scholarly journals Ongoing use of SSRIs and the hospital course of COVID-19 patients: a retrospective outcome analysis

2021 ◽  
Author(s):  
Steven H. Rauchman ◽  
Sherri G. Mendelson ◽  
Courtney Rauchman ◽  
Lora J. Kasselman ◽  
Aaron Pinkhasov ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Logistic Regression Model ◽  
Large Sample Size ◽  
Gender And Race ◽  
Clinical Databases ◽  
Significant Difference ◽  
The Impact ◽  
Ssri Treatment ◽  
Age Category

Background: The SARS-CoV2 virus continues to have devastating consequences worldwide. Though vaccinations have helped to reduce the impact of the virus, new strains still pose a threat to unvaccinated, and to a lesser extent vaccinated, individuals. Therefore, it is imperative to identify treatments that can prevent the development of severe COVID-19. Recently, acute use of SSRI antidepressants in COVID+ patients has been shown to reduce the severity of symptoms compared to placebo. Since SSRIs are a widely used anti-depressant, the aim of this study was to determine if COVID+ patients already on SSRI treatment upon admission to the hospital had reduced mortality compared to COVID+ patients not on chronic SSRI treatment. Methods: A retrospective observational study design was used. Electronic medical records of 9,043 patients with a laboratory-confirmed diagnosis of Covid-19 from 03/2020 to 03/2021from six hospitals were queried for demographic and clinical information. Using R, a logistic regression model was run with mortality as the outcome and SSRI status as the exposure. An adjusted logistic regression model was run to account for age category, gender, and race. All tests were considered significant at p of 0.05 or less. Results: In this sample, no patients admitted on SSRIs had them discontinued. This is consistent with current recommendations. There was no significant difference in the odds of dying between COVID+ patients on chronic SSRIs vs COVID+ patients not taking SSRIs, after controlling for age category, gender, and race. The odds of COVID+ patients on SSRIs dying was 0.98 (95%CI: 0.81, 1.18) compared to COVID+ patients not on SSRIs (p=0.83). Conclusion: In times of pandemics due to novel infectious agents it is difficult, but critical to evaluate safety and efficacy of drugs that might be repurposed for treatment. This large sample size of 9,043 patients suggests that there will be no significant benefit to use of SSRIs to decrease mortality rates for hospitalized patients with Covid-19 who are not currently on SSRI medications. This study shows the utility of large clinical databases in addressing the urgent issue of determining what commonly prescribed drugs might be useful in treating COVID-19.

scholarly journals Ongoing Use of SSRIs Does Not Alter Outcome in Hospitalized COVID-19 Patients: A Retrospective Analysis

2021 ◽  
Vol 11 (1) ◽  
pp. 70
Author(s):  
Steven H. Rauchman ◽  
Sherri G. Mendelson ◽  
Courtney Rauchman ◽  
Lora J. Kasselman ◽  
Aaron Pinkhasov ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
Symptom Severity ◽  
Medical Records ◽  
Logistic Regression Model ◽  
Clinical Information ◽  
Infectious Agents ◽  
Clinical Databases ◽  
Significant Difference ◽  
Ssri Treatment ◽  
Age Category

SARS-CoV-2 continues to have devastating consequences worldwide. Though vaccinations have helped reduce spread, new strains still pose a threat. Therefore, it is imperative to identify treatments that prevent severe COVID-19 infection. Recently, acute use of SSRI antidepressants in COVID+ patients was shown to reduce symptom severity. The aim of this retrospective observational study was to determine whether COVID+ patients already on SSRIs upon hospital admission had reduced mortality compared to COVID+ patients not on chronic SSRI treatment. Electronic medical records of 9044 patients with laboratory-confirmed COVID-19 from six hospitals were queried for demographic and clinical information. Using R, a logistic regression model was run with mortality as the outcome and SSRI status as the exposure. In this sample, no patients admitted on SSRIs had them discontinued. There was no significant difference in the odds of dying between COVID+ patients on chronic SSRIs vs. those not taking SSRIs, after controlling for age category, gender, and race. This study shows the utility of large clinical databases in determining what commonly prescribed drugs might be useful in treating COVID-19. During pandemics due to novel infectious agents, it is critical to evaluate safety and efficacy of drugs that might be repurposed for treatment.

