1156. Clinical and epidemiological features and outcomes of Blastomycosis in a tertiary hospital in Kentucky

Abstract Background Blastomycosis is an endemic dimorphic fungal infection caused by Blastomyces dermatitidis. The risk factors associated with severe presentation are not well defined. Methods Retrospective study of patients treated for blastomycosis at the University of Kentucky Hospital from 2004-2019. Statistical analyses were performed with STATA version 12.0 (College Station, Texas). Logistic regression was used to identify variables associated with severe infections. Results Among 82 patients, median age was 48 years old (range: 16 - 89); 66 (80.5%) were male and 71 (92.2%) were white, 25/77 (32.4%) were obese, 24 (29.2%) were diabetic, 21 (25.6%) had COPD, 26 (31.7%) had at least one immunosuppressive condition. The median duration of illness was 86 (3-365) days. 37 (45.1%) had cough and 35 (42.6%) had dyspnea 19 (23.1%) patients were treated in the ICU, 42 (51.3%) in non-ICU inpatient wards, and 21 (25.6%) in an outpatient setting. Cultures were obtained in 69 cases, 59 (85.5%) reported as positive, KOH stain positive in 30/61 (49.1%). Histopathology was positive in 48/66 (72.7%) samples. Urine Histoplasma or Blastomyces antigen was positive in 41/58 (70.6%), and Serum Histoplasma or Blastomyces antigen was positive in 22/34 (64.7%). Among 64 (78.0%) patients with pulmonary blastomycosis, acute and chronic pneumonia were 16 (25.0%) and 12 (18.7%) cases respectively, and nodular lung lesions were reported in 36 (56.2%). Initial antifungal treatment was amphotericin B liposomal in 38/80 (47.5%), overall mortality was 11 (13.4%). A multivariable analysis was performed to find predictors of severe blastomycosis infection, no association was seen with factors as male sex (IRR 1.96; 95%CI 0.84 – 4.55), and was confirmed that significant independent associated risk factors for severe infection were age older than 50 (IRR 3.5; 95%CI 1.42-8.83), obesity (IRR 3.1; 95% CI 1.41-6.87), diabetes (IRR 2.5; 95% CI 1.16-5.50), leukocytosis (IRR 1.03; 95%CI 1.00-1.07) and anemia (IRR 3.0; 95% CI 1.55-5.85). Conclusion Pulmonary Blastomycosis is the most common presentation. Culture and histopathology are more sensitive than antigen assay. Independent factors associated to severe disease were older age, obesity, diabetes, and anemia at admission. Disclosures All Authors: No reported disclosures

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Clinical Characteristics And Analysis Of Risk Factors For Disease Progression Of COVID-19 Among Patients Within Wad Medani Isolation Centers, Gezira State: A Prospective Cohort Study From Sudan

10.21203/rs.3.rs-967313/v1 ◽

2021 ◽

Author(s):

Mohammed Yousif Elnaeem Yousif ◽

Moh.Mah.Fadel Allah Eljack ◽

Osman Amir ◽

Mohammed Alfatih ◽

Akram Khalid Al Tigany Al Shiekh ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Mortality Rate ◽

