scholarly journals AB0897 BIMODAL DISTRIBUTION OF VERTEBRAL FRAGILITY FRACTURES (VFF) IN A FRACTURE LIAISON SERVICE (FLS). RESULTS OF A COMPARATIVE ANALYSIS OF PATIENTS WITH VFF VERSUS THOSE WITH OTHER FRAGILITY FRACTURES (OFF).

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1752.1-1752
Author(s):  
B. Hernández-Cruz ◽  
F. J. Olmo Montes ◽  
M. J. Miranda García ◽  
M. D. Jimenez Moreno ◽  
M. A. Vázquez Gómez ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Lower Risk ◽  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Fragility Fractures ◽  
Bimodal Distribution ◽  
Nonparametric Tests ◽  
University Hospital ◽  
Vertebral Compression Fractures ◽  
Risk Of Falls

Background:Fragility fractures (FF) represent a health problem and among them, the VFF. They have worse vital prognosis, are at greater risk of new FF, had higher comorbidity, with clinical manifestations in only 30%-40% of cases. One in 6 women and one in 12 adult males will have a VFF.Objectives:To analyze the clinical characteristics of FF patients attended in the FLS at Virgen Macarena University Hospital. Compare the sociodemographic and clinical characteristics of VFF patients with those with OFF.Methods:Design: Prospective cohort. Patients attended in the FLS from May 2018 to November 2019 in a protocolized manner (Openclinica®). Inclusion criteria: a clinical FF in the previous two years. Descriptive statistics: percentages and means with 25thand 75thpercentile. Inferential statistic by parametric and nonparametric tests. The project was approved by the Ethics Committee and patients signed consent to participate.Results:Data from 414 patients with a first FF are analyzed, 101 (25%) with VFF and 313 (76%) with OFF [188 (45%) hip, 66 (16%) distal radius, 32 (8%) humerus and 27 (6%) miscellaneous (pelvis, ribs, tibia)]. All VFFs analyzed had clinical symptoms and the number of fractured vertebrae was 2 (1-3). In 28 (37%) were FF of dorsal vertebrae, at 25 (33%) lumbar and 23 (30%) dorsal and lumbar. Comparative analysis showed differences in age VFF 71 (62-77) vs OFF 76 (66 – 83) years, p=0.0003. It highlighted a bimodal distribution according to age, with a peak incidence of 55 to 68 years and another between 75-80 years (Graph). Referral unit to FLS: VFF Rheumatology (42%) and/or Traumatology Emergency Room (44%) vs OFF Internal Medicine (45%) and General Traumatology Unit (38%), p=0.0001. There were also differences in the treatment with teriparatide (VFF 20% vs OFF 4%); zoledronate (VFF 6% vs OFF 3%) and alendronate (VFF 44% vs OFF 63%, p=0001); days of immobilization (VFF 30 (0 - 60) vs OFF 10 (0 - 30), p-0.01); they have greater independence to carry out activities of daily life (Barthel Scale) VFF 95(81 – 100) vs OFF 80 (60 – 95), p=0.00001; increased clamping force of hands 18 (12 - 20) vs 12 (8 - 18) mmHg, p=0.001, and lower risk of falls (J D Downton Scale) (VFF 43% vs OFF 60%, p=0,01). While the number of relevant comorbidities was higher in VFF 3 (1 - 5) vs OFF 2 (1 - 4) it was no statistical, p=0.3. The use of GCC was risky for VFF (n=13, 13%) vs OFF (n=17, 5%), p=0.01 and RR (95%CI) 2.3 (1.01 – 5.3) and not for other drugs (GnRH inhibitors, aromatase inhibitors or chemotherapy). No differences in sex were found (VFF 80%- vs OFF 80% women, p=0.9), previous FF history (9% vs 12%, p=0.2), secondary OP (16% vs 21%, p=0.1); percentage of patients with OP by femoral neck DEXA (VFF 35% vs 42%, p=0.2) or by lumbar spine DEXA (VFF 36% vs OFF 34%, p=0.8).Conclusion:VFF have a bimodal age-based distribution, usually occurring in younger patients, with a higher degree of independence and muscle strength and lower risk of falls, although they are associated with longer duration of immobilization, compared to OFF. In our cohort, VFFs affect 2 or more vertebrae and they are commonly treated with parenteral osteoporotic drugs. The use of glucocorticoids doubled the risk of developing a VFF, these findings are similar to those of others published cohorts.This project received a grant of the Ministry Health of the Junta de Andalucía Ref.PIN-0092-2016.Bibliography:[1]Gerdhem P. Best Practice & Research Clinical Rheumatology 27 (2013) 743–755[2]McCarty J,et al. Diagnosis and management for vertebral compression fractures. American Family of Physicians Jul1, 2016 Vol 94 No 1.Disclosure of Interests:Blanca Hernández-Cruz Speakers bureau: Abbvie, Lilly, Sanofi, BMS, STADA, Francisco Jesús Olmo Montes: None declared, Maria José Miranda García: None declared, María Dolores Jimenez Moreno: None declared, María Angeles Vázquez Gómez: None declared, Mercedes Giner García: None declared, Miguel Angel Colmenero Camacho: None declared, José Javier Pérez Venegas: None declared, María José Montoya García: None declared

