scholarly journals 331. Hospitalized COVID-19 infections in Infants < 1 Year of Age

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S271-S272
Author(s):  
Christina Gagliardo ◽  
Eberechi I Nwaobasi-Iwuh ◽  
Niva Shah ◽  
Aparna Prasad ◽  
Neeraja Kairam ◽  
...  
Keyword(s):  
Cardiac Involvement ◽  
Preventive Measures ◽  
Severe Disease ◽  
Pediatric Intensive Care ◽  
The United States ◽  
Severe Illness ◽  
Hospital System ◽  
Presenting Symptoms ◽  
Young Infants ◽  
Increased Risk

Abstract Background Nearly 4 million children have tested positive for coronavirus disease 2019 (COVID-19) in the United States. Some studies suggest infants might be at increased risk for severe illness and hospitalization from COVID-19. Our objective was to describe the clinical and laboratory features of young infants admitted to a hospital system with COVID-19. Methods An observational retrospective study was performed in infants ≤1 year of age admitted with COVID-19 from March 1, 2020 to May 30, 2021. Data was extracted into a REDCap database and analyzed using descriptive statistics. Results Sixteen infants &lt; 1 year were hospitalized with COVID-19. Fever, poor feeding, and respiratory symptoms were the most common presenting symptoms (Table 1). Two required pediatric intensive care unit (ICU) care, three required oxygen support, and one was intubated. There were no deaths. Five infants with echocardiograms performed showed normal findings. Four infants received Remdesivir without side effects. Conclusion Infants with COVID-19 can present with severe disease requiring ICU care and oxygen support. In our experience, a large proportion of infants developed hematologic abnormalities, but none had cardiac involvement. Preventive measures including vaccination will become critical to decrease transmission and severe disease in this young patient population. Disclosures All Authors: No reported disclosures

Personalized stratification of back to work risk amidst COVID-19: A machine learning approach (Preprint)

2020 ◽  
Author(s):  
Carson Lam ◽  
Jacob Calvert ◽  
Gina Barnes ◽  
Emily Pellegrini ◽  
Anna Lynn-Palevsky ◽  
...  
Keyword(s):  
Machine Learning ◽  
High Risk ◽  
Learning Algorithm ◽  
Severe Disease ◽  
High Specificity ◽  
Population Level ◽  
The United States ◽  
Health Condition ◽  
Available P ◽  
Severe Illness

BACKGROUND In the wake of COVID-19, the United States has developed a three stage plan to outline the parameters to determine when states may reopen businesses and ease travel restrictions. The guidelines also identify subpopulations of Americans that should continue to stay at home due to being at high risk for severe disease should they contract COVID-19. These guidelines were based on population level demographics, rather than individual-level risk factors. As such, they may misidentify individuals at high risk for severe illness and who should therefore not return to work until vaccination or widespread serological testing is available. OBJECTIVE This study evaluated a machine learning algorithm for the prediction of serious illness due to COVID-19 using inpatient data collected from electronic health records. METHODS The algorithm was trained to identify patients for whom a diagnosis of COVID-19 was likely to result in hospitalization, and compared against four U.S policy-based criteria: age over 65, having a serious underlying health condition, age over 65 or having a serious underlying health condition, and age over 65 and having a serious underlying health condition. RESULTS This algorithm identified 80% of patients at risk for hospitalization due to COVID-19, versus at most 62% that are identified by government guidelines. The algorithm also achieved a high specificity of 95%, outperforming government guidelines. CONCLUSIONS This algorithm may help to enable a broad reopening of the American economy while ensuring that patients at high risk for serious disease remain home until vaccination and testing become available.

