scholarly journals Association between Morality in Covid-19 Patients and Underlying Co-Morbidities in Patients above 40 Years of Age: A Rapid Review

2020 ◽  
pp. 1-11
Author(s):  
Shafi Bhuiyan ◽  
Housne Begum
Keyword(s):  
English Language ◽  
Healthcare Providers ◽  
Female Gender ◽  
Cerebrovascular Diseases ◽  
Rapid Review ◽  
Set Inclusion ◽  
Number Of Patients ◽  
Vulnerable People ◽  
Severity Of The Disease ◽  
Underlying Mechanisms

COVID-19 pandemic has dramatically affected various aspects of people’s lives worldwide. The severity of the disease, the easy spread and the high mortality associated with COVID-19 has turned this pandemic into an important and high priority research topic. Mortality in patients diagnosed with COVID-19 is multifactorial. We have tried to find the association between mortality and specific comorbidities, especially in people above 40 years of age. The findings can potentially help healthcare providers to make appropriate guidelines to triage patients in COVID-19 care centers and aim to reduce mortality. This can also help policy makers to provide supportive measures especially for vulnerable people with the specific comorbidities to reduce the chance of contracting the infection. Objective: Literature suggests that age is one of the crucial factors in increasing the severity and mortality of COVID-19 patients. Hence in our study, our objective is to see the available evidence on different types of comorbidities associated with mortality in COVID-19 patients. Methods: This study was a rapid review aiming to investigate the leading comorbidities toward mortality among COVID-19 patients. We searched PubMed and Google Scholar and selected English language articles that were published between March and July 2020. The studies were selected based on the pre-set inclusion and exclusion criteria. Data of selected articles have been extracted based on the comorbidities of each organ system and the number of patients in each category. Result: Based on our review, apart from increased age, hypertension (66.63%) has been the most commonly seen comorbidity associated with mortality due to COVID-19. Other comorbidities include diabetes (26.34%), cardio-cerebrovascular diseases (39.61%), COPD (14.93%), chronic kidney disease (17.31%) and cancer (20.66%). From the studies with details on gender ratios, male gender (66.66%) and female gender (33.33%) were respectively associated with mortality. It is estimated that male patients are around 2 times more likely to be deceased with COVID 19 in comparison to other genders. Conclusion: More studies regarding the underlying mechanisms related to mortality are required to further decipher the disease correlation. Understanding the association between these specific underlying comorbidities and mortality due to COVID-19 can help healthcare providers triage patients in COVID-19 care centers. It can also be used to assist in making clinical guidelines and policies on social measures, thereby, protecting the vulnerable people with the mentioned comorbidities from community spread and possible infection

scholarly journals Effects of underlying morbidities on the occurrence of deaths in COVID-19 patients: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Mostaured Khan ◽  
Md Nuruzzaman Khan ◽  
Md. Golam Mustagir ◽  
Juwel Rana ◽  
Md Saiful Islam ◽  
...  
Keyword(s):  
Systematic Review ◽  
Publication Bias ◽  
English Language ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Healthcare Providers ◽  
Cerebrovascular Diseases ◽  
Reference List ◽  
Trim And Fill

Abstract Background: Coronavirus disease 2019 (COVID-19), the most hectic pandemic of the era, is increasing exponentially and taking thousands of lives worldwide. This study aimed to assess the prevalence of pre-existing morbidities among COVID-19 infected patients and their mortality risks against each type of pre-existing morbidity category. Methods: To conduct this systematic review and meta-analysis, Medline, Web of Science, Scopus, and CINAHL databases were searched using specified relavent keywords. Further searches were conducted using the reference list of the selected studies, renowned pre-print servers (e.g., medRxiv, bioRixv, SSRN), and relevant journal websites. Studies written in the English language included if those were conducted among COVID-19 patients with and without comorbidities and presented survivor vs. non-survivor counts or hazard/odds of deaths or survivors against types of pre-existing morbidities. Comorbidities reported in the selected studies were grouped into eight categories. The pooled likelihoods of deaths in each category were estimated using a fixed or random-effect model, based on the heterogeneity assessment. Publication bias was assessed by visual inspection of the funnel plot asymmetry and Eggers regression test. Trim and Fill method was used if there any publication bias was found. Results: A total of 42 studies included in this study comprised of 39,398 samples. The most common pre-existing morbidities in COVID-19 infected patients were hypertension (36.5%), cardiovascular disease (11.9%), and diabetes (22.0%). The higher likelihood of deaths was found among COVID-19 patients who had pre-existing cardiovascular diseases (OR: 3.32, 95% CI: 2.79-3.95), immune and metabolic disorders (OR: 2.39, 95% CI: 2.00-2.85), respiratory diseases (OR: 2.02, 95% CI: 1.80-2.26), cerebrovascular diseases (OR: 4.12, 95% CI: 3.04-5.58), any types of cancers (OR: 2.22, 95% CI: 1.63-3.03), renal (OR: 3.02, 95% CI: 2.60-3.52), and liver diseases (OR: 1.44, 95% CI: 1.21-1.71). Conclusions: This study provides evidence of a higher likelihood of deaths among COVID-19 patients against morbidity categories. These findings could potentially help healthcare providers to sort out the most endangered COVID-19 patients by comorbidities, take precautionary measures during hospitalization, assess susceptibility to death, and prioritize their treatment, which could potentially reduce the number of fatalities in COVID-19.

