scholarly journals Demographic and clinical features associated with in-hospital mortality in Egyptian COVID-19 patients: A retrospective cohort study

2021 ◽  
Author(s):  
Noha Asem ◽  
Mohamed Hassany ◽  
Khaled Taema ◽  
Hossam Masoud ◽  
Gehan Elassal ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Hospital Mortality ◽  
Clinical Laboratory ◽  
Strong Association ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Neutrophil Lymphocyte Ratio ◽  
Artery Disease ◽  
Study Participants ◽  
Ct Finding

Introduction: Since the worldwide emergence of the COVID-19, several protocols were used by different healthcare organisations. We evaluated in this study the demographic and clinical characteristics of COVID-19 disease in Egyptian population with special consideration for its mortality predictors. Methodology: 8162 participants (mean age 48.7 years,54.5% males) with RT-PCR positive COVID-19 were included. The electronic medical records were reviewed for demographic, clinical, laboratory, and radiologic features. The primary outcome was the in-hospital mortality rate. Results: The in-hospital mortality was 11.2%. There was a statistically significant strong association of in-hospital mortality with age >60 years old (OR:4.7; 95% CI 4.1-5.4;p<0.001), diabetes mellitus (OR:4.6; 95% CI 3.99-5.32;p<0.001), hypertension (OR:3.9; 95% CI 3.4-4.5;p<0.001), coronary artery disease (OR:2.7; 95% CI 2.2-3.2;p<0.001), chronic obstructive pulmonary disease (OR:2.1; 95% CI 1.7-2.5;p<0.001), chronic kidney disease (OR:4.8; 95% CI 3.9-5.9;p<0.001), malignancy (OR:3.7; 95% CI 2.3-5.75;p<0.001), neutrophil-lymphocyte ratio >3.1 (OR:6.4; 95% CI 4.4-9.5;P< 0.001), and ground glass opacities (GGOs) in CT chest (OR:3.5; 95% CI 2.84-4.4;P<0.001), respectively. There was a statistically significant moderate association of in-hospital mortality with male gender (OR:1.6; 95% CI 1.38-1.83;p<0.001) and smoking (OR:1.6; 95% CI 1.3-1.9;p<0.001). GGOs was reported as the most common CT finding (occurred in 73.1% of the study participants). Conclusions: This multicenter, retrospective study ascertained the higher in-hospital mortality rate in Egyptian COVID-19 patients with different comorbidities.

scholarly journals Demographic and Clinical Features Associated with in-Hospital Mortality in Egyptian COVID-19 Patients: A Retrospective Cohort Study

2021 ◽  
Vol 9 (E) ◽  
pp. 1068-1075
Author(s):  
Noha Asem ◽  
Mohamed Hassany ◽  
Khaled Taema ◽  
Hossam Masoud ◽  
Gehan Elassal ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Hospital Mortality ◽  
Clinical Laboratory ◽  
Strong Association ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Neutrophil Lymphocyte Ratio ◽  
Artery Disease ◽  
Study Participants ◽  
Ct Finding

Aim: We evaluated in this study the demographic and clinical characteristics of COVID-19 disease in Egyptian population with special consideration for its mortality predictors. Methods: 8162 participants (mean age 48.7±17.3 years,54.5% males) with RT-PCR positive COVID-19 were included. The electronic medical records were reviewed for demographic, clinical, laboratory, and radiologic features. The primary outcome was the in-hospital mortality rate. Results: The in-hospital mortality was 11.2%. There was a statistically significant strong association of in-hospital mortality with age >60 years old (OR:4.7; 95% CI 4.1-5.4;p<0.001), diabetes mellitus (OR:4.6; 95% CI 3.99-5.32;p<0.001), hypertension (OR:3.9; 95% CI 3.4-4.5;p<0.001), coronary artery disease (OR:2.7; 95% CI 2.2-3.2;p<0.001), chronic obstructive pulmonary disease (OR:2.1; 95% CI 1.7-2.5;p<0.001), chronic kidney disease (OR:4.8; 95% CI 3.9-5.9;p<0.001), malignancy (OR:3.7; 95% CI 2.3-5.75;p<0.001), neutrophil-lymphocyte ratio >3.1 (OR:6.4; 95% CI 4.4-9.5;P< 0.001), and ground glass opacities (GGOs) in CT chest (OR:3.5; 95% CI 2.84-4.4;P<0.001), respectively. There was a statistically significant moderate association of in-hospital mortality with male gender (OR:1.6; 95% CI 1.38-1.83;p<0.001) and smoking (OR:1.6; 95% CI 1.3-1.9;p<0.001). GGOs was reported as the most common CT finding (occurred in 73.1% of the study participants). Conclusion: This multicenter, retrospective study ascertained the higher in-hospital mortality rate in Egyptian COVID-19 patients with different comorbidities.

