scholarly journals Risk factors for delayed negative conversion of SARS-CoV-2 in patients with COVID-19 pneumonia: a retrospective cohort study

2020 ◽  
Vol 148 ◽  
Author(s):  
Pingzheng Mo ◽  
Liping Deng ◽  
Xiaoping Liu ◽  
Shicheng Gao ◽  
Ke Liang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Short Term ◽  
Factors Associated ◽  
Single Centre Study ◽  
Chief Complaints ◽  
Area Under Roc Curve ◽  
Conversion Time ◽  
To Receive ◽  
Negative Conversion

Abstract The epidemic of coronavirus disease 2019 (COVID-19) began in China and had spread rapidly to many other countries. This study aimed to identify risk factors associated with delayed negative conversion of SARS-CoV-2 in COVID-19 patients. In this retrospective single-centre study, we included 169 consecutive patients with confirmed COVID-19 in Zhongnan Hospital of Wuhan University from 15th January to 2nd March. The cases were divided into two groups according to the median time of SARS-CoV-2 negative conversion. The differences between groups were compared. In total, 169 patients had a median virus negative conversion time of 18 days (interquartile range: 11–25) from symptom onset. Compared with the patients with short-term negative conversion, those with long-term conversion had an older age, higher incidence of comorbidities, chief complaints of cough and chest distress/breath shortness and severer illness on admission, higher level of leucocytes, neutrophils, aspartate aminotransferase, creatine kinase and erythrocyte sedimentation rate (ESR), lower level of CD3+CD4+ lymphocytes and albumin and more likely to receive mechanical ventilation. In multivariate analysis, cough, leucocytes, neutrophils and ESR were positively correlated with delayed virus negative conversion, and CD3+CD4+ lymphocytes were negatively correlated. The integrated indicator of leucocytes, neutrophils and CD3+CD4+ lymphocytes showed a good performance in predicting the negative conversion within 2 weeks (area under ROC curve (AUC) = 0.815), 3 weeks (AUC = 0.804), 4 weeks (AUC = 0.812) and 5 weeks (AUC = 0.786). In conclusion, longer quarantine periods might be more justified for COVID-19 patients with cough, higher levels of leucocytes, neutrophils and ESR and lower levels of CD3+CD4+ lymphocytes.

scholarly journals Clinical Risk Factors for Long-term Hospital Stay in Common Patients with coronavirus disease 2019(COVID-19)

2020 ◽  
Author(s):  
Wei Lu ◽  
Junjie Fang ◽  
Bin Chen ◽  
Dan Wu ◽  
Chunyao Yu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Stay ◽  
Potential Risk ◽  
Clinical Laboratory ◽  
Short Term ◽  
Factors Associated ◽  
Regression Methods ◽  
Potential Risk Factors ◽  
Multivariable Regression

Abstract Background This study aimed to investigate the potential risk factors associated with hospital stay in mild patients with COVID-19. Methods A total of 109 laboratory-confirmed COVID patients with initial common subtype diseased by real-time RT-PCR that meet discharge standards were retrospectively included from January 16 to March 15 of 2020. Baseline demographic, clinical, laboratory examination was extracted from electronic medical records at the first day of admission and compared between short-term hospital stay and long-term hospital stay. Univariable and multivariable logistic regression methods were used to explore the risk factors associated with hospital stay. Results Of 109 COVID-19 patients, 61 patients were short-term stay (≤ 10 days) and 48 patients were long-term stay (> 10 days). The average age of patients in short-term stay were younger than those long-term stay(P = 0.01). Hypertension was the most common comorbidity (34%, 21/61), followed by diabetes (15%,9/61) and Cardiopathy (8%, 5/61). Fever and cough were the typical clinical manifestation in two group. Decreased WBC, Hemoglobin and increased Monocyte, MLR (Monocyte Lymphocyte ratio) and Hypersensitive CRP showed a long-term stay (all P < 0.05). The treatment of Resochin and Human immunoglobulin had a shorter hospital stay. Multivariable regression showed that MLR and CRP on admission were risk factors for predicting the hospital stay, with the HR (hazard ratio 2.03, 1.02–5.39; P = 0.022) and (1.32,1.05–3.24, P = 0.045) respectively. Conclusions The potential risk factors of MLR and CRP may help clinicians to predict the hospital stay of COVID-19 patients.