Clinical Characteristics ◽

Severe Disease ◽

Severe Infection ◽

Chi Square ◽

Factors Associated ◽

Glucose Levels ◽

Chi Square Test

Abstract Background : (COVID-19) had a great impact on the world’s health systems since December 2019. A little is known about the clinical characteristics and risk factors associated with COVID-19 severity in Sudanese Patients; therefor it is necessary to summarize the clinical characteristics of patients with COVID-19 and to explore the risk factors associated with COVID-19 severity. Methods : A one-year retrospective cohort study (May 2020- May2021) was done at three isolation centers in Wad Medani. Sample contained all COVID-19 patients who are over 18 years old and were confirmed to be COVID-19 by nucleic acid testing or features Suggestive of Covid19 on Chest CT scan. Results : This study included 418 patients confirmed COVID-19 cases with a median age of 66.3±13years. 179 (64.2%) patients were men. Hypertension (n=195; 46.7%) and diabetes (n=187; 44.7%) were the most common comorbidities. The most common symptoms at COVID-19 onset were fever (n=303; 72.5%), cough (n=278; 66.5%) and dyspnea (n= 256; 61.2%). the overall mortality rate was 35.4% (n=148). The morality rate was 42.3% (n=118) among patients with severe disease. The Chi-square test and ANOVA analysis revealed that older age, anemia, neutrophilia and lymphcytopenia, higher glucose levels, HbA1c levels and creatinine levels were variables associated with severe COVID-19. In inflammatory markers, the levels of CRP and d-dimer were elevated in severe infection more than moderate and mild infections. Conclusion : Patients with these factors are more likely to deteriorate into severe infection and have higher mortality rate than those without these factors.

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Severe SARS-CoV-2 infection in humans is defined by a shift in the serum lipidome resulting in dysregulation of eicosanoid immune mediators

10.1101/2020.07.09.20149849 ◽

2020 ◽

Cited By ~ 3

Author(s):

Benjamin Schwarz ◽

Lokesh Sharma ◽

Lydia Roberts ◽

Xiaohua Peng ◽

Santos Bermejo ◽

...

Keyword(s):

Risk Factors ◽

Severe Disease ◽

Severe Infection ◽

Factors Associated ◽

Immune Mediators ◽

Mechanistic Insight ◽

Immune Balance ◽

Diabetes And Obesity ◽

Insight Into

The COVID-19 pandemic has affected more than 10 million people worldwide with mortality exceeding half a million patients. Risk factors associated with severe disease and mortality include advanced age,hypertension, diabetes, and obesity. Clear mechanistic understanding of how these comorbidities converge to enable severe infection is lacking. Notably each of these risk factors pathologically disrupts the lipidome and this disruption may be a unifying feature of severe COVID-19. Here we provide the first in depth interrogation of lipidomic changes, including structural-lipids as well as the eicosanoids and docosanoids lipid mediators (LMs), that mark COVID-19 disease severity. Our data reveal that progression from moderate to severe disease is marked by a loss of specific immune regulatory LMs and increased pro-inflammatory species. Given the important immune regulatory role of LMs, these data provide mechanistic insight into the immune balance in COVID-19 and potential targets for therapy with currently approved pharmaceuticals.

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Risk factors associated with acute hepatopancreatic necrosis disease at shrimp farm level in Bac Lieu Province, Vietnam

Veterinary World ◽

10.14202/vetworld.2021.1050-1058 ◽

2021 ◽

Vol 14 (4) ◽

pp. 1050-1058

Author(s):

Hien The Nguyen ◽

Toan Nguyen Van ◽

Tien Tien Ngoc ◽

Visanu Boonyawiwat ◽

Theera Rukkwamsuk ◽

...

Keyword(s):

Risk Factors ◽

Severe Disease ◽

Multivariable Analysis ◽

Surveillance Program ◽

Shrimp Farm ◽

Farm Level ◽

Factors Associated ◽

Potential Risk Factors ◽

Acute Hepatopancreatic Necrosis Disease ◽

Shrimp Farms

Background and Aim: Acute hepatopancreatic necrosis disease (AHPND) is a severe disease in shrimp farms and adversely affected the shrimp industry of Vietnam. So far, the study on risk factors associated with AHPND outbreaks is limited. The objective of this study was to determine the potential risk factors of AHPND at the shrimp farm level in Bac Lieu Province, Vietnam. Materials and Methods: Real-time-Polymerase chain reaction was used to analyze data collected from an active surveillance program of shrimp farms in 2017 in the Vinh Tien and Vinh Lac villages, Vinh Thinh commune, Hoa Binh district in Bac Lieu Province, Vietnam. The matched case-control study selected 20 cases and 20 control farms from 134 shrimp farms. In 2018, face-to-face interviews using structured questionnaires were conducted with the farmers of these selected farms. Results: Of the 59 studied variables, seven had p≤0.2 based on bivariate analyses. The results of multivariable analysis showed that the presence of fish-eating birds on shrimp farms was a significant association with AHPND (odds ratio=8, p=0.049). Conclusion: To reduce the effect of AHPND, farmers should apply effective methods to manage wild animals such as using a grid or net to cover the pond, combined with improved biosecurity.

