scholarly journals Determinants of Time to Convalescence among COVID-19 Patients at Millennium COVID-19 Care Center in Ethiopia: A prospective cohort study

2020 ◽  
Author(s):  
Tigist W. Leulseged ◽  
Ishmael S. Hassen ◽  
Endalkachew H. Maru ◽  
Wuletaw C. Zewde ◽  
Nigat W. Chamesew ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Care Center ◽  
Viral Clearance ◽  
Rank Test ◽  
P Value ◽  
Treatment Practice ◽  
Viral Shedding ◽  
Log Rank Test

ABSTRACTAimTo estimate time to recovery/convalescence and identify determinants among COVID-19 infected patients admitted to Millennium COVID-19 Care Center in Addis Ababa, Ethiopia.MethodsA prospective cohort study was conducted among a randomly selected sample of 360 COVID-19 patients who were on follow up from 2nd June to 5th July 2020. Kaplan Meier plots, median survival times, and Log-rank test were used to describe the data and compare survival distribution between groups. Association between time to recovery/ convalescence and determinants was assessed using the Cox proportional hazard survival model, where hazard ratio, P-value, and 95% CI for hazard ratio were used for testing significance.ResultsThe mean age of the participants was 32.4 years (± 12.5 years). On admission, 86.9 % had mild COVID-19, 78.6% were asymptomatic and 11.4% of the patients had a history of pre-existing co-morbid illness. The Median time to recovery/ convalescence among the study population was 16 days. The log-rank test shows that having non-mild (moderate and severe) disease, having one or more symptoms at presentation, and presenting with respiratory and constitutional symptoms seems to extend the time needed to achieve recovery. The Final Cox regression result shows that the presence of symptom at presentation was found to be a significant factor that affects time to recovery/ convalescence, the rate of achieving recovery/ convalescence among symptomatic patients was 44% lower than patients who were asymptomatic at presentation (HR= 0.560, 95% CI= 0.322-0.975, p-value=0.040).ConclusionsPresence of symptom was found to be associated with delayed viral clearance. This implies symptomatic patients are more likely to be infectious because of the prolonged viral shedding in addition to the presence of a more concentrated virus in the upper respiratory tract that enhances the transmission. Therefore, attention should be given in the isolation and treatment practice of COVID-19 patients with regard to presence of symptom.Key MessagesThe study assessed the time to RT-PCR proven recovery (two consecutive negative viral shedding) and identified determinants that affected the time.Symptomatic infection is associated with delayed viral clearance.The finding of the study could be used to guide the isolation and treatment practice.

Prediction value of IVIM Combining with BOLD-MRI in Diabetic Kidney Disease: A Prospective Cohort Study

2020 ◽  
Author(s):  
Jing Li ◽  
Yanhui Wang ◽  
Xiaokai Mo ◽  
Jianteng Xie ◽  
Qiuling Li ◽  
...  
Keyword(s):  
Cohort Study ◽  
Kidney Disease ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Diabetic Kidney Disease ◽  
Rank Test ◽  
Clinical Trial Registry ◽  
Diabetic Kidney ◽  
Bold Mri ◽  
Log Rank Test

