scholarly journals QT interval evaluation associated with the use of hydroxychloroquine with combined use of azithromycin among hospitalised children positive for coronavirus disease 2019

2020 ◽  
Vol 30 (10) ◽  
pp. 1482-1485 ◽  
Author(s):  
Tunc Tuncer ◽  
Mehmet Karaci ◽  
Aysun Boga ◽  
Hilal Durmaz ◽  
Sirin Guven
Keyword(s):  
Intensive Care ◽  
Qt Interval ◽  
Clinical Symptoms ◽  
Qt Prolongation ◽  
Radiological Findings ◽  
Single Centre ◽  
Combined Use ◽  
Laboratory Results ◽  
Interval Evaluation ◽  
Training And Research

AbstractIntroduction and aim:Hydroxychloroquine alone or in combination with azithromycin has been increasingly used for patients with coronavirus disease 2019, in both children and adults. Drugs are generally well tolerated in clinical practice; however, both can cause corrected QT prolongation. We aimed to report our experience of QT interval evaluation associated with the use of hydroxychloroquine with concurrent azithromycin among children testing positive for coronavirus disease 2019.Methods:Our single-centre; retrospective, study evaluated children with coronavirus disease 2019 disease admitted to the Pediatric Department at Sancaktepe Training and Research Hospital Istanbul, Turkey from 10 March, 2020 to 10 April, 2020. The data including demographics, clinical symptoms, co-morbid diseases, laboratory, radiological findings as well as electrocardiographs of the patients were obtained from our records. Electrocardiograms were evaluated before, one day after and at the termination of the treatment.Results:21 patients aged 9 to 18 years were evaluated. The median age was 170 months (range 112–214), 51.1% of them were girls and 48.9% were boys. Their laboratory results did not reveal any abnormalities. None of them needed intensive care. We did not detect QT prolongation during or at the termination of the treatment.Conclusion:We did not detect QT prolongation during or at the termination of the treatment in our patients due to the fact that they were not severely affected by the disease. Patients were treated in our inpatient clinic and none of them required intensive care. Laboratory results were also insignificant. Furthermore, they did not need other medications.

scholarly journals The Reflections of Covid-19 pandemic: Turkey's results during the first month of the pandemic

2021 ◽  
Vol 8 (1) ◽  
pp. 45-49
Author(s):  
Suna Eraybar ◽  
Huseyin AYGUN
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Emergency Service ◽  
Radiological Findings ◽  
History Of ◽  
Training And Research ◽  
Oropharyngeal Swab ◽  
The Mean ◽  
The Relationship

Objective:  This study aims to evaluate the clinical and epidemiological findings of patients with suspected COVID-19 admitted to the emergency service of a 3rd step training and research hospital. Material and Methods: Patients older than 18 years of age, suspected COVID-19 disease and received diagnostic combined nasal and oropharyngeal swab between April 1, 2020 and April 30, 2020 were evaluated retrospectively. Demographic, laboratory, radiological findings and PCR results of the patients were recorded. In addition, the patients' home isolation, hospitalization, intensive care follow-up requirements and 28-day mortality were analyzed. Results: Total 3020 patients were included in the study, and the mean age of the patients was found to be 41 ± 16.22. 55.4% (n = 1673) of the patients were female and 83.0% (n = 2508) of them were found to have negative PCR results. Mortality occurred in 3.5% of the patients (n = 107) within 28 days. The relationship between the PCR results, pneumonia status and type of hospitalization and 28-day mortality results were compared, and a statistically significant relationship was found. [(p<0.001), (p<0.001), (p<0.001)]. Conclusion: In line with these data obtained at the beginning of the pandemic, positive PCR results, presence of pneumonia and the history of intensive care unit hospitalization are risk factors for mortality

Re-hospitalisation Rate of Patients Hospitalised with a Diagnosis Of COVID-19: A Training And Research Hospital Example

2021 ◽  
Vol 6 (13) ◽  
pp. 7-17
Author(s):  
Hatice ESEN ◽  
Tuğba ÇALIŞKAN ◽  
Ayşegül SEREMET KESKİN
Keyword(s):  
Clinical Symptoms ◽  
Nonparametric Tests ◽  
Hospitalisation Rate ◽  
Patient Assessment ◽  
Medical Treatments ◽  
Laboratory Results ◽  
Care Approach ◽  
Training And Research ◽  
The Mean ◽  
The Difference

