scholarly journals Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry

2020 ◽  
Author(s):  
Jesús Díez-Manglano ◽  
Marta Nataya Solís Marquínez ◽  
Andrea Álvarez García ◽  
Nicolás Alcalá-Rivera ◽  
Irene Maderuelo Riesco ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Healthcare Workers ◽  
Clinical Laboratory ◽  
Population Data ◽  
Clinical Severity ◽  
Multivariate Logistic Regression Model ◽  
Risk Of Death ◽  
Professional Exposure ◽  
Treatment Data ◽  
Observational Cohort

ABSTRACTAimTo determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW).MethodsObservational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20-65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality.ResultsAs of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p=0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.219, 95%CI 0.069-0.693, p=0.01). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001).ConclusionsHospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality.

scholarly journals Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247422
Author(s):  
Jesús Díez-Manglano ◽  
Marta Nataya Solís-Marquínez ◽  
Andrea Álvarez García ◽  
Nicolás Alcalá-Rivera ◽  
Irene Maderuelo Riesco ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Healthcare Workers ◽  
Clinical Laboratory ◽  
Population Data ◽  
Clinical Severity ◽  
Multivariate Logistic Regression Model ◽  
Risk Of Death ◽  
Professional Exposure ◽  
Treatment Data ◽  
Observational Cohort

Aim To determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW). Methods Observational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20–65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality. Results As of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p = 0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.211, 95%CI 0.067–0.667, p = 0.008). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001). Conclusions Hospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality.

scholarly journals Convalescent Plasma Reduces Mortality and Decreases Hospitalization Stay in Patients with Moderate COVID-19 Pneumonia

Metabolites ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 761
Author(s):  
Maamoun Basheer ◽  
Elias Saad ◽  
Dorin Shlezinger ◽  
Nimer Assy
Keyword(s):  
Clinical Laboratory ◽  
Wide Spectrum ◽  
Clinical Severity ◽  
Upper Respiratory Tract ◽  
Elderly Age ◽  
Plasma Therapy ◽  
Risk Of Death ◽  
Respiratory Tract Illnesses ◽  
Study Population ◽  
Discriminant Analyses

Humans infected with SARS-CoV-2 may develop COVID-19, which manifests across a wide spectrum of clinical severity ranging from mild upper respiratory tract illnesses to diffuse viral pneumonia, causing acute respiratory failure. Many therapies have been tested for their efficacy in treating COVID-19. Controversy surrounds convalescent plasma transfusions as an effective treatment for COVID-19. This study discusses the efficacy of this treatment on COVID-19 patients. Electronic medical record data were collected from patients diagnosed with COVID-19, from November 2020 to August 2021, in the Galilee Medical Center’s COVID-19 departments. Epidemiological, clinical, laboratory and imaging variables were analyzed. Multivariate stepwise regression and discriminant analyses were used to identify and validate the correlation between convalescent treatment and either death or time to negative PCR and hospitalization length. The study population included 270 patients, 100 of them treated with convalescent plasma. The results show that convalescent plasma therapy significantly prevented mortality in moderate patients, reduced hospitalization length and time to negative PCR. Additionally, high BMI, elderly age, high CRP and 4C-scores correlated with the severity and mortality of COVID-19 patients. Convalescent plasma also significantly reduced inflammatory markers, especially in moderate COVID-19 patients. In non-critical hospitalized patients, convalescent plasma therapy reduces morbidity and mortality in moderate COVID-19 patients and hospitalization length. Identifying patients who could benefit from this treatment could reduce the risk of death and shorten their hospitalization stay.

scholarly journals Plasma IL-6/IL-10 Ratio and IL-8, LDH, and HBDH Level Predict the Severity and the Risk of Death in AIDS Patients withPneumocystisPneumonia

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Jia Sun ◽  
Junwei Su ◽  
Yirui Xie ◽  
Michael T. Yin ◽  
Ying Huang ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Oxygenation Index ◽  
Inverse Correlation ◽  
Clinical Severity ◽  
Clinical Parameters ◽  
Blood Biomarkers ◽  
Biochemical Indicators ◽  
Early Evaluation ◽  
Risk Of Death ◽  
Time Of Admission

