scholarly journals Clinical features and outcomes of discharged coronavirus disease 2019 patients: a prospective cohort study

QJM ◽  
2020 ◽  
Vol 113 (9) ◽  
pp. 657-665 ◽  
Author(s):  
X Wang ◽  
H Xu ◽  
H Jiang ◽  
L Wang ◽  
C Lu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clinical Outcomes ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Close Contact ◽  
Post Discharge ◽  
Global Pandemic ◽  
Discharged Patients ◽  
Suspected Recurrence

Summary Background Coronavirus disease 2019 (COVID-19) is a global pandemic but the follow-up data of discharged patients was barely described. Aim To investigate clinical outcomes, distribution of quarantine locations and the infection status of the contacts of COVID-19 patients after discharge. Design A prospective cohort study. Methods Demographics, baseline characteristics of 131 COVID-19 patients discharged from 3 February 2020 to 21 February 2020 in Wuhan, China were collected and analyzed by reviewing the medical records retrospectively. Post-hospitalization data related to clinical outcomes, quarantine locations and close contact history were obtained by following up the patients every week up to 4 weeks. Results Fifty-three (40.05%) patients on discharge had cough (29.01%), fatigue (7.63%), expectoration (6.11%), chest tightness (6.11%), dyspnea (3.82%), chest pain (3.05%) and palpitation (1.53%). These symptoms constantly declined in 4 weeks post-discharge. Transient fever recurred in 11 (8.4%) patients. Among the discharged patients, 78 (59.5%) underwent chest CT and 2 (1.53%) showed deterioration. A total of 94 (71.8%) patients received SARS-CoV-2 retest and 8 (6.10%) reported positive. Seven (2.29%) patients were readmitted because of fever or positive SARS-CoV-2 retest. After discharge, 121 (92.37%) and 4 (3.05%) patients were self-quarantined at home or community spots, respectively, after a close contact with 167 persons in total who were free of COVID-19 at the endpoint of study. Conclusion The majority of COVID-19 patients after discharge were in the course of recovery. Readmission was required in rare cases due to suspected recurrence of COVID-19. Although no contacted infection observed, appropriate self-quarantine and regular re-examination are necessary, particularly for those who have recurred symptoms.

scholarly journals Post-discharge opioid use and handling in surgical patients: A multicentre prospective cohort study

2020 ◽  
Vol 48 (1) ◽  
pp. 36-42 ◽  
Author(s):  
Megan L Allen ◽  
Charles C Kim ◽  
Sabine Braat ◽  
Karin Jones ◽  
Noam Winter ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Surgical Patients ◽  
Opioid Use ◽  
Post Discharge ◽  
Opioid Medication ◽  
Post Surgery ◽  
Opioid Medications

Our aim was to determine the frequency and characteristics of post-surgery prescription of opioid medication and to describe patients’ handling of discharge opioid medications. We performed a multicentre prospective cohort study of adult patients undergoing elective or emergency surgery with a postoperative stay of one or more nights, with phone follow-up at two weeks after hospital discharge. The main outcome measures included the proportion of patients prescribed discharge opioid medications, post-discharge opioid use, opioid storage and disposal. Of the 1450 eligible surgical patients, opioids were dispensed on discharge to 858 (59%, 95% confidence interval (CI) (57%–62%)), with immediate-release oxycodone the most common medication. Of the 581 patients who were discharged with opioid medication and completed follow-up, 27% were still requiring opioids two weeks after discharge. Post-discharge opioid consumption was highly variable in the study cohort. The majority (70%) of patients had leftover opioids and only a small proportion (5%) reported disposal of the surplus. In a multivariate model, patients with characteristics of age 45 years or less (odds ratio, OR = 1.78, 95% CI (1.36–2.33) versus older than 45 years), American Society of Anesthesiologists’ physical status (ASA) scores of 1 or 2 (OR = 1.96, 95% CI (1.52–2.53) versus ASA score 3 to 5), higher anticipated surgical pain (OR = 1.45, 95% CI (1.08–1.94) severe versus moderate, OR = 17.48, 95% CI (5.79–52.69) severe versus nil/mild) and public funding status (OR = 1.89, 95% CI (1.36–2.64) versus other) were more likely ( P < 0.001) to receive discharge opioids. Post-surgery prescription of opioids is common and supply is often excessive. Post-discharge opioid handling included suboptimal storage and disposal.

scholarly journals Locking Intramedullary Nails Versus Locking Plates in the Treatment of 2-part and 3-part Proximal Humeral Surgical Neck Fractures in Elderly Patients: A Prospective Cohort Study

