scholarly journals POS1245 MORTALITY OF COVID-19 IN PATIENTS WITH RHEUMATIC DISEASES: COMPARISON TO THE GENERAL POPULATION IN MÉXICO

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 905.2-906
Author(s):  
M. U. Martínez-Martínez ◽  
F. Irazoque-Palazuelos ◽  
T. S. Rodriguez-Reyne ◽  
E. Zamora ◽  
A. Castillo Ortiz ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
General Population ◽  
Rheumatic Diseases ◽  
Demographic Characteristics ◽  
Renal Diseases ◽  
Bivariate Analysis ◽  
Chronic Obstructive ◽  
P Value ◽  
Obstructive Pulmonary Disease ◽  
Mexican Patients

Background:COVID-19 outcomes in Mexican patients with rheumatic diseases (RDs) in comparison to general population patients are unknown.Objectives:To compare mortality and hospitalization of COVID-19 patients with RDs and those without.Methods:We included for this study all the Mexican patients with RDs and COVID-19 registered from April 17th to October 30th, 2020 in the COVID-19 Global Rheumatology Alliance registry. We compare clinical and demographic characteristics of patients with RDs and COVID-19 to patients with COVID-19 that were selected randomly from the Mexican Epidemiology database (1:3). A logistic regression analysis was performed to adjust for confusion variables.Results:We included 322 patients with COVID-19 and RDs and 969 controls without RDs. Table 1 shows the demographic characteristics and comorbidities of both groups. Bivariate analysis showed that patients with RDs had higher mortality, were older, and were more frequently hospitalized. Comorbidities, such as diabetes, hypertension, cardiovascular and renal diseases were also more frequent in patients with RDs. In the multivariate analysis, having a RD was no longer associated with mortality (Figure 1).Figure 1.Multivariate analysis of mortalityConclusion:Patients with RDs had higher comorbidities, hospitalizations, and mortality than the general population in the bivariate analysis. However, adjusted multivariate analysis showed that the odds for mortality were not increased because of having a RD. These findings suggest that the increased mortality of Mexican patients with RDs may be explained by the higher frequency of comorbidities in this population.Table 1.Comparison of patients with COVID-19 with and without RDsCOVID-19 patients without RDsCOVID-19 patients with RDsp-valueN969323Age (mean (SD))42.6 (17.4)51.2 (13.9)<0.001Sex = Male (%)455 (47.0)55 (17.0)<0.001Deceased = Yes (%)55 (5.7)43 (13.3)<0.001Hospitalization = Hospitalized (%)164 (16.9)152 (47.1)<0.001Intubation = Yes (%)27 (2.8)32 (11.8)<0.001COPD_Asthma = Yes (%)37 (3.8)15 (4.6)0.522Diabetes = Yes (%)114 (11.8)49 (15.2)0.116Obesity = Yes (%)128 (13.3)21 (6.5)0.001Hypertension = Yes (%)152 (15.8)88 (27.2)<0.001Cardiovascular disease = Yes (%)19 (2.0)14 (4.3)0.02CRF = Yes (%)22 (2.3)17 (5.3)0.007Pregnancy = Yes (%)5 (0.5)2 (0.6)0.827Smoker = Yes (%)86 (8.9)10 (3.1)0.001Abbreviations: RDs, rheumatic diseases; COPD, chronic obstructive pulmonary disease; CRF, chronic renal failure.Disclosure of Interests:None declared

scholarly journals COVID-19 in CKD Patients: Lessons from 553 CKD Patients with Biopsy-Proven Kidney Disease

2021 ◽  
pp. 1-8
Author(s):  
Juan León Román ◽  
Clara García-Carro ◽  
Irene Agraz ◽  
Nestor Toapanta ◽  
Ander Vergara ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Kidney Disease ◽  
Kidney Biopsy ◽  
Cox Regression ◽  
Gastrointestinal Symptoms ◽  
Bivariate Analysis ◽  
Chronic Obstructive ◽  
Nasopharyngeal Swab ◽  
Obstructive Pulmonary Disease ◽  
Immunosuppressed Patients

<b><i>Introduction:</i></b> Chronic kidney disease (CKD) patients infected with COVID-19 are at risk of serious complications such as hospitalization and death. The prognosis and lethality of COVID-19 infection in patients with established kidney disease has not been widely studied. <b><i>Methods:</i></b> Data included patients who underwent kidney biopsy at the Vall d’Hebron Hospital between January 2013 and February 2020 with COVID-19 diagnosis during the period from March 1 to May 15, 2020. <b><i>Results:</i></b> Thirty-nine (7%) patients were diagnosed with COVID-19 infection. Mean age was 63 ± 15 years and 48.7% were male. Hypertension was present in 79.5%, CKD without renal replacement therapy in 76.9%, and cardiovascular disease in 64.1%. Nasopharyngeal swab was performed in 26 patients; older (<i>p</i> = 0.01), hypertensive (<i>p</i> = 0.005), and immunosuppressed (<i>p</i> = 0.01) patients, those using RAS-blocking drugs (<i>p</i> = 0.04), and those with gastrointestinal symptoms (<i>p</i> = 0.02) were more likely to be tested for CO­VID-19. Twenty-two patients required hospitalization and 15.4% died. In bivariate analysis, mortality was associated with older age (<i>p</i> = 0.03), cardiovascular disease (<i>p</i> = 0.05), chronic obstructive pulmonary disease (<i>p</i> = 0.05), and low hemoglobin levels (<i>p</i> = 0.006). Adjusted Cox regression showed that low hemoglobin levels at admission had 1.81 greater risk of mortality. <b><i>Conclusions:</i></b> Patients with CO­VID-19 infection and kidney disease confirmed by kidney biopsy presented a mortality of 15.4%. Swab test for COVID-19 was more likely to be performed in older, hypertensive, and immunosuppressed patients, those using RAS-blocking drugs, and those with gastrointestinal symptoms. Low hemoglobin is a risk factor for mortality.

A COMPARATIVE STUDY OF ABG PATTERN IN PATIENTS OF COPD WITH OR WITHOUT COR PULMONALE

2021 ◽  
pp. 64-66
Author(s):  
Md Shoeb Alam ◽  
Rahul Ranjan ◽  
V N Jha
Keyword(s):  
Hypoxic Pulmonary Vasoconstriction ◽  
Respiratory Acidosis ◽  
Public Health Problem ◽  
Cor Pulmonale ◽  
Chronic Obstructive ◽  
P Value ◽  
Major Public Health Problem ◽  
Close Monitoring ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is a major public health problem. COR PULMONALE describes the enlargement and failure of the right ventricