scholarly journals Childhood Asthma and COVID-19: A Nested Case-Control Study

2021 ◽  
Author(s):  
Kristina Gaietto ◽  
Megan Culler Freeman ◽  
Leigh Anne DiCicco ◽  
Sherry Rauenswinter ◽  
Joseph R Squier ◽  
...  
Keyword(s):  
Case Control Study ◽  
Symptom Control ◽  
Asthma Severity ◽  
Underlying Disease ◽  
Case Control ◽  
Individual Level ◽  
Clinical Registries ◽  
Using Data ◽  
Nested Case Control ◽  
Control Study

BACKGROUND: Most pediatric studies of asthma and COVID-19 to date have been ecological, which offer limited insight. We evaluated the association between asthma and COVID-19 at an individual level. METHODS: Using data from prospective clinical registries, we conducted a nested case-control study comparing three groups: children with COVID-19 and underlying asthma ("A+C" cases); children with COVID-19 without underlying disease ("C+" controls); and children with asthma without COVID-19 ("A+" controls). RESULTS: The cohort included 142 A+C cases, 1110 C+ controls, and 140 A+ controls. A+C cases were more likely than C+ controls to present with dyspnea and wheezing, to receive pharmacologic treatment including systemic steroids (all p<0.01), and to be hospitalized (4.9% vs 1.7%, p=0.01). In the adjusted analysis, A+C cases were nearly 4 times more likely to be hospitalized than C+ controls (adjusted OR=3.95 [95%CI=1.4-10.9]); however, length of stay and respiratory support level did not differ between groups. Among A+C cases, 8.5% presented with an asthma exacerbation and another 6.3% developed acute exacerbation symptoms shortly after testing positive for SARS-CoV-2. Compared to historic A+ controls, A+C cases had less severe asthma, were less likely to be on controller medications, and had better asthma symptom control (all p<0.01). CONCLUSIONS: In our cohort, asthma was a risk factor for hospitalization in children with COVID-19, but not for worse COVID-19 outcomes. SARS-CoV-2 does not seem to be a strong trigger for pediatric asthma exacerbations. Asthma severity was not associated with higher risk of COVID-19.

The Effect of Malignancy on Outcomes Following Revascularization for Critical Limb Ischemia: A Case–Control Study

2018 ◽  
Vol 52 (5) ◽  
pp. 325-329
Author(s):  
Tom Calderbank ◽  
Ahmed Karim ◽  
Mike Wall ◽  
Arooj Syed ◽  
Robert S. M. Davies ◽  
...  
Keyword(s):  
Lower Limb ◽  
Case Control Study ◽  
Limb Ischemia ◽  
Case Control ◽  
Limb Amputation ◽  
Prospective Data ◽  
Using Data ◽  
Nested Case Control ◽  
Control Study ◽  
Prospective Analyses

Aim: Malignancy is common in patients presenting with critical lower limb ischemia (CLI). However, outcomes in patients with concomitant active malignancy and CLI have not been well defined in comparative prospective analyses. Using contemporary prospective data, we aimed to assess outcomes following revascularization in patients with CLI and active malignancy. Methods: A nested case–control study was performed using data from 2 tertiary referral centers for vascular disease. A total of 48 consecutive patients undergoing intervention for CLI who had a diagnosis of active malignancy were identified and matched to patients with CLI but no malignancy for age, sex, diabetes, and smoking. Patency rates and morbidity/mortality were assessed using duplex ultrasonography and regular clinical review. Results: A total of 48 consecutive patients (median age: 74.5 years; interquartile range: 68-80 years) with active malignancy and CLI were identified and case-matched (age, sex, diabetes, and smoking) to 48 patients undergoing intervention for CLI who had no malignancy. Major cardiovascular risk factors did not differ. All-cause mortality was 23% versus 12% ( P = .41) at 6 months and 54% versus 15% ( P < .001) at 12 months. None of the patients died due to complications relating directly to the lower limb intervention or within 30 days of the intervention. A total of 4 (8.3%) patients had required a major limb amputation at 6 months in both groups, compared with 5 (10.4%) patients with malignancy versus 4 (8.3%) patients without ( P = .73) at 12 months. Patency rates were similar at 12 months (73% vs 80%). Three patients had required reintervention in both groups (endovascular in all cases) at 12 months. Conclusion: Revascularization can be offered safely in selected patients with active malignancy; patency rates in those surviving to 1 year are similar to patients without malignancy.

scholarly journals Modifiable risk factors for external cause mortality after release from prison: a nested case–control study

2017 ◽  
Vol 28 (2) ◽  
pp. 224-233 ◽  
Author(s):  
M. J. Spittal ◽  
S. Forsyth ◽  
R. Borschmann ◽  
J. T. Young ◽  
S. A. Kinner
Keyword(s):  
Case Control Study ◽  
Case Control ◽  
Clinical Markers ◽  
Indigenous Status ◽  
Increased Risk ◽  
Specific Mortality ◽  
Using Data ◽  
Nested Case Control ◽  
Control Study ◽  
Release From Prison

Aim.People released from prison are at higher risk of mortality from potentially preventable causes than their peers in the general population. Because most studies of this phenomenon are reliant on registry data, there is little health and behavioural information available on those at risk, hampering the development of targeted, evidence-based preventive responses. Our aim was to identify modifiable risk and protective factors for external cause and cause-specific mortality after release from prison.Methods.We undertook a nested case–control study using data from a larger retrospective cohort study of mortality after release from prison in Queensland, Australia between 1994 and 2007. Cases were 286 individuals who had died from external causes (drug overdose, suicide, transport accidents, or violence) matched with 286 controls on sex, Indigenous status, and release date. We extracted data from detention, case-management, and prison medical records.Results.Factors associated with increased risk of external cause mortality included use of heroin and other opioids in the community [odds ratio (OR) = 2.20, 95% CI 1.41–3.43,p< 0.001], a prescription for antidepressants during the current prison sentence (OR = 1.94, 95% CI 1.02–3.67,p= 0.042), a history of problematic alcohol use in the community (OR = 1.54, 95% CI 1.05–2.26,p= 0.028), and having ever served two or more custodial sentences (OR = 1.51, 95% CI 1.01–2.25,p= 0.045). Being married (OR = 0.45, 95% CI 0.29–0.70,p< 0.001) was protective. Fewer predictors were associated with cause-specific mortality.Conclusions.We identified several behavioural, psychosocial, and clinical markers associated with mortality from preventable causes in people released from prison. Emerging evidence points to interventions that could be targeted at those at increased risk of external cause mortality. These include treatment and harm reduction programmes (for substance use), improving transitional support programmes and continuity of care (for mental health), diversion and drug reform (for repeat incarceration) and nurturing stable relationships during incarceration. The period of imprisonment and shortly after release provides a unique opportunity to improve the long-term health of ex-prisoners and overcome the disadvantage associated with imprisonment.

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