2020 ◽  
Author(s):  
Rui Geng ◽  
Hao Wu ◽  
Ke Ren ◽  
Qing Chang ◽  
Yalikun Yusufu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Elderly Patients ◽  
Clinical Outcomes ◽  
Prospective Cohort Study ◽  
Complication Rate ◽  
Prospective Cohort ◽  
Locking Plates ◽  
Intramedullary Nails ◽  
Neck Shaft Angle

Abstract Background: Locking intramedullary nails and locking plates are most widely used in the treatment of 2-part and 3-part proximal humeral surgical neck fractures, however, the clinical outcomes are controversial. This study aimed to compare the clinical outcomes of treatment with these two implants in elderly patients.Methods: In this prospective cohort study with a 24-month follow-up period, from June 2014 to November 2016, a total of 53 elderly patients with 2-part and 3-part proximal humeral surgical neck fractures treated with locking intramedullary nails and locking plates were included. We analyzed the intraoperative and radiographic parameters. The American Shoulder and Elbow Surgeons (ASES) score, Constant–Murley score and range of motion (ROM) were used to evaluate shoulder function. We also assessed the visual analog scale (VAS) score and complication rate.Results: For both 2-part and 3-part proximal humeral surgical neck fractures, the nail group showed statistically significant superiority compared with the plate group in terms of the operative duration, incision length, blood loss, hemoglobin loss, neck-shaft angle (NSA) loss, time to bony union and pain. Good to satisfactory clinical outcomes were obtained with both types of implants. Significant differences were not found in the functional results or complication rate between the two groups at different time points during the follow-up period.Conclusions: Treatment with both locking intramedullary nails and locking plates achieves similar and good to satisfactory clinical outcomes in elderly patients. We favor locking intramedullary nails, especially in the treatment of 2-part proximal humeral surgical neck fractures.Trial registration: Medical Ethics Committee for Clinical Research of Zhongda hospital, ZDYJLY (2014) new No. 9. Registered 05 March 2014，http://www.njzdyy.com

Clinical outcomes and bone‐level alterations around one‐piece mini dental implants retaining mandibular overdentures: 5‐year follow‐up of a prospective cohort study

2020 ◽  
Vol 31 (6) ◽  
pp. 549-556 ◽  
Author(s):  
Norbert Enkling ◽  
Rim Moazzin ◽  
Gregor Geers ◽  
Stephanie Kokoschka ◽  
Samir Abou‐Ayash ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clinical Outcomes ◽  
Dental Implants ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Bone Level

scholarly journals P162: Patient-important outcomes in hyperglycemia after discharge from the emergency department: a prospective cohort study

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S114-S115
Author(s):  
J. W. Yan ◽  
L. Siddiqi ◽  
K. Van Aarsen ◽  
M. Columbus ◽  
K. M. Gushulak
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Healthcare Provider ◽  
Prospective Cohort Study ◽  
Burden Of Disease ◽  
Prospective Cohort ◽  
Tertiary Care ◽  
Adverse Outcomes ◽  
Post Discharge

Introduction: Hyperglycemic emergencies, including diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS), carry significant morbidity for individuals even after discharge. The objective of this study was to describe the patient-important outcomes and burden of disease for emergency department (ED) patients with hyperglycemia after discharge from hospital. Methods: This was a prospective cohort study of patients 18 years presenting to two tertiary care EDs (combined annual census 150,000 visits) with a discharge diagnosis of hyperglycemia, DKA or HHS over a 15-month period (Jul 2016-Oct 2017). During the ED visit, consent was obtained for a telephone follow-up call to determine patient-important outcomes. Trained research personnel collected data from medical records and completed a 14 day telephone follow-up using a standardized questionnaire to determine medication changes, missed days of school or work, and repeat admissions or visits to a healthcare provider. Descriptive statistics were used where appropriate to summarize the data. Results: Thus far, 172 patients have been enrolled in our study. Mean (SD) age is 53.9 (19.3) years and 97 (56.4%) are male. 65 (37.8%) patients were admitted from their initial ED visit. Of the 125 patients (72.7%) providing post-discharge outcomes, 75 (60.0%) required an adjustment to their diabetes medications or insulin. 21 (16.8%) patients missed days of school or work for a median (IQR) duration of 3.5 (1.3, 7.0) days. 85 (68.0%) saw another healthcare provider within a 14 day period, 45 (36.0%) saw their family physician, and 34 (27.2%) saw an internist or endocrinologist. 9 (7.2%) were seen again in the ED, 5 of these patients required admission to hospital. There was one death that occurred within the follow-up period. Conclusion: This prospective study builds on our previous retrospective work and demonstrates that visits for hyperglycemia carry a significant burden of disease beyond what may be seen in a single ED encounter. Further research will attempt to identify the factors that may be predictive of adverse outcomes in hyperglycemic patients presenting to the ED.

