; 95% CI = 0.20-2.00, P = .594) for the left. Waist circumference (P = .001), body mass index (P = .013), triglycerides (P 

  6. Sharudin NA, Murtadha Noor Din AH, Azahar II, Mohd Azlan M, Yaacob NS, Sarmiento ME, et al.
    Asian Pac J Cancer Prev, 2022 Sep 01;23(9):2953-2964.
    PMID: 36172657 DOI: 10.31557/APJCP.2022.23.9.2953
    BACKGROUND: Detectable neonatal Nav1.5 (nNav1.5) expression in tumour breast tissue positive for lymph node metastasis and triple-negative subtype serves as a valid tumour-associated antigen to target and prevent breast cancer invasion and metastasis. Therapeutic antibodies against tumour antigens have become the predominant class of new drugs in cancer therapy because of their fewer adverse effects and high specificity.

    OBJECTIVE: This study was designed to investigate the therapeutic and anti-metastatic potential of the two newly obtained anti-nNav1.5 antibodies, polyclonal anti-nNav1.5 (pAb-nNav1.5) and monoclonal anti-nNav1.5 (mAb-nNav1.5), on breast cancer invasion and metastasis.

    METHODS: MDA-MB-231 and 4T1 cells were used as in vitro models to study the effect of pAb-nNav1.5 (59.2 µg/ml) and mAb-nNav1.5 (10 µg/ml) (24 hours treatment) on cell invasion. 4T1-induced mammary tumours in BALB/c female mice were used as an in vivo model to study the effect of a single dose of intravenous pAb-nNav1.5 (1 mg/ml) and mAb-nNav1.5 (1 mg/ml) on the occurrence of metastasis. Real-time PCR and immunofluorescence staining were conducted to assess the effect of antibody treatment on nNav1.5 mRNA and protein expression, respectively. The animals' body weight, organs, lesions, and tumour mass were also measured and compared.

    RESULTS: pAb-nNav1.5 and mAb-nNav1.5 treatments effectively suppressed the invasion of MDA-MB-231 and 4T1 cells in the 3D spheroid invasion assay. Both antibodies significantly reduced nNav1.5 gene and protein expression in these cell lines. Treatment with pAb-nNav1.5 and mAb-nNav1.5 successfully reduced mammary tumour tissue size and mass and prevented lesions in vital organs of the mammary tumour animal model whilst maintaining the animal's healthy weight. mRNA expression of nNav1.5 in mammary tumour tissues was only reduced by mAb-nNav1.5.

    CONCLUSION: Overall, this work verifies the uniqueness of targeting nNav1.5 in breast cancer invasion and metastasis prevention, but more importantly, humanised versions of mAb-nNav1.5 may be valuable passive immunotherapeutic agents to target nNav1.5 in breast cancer.

  7. Mussa A, Afolabi HA, Syed NH, Talib M, Murtadha AH, Hajissa K, et al.
    Biomedicines, 2023 Mar 30;11(4).
    PMID: 37189677 DOI: 10.3390/biomedicines11041060
    Breast cancer (BC) is the most common cancer type among women with a distinct clinical presentation, but the survival rate remains moderate despite advances in multimodal therapy. Consequently, a deeper understanding of the molecular etiology is required for the development of more effective treatments for BC. The relationship between inflammation and tumorigenesis is well established, and the activation of the pro-inflammatory transcription factor nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) is frequently identified in BC. Constitutive NF-κB activation is linked to cell survival, metastasis, proliferation, and hormonal, chemo-, and radiotherapy resistance. Moreover, the crosstalk between NF-κB and other transcription factors is well documented. It is reported that vitamin C plays a key role in preventing and treating a number of pathological conditions, including cancer, when administered at remarkably high doses. Indeed, vitamin C can regulate the activation of NF-κB by inhibiting specific NF-κB-dependent genes and multiple stimuli. In this review, we examine the various NF-κB impacts on BC development. We also provide some insight into how the NF-κB network may be targeted as a potential vulnerability by using natural pro-oxidant therapies such as vitamin C.
  8. Amira Khairil Anwar N, Najmi Mohd Nazri M, Rosliza Mohd Adzemi E, Amilda Anthony A, Mohd Azlan M, Balakrishnan V, et al.
    Cytokine, 2024 Jul 22;182:156698.
    PMID: 39042994 DOI: 10.1016/j.cyto.2024.156698
    BACKGROUND: Elevated serum levels of soluble PD-L1 (sPD-L1) have been reported in many cancers; however, there is limited data of sPD-L1 in breast cancer, especially those representing Asian (Malay) women. The purpose of this study was to evaluate sPD-L1 serum levels and analyze its correlation with clinical characteristics in breast cancer patients at Hospital Universiti Sains Malaysia (HUSM).