General medical disorders with psychiatric implications

2015 ◽  
Author(s):  
Erik J. Garcia ◽  
Warren J. Ferguson
Keyword(s):  
Mental Illness ◽  
Psychiatric Symptoms ◽  
The United States ◽  
Prior History ◽  
Medical Illness ◽  
Medical Conditions ◽  
Presenting Symptoms ◽  
Medical Disorders ◽  
Increased Risk ◽  
History Of

Traditionally the domain of consultation/ liaison psychiatry, the challenge of recognizing and then appropriately treating the psychiatric complications of general medical disorders requires thoughtful planning and attention in corrections. Medical conditions that have psychiatric symptoms represent a significant diagnostic dilemma, particularly in the correctional health setting. Over half of the inmates in the United States have symptoms of a major mental illness, but the pervasiveness of substance use disorders, the increasing prevalence of elderly inmates, and limited access to a patient’s past medical and psychiatric records all contribute to the challenge of discerning when a psychiatric presentation results from an underlying medical condition. One early study underscored this challenge, noting that 46% of the patients admitted to community psychiatric wards had an unrecognized medical illness that either caused or exacerbated their psychiatric illness. A more recent study observed that 2.8% of admissions to inpatient psychiatry were due to unrecognized medical conditions. Emergency room medical clearance of patients presenting for psychiatric admission has revealed an increased risk for such underlying medical conditions among patients with any of five characteristics: elderly, a history of substance abuse, no prior history of mental illness, lower socioeconomic status, or significant preexisting medical illnesses. This chapter examines several of these risk groups and focuses on the presenting symptoms of delirium, mood disorders, and psychosis and the underlying medical conditions that can mimic or exacerbate them.

scholarly journals Increased Activity of Coxsackievirus B1 Strains Associated with Severe Disease among Young Infants in the United States, 2007–2008

2009 ◽  
Vol 49 (5) ◽  
pp. e44-e51 ◽  
Author(s):  
Mary E. Wikswo ◽  
Nino Khetsuriani ◽  
Ashley L. Fowlkes ◽  
Xiaotian Zheng ◽  
Silvia Peñaranda ◽  
...  
Keyword(s):  
United States ◽  
Severe Disease ◽  
The United States ◽  
Young Infants ◽  
Increased Activity ◽  
Coxsackievirus B1

scholarly journals COVID-19 hospitalizations in five California hospitals: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Miriam Nuño ◽  
Yury García ◽  
Ganesh Rajasekar ◽  
Diego Pinheiro ◽  
Alec J. Schmidt
Keyword(s):  
Mortality Rate ◽  
Hospital Admissions ◽  
Large Population ◽  
Case Series ◽  
The United States ◽  
Composite Outcome ◽  
Retrospective Case ◽  
Hospital System ◽  
Icu Admission ◽  
Increased Risk

Abstract Background The novel coronavirus pandemic has had a differential impact on communities of color across the US. The University of California hospital system serves a large population of people who are often underrepresented elsewhere. Data from hospital stays can provide much-needed localized information on risk factors for severe cases and/or death. Methods Patient-level retrospective case series of laboratory-confirmed COVID-19 hospital admissions at five UC hospitals (N = 4730). Odds ratios of ICU admission, death, and a composite of both outcomes were calculated with univariate and multivariate logistic regression based on patient characteristics, including sex, race/ethnicity, and select comorbidities. Associations between comorbidities were quantified and visualized with a correlation network. Results Overall mortality rate was 7.0% (329/4,730). ICU mortality rate was 18.8% (225/1,194). The rate of the composite outcome (ICU admission and/or death) was 27.4% (1298/4730). Comorbidity-controlled odds of a composite outcome were increased for age 75–84 (OR 1.47, 95% CI 1.11–1.93) and 85–59 (OR 1.39, 95% CI 1.04–1.87) compared to 18–34 year-olds, males (OR 1.39, 95% CI 1.21–1.59) vs. females, and patients identifying as Hispanic/Latino (OR 1.35, 95% CI 1.14–1.61) or Asian (OR 1.43, 95% CI 1.23–1.82) compared to White. Patients with 5 or more comorbidities were exceedingly likely to experience a composite outcome (OR 2.74, 95% CI 2.32–3.25). Conclusions Males, older patients, those with multiple pre-existing comorbidities, and those identifying as Hispanic/Latino or Asian experienced an increased risk of ICU admission and/or death. These results are consistent with reported risks among the Hispanic/Latino population elsewhere in the United States, and confirm multiple concerns about heightened risk among the Asian population in California.