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Severe SARS-CoV-2 infection is defined by a shift in the serum lipidome resulting in dysregulation of eicosanoid lipid immune mediators

10.21203/rs.3.rs-42999/v1 ◽

2020 ◽

Cited By ~ 1

Author(s):

Benjamin Schwarz ◽

Lokesh Sharma ◽

Lydia Roberts ◽

Xiaohua Peng ◽

Santos Bermejo ◽

...

Keyword(s):

Risk Factors ◽

Severe Disease ◽

Severe Infection ◽

Factors Associated ◽

Immune Mediators ◽

Mechanistic Insight ◽

Immune Balance ◽

Diabetes And Obesity ◽

Insight Into

Abstract The COVID-19 pandemic has affected more than 10 million people worldwide with mortality exceeding3 half a million patients. Risk factors associated with severe disease and mortality include advanced age,4 hypertension, diabetes, and obesity.1 Clear mechanistic understanding of how these comorbidities5 converge to enable severe infection is lacking. Notably each of these risk factors pathologically disrupts6 the lipidome and this disruption may be a unifying feature of severe COVID-19.1-7 Here we provide the first in depth interrogation of lipidomic changes, including structural-lipids as well as the eicosanoids and docosanoids lipid mediators (LMs), that mark COVID-19 disease severity. Our data reveal that progression from moderate to severe disease is marked by a loss of specific immune regulatory LMs and increased pro-inflammatory species. Given the important immune regulatory role of LMs, these data provide mechanistic insight into the immune balance in COVID-19 and potential targets for therapy with currently approved pharmaceuticals.8

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Seroprevalence of Brucellosis and Associated Risk Factors among Indigenous Breeds of Goats in Wukari, Taraba State, Nigeria

Journal of Pathogens ◽

10.1155/2018/5257926 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Olaolu T. Olufemi ◽

Danjuma B. Dantala ◽

Paul A. Shinggu ◽

Umesi A. Dike ◽

Gbeminiyi R. Otolorin ◽

...

Keyword(s):

Risk Factors ◽

Cross Sectional Study ◽

Chi Square ◽

Cross Sectional ◽

Exact Test ◽

The Public ◽

Factors Associated ◽

Males And Females ◽

Associated Risk Factors ◽

La Jolla

A cross-sectional study was conducted in Wukari, Taraba state, Nigeria, to determine the prevalence of Brucella antibodies and the risk factors associated with brucellosis in indigenous breeds of goats. A total of 386 goats were sampled from three political wards: Puje, Avyi, and Hospital: harvested sera samples were subjected to Rose Bengal Plate Test (RBPT). GraphPad Prism version 7.03 for Windows (GraphPad Software, La Jolla California, USA) was used to analyse the association between seroprevalence of brucellosis and age, sex, breed, location, and management system by using Chi square and Fisher’s exact test as appropriate. Brucellosis was detected in all three wards: Puje; 15%, Avyi; 6.6%, and Hospital; 7.6%. A prevalence rate of 2.8%, 8%, 18.7%, and 1% was recorded for <20-month, 22-35-month, 36-45-month, and ≥46-55-month age categories, respectively (P < 0.05). Only 9.5% was observed for male animals while 9.8% was observed for female animals with no statistical difference between the males and females. Breed-specific seroprevalence yielded 7.4%, 5.4% 12%, 12.8%, and 11.6%, for Cross, West Africa Dwarf, Red Sokoto, Kano Brown, and Sahel breeds of goat, respectively. There is an evidence of brucellosis (9.6%) in Wukari L.G.A, Taraba State, and age is a risk factor for the disease in the study area. There is a need to enlighten the public on the zoonotic potentials and economic impacts of brucellosis.