    METHODS: Blood specimens were obtained from 92 malignant, 16 benign breast cancer patients and 23 healthy controls. The serum concentrations of sPD-L1 were assessed by enzyme-linked immunosorbent assay (ELISA).

    RESULTS: The median serum sPD-L1 concentration of malignant and benign breast cancer patients was significantly elevated compared to the healthy cohorts (12.50 ng/mL vs 13.97 ng/mL vs 8.75 ng/mL, p 

  9. Zainol Abidin MN, Goh PS, Said N, Ismail AF, Othman MHD, Hasbullah H, et al.
    ACS Appl Mater Interfaces, 2020 Jul 22;12(29):33276-33287.
    PMID: 32589391 DOI: 10.1021/acsami.0c08947
    The development of wearable artificial kidney demands an efficient dialysate recovery, which relies upon the adsorption process. This study proposes a solution to solve the problem of competitive adsorption between the uremic toxins by employing two adsorptive components in a membrane separation process. Dual-layer hollow fiber (DLHF) membranes, which are composed of a polysulfone (PSf)/activated carbon (AC) inner layer and a PSf/poly(methyl methacrylate) (PMMA) outer layer, were prepared for co-adsorptive removal of creatinine and urea from aqueous solution. The DLHF membranes were characterized in terms of morphological, physicochemical, water transport, and creatinine adsorption properties. The membrane was then subjected to an ultrafiltration adsorption study for performance evaluation. The incorporation of AC in membrane, as confirmed by microscopic and surface analyses, has improved the pure water flux up to 25.2 L/(m2 h). A membrane with optimum AC loading (9 wt %) demonstrated the highest maximum creatinine adsorption capacity (86.2 mg/g) based on the Langmuir adsorption isotherm model. In the ultrafiltration adsorption experiment, the membrane removed creatinine and urea with a combined average percent removal of 29.3%. Moreover, the membrane exhibited creatinine and urea uptake recoveries of 98.8 and 81.2%, respectively. The combined action of PMMA and AC in the PSf DLHF membrane has made the adsorption of multiple uremic toxins possible during dialysate recovery.
  10. Khairil Anwar NA, Mohd Nazri MN, Murtadha AH, Mohd Adzemi ER, Balakrishnan V, Mustaffa KMF, et al.
    Acta Biochim Biophys Sin (Shanghai), 2021 Jul 28;53(8):961-978.
    PMID: 34180502 DOI: 10.1093/abbs/gmab077
    Aggressive tissue biopsy is commonly unavoidable in the management of most suspected tumor cases to conclusively verify the presence of cancerous cells through histological assessment. The extracted tissue is also immunostained for detection of antigens (tissue tumor markers) of potential prognostic or therapeutic importance to assist in treatment decision. Although liquid biopsies can be a powerful tool for monitoring treatment response, they are still excluded from standard cancer diagnostics, and their utility is still being debated in the scientific community. With a myriad of soluble tissue tumor markers now being discovered, liquid biopsies could completely change the current paradigms of cancer management. Recently, soluble programmed cell death ligand-1 (sPD-L1), which is found in the peripheral blood, i.e. serum and plasma, has shown potential as a pre-therapeutic predictive marker as well as a prognostic biomarker to monitor treatment efficacy. Thus, this review focuses on the emergence of sPD-L1 and promising technologies for its detection in order to support liquid biopsies for future cancer management.
  11. Abidin MNZ, Goh PS, Ismail AF, Othman MHD, Hasbullah H, Said N, et al.
    Mater Sci Eng C Mater Biol Appl, 2016 Nov 01;68:540-550.
    PMID: 27524052 DOI: 10.1016/j.msec.2016.06.039
    Poly (citric acid)-grafted-MWCNT (PCA-g-MWCNT) was incorporated as nanofiller in polyethersulfone (PES) to produce hemodialysis mixed matrix membrane (MMM). Citric acid monohydrate was polymerized onto the surface of MWCNTs by polycondensation. Neat PES membrane and PES/MWCNTs MMMs were fabricated by dry-wet spinning technique. The membranes were characterized in terms of morphology, pure water flux (PWF) and bovine serum albumin (BSA) protein rejection. The grafting yield of PCA onto MWCNTs was calculated as 149.2%. The decrease of contact angle from 77.56° to 56.06° for PES/PCA-g-MWCNTs membrane indicated the increase in surface hydrophilicity, which rendered positive impacts on the PWF and BSA rejection of the membrane. The PWF increased from 15.8Lm(-2)h(-1) to 95.36Lm(-2)h(-1) upon the incorporation of PCA-g-MWCNTs due to the attachment of abundant hydrophilic groups that present on the MWCNTs, which have improved the affinity of membrane towards the water molecules. For protein rejection, the PES/PCA-g-MWCNTs MMM rejected 95.2% of BSA whereas neat PES membrane demonstrated protein rejection of 90.2%. Compared to commercial PES hemodialysis membrane, the PES/PCA-g-MWCNTs MMMs showed less flux decline behavior and better PWF recovery ratio, suggesting that the membrane antifouling performance was improved. The incorporation of PCA-g-MWCNTs enhanced the separation features and antifouling capabilities of the PES membrane for hemodialysis application.