Objective. To identify blood biomarkers to predict severity and mortality in AIDS PCP patients.Methods. Biomarkers including clinical parameters and plasma inflammatory cytokines were assessed in 32 HIV-infected patients withPneumocystispneumonia (PCP) at time of admission. Predictive value of the biomarkers for clinical severity and in-hospital mortality was evaluated by corresponding ROC curve.Results. Levels of CRP, WBC, LDH, HBDH, and Ferritin were significantly higher in the severe and nonsurvivor AIDS PCP patients. These important biochemical indicators have inverse correlation with oxygenation index, especially levels of LDH (P=0.008,R2=0.258), HBDH (P=0.001,R2=0.335), and Ferritin (P=0.005,R2=0.237). Plasma IL-8 and IL-6 levels were significantly higher in patients with PaO2/FiO2≤ 200 mmHg and nonsurvivors than in those with PaO2/FiO2> 200 mmHg and survivors. Severe and nonsurvival groups showed higher ratio of mean IL-6/IL-10 level (1.78 ± 1.56,P<0.001; 1.11 ± 0.72,P=0.043), larger AUC (95% CI 0.781–1.000,P<0.001; 95% CI 0.592–0.917,P=0.043), and more significantly inverse correlation with the oxygenation index.Conclusion. Plasma IL-8, LDH, and HBDH levels and IL-6/IL-10 ratio could be helpful for early evaluation of the severity and predicting fatal outcomes in AIDS PCP patients.

scholarly journals Emergency room comprehensive assessment of demographic, radiological, laboratory and clinical data of patients with COVID-19: determination of its prognostic value for in-hospital mortality

2021 ◽  
Author(s):  
Marco Gatti ◽  
Marco Calandri ◽  
Andrea Biondo ◽  
Carlotta Geninatti ◽  
Clara Piatti ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Emergency Room ◽  
Clinical Laboratory ◽  
Laboratory Data ◽  
Binary Logistic Regression ◽  
Integrated Approach ◽  
Roc Curve Analysis ◽  
Reactive Protein ◽  
Risk Of Death

AbstractMortality risk in COVID-19 patients is determined by several factors. The aim of our study was to adopt an integrated approach based on clinical, laboratory and chest x-ray (CXR) findings collected at the patient’s admission to Emergency Room (ER) to identify prognostic factors. Retrospective study on 346 consecutive patients admitted to the ER of two North-Western Italy hospitals between March 9 and April 10, 2020 with clinical suspicion of COVID-19 confirmed by reverse transcriptase-polymerase reaction chain test (RT-PCR), CXR performed within 24 h (analyzed with two different scores) and recorded prognosis. Clinical and laboratory data were collected. Statistical analysis on the features of 83 in-hospital dead vs 263 recovered patients was performed with univariate (uBLR), multivariate binary logistic regression (mBLR) and ROC curve analysis. uBLR identified significant differences for several variables, most of them intertwined by multiple correlations. mBLR recognized as significant independent predictors for in-hospital mortality age > 75 years, C-reactive protein (CRP) > 60 mg/L, PaO2/FiO2 ratio (P/F) < 250 and CXR “Brixia score” > 7. Among the patients with at least two predictors, the in-hospital mortality rate was 58% against 6% for others [p < 0.0001; RR = 7.6 (4.4–13)]. Patients over 75 years had three other predictors in 35% cases against 10% for others [p < 0.0001, RR = 3.5 (1.9–6.4)]. The greatest risk of death from COVID-19 was age above 75 years, worsened by elevated CRP and CXR score and reduced P/F. Prompt determination of these data at admission to the emergency department could improve COVID-19 pretreatment risk stratification.

scholarly journals Association of Mortality-Related Risk Factors in Patients with COVID-19: A Retrospective Cohort Study

Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1468
Author(s):  
Shazia Rehman ◽  
Nadia Rehman ◽  
Ayesha Mumtaz ◽  
Jindong Jiang
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Cardiovascular Diseases ◽  
Hospital Mortality ◽  
Troponin I ◽  
World Health ◽  
Multivariate Logistic Regression Model ◽  
Risk Of Death ◽  
Related Risk

COVID-19 is a rapidly disseminating infectious disease conferred by the World Health Organization (WHO) as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics data have been identified for patients with COVID-19, but mortality-related risk factors and a comprehensive clinical course of disease in a developing country have not been specifically defined. This retrospective, single-center cohort study involved all successive inpatients having a positive COVID-19 polymerase chain reaction (PCR), with deceased or discharged clinical outcomes from 1 January to 10 May 2021. Data were extracted from electronic medical records on demographic, clinical, radiological, and laboratory findings as well as complications faced and treatment provided during follow-up, involving serial samples for viral RNA identification, and compared between the dead and survivors. To investigate the risk factors associated with in-hospital mortality, we employed the multivariate logistic regression model. In this study, 2048 patients were involved, 1458 of whom were discharged, and 590 died in hospital. More than half of patients were identified as male with old age being the potential risk factor of mortality. Exactly 94.8% of all patients presented with fever at the time of admission. Several comorbidities were present in the study population, with the most frequent comorbidity being cardiovascular diseases (1177 of 2048) and hypertension (975 of 2048) followed by cerebrovascular disease and diabetes mellitus. Mortality rates for infected patients were observed as higher in severe patients (46.3%) compared with non-severe cases (26.1%) during a follow-up. Multivariate regression analysis showed a significant association of in-hospital mortality of patients with older age, presence of hypertension and cardiovascular diseases as underlying comorbidities, increased level of cardiac troponin I and d-dimer concentration on admission, as well as septicemia and ARDS as a complication during illness. To minimize the risk of death in COVID19 patients, as well as the risk of severe complications, urgent public health measures should be properly planned and implemented on those vulnerable populations. To detect early manifestations of clinical problems, thorough and regular follow-up is warranted.

scholarly journals The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Antoni Torres ◽  
Anna Motos ◽  
Jordi Riera ◽  
Laia Fernández-Barat ◽  
Adrián Ceccato ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Cohort Study ◽  
Prognostic Factor ◽  
Hospital Mortality ◽  
Clinical Data ◽  
Observational Cohort Study ◽  
Mechanically Ventilated ◽  
Icu Admission ◽  
Risk Of Death ◽  
Observational Cohort

Abstract Background Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0–171.2] to 180.0 [135.4–227.9] mmHg and the ventilatory ratio from 1.73 [1.33–2.25] to 1.96 [1.61–2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01–1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01–1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93–1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation.

scholarly journals Recognition in Emergency Department of Septic Patients at Higher Risk of Death: Beware of Patients without Fever

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 612
Author(s):  
Emanuela Sozio ◽  
Alessio Bertini ◽  
Giacomo Bertolino ◽  
Francesco Sbrana ◽  
Andrea Ripoli ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hospital Mortality ◽  
Protective Factor ◽  
Early Recognition ◽  
Multivariate Logistic Regression Model ◽  
Multivariate Logistic Regression ◽  
Sepsis Management ◽  
Risk Of Death ◽  
Mortality Outcome ◽  
Prompt Diagnosis

Background and Objectives: Chances of surviving sepsis increase markedly upon prompt diagnosis and treatment. As most sepsis cases initially show-up in the Emergency Department (ED), early recognition of a septic patient has a pivotal role in sepsis management, despite the lack of precise guidelines. The aim of this study was to identify the most accurate predictors of in-hospital mortality outcome in septic patients admitted to the ED. Materials and Methods: We compared 651 patients admitted to ED for sepsis (cases) with 363 controls (non-septic patients). A Bayesian mean multivariate logistic regression model was performed in order to identify the most accurate predictors of in-hospital mortality outcomes in septic patients. Results: Septic shock and positive qSOFA were identified as risk factors for in-hospital mortality among septic patients admitted to the ED. Hyperthermia was a protective factor for in-hospital mortality. Conclusions: Physicians should bear in mind that fever is not a criterium for defining sepsis; according to our results, absence of fever upon presentation might be indicative of greater severity and diagnosis of sepsis should not be delayed.