scholarly journals Clinical Characteristics and Outcome of Patients with Infective Endocarditis Diagnosed in a Department of Internal Medicine

2020 ◽  
Vol 9 (3) ◽  
pp. 864
Author(s):  
Louis Kreitmann ◽  
David Montaigne ◽  
David Launay ◽  
Sandrine Morell-Dubois ◽  
Hélène Maillard ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Infective Endocarditis ◽  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
High Sensitivity ◽  
University Hospital ◽  
Delay In Diagnosis ◽  
Duke Classification ◽  
Diagnostic Work ◽  
Work Up

Clinical manifestations of infective endocarditis (IE) can be highly non-specific. Our objective was to describe the clinical characteristics of patients initially referred to a department of internal medicine for a diagnostic work-up, and eventually diagnosed with IE. We retrospectively retrieved adult patients admitted to the department of internal medicine at Lille University Hospital between 2004 and 2015 who fulfilled Duke Classification criteria for definite IE. Thirty-five patients were included. The most frequently involved bacteria were non-hemolytic streptococci. Most patients presented with various systemic, cardiac, embolic, rheumatic, and immunological findings, with no sign or symptom displaying high sensitivity. The first transthoracic echocardiogram was negative in 42% of patients. Furthermore, definite diagnosis required performing at least 2 transesophageal examinations in 24% of patients. We observed a trend towards decreased survival in the subgroup of patients in whom the delay between onset of symptoms and diagnosis was >30 days. In conclusion, patients who are initially referred to internal medicine for a diagnosis work-up and who are ultimately diagnosed with IE have non-specific symptoms and a high percentage of initial normal echocardiography. Those patients require prolonged echocardiographic monitoring as a prolonged delay in diagnosis is associated with poorer outcomes such as death.

scholarly journals Normocalcemic Primary Hyperparathyroidism: A Comparison with the Hypercalcemic Form in a Tertiary Referral Population

2018 ◽  
Vol 50 (11) ◽  
pp. 797-802 ◽  
Author(s):  
Jan Pierreux ◽  
Bert Bravenboer
Keyword(s):  
Primary Hyperparathyroidism ◽  
Clinical Manifestations ◽  
Fragility Fractures ◽  
Urinary Calcium ◽  
University Hospital ◽  
Calcium Excretion ◽  
Mean Values ◽  
Vitamin D Levels ◽  
Indolent Disease ◽  
Relative Prevalence

