scholarly journals FANSY POSTCOV: A composite clinical immunological predictive index for post‐COVID‐19 syndrome unveils distinctive features in a cohort study of mild to critical patients

2021 ◽  
Vol 11 (11) ◽  
Author(s):  
Jiram Torres‐Ruiz ◽  
Julieta Lomelín‐Gascón ◽  
Jaquelin Lira‐Luna ◽  
Alfredo Pérez‐Fragoso ◽  
Roberto Tapia‐Conyer ◽  
...  
2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S203-S203
Author(s):  
paraskeui chra ◽  
Evdokia Gavrielatou ◽  
prodromos Temperikidis ◽  
Michalis Tsimaras ◽  
eleni magira

Abstract Background The aim of this work were to investigate the rate and aetiology of bloodstream infection collected from COVID and non-COVID patients admitted in the ICU Methods A retrospective cohort study was conducted on PCR Covid-19 positive patients admitted in the ICU from 20th March to 30th April 2020. Corresponding data from the same period in 2019 collected of all consecutive patients admitted in the same ICU were retrospectively reviewed for the presence of microbiologically documented bloodstream infections at least 8 hours after admission. All patients in the cohort study were on mechanical ventilation, or at some point during their ICU admission required mechanical ventilation. Results We identified a total of 19 (38%) BSIs in the COVID-19 group and 10 (12%) BSI in the non-COVID-19 group (p=0,8). COVID-19 patients had an increased probability to develop ICU-BSI, at a median of 8 days of ICU admission as opposed to 6 in the non-COVID-19 group. Patients were comparable in terms of age, and APACHE II score. Out of 19 BSI CoVID-19 patients, 14 (73%) were male vs 5 (50%) in the non-CoVID-19 BSI patients (p=0.0007). Of all BSI-CoVID-19 patients, 7 cases (37%), 3 (16%), and 3(16%) had underlying diseases such as hypertension, diabetes, and obesity vs 1(9%), 0(0%), and 0 (0%) in the BSI-non CoVID-19 patients statistically significant at p=0.004, p=0.05, and p=0.05, respectively. ICU-acquired BSIs were mostly due to multi-drug-resistant pathogens. Clinical outcomes were statistically significantly different between patients with CoVid-19 BSI 7(37% ) and 2(20%)in BSI- non-CoVID-19 pneumonia (p=0.02). Conclusion Our findings emphasize that although the incidence of BSI in CoVID-19 positive ICU admitted patients slightly increased their impact on overall outcome was significantly worse. Consequently, it is important to pay attention to bacterial superinfections in critical patients positive for COVID-19. Disclosures All Authors: No reported disclosures


2017 ◽  
Vol 70 (5) ◽  
pp. 942-948 ◽  
Author(s):  
Clarita Terra Rodrigues Serafim ◽  
Magda Cristina Queiroz Dell’Acqua ◽  
Meire Cristina Novelli e Castro ◽  
Wilza Carla Spiri ◽  
Hélio Rubens de Carvalho Nunes

ABSTRACT Objective: To analyze whether an increase in patient severity and nursing workload are correlated to a greater incidence of adverse events (AEs) in critical patients. Method: A prospective single cohort study was performed on a sample of 138 patients hospitalized in an intensive care unit (ICU). Results: A total of 166 AEs, occurred, affecting 50.7% of the patients. Increased patient severity presented a direct relationship to the probability of AEs occurring. However, nursing workload did not present a statistically significant relationship with the occurrence of AEs. Conclusion: The results cast light on the importance of using evaluation tools by the nursing personnel in order to optimize their daily activities and focus on patient safety.


2020 ◽  
Author(s):  
Yichen Li ◽  
Jie Li ◽  
Jia Ke ◽  
Sijing Cheng ◽  
Lixin Zhu ◽  
...  

Abstract BackgroundCurrently no satisfactory pharmaceutical intervention is available for COVID-19. This retrospective study aimed to determine the therapeutic effect of thymosin alpha1 in critical COVID-19. ResultsWe enrolled 109 critically ill severe acute respiratory syndrome-related coronavirus-2 RNA positive patients from 15 hospitals. The mortality rate in critical patients treated with thymosin alpha1 was 11%, compared to 56% in critical patients not treated with thymosin alpha1. With confounding factors adjusted in multivariate logistic regression, thymosin alpha1 treatment was identified as a protective factor for critical COVID-19. ConclusionOur observation advocates the treatment of critical COVID-19 with thymosin alpha1.