scholarly journals The usefulness of Shock Index and Modified Shock Index in predicting outcome of COVID-19 patients

2021 ◽  
pp. 1-16
Author(s):  
Erdem KURT ◽  
Suphi BAHADIRLI
Keyword(s):  
Hospital Mortality ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Male Gender ◽  
Chronic Obstructive ◽  
Shock Index ◽  
Obstructive Pulmonary Disease ◽  
Predicting Outcome ◽  
The Mean ◽  
Artery Disease

Abstract Objective: The aim of this study is to investigate the accuracy of shock index (SI) and modified shock index (mSI) in predicting intensive care unit (ICU) requirement and in-hospital mortality among COVID-19 patients who admitted to the emergency department (ED). Likewise, the effects of patients’ conditions such as age, gender and comorbidity on prognosis will be analyzed. Methods: The files were retrospectively scanned for all COVID-19 patients over the age of 18 who were admitted to the ED and hospitalized between January 1, 2021 and March 15, 2021. The area under the receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to assess each scoring system discriminatory for predicting in-hospital mortality and ICU admission. Results: There were 464 patients included in this study. The mean age of the patients was 62.4±16.7, of which 245 were men and 219 were women. The most common comorbidity in patients was hypertension 200 (43.1%), followed by chronic obstructive pulmonary disease 174 (37.5%) and coronary artery disease 154 (33.2%). In terms of in-hospital mortality, the AUC of SI, and mSI were 0.719, and 0.739, respectively. In terms of ICU requirement, the AUC of SI, and mSI were 0.704, and 0.729, respectively. Conclusions: In this study, it was concluded that SI and mSI are useful in predicting in-hospital mortality and ICU requirement in COVID-19 patients. In addition, it is another important result of the study that advanced age, male gender and hypertension may be associated with poor prognosis.

Influence of Comorbidities on Hospital Mortality and Healthcare Utilization in Hospitalized Chronic Obstructive Pulmonary Disease Patients

2020 ◽  
Vol 103 (7) ◽  
Keyword(s):  
Atrial Fibrillation ◽  
Chronic Obstructive Pulmonary Disease ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Hospital Mortality ◽  
Healthcare Utilization ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Artery Disease

Background: Comorbidities of chronic obstructive pulmonary disease (COPD) are associated with both increased short-term and long-term mortality. However, information on regarding the influence of comorbidities on hospital mortality and healthcare utilization remain limited. Objective: To evaluate the influence of COPD and comorbidities associated with increased risk of hospital mortality and healthcare utilization. Materials and Methods: A retrospective cohort study was performed on COPD patients admitted to the Chiang Mai University Hospital between 2007 and 2013. Logistic regression was performed to identify independent comorbidities that increased the risk of hospital mortality and influenced healthcare utilization. Results: The present study involved 739 COPD patients with 1,099 visits. The hospital mortality rate was 12.3%. The comorbidities associated with increased hospital mortality were depression (odds ratio [OR] 8.61, 95% confidence interval [CI] 1.66 to 43.95, p=0.010), atrial fibrillation (OR 2.37, 95% CI 1.33 to 4.21, p=0.003), and coronary artery disease (OR 1.85, 95% CI 1.03 to 3.32, p=0.04). The comorbidities were also associated with increased hospital length of stay [7 (3 to 12) versus 5 (3 to 8) days, p=0.001], mechanical ventilation days [5 (2 to 13) versus 3 (2 to 6) days, p=0.029], and total hospital costs [915.1 (401.2 to 2,258.4) versus 562.1 (338.1 to 1,372.9) USD, p=0.010]. In addition, comorbidities were associated with increased hospital mortality (one and two comorbidities: OR 2.06, 95% CI 1.24 to 3.43, p=0.005 and OR 5.47, 95% CI 2.07 to 14.47, p=0.001, respectively). Conclusion: The COPD comorbidities, which are depression, atrial fibrillation, and coronary artery disease, were associated with increased hospital mortality and healthcare utilization. Keywords: COPD, Comorbidity, Mortality, Healthcare utilization

scholarly journals Characteristics and outcomes in acute patients receiving mechanical ventilation in a Coronary Care Unit (CCU)