AbstractNormocalcemic primary hyperparathyroidism (NPHPT) is a formally recognized variant of primary hyperparathyroidism (PHPT), characterized by normal total and ionized serum calcium concentrations and elevated parathyroid hormone (PTH) levels, in the absence of secondary causes for hyperparathyroidism. NPHPT has been studied previously, but data are limited and confounded. We aimed to compare the clinical and biochemical data of normocalcemic and hypercalcemic subjects in a hospital-based population.We retrospectively analysed the medical records of 131 subjects diagnosed with PHPT at the university hospital Brussels (UZ Brussel) between January 1st 2007 and December 31st 2016, including 25 normocalcemic and 106 hypercalcemic subjects.The mean values of age, BMI, sex, serum 25-OH vitamin D levels and urinary phosphate excretion were comparable between both groups. Subjects diagnosed with NPHPT had significantly lower plasma PTH levels, lower urinary calcium excretion and lower serum creatinine levels compared to the hypercalcemic subjects with PHPT. Corresponding eGFR values were higher in the normocalcemic group. Normocalcemic subjects (NPHPT) presented with a high prevalence of nephrolithiasis (36%), fragility fractures (12%) and osteoporosis (25%). Clinical manifestations and BMD measurements revealed no statistically significant differences between both groups.Our data show a relative prevalence of 19% NPHPT in PHPT. NPHPT may present the earliest form of PHPT with an extension in time, but is not an indolent disease state. Normocalcemic subjects should be managed as hypercalcemic subjects with PHPT. Further research regarding the pathophysiology and natural course of NPHPT is required.

Postoperative cognitive dysfunction: progress mechanisms and clinical characteristics

2019 ◽  
Vol 2 (19) ◽  
pp. 29-33
Author(s):  
K. B. Manysheva ◽  
M. A. Akhmedov ◽  
A. A. Rakhmanova ◽  
S. M. Khutalieva
Keyword(s):  
Cognitive Dysfunction ◽  
Clinical Characteristics ◽  
Cognitive Deficit ◽  
Neuropsychological Testing ◽  
Postoperative Cognitive Dysfunction ◽  
Clinical Manifestations ◽  
Postoperative Recovery ◽  
Neuropsychological Rehabilitation ◽  
Brain Barrier Permeability ◽  
The Central Nervous System

The article is devoted to the study of postoperative cognitive dysfunction — a syndrome that is often found in the postoperative period and does not depend on the volume of surgeon. Based on the analysis of the results of modern studies, the authors cite the most likely etiological causes of the syndrome, grouped according to different categories of risk factors. The pathogenetic algorithm for cognitive dysfunction includes the appearance of systemic inflammation, improving blood-brain barrier permeability with the endothelial dysfunction, the migration of inflammatory agents into the central nervous system, and the formation of oxidative stress. The clinical manifestations of cognitive deficit in the outcome of surgeon performed under general anesthesia, the authors illustrate with their own observations of patients with a neurosurgical profile with spinal pathology operated on with the use of propofol anesthesia, comparing the results of neuropsychological testing with an assessment of the level of anxiety. In conclusion, the authors outline a strategy for the prevention of postoperative cognitive dysfunction and recommend conducting neuropsychological rehabilitation as an important component of postoperative recovery for all patients with a diagnosed cognitive deficit that occurred after surgery.

STUDY ON CLINICAL CHARACTERISTICS AND RESULT OF TREATMENT BENIGN VOCAL CORD TUMOR WITH RIGID LARYNGEAL ENDOSCOPIC SURGERY

2012 ◽  
pp. 58-65
Author(s):  
Duy Thai Truong ◽  
Van Dung Phan ◽  
Tu The Nguyen
Keyword(s):  
Vocal Cord ◽  
Endoscopic Surgery ◽  
Clinical Characteristics ◽  
University Hospital ◽  
High Rate ◽  
Treatment Rate ◽  
Reinke’S Edema ◽  
Vocal Nodules ◽  
A Prospective Study