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RISK FACTORS ASSOCIATED WITH NEONATAL HYPOGLYCEMIA

The Professional Medical Journal ◽

10.29309/tpmj/2006.13.04.4952 ◽

2006 ◽

Vol 13 (04) ◽

pp. 687-690

Author(s):

MUNIR AKMAL LODHI ◽

GHULAM SHABBIR ◽

NASIR ALI SHAH

Keyword(s):

Risk Factors ◽

Low Birthweight ◽

Birth Asphyxia ◽

Neonatal Hypoglycemia ◽

Factors Associated ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Associated Risk Factors ◽

Glucose Estimation

Objectives: Recurrent episodes of neonatal hypoglycemia are strongly associated with long termphysical and neuro-developmental deficits. (1) Moreover in neonates hypoglycemia can be overlooked as it may havenonspecific symptoms only. (2) This study was therefore carried out to analyse the risk factors associated with neonatalhypoglycemia and to evaluate the risk factors which have predictive value in its diagnosis. .Design: Based case controlstudy. Period: Six months from January 2005 to June 2005. Setting CMH Pano Aqil. Material and Methods: 385newborns were studied. Newborns of both civilians as well as military personnel were included in the study. 11newborns were excluded. Out of remaining 347 patients 101 were found to be hypoglycemia. Five risk factors (low birthweight, Birth Asphyxia, Neonatal sepsis, Meconeum aspiration syndrome delayed feeding ) strongly and independentlypredicated the risk of hypoglycemia. Results: The most common associated risk factor was low birth weight (47.47%)followed by delayed feeding (46.29%). Blood sampling for glucose estimation was done at birth / admission at 6 hours,12 hours, 24 hours and 48 hours. Test was initially performed by glucometer, the reading which were confirmed bylaboratory testing in border line case. Conclusions: In neonates with associated risk factors it is cost affective to carryout blood glucose levels at the time of birth and follow up readings taken as indicated by clinical progress later on.

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945. Prevalence of HIV Associated Non-AIDS Conditions and Associated Risk Factors among Hospitalized HIV-infected Patients in India

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1131 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S504-S505

Author(s):

Amyeo A Jereen ◽

Celia Kucera ◽

Saniya Pervin ◽

Muralidhar Varma ◽

Radhakrishnan Rajesh ◽

...

Keyword(s):