Abstract Background Noninvasive evaluation of hypoxia and fibrosis in kidney simultaneously by functional magnetic resonance imaging (MRI) to predict the prognosis of patients in prospective diabetic kidney disease (DKD) cohort has not been reported. We aim to assess the prediction value of blood oxygen level-dependent (BOLD) MRI and intravoxel incoherent motion (IVIM) diffusion-weighted image (DWI) in the prognosis of DKD.Methods 77 patients with diabetes mellitus (67 with DKD) were enrolled in this prospective cohort study in single center. BOLD-MRI and IVIM-DWI were used to assess renal hypoxia and fibrosis. A well-validated, reproducible method called twelve-layer concentric objects (TLCO) was applied to quantify the R2* values of BOLD (corresponds to oxygenation) and D values of IVIM (corresponds to fibrosis) derived from MRI. All patients received standard medical care according to guideline during study and followed up for 24.8 ± 12.6 months. The primary end points were serum creatinine (Scr) increasing > 30%, ERSD, or death.Results Our data demonstrated that medullary R2* value (MR2*) was significantly higher and cortical D value (CD) was markedly lower in DKD than those of diabetic controls, and strongly correlated with estimated glomerular filtration rate. Both the higher MR2* (log-rank test, P < 0.001) and the lower CD (log-rank test, P < 0.001) predicted a worse outcome of DKD. The corresponding areas under the curve (AUC) were 0.80 [95% confidence interval (CI) 0.69–0.89] and 0.77 (95% CI 0.64–0.89) respectively. Importantly, combination of MR2* and CD exhibited a more significant efficiency (AUC 0.85, 95% CI 0.74–0.95) than each of them respectively in predicting the outcomes of DKD.Conclusions Integrating BOLD-MRI and IVIM-DWI quantified by TLCO was more efficient than each single of them in assessment of renal outcomes; thus, could be a noninvasive tool to predict the prognosis of DKD.Trial registration The study protocol was registered at the Chinese Clinical Trial Registry Center (NO: ChiCTR-RRC-17012687; date of registration: 16/09/2017).

scholarly journals Clinical outcomes of colistin in combination with either 6-g sulbactam or carbapenems for the treatment of extensively drug-resistant Acinetobacter baumannii pneumonia with high MIC to sulbactam, a prospective cohort study

2019 ◽  
Author(s):  
Chutchawan Ungthammakhun ◽  
Vasin Vasikasin ◽  
Dhitiwat Changpradub
Keyword(s):  
Cohort Study ◽  
Length Of Stay ◽  
Acinetobacter Baumannii ◽  
Clinical Outcomes ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Mortality Rates ◽  
P Value ◽  
Drug Resistant ◽  
Extensively Drug Resistant

Abstract Background: Extensively drug-resistant Acinetobacter baumannii (XDRAB) is an important cause of nosocomial pneumonia with limited therapeutic options. Colistin based regimen is recommended treatment. Which drugs should be combined with colistin remains uncertain. The aim of this study was to investigate the clinical outcomes of patients with XDRAB pneumonia who were treated with colistin, combined with either 6-g sulbactam or carbapenems, in the setting of high MIC to sulbactam. Methods: In this prospective cohort study, hospitalized patients diagnosed with XDRAB pneumonia in Phramongkutklao Hospital were enrolled. The primary outcome was the 28-day mortality. Secondary outcomes were 7 and 14-day mortality, length of stay, ventilator days and factors associated with mortality. Results: From 1 July 2016 to 30 September 2017, 192 patients were included; 92 received colistin plus sulbactam and 90 received colistin plus carbapenems. Most of the patients were male diagnosed with ventilator associated pneumonia in medical intensive care unit. Overall mortality rates at 7, 14, 28 days were 24.2%, 37.4%, 53.3%, respectively. Mortality rates did not differ between sulbactam group and carbapenems groups at 7 days (19.6% vs. 28.9%, p-value 0.424, adjusted HR 1.277; 95% CI = 0.702-2.322), 14 days (34.8% vs. 40%, p = 0.658, adjusted HR 1.109; 95% CI = 0.703-1.749) and 28 days (51.1% vs. 55.6%, p = 0.857, adjusted HR 1.038; 95% CI = 0.690-1.562). Length of stay, ICU days and ventilator days did not differ. Complications of treatment including acute kidney injury were not statistically different. Conclusions: In XDRAB pneumonia with high MIC to sulbactam, mortality rates were not statistically significant between colistin plus 6-g sulbactam and colistin plus carbapenems. Keywords: XDR A. baumannii pneumonia, mortality rate, colistin based, sulbactam, carbapenems

Gestational metabolic syndrome and neonatal anthropometric indices: a prospective cohort study