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
M Rivadeneira Ruiz ◽  
DF Arroyo Monino ◽  
T Seoane Garcia ◽  
MP Ruiz Garcia ◽  
JC Garcia Rubira
Keyword(s):  
Mechanical Ventilation ◽  
Cardiac Arrest ◽  
Hospital Mortality ◽  
Coronary Care Unit ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Funding Sources ◽  
Copd Patients ◽  
The Mean ◽  
Coronary Care

Abstract Funding Acknowledgements Type of funding sources: None. Objectives Mechanical ventilation is the short-term technical support most widely used and cardiac arrest its main indication in a Coronary Care Unit (CCU). However, the knowledge about the specific moment and ventilator mode of onset to avoid the acute lung injury is still equivocal. Our objective is to determine the survival rate and the prognostic factors in patients supported by mechanical ventilation. Methods We conducted a retrospective cohort study of adult patients admitted to the CCU between January 2018 and November 2020 that received mechanical ventilation during the hospital stay. Results We collected 94 patients, 28% females with a median age of 68 ± 11,9. 43% were diabetics and almost one quarter of them had some degree of chronic obstructive pulmonary disease (COPD). Ischemic cardiopathy (33%) and heart failure (31%) were frequent pathologies as well as renal injury (29% patients a filtration rate below 45 mL/min/1,73m2). The reason for initiating mechanical ventilation was cardiac arrest in the half of the patients. Volume-controlled ventilation (73%) was the initial setting mode in most cases. The support with vasoactive drugs were highly necessary in these patients (Infection rate of 48%). In the subgroup analysis, we realized that the number of reintubations and the necessity of non-invasive ventilation were higher in the COPD group (p = 0,01), as well as tracheostomy (p = 0,03). COPD patients also needed higher maintaining PEEP, though this was not statistically significant. The mean length of stay in the intensive care unit of our cohort was 11 days (range: 1-78 days; median: 8 days) and the mean length of mechanical ventilation 6 days (range: 1-64 days; median: 3 days). The in-hospital mortality was 41,4%. Conclusions Cardiac arrest is the most common reason of mechanical ventilation support. Our study showed that COPD patients presented more complications during the weaning and the period after extubation. In-hospital mortality remains high in intubated patients.

scholarly journals All-cause mortality and location of death in patients with established cardiovascular disease before, during, and after the COVID-19 lockdown: a Danish Nationwide Cohort Study

2021 ◽  
Author(s):  
Jawad H Butt ◽  
Emil L Fosbøl ◽  
Thomas A Gerds ◽  
Charlotte Andersson ◽  
Kristian Kragholm ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Location Of Death ◽  
All Cause Mortality ◽  
History Of ◽  
Adjusted Incidence Rate ◽  
Artery Disease ◽  
Adjusted Incidence ◽  
Overall Mortality

Abstract Background On 13 March 2020, the Danish authorities imposed extensive nationwide lockdown measures to prevent the spread of the coronavirus disease 2019 (COVID-19) and reallocated limited healthcare resources. We investigated mortality rates, overall and according to location, in patients with established cardiovascular disease before, during, and after these lockdown measures. Methods and results Using Danish nationwide registries, we identified a dynamic cohort comprising all Danish citizens with cardiovascular disease (i.e. a history of ischaemic heart disease, ischaemic stroke, heart failure, atrial fibrillation, or peripheral artery disease) alive on 2 January 2019 and 2020. The cohort was followed from 2 January 2019/2020 until death or 16/15 October 2019/2020. The cohort comprised 340 392 and 347 136 patients with cardiovascular disease in 2019 and 2020, respectively. The overall, in-hospital, and out-of-hospital mortality rate in 2020 before lockdown was significantly lower compared with the same period in 2019 [adjusted incidence rate ratio (IRR) 0.91, 95% confidence interval (CI) CI 0.87–0.95; IRR 0.95, 95% CI 0.89–1.02; and IRR 0.87, 95% CI 0.83–0.93, respectively]. The overall mortality rate during and after lockdown was not significantly different compared with the same period in 2019 (IRR 0.99, 95% CI 0.97–1.02). However, the in-hospital mortality rate was lower and out-of-hospital mortality rate higher during and after lockdown compared with the same period in 2019 (in-hospital, IRR 0.92, 95% CI 0.88–0.96; out-of-hospital, IRR 1.04, 95% CI1.01–1.08). These trends were consistent irrespective of sex and age. Conclusions Among patients with established cardiovascular disease, the in-hospital mortality rate was lower and out-of-hospital mortality rate higher during lockdown compared with the same period in the preceding year, irrespective of age and sex.

scholarly journals An Emerging Syndemic of Smoking and Cardiopulmonary Diseases in People Living with HIV in Africa