scholarly journals ACUTE KIDNEY INJURY AFTER LUNG TRANSPLANTATION: PERIOPERATIVE RISK FACTORS AND OUTCOME

2019 ◽  
Author(s):  
Enora Atchade ◽  
Samira Barour ◽  
Alexy Tran-Dinh ◽  
Sylvain Jean-Baptiste ◽  
Sébastien Tanaka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Multivariate Analysis ◽  
Lung Transplantation ◽  
Kidney Injury ◽  
Short Term ◽  
Factors Associated ◽  
Icu Stay ◽  
Long Term Mortality

Abstract BACKGROUND Acute kidney injury (AKI) is associated with increased short-term and long-term mortality and morbidity after lung transplantation (LT). The primary objective of this study was to analyze the perioperative factors associated with AKI according to KDIGO criteria during hospitalization in an intensive care unit (ICU) after LT. METHODS This was a single-center observational, prospective study. AKI was defined according to KDIGO criteria. Results are expressed as median, interquartile range, absolute numbers and percentages. Statistical analyses were performed using Chi-square test, Fisher’s exact test and Mann-Witney U test (p<0.05 was considered to be significant). Multivariate analysis was performed to identify independent risk factors. RESULTS Between January 2016 and April 2018, 94 patients (pts) underwent LT (70% bilateral LT). AKI occurred during ICU stay in 46 pts (49%). KDIGO 1 AKI was observed in 16 pts (17%), KDIGO 2 in 14 pts (15%), and KDIGO 3 in 16 pts (17%) including 12 pts (75%) who required renal replacement therapy (RRT). AKI occurred before the fifth day after surgery for 38 patients (82% of the AKI patients). On multivariate analysis, independent factors associated with AKI were bilateral LT and mechanical ventilation (MV) > 3 days (OR 4.26 95%CI [1.49; 13.63] p=0.010 and OR 5.56 [1.25; 11.47] p=0.018, respectively). AKI and the need for RRT were significantly associated with ICU mortality, 28-day mortality and one-year mortality. CONCLUSION AKI is common during ICU stay after LT, especially after bilateral LT and is associated with prolonged MV, and increased short-term and long-term mortality.

scholarly journals OP0133 THE PREVALENCE AND RISK FACTORS OF RETINAL TOXICITY ASSOCIATED WITH LONG-TERM HYDROXYCHLOROQUINE USE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 77-78
Author(s):  
S. Do ◽  
J. H. Du ◽  
J. X. An ◽  
J. Wang ◽  
A. Lin
Keyword(s):  
Risk Factors ◽  
Cumulative Dose ◽  
Daily Intake ◽  
Retinal Toxicity ◽  
Factors Associated ◽  
Duration Of Therapy ◽  
Increased Risk ◽  
Hydroxychloroquine Retinopathy ◽  
Risk Of Retinopathy

