scholarly journals Is Higher Viral Load in SARS-CoV-2 Associated With Death?

2020 ◽  
Author(s):  
Klinger Soares Faico-Filho ◽  
Victor Cabelho Passarelli ◽  
Nancy Bellei
Keyword(s):  
Cohort Study ◽  
Viral Load ◽  
Disease Severity ◽  
Prognostic Marker ◽  
Patient Outcomes ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Severe Disease ◽  
High Viral Load ◽  
Nasopharyngeal Swab

There is no proven prognostic marker or adequate number of studies in patients hospitalized for Coronavirus Disease-2019 (COVID-19). We conducted a retrospective cohort study of patients hospitalized with COVID-19 from March 14 to June 17, 2020, at Sao Paulo Hospital. SARS-CoV-2 viral load was assessed using the cycle threshold (Ct) values obtained from an RTPCR assay applied to the nasopharyngeal swab samples. Disease severity and patient outcomes were compared. Among the 875 patients, 50.1% (439/875) had mild, 30.4% (266/875) moderate, and 19.5% (170/875) severe disease. A Ct value of <25 (472/875) indicated a high viral load, which was independently associated with mortality (OR: 0,34; 95% CI: 0,217 to 0,533; p < 0.0001). Admission SARS-CoV-2 viral load is an important surrogate biomarker of infectivity and is independently associated with mortality among patients hospitalized with COVID-19.

Implications of Hidradenitis Suppurativa Phenotypes in Cardiovascular Risk and Treatment Decisions: A Retrospective Cohort Study

Dermatology ◽  
2021 ◽  
pp. 1-6
Author(s):  
Carlos Cuenca-Barrales ◽  
Trinidad Montero-Vilchez ◽  
Luis Salvador-Rodríguez ◽  
Manuel Sánchez-Díaz ◽  
Salvador Arias-Santiago ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cardiovascular Risk ◽  
Disease Severity ◽  
Retrospective Cohort Study ◽  
Therapeutic Approach ◽  
Retrospective Cohort ◽  
Hidradenitis Suppurativa ◽  
Severe Disease ◽  
Treatment Decisions ◽  
Lesion Pattern

<b><i>Background:</i></b> New integrative hidradenitis suppurativa (HS) lesion pattern phenotypes have been proposed, an inflammatory phenotype (IP) and a follicular phenotype (FP). They are characterized by different lesion patterns, symptoms, and risks of disease progression. <b><i>Objectives:</i></b> To evaluate whether lesion pattern phenotypes (1) have a different cardiovascular risk factor profile, and (2) are associated with a different therapeutic approach in the setting of an HS clinic. <b><i>Methods:</i></b> A retrospective cohort study was conducted on 233 patients with HS. They were classified according to lesion pattern phenotype criteria. Data regarding cardiovascular risk factors and treatment decisions were gathered. <b><i>Results:</i></b> One hundred and seventeen HS patients (50.21%) were classified as FP and 112 (48.07%) as IP. IP was associated with more severe disease and greater impairment of quality of life. Regardless of disease severity, patients with IP may have a higher cardiovascular risk, assessed according to higher C-reactive protein (CRP) levels (12.75 vs. 5.89, <i>p</i> = 0.059). The lesion pattern phenotype also influenced treatment decisions regardless of disease severity. Patients with IP were more likely to be treated with systemic corticosteroids and adalimumab, showing that lesion pattern phenotypes are associated with different therapeutic approaches. <b><i>Conclusions:</i></b> IP is associated with higher CRP values, suggesting a greater cardiovascular risk in these patients and also a different therapeutic approach. This information could help guide dermatologists in the management of HS patients and help to determine future treatment recommendations.

scholarly journals Viral Load Suppression after Enhanced Adherence Counseling and Its Predictors among High Viral Load HIV Seropositive People in North Wollo Zone Public Hospitals, Northeast Ethiopia, 2019: Retrospective Cohort Study

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Gedefaw Diress ◽  
Samuel Dagne ◽  
Birhan Alemnew ◽  
Seteamlak Adane ◽  
Amanuel Addisu
Keyword(s):  
Cohort Study ◽  
Viral Load ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Viral Suppression ◽  
High Viral Load ◽  
Counseling Session ◽  
Viral Load Suppression ◽  
Adherence Counseling ◽  
Hiv Seropositive