2021 ◽  
Vol 18 (6) ◽  
pp. 3111
Author(s):  
Emmanuel Peprah ◽  
Mari Armstrong-Hough ◽  
Stephanie H. Cook ◽  
Barbara Mukasa ◽  
Jacquelyn Y. Taylor ◽  
...  
Keyword(s):  
Current Evidence ◽  
Chronic Obstructive ◽  
People Living With Hiv ◽  
African Countries ◽  
Obstructive Pulmonary Disease ◽  
Cardiopulmonary Disease ◽  
Current Trends ◽  
Significant Public Health ◽  
Artery Disease ◽  
Living With Hiv

Background: African countries have the highest number of people living with HIV (PWH). The continent is home to 12% of the global population, but accounts for 71% of PWH globally. Antiretroviral therapy has played an important role in the reduction of the morbidity and mortality rates for HIV, which necessitates increased surveillance of the threats from pernicious risks to which PWH who live longer remain exposed. This includes cardiopulmonary comorbidities, which pose significant public health and economic challenges. A significant contributor to the cardiopulmonary comorbidities is tobacco smoking. Indeed, globally, PWH have a 2–4-fold higher utilization of tobacco compared to the general population, leading to endothelial dysfunction and atherogenesis that result in cardiopulmonary diseases, such as chronic obstructive pulmonary disease and coronary artery disease. In the context of PWH, we discuss (1) the current trends in cigarette smoking and (2) the lack of geographically relevant data on the cardiopulmonary conditions associated with smoking; we then review (3) the current evidence on chronic inflammation induced by smoking and the potential pathways for cardiopulmonary disease and (4) the multifactorial nature of the syndemic of smoking, HIV, and cardiopulmonary diseases. This commentary calls for a major, multi-setting cohort study using a syndemics framework to assess cardiopulmonary disease outcomes among PWH who smoke. Conclusion: We call for a parallel program of implementation research to promote the adoption of evidence-based interventions, which could improve health outcomes for PWH with cardiopulmonary diseases and address the health inequities experienced by PWH in African countries.

scholarly journals The Association of Healthy Aging with Multimorbidity: IKARIA Study

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1386
Author(s):  
Alexandra Foscolou ◽  
Christina Chrysohoou ◽  
Kyriakos Dimitriadis ◽  
Konstantina Masoura ◽  
Georgia Vogiatzi ◽  
...  
Keyword(s):  
Chronic Diseases ◽  
Clinical Characteristics ◽  
Healthy Aging ◽  
Chronic Obstructive ◽  
Younger Adults ◽  
Obstructive Pulmonary Disease ◽  
Aging Index ◽  
Unit Increase ◽  
Depression Symptomatology ◽  
Study Participants

The aim of this study was to evaluate several sociodemographic, lifestyle, and clinical characteristics of the IKARIA study participants and to find healthy aging trajectories of multimorbidity of Ikarian islanders. During 2009, 1410 people (aged 30+) from Ikaria Island, Greece, were voluntarily enrolled in the IKARIA study. Multimorbidity was defined as the combination of at least two of the following chronic diseases: hypertension; hypercholesterolemia; diabetes; obesity; cancer; CVD; osteoporosis; thyroid, renal, and chronic obstructive pulmonary disease. A healthy aging index (HAI) ranging from 0 to 100 was constructed using 4 attributes, i.e., depression symptomatology, cognitive function, mobility, and socializing. The prevalence of multimorbidity was 51% among men and 65.5% among women, while the average number of comorbidities was 1.7 ± 1.4 for men and 2.2 ± 1.4 for women. The most prevalent chronic diseases among men with multimorbidity were hypertension, hypercholesterolemia, and obesity while among women they were hypertension, hypercholesterolemia, and thyroid disease. Multimorbidity was correlated with HAI (Spearman’s rho = −0.127, p < 0.001) and for every 10-unit increase in HAI, participants had 20% lower odds of being multimorbid. Multimorbidity in relation to HAI revealed a different trend across aging among men and women, coinciding only in the seventh decade of life. Aging is usually accompanied by chronic diseases, but multimorbidity seems to also be common among younger adults. However, healthy aging is a lifelong process that may lead to limited co-morbidities across the lifespan.