Background:Hydroxychloroquine (HCQ) is commonly used for the treatment of various autoimmune diseases. The medication is generally well-tolerated. However, long-term use after 5 years may increase the risk of retinopathy. One study in 2014 has demonstrated the risk can be as high as 7.5%. Optical Coherence Tomography (OCT) has become a major modality in screening retinopathy.Objectives:To evaluate the prevalence of retinal toxicity among patients using hydroxychloroquine and to determine various risk factors associated with hydroxychloroquine-associated retinal toxicity.Methods:We performed a retrospective chart review on a cohort of adult patients with long-term use (≥ 5 years cumulative) of HCQ between January 1st, 2011 to December 31st, 2018 from the Kaiser Permanente San Bernardino County and Riverside medical center areas in Southern California, USA. Patients were excluded if they had previously been diagnosed with retinopathy prior to hydroxychloroquine use, were deceased, or had incomplete OCT exam. Our primary endpoint was the prevalence of patients who developed retinal toxicity detected by OCT, and later confirmed by retinal specialist. Potential risk factors (age, duration of therapy, daily consumption per actual body weight, cumulative dose, confounding diseases and medication) for developing retinopathy were also evaluated. Univariable and multivariable logistic regression analyses were used to determine risk factors associated with retinal toxicity.Results:Among 676 patients exposed to more than 5 years of HCQ, the overall prevalence of retinal toxicity was 6.8%, and ranged from 2.5% to 22.2% depending on the age, weight-based dosing, duration of use and cumulative dose. Duration of therapy for 10 years or more increased risk of retinopathy by approximately 5 to 19 folds. Similarly, weight-based dose of 7 mg/kg/day or greater was assciated with increased risk of retinopathy by approximately 5 times. Patients with cumulative dose of 2000 grams or more had greater than 15 times higher risk of developing retinopathy. Duration of use for10 years or more (odd ratio 4.32, 95% CI 1.99 – 12.49), age (odd ratio 1.04; 95% CI 1.01 - 1.08), cumulative dose of more than 1500 g (odd ratio 7.4; 95% CI 1.40 – 39.04) and atherosclerosis of the aorta (odd ratio 2.59; 95% CI, 1.24 – 5.41) correlated with higher risk of retinal toxicity.Conclusion:The overall prevalence of retinopathy was 6.8%. Regular OCT screening, especially in patients with hydroxychloroquine use for more than 10 years, daily intake > 7 mg/kg, or cumulative dose > 1500 grams is important in detecting hydroxychloroquine-associated retinal toxicityReferences:[1]Hobbs HE. Sorsby A, & Freedman A. Retinopathy Following Chloroquine Therapy. The Lancet. 1959; 2(7101): 478-480.[2]Levy, G. D., Munz, S. J., Paschal, J., Cohen, H. B., Pince, K. J., & Peterson, T. Incidence of hydroxychloroquine retinopathy in 1,207 patients in a large multicenter outpatient practice. Arthritis & Rheumatism: 1997; 40(8): 1482-1486.[3]Ding, H. J., Denniston, A. K., Rao, V. K., & Gordon, C. Hydroxychloroquine-related retinal toxicity. Rheumatology. 2016; 55(6): 957-967.[4]Stelton, C. R., Connors, D. B., Walia, S. S., & Walia, H. S. Hydrochloroquine retinopathy: characteristic presentation with review of screening. Clinical rheumatology. 2013; 32(6): 895-898.[5]Marmor, M. F., Kellner, U., Lai, T. Y., Melles, R. B., & Mieler, W. F. Recommendations on screening for chloroquine and hydroxychloroquine retinopathy (2016 revision). Ophthalmology. 2016; 123(6): 1386-1394.[6]Melles, R. B., & Marmor, M. F. The risk of toxic retinopathy in patients on long-term hydroxychloroquine therapy. JAMA ophthalmology. 2014; 132(12): 1453-1460.Disclosure of Interests:None declared

Long‐term Surgical Outcomes after Resection of Presacral Tumours and Risk Factors Associated with Recurrence

2021 ◽  
Author(s):  
Di Zhang ◽  
Yizhou Sun ◽  
Lei Lian ◽  
Bang Hu ◽  
Heng Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Outcomes ◽  
Factors Associated

scholarly journals Influence of lifestyle risk factors on work ability and sick leave in a general working population in Norway: a 5-year longitudinal study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e045678
Author(s):  
Marit Müller De Bortoli ◽  
Inger M. Oellingrath ◽  
Anne Kristin Moeller Fell ◽  
Alex Burdorf ◽  
Suzan J. W. Robroek
Keyword(s):  
Risk Factors ◽  
Longitudinal Study ◽  
Sick Leave ◽  
Work Ability ◽  
Working Population ◽  
Short Term ◽  
Lifestyle Risk Factors ◽  
Lifestyle Risk