scholarly journals Male gender and kidney illness associated with an increased risk of severe laboratory-confirmed coronavirus disease

2020 ◽  
Author(s):  
Efrén Murillo-Zamora ◽  
Xóchitl Trujillo ◽  
Miguel Huerta ◽  
Mónica Ríos-Silva ◽  
Oliver Mendoza-Cano
Keyword(s):  
Latin American ◽  
Severe Disease ◽  
Male Gender ◽  
Severe Illness ◽  
Chain Reaction ◽  
Thoracic Pain ◽  
Increased Risk ◽  
Polymerase Chain ◽  
Risk Ratios ◽  
Latin American Population

AbstractObjectiveTo identify factors predicting severe coronavirus disease 2019 (COVID-19) in adolescent and adult patients with laboratory-positive (quantitative reverse-transcription polymerase chain reaction) infection.MethodsA retrospective cohort study took place, and data from 740 subjects, from all 32 states of Mexico, were analyzed. The association between the studied factors and severe (dyspnea requiring hospital admission) COVID-19 was evaluated through risk ratios (RRs) and 95% confidence intervals (CIs).ResultsSevere illness was documented in 28% of participants. In multiple analysis, male gender (RR = 1.13, 95% CI 1.06 - 1.20), advanced age ([reference: 15 - 29 years old] 30 - 44, RR = 1.02, 95% CI 0.94 - 1.11; 45 - 59, RR = 1.26, 95% CI 1.15 - 1.38; 60 years or older, RR = 1.44, 95% CI 1.29 - 1.60), chronic kidney disease (RR = 1.31, 95% CI 1.04 - 1.64) and thoracic pain (RR = 1.16, 95% CI 1.10 - 1.24) were associated with an increased risk of severe disease.ConclusionsTo the best of our knowledge, this is the first study evaluating predictors of COVID-19 severity in a large subset of the Latin-American population. It is also the first in documenting gender-related differences regarding the severity of the illness. These results may be useful for health care protocols for the early detection and management of COVID-19 patients that may benefit from opportune and specialized supportive medical treatment.

scholarly journals Hospitalized COVID-19 Patients treated with Convalescent Plasma in a Mid-size City in the Midwest

2020 ◽  
Author(s):  
William Hartman ◽  
Aaron S Hess ◽  
Joseph P Connor
Keyword(s):  
Mechanical Ventilation ◽  
Care Center ◽  
Severe Disease ◽  
Tertiary Care ◽  
The United States ◽  
Severe Illness ◽  
Care Needs ◽  
Course Of Disease ◽  
Effective Option ◽  
Life Threatening

AbstractBackgroundSARS-CoV-2 and its associated disease, COVID-19, has infected over seven million people world-wide, including two million people in the United States. While many people recover from the virus uneventfully, a subset of patients will require hospital admission, some with intensive care needs including intubation, and mechanical ventilation. To date there is no cure and no vaccine is available. Passive immunotherapy by the transfusion of convalescent plasma donated by COVID-19 recovered patients might be an effective option to combat the virus, especially if used early in the course of disease. Here we report our experience of using convalescent plasma at a tertiary care center in a mid-size, midwestern city that did not experience an overwhelming patient surge.MethodsHospitalized COVID-19 patients categorized as having Severe or Life-Threatening disease according to the Mayo Clinic Emergency Access Protocol were screened, consented, and treated with convalescent plasma collected from local donors recovered from COVID-19 infection. Clinical data and outcomes were collected retrospectively.Results31 patients were treated, 16 severe patients and 15 life-threatened patients. Overall mortality was 27% (4/31) but only patients with life-threatening disease died. 94% of transfused patients with severe disease avoided escalation to ICU care and mechanical ventilation. 67% of patients with life-threatening disease were able to be extubated. Most transfused patients had a rapid decrease in their respiratory support requirements on or about day 7 following convalescent plasma transfusion.ConclusionOur results demonstrate that convalescent plasma is associated with reducing ventilatory requirements in patients with both severe and life-threatening disease, but appears to be most beneficial when administered early in the course of disease when patients meet the criteria for severe illness.

