scholarly journals Radiographic Findings and other Predictors in Adults with Covid-19

2020 ◽  
Author(s):  
Kaiyan Li ◽  
Dian Chen ◽  
Shenchong Chen ◽  
Yuchen Feng ◽  
Chenli Chang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ethics Committee ◽  
Regional Hospital ◽  
Older Age ◽  
Radiographic Findings ◽  
Radiographic Change ◽  
Hospital Ethics ◽  
D Dimer

As of March 20, 2020, there were 234,073 confirmed cases of coronavirus disease 2019 (Covid-19) and 9,840 deaths worldwide 1. Older age and elevated d-dimer are reported risk factors for Covid-19 2,3. However, whether early radiographic change is a predictor of fatality remains unknown. We retrospectively reviewed records of all laboratory-confirmed patients admitted to a quarantine unit at Tongji Hospital, a large regional hospital in Wuhan, China, between January 31 and March 5, 2020. The Tongji Hospital ethics committee approved this study.

scholarly journals Factors associated with 90-day acute ischemic stroke in patients ≥70 years old with total hip arthroplasty for hip fracture

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Rui He ◽  
Guoyou Wang ◽  
Ting Li ◽  
Huarui Shen ◽  
LijuanZhang
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Logistic Regression ◽  
Ischemic Stroke ◽  
Hip Fracture ◽  
Total Hip Arthroplasty ◽  
Older Age ◽  
Factors Associated ◽  
Independent Risk Factors ◽  
D Dimer

Abstract Background Postoperative ischemic stroke is a devastating complication following total hip arthroplasty (THA). The purpose of the current study was to investigate the incidence of postoperative acute ischemic stroke (AIS) in patients ≥70 years old with THA for hip fracture after 90 days and independent risk factors associated with 90-day AIS. Methods A multicenter retrospective study was conducted, patients ≥70 years old with THA for hip fracture under general anesthesia were included from February 2017 to March 2020. Patients with AIS within 90 days after THA were identified as AIS group; patients with no AIS were identified as no AIS group. The baseline characteristics and risk factors were collected, multivariable logistic regression was used to identify independent risk factors of 90-dayAIS. Results: 2517 patients (mean age 76.18 ± 6.01) were eligible for inclusion in the study. 2.50% (63/2517) of patients had 90-day AIS. Compared with no AIS, older age, diabetes, hyperlipidemia, atrial fibrillation (AF) and higher D-dimer value were more likely in patients with AIS (P < 0.05), and anticoagulant use was fewer in patients with AIS. ROC curve analysis showed that the optimal cut point of D-dimer for AIS was D-dimer≥4.12 μg/ml. Multivariate logistic regression analysis showed that D-dimer≥4.12 μg/ml [adjusted odds ratio (aOR), 4.44; confidence interval (CI), 2.50–7.72; P < 0.001], older age (aOR, 1.08; 95%CI, 1.03–1.12; P < 0.001), hyperlipidemia (aOR, 2.28; 95%CI, 1.25–4.16; P = 0.007), atrial fibrillation (aOR, 5.84; 95% CI, 1.08–15.68; P = 0.001), and diabetes (aOR, 2.60; 95% CI, 1.56–4.39; P < 0.001) were associated with increased risk of 90-day AIS after THA. Conclusions In conclusion, we found that the incidence of 90-day AIS in patients≥70 years old with THA for hip fracture was 2.5%. Older age, diabetes, hyperlipidemia, AF and higher D-dimer value were independent risk factors for 90-day AIS in patients≥70 years old with THA for hip fracture.

scholarly journals Clinical Determinants of the Severity of Coronavirus Disease 2019 (COVID-19): A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Yanling Wu ◽  
Hu Li ◽  
Shengjin Li
Keyword(s):  
Risk Factors ◽  
Cerebrovascular Disease ◽  
Respiratory Disease ◽  
Meta Analysis ◽  
Case Fatality ◽  
Older Age ◽  
Fatality Risk ◽  
Male Sex ◽  
Case Fatality Risk ◽  
D Dimer

Abstract Background: SARS-CoV-2 is an emerging pathogen, and coronavirus disease 2019 (COVID-19) has been declared a global pandemic. We aim to summarize current evidence regarding the risk of death and the severity of COVID-19 as well as risk factors for severe COVID-19.Methods: The PubMed, Embase, and Web of Science databases as well as some Chinese databases were searched for clinical and epidemiological studies on COVID-19. We conducted a meta-analysis to examine COVID-19-related death and risk factors for the severity of COVID-19.Results: A total of 55 studies fulfilled the criteria for this review. The case fatality risk ranged from 0 to 61.5%, with a pooled estimate of 3.3%. The risks of ICU admission, acute respiratory distress syndrome (ARDS)and severe COVID-19 were 24.9%, 20.9% and 26.6%, respectively. Factors related to the risk of severe COVID-19 were older age (MD=10.09, 95% CI:7.03, 13.16), male sex (OR=1.62, 95% CI:1.32, 1.99), hypertension (OR=2.34, 95% CI:1.47, 3.73), diabetes (OR=2.25, 95% CI:1.68, 3.03), chronic renal disease (OR=3.60, 95% CI:1.53, 8.46), heart disease (OR=2.76, 95% CI:1.78, 4.30), respiratory disease (OR=3.74, 95% CI:2.15, 6.49), cerebrovascular disease (OR=2.21, 95% CI:1.23, 3.98), higher D-dimer levels (SMD=0.62, 95% CI:0.28, 0.96), and higher IL-6 levels (SMD=2.21, 95% CI:0.11, 4.31). However, liver disease (OR=0.63, 95% CI: 0.36, 1.10) was found to be a nonsignificant predictor of the severity of COVID-19.Conclusions: The case fatality risk of COVID-19 and the risk of severe manifestations were not very high, and variances in the study designs and regions led to high heterogeneity among the studies. Male sex, older age, comorbidities such as hypertension, diabetes, cardiovascular disease, respiratory disease and cerebrovascular disease could increase the risk of developing a severe case of COVID-19. Laboratory parameters, such as D-dimer and IL-6 levels, could affect the prognosis of COVID-19.

scholarly journals Risk factors for postoperative ischemic complications in pediatric moyamoya disease

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaofeng Deng ◽  
Peicong Ge ◽  
Rong Wang ◽  
Dong Zhang ◽  
Jizong Zhao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Moyamoya Disease ◽  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Older Age ◽  
Radiographic Findings ◽  
Ischemic Complications ◽  
Direct Bypass ◽  
Ischemic Events

Abstract Background Ischemic events are the most common postoperative complication in bypass surgery for moyamoya disease (MMD), but the risk factors for pediatric MMD remain unclear. The goal of the study was to investigate the risk factors for postoperative ischemic complications in pediatric MMD patients. Methods We retrospectively reviewed a consecutive series of pediatric MMD cases at Beijing Tiantan Hospital, Capital Medical University from June 2010 through June 2019. Preoperative clinical variables and radiographic findings were recorded, and logistic regression analysis was carried out to identify the risk factors for postoperative ischemic events. Results A total of 533 operations in 336 patients were included in this study. Postoperative complications occurred after 51 operations (9.6%), including 40/447 indirect bypass procedures, 9/70 direct bypass procedures, and 2/16 combined bypass procedures. Postoperative ischemic events were the most common complication and occurred in 30 patients after 31 procedures (8.9% per patient; 5.8% per operation), including 26/447 indirect bypass procedures, 4/70 direct bypass procedures, and 1/16 combined bypass procedures, and the incidence of these events did not differ significantly between indirect and non-indirect bypass (5.8% vs 5.8%; p = 0.999). Multivariate logistic regression analyses revealed that older age at operation (OR 1.129, 95% CI 1.011–1.260, p = 0.032) and posterior cerebral artery involvement (OR 2.587, 95% CI 1.030–6.496, p = 0.043) were significantly associated with postoperative ischemic events. Conclusion We speculate that older age at operation and posterior cerebral artery involvement are risk factors for postoperative ischemic events in pediatric MMD patients.

scholarly journals Mortality-related risk factors of COVID-19: a systematic review and meta-analysis of 42 studies and 423,117 patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zelalem G. Dessie ◽  
Temesgen Zewotir
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Acute Kidney Injury ◽  
Smoking Status ◽  
Kidney Injury ◽  
Current Smoker ◽  
Older Age ◽  
Cochrane Library ◽  
Risk Of Mortality ◽  
D Dimer

