scholarly journals COVID-19 patients with hypertension are at potential risk of worsened organ injury

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Fei Xia ◽  
Mingwei Zhang ◽  
Bo Cui ◽  
Wei An ◽  
Min Chen ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Severe Disease ◽  
Organ Injury ◽  
Health Concern ◽  
Hypertensive Patients ◽  
Inflammatory Reactions ◽  
Illness Onset ◽  
Common Chronic Disease ◽  
Related Data ◽  
Amyloid A

AbstractIn less than 6 months, COVID-19 spread rapidly around the world and became a global health concern. Hypertension is the most common chronic disease in COVID-19 patients, but its impact on these patients has not been well described. In this retrospective study, 82 patients diagnosed with COVID-19 were enrolled, and epidemiological, demographic, clinical, laboratory, radiological and therapy-related data were analyzed and compared between COVID-19 patients with (29 cases) or without (53 cases) hypertension. The median age of the included patients was 60.5 years, and the cohort included 49 women (59.8%) and 33 (40.2%) men. Hypertension (31 [28.2%]) was the most common chronic illness, followed by diabetes (16 [19.5%]) and cardiovascular disease (15 [18.3%]). The most common symptoms were fatigue (55 [67.1%]), dry cough (46 [56.1%]) and fever ≥ 37.3 °C (46 [56.1%]). The median time from illness onset to positive RT-PCR test was 13.0 days (range 3–25 days). There were 6 deaths (20.7%) in the hypertension group and 5 deaths (9.4%) in the nonhypertension group, and more hypertensive patients with COVID-19 (8 [27.6%]) than nonhypertensive patients (2 [3.8%]) (P = 0.002) had at least one comorbid disease. Compared with nonhypertensive patients, hypertensive patients exhibited higher neutrophil counts, serum amyloid A, C-reactive protein, and NT-proBNP and lower lymphocyte counts and eGFR. Dynamic observations indicated more severe disease and poorer outcomes after hospital admission in the hypertension group. COVID-19 patients with hypertension have increased risks of severe inflammatory reactions, serious internal organ injury, and disease progression and deterioration.

scholarly journals COVID-19 patients with hypertension under potential risk of worsened organ injuries

2020 ◽  
Author(s):  
Fei Xia ◽  
Mingwei Zhang ◽  
Bo Cui ◽  
Wei An ◽  
Min Chen ◽  
...  
Keyword(s):  
Chronic Illness ◽  
Clinical Laboratory ◽  
Health Concern ◽  
Pcr Analysis ◽  
Rt Pcr ◽  
C Reactive Protein ◽  
Inflammatory Reactions ◽  
Illness Onset ◽  
Reactive Protein ◽  
Amyloid A

Abstract COVID -19 has rapidly spread from Wuhan to worldwide, and now has become a global health concern. Hypertension is the most common chronic illness in COVID-19, while the influence on those patients have not been well described. In this retrospective study, 82 confirmed patients with COVID-19 were enrolled, with epidemiological, demographic, clinical, laboratory, radiological, and therapies data analyzed and compared between COVID-19 patients with (29 cases) or without (53 cases) hypertension. Of all 82 patients with COVID-19, the median age of all patients was 60.5 years, including 49 females (59.8%) and 33 (40.2%) males. Hypertension (31[28.2%]) was the most chronic illness, followed by diabetes (16 [19.5%]) and cardiovascular disease (15 [18.3%]). Common symptoms included fatigue (55[67.1%]), dry cough (46 [56.1%]) and fever (≥37.3℃ (46 [56.1%]). The median time from illness onset to positive outcomes of RT-PCR analysis were 13.0 days, ranging from 3-25 days. In hypertension group, 6 (20.7%) patients died compared to 5 (9.4%) died in non-hypertension group. More hypertension patients with COVID-19 (8 [27.6%]) had at least one coexisting disease than those of non-hypertension patients (2 [3.8%]) (P=0.002). Compared with non-hypertension patients, higher levels of neutrophil counts, serum amyloid A, C-reactive protein, and NT-proBNP were observed in hypertension group, whereas levels of lymphocyte count and eGFR were decreased. Dynamic observations displayed more significant and worsened outcomes in hypertension group after hospital admission. COVID-19 patients with hypertension take more risks of severe inflammatory reactions, worsened internal organ injuries, and deteriorated progress.

A multicenter study of the clinical, laboratory characteristics, and potential prognostic factors in patients with amyloid A amyloidosis on hemodialysis

2021 ◽  
Author(s):  
Ece Bilgic Koylu ◽  
Rezzan Eren Sadioglu ◽  
Sahin Eyupoglu ◽  
Ihsan Ergun ◽  
Gokhan Nergizoglu ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Multicenter Study ◽  
Clinical Laboratory ◽  
Amyloid A

scholarly journals SPACIA1/SAAL1 Deletion Results in a Moderate Delay in Collagen-Induced Arthritis Activity, along with mRNA Decay of Cyclin-dependent Kinase 6 Gene

2018 ◽  
Vol 19 (12) ◽  
pp. 3828
Author(s):  
Ryoji Fujii ◽  
Rie Komatsu ◽  
Tomoo Sato ◽  
Iwao Seki ◽  
Koji Konomi ◽  
...  
Keyword(s):  
Severe Disease ◽  
Critical Factor ◽  
Synovial Fibroblasts ◽  
Transcriptional Level ◽  
Cyclin Dependent Kinase ◽  
Collagen Induced Arthritis ◽  
Expression Levels ◽  
Amyloid A ◽  
Interfering Rna ◽  
Deficient Mice

This study was performed to elucidate the molecular function of the synoviocyte proliferation-associated in collagen-induced arthritis (CIA) 1/serum amyloid A-like 1 (SPACIA1/SAAL1) in mice CIA, an animal model of rheumatoid arthritis (RA), and human RA-synovial fibroblasts (RASFs). SPACIA1/SAAL1-deficient mice were generated and used to create mouse models of CIA in mild or severe disease conditions. Cell cycle-related genes, whose expression levels were affected by SPACIA1/SAAL1 small interfering RNA (siRNA), were screened. Transcriptional and post-transcriptional effects of SPACIA1/SAAL1 siRNA on cyclin-dependent kinase (cdk) 6 gene expression were investigated in human RASFs. SPACIA1/SAAL1-deficient mice showed later onset and slower progression of CIA than wild-type mice in severe disease conditions, but not in mild conditions. Expression levels of cdk6, but not cdk4, which are D-type cyclin partners, were downregulated by SPACIA1/SAAL1 siRNA at the post-transcriptional level. The exacerbation of CIA depends on SPACIA1/SAAL1 expression, although CIA also progresses slowly in the absence of SPACIA1/SAAL1. The CDK6, expression of which is up-regulated by the SPACIA1/SAAL1 expression, might be a critical factor in the exacerbation of CIA.

scholarly journals Factors Associated with Disease Severity and Mortality among Patients with Coronavirus Disease 2019: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Vignesh Chidambaram ◽  
Nyan Lynn Tun ◽  
Waqas Haque ◽  
Marie Gilbert Majella ◽  
Ranjith Kumar Sivakumar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Disease Severity ◽  
English Language ◽  
Clinical Decision Making ◽  
Clinical Laboratory ◽  
Data Extraction ◽  
Meta Analysis ◽  
Severe Disease ◽  
Factors Associated ◽  
Risk Of Mortality

Background: Understanding the factors associated with disease severity and mortality in Coronavirus disease (COVID19) is imperative to effectively triage patients. We performed a systematic review to determine the demographic, clinical, laboratory and radiological factors associated with severity and mortality in COVID-19. Methods: We searched PubMed, Embase and WHO database for English language articles from inception until May 8, 2020. We included Observational studies with direct comparison of clinical characteristics between a) patients who died and those who survived or b) patients with severe disease and those without severe disease. Data extraction and quality assessment were performed by two authors independently. Results: Among 15680 articles from the literature search, 109 articles were included in the analysis. The risk of mortality was higher in patients with increasing age, male gender (RR 1.45; 95%CI 1.23,1.71), dyspnea (RR 2.55; 95%CI 1.88,2.46), diabetes (RR 1.59; 95%CI 1.41,1.78), hypertension (RR 1.90; 95%CI 1.69,2.15). Congestive heart failure (OR 4.76; 95%CI 1.34,16.97), hilar lymphadenopathy (OR 8.34; 95%CI 2.57,27.08), bilateral lung involvement (OR 4.86; 95%CI 3.19,7.39) and reticular pattern (OR 5.54; 95%CI 1.24,24.67) were associated with severe disease. Clinically relevant cut-offs for leukocytosis(>10.0 x109/L), lymphopenia(< 1.1 x109/L), elevated C-reactive protein(>100mg/L), LDH(>250U/L) and D-dimer(>1mg/L) had higher odds of severe disease and greater risk of mortality. Conclusion: Knowledge of the factors associated of disease severity and mortality identified in our study may assist in clinical decision-making and critical-care resource allocation for patients with COVID-19.

