New insight into the clinical characteristics of adults vs children with severe asthma

Purpose: To understand the association between biomarkers and exacerbations of severe asthma in adult patients in Taiwan. Materials and Methods: Demographic, clinical characteristics and biomarkers were retrospectively collected from the medical charts of severe asthma patients in six hospitals in Taiwan. Exacerbations were defined as those requiring asthma-specific emergency department visits/hospitalizations, or systemic steroids. Enrolled patients were divided into: (1) those with no exacerbations (non-exacerbators) and (2) those with one or more exacerbations (exacerbators). Receiver operating characteristic curves were used to determine the optimal cut-off value for biomarkers. Generalized linear models evaluated the association between exacerbation and biomarkers. Results: 132 patients were enrolled in the study with 80 non-exacerbators and 52 exacerbators. There was no significant difference in demographic and clinical characteristics between the two groups. Exacerbators had significantly higher eosinophils (EOS) counts (367.8 ± 357.18 vs. 210.05 ± 175.24, p = 0.0043) compared to non-exacerbators. The optimal cut-off values were 292 for EOS counts and 19 for the Fractional exhaled Nitric Oxide (FeNO) measure. Patients with an EOS count ≥ 300 (RR = 1.88; 95% CI, 1.26–2.81; p = 0.002) or FeNO measure ≥ 20 (RR = 2.10; 95% CI, 1.05–4.18; p = 0.0356) had a significantly higher risk of exacerbation. Moreover, patients with both an EOS count ≥ 300 and FeNO measure ≥ 20 had a significantly higher risk of exacerbation than those with lower EOS count or lower FeNO measure (RR = 2.16; 95% CI, 1.47–3.18; p = < 0.0001). Conclusions: Higher EOS counts and FeNO measures were associated with increased risk of exacerbation. These biomarkers may help physicians identify patients at risk of exacerbations and personalize treatment for asthma patients.

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Clinical Characteristics and Outcomes of Diabetic COVID-19 patients in Kuwait

10.1101/2020.08.20.20178525 ◽

2020 ◽

Cited By ~ 1

Author(s):

Abdullah Alshukry ◽

Mohammad Bu Abbas ◽

Yaseen Ali ◽

Barrak Alahmad ◽

Abdullah A. Al-Shammari ◽

...

Keyword(s):

Clinical Characteristics ◽

Clinical Laboratory ◽

Fasting Blood Glucose ◽

List Type ◽

Laboratory Findings ◽

Reactive Protein ◽

Patients With Diabetes ◽

Laboratory Investigations ◽

Insight Into ◽

Variable Clinical Presentation

AbstractBackgroundCOVID-19 has a highly variable clinical presentation, ranging from asymptomatic to severe respiratory symptoms and death. Diabetes seems to be one of the main comorbidities contributing to a worse COVID-19 outcome.ObjectiveIn here we analyze the clinical characteristics and outcomes of diabetic COVID-19 patients.MethodsIn this single-center, retrospective study of 417 consecutive COVID-19 patients, we analyze and compare disease severity, outcome, associated complications, and clinical laboratory findings between diabetic and non-diabetic COVID-19 patients.ResultsCOVID-19 patients with diabetes had more severe outcomes and higher mortality than non-diabetic COVID-19 patients. Diabetic COVID-19 patients had significantly higher prevalence of comorbidities, such as hypertension. Laboratory investigations also highlighted notably higher levels of C-reactive protein in diabetic COVID019 patients and lower estimated glomerular filtration rate. They also showed a higher incidence of complications.ConclusionDiabetes could be a major contributor to worsening outcomes in COVID-19 patients. Understanding the pathophysiology underlining these findings could provide insight into better management and improved outcome of such cases.Highlights of the StudyA significantly higher proportion of Diabetic COVID-19 patients required admission to the ICU.Higher fasting blood glucose was associated with higher risk of COVID-19 associated mortality.Diabetic COVID-19 patients had significantly higher incidence of complications including sepsis, ARDS, cardiac failure and renal failure.

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Clinical Characteristics of Severe Asthma Patients in a Tertiary Pediatric Subspecialty Clinic

10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a3732 ◽

2020 ◽

Author(s):

J.F. Chocano ◽

C. Hornersmith

Keyword(s):

Severe Asthma ◽

Clinical Characteristics ◽

Asthma Patients ◽

Pediatric Subspecialty

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836 Clinical characteristics of severe asthma

Journal of Allergy and Clinical Immunology ◽

10.1016/s0091-6749(00)91264-8 ◽

2000 ◽

Vol 105 (1) ◽

pp. S284-S285

Author(s):

J SPAHN

Keyword(s):

Severe Asthma ◽

Clinical Characteristics

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Cognitive subtypes in non-affected siblings of schizophrenia patients: characteristics and profile congruency with affected family members

Psychological Medicine ◽

10.1017/s0033291713000809 ◽

2013 ◽

Vol 44 (2) ◽

pp. 395-405 ◽

Cited By ~ 9

Author(s):

P. J. Quee ◽

B. Z. Alizadeh ◽

A. Aleman ◽

E. R. van den Heuvel ◽

Keyword(s):

Cognitive Function ◽

Functional Outcomes ◽

Clinical Characteristics ◽

Cognitively Impaired ◽

Cognitive Tests ◽

Genetic Studies ◽

Intellectual Function ◽

Symptomatic Remission ◽

Insight Into ◽

Performance Pattern

BackgroundAlthough cognitive subtypes have been suggested in schizophrenia patients, similar analyses have not been carried out in their non-affected siblings. Subtype classification may provide more insight into genetically driven variation in cognitive function. We investigated cognitive subtypes in siblings.MethodCluster analyses were performed in 654 non-affected siblings, on a cognitive battery that included tests of attention, intellectual function and episodic memory. Resulting subtypes in the siblings were analyzed for cognitive, demographic and clinical characteristics and compared with those of their probands.ResultsThree sibling subtypes of cognitive function were distinguished: ‘normal’, ‘mixed’ and ‘impaired’. Normal profile siblings (n = 192) were unimpaired on cognitive tests, in contrast to their proband (n = 184). Mixed profile siblings (n = 228) and their probands (n = 222) had a more similar performance pattern. Impaired profile siblings had poorer functional outcomes (n = 234) and their profile was almost identical to that of their proband (n = 223). Probands with cognitively impaired siblings could be distinguished from other schizophrenia patients by their own cognitive performance. They also had poorer clinical characteristics, including achievement of symptomatic remission.ConclusionsUnaffected siblings of patients with schizophrenia are heterogeneous with respect to cognitive function. The poorer the cognitive profile of the sibling, the higher the level of correspondence with the proband. The sibling's cognitive subtype was predictive for disease course in the proband. Distinguishing cognitive subtypes of unaffected siblings may be of relevance for genetic studies.

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