scholarly journals Work absence and multimorbidity in Portugal: results from the 1st National Health Examination Survey

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Matos ◽  
C Matias Dias ◽  
A Félix
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Chronic Diseases ◽  
National Health ◽  
Logistic Regression Model ◽  
Health Examination ◽  
Work Absence ◽  
Health Examination Survey ◽  
Absence From Work ◽  
The Impact

Abstract Background Studies on the impact of patients with multimorbidity in the absence of work indicate that the number and type of chronic diseases may increase absenteeism and that the risk of absence from work is higher in people with two or more chronic diseases. This study analyzed the association between multimorbidity and greater frequency and duration of work absence in the portuguese population between the ages of 25 and 65 during 2015. Methods This is an epidemiological, observational, cross-sectional study with an analytical component that has its source of information from the 1st National Health Examination Survey. The study analyzed univariate, bivariate and multivariate variables under study. A multivariate logistic regression model was constructed. Results The prevalence of absenteeism was 55,1%. Education showed an association with absence of work (p = 0,0157), as well as professional activity (p = 0,0086). It wasn't possible to verify association between the presence of chronic diseases (p = 0,9358) or the presence of multimorbidity (p = 0,4309) with absence of work. The prevalence of multimorbidity was 31,8%. There was association between age (p < 0,0001), education (p < 0,001) and yield (p = 0,0009) and multimorbidity. There is no increase in the number of days of absence from work due to the increase in the number of chronic diseases. In the optimized logistic regression model the only variables that demonstrated association with the variable labor absence were age (p = 0,0391) and education (0,0089). Conclusions The scientific evidence generated will contribute to the current discussion on the need for the health and social security system to develop policies to patients with multimorbidity. Key messages The prevalence of absenteeism and multimorbidity in Portugal was respectively 55,1% and 31,8%. In the optimized model age and education demonstrated association with the variable labor absence.

Entrepreneurship Program at Secondary School

2019 ◽  
pp. 202-217
Author(s):  
Maria Jose Madeira ◽  
Andreia Rocha
Keyword(s):  
Logistic Regression ◽  
Secondary School ◽  
Regression Model ◽  
Extracurricular Activities ◽  
Secondary School Students ◽  
Logistic Regression Model ◽  
Secondary Level ◽  
Entrepreneurial Intentions ◽  
School Students ◽  
The Impact

The aim of this study is the analysis of the effect that the entrepreneurship activities have in the development of an entrepreneurial profile of the students of a secondary level and their future entrepreneurial intentions. To empirically test the formulated hypothesis, a questionnaire was developed. By the application of methods of factorial analysis and a logistic regression model, it was concluded that variables like the incentive given by school agents, the participation of students in extracurricular activities and the desire to continue studying, influenced the entrepreneurial intentions of the students. Concerning the entrepreneurial profile, it was concluded that the students who have higher capacity of creation and concretization of entrepreneurial projects and a winning will, have a higher propensity to create their own business. This research analysed the impact of entrepreneurship activities on the development of the secondary school students' entrepreneurial profile, and understand whether these same activities influence their future intentions.

scholarly journals Variation Among Hospitals in the Continuity of Care for Older Hospitalized Patients: a Cross-sectional Cohort Study

2021 ◽  
Author(s):  
James S. Goodwin ◽  
Shuang Li ◽  
Jie Zhou ◽  
Yong-Fang Kuo ◽  
Ann Nattinger
Keyword(s):  
Logistic Regression ◽  
Length Of Stay ◽  
Regression Model ◽  
Continuity Of Care ◽  
Logistic Regression Model ◽  
Large Degree ◽  
Patient Characteristics ◽  
Hospitalized Patients ◽  
Cross Sectional ◽  
The Impact