Background. The World Health Organization currently encourages enhanced adherence counseling for human immunodeficiency virus (HIV) seropositive people with a high viral load count before a treatment switch to the second-line regimen, yet little is known about viral load suppression after the outcome of enhanced adherence counseling. Therefore, this study aimed to assess viral suppression after enhanced adherence counseling sessions and its predictors among high viral load HIV seropositive people. Methods. Institutional-based retrospective cohort study was conducted among 235 randomly selected HIV seropositive people who were on ART and had a high viral load (>1000 copies/ml) from June 2016 to January 2019. The proportion of viral load suppression after enhanced adherence counseling was determined. Time to completion of counseling sessions and time to second viral load tests were estimated by the Kaplan–Meier curve. Log binomial regression was used to identify predictors of viral re-suppression after enhanced adherence counseling sessions. Result. The overall viral load suppression after enhanced adherence counseling was 66.4% (60.0–72.4). The median time to start adherence counseling session after high viral load detected date was 8 weeks (IQR 4–8 weeks), and the median time to complete the counseling session was 13 weeks (IQR 8–25 weeks). The probability of viral load suppression was higher among females (ARR = 1.2, 95% CI: 1.02–1.19) and higher educational status (ARR = 1.7, 95% CI: 1.25–2.16). The probability of viral load suppression was lower among people who had 36–59 months duration on ART (ARR = 0.35, 95% CI: 0.130–0.9491) and people who had > 10,000 baseline viral load count (ARR = 0.44, 95% CI: 0.28–0.71). Conclusion. This study showed that viral suppression after enhanced adherence counseling was near to the WHO target (70%) but highlights gaps in time to enrolment into counseling session, timely completion of counseling session, and repeat viral load testing after completing the session.

scholarly journals Can initial chest CT scan predict status and clinical outcomes of COVID-19 infection? A retrospective cohort study

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Iman Abdollahi ◽  
Mehrdad Nabahati ◽  
Mostafa Javanian ◽  
Hoda Shirafkan ◽  
Rahele Mehraeen
Keyword(s):  
Cohort Study ◽  
Ct Scan ◽  
Disease Severity ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Severe Disease ◽  
Chest Ct ◽  
Rt Pcr ◽  
Icu Admission ◽  
Chest Ct Scan

Abstract Background We aimed to investigate the association of initial chest CT scan findings with status and adverse outcomes of COVID-19 (including ICU admission, mortality, and disease severity). This retrospective cohort study was performed in three hospitals in Babol, northern Iran, between February and March 2020. Cases were confirmed by real-time polymerase chain reaction (RT-PCR). Clinical and paraclinical data of the patients were collected from their medical records. CT severity score (CSS) was calculated by a senior radiologist. Disease severity was determined based on the World Health Organization criteria. Results In total, 742 patients were included, of whom 451 (60.8%) were males and 291 (39.2%) were females. The mean age was 56.59 ± 14.88 years old. Also, 523 (70.5%) were RT-PCR-positive. Ground glass opacity was directly associated with RT-PCR positivity (odds ratio [OR] = 2.07). Also, RT-PCR-positive cases had significantly a higher CSS than RT-PCR-negative cases (p = 0.037). In patients confirmed with COVID-19, peribronchovascular distribution of lesions, number of zones involved, and CSS were associated with increased risk of ICU admission (OR = 2.93, OR = 2.10, and OR = 1.14, respectively), mortality (OR = 2.30, OR = 1.35, and OR=1.08, respectively), severe disease (OR = 2.06, OR = 1.68, and OR = 1.10, respectively), and critical disease (OR = 4.62, OR = 3.21, and OR = 1.23, respectively). Also, patients who had consolidation were at a higher risk of severe disease compared with those who did not (OR = 4.94). Conclusion Initial chest CT scan can predict COVID-19 positivity, ICU admission, mortality, and disease severity, specifically through CSS.

scholarly journals Incidence and Outcomes of Acute Kidney Injury in Patients Admitted to Hospital With COVID-19: A Retrospective Cohort Study

2021 ◽  
Vol 8 ◽  
pp. 205435812110277
Author(s):  
Tyler Pitre ◽  
Angela (Hong Tian) Dong ◽  
Aaron Jones ◽  
Jessica Kapralik ◽  
Sonya Cui ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Acute Kidney Injury ◽  
Cohort Study ◽  
Hospital Mortality ◽  
Disease Severity ◽  
Retrospective Cohort Study ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Kidney Injury ◽  
Icu Admission