Abstract Background Mortality rates of coronavirus disease-2019 (COVID-19) continue to rise across the world. The impact of several risk factors on coronavirus mortality has been previously reported in several meta‐analyses limited by small sample sizes. In this systematic review, we aimed to summarize available findings on the association between comorbidities, complications, smoking status, obesity, gender, age and D-dimer, and risk of mortality from COVID-19 using a large dataset from a number of studies. Method Electronic databases including Google Scholar, Cochrane Library, Web of Sciences (WOS), EMBASE, Medline/PubMed, COVID-19 Research Database, and Scopus, were systematically searched till 31 August 2020. We included all human studies regardless of language, publication date or region. Forty-two studies with a total of 423,117 patients met the inclusion criteria. To pool the estimate, a mixed-effect model was used. Moreover, publication bias and sensitivity analysis were evaluated. Results The findings of the included studies were consistent in stating the contribution of comorbidities, gender, age, smoking status, obesity, acute kidney injury, and D-dimer as a risk factor to increase the requirement for advanced medical care. The analysis results showed that the pooled prevalence of mortality among hospitalized patients with COVID-19 was 17.62% (95% CI 14.26–21.57%, 42 studies and 423,117 patients). Older age has shown increased risk of mortality due to coronavirus and the pooled odds ratio (pOR) and hazard ratio (pHR) were 2.61 (95% CI 1.75–3.47) and 1.31 (95% CI 1.11–1.51), respectively. A significant association were found between COVID-19 mortality and male (pOR = 1.45; 95% CI 1.41–1.51; pHR = 1.24; 95% CI 1.07–1.41), and current smoker (pOR = 1.42; 95% CI 1.01–1.83). Furthermore, risk of mortality among hospitalized COVID-19 patients is highly influenced by patients with Chronic Obstructive Pulmonary Disease (COPD), Cardiovascular Disease (CVD), diabetes, hypertension, obese, cancer, acute kidney injury and increase D-dimer. Conclusion Chronic comorbidities, complications, and demographic variables including acute kidney injury, COPD, diabetes, hypertension, CVD, cancer, increased D-dimer, male gender, older age, current smoker, and obesity are clinical risk factors for a fatal outcome associated with coronavirus. The findings could be used for disease’s future research, control and prevention.

scholarly journals Clinical Characteristics and Risk Factors of Mortality Among Severe COVID-19 Patients

2021 ◽  
Author(s):  
Reham Mohamed Elmorshedy ◽  
Maha Mohamed El-kholy ◽  
Alaa Eldin AbdelMoniem ◽  
Shimaa Abbas Hassan ◽  
Samiaa Hamdy Sadek
Keyword(s):  
Risk Factors ◽  
Clinical Characteristics ◽  
Laboratory Data ◽  
Ground Glass Opacity ◽  
Older Age ◽  
Ground Glass ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Increased Risk ◽  
D Dimer

Abstract Background:The novel corona virus is attacking several millions of people worldwide, resulting in death of almost a million and a half-humans. The rational of the current study was to detect clinical characteristics of severe COVID- 19 patients, and assessment of risk factors for death.Methodology:This retrospective cohort study included all laboratory confirmed COVID-19 patients with severe disease admitted to critical care unit in June and July 2020. All recorded data were collected,which included clinincal, radiological, and laboratory data, in addition to the outcome and duration of ICU stay.Statistical analysis was performed for obtaining descriptive information, comparison between living and dead patients,in addition to regression analysis to identify risk factors for mortality.Results:One hundred and three patients were included in the current study;cough and fever were the most common clinical presentations, and bilateral ground glass opacity was the most common radiological presentation. Patients had elevated values of neutrophils, neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), serum ferritin, CRP, and D-dimer, also had longer ICU stay ,with reduced values of lymphocytes, and PaO2/FIO2 ratio. Most of these variables were more exaggerated in dead patients compared to living ones. Older age, lower values of PaO2/FIO2 ratio, and higher values of neutrophils, NLR, and D-dimer were predictors for death.Conclusion: Cough, fever and bilateral ground glass opacity were the most common clinical and radiological presentation of severe COVID 19. Older age, lower value of PaO2/FIO2 ratio, and higher values of D- dimer, neutrophil and NLR were risk factors associated with increased risk of mortality.

scholarly journals Risk Factors of In-Hospital Mortality in Non-Specialized Tertiary Center Repurposed for Medical Care to COVID-19 Patients in Russia

Diagnostics ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 1687
Author(s):  
Anton Kondakov ◽  
Alexander Berdalin ◽  
Vladimir Lelyuk ◽  
Ilya Gubskiy ◽  
Denis Golovin
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Medical Care ◽  
Hospitalized Patients ◽  
Older Age ◽  
Cerebrovascular Event ◽  
Emergency Setting ◽  
Radiographic Findings ◽  
Risk Of Death ◽  
Tertiary Center

The purpose of our study is to investigate the risk factors of in-hospital mortality among patients who were admitted in an emergency setting to a non-specialized tertiary center during the first peak of coronavirus disease in Moscow in 2020. The Federal Center of Brain and Neurotechnologies of the Federal Medical and Biological Agency of Russia was repurposed for medical care for COVID-19 patients from 6th of April to 16th of June 2020 and admitted the patients who were transported by an ambulance with severe disease. In our study, we analyzed the data of 635 hospitalized patients aged 59.1 ± 15.1 years. The data included epidemiologic and demographic characteristics, laboratory, echocardiographic and radiographic findings, comorbidities, and complications of the COVID-19, developed during the hospital stay. Results of our study support previous reports that risk factors of mortality among hospitalized patients are older age, male gender (OR 1.91, 95% CI 1.03–3.52), previous myocardial infarction (OR 3.15, 95% CI 1.47–6.73), previous acute cerebrovascular event (stroke, OR = 3.78, 95% CI 1.44–9.92), known oncological disease (ОR = 3.39, 95% CI 1.39–8.26), and alcohol abuse (ОR 6.98, 95% CI 1.62–30.13). According to the data collected, high body mass index and smoking did not influence the clinical outcome. Arterial hypertension was found to be protective against in-hospital mortality in patients with coronavirus pneumonia in the older age group. The neutrophil-to-lymphocyte ratio showed a significant increase in those patients who died during the hospitalization, and the borderline was found to be 2.5. CT pattern of “crazy paving” was more prevalent in those patients who died since their first CT scan, and it was a 4-fold increase in the risk of death in case of aortic and coronal calcinosis (4.22, 95% CI 2.13–8.40). Results largely support data from other studies and emphasize that some factors play a major role in patients’ stratification and medical care provided to them.

scholarly journals Risk Factors for Failure in Conservatively Treated Osteoporotic Vertebral Fractures: A Systematic Review

2021 ◽  
pp. 219256822098227
Author(s):  
Max J. Scheyerer ◽  
Ulrich J. A. Spiegl ◽  
Sebastian Grueninger ◽  
Frank Hartmann ◽  
Sebastian Katscher ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Treatment Failure ◽  
Patient Specific ◽  
Mineral Density ◽  
Radiographic Findings ◽  
Specific Risk ◽  
Fracture Development ◽  
Predict Treatment Failure

Study Design: Systematic review. Objectives: Osteoporosis is one of the most common diseases of the elderly, whereby vertebral body fractures are in many cases the first manifestation. Even today, the consequences for patients are underestimated. Therefore, early identification of therapy failures is essential. In this context, the aim of the present systematic review was to evaluate the current literature with respect to clinical and radiographic findings that might predict treatment failure. Methods: We conducted a comprehensive, systematic review of the literature according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) checklist and algorithm. Results: After the literature search, 724 potentially eligible investigations were identified. In total, 24 studies with 3044 participants and a mean follow-up of 11 months (range 6-27.5 months) were included. Patient-specific risk factors were age >73 years, bone mineral density with a t-score <−2.95, BMI >23 and a modified frailty index >2.5. The following radiological and fracture-specific risk factors could be identified: involvement of the posterior wall, initial height loss, midportion type fracture, development of an intravertebral cleft, fracture at the thoracolumbar junction, fracture involvement of both endplates, different morphological types of fractures, and specific MRI findings. Further, a correlation between sagittal spinal imbalance and treatment failure could be demonstrated. Conclusion: In conclusion, this systematic review identified various factors that predict treatment failure in conservatively treated osteoporotic fractures. In these cases, additional treatment options and surgical treatment strategies should be considered in addition to follow-up examinations.

scholarly journals POS0875 MYOSITIS-SPECIFIC ANTIBODIES IN A RETROSPECTIVE SINGLE-CENTER OBSERVATIONAL STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 693.2-694
Author(s):  
J. Álvarez Troncoso ◽  
S. Carrasco Molina ◽  
J. Valdivieso ◽  
P. Nozal ◽  
Á. Robles Marhuenda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Observational Study ◽  
Interstitial Pneumonia ◽  
Usual Interstitial Pneumonia ◽  
Older Age ◽  
Single Center ◽  
Specific Antibodies ◽  
Factors Associated ◽  
Risk Of Cancer ◽  
Single Center Observational Study