Abstract Background: Little is known about how continuity of care for hospitalized patients varies among hospitals. We describe the number of different general internal medicine physicians seeing hospitalized patients during a medical admission and how that varies by hospital. Methods: We conducted a retrospective study of a national 20% sample of Medicare inpatients from 01/01/16 to 12/31/18. In patients with routine medical admissions (length of stay of 3-6 days, no Intensive Care Unit stay, and seen by only one generalist per day), we assessed odds of receiving all generalist care from one generalist. We calculated rates for each hospital, adjusting for patient and hospital characteristics in a multi-level logistic regression model. Results: Among routine medical admissions with 3- to 6-day stays, only 43.1% received all their generalist care from the same physician. In those with a 3-day stay, 50.1% had one generalist providing care vs. 30.8% in those with a 6-day stay. In a two-level (admission and hospital) logistic regression model controlling for patient characteristics and length of stay, the odds of seeing just one generalist did not vary greatly by patient characteristics such as age, race/ethnicity, comorbidity or reason for admission. There were large variations in continuity of care among different hospitals and geographic areas. In the highest decile of hospitals, the adjusted mean percentage of patients receiving all generalist care from one physician was >84.1%, vs. <24.1% in the lowest decile. This large degree of variation persisted when hospitals were stratified by size, ownership, location or teaching status. Conclusions: Continuity of care provided by generalist physicians to medical inpatients varies widely among hospitals. The impact of this variation on quality of care is unknown.

scholarly journals The Impact of International Remittances on Poverty Alleviation in Bangladesh

2019 ◽  
Vol 4 (1) ◽  
pp. 67-86 ◽  
Author(s):  
Bezon Kumar
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Poverty Alleviation ◽  
Logistic Regression Model ◽  
Binary Logistic Regression ◽  
Primary Data ◽  
Binary Logistic Regression Model ◽  
Household Poverty ◽  
International Remittances ◽  
The Impact

This article mainly explores to what extent international remittances alleviate household poverty in Bangladesh. This study uses primary data collected from 216 households and employs multi-methods. Firstly, I measure the level of household poverty through Foster-Greer-Thorbecke index. The article secondly focuses on the impact of remittances on household poverty using a binary logistic regression model. I found that the level of poverty among remittance recipient households is notably lower than households that are not receiving remittances. Similarly, the probability of a household being poor is alleviated by 28.07 per cent if the household receives remittance. It can be suggested that nursing international remittances can be useful for poverty alleviation in Bangladesh. 

scholarly journals Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in Hematologic Patients: Experience at the Hospital Attending More Patients in Spain

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 30-31
Author(s):  
Alba Cabirta ◽  
Macarena Izuzquiza ◽  
Isabel Ruiz-Camps ◽  
David Valcarcel ◽  
Eva Catala ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Severe Acute Respiratory Syndrome ◽  
Regression Model ◽  
Logistic Regression Model ◽  
Hematologic Malignancies ◽  
Active Therapy ◽  
Multivariable Logistic Regression Model ◽  
Hematopoietic Stem ◽  
Multivariable Logistic Regression ◽  
The Impact