General medical disorders with psychiatric implications

2017 ◽  
Author(s):  
Erik J. Garcia ◽  
Warren J. Ferguson
Keyword(s):  
Mental Illness ◽  
Psychiatric Symptoms ◽  
The United States ◽  
Prior History ◽  
Medical Illness ◽  
Medical Conditions ◽  
Presenting Symptoms ◽  
Medical Disorders ◽  
Increased Risk ◽  
History Of

Traditionally the domain of consultation/ liaison psychiatry, the challenge of recognizing and then appropriately treating the psychiatric complications of general medical disorders requires thoughtful planning and attention in corrections. Medical conditions that have psychiatric symptoms represent a significant diagnostic dilemma, particularly in the correctional health setting. Over half of the inmates in the United States have symptoms of a major mental illness, but the pervasiveness of substance use disorders, the increasing prevalence of elderly inmates, and limited access to a patient’s past medical and psychiatric records all contribute to the challenge of discerning when a psychiatric presentation results from an underlying medical condition. One early study underscored this challenge, noting that 46% of the patients admitted to community psychiatric wards had an unrecognized medical illness that either caused or exacerbated their psychiatric illness. A more recent study observed that 2.8% of admissions to inpatient psychiatry were due to unrecognized medical conditions. Emergency room medical clearance of patients presenting for psychiatric admission has revealed an increased risk for such underlying medical conditions among patients with any of five characteristics: elderly, a history of substance abuse, no prior history of mental illness, lower socioeconomic status, or significant preexisting medical illnesses. This chapter examines several of these risk groups and focuses on the presenting symptoms of delirium, mood disorders, and psychosis and the underlying medical conditions that can mimic or exacerbate them.

scholarly journals Male gender and kidney illness are associated with an increased risk of severe laboratory-confirmed coronavirus disease

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Efrén Murillo-Zamora ◽  
Xóchitl Trujillo ◽  
Miguel Huerta ◽  
Mónica Ríos-Silva ◽  
Oliver Mendoza-Cano
Keyword(s):  
Latin American ◽  
Severe Disease ◽  
Male Gender ◽  
Severe Illness ◽  
Chain Reaction ◽  
Thoracic Pain ◽  
Increased Risk ◽  
Polymerase Chain ◽  
Risk Ratios ◽  
Latin American Population

Abstract Background To identify factors predicting severe coronavirus disease 2019 (COVID-19) in adolescent and adult patients with laboratory-positive (quantitative reverse-transcription polymerase chain reaction) infection. Method A retrospective cohort study took place, and data from 740 subjects, from all 32 states of Mexico, were analyzed. The association between the studied factors and severe (dyspnea requiring hospital admission) COVID-19 was evaluated through risk ratios (RRs) and 95% confidence intervals (CIs). Results Severe illness was documented in 28% of participants. In multiple analysis, male gender (RR = 1.13, 95% CI 1.06–1.20), advanced age ([reference: 15–29 years old] 30–44, RR = 1.02, 95% CI 0.94–1.11; 45–59, RR = 1.26, 95% CI 1.15–1.38; 60 years or older, RR = 1.44, 95% CI 1.29–1.60), chronic kidney disease (RR = 1.31, 95% CI 1.04–1.64) and thoracic pain (RR = 1.16, 95% CI 1.10–1.24) were associated with an increased risk of severe disease. Conclusions To the best of our knowledge, this is the first study evaluating predictors of COVID-19 severity in a large subset of the Latin-American population. Male gender and kidney illness were independently associated with the risk of severe COVID-19. These results may be useful for health care protocols for the early detection and management of patients that may benefit from opportune and specialized supportive medical treatment.