ObjectivesThe aim of this study is to assess (1) whether lifestyle risk factors are related to work ability and sick leave in a general working population over time, and (2) these associations within specific disease groups (ie, respiratory diseases, cardiovascular disease and diabetes, and mental illness).SettingTelemark county, in the south-eastern part of Norway.DesignLongitudinal study with 5 years follow-up.ParticipantsThe Telemark study is a longitudinal study of the general working population in Telemark county, Norway, aged 16 to 50 years at baseline in 2013 (n=7952) and after 5-year follow-up.Outcome measureSelf-reported information on work ability (moderate and poor) and sick leave (short-term and long-term) was assessed at baseline, and during a 5-year follow-up.ResultsObesity (OR=1.64, 95% CI: 1.32 to 2.05) and smoking (OR=1.62, 95% CI: 1.35 to 1.96) were associated with long-term sick leave and, less strongly, with short-term sick leave. An unhealthy diet (OR=1.57, 95% CI: 1.01 to 2.43), and smoking (OR=1.67, 95% CI: 1.24 to 2.25) were associated with poor work ability and, to a smaller extent, with moderate work ability. A higher lifestyle risk score was associated with both sick leave and reduced work ability. Only few associations were found between unhealthy lifestyle factors and sick leave or reduced work ability within disease groups.ConclusionLifestyle risk factors were associated with sick leave and reduced work ability. To evaluate these associations further, studies assessing the effect of lifestyle interventions on sick leave and work ability are needed.

CLINICAL PROFILE OF PATIENTS OF YOUNG STROKE.

2021 ◽  
pp. 68-70
Author(s):  
Nitin Hiraman Suryawanshi ◽  
Amit Aggarwal ◽  
Abhijit Kadam
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Young Patients ◽  
Behavioural Pattern ◽  
Long Term Outcomes ◽  
Short Term ◽  
Traditional Risk Factors ◽  
The Individual ◽  
Stroke In Young

A study of stroke in young patients has recently become a subject of interest. This is due to a lot of impact on the individual and society. Study of stroke in young patients can lead to therapeutical results affecting both short term and long-term outcomes. Our study is hospital based retrospective study for duration of 1 year. Thi Methods: Results: s study revealed stroke in young in 25.16% of all stroke cases, with cerebral infarction in 56% and followed by intracerebral haemorrhage in 25.64%, and cerebral venous thrombosis in 18%. The most common presenting symptom was hemiparesis. The most prevalent risk factor for stroke in young was hypertension followed by diabetes mellitus, alcohol consumption and smoking. Stroke in young requires a differe Conclusion: nt approach to investigate and treat. This is due to different underlying etilogy as compared to elderly. Although traditional risk factors are associated with stroke, behavioural pattern such as smoking and alcohol may cause and promote development of stroke in young.

scholarly journals Analysis of Risk Factors Associated with Outcomes in Road Traffic Injury Patients with Acute Lung Injury

2009 ◽  
Vol 37 (3) ◽  
pp. 835-840
Author(s):  
L Sheng ◽  
J-S Wu ◽  
M Zhang ◽  
S-W Xu ◽  
J-X Gan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Lung Injury ◽  
Lung Injury ◽  
Road Traffic ◽  
Road Traffic Injury ◽  
Apache Ii Score ◽  
Factors Associated ◽  
Traffic Injury ◽  
Short And Long Term

Over 50% of road traffic injury (RTI) patients experience post-traumatic acute lung injury (ALI) and it is, therefore, extremely important to identify the risk factors related to the poor outcomes associated with ALI in RTI populations. This study evaluated 19 potential risk factors associated with the outcomes of ALI in 366 RTI patients. They were divided into two groups: a ‘favourable outcomes group’ and an ‘unfavourable outcomes group’. The results indicated that the Acute Physiology and Chronic Health Evaluation II (APACHE II) score and the presence of gastrointestinal haemorrhage may help predict the outcomes of ALI in the early post-trauma phase of treatment. The duration of trauma and sepsis were shown to impact strongly on both the short- and long-term outcomes of ALI. Age (≥ 65 years) and disseminated intravascular coagulation in the early RTI phase were also independent risk factors for a poorer short- and long-term outcome in ALI.

scholarly journals Examination of main lymph node (No.253) metastasis in left colorectal cancer: A retrospective analysis of a single-institution cohort