Abstract WP340: Prevalence and Influence of Chronic Obstructive Pulmonary Disease on Stroke Outcomes in Hospitalized Stroke Patients

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Oladimeji Akinboro ◽  
Odunayo Olorunfemi ◽  
Stanley Holstein ◽  
Daniel Pomerantz ◽  
Stephen Jesmajian ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Hospital Mortality ◽  
The United States ◽  
Mortality Rates ◽  
Chronic Obstructive ◽  
Stroke Patients ◽  
Obstructive Pulmonary Disease ◽  
Index Stroke ◽  
Nationally Representative ◽  
Shared Risk

Background: COPD recently overtook stroke as the third leading cause of death in the United States. Intriguingly, smoking is an important shared risk factor for both stroke and COPD; COPD patients have baseline cerebral hypoxia and hypercapnia that could potentially exacerbate vascular brain injury; and stroke patients with COPD are at higher risk of aspiration than those without COPD. Yet, relatively little is known about the prevalence of COPD among stroke patients or its impact on outcomes after an index stroke. Objective: To assess prevalence of COPD among hospitalized stroke patients in a nationally representative sample and examine the effect of COPD with risk of dying in the hospital after a stroke. Methods: Data were obtained for patients, 18 years and older, from the National Inpatient Sample from 2004-2009 (n=48,087,002). Primary discharge diagnoses of stroke were identified using ICD-9 diagnosis codes 430-432 and 433-436, of which a subset with comorbid COPD were defined with secondary ICD-9 diagnoses codes 490-492, 494, and 496. In-hospital mortality rates were calculated, and independent associations of COPD with in-hospital mortality following stroke were evaluated with logistic regression. All analysis were survey-weighted. Results: 11.71% (95% CI 11.48-11.94) of all adult patients hospitalized for stroke had COPD. The crude and age-adjusted in-hospital mortality rates for these patients were 6.33% (95% CI 6.14-6.53) and 5.99% (95% CI 4.05-7.94), respectively. COPD was independently and modestly associated with overall stroke mortality (OR 1.03, 95% CI 1.01-1.06; p=0.02). However, when analyzed by subtype, greater risks of mortality were seen in those with intracerebral hemorrhage (OR 1.12, 95% CI 1.03-1.20; p<0.01), and ischemic stroke (OR 1.08; 95% CI 1.03-1.13, p<0.01), but not subarachnoid hemorrhage (OR 0.98, 95% CI 0.85-1.13; p=0.78). There were no statistically significant interactions between COPD and age, gender, or race. Conclusion: 12% of hospitalized stroke patients have COPD. Presence of COPD is independently associated with higher odds of dying during ischemic stroke hospitalization. Prospective studies are needed to identify any modifiable risk factors contributing to this deleterious relationship.

scholarly journals High prevalence of undiagnosed COPD among patients evaluated for suspected myocardial ischaemia

Open Heart ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. e000848 ◽  
Author(s):  
Andreas Jönsson ◽  
Artur Fedorowski ◽  
Gunnar Engström ◽  
Per Wollmer ◽  
Viktor Hamrefors
Keyword(s):  
Myocardial Ischaemia ◽  
Chronic Obstructive Lung Disease ◽  
Chronic Obstructive ◽  
Clinical Factors ◽  
Obstructive Pulmonary Disease ◽  
Presenting Symptoms ◽  
High Prevalence ◽  
History Of ◽  
Artery Disease ◽  
Global Initiative

ObjectiveChronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD) are leading causes of global morbidity and mortality. Despite the well-known comorbidity between COPD and CAD, the presence of COPD may be overlooked in patients undergoing coronary evaluation. We aimed to assess the prevalence of undiagnosed COPD among outpatients evaluated due to suspected myocardial ischemia.MethodsAmong 500 outpatients who were referred to myocardial perfusion imaging due to suspected stable myocardial ischaemia, 433 patients performed spirometry. Of these, a total of 400 subjects (age 66 years; 45% women) had no previous COPD diagnosis and were included in the current study. We compared the prevalence of previously undiagnosed COPD according to spirometry criteria from The Global Initiative for Chronic Obstructive Lung Disease (GOLD) or lower limit of normal (LLN) and reversible myocardial ischaemia according to symptoms and clinical factors.ResultsA total of 134 (GOLD criteria; 33.5 %) or 46 patients (LLN criteria; 11.5%) had previously undiagnosed COPD, whereas 55 patients (13.8 %) had reversible myocardial ischaemia. The presenting symptoms (chest discomfort, dyspnoea) did not differ between COPD, myocardial ischaemia and normal findings. Except for smoking, no clinical factors were consistently associated with previously undiagnosed COPD.ConclusionsAmong middle-aged outpatients evaluated due to suspected myocardial ischaemia, previously undiagnosed COPD is at least as common as reversible myocardial ischaemia and the presenting symptoms do not differentiate between these entities. Patients going through a coronary ischaemia evaluation should be additionally tested for COPD, especially if there is a positive history of smoking.

Sign in / Sign up

Export Citation Format

Share Document