scholarly journals Prevalence and Course of IgA and IgG Antibodies against SARS-CoV-2 in Healthcare Workers during the First Wave of the COVID-19 Outbreak in Germany: Interim Results from an Ongoing Observational Cohort Study

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 498
Author(s):  
Mark Reinwald ◽  
Peter Markus Deckert ◽  
Oliver Ritter ◽  
Henrike Andresen ◽  
Andreas G. Schreyer ◽  
...  
Keyword(s):  
Cohort Study ◽  
Healthcare Workers ◽  
Significant Proportion ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Observational Cohort Study ◽  
Igg Antibodies ◽  
University Hospitals ◽  
Observational Cohort

(1) Background: Healthcare workers (HCWs) are prone to intensified exposure to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in the ongoing pandemic. We prospectively analyzed the prevalence of antibodies against SARS-CoV-2 in HCWs at baseline and follow up with regard to clinical signs and symptoms in two university hospitals in Brandenburg, Germany. (2) Methods: Screening for anti-SARS-CoV-2 IgA and IgG antibodies was offered to HCWs at baseline and follow up two months thereafter in two hospitals of Brandenburg Medical School during the first wave of the COVID-19 pandemic in Germany in an ongoing observational cohort study. Medical history and signs and symptoms were recorded by questionnaires and analyzed. (3) Results: Baseline seroprevalence of anti-SARS-CoV-2 IgA was 11.7% and increased to 15% at follow up, whereas IgG seropositivity was 2.1% at baseline and 2.2% at follow up. The rate of asymptomatic seropositive cases was 39.5%. Symptoms were not associated with general seropositivity for anti-SARS-CoV-2; however, class switch from IgA to IgG was associated with increased symptom burden. (4) Conclusions: The seroprevalence of antibodies against SARS-CoV-2 was low in HCWs but higher compared to population data and increased over time. Screening for antibodies detected a significant proportion of seropositive participants cases without symptoms.

scholarly journals Impact of peripheral muscle strength on prognosis after extubation and functional outcomes in critically ill patients: a feasibility study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tsung-Hsien Wang ◽  
Chin-Pyng Wu ◽  
Li-Ying Wang
Keyword(s):  
Muscle Strength ◽  
Hospital Mortality ◽  
Functional Outcomes ◽  
Extubation Failure ◽  
General Ward ◽  
Walk Test ◽  
Peripheral Muscle ◽  
Observational Cohort ◽  
Minute Walk ◽  
Overall Mortality

AbstractThe influence of peripheral muscle strength on prognosis after extubation and subsequent functional outcomes is not evident. The objectives of this study were to determine (1) whether peripheral muscle strength can be used as a predictor for patients’ prognoses after extubation, and (2) whether the peripheral muscle strength before extubation is correlated with patients’ subsequent ambulation ability and in-hospital mortality. This study was a prospective observational cohort study. A hand-held dynamometer was used for evaluated the muscle strength of the biceps and quadriceps right before extubation. Besides, after the patients had been transferred from the ICU to the general ward, a 2-minute walk test was performed. A total of 52 patients were enrolled in this study, and the rate of extubation failure was 15%. The muscle strength of the quadriceps was significantly correlated with the prognosis after extubation, 48% of the patients were able to ambulate after being transferred to the general ward. The overall mortality rate was 11%, and there was a significant correlation between the biceps muscle strength and in-hospital mortality. Peripheral muscle strength may serve as an important predictor of a patients’ prognoses after extubation. Poor peripheral muscle strength is indicative of not only a higher risk of re-intubation but also higher in-hospital mortality and poorer functional outcomes.Trial registration: ISRCTN16370134. Registered 30 May 2019, prospectively registered. https://www.isrctn.com/ISRCTN16370134.

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