scholarly journals COVID-19 induces a hyperactive phenotype in circulating platelets

2020 ◽  
Author(s):  
Shane P Comer ◽  
Sarah Cullivan ◽  
Paulina B Szklanna ◽  
Luisa Weiss ◽  
Steven Cullen ◽  
...  
Keyword(s):  
Intensive Care ◽  
Platelet Function ◽  
Clinical Laboratory ◽  
Platelet Reactivity ◽  
Severe Disease ◽  
Blood Parameters ◽  
Full Blood Count ◽  
Specific Marker ◽  
Platelet Activity ◽  
Thrombotic Risk

Background Coronavirus disease 2019 (COVID-19), caused by novel coronavirus SARS-CoV-2, has to date affected over 13.3 million globally. Although high rates of venous thromboembolism and evidence of COVID-19-induced endothelial dysfunction have been reported, the precise aetiology of the increased thrombotic risk associated with COVID-19 infection remains to be fully elucidated. Objectives Here, we assessed clinical platelet parameters and circulating platelet activity in patients with severe and non-severe COVID-19. Methods An assessment of clinical blood parameters in patients with severe COVID-19 disease (requiring intensive care), patients with non-severe disease (not requiring intensive care), general medical in-patients without COVID-19 and healthy donors was undertaken. Platelet function and activity were also assessed by secretion and specific marker analysis. Results We show that routine clinical blood parameters including increased MPV and decreased platelet:neutrophil ratio are associated with disease severity in COVID-19 upon hospitalisation and intensive care unit admission. Strikingly, agonist-induced ADP release was dramatically higher in COVID-19 patients compared with non-COVID-19 hospitalized patients and circulating levels of PF4, sP-selectin and TPO were also significantly elevated in COVID-19. Conclusion Distinct differences exist in routine full blood count and other clinical laboratory parameters between patients with severe and non-severe COVID-19. Moreover, we have determined that COVID-19 patients possess hyperactive circulating platelets. These data suggest that abnormal platelet reactivity may contribute to hypercoagulability in COVID-19. Further investigation of platelet function in COVID-19 may provide additional insights into the aetiology of thrombotic risk in this disease and may contribute to the optimisation of thrombosis prevention and treatment strategies.

scholarly journals Association of PM2.5 and its Components with Lengths of Hospital Stay for Hand Foot and Mouth Disease in Children

2021 ◽  
Author(s):  
Wei Li ◽  
Jieguo Wang ◽  
Kai Zhou ◽  
Ye Tian ◽  
Feiran Wei ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Health Concern ◽  
Public Health Concern ◽  
Short Term ◽  
Illness Onset ◽  
Short Term Exposure ◽  
Foot And Mouth ◽  
Demographic Features

Abstract Background Hand foot and mouth disease (HFMD) is a public health concern. Studies on air pollution and the lengths of hospital stay (LOS) of HFMD are scarce. Methods We characterized the clinic demographic features of 5135 hospitalized HFMD in Nanjing, China from 2012 to 2017, and analyzed the association between short-term exposure to PM2.5 as well as its components (OM, BC, SO42−, NH4+, NIT, SOIL and SS) and the LOS of HFMD. Results Among them 98.62% were aged 0–6 years old, and 3772 (73.46%) were hospitalized for seven days or less. The LOS of HFMD children was different in different ages, illness onset years and illness onset seasons (P<0.01). For per IQR increase in PM2.5 concentrations, LOS of HFMD increased by 0.52(0.33, 0.71), 0.50 (95% CI, 0.31–0.69) and 0.46 (95% CI, 0.28–0.65) day in adjusted models at lag 3 days, lag 7days and lag 14 days, respectively. In addition, per IQR increase of BC, SO42−, NH4+, NIT and SOIL were also significantly associated with the LOS of HFMD. Conclusions Our findings corroborated the hypothesis that short-term PM2.5 exposure was associated with increased the LOS of HFMD, and its components (BC, SO42−, NH4+, NIT and SOIL) of PM2.5 might play a key role in the prolonged LOS of HFMD.