  12. Zailani MZ, Ismail AF, Sheikh Abdul Kadir SH, Othman MH, Goh PS, Hasbullah H, et al.
    J Biomed Mater Res A, 2017 05;105(5):1510-1520.
    PMID: 28000366 DOI: 10.1002/jbm.a.35986
    In this study, poly (1,8-octanediol citrate) (POC) was used to modify polyethersulfone (PES)-based membrane to enhance its hemocompatibility. Different compositions of POC (0-3%) were added into the polyethersulfone (PES) dope solutions and polyvinylpyrrolidone (PVP) was used as pore forming agent. The hemocompatible POC modified PES membranes were fabricated through phase-inversion technique. The prepared membranes were characterized using attenuated total reflectance-Fourier transform infrared (ATR-FTIR), thermogravimetric analysis (TGA), scanning electron microscopy (SEM), Atomic-force microscopy (AFM), contact angle, Zeta-potential, membrane porosity and pore size and pure water flux (PWF) and BSA rejection. The hemocompatibility of the modified PES membranes was evaluated by human serum fibrinogen (FBG) protein adsorption, platelet adhesion, activated partial thromboplastin time (APTT) and prothrombin time (PT), and thrombin-antithrombin III (TAT), complement (C3a and C5a) activation and Ca2+ absorption on membrane. Results showed that by increasing POC concentration, FBG adsorption was reduced, less platelets adhesion, prolonged APTT and PT, lower TAT, C5a and C3a activation and absorb more Ca2+ ion. These results indicated that modification of PES with POC has rendered improved hemocompatibility properties for potential application in the field of blood purification, especially in hemodialysis. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 1510-1520, 2017.
  13. Abidin MNZ, Goh PS, Ismail AF, Othman MHD, Hasbullah H, Said N, et al.
    Mater Sci Eng C Mater Biol Appl, 2017 Aug 01;77:572-582.
    PMID: 28532067 DOI: 10.1016/j.msec.2017.03.273
    A novel approach in the design of a safe, high performance hemodialysis membrane is of great demand. Despite many advantages, the employment of prodigious nanomaterials in hemodialysis membrane is often restricted by their potential threat to health. Hence, this work focusses on designing a biocompatible polyethersulfone (PES) hemodialysis membrane embedded with poly (citric acid)-grafted-multi walled carbon nanotubes (PCA-g-MWCNTs). Two important elements which could assure the safety of the nanocomposite membrane, i.e. (i) dispersion stability and (ii) leaching of MWCNTs were observed. The results showed the improved dispersion stability of MWCNTs in water and organic solvent due to the enriched ratio of oxygen-rich groups which subsequently enhanced membrane separation features. It was revealed that only 0.17% of MWCNTs was leached out during the membrane fabrication process (phase inversion) while no leaching was detected during permeation. In terms of biocompatibility, PES/PCA-g-MWCNT nanocomposite membrane exhibited lesser C3 and C5 activation (189.13 and 5.29ng/mL) and proteins adsorption (bovine serum albumin=4.5μg/cm2, fibrinogen=15.95μg/cm2) as compared to the neat PES membrane, while keeping a normal blood coagulation time. Hence, the PES/PCA-g-MWCNT nanocomposite membrane is proven to have the prospect of becoming a safe and high performance hemodialysis membrane.
  14. Abidin MNZ, Goh PS, Ismail AF, Said N, Othman MHD, Hasbullah H, et al.
    Carbohydr Polym, 2018 Dec 01;201:257-263.
    PMID: 30241818 DOI: 10.1016/j.carbpol.2018.08.069
    Portable dialysis is a need to implement daily and nocturnal hemodialysis. To realize portable dialysis, a dialysate regeneration system comprising superior adsorbents is required to regenerate the used dialysate. This study aims to develop a nano-adsorbent, derived from corn starch for urea removal. Oxidized starch nanoparticles (oxy-SNPs) were prepared via liquid phase oxidation, followed by chemical dissolution and non-solvent precipitation. The oxy-SNPs possessed Z-average size of 177.7 nm with carbonyl and carboxyl contents of 0.068 and 0.048 per 100 glucose units, respectively. The urea adsorption achieved the equilibrium after 4 h with 95% removal. The adsorption mechanism fitted Langmuir isotherm while the adsorption kinetics obeyed pseudo-second-order model. This new material has a maximum adsorption capacity of 185.2 mg/g with a rate constant of 0.04 g/mg.h. Moreover, the oxy-SNPs exhibited the urea uptake recovery of 91.6%. Oxy-SNPs can become a promising adsorbent for dialysate regeneration system to remove urea.