scholarly journals Hospitalized COVID-19 patients treated with convalescent plasma in a mid-size city in the Midwest

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
William R. Hartman ◽  
Aaron S. Hess ◽  
Joseph P. Connor
Keyword(s):  
Mechanical Ventilation ◽  
Care Center ◽  
Severe Disease ◽  
Tertiary Care ◽  
The United States ◽  
Severe Illness ◽  
Care Needs ◽  
Course Of Disease ◽  
Effective Option ◽  
Life Threatening

Abstract Background SARS-CoV-2 and its associated disease, COVID-19, has infected over seven million people world-wide, including two million people in the United States. While many people recover from the virus uneventfully, a subset of patients will require hospital admission, some with intensive care needs including intubation, and mechanical ventilation. To date there is no cure and no vaccine is available. Passive immunotherapy by the transfusion of convalescent plasma donated by COVID-19 recovered patients might be an effective option to combat the virus, especially if used early in the course of disease. Here we report our experience of using convalescent plasma at a tertiary care center in a mid-size, midwestern city that did not experience an overwhelming patient surge. Methods Hospitalized COVID-19 patients categorized as having Severe or Life-Threatening disease according to the Mayo Clinic Emergency Access Protocol were screened, consented, and treated with convalescent plasma collected from local donors recovered from COVID-19 infection. Clinical data and outcomes were collected retrospectively. Results 31 patients were treated, 16 severe patients and 15 life-threatened patients. Overall mortality was 27% (4/31) but only patients with life-threatening disease died. 94% of transfused patients with severe disease avoided escalation to ICU care and mechanical ventilation. 67% of patients with life-threatening disease were able to be extubated. Most transfused patients had a rapid decrease in their respiratory support requirements on or about day 7 following convalescent plasma transfusion. Conclusion Our results demonstrate that convalescent plasma is associated with reducing ventilatory requirements in patients with both severe and life-threatening disease, but appears to be most beneficial when administered early in the course of disease when patients meet the criteria for severe illness.

scholarly journals Human Parechovirus: an Increasingly Recognized Cause of Sepsis-Like Illness in Young Infants

2017 ◽  
Vol 31 (1) ◽  
Author(s):  
Laudi Olijve ◽  
Lance Jennings ◽  
Tony Walls
Keyword(s):  
Viral Infections ◽  
Severe Disease ◽  
Diagnostic Techniques ◽  
Molecular Diagnostic ◽  
Molecular Diagnostic Techniques ◽  
Human Parechovirus ◽  
Content Type ◽  
Cns Infections ◽  
Young Infants ◽  
Increased Risk

SUMMARYHuman parechovirus (HPeV) is increasingly being recognized as a potentially severe viral infection in neonates and young infants. HPeV belongs to the familyPicornaviridaeand is currently divided into 19 genotypes. HPeV-1 is the most prevalent genotype and most commonly causes gastrointestinal and respiratory disease. HPeV-3 is clinically the most important genotype due to its association with severe disease in younger infants, which may partly be explained by its distinct virological properties. In young infants, the typical clinical presentation includes fever, severe irritability, and rash, often leading to descriptions of “hot, red, angry babies.” Infants with severe central nervous system (CNS) infections are at an increased risk of long-term sequelae. Considering the importance of HPeV as a cause of severe viral infections in young infants, we recommend that molecular diagnostic techniques for early detection be included in the standard practice for the investigation of sepsis-like illnesses and CNS infections in this age group.

Sign in / Sign up

Export Citation Format

Share Document