Background: The incidence of acute kidney injury (AKI) in patients with COVID-19 and its association with mortality and disease severity is understudied in the Canadian population. Objective: To determine the incidence of AKI in a cohort of patients with COVID-19 admitted to medicine and intensive care unit (ICU) wards, its association with in-hospital mortality, and disease severity. Our aim was to stratify these outcomes by out-of-hospital AKI and in-hospital AKI. Design: Retrospective cohort study from a registry of patients with COVID-19. Setting: Three community and 3 academic hospitals. Patients: A total of 815 patients admitted to hospital with COVID-19 between March 4, 2020, and April 23, 2021. Measurements: Stage of AKI, ICU admission, mechanical ventilation, and in-hospital mortality. Methods: We classified AKI by comparing highest to lowest recorded serum creatinine in hospital and staged AKI based on the Kidney Disease: Improving Global Outcomes (KDIGO) system. We calculated the unadjusted and adjusted odds ratio for the stage of AKI and the outcomes of ICU admission, mechanical ventilation, and in-hospital mortality. Results: Of the 815 patients registered, 439 (53.9%) developed AKI, 253 (57.6%) presented with AKI, and 186 (42.4%) developed AKI in-hospital. The odds of ICU admission, mechanical ventilation, and death increased as the AKI stage worsened. Stage 3 AKI that occurred during hospitalization increased the odds of death (odds ratio [OR] = 7.87 [4.35, 14.23]). Stage 3 AKI that occurred prior to hospitalization carried an increased odds of death (OR = 5.28 [2.60, 10.73]). Limitations: Observational study with small sample size limits precision of estimates. Lack of nonhospitalized patients with COVID-19 and hospitalized patients without COVID-19 as controls limits causal inferences. Conclusions: Acute kidney injury, whether it occurs prior to or after hospitalization, is associated with a high risk of poor outcomes in patients with COVID-19. Routine assessment of kidney function in patients with COVID-19 may improve risk stratification. Trial registration: The study was not registered on a publicly accessible registry because it did not involve any health care intervention on human participants.

A modified community viral load measure to support the evaluation of transmission potential of HIV in the population: a retrospective cohort study

The Lancet ◽  
2015 ◽  
Vol 386 ◽  
pp. S47
Author(s):  
Ngai Sze Wong ◽  
Owen T Y Tsang ◽  
Ka Hing Wong ◽  
Man Po Lee ◽  
Denise P C Chan ◽  
...  
Keyword(s):  
Cohort Study ◽  
Viral Load ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Transmission Potential

Impact of timing of reversal of loop ileostomy on patient outcomes: a retrospective cohort study

2021 ◽  
Vol 25 (11) ◽  
pp. 1217-1224
Author(s):  
T.-W. Khoo ◽  
N. N. Dudi-Venkata ◽  
Y. Z. Beh ◽  
S. Bedrikovetski ◽  
H. M. Kroon ◽  
...  
Keyword(s):  
Cohort Study ◽  
Patient Outcomes ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Loop Ileostomy

scholarly journals Comparing the impact of Hydroxychloroquine based regimens and standard treatment on COVID-19 patient outcomes: A retrospective cohort study

2020 ◽  
Vol 28 (12) ◽  
pp. 1877-1882 ◽  
Author(s):  
Saja H. Almazrou ◽  
Ziyad S. Almalki ◽  
Abdullah S. Alanazi ◽  
Abdulhadi M. Alqahtani ◽  
Saleh M. Alghamd
Keyword(s):  
Cohort Study ◽  
Patient Outcomes ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Standard Treatment ◽  
The Impact

scholarly journals What is the Best Setting for Receiving Dialysis Vascular access Repair and Maintenance Services?

2017 ◽  
Vol 18 (6) ◽  
pp. 473-481 ◽  
Author(s):  
Audrey M. El-Gamil ◽  
Al Dobson ◽  
Nikolay Manolov ◽  
Joan E. DaVanzo ◽  
Gerald A. Beathard ◽  
...  
Keyword(s):  
United States ◽  
Organizational Culture ◽  
Cohort Study ◽  
Patient Outcomes ◽  
Vascular Access ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Data System ◽  
Propensity Matching ◽  
Annual Mortality

Introduction Advances in dialysis vascular access (DVA) management have changed where beneficiaries receive this care. The effectiveness, safety, quality, and economy of different care settings have been questioned. This study compares patient outcomes of receiving DVA services in the freestanding office-based center (FOC) to those of the hospital outpatient department (HOPD). It also examines whether outcomes differ for a centrally managed system of FOCs (CMFOC) compared to all other FOCs (AOFOC). Methods Retrospective cohort study of clinically and demographically similar patients within Medicare claims available through United States Renal Data System (USRDS) (2010-2013) who received at least 80% of DVA services in an FOC (n = 80,831) or HOPD (n = 133,965). Separately, FOC population is divided into CMFOC (n = 20,802) and AOFOC (n = 80,267). Propensity matching was used to control for clinical, demographic, and functional characteristics across populations. Results FOC patients experienced significantly better outcomes, including lower annual mortality (14.6% vs. 17.2%, p<0.001) and DVA-related infections (0.16 vs. 0.20, p<0.001), fewer hospitalizations (1.65 vs. 1.91, p<0.001), and lower total per-member-per-month (PMPM) payments ($5042 vs. $5361, p<0.001) than HOPD patients. CMFOC patients had lower annual mortality (12.5% vs. 13.8%, p<0.001), PMPM payments (DVA services) ($1486 vs. $1533, p<0.001) and hospitalizations ($1752 vs. $1816, p<0.001) than AOFOC patients. Conclusions Where nephrologists send patients for DVA services can impact patient clinical and economic outcomes. This research confirmed that patients who received DVA care in the FOC had better outcomes than those treated in the HOPD. The organizational culture and clinical oversight of the CMFOC may result in more favorable outcomes than receiving care in AOFOC.

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