scholarly journals Correction to: Trends in clinical profiles, organ support use and outcomes of patients with cancer requiring unplanned ICU admission: a multicenter cohort study

2020 ◽  
Author(s):  
Fernando G. Zampieri ◽  
Thiago G. Romano ◽  
Jorge I. F. Salluh ◽  
Leandro U. Taniguchi ◽  
Pedro V. Mendes ◽  
...  
Keyword(s):  
Cohort Study ◽  
Organ Support ◽  
Multicenter Cohort Study ◽  
Icu Admission ◽  
Patients With Cancer ◽  
Multicenter Cohort ◽  
Clinical Profiles

scholarly journals Consequences of the COVID-19 Pandemic and Governmental Containment Policies on the Detection and Therapy of Oral Malignant Lesions—A Retrospective, Multicenter Cohort Study from Germany

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2892
Author(s):  
Diana Heimes ◽  
Lena Katharina Müller ◽  
Alexandra Schellin ◽  
Hendrik Naujokat ◽  
Christian Graetz ◽  
...  
Keyword(s):  
Cohort Study ◽  
Tumor Stage ◽  
Federal State ◽  
Multicenter Cohort Study ◽  
Patients With Cancer ◽  
Multicenter Cohort ◽  
Tumor Stages ◽  
Patients At Risk ◽  
Dental Practices ◽  
The Impact

(1) Background: In response to the global COVID-19 pandemic, governmental measures have been undertaken. The impact of the crisis on the healthcare of patients with cancer is largely unexplored. This multicenter cohort study aimed to investigate a potential screening delay and its consequences in patients with oral cancer (OC) during the pandemic. (2) Material and Methods: Data of patients who were first diagnosed with OC during different periods were collected, especially in terms of OC incidence, tumor stage/entity and time to intervention. The periods lockdown (LD) (13 March–16 June 2020), post-lockdown (PLD) (17 June–1 November 2020), and the corresponding equivalents in 2018/19 were differentiated and compared. (3) Results: There was no obvious trend towards a higher incidence of OC or higher tumor stages, whereas a trend towards a shorter time to intervention during the LD2020 could be observed. Subgroup analyses revealed an increased incidence in OC within the PLD2020 in Mainz, which might be explained by the partial closure of dental practices in this federal state during LD. (4) Conclusions: While there was no overall higher incidence of OC, we found closure of practices during LD to possibly delay cancer diagnosis. Therefore, measures must be taken to identify patients at risk and to ensure basic healthcare, especially in the context of dental screening measures.

Malnutrition in pediatric patients with cancer at diagnosis and throughout therapy: A multicenter cohort study

2012 ◽  
Vol 60 (4) ◽  
pp. 642-649 ◽  
Author(s):  
Karin Zimmermann ◽  
Roland A. Ammann ◽  
Claudia E. Kuehni ◽  
Sabina De Geest ◽  
Eva Cignacco
Keyword(s):  
Cohort Study ◽  
Pediatric Patients ◽  
Multicenter Cohort Study ◽  
Patients With Cancer ◽  
Multicenter Cohort

scholarly journals ECMO Therapy for Critically Ill Coronavirus Disease 2019 Patients in Wuhan, China: A Retrospective Multicenter Cohort Study

2020 ◽  
Author(s):  
Jing Fang ◽  
Yue Chen ◽  
Ming Hu ◽  
Rui Li ◽  
Juanjuan Qin ◽  
...  
Keyword(s):  
Cohort Study ◽  
Propensity Score ◽  
Cox Model ◽  
Multicenter Cohort Study ◽  
Mixed Effect ◽  
Icu Admission ◽  
Multicenter Cohort ◽  
All Cause Mortality ◽  
Ecmo Therapy ◽  
D Dimer

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has led to surges in the demand for extracorporeal membrane oxygenation (ECMO) therapy. However, little in-depth evidence is known about the application of ECMO therapy in COVID-19 patients. Methods This retrospective multicenter cohort study included 88 patients who had been diagnosed with COVID-19 and received ECMO therapy at seven designated hospitals in Wuhan, China. The clinical characteristics, laboratory examinations, treatments, and outcomes were extracted from electronic medical records and compared between weaned and non-weaned ECMO patients. The patients were followed until June 30, 2020. Logistic regression analyses were performed to identify the risk factors associated with unsuccessful ECMO weaning. Propensity score matching was used to match patients who received veno-venous ECMO with those who received invasive mechanical ventilation (IMV)-only therapy. The primary endpoint, 120-day all-cause mortality after intensive care unit (ICU) admission during hospitalization, was compared using a mixed-effect Cox model. Results Of 88 patients who received ECMO therapy, 27 and 61 patients were and were not successfully weaned from ECMO, respectively. Additionally, 15, 15, and 65 patients were further weaned from IMV, discharged from hospital, or died during hospitalization, respectively. A lymphocyte count ≤ 0.5 × 109/L and D-dimer concentration > 4 × the upper limit of normal at ICU admission, a peak PaCO2 > 60 mmHg at 24 hours before ECMO initiation, and no tracheotomy performed during the ICU stay were independently associated with lower odds of ECMO weaning. In the propensity score-matched analysis, a mixed-effect Cox model detected a lower hazard ratio for 120-day all-cause mortality after ICU admission during hospitalization in the ECMO group, as compared with the IMV-only group. Conclusion Patients in Wuhan who received ECMO therapy had a relatively high mortality rate. This outcome may be largely attributable to resource-limited situations during the COVID-19 outbreak. In future, the presence of lymphocytopenia and higher D-dimer concentrations at ICU admission and hypercapnia at 24 hours before ECMO initiation could help to identify patients with a poor prognosis. Moreover, tracheotomy could facilitate weaning from ECMO. Despite the high mortality, ECMO was associated with improved outcomes relative to IMV-only therapy in critically ill COVID-19 patients.

scholarly journals Early Versus Late Use of Dexamethasone in Critically Ill Patients With COVID-19: A Multicenter, Cohort Study

2021 ◽  
Author(s):  
Khalid Al Sulaiman ◽  
Ohoud Al Juhani ◽  
Ghazwa B. Korayem ◽  
Khalid Eljaaly ◽  
Alaa Alhubaishi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Propensity Score ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Positive Outcomes ◽  
Multicenter Cohort Study ◽  
Mechanically Ventilated ◽  
Icu Admission ◽  
Multicenter Cohort ◽  
Early Use

Abstract Rationale: It is unclear whether the timing of dexamethasone initiation is associated with positive outcomes. Objectives: To evaluate the appropriate timing of systemic dexamethasone initiation in critically ill patients with COVID-19. Methods: A multicenter, non-interventional cohort study including adults with COVID-19 patients admitted to intensive care units (ICUs) received systemic dexamethasone between March 2020 and January 2021. Patients were divided into two groups based on the timing for dexamethasone use (early vs. late). Early use is defined as the new initiation of dexamethasone within 24 hours of ICU admission. Propensity score matching was used based on the patient’s SOFA score, MV within 24 hours of ICU admission, proning status, and tocilizumab use during ICU stay. Results: A total of 480 patients were included in the study; dexamethasone was initiated early within 24 hours of ICU admission in 367 patients. Among 202 patients matched using propensity score, 101 had received dexamethasone after 24 hours of ICU admission (1:1 ratio). The 30-day mortality (OR [95%CI]: 1.82[1.04, 3.19], P=0.04) and in-hospital mortality (OR [95%CI]: 1.80[1.03, 3.15], P=0.04). Among the non-mechanically ventilated patients, late use of dexamethasone was associated with higher odds of developing respiratory failure that required MV (OR [95%CI]: 3.8 [1.41, 10.3], P=0.008) Conclusion: Early use of dexamethasone within 24 hours of ICU admission in critically ill patients with COVID-19 was associated with mortality benefits. Moreover, dexamethasone's early use might be considered a proactive measure in non-mechanically ventilated critically ill patients with COVID-19, to prevent further complications.

scholarly journals High mortality among kidney transplant recipients diagnosed with coronavirus disease 2019: Results from the Brazilian multicenter cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254822
Author(s):  
Lúcio R. Requião-Moura ◽  
Tainá Veras de Sandes-Freitas ◽  
Laila Almeida Viana ◽  
Marina Pontello Cristelli ◽  
Luis Gustavo Modelli de Andrade ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Study ◽  
Kidney Transplant ◽  
Cumulative Incidence ◽  
The Other ◽  
High Dose ◽  
Multicenter Cohort Study ◽  
Icu Admission ◽  
Multicenter Cohort ◽  
Other Hand

Background Kidney transplant (KT) recipients are considered a high-risk group for unfavorable outcomes in the course of coronavirus disease 2019 (COVID-19). Aim To describe the clinical aspects and outcomes of COVID-19 among KT recipients. Methods This multicenter cohort study enrolled 1,680 KT recipients diagnosed with COVID-19 between March and November 2020, from 35 Brazilian centers. The main outcome was the 90-day cumulative incidence of death, for the entire cohort and according to acute kidney injury (AKI) and renal replacement therapy (RRT) requirement. Fatality rates were analyzed according to hospitalization, intensive care unit (ICU) admission, and mechanical ventilation (MV) requirement. Multivariable analysis was performed by logistic regression for the probability of hospitalization and death. Results The median age of the recipients was 51.3 years, 60.4% were men and 11.4% were Afro-Brazilian. Comorbidities were reported in 1,489 (88.6%), and the interval between transplantation and infection was 5.9 years. The most frequent symptoms were cough (54%), myalgia (40%), dyspnea (37%), and diarrhea (31%), whereas the clinical signs were fever (61%) and hypoxemia (13%). Hospitalization was required in 65.1%, and immunosuppressive drugs adjustments were made in 74.4% of in-hospital patients. ICU admission was required in 34.6% and MV in 24.9%. In the multivariable modeling, the variables related with the probability of hospitalization were age, hypertension, previous cardiovascular disease, recent use of high dose of steroid, and fever, dyspnea, diarrhea, and nausea or vomiting as COVID-19 symptoms. On the other hand, the variables that reduced the probability of hospitalization were time of COVID-19 symptoms, and nasal congestion, headache, arthralgia and anosmia as COVID-19 symptoms. The overall 90-day cumulative incidence of death was 21.0%. The fatality rates were 31.6%, 58.2%, and 75.5% in those who were hospitalized, admitted to the ICU, and required MV, respectively. At the time of infection, 23.2% had AKI and 23.4% required RRT in the follow-up. The cumulative incidence of death was significantly higher among recipients with AKI (36.0% vs. 19.1%, P < 0.0001) and in those who required RRT (70.8% vs. 10.1%, P < 0.0001). The variables related with the probability of death within 90 days after COVID-19 were age, time after transplantation, presence of hypertension, previous cardiovascular disease, use of tacrolimus and mycophenolate, recent use of high dose of steroids, and dyspnea as COVID-19 symptom. On the other hand, the variables that reduced the risk of death were time of symptoms, and headache and anosmia as COVID-19 symptoms. Conclusion The patients diagnosed with COVID-19 were long-term KT recipients and most of them had some comorbidities. One in every five patients died, and the rate of death was significantly higher in those with AKI, mainly when RRT was required.

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