INTRODUCTION: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic raises many questions about the management of patients with significant comorbidities. Hematologic patients are usually fragile due to an important immunosuppression, so the impact of coronavirus disease (COVID-19) is yet to be determined. MATERIALS AND METHODS: We conducted a single-center retrospective observational study of patients with hematologic malignancies diagnosed with SARS-CoV-2 at Vall d´Hebron University Hospital (HUVH) between March 1st and May 31st 2020 to analyze their clinical characteristics and evolution. Patient's demographic data, underlying pathology, signs and symptoms of COVID-19, treatment received and clinical course were collected. A statistical analysis was performed to identify the possible variables associated with COVID-19 mortality. For this purpose, we used univariate and multivariable logistic regression models. RESULTS: We identified 70 patients with PCR confirmed SARS-CoV-2 infection and hematologic malignancy. The median age was 75 years (range 22-91), and 44% were female. The majority (74%) had evidence of active malignancy and 53% were receiving active therapy. Lymphoid pathology (73%) predominated over myeloid. The median number of previous lines of treatment was 0 (range 0-6), 23% had received at least 2 lines, whereas 10% underwent hematopoietic stem cell transplantation (HSCT) (5 patients allo-HSCT, 2 auto-HSCT). Half of the patients had more than one pre-existing comorbidity (17% obstructive pulmonary disease). At diagnosis the most common symptoms were fever (76%), cough (60%) and dyspnea (31%). We observed that 58% of patients presented a chest X-ray compatible with COVID-19. Regarding laboratory parameters, stood out lymphopenia (65% of patients presented &lt;1200 lymphocytes/mm3) and elevation of inflammation parameters, such as D-dimer (median 365 ng/mL, range 50-5860), ferritin (median 1063 ng/mL, range 73-14191), IL-6 (median 59,6 pg/mL, range 3-4079) and PCR (median 11,2 mg/dL, range 0,3-79,9). Empirical therapy for COVID-19 included antibiotics (78%), anti-virals (50%, 3% remdesivir), and hydroxychloroquine (88%). Only 24% received tocilizumab, 50% heparin (33% prophylactic dose), 12% G-CSF, 9% norepinephrine, 4% corticosteroids and 1% ß-IFN. Most of patients (73%) required oxygen therapy: 36% high-flow, 29% low flow and 8% endotracheal intubation. There were 6 patients who did not receive any treatment. COVID-19 was acquired via nosocomial infection in 23% of patients, 91% of them requiring hospitalization, 14% in the Intensive Care Unit (ICU). The median days of hospitalization since diagnosis was 17 (range 3-55). The case fatality rate (CFR) from COVID-19 was higher in hematologic patients than the one observed in non-hematologic patients at the HUVH (figure 1), being of 41% at 11 days from diagnosis. CFR was higher in patients older than 75 years old (61%), while the mortality among patients receiving active therapy was 42%. The main cause of death was acute respiratory failure (93%). In the univariate logistic regression model, age &gt;75 years (OR 1.07; p=0.008), active malignancy (OR 5; p=0,02), &gt;1 comorbidity (OR 5.3; p=0,049) and high levels of IL-6 (OR 8.2; p= 0.005) were statistically significant. In the multivariable logistic regression model, age ≥75 years (OR 4.4; p=0.01) and IL-6 levels at baseline &gt; 59.6 pg/mL (OR 7.2; p=0.01) were associated with a higher mortality (table 1). The presence of an active malignancy was not a significant variable in the multivariable logistic regression model. CONCLUSIONS: Patients with hematologic malignancies and COVID-19 presented similar symptoms, signs and radiological characteristics to those described in the general population at diagnosis. In our cohort, advanced age and high IL-6 values were associated with higher mortality. Furthermore, it was observed that active hematologic disease is a factor of poor prognosis of COVID-19. Disclosures Salamero: Daichii Sankyo:Honoraria;Celgene:Consultancy, Honoraria;Novartis:Consultancy, Honoraria;Jazz Pharmaceuticals:Consultancy, Honoraria;Pfizer:Consultancy.Abrisqueta:Janssen:Consultancy, Honoraria, Speakers Bureau;AbbVie:Consultancy, Honoraria, Speakers Bureau;Roche:Consultancy, Honoraria, Speakers Bureau;Celgene:Consultancy, Honoraria.Bosch:Hoffmann-La Roche:Research Funding.

scholarly journals Association between Attention Deficit Hyperactivity Disorder and Suicide Attempts in Patients with Bipolar Disorder

2019 ◽  
Author(s):  
Jafar Fili ◽  
Marzieh Nojomi ◽  
Katayoon Razjouyan ◽  
Mojgan Kahdemi ◽  
Rozita Davari- Ashtiani
Keyword(s):  
Bipolar Disorder ◽  
Logistic Regression ◽  
Regression Model ◽  
Logistic Regression Model ◽  
Suicide Attempts ◽  
P Value ◽  
Hyperactivity Disorder ◽  
Significant Difference ◽  
Chi Squared ◽  
History Of

Objective: The present study aimed to examine the association between ADHD and suicide attempts among adolescents with bipolar disorder. Method: Participants were 168 adolescents who fulfilled DSM-IV-TR criteria for bipolar disorder. They were divided into 2 groups: The first group of patients with bipolar disorder with a history of suicide attempts (n = 84) and the second group without a history of suicide attempts (n = 84). ADHD and other variables were analyzed using a chi-squared test and logistic regression model. Results: No significant difference was observed between the 2 groups in comorbidity of ADHD and other psychiatric disorders (P value > 0/05). In the logistic regression model, and after controlling for other factors, gender (OR = 3.9, CI 95%: 1.5-9.6) and history of sexual abuse (OR = 3.4; CI 95%: 1.06-11.3) were the only 2 factors associated with a history of suicide attempts. Conclusion: No significant association was found between ADHD and suicide attempts in adolescents with bipolar disorder.

scholarly journals Negative Impact of Amphetamine-Type Stimulant Use on Opioid Agonist Treatment Retention in Ontario, Canada