Ion Channel Remodelling in Atrial Fibrillation

2011 ◽  
Vol 7 (2) ◽  
pp. 97 ◽  
Author(s):  
Niels Voigt ◽  
Dobromir Dobrev ◽  
◽  
Keyword(s):  
Atrial Fibrillation ◽  
Ion Channel ◽  
Antiarrhythmic Drugs ◽  
Current Knowledge ◽  
Bleeding Complications ◽  
Large Size ◽  
Cardiovascular Morbidity And Mortality ◽  
Number Of Patients ◽  
Life Threatening ◽  
Underlying Mechanisms

Atrial fibrillation (AF) is the most common arrhythmia and is associated with substantial cardiovascular morbidity and mortality, with stroke being the most critical complication. Present drugs used for the therapy of AF (antiarrhythmics and anticoagulants) have major limitations, including incomplete efficacy, risks of life-threatening proarrhythmic events and bleeding complications. Non-pharmacological ablation procedures are efficient and apparently safe, but the very large size of the patient population allows ablation treatment of only a small number of patients. These limitations largely result from limited knowledge about the underlying mechanisms of AF and there is a hope that a better understanding of the molecular basis of AF may lead to the discovery of safer and more effective therapeutic targets. This article reviews the current knowledge about AF-related ion-channel remodelling and discusses how these alterations might affect the efficacy of antiarrhythmic drugs.

Survey of Cloud Computing in Healthcare Sector

2017 ◽  
Vol 7 (7) ◽  
pp. 337
Author(s):  
S. Karthiga Devi ◽  
B. Arputhamary
Keyword(s):  
Cloud Computing ◽  
Healthcare Providers ◽  
High Volume ◽  
Healthcare Services ◽  
Healthcare Sector ◽  
Cloud Infrastructure ◽  
Healthcare Organizations ◽  
Privacy And Security ◽  
Healthcare Data ◽  
Number Of Patients

Today the volume of healthcare data generated increased rapidly because of the number of patients in each hospital increasing.  These data are most important for decision making and delivering the best care for patients. Healthcare providers are now faced with collecting, managing, storing and securing huge amounts of sensitive protected health information. As a result, an increasing number of healthcare organizations are turning to cloud based services. Cloud computing offers a viable, secure alternative to premise based healthcare solutions. The infrastructure of Cloud is characterized by a high volume storage and a high throughput. The privacy and security are the two most important concerns in cloud-based healthcare services. Healthcare organization should have electronic medical records in order to use the cloud infrastructure. This paper surveys the challenges of cloud in healthcare and benefits of cloud techniques in health care industries.

COGNITIVE DEFICIENCY AT ISCHEMIC OM STROKE

2020 ◽  
Vol 1 (1) ◽  
pp. 55-57
Author(s):  
Dildora Khaydarova ◽  
◽  
Hilola Davronova ◽  
Asliddin Akbarov ◽  
Keyword(s):  
Social Problems ◽  
Cerebrovascular Diseases ◽  
Cerebral Stroke ◽  
Number Of Patients ◽  
High Prevalence ◽  
The World ◽  
Cognitive Deficiency ◽  
Complications And Mortality

Cerebrovascular diseases remain one of the most pressing medical and social problems in many countries of the world, due to their high prevalence, severity of complications and mortality. In Uzbekistan, the number of patients with cerebral stroke is quite large -about 40-45 thousandcases of cerebral stroke are registered annually

scholarly journals Neurological Complications of COVID-19: Underlying Mechanisms and Management

2021 ◽  
Vol 22 (8) ◽  
pp. 4081
Author(s):  
Ghaydaa A. Shehata ◽  
Kevin C. Lord ◽  
Michaela C. Grudzinski ◽  
Mohamed Elsayed ◽  
Ramy Abdelnaby ◽  
...  
Keyword(s):  
Neuromuscular Junctions ◽  
Neurological Complications ◽  
Cerebrovascular Diseases ◽  
World Health ◽  
Neurological Sequelae ◽  
Global Pandemic ◽  
Underlying Mechanisms ◽  
Health Organization ◽  
Demyelinating Disorders ◽  
Taste And Smell