2021 ◽  
Vol 29 (7) ◽  
pp. 386-391
Author(s):  
Zeinab Hatamian ◽  
Lida Moghaddam-Banaem ◽  
Samira Mokhlesi ◽  
Marzieh Saei Ghare Naz
Keyword(s):  
Metabolic Syndrome ◽  
Cohort Study ◽  
Birth Weight ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Linear Regression Analysis ◽  
First Trimester ◽  
P Value ◽  
Anthropometric Parameters ◽  
First Trimester Of Pregnancy

Background and aim There is limited knowledge about the effect of maternal metabolic syndrome (MetS) on the anthropometric parameters of newborns. Therefore, the authors aimed to evaluate the association between MetS in the first trimester of pregnancy with weight and height of the newborn. Methods This prospective cohort study was conducted on 455 pregnant women in Tehran during their first trimester of pregnancy. MetS was defined as the coexistence of three or more of the following criteria: fasting blood sugar (FBS) level ≥92 mg/dl, blood pressure ≥130.85 mm/hg, triglyceride ≥150 mg/dl, high density lipoprotein ≤50 mg/dl, and body mass index (BMI) ≥30 kg/m2. All participants were followed up to childbirth. After birth, the baby's weight and height data were collected from the birth certificate. Results Linear regression analysis showed FBS (ß: 0.100, p-value: 0.038), BMI (ß: 0.139, p-value: 0.004), and MetS (ß: -0.122, p-value: 0.015) were significantly associated with birth weight but no statistically significant results were found for birth height. Conclusion MetS and some of its components in pregnancy can affect birth weight of neonates.

scholarly journals Prevalence and clinical predictors for early post-operative urinary retention in patients undergoing pelvic reconstructive surgeries: a prospective cohort study

2018 ◽  
Vol 7 (4) ◽  
pp. 1452
Author(s):  
Annie P. Vijjeswarapu ◽  
Vaibhav Londhe ◽  
Mahasampath Gowri ◽  
Aruna Kekre ◽  
Nitin Kekre
Keyword(s):  
Cohort Study ◽  
Pelvic Organ Prolapse ◽  
Urinary Retention ◽  
Prospective Cohort Study ◽  
Reconstructive Surgery ◽  
Prospective Cohort ◽  
Pelvic Organ ◽  
P Value ◽  
Pelvic Reconstructive Surgery ◽  
Clinical Predictors

Background: Pelvic organ prolapse (POP) has a significant impact on quality of life. Post-operative voiding dysfunction is seen in 2.5 to 24% of patients following pelvic reconstructive surgery. Risk factors like age of the patient, size of the genital hiatus and stage of prolapse are known to be associated with early post-operative voiding disorders.Methods: This is a prospective cohort study done in Christian Medical College, Vellore over one year. Patients with stage II to IV pelvic organ prolapse who underwent pelvic reconstructive surgery were observed post operatively for covert and overt urinary retention. Inability to void accompanied by pain and discomfort is defined as overt retention. Early post-operative urinary retention (POUR) is retention of urine in the first 72 hours postoperatively. Covert retention is defined as a non-painful bladder with chronic high post void residue. Chi- square test or Fisher’s exact test was used to assess the association between the clinical predictors and early post-operative urinary retention in univariate analysis.Results: In this study, 75 patients were recruited. Nine patients had POUR. Among the patients who had post-operative urinary retention, 77.78% had stage III pelvic organ prolapse (n=7). P value was 0.042. The prevalence of early POUR after pelvic reconstructive surgery was 12.85 % (n=9). A 55.55% had covert retention (n=5) and 44.44% patients had overt retention (n=4).Conclusions: The prevalence of early POUR after pelvic reconstructive surgery was 12.85%. Stage of the prolapse was an independent predictor for early postoperative urinary retention.

scholarly journals Psychosocial factors and hospitalisations for COVID-19: Prospective cohort study of the general population

2020 ◽  
Author(s):  
George David Batty ◽  
Ian Deary ◽  
Michelle Luciano ◽  
Drew Altschul ◽  
Mika Kivimaki ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cognitive Function ◽  
Psychosocial Factors ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Area Deprivation ◽  
P Value ◽  
Numerical Reasoning ◽  
Statistical Adjustment ◽  
And Performance