Background/aim: COVID-19 cases originated in Wuhan and it has become a global problem. The purpose of study to examine the rate of re-hospitalisation within 30 days after the completion of medical treatments for patients suffering from COVID-19. Materials and methods: In this study, the results of COVID-19 patients who were re-admitted to the hospital within 30 days were examined. The general and clinical characteristics of the patients and laboratory results were evaluated using parametric and nonparametric tests. Results: Included in this study were 22 patients, comprising 14 males and 8 females, with re-hospitalisation rate within 30 days and a diagnosis of COVID-19 that was 0.6%. The mean age of the patients who were re-hospitalised was 56.45 years. The major clinical symptoms of the patients who were re-hospitalised, respectively, were cough, shortness of breath, fever. When the levels from the first hospitalisation and the second hospitalisation were compared, an increase in the LYM count and N/L ratio was detected and the difference was statistically significant. Conclusion: A holistic patient assessment and care approach should be adopted by evaluating the symptomatic complaints as well as the comorbidities of the patients, so as to reduce the number of re-hospitalisations.

scholarly journals Paediatric admissions to a district general hospital adult intensive care unit over a six year period: A single centre retrospective case series, with review of practitioner confidence and competence in paediatric critical care

2021 ◽  
pp. 175114372110121
Author(s):  
Stephen A Spencer ◽  
Joanna S Gumley ◽  
Marcin Pachucki
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Case Series ◽  
Critically Ill Children ◽  
Single Centre ◽  
Retrospective Case ◽  
Retrospective Case Series ◽  
Paediatric Critical Care ◽  
Doctors And Nurses

Background Critically ill children presenting to district general hospitals (DGH) are admitted to adult intensive care units (AICUs) for stabilisation prior to transfer to paediatric intensive care units (PICUs). Current training in PICU for adult intensive care physicians is only three months. This single centre retrospective case series examines the case mix of children presenting to a DGH AICU and a multidisciplinary survey assesses confidence and previous experience, highlighting continued training needs for DGH AICU staff. Methods all paediatric admissions to AICU and paediatric retrievals were reviewed over a 6-year period (2014-2019). Cases were identified from the Electronic Patient Record (EPR) and from data provided by the regional paediatric retrieval service. A questionnaire survey was sent to AICU doctors and nurses to assess confidence and competence in paediatric critical care. Results Between 2014-2019, 284 children were managed by AICU. In total 35% of cases were <1 y, 48% of cases were <2 y and 64% of cases were <5 y, and 166/284 (58%) children were retrieved. Retrieval reduced with increasing age (OR 0.49 [0.40-0.60], p < 0.0001). The survey had an 82% response rate, and highlighted that only 13% of AICU nurses and 50% of doctors had received prior PICU training. Conclusion At least one critically unwell child presents to the AICU each week. Assessment, stabilisation and management of critically unwell children are vital skills for DGH AICU staff, but confidence and competence are lacking. Formalised strategies are required to develop and maintain paediatric competencies for AICU doctors and nurses.

Changes of QT interval in the acute phase after pulmonary vein isolation for paroxysmal atrial fibrillation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Chikata ◽  
T Kato ◽  
K Ududa ◽  
S Fujita ◽  
K Otowa ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Female Patient ◽  
Pulmonary Vein Isolation ◽  
Acute Phase ◽  
Paroxysmal Atrial Fibrillation ◽  
Qt Interval ◽  
Qt Prolongation ◽  
Qtc Interval ◽  
The Impact