COVID-19 is a severe respiratory disease caused by the newly identified human coronavirus (HCoV) Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). The virus was discovered in December 2019, and in March 2020, the disease was declared a global pandemic by the World Health Organization (WHO) due to a high number of cases. Although SARS-CoV-2 primarily affects the respiratory system, several studies have reported neurological complications in COVID-19 patients. Headache, dizziness, loss of taste and smell, encephalitis, encephalopathy, and cerebrovascular diseases are the most common neurological complications that are associated with COVID-19. In addition, seizures, neuromuscular junctions’ disorders, and Guillain–Barré syndrome were reported as complications of COVID-19, as well as neurodegenerative and demyelinating disorders. However, the management of these conditions remains a challenge. In this review, we discuss the prevalence, pathogenesis, and mechanisms of these neurological sequelae that are secondary to SARS-CoV-2 infection. We aim to update neurologists and healthcare workers on the possible neurological complications associated with COVID-19 and the management of these disease conditions.

Improving Genetics Clinic Efficiency and Capacity Using Design and Human Factors Methods

2021 ◽  
Vol 10 (1) ◽  
pp. 204-210
Author(s):  
Maryam Attef ◽  
Mireille Cloutier ◽  
Meredith Gillespie ◽  
Chantal Trudel ◽  
Kym Boycott
Keyword(s):  
Human Factors ◽  
Task Analysis ◽  
Healthcare Providers ◽  
Time On Task ◽  
Prenatal Genetics ◽  
Factors Influencing ◽  
Number Of Patients ◽  
Clinic Efficiency ◽  
Before And After ◽  
Improve Access

This quality improvement study focused on developing an understanding of factors influencing the ability of prenatal genetics counsellors (GCs) to efficiently see patients during the COVID-19 pandemic and strategies to improve their workflow using techniques from human factors and design. The demand for Prenatal Genetics Clinics is rising which has increased pressure on GCs to become more efficient. Genetics counsellors can improve access to their services by reducing the time spent on the tasks performed before and after a genetic counselling encounter, thereby increasing the number of patients they see. We were limited to certain methods to understand the differences in workflow before and during the COVID-19 pandemic. This study involved a literature review, archival analysis of workflow studies conducted before the pandemic, stakeholder meetings and mapping, a brainstorming session, as well as documenting time-on-task in a diary and naturalistic observation sessions. A task analysis was developed to identify factors influencing efficiency related to the design of the space, processes and the use of artefacts. Virtual and on-site workflows show that GCs spend at least half of their time on tasks before and/or after the patient’s appointment. Looking at potential inefficiencies or bottlenecks in workflow formed the development of a strategic plan for improving GC workflows at the prenatal Genetics Clinic. Improvements suggested through this analysis were constrained to support the current number of healthcare providers working within the existing space configuration.

MEDICARE AI-ASSISTED AI IN HEALTHCARE

2021 ◽  
pp. 40-44
Author(s):  
Nitish Nagar ◽  
Plaban Roy ◽  
Saurabh Deswal ◽  
Parth Pandya ◽  
Aashna Bhardwaj ◽  
...  
Keyword(s):  
Real Time ◽  
Healthcare Providers ◽  
Medical Checkup ◽  
Severity Of The Disease

Articial Intelligence is nowadays at the peak, and considering chatbots is one of the primary examples contributing to success. In the project paper, we implemented an instant diagnostic medical checkup for the patient, which can help doctors/healthcare providers, as this order saves time. By analyzing the symptoms, the Assist AI system will help determine the severity of the disease in real-time and will respectively guide the patient with the different stages – disease denition, precaution and recommendation.

scholarly journals Predictors of discharge destination from acute care in patients with traumatic brain injury

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e016694 ◽  
Author(s):  
Sareh Zarshenas ◽  
Laetitia Tam ◽  
Angela Colantonio ◽  
Seyed Mohammad Alavinia ◽  
Nora Cullen
Keyword(s):  
Systematic Review ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Acute Care ◽  
English Language ◽  
Healthcare Providers ◽  
Trial Registration ◽  
Future Research ◽  
Reference List ◽  
Registration Number