scholarly journals High prevalence of infection and low incidence of disease in child contacts of patients with drug-resistant tuberculosis: a prospective cohort study

2018 ◽  
Vol 104 (7) ◽  
pp. 622-628 ◽  
Author(s):  
Helena Huerga ◽  
Elisabeth Sanchez-Padilla ◽  
Nara Melikyan ◽  
Hakob Atshemyan ◽  
Armen Hayrapetyan ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Close Contact ◽  
Latent Tuberculosis ◽  
Interferon Gamma Release Assay ◽  
Drug Resistant ◽  
Repeated Testing ◽  
Increased Risk

ObjectiveWe aimed to measure the prevalence and incidence of latent tuberculosis infection (LTBI) and tuberculosis (TB) disease in children in close contact with patients with drug-resistant TB (DR-TB) in a country with high DR-TB prevalence.Design and settingThis is a prospective cohort study of paediatric contacts of adult patients with pulmonary DR-TB in Armenia. Children were screened using tuberculin skin test, interferon-gamma release assay and chest X-ray at the initial consultation, and were reassessed every 3–6 months for a period of 24 months. Children did not receive preventive treatment.Main outcome measuresPrevalence and incidence of LTBI and TB disease; factors associated with prevalent LTBI.ResultsAt initial evaluation, 3 of the 150 children included were diagnosed with TB disease (2.0%). The prevalence of LTBI was 58.7%. The incidence of LTBI was 19.9 per 100 children per year, and was especially high during the first 6 months of follow-up (33.3 per 100 children per year). No additional cases with incident disease were diagnosed during follow-up. After adjustment, prevalent LTBI was significantly associated with the child’s age, sleeping in the same house, higher household density, the index case’s age, positive smear result and presence of lung cavities.ConclusionsChildren in close contact with patients with DR-TB or in contact with very contagious patients had an increased risk of prevalent LTBI. Although none of the children developed TB disease during a 2-year follow-up period, screening for symptoms of TB disease, based on the prevalence of disease at recruitment, together with follow-up and repeated testing of non-infected contacts, is highly recommended in paediatric contacts of patients with DR-TB.

scholarly journals Follow-Up of Post-Discharge Growth and Mortality after Treatment for Severe Acute Malnutrition (FuSAM Study): A Prospective Cohort Study

PLoS ONE ◽  
2014 ◽  
Vol 9 (6) ◽  
pp. e96030 ◽  
Author(s):  
Marko Kerac ◽  
James Bunn ◽  
George Chagaluka ◽  
Paluku Bahwere ◽  
Andrew Tomkins ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Post Discharge

scholarly journals Prospective cohort study of workers diagnosed with COVID-19 and subsequent unemployment

2021 ◽  
Author(s):  
Tomohisa Nagata ◽  
Masako Nagata ◽  
Ayako Hino ◽  
Seiichiro Tateishi ◽  
Akira Ogami ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Odds Ratio ◽  
Close Contact ◽  
Total Sample ◽  
Baseline Survey ◽  
History Of ◽  
Multilevel Logistic Model

Objectives: The purpose of this study was to investigate the relationships of workers being diagnosed with coronavirus disease 2019 (COVID-19) and being identified as close contacts of infected persons with unemployment in Japan. Methods: This was a prospective cohort study using questionnaires about COVID-19 administered to Japanese workers. A baseline survey conducted on December 22-25, 2020, was used to determine history of being diagnosed with COVID-19 or being identified as a close contact of an infected person. Unemployment since the baseline survey was ascertained with a follow-up survey on February 18 and 19, 2021. The odds ratios of unemployment were estimated using a multilevel logistic model with adjusted covariates nested in prefecture of residence. Results: Women (n=8,771) accounted for 44% of the total sample (n=19,941), and the mean age was 48.0 years. In terms of unemployment because of negative reasons, the multivariate analysis showed that the odds ratio of unemployment associated with being diagnosed with COVID-19 was 2.18 (95% CI: 1.05-4.55) and that the odds ratio associated with being identified as a close contact was 0.93 (95% CI: 0.29-2.95). Conclusions: There is an association between workers being diagnosed with COVID-19 and unemployment. Occupational health professionals should follow up closely with workers diagnosed with COVID-19 after they return to work to prevent them from becoming unemployed against their will.

Sign in / Sign up

Export Citation Format

Share Document