Objective: To examine the association of a range of psychosocial factors with hospitalisation for COVID-19. Design: Prospective cohort study. Setting: England. Participants: UK Biobank comprises around half a million people who were aged 40 to 69 years at study induction between 2006 and 2010 when information on psychosocial factors and covariates were captured. Main outcome measure: Hospitalisation for COVID-19 in England between 16th March and 26th April 2020 as provided by Public Health England. Results: There were 908 hospitalisations for COVID-19 in an analytical sample of 431,051 people. In age- and sex-adjusted analyses, an elevated risk of COVID-19 was related to disadvantaged levels of education (odds ratio; 95% confidence interval: 2.05; 1.70, 2.47), income (2.00; 1.63, 2,47), area deprivation (2.20; 1.86, 2.59), occupation (1.39; 1.14, 1.69), psychological distress (1.58; 1.32, 1.89), mental health (1.50; 1.25, 1.79), neuroticism (1.19; 1.00, 1.42), and performance on two tests of cognitive function: verbal and numerical reasoning (2.66; 2.06, 3.34) and reaction speed (1.27; 1.08, 1.51). These associations were graded (p-value for trend <=0.038) such that effects were apparent across the full psychosocial continua. After mutual adjustment for these characteristics plus ethnicity, comorbidity, and lifestyle factors, only the relationship between lower cognitive function as measured using the reasoning test and a doubling in the risk of the infection remained (1.98; 1.38, 2.85). Conclusion: A range of psychosocial factors revealed associations with hospitalisations for COVID-19 of which the relation with cognitive function was most robust to statistical adjustment.

scholarly journals Utilization of Offset Iliac Connectors as Anchoring Sites in Severe Rigid Scoliosis: New Technique

2020 ◽  
pp. 219256822091423
Author(s):  
Ahmed Barakat ◽  
Yasser El Mansy ◽  
Hesham El Saghir
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Posterior Instrumentation ◽  
Statistical Significance ◽  
Neurological Complications ◽  
P Value ◽  
Severe Scoliosis ◽  
Screw Density

Study Design: This was a prospective cohort study. Objectives: To introduce the iliac connectors as fixation options in spinal constructs used for correction of severe scoliosis at locations other than the lumbopelvic region. Methods: Nine patients with severe rigid scoliosis undergoing surgical release and posterior instrumentation in the period between January 2013 and January 2015 were included in this prospective cohort study. Mean age was 18.4 years; 8 had triple structural curves, and the remaining patient had double structural curves. Cobb angles of the primary and compensatory curves were compared with the immediate, 1-year, and 2-year postoperative measurements using the F test, with P value ≤.05 indicating statistical significance. Screw densities of the final constructs were calculated and compared with the screw densities when the offset iliac connectors were not used. Results: One to 4 offset iliac connectors were used in all 9 patients, increasing screw density by a mean of 6.24 ( P < .001). The mean Cobb angle of the major curve was corrected from 98.44° to 58.2° ( P < .001), that of the first compensatory curve, from 56.55° to 38.33° ( P < .001), and that of the second compensatory curve, from 40.75° to 26.63° ( P < .001). There were no intraoperative neurological complications. After a mean follow-up of 30.6 months, the construct remained stable in all patients with no loss of correction. Conclusion: Offset iliac connectors can be a valuable tool to increase screw density in correction of severe scoliosis, thus increasing overall biomechanical strength of the final construct.

scholarly journals Accelerated cardiovascular risk after viral clearance in hepatitis C patients with the NAMPT-rs61330082 TT genotype: An 8-year prospective cohort study

Virulence ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 270-280
Author(s):  
Ming-Ling Chang ◽  
Yu-Sheng Lin ◽  
Ming-Yu Chang ◽  
Chia-Lin Hsu ◽  
Rong-Nan Chien ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cardiovascular Risk ◽  
Hepatitis C ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Viral Clearance
Sign in / Sign up

Export Citation Format

Share Document