IntroductionMany studies have assessed the predictors of morbidity/mortality of patients with traumatic brain injury (TBI) in acute care. However, with the increasing rate of survival after TBI, more attention has been given to discharge destinations from acute care as an important measure of clinical priorities. This study describes the design of a systematic review compiling and synthesising studies on the prognostic factors of discharge settings from acute care in patients with TBI.Methods and analysisThis systematic review will be conducted on peer-reviewed studies using seven databases including Medline/Medline in-Process, Embase, Cochrane Database of Systematic Reviews, Cochrane CENTRAL, PsycINFO, CINAHL and Supplemental PubMed. The reference list of selected articles and Google Scholar will also be reviewed to determine other relevant articles. This study will include all English language observational studies that focus on adult patients with TBI in acute care settings. The quality of articles will be assessed by the Quality in Prognostic Studies tool.Ethics and disseminationThe results of this review will provide evidence that may guide healthcare providers in making more informed and timely discharge decisions to the next level of care for patient with TBI. Also, this study will provide valuable information to address the gaps in knowledge for future research.Trial registration numberTrial registration number (PROSPERO) is CRD42016033046.

scholarly journals The role of telehealth during COVID-19 outbreak: A systematic review based on current evidence

2020 ◽  
Author(s):  
Elham Monaghesh ◽  
Alireza Hajizadeh
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Healthcare Providers ◽  
Physical Contact ◽  
Current Evidence ◽  
Health Providers ◽  
Search Results ◽  
Effective Option ◽  
Critical Appraisal Skills

Abstract Purpose The outbreak of coronavirus disease-19 (COVID-19) is a public health emergency of international concern. Telehealth is effective option to fight COVID-19 outbreak. The aim of this systematic review was to identify the role of telehealth services during COVID-19 outbreak.Methods This systematic review was conducted through searching five databases including PubMed, Scopus, Embase, Web of Science and Science direct. Inclusion criteria included studies clearly defined role of telehealth services in COVID-19 outbreak, published from December 31, 2019, written in English language and published in peer reviewed. Two reviewers independently assessed search results, extracted data, and assessed quality of included studies. Quality assessment was based on the Critical Appraisal Skills Program (CASP) checklist. Narrative synthesis was undertaken to summarize and report the findings.Results Eight studies met the inclusion out of the 142 search results. Currently, healthcare providers and patients who are self-isolating, telehealth is certainly appropriate to minimizing the risk of COVID-19 transmission. This solution has the potential to avoidance of direct physical contact, provide continuous care to the community and finally reduce morbidity and mortality in COVID-19 outbreak.Conclusions The use of telehealth improves the provision of health services. Therefore, telehealth should be an important tool in caring services while keeping patients and health providers safe as the COVID-19 outbreak.

COVID-19: An Experience from a Tertiary Care Hospital of Nowshera

2020 ◽  
Vol 24 (2) ◽  
pp. 149-155
Author(s):  
Hamzullah Khan ◽  
Mohammad Zahid Khan ◽  
Mian Mohammad Naveed
Keyword(s):  
Tertiary Care ◽  
Relevant Information ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Epidemic Area ◽  
History Of ◽  
Severity Of The Disease ◽  
Age Range

Objective: To determine the frequency of COVID-19 and characteristics of patients presenting to the COVID-19 clinic at Qazi Hussain Ahmed Medical Complex (QHAMC) Nowshera. Methodology: This cross-sectional study was conducted from 21st Feb 2019 to April 8, 2020, in QHAMC Nowshera. Relevant information was collected on a pre-designed Performa prepared following the objectives of the study. Results: Out of 220 patients, 165(75%) were males, and 55(25%) females. 96(43.6%) of the patients were in the age range 18-30 years followed by 52(23.6%) in age range 31-45years and 17(7.7%) with age>60 years etc. Out of total the nasopharyngeal swabs of 26(11.6%) strong suspects were sent for PCR testing. 208(94.5%) were sent home while 12(5.5%) were advised quarantine. Forty-seven (21.4%) had a travel history to an epidemic area in the last 14 days. 51(23.2%) had a positive history of contact. Eighty-five (38.6%) had a fever and sore throat followed by 27(12.3%) with (fever & cough), 24(10.9%) with (cough and shortness of breath/dyspnea) and 14(6.4%) with a simple flue, etc. Out of 26 cases, 6(2.7%) were COVID-19 Positive, 12(5.5%) were negative and results of 8(3.6%) were still awaited. The PCR repeated the test for confirmed cases showed;  4(1.8%) negative, one died and one was refractory positive.  A positive correlation (p=0.03, r=0.4) of an increase in age with the severity of the disease/outcome was recorded. Conclusion: The frequency of infectivity with COVID-19 was 2.6%. A higher number of patients with mild symptoms attend the COVID clinic. The rate of infection and mortality was higher in age> 60 years.

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