2021 ◽  
Author(s):  
Takefumi Yoshida ◽  
Fumihiko Fujita ◽  
Dai Shida ◽  
Kenichi Koushi ◽  
Kenji Fujiyoshi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Poor Prognosis ◽  
Advanced Colorectal Cancer ◽  
D3 Lymphadenectomy ◽  
Positive Group ◽  
Factors Associated

Abstract Background. The extent of lymph node dissection in advanced colorectal cancer varies according to regional guidelines. D3 lymphadenectomy is routinely performed in Japan but is associated with several risk factors. Metastases of the main lymph nodes (No.253 lymph nodes), which are located at the root of the inferior mesenteric artery, are rare in left-sided colorectal cancer. Tumor depth (T4) is an identifier of No.253 lymph node metastasis (LNM) risk, but other risk factors associated with No.253 LNM are unclear. This study was undertaken to investigate the frequency of No.253 LNM and to identify other clinicopathological risk factors associated with No.253 LNM in left-sided colorectal cancer. In this study, we aimed to evaluate the clinical benefit of routine D3 lymphadenectomy in surgically treated advanced colorectal cancer. Methods. A retrospective database of patients with colorectal cancer who underwent D3 dissection and R0 resection at Kurume University Hospital from 1978 to 2017 was constructed and used to search for the frequency and risk factors of No.253 LNM to investigate long-term prognosis. Clinicopathological factors associated with No.253 LNM, including age, sex, tumor location, T stage, tumor diameter, carcinoembryonic antigen levels, and various dissected lymph nodes, were analyzed. Results. Among 1,614 consecutive patients, No.253 LNM was observed in 23 cases (1.4%). The presence of three or more regional LNMs was an independent risk factor for No.253 LNM (odds ratio: 26.8). The 5-year overall survival rate was 49.1% in the No.253 LNM-positive group and 78.4% in the No.253 LNM-negative group (p=0.002). Conclusion. In left-sided colorectal cancer, No.253 LNM was a poor prognosis factor, and three or more regional LNMs were a risk factor for No.253 LNM. The No.253 LNM-positive group had a poor prognosis, but there are cases of long-term survival, with a 5-year survival rate of 49%. D3 lymphadenectomy is suitable when three or more metastatic LNs are identified prior to surgery.

scholarly journals Outcome of pinning in patients with slipped capital femoral epiphysis: risk factors associated with avascular necrosis, chondrolysis, and femoral impingement

2017 ◽  
Vol 46 (6) ◽  
pp. 2120-2127 ◽  
Author(s):  
Alexandru Ulici ◽  
Madalina Carp ◽  
Iulia Tevanov ◽  
Catalin Alexandru Nahoi ◽  
Alin Gabriel Sterian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Avascular Necrosis ◽  
Slipped Capital Femoral Epiphysis ◽  
Normal Weight ◽  
Single Centre ◽  
Factors Associated ◽  
Hip Impingement ◽  
Α Angle

Objective This study aimed to assess the principal risk factors that could lead to the most common long-term complications of slipped capital femoral epiphysis, such as avascular necrosis, chondrolysis, and hip impingement. Methods We conducted a single-centre, retrospective study and evaluated patients (70 patients, 81 hips) who were treated for slipped capital femoral epiphysis from 2010 to 2015 and who underwent pinning. We measured the severity of displacement radiologically using the Southwick angle. Postoperative radiographs were evaluated for the most frequent long-term complications of avascular necrosis (AVN), chondrolysis, and femoral acetabular impingement (FAI). Results We found seven cases of AVN, 14 cases of chondrolysis, and 31 hips had an α angle of 60°. Sex, ambulation, and symptoms did not affect development of these complications. Patients with a normal weight were almost two times more likely to develop FAI. Patients with moderate and severe slips had a similar percentage of AVN. In severe slips, 85.7% of patients had an α angle higher than 60°. Conclusions This study shows that severe slips have a higher risk of developing AVN and hip impingement. Every patient who suffers from SCFE (even the mildest forms) should be regularly checked for FAI.

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