Abstract Introduction Pulmonary vein isolation (PVI) affects ganglionated plexi (GP) around the atrium, leading to a modification of the intrinsic cardiac autonomic system (ANS). In animal models, GP ablation has a potential risk of QT prolongation and ventricular arrhythmias. However, the impact of PVI on QT intervals in humans remains unclear. Purpose This study aims to evaluate the Impact of PVI on QT interval in patients with paroxysmal atrial fibrillation. Methods We analyzed consecutive 117 PAF patients for their first PVI procedures. 12-lead ECG was evaluated at baseline, 4 hr, day 1, 1 month, and 3 months after ablation. Only patients with sinus rhythm on 12-lead ECG at each evaluation point without antiarrhythmic drugs were included. Results Heart rate significantly increased at 4 hr, day 1, and 1 month. Raw QT interval prolonged at 4 hr (417.1±41.6 ms, P&lt;0.001) but shortened at day 1 (376.4±34.1 ms, P&lt;0.001), 1 month (382.2±31.5 ms, P&lt;0.001), and 3 months (385.1±32.8 ms, P&lt;0.001) compared to baseline (391.6±31.4 ms). Bazett- and Fridericia- corrected QTc intervals significantly prolonged at 4hr (Bazett: 430.8±27.9 ms, P&lt;0.001; Fridericia: 425.8±27.4 ms, P&lt;0.001), day1 (Bazett: 434.8±22.3 ms, P&lt;0.001; Fridericia: 414.1±23.7 ms, P&lt;0.001), 1M (Bazett: 434.8±22.3 ms, P&lt;0.001; Fridericia: 408.2±21.0 ms, P&lt;0.05), and 3M (Bazett: 420.1±21.8 ms, P&lt;0.001; Fridericia: 407.8±21.1 ms, P&lt;0.05) compared to baseline (Bazett: 404.9±25.2 ms; Fridericia: 400.0±22.6 ms). On the other hand, Framingham- and Hodges- corrected QTc interval significantly prolonged only at 4hr (Framingham: 424.1±26.6 ms, P&lt;0.001; Hodges: 426.8±28.4 ms, P&lt;0.001) and at day1 (Framingham: 412.3±29.3 ms, P&lt;0.01; Hodges: 410.6±40.2 ms, P&lt;0.05) compared to baseline (Framingham: 399.2±22.7 ms; Hodges: 400.7±22.8 ms). At 4 hr after ablation, raw QT and QTc of all formulas significantly prolonged than baseline. Raw QT and QTc prolongation at 4hr after ablation were more frequently observed in female patients. Multiple regression analysis revealed that female patient is a significant predictor of raw QT and QTc interval prolongation of all formulas 4hr after PVI. Conclusions Raw QT and QTc prolonged after PVI, especially in the acute phase. Female patient is a risk factor for QT prolongation in the acute phase after PVI. Funding Acknowledgement Type of funding source: None

scholarly journals Increased blood culture contamination rate during COVID-19 outbreak in intensive care unit: A brief report from a single-centre

2021 ◽  
pp. 175114372110121
Author(s):  
Emanuele Russo ◽  
Giuliano Bolondi ◽  
Emiliano Gamberini ◽  
Domenico Pietro Santonastaso ◽  
Alessandro Circelli ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Culture ◽  
Contamination Rate ◽  
Single Centre

scholarly journals Variable clinical characteristics and laboratory results in five patients with Chinese Good's syndrome (thymoma and hypogammaglobulinemia): an 8-year retrospective analysis in a university hospital in China

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jinyao Ni ◽  
Junwu Zhang ◽  
Yanxia Chen ◽  
Weizhong Wang ◽  
Jinlin Liu
Keyword(s):  
Information System ◽  
Lichen Planus ◽  
Hospital Information System ◽  
Clinical Characteristics ◽  
Opportunistic Infections ◽  
Clinical Symptoms ◽  
University Hospital ◽  
Ivig Treatment ◽  
Good’S Syndrome ◽  
Laboratory Results

Abstract Background Good's syndrome (GS) is a rare secondary immunodeficiency disease presenting as thymoma and hypogammaglobulinemia. Due to its rarity, the diagnosis of GS is often missed. Methods We used the hospital information system to retrospectively screen thymoma and hypogammaglobulinemia patients at the First Affiliated Hospital of Wenzhou Medical University from Apr 2012 to Apr 2020. The clinical, laboratory, treatment, and outcome data for these patients were collected and analyzed. Results Among the 181 screened thymoma patients, 5 thymoma patients with hypogammaglobulinemia were identified; 3 patients had confirmed diagnoses of GS, and the other 2 did not have a diagnosis of GS recorded in the hospital information system. A retrospective review of the clinical characteristics, laboratory results, and follow-up data for these 2 undiagnosed patients confirmed the diagnosis of GS. All 5 GS patients presented with pneumonia, 2 patients presented with recurrent skin abscesses, 2 patients presented with recurrent cough and expectoration, 1 patient presented with recurrent oral lichen planus and diarrhea, and 1 patient presented with tuberculosis and granulomatous epididymitis. In the years after the diagnosis of hypogammaglobulinemia with mild symptoms, all 5 patients had received irregular intravenous immunoglobulin (IVIG) treatment. As the course of the disease progressed, the clinical symptoms of all patients worsened, but the symptoms were partly resolved with IVIG in these patients. However, 4 patients died due to comorbidities. Conclusion GS should be investigated as a possible diagnosis in thymoma patients who present with hypogammaglobulinemia, especially those with recurrent opportunistic infections, recurrent skin abscesses, chronic diarrhea, or recurrent lichen planus.