Objective: Study on clinical characteristics and result of treatment benign vocal cord tumor with suspensive laryngeal endoscopic surgery. Materials and Methods: A prospective study was undertaken in 43 patients who had benign vocal cord tumor and performed a suspensive laryngeal endoscopic surgery at ENT Dept. of Hue University Hospital, from 3/2010 to 5/2011. Results: The most common was group was 31 - 45 (44.2%). There was no difference of gender. Moderate hoarness was 67.4%. Classification of benign laryngeal tumor: vocal nodules (13 cases), vocal cyst (18 cases), vocal polyp (10 cases) and Reinke’s edema (2 cases). The successful treatment rate of vocal benign tumor was 88.4%. Conclusions: Suspensive laryngeal endoscopic surgery was the best method to cure benign vocal cord tumor. The surgeon had a clear operative field, easy manoeuver, high rate of cure and less complication.

CLINICAL AND PARA-CLINICAL CHARACTERISTICS OF SICK NEWBORN BABIES TREATED AT PEDIATRIC DEPARTMENT OF HUE UNIVERSITY HOSPITAL

2011 ◽  
pp. 112-117
Author(s):  
Thi Kieu Nhi Nguyen
Keyword(s):  
Respiratory Distress ◽  
Congenital Malformation ◽  
Clinical Characteristics ◽  
Descriptive Study ◽  
Neonatal Unit ◽  
University Hospital ◽  
Pediatric Department ◽  
Sick Newborn ◽  
Observational Descriptive Study

Objectives: 1. Describe neonatal classification of WHO. 2. Identify some principal clinical and paraclinical signs of term, preterm, post term babies. Patients and method: an observational descriptive study of 233 newborns hospitalized in neonatal unit at Hue university‘ s hospital was done during 12 months from 01/01/2009 to 31/12/2009 for describing neonatal classification and identifying principal clinical and paraclinical signs. Results: Premature (16.74%); Term babies (45.5%); Post term (37.76%); Premature: asphyxia (43.59%), hypothermia (25.64%), vomit (30.77%), jaundice (61.54%), congenital malformation (17.95%); CRP > 10mg/l (53.85%); anemia Hb < 15g/dl (12.82%). Term babies: poor feeding (21.7%); fever (24.53%); CRP > 10mg/l (53.77%); Hyperleucocytes/ Leucopenia (35.85%). Post term: respiratory distress (34%); lethargy (29.55%); vomit (26.14%); polycuthemia (1.14%); hypoglycemia (22.73%). Conclusion: each of neonatal type classified by WHO presente different clinical and paraclinical. Signs. The purpose of this research is to help to treat neonatal pathology more effectively.

CLINICAL AND PARACLINICAL CHARACTERISTICS AND RESULTS FROM TREATMENT OF FOREIGN BODIES INGESTION

2016 ◽  
pp. 63-69
Author(s):  
Hoang Cuong Vo ◽  
Thanh Dang ◽  
Phuong Nam Tran ◽  
Thanh Thai Le
Keyword(s):  
Foreign Body ◽  
Clinical Characteristics ◽  
Foreign Bodies ◽  
University Hospital ◽  
Age Group ◽  
Central Hospital ◽  
Results Of Treatment ◽  
Rigid Esophagoscopy ◽  
Flexible Esophagoscopy ◽  
Esophageal Foreign Bodies

Background: Foreign bodies ingestion is a emergency in otology, knowledge of people about foreign bodies ingestion is not enough. Objective: To study the clinical characteristics, paraclinical characteristics and results of treatment from foreign bodies ingestion in Hue Central Hospital and Hue University Hospital. Methods and patiens: A cross descriptive and prospective study over the period from 6/2014 to 5/2016, total are 137 patients come to be diagnosised and treatmented. Results: the average age is 35 years old. Gender: male (51.8%) and women (48.2%). Adults (84.7%) having more than children (15.3%). Age group from 16-30 years is highest (32.8%). There are 95.7% of organic foreign bodies, 4.3% are inorganic foreign bodies. There are 90.5% of patients on diagnosis and treatment in stages less inflammation, arthritis 8.0% in the period and 1.5% in the period complications. Foreign body in the throat problems (73.7%), esophageal foreign bodies (26.3%). Pick up directly foreign bodies 54%, indirectly by the mirror 11.7% and endoscopy 8%, rigid esophagoscopy is 17.5%, flexible esophagoscopy is 7.3%, cervicotomy is 1.5%. Conclusion: Practing direction with in the oropharynx foreign body, using the larynx mirror or endoscopy with in the laryngopharynx for the esophagus foreign bodies, rigid esophagoscopy is better. Key words: Foreign bodies ingestion

STUDYING SOME CLINICAL AND PARACLINICAL CHARACTERISTICS OF POSMATURE BABIES CARED IN NICU AT HUE UNIVERSITY HOSPITAL

2012 ◽  
pp. 74-84
Author(s):  
Thi Kieu Nhi Nguyen
Keyword(s):  
Respiratory Rate ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
University Hospital ◽  
Maternal Characteristics ◽  
Exact Test ◽  
Menstrual Cycles ◽  
Term Newborns ◽  
Student’S T ◽  
The Individual

Objectives: 1. Estimating the ratios of clinical and paraclinical signs of post-term newborns hospitalized at Pediatric Department of Hue University Hospital. 2. Identifying the relation between clinical signs and paraclinical signs. Materials and Method: 72 post- term babies < 7 days of life hospitalized at NICU from 2010/5 to 2011/4. Classification of post - term newborn was based on WHO 2003: gestational age ≥ 42 weeks with clinical manifestations: desquamation on press with fingers or natural desquamation, withered or meconial umbilicus, meconial long finger nails (*) or geatational age still < 42 weeks with theses clinical manifestations (*). Data were recorded on a clinical record form. Per-protocol analysis of clinical outcomes was performed by using Medcalc 11.5 and Excell 2007. Analyses used the χ2 test or Fisher's exact test for categorical data; Student's t test was used for continuous data and the Mann-Whitney U test for nonparametric data. Data were presented as means or proportions with 95% CIs. Results: Clinical characteristics: Tachypnea and grasp were main reasons of hospitalisation (48.61%). Poor feeding, vomitting (16.67%). Asphyxia (8.34%). Jawndice (6.94%). Hypothermia < 36.50C (13.89%), fever (13.89%). Tachypnea (59.72%). Bradycardia (1.39%). Poor feeding (11.11%). Hypertonia (9.72%). Paraclinical characteristics: Erythrocytes < 4.5.1012/l (51.39%), Leucocytes 5 – 25.103/mm3 (81.94%), Thrombocytes 100- 400.103/mm3 (94.44%). Hemoglobinemia < 10mg/l (67.61%). Maternal characteristics: Menstrual cycles regular (75%). Primiparity (75%). Amniotic volume average (70.42%), little (29.58%). Aminiotic liquid clair (62.5%), aminiotic liquid yellow (4.17%), aminiotic meconial liquid (33.33%). Maternal manifestation of one of many risk factors consist of genital infection; urinary infection; fever before, during, after 3 days of birth; prolonged delivery; medical diseases influence the foetus (75%). The relation between clinical signs and paraclinical signs: There was significantly statistical difference: between gestationnal age based on obstetrical criteria and amniotic volume on ultrasound (p < 0.05); between birth weight and glucosemia p < 0.02). There was conversional correlation of average level between erythroctes number and respiratory rate (r = - 0.5158; p < 0,0001), concordance correlation of weak level betwwen leucocytes number and respiratory rate r = 0.3045; p = 0.0093). Conclusion: It should made diagnosis of postterm baby based on degree of desquamation. The mother who has menstrual cycles regular is still delivered of a postterm baby. A postterm baby has the individual clinical and paraclinical signs.

URINARY INFECTION AT DEPARTMENT OF UROLOGY OF HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

2018 ◽  
pp. 100-108
Author(s):  
Dinh Khanh Le ◽  
Dinh Dam Le ◽  
Khoa Hung Nguyen ◽  
Xuan My Nguyen ◽  
Minh Nhat Vo ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Clinical Manifestations ◽  
University Hospital ◽  
E Coli ◽  
Positive Urine ◽  
Tract Infections

Objectives: To investigate clinical characteristics, bacterial characteristics, drug resistance status in patients with urinary tract infections treated at Department of Urology, Hue University Hospital. Materials and Method: The study was conducted in 474 patients with urological disease treated at Department of Urology, Hue Universiry Hospital from July 2017 to April 2018. Urine culture was done in the patients with urine > 25 Leu/ul who have symptoms of urinary tract disease or infection symptoms. Patients with positive urine cultures were analyzed for clinical and bacterial characteristics. Results: 187/474 (39.5%) patients had symptoms associated with urinary tract infections. 85/474 (17.9%) patients were diagnosed with urinary tract infection. The positive urine culture rate was 45.5%. Symptoms of UTI were varied, and no prominent symptoms. E. coli accounts for the highest proportion (46.67%), followed by, Staphycoccus aureus (10.67%), Pseudomonas aeruginsa (8,0%), Streptococcus faecali and Proteus (2.67%). ESBL - producing E. coli was 69.23%, ESBL producing Enterobacter spp was 33.33%. Gram-negative bacteria are susceptible to meropenem, imipenem, amikacin while gram positive are vancomycin-sensitive. Conclusions: Clinical manifestations of urinary tract infections varied and its typical symptoms are unclear. E.coli is a common bacterium (46.67%). Isolated bacteria have a high rate of resistance to some common antibiotics especially the third generation cephalosporins and quinolones. Most bacteria are resistant to multiple antibiotics at the same time. Gram (+) bacteria are susceptible to vancomycin, and gram (-) bacteria are susceptible to cefoxitin, amikacin, and carbapenem. Key words: urinary tract infection

scholarly journals Patients with infective endocarditis and history of injection drug use in a Swedish referral hospital during 10 years

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anna Damlin ◽  
Katarina Westling
Keyword(s):  
Infective Endocarditis ◽  
Drug Use ◽  
Injection Drug Use ◽  
Clinical Characteristics ◽  
National Registry ◽  
Injection Drug ◽  
University Hospital ◽  
Prosthetic Heart Valves ◽  
Increased Risk ◽  
History Of

Abstract Background Patients with injection drug use (IDU) have increased risk of developing infective endocarditis (IE). Previous studies have reported recurrent IE, increased duration of hospital stay, poor adherence and compliance as well as higher mortality and worse outcomes after surgery in the IDU-IE patient group. Further studies are needed to provide a basis for optimized care and prevention of readmissions in this population. This study aims to describe the clinical characteristics and outcomes among patients with IDU-IE. Methods Data of adults with IDU-IE and non-IDU-IE, treated between 2008 and 2017 at the Karolinska University Hospital in Stockholm were obtained from the Swedish National Registry of Infective Endocarditis. Clinical characteristics, microbiological results, treatment durations, results from echocardiography and in-hospital mortality were compared between the groups. Results Of the total 522 patients, 165 (32%) had IDU-IE. Patients with IDU-IE were younger than the patients with non-IDU-IE (mean age IDU-IE: 41.6 years, SD 11.9 years; non-IDU-IE: 64.3 years, SD 16.4 years; P <  0.01). No difference in distribution of gender was observed, 33% were females in both the IDU-IE and the non-IDU-IE group. History of previous IE (IDU-IE: n = 49, 30%; non-IDU-IE: n = 34, 10%; P <  0.01) and vascular phenomena (IDU-IE: n = 101, 61%; non-IDU-IE: n = 120, 34%; P <  0.01) were more common among patients with IDU-IE while prosthetic heart valves (IDU-IE: n = 12, 7%; non-IDU-IE: n = 83, 23%; P <  0.01) and known valvular disease (IDU-IE: n = 3, 2%; non-IDU-IE: n = 78, 22%; P <  0.01) were more common among patients with non-IDU-IE. Aetiology of Staphylococcus aureus (IDU-IE: n = 123, 75%; non-IDU-IE: n = 118, 33%; P <  0.01) as well as tricuspid (IDU-IE: n = 91, 55%; non-IDU-IE: n = 23, 6%; P <  0.01) or pulmonary valve vegetations (IDU-IE: n = 7, 4%; non-IDU-IE: n = 2, 1%; P <  0.01) were more common in the IDU-IE group. The overall incidence of IDU-IE decreased during the study period, while the incidence of definite IE increased (P <  0.01). Conclusions This study presents that patients with IDU-IE were younger, less frequently treated with surgery and had higher prevalence of vascular phenomena and history of previous IE, aspects that are important for improved management of this population.

scholarly journals 369. Clinical Characteristics of the First 177 Patients Admitted with COVID-19 at a Bronx Community Hospital

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S254-S254
Author(s):  
Victoria Bengualid ◽  
Maria Martinez ◽  
Zhenisa Hysenaj ◽  
Debra M Willner ◽  
Judith Berger
Keyword(s):  
Oxygen Saturation ◽  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Retrospective Chart Review ◽  
Patient Characteristics ◽  
Altered Mental Status ◽  
Channel Blockers ◽  
First Case ◽  
Overall Mortality

Abstract Background The first case of COVID-19 was admitted on March 15th 2020 to our community based hospital in the Bronx, NY. The aim of this study is to describe the clinical characteristics and outcome of these first COVID-19 patients. Patient Characteristics and Outcome Methods IRB approved retrospective chart review study of all COVID-19 patients admitted during March 2020 focusing on patient characteristics, co-morbidities, clinical manifestations and outcome. Results A total of 177 patients were admitted during March 2020: 57% African American 23.1% Hispanic and 16.9% White. 44.9% female, average age 60 years, and 90% had at least one comorbidity. Outcome was available on all patients except for one who was transferred to another institution for ECMO. Overall mortality was 33%. Clinical presentation: 69.4% presented with cough or shortness of breath, 15.8% with diarrhea, nausea, vomiting or abdominal pain, and 14.6% with myalgia, dizziness or altered mental status. 6.2% presented only with fever. However 59.8% of patients presented with fever and respiratory or gastrointestinal symptoms. Mortality The table compares patients who died vs discharged (either home or to a short term facility). Those that were 65 years or older, hypertensive or presented to the ER with an oxygen saturation of 94% or lower, were more likely to die. Ventilated patients: 31.6% of patients were intubated with a mortality rate of 77%. 22% of these patients were intubated in the first 24 hours. Compared to non-intubated patients, there was no difference in BMI, diabetes, hypertension, COPD/Asthma, use of statins, aspirin or calcium channel blockers. Intubated patients older than 64 years had significantly higher mortality rates (p=0.0001). Conclusion This cohort of COVID-19 patients is unique as almost all received Hydroxychloroquine and Azithromycin. Only 9% received steroids and even fewer received an interleukin-6 inhibitor, convalescent plasma or Remdesivir. African Americans and Hispanics accounted for 80% of patients. Greater than 90% received Medicaid. Overall mortality was 33%. The most common presentation was respiratory followed by gastrointestinal symptoms. The overall mortality was 33% but increased to 77% in intubated patients. Age, hypertension, and ER oxygen saturation correlated with mortality. Disclosures All Authors: No reported disclosures

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