Risk Factors ◽

Transmitted Disease ◽

Multivariate Logistic Regression Analysis ◽

Patient Risk ◽

Sexually Transmitted ◽

Factors Associated ◽

Immunodeficiency Virus ◽

History Of ◽

Artery Disease ◽

Associated Risk Factors

Abstract Background HIV-associated non-AIDS (HANA) conditions are becoming common as People Living with Human Immunodeficiency Virus (PLWHIV) age. However, data estimating the prevalence of HANA conditions and associated risk factors is lacking in developing countries. This study evaluates reasons for hospitalizations among PLWHIV in Udupi, India in the antiretroviral era, and describes associated risk factors. Methods Demographic and clinical data were extracted from medical charts of 1280 HIV-infected patients 18 years and older who were admitted to Kasturba Hospital, Manipal, India between January 1, 2013 and December 31, 2017, for a total of 2157 hospitalizations. Primary reasons for hospitalization were categorized into AIDS-defining vs Non-AIDS-defining and HANA vs Non-HANA conditions (Fig 1). Multivariate logistic regression analysis was performed to estimate demographic and clinical factors associated with hospitalizations due to AIDS-defining illness and HANA conditions. Categorization of Reasons for Hospitalization Results Patients’ median age was 45 (18-80) years; 70% male. Median age of patients with AIDS-defining illness (45% of hospitalizations) was lower at 44 (18-75) years compared with HANA (15% of hospitalizations) at 48 (21-80) years. Age (OR, 95% CI) (0.985, 0.974-0.995), admission CD4 (0.998, 0.997 - 0.998), history of hypertension (HTN) (0.59, 0.42-0.82), stroke (0.49, 0.24 - 0.93), diabetes (1.56, 1.10 - 2.19), and AIDS-defining cancers (1.74, 1.05 - 2.89) were associated with AIDS-defining hospitalizations (Fig 2). Additionally, age (1.016, 1.001 - 1.031), history of HTN (1.70, 1.16 - 2.46), coronary artery disease (CAD) (4.02, 1.87- 9.02), chronic kidney disease (CKD) (2.30, 1.15 - 4.61), stroke (2.93, 1.46 - 5.96), Hepatitis B (3.32, 1.66- 6.72), Hepatitis C (16.1, 2.84 - 314), sexually transmitted disease (STD) (3.76, 1.38- 10.8), and HANA-associated cancer (2.44, 1.28- 6.42) were associated with HANA hospitalizations (Fig 3). Patient Risk Factors for AIDS-related Hospitalization Patient Risk Factors for HANA-related Hospitalization Conclusion Prevalence of HANA conditions was lower than AIDS-defining illnesses possibly because of a younger population. Patients with AIDS-defining illnesses were also likely to have HANA conditions. Early detection and effective treatment of both HIV and HANA conditions is essential to decrease hospitalizations in low-resource settings. Disclosures All Authors: No reported disclosures

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Epidemiological characteristics, clinical characteristics, and prognostic factors of children with atopy hospitalised with adenovirus pneumonia

BMC Infectious Diseases ◽

10.1186/s12879-021-06741-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Miao Li ◽

Xiao-Hua Han ◽

Li-Yun Liu ◽

Hui-Sheng Yao ◽

Li-Li Yi

Keyword(s):

Risk Factors ◽

Disease Severity ◽

Clinical Characteristics ◽

Severe Infection ◽

Small Airway ◽

Personal History ◽

Factors Associated ◽

History Of ◽

Radiological Changes ◽

Epidemiological Characteristics

Abstract Background Atopy may be associated with disease severity and a poor prognosis of human adenovirus (HAdV) pneumonia in children. Our aim was to observe the clinical characteristics and pulmonary radiological changes in children with atopy and HAdV pneumonia in China. Methods Children hospitalised with HAdV pneumonia from June 2018 to December 2019 were analysed. All children were divided into atopic with HAdV, non-atopic with HAdV, and atopic without HAdV infection group. Each group was further divided into the mild and severe pneumonia groups according to disease severity. Standard treatment was initiated after admission, and regular follow-up evaluations were conducted at 1 month after discharge. Baseline and clinical characteristics and pulmonary radiological changes in children with and without atopy were evaluated. Risk factors associated with small airway lesions in patients with HAdV pneumonia were analysed. Results The eosinophil count in the atopic group was significantly higher than that in the non-atopic group (P < 0.05). Severe coughing, wheezing, and small airway lesions on chest high-resolution computed tomography (HRCT) upon admission, after discharge and 1 month after discharge were significantly higher in the atopic group (with or without HAdV infection) than in the non-atopic group (P < 0.05). There were significant differences in the number of patients with wheezing and small airway lesions during hospitalisation and after discharge among the three groups (P < 0.05). The risks of small airway lesions in children with a family or personal history of asthma, severe infection, atopy, and HAdV infection were 2.1-, 2.7-, 1.9-, 2.1-, and 1.4-times higher than those in children without these characteristics, respectively. Conclusions Children with atopy and HAdV pneumonia may experience severe coughing in mild cases and wheezing in mild and severe cases. Children with atopy are more susceptible to the development of small airway lesions, recurrent wheezing after discharge and slower recovery of small airway lesions as observed on pulmonary imaging than non-atopic children after HAdV infection. A family or personal history of asthma, atopy, severe infection, and HAdV infection are independent risk factors associated with the development of small airway lesion as observed on chest HRCT.

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