COVID-19 situation in Baden-Württemberg, Germany: Preliminary case series study during the first wave

2021 ◽  
Vol 1 (1) ◽  
pp. 6-11
Author(s):  
Dzmitry Katovich ◽  
Claudia Grun ◽  
Hanna Katovich ◽  
Bastian Hauer ◽  
Thomas Iber ◽  
...  
Keyword(s):  
Intensive Care ◽  
Clinical Symptoms ◽  
Fatal Outcome ◽  
Laboratory Data ◽  
Case Series ◽  
Severe Illness ◽  
Case Series Study ◽  
Regional Factors ◽  
Series Study

The present case series study presents the preliminary data of 347 of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) positively tested patients in the Mittelbaden hospital, Baden-Baden Bühl, Germany, during the period from March to June 2020. Among the 347 patients, 55% were males. The mean age-wise was 52.5±20.2 years in the overall cohort and 78.9±11.1 years in fatal outcome cases. A total of 120/347 patients (34.6%) required hospitalization, but only 36/347 (10.37%) cases required intensive care. The overall fatality rate was 6.6% (23/347), of which 12 patients were from the intensive care unit. The most frequent clinical symptoms observed were cough (62.5%), hyperthermia (47.8%), rhinorrhea (25.1%), sore throat (23.1%), dyspnea (22.8%), and headache (19.3%). Laboratory data analysis showed no specific findings, but severe laboratory disturbances could predict critical illness. A higher risk of severe illness or lethal outcome in elderly patients with several comorbidities was the most frequent. The fight against COVID-19 infection in Germany seems to be more successful during the first wave than in other countries. The improvement of the healthcare system against infectious outbreaks depends directly on the analysis of regional factors.

Abstract 14311: Qt Interval Correlation Between Telemetry and 12-lead Electrocardiogram

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Mohamed Farhan Nasser ◽  
Ahmad Jabri ◽  
Saima Karim ◽  
Elizabeth Kaufman
Keyword(s):  
Qt Interval ◽  
Ventricular Arrhythmias ◽  
Qt Prolongation ◽  
T Wave ◽  
Qt Intervals ◽  
Increased Risk ◽  
Tangent Method ◽  
Wave Morphology ◽  
Monitoring Service ◽  
Inpatient Units

Introduction: QT prolongation is associated with increased risk of ventricular arrhythmias.As many patients with COVID19 may be started on QT prolonging drugs, measuring and monitoring QT is imperative to prevent fatal ventricular arrhythmias. However, we need to limit exposure of staff to patients with confirmed COVID19 and judiciously use personal protective equipment. Thus, it is important to find alternatives to doing frequent 12-lead ECGs. Hypothesis: We hypothesize that the QT interval measured from telemetry is similar to the QT interval on 12-lead ECG. Methods: Telemetry recordings and 12-lead ECGs were obtained from 15 patients at the same time and identical heart rates. Patients were from two different inpatient units with the same telemetry monitoring service. QT intervals were measured manually using calipers with the tangent method, excluding U waves. Telemetry recordings included lead I and II or a precordial lead. QT from telemetry was compared to the corresponding leads and to the longest QT on the 12-lead ECG. In cases of atrial fibrillation (AF), the QT from all the complexes was averaged. Results: Of 15 patients, 2 were in AF and 2 had RBBB. One patient had abnormal T-wave morphology and QT prolongation (abnormal repolarization). In all patients, QT intervals from the same leads as telemetry matched the QT measured from 12-lead. In 14 of 15 patients, telemetry QT matched the longest QT on the 12-lead ECG. However, in the patient with abnormal repolarization, maximum QT on 12-lead ECG was substantially longer than telemetry QT (Figure 1). Conclusion: When using the same lead, QT intervals were identical on telemetry and 12-lead ECG. However, in the patient with abnormal repolarization, the longest QT on 12-lead ECG was not represented on telemetry. In patients with abnormal repolarization on 12-lead ECG, we recommend serial 12-lead ECGs while on QT-prolonging drugs. Telemetry may suffice as a surrogate for 12-lead ECG to follow QT intervals in most patients.

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