2021 ◽  
Vol 12 ◽  
Author(s):  
Kristen A. Morin ◽  
Frank Vojtesek ◽  
Shreedhar Acharya ◽  
David C. Marsh
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Drug Screening ◽  
Urban Areas ◽  
Logistic Regression Model ◽  
Opioid Agonist ◽  
Stimulant Use ◽  
Urine Drug ◽  
The Impact ◽  
Urine Drug Screening

Objective: The objective of this study was to evaluate epidemiological trends of co-use patterns of amphetamine-type stimulants and opioids and the impact of co-use patterns on Opioid Agonist Treatment (OAT) retention in Ontario, Canada. The secondary objective was to assess geographical variation in amphetamine-type stimulant use in Northern Rural, Northern Urban, Southern Rural and Southern Urban Areas of Ontario.Methods: A retrospective cohort study on 32,674 adults receiving OAT from ~70 clinics was conducted between January 1, 2014, and December 31, 2020, in Ontario, Canada. Patients were divided into four groups base on the proportion of positive urine drug screening results for amphetamine-type stimulants during treatment: group 1 (0–25%), group 2 (25–50%), group 3 (50–75%), and groups 4 (75–100%). A Fractional logistic regression model was used to evaluate differences over time in amphetamine-type stimulant use with urine drug screening results. A Cox Proportional Hazard Ratio model was used to calculate the impact of amphetamine-type stimulant use on retention in OAT and adjusted for sociodemographic characteristics, drug use and clinical factors. Lastly, a logistic regression model was used on a subgroup of patients to assess the impact of geography on amphetamine-type stimulant use in Northern Rural, Northern Urban, Southern Rural and Southern Urban Areas of Ontario.Results: There were significant differences in amphetamine-type stimulant positive urine drug screening results year-over-year from 2015 to 2020. Significant differences were observed between amphetamine-type stimulant groups with regards to sociodemographic, clinical and drug use factors. Compared to those with no amphetamine-type stimulant use, the number of days retained in OAT treatment for amphetamine-type stimulant users was reduced (hazard ratio 1.19; 95% confidence interval = 1.07–1.17; p &lt; 0.001). Lastly, an adjusted logistic regression model showed a significant increase in the likelihood of amphetamine-type stimulant use in Northern Rural regions compared to Southern Urban areas.Conclusion: There was a significant increase in amphetamine-type stimulant use among individuals in OAT from 2014 to 2020, associated with decreased OAT retention. Research is required to determine if tailored strategies specific to individuals in OAT who use amphetamine-type stimulants can improve OAT outcomes.

Factors Relating to Preventive Practices of Health Science Students during the Early Stage of the COVID-19 Pandemic

MedPharmRes ◽  
2020 ◽  
Vol 4 (4) ◽  
pp. 27-32
Author(s):  
Giao Huynh ◽  
Le An Pham ◽  
Vien Truong Nguyen ◽  
Thuong Thi Hoai Do ◽  
Han Thi Ngoc Nguyen ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Logistic Regression Model ◽  
Early Stage ◽  
Health Science ◽  
P Value ◽  
Prevention Measures ◽  
Good Practices ◽  
Preventive Practices ◽  
Significant Difference

Objectives: We assessed the factors relating to the prevention of the Novel Coronavirus Disease (COVID-19) for students at the University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam. Methods: A cross-sectional study was performed in February and March 2020. A 21 item self-administered questionnaire on the knowledge, attitude, and practices regarding COVID-19 was collected from students of the first to the sixth year using the strategy of simple random sampling. The aim was to establish factors that relate to practices using Odds ratio (OR) and 95% confidence interval (95% CI) which were estimated by the logistic regression model, p-value <0.05 shows a significant difference. Results: Of the 551 students, 41.0% recorded responses indicating good practices toward prevention measures, while around half the students reported that they did not wash their hands for 20 full seconds (50.5%). The overall rate of good knowledge and positive attitude was 49.0% and 26.1%, respectively. When adjusted for all variables in the logistic regression model, a positive overall attitude was associated with good overall preventive practice; AOR = 1.72 (95% CI: 1.16 – 2.55). Furthermore, students mainly accessed information via social media and television (95.8% and 85.8%, respectively). Conclusions: There were only 41.0% recorded responses indicating good practices toward prevention measures. Besides, knowledge and attitudes about COVID-19 among students were inadequate. Further health education interventions should be focused to change bad hand-washing habits via mass media messages.

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