  15. Mansur S, Othman MHD, Ismail AF, Kadir SHSA, Goh PS, Hasbullah H, et al.
    Mater Sci Eng C Mater Biol Appl, 2019 Jun;99:491-504.
    PMID: 30889724 DOI: 10.1016/j.msec.2019.01.092
    Polyurethane (PU) with three different functional groups: carboxyl, hydroxyl and sulphonyl group on its molecular structure were synthesised in this work. The synthesised material suppresses blood clotting and exhibits anticoagulant characteristics due to the presence of the important anionic groups. The synthesised PU was blended with polyethersulphone (PES) and fabricated into flat-sheet membrane to study the physico-chemical and biocompatibility properties of the PES membrane for blood purification application. PES-PU flat-sheet membranes were fabricated via the dry-wet phase separation technique. Different loading of PU (0, 1, 2, 3, 4, and 5%) blended with PES was studied and compared. Based on the in-vitro biocompatibility analysis of the membrane, it can be suggested that the membrane incorporated with PU has better anticoagulant properties compared to the pristine PES membrane. PU incorporation prolonged the clotting time, decreased the formation of thrombin, decreased soluble complement component 3a (C3a) generation and suppressed platelet adhesion and aggregation. The anionic groups on the membrane surface might bind to coagulation factors (antithrombin) and the calcium ions, Ca2+ and thus improve anticoagulant ability. Based on both physico-chemical and in-vitro studied, 4% loading of PU is the optimum loading for incorporation with PES membrane. These results suggested that the blended PES-PU membranes with good haemocompatibility allowed practical application in the field of blood purification.
  16. Dass SA, Tan KL, Selva Rajan R, Mokhtar NF, Mohd Adzmi ER, Wan Abdul Rahman WF, et al.
    Medicina (Kaunas), 2021 Jan 12;57(1).
    PMID: 33445543 DOI: 10.3390/medicina57010062
    Triple-negative breast cancer (TNBC) is an aggressive breast type of cancer with no expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2). It is a highly metastasized, heterogeneous disease that accounts for 10-15% of total breast cancer cases with a poor prognosis and high relapse rate within five years after treatment compared to non-TNBC cases. The diagnostic and subtyping of TNBC tumors are essential to determine the treatment alternatives and establish personalized, targeted medications for every TNBC individual. Currently, TNBC is diagnosed via a two-step procedure of imaging and immunohistochemistry (IHC), which are operator-dependent and potentially time-consuming. Therefore, there is a crucial need for the development of rapid and advanced technologies to enhance the diagnostic efficiency of TNBC. This review discusses the overview of breast cancer with emphasis on TNBC subtypes and the current diagnostic approaches of TNBC along with its challenges. Most importantly, we have presented several promising strategies that can be utilized as future TNBC diagnostic modalities and simultaneously enhance the efficacy of TNBC diagnostic.
  17. Chai CS, Bin Ibrahim MA, Binti Azhar NA, Binti Roslan Z, Binti Harun R, Krishnabahawan SL, et al.
    Sci Rep, 2024 Jul 16;14(1):16413.
    PMID: 39013943 DOI: 10.1038/s41598-024-67536-2
    Understanding the prevalence of abnormal lung function and its associated factors among patients recovering from COVID-19 is crucial for enhancing post-COVID care strategies. This study primarily aimed to determine the prevalence and types of spirometry abnormalities among post-COVID-19 patients in Malaysia, with a secondary objective of identifying its associated factors. Conducted at the COVID-19 Research Clinic, Faculty of Medicine, University Technology MARA, from March 2021 to December 2022, this study included patients at least three months post-discharge from hospitals following moderate-to-critical COVID-19. Of 408 patients studied, abnormal spirometry was found in 46.8%, with 28.4% exhibiting a restrictive pattern, 17.4% showing preserved ratio impaired spirometry (PRISm), and 1.0% displaying an obstructive pattern. Factors independently associated with abnormal spirometry included consolidation on chest X-ray (OR 8.1, 95% CI 1.75-37.42, p = 0.008), underlying cardiovascular disease (OR 3.5, 95% CI 1.19-10.47, p = 0.023), ground-glass opacity on chest X-ray (OR 2.6, 95% CI 1.52-4.30, p 
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