Author(s):  
Samreen Sarfaraz ◽  
Quratulain Shaikh ◽  
Sundus Iftikhar ◽  
Fivzia Farooq Herekar ◽  
Syed Ghazanfar Saleem ◽  
...  

Abstract ObjectivesTo compare the outcome of severe COVID-19 patients treated with Tocilizumab (TCZ). Methods: A retrospective cohort study comparing the clinical characteristics and outcomes of patients who received TCZ with those who did not, was conducted at The Indus Hospital, Karachi. A sub-group analysis was conducted on the TCZ group to identify predictors of mortality. Results 88 patients including 41 patients in the TCZ group and 47 in non-TCZ group were recruited. Baseline characteristics were comparable. TCZ group patients presented with worse clinical features including median SpO2 82% vs 88%, p<0.05 and CRP 193 vs 133.9 mg/L, p<0.05. TCZ group showed severe bilateral chest x-ray findings (92% vs 31%, p<0.05) compared to non-TCZ. In the TCZ group 85.4% were admitted in ICU compared to 69.8% in non-TCZ group, p>0.05. Mortality was not different among the groups (46% in TCZ group vs 51.1% in non-TCZ group, p>0.05). Median length of hospital stay, days of intubation, use of inotropic agents, use of invasive ventilation or in-hospital complications were not different between the groups. Sub-group analysis revealed that mortality within TCZ group was associated with high IL-6 levels (173 vs 69.66 pg/ml, p<0.05), ICU admission (100% vs 72%, p<0.05), need for mechanical ventilation (100% vs 13.6%, p<0.05) and higher incidence of in-hospital complications, p<0.05. ConclusionTCZ group had more critical patients and TCZ failed to demonstrate any mortality benefit in these patients. Non-survivors within the TCZ group were more critical compared to survivors and developed higher proportion of in hospital complications


Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 1021-P
Author(s):  
AJAY K. SINHA ◽  
DIVYANSHU PANDEY ◽  
MAJOR MADHUKAR ◽  
ROSHAN K. TOPNO ◽  
RISHIKESH KUMAR ◽  
...  

Infection ◽  
2018 ◽  
Vol 46 (5) ◽  
pp. 679-686 ◽  
Author(s):  
Juan Aguilar-Company ◽  
Carles Pigrau ◽  
Nuria Fernández-Hidalgo ◽  
Dolors Rodríguez-Pardo ◽  
Vicenç Falcó ◽  
...  

2021 ◽  
Vol 5 (1) ◽  
pp. 042-046
Author(s):  
Yang Qilin ◽  
Huang Weichao ◽  
Zeng Xiaomei ◽  
Zheng Jiezhao ◽  
Chen Weixiao ◽  
...  

Background: Acute kidney injury (AKI) is a major health problem affecting millions of people worldwide. Effective preventative and therapeutic treatments remain to be produced. We aim to determine the association between blood glucose and mortality in critical patients with AKI. Method: This cohort study included 18,703 patients with AKI. The exposure of interest was baseline blood glucose. The outcome was 30-day mortality. Multivariable Cox regression analyses and smooth curve fitting were adopted to assess the independent association between blood glucose and 30-day mortality. Results: We identified 18,703 consecutive individuals with AKI. The average age of the participants was 66.8 ± 16.0 years, and about 42.7% of them were female. The overall 30-day mortality was 16.9%. Through the multivariate COX regression model and smooth curve fitting, we observed that the correlation between blood glucose and 30-day mortality is nonlinear. An inflection point was found at about 5.93 mmol/L. On the left side of inflection point, the effect size was 0.81 (HR: 0.81, 95% CI 0.74-0.89, p < 0.001). On the right side of inflection point, the effect size was 1.02 (HR: 1.02,95% CI 1.01-1.03, p < 0.001). Conclusion: Our study suggested that, among patients with AKI, there was a nonlinearity relationship between blood glucose and mortality in patients with AKI. The optimal of blood glucose associated with the lowest risk of 30-day mortality was around 5.93 mmol/L.


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