Background:Myositis-specific antibodies (MSA) are highly specific and useful to classify patients as having syndromes with distinct clinical features and prognosis. MSA are almost always mutually exclusive and quite specific, adding value as a useful biomarker for diagnosis. Although individual autoantibodies aren’t sensitive enough to detect the full spectrum of idiopathic inflammatory myopathies (IIM), the sensitivity of a myositis panel is increasing as more autoantibodies are discovered, and as better assays become available.Objectives:We aimed to analyze the usefulness of a myositis-specific immunoblot for the diagnosis of IIM in a hospital cohort from January 2019 to December 2020. We also seek to correlate immunological findings with the risk of associated interstitial lung disease (ILD), cancer, or death.Methods:Retrospective single-center observational study conducted in a Spanish tertiary hospital. In patients with high clinical suspicion of IIM, a myositis immunoblot was performed including Jo1, PL-7, PL-12, EJ, SRP, Mi2, Ku, MDA-5, TIF1-γ, HMGCR, PM-Scl and Ro52 antibodies. The demographic characteristics, the risk of ILD, cancer and death were analyzed.Results:In a cohort of 313 patients with high suspicion of IIM, 87 patients (27.8%) presented a positive MSA (MSA+ve). The mean age at diagnosis was 56.7±16.9 years, with no significant differences between MSA+ve and MSA-ve (p=0.597). Most of the patients were women with significant differences between both groups (80.5% MSA+ve vs 68.1% MSA-ve, p=0.030).IIM were classified as antisynthetase syndrome (ARS) (38%), dermatomyositis (DM) (31%), overlap myopathy (OM) (16.9%) and necrotizing myopathy (NM) (14.1%) according to the manifestations and MSA found (Jo1, PL-12, PL-7, EJ in ARS; Mi-2, MDA-5 and TIF1-γ in DM; Ku and PM-Scl in OM; HMGCR and SRP in NM). The most frequent MSA were anti-Jo1 (16.9%), TIF1-γ (15.5%), Ku (12.7%), Mi-2 (9.9%), PL-7 (9.9%), HMCGR (8.5%), PL-12 (7%), MDA-5 (5.6%), SRP (5.6%) and EJ (4.2%). The presence of Ro52 associated with other MSA was found in 20 patients (22.9%).ILD was the most frequent manifestation (45.2% of the MSA+ve). Non-specific interstitial pneumonia (NSIP) was the most frequent ILD (39.5%), followed by usual interstitial pneumonia (34.2%). The main risk factors associated with IIM-ILD were some subtypes of the MSAs (p<0.001), the association of Ro52 (p<0.001), and older age (p=0.027). Among the IIM, ARS and OM (p<0.001) were more frequently associated with IIM-ILD. The MSAs most associated with IIM-ILD were Jo1, PL-7, PM-Scl, Ku and SRP (p<0.001).Cancer was found in 9.6% of MSA+ve patients. The most frequent tumors were gynecological (37.5%), followed by gastrointestinal (25%) and breast cancer (12.5%). Factors associated with cancer were age (p=0.010), TIF1-γ (p<0.001), SRP (p=0.004), PL-12 (p=0.013), PL-7 (p=0.047) and HMGCR (p=0.027).The mortality of these patients was 3.5%. There were no differences regarding MSA+ve/-ve (p = 0.911). However, MDA-5 (p=0.033) and older age (p=0.001) were associated with higher mortality. There were no significant differences between the IIM classifications, the associated SAD, the presence of cancer or ILD. However, longer follow-up periods and future studies are necessary to confirm these results.Conclusion:The use of a myositis blot allowed classifying, stratifying the risk of ILD, the risk of cancer and the risk of mortality in IIM. IIM-ILD was the most frequent complication, usually manifested as NSIP. The associated risk factors were ARS, OM, some MSAs, Ro52+ and older age. Cancer was a serious and frequent manifestation in these patients, especially in patients with TIF1-γ and other MSAs, so it is essential to know the risk factors and perform an early screening, especially in older patients.A better knowledge of the serological profiles of IIM will provide more individualized approaches and better risk stratification, helping in the management and treatment of these patients.References:[1]Satoh et al. Clin Rev Allergy Immunol. 2017 Feb;52(1):1-19.[2]Betteridge et al. J Intern Med. 2016 Jul;280(1):8-23.Disclosure of Interests:None declared

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