scholarly journals Assessment of self-care practices among hypertensive patients: a clinic based study in rural area of Singur, West Bengal

2017 ◽  
Vol 5 (1) ◽  
pp. 262 ◽  
Author(s):  
Aparajita Dasgupta ◽  
Sembagamuthu Sembiah ◽  
Bobby Paul ◽  
Ayon Ghosh ◽  
Bijit Biswas ◽  
...  
Keyword(s):  
Public Health ◽  
Logistic Regression ◽  
Rural Area ◽  
Lifestyle Modification ◽  
Self Care ◽  
The Self ◽  
Health Concern ◽  
Hypertensive Patients ◽  
Factors Associated ◽  
Care Practices

Background: Hypertension, also known as high blood pressure is a global public health concern. It is an important modifiable risk factor for cardiovascular disease and stroke. It remains silent, being generally asymptomatic during its clinical course and it accounts for a large proportion of cardiovascular deaths; lifestyle modification is the first line of intervention for all patients with hypertension, yet it was never been empirical. The aim of the study was to assess the pattern of self-care practices, if any and also to find out the factors associated with it, among the hypertensive patients in the outpatient department. Methods: A clinic-based, observational, cross-sectional study was conducted at health center under RHU & TC, Singur, which is the rural field practice area of All India Institute of Hygiene and Public Health, Kolkata among 124 hypertensive subjects. Binary logistic regression was done to find out the factors associated with the self-care practices using SPSS software. Results: In the present study, 62.9% of study participants suffering from hypertension had unfavourable self-care practices. Logistic regression showed age above 60 years (OR-3.1), primary level education (OR-5.6), poor socio economic status (OR-2.4), widow/separated (OR-3.3) and people with self-perceived poor health status (OR-2.8)had significant association with unfavourable self-care practices. After adjusting with other variables, age (AOR-2.3) and education (AOR-3.8) remained significant predictor of outcome. Conclusions: The findings revealed that the self-care practices among hypertensive patients were unfavourable in rural area. This calls for a deep need in increasing the awareness about healthy lifestyle among hypertensive patients. This study provides key elements to affect policy changes and social interventions. 

Abstract 18144: Mobile Phone Text Messaging Improves Antihypertensive Drug Adherence in the Community

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Paola Varleta ◽  
Carlos Akel ◽  
Monica Acevedo ◽  
Claudia Salinas ◽  
Javier Pino ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Mobile Phone ◽  
Antihypertensive Drug ◽  
Educational Level ◽  
Text Messaging ◽  
Health Concern ◽  
Drug Adherence ◽  
Hypertensive Patients

Introduction: Hypertension is a major public health concern and the leading cause of cardiovascular disease worldwide. Prevalence of adequate blood pressure control is low and it is mainly associated to poor antihypertensive drug adherence. We hypothesized that education through mobile phone text messaging (SMS) would improve antihypertensive drug adherence in hypertensive patients followed in a primary care setting. Methods: Recently diagnosed hypertensive patients receiving antihypertensive drug treatment for less than 6 months were randomised to receive SMS related to improve drug adherence and to follow a healthy life style or no messages. Exclusion criteria were history of stroke, heart failure, myocardial infarction and hemodialysis. Patients were recruited from 12 different primary care clinics in Santiago, Chile, where free antihypertensive drug therapy was provided. All patients signed an informed consent after which a survey was performed. Compliance was assessed using Morinsky- Green-Levine Questionnaire.Text messages were sent every 12± 2 days. After a 6-month follow-up, a new survey was applied. An Ordinary Least Squares regression model was used to analyse the net difference between the two groups. Results: A total of 314 subjects were recruited, mean age 60 ±10 years, 35% male, 67% with low or medium educational level (≤12 years). Mean drug pill number was 2.1 per day and the mean time of drug prescription was 4±1 months; 150 subjects were randomised to text messages. No statistical difference between the control and the intervention groups in regards to gender, age, educational level, blood pressure and baseline compliance was found. Eleven patients were lost of follow-up. Adherence in the control group decreased from to 59,7 % at baseline to 51,7% ( p<0,05) at 6 months. By contrast, in the intervention group, it increased from 50,9 % to 62,7 % ( p<0,05). The absolute difference in mean adherence rate between the two groups was 19,8 % (Standard error: 0.081, p: 0.015). Conclusion: This study shows that education through SMS in patients with recently prescribed antihypertensive drugs improved adherence to treatment. SMS could become a good and easy- to- use intervention tool to overcome low adherence to drug treatments in the community.

Bordetella infection

2020 ◽  
pp. 1073-1076
Author(s):  
Cameron C. Grant
Keyword(s):  
Bordetella Pertussis ◽  
Whooping Cough ◽  
Severe Disease ◽  
Diagnostic Methods ◽  
Illness Onset ◽  
Young Infants ◽  
Adolescents And Adults ◽  
Risk Of Exposure ◽  
Acellular Vaccines ◽  
Infectious Organism

Bordetella are small Gram-negative coccobacilli, of which Bordetella pertussis is the most important human pathogen. Bordetella pertussis is the cause of whooping cough, which remains one of the 10 leading causes of death among children less than five years old. Transmission of this highly infectious organism is primarily by aerosolized droplets. The preferred diagnostic methods are polymerase chain reaction detection from nasopharyngeal samples and serology (IgG antibodies to pertussis toxin). Macrolide antibiotics are recommended if started within four weeks of illness onset. Preventing severe disease in young children remains the primary goal, hence schedules consist of a three-dose infant series and subsequent booster doses. Acellular vaccines enable immunization schedules to include adolescents and adults. Acellular pertussis vaccine given to pregnant women reduces the risk of pertussis in young infants. Antibiotic prophylaxis is given when there is an infant at risk of exposure.

scholarly journals Epidemiological and clinical characteristics of 671 COVID-19 patients in Henan Province, China

2020 ◽  
Vol 49 (4) ◽  
pp. 1085-1095
Author(s):  
Yifei Nie ◽  
Jitian Li ◽  
Xueyong Huang ◽  
Wanshen Guo ◽  
Xiaobai Zhang ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Case Series ◽  
Henan Province ◽  
X Rays ◽  
Illness Onset ◽  
Medical Disorders ◽  
History Of ◽  
The Mean ◽  
Wet Market ◽  
Mean Time

Abstract Background Despite many reports on the characteristics of coronavirus disease 2019 (COVID-19) in Wuhan, China, relatively little is known about the transmission features of COVID-19 outside Wuhan, especially at the provincial level. Methods We collected epidemiological, demographic, clinical, laboratory, radiological and occupation information, along with contact history, of 671 patients with laboratory-confirmed COVID-19 reported from January 23 to February 5, 2020, in Henan province, China. We described characteristics of these cases, compared the diagnostic accuracy and features of blood testing, computed tomography (CT) scans and X-rays, and analysed SARS-CoV-2 transmission sources and patients’ occupations in Henan province. Results The mean age of patients in this case series was 43 years, 56.2% were male and 22.4% had coexisting medical disorders. The death rate was 0.3%. Fourteen patients did not show any symptoms. Lymphocyte percentage was associated with disease severity (χ2 = 6.71, P = 0.035) but had a large variation in each sample group. The mean time from illness onset to diagnosis was 5.6 days. A total of 330 patients had ever lived in or visited Wuhan, 150 had contact with confirmed cases, 323 had been to a hospital and 119 had been to a wet market. There were 33 patients who did not have a traceable transmission source, with 21.2% of these being farmers and 15.2% being workmen. Conclusions Lymphocyte percentage was a sign of severe COVID-19 in general but was not a good diagnostic index. Longer time from illness onset to diagnosis was associated with higher COVID-19 severity, older age, higher likelihood of having coexisting cardiovascular diseases including hypertension, and being male. Farming was found to be a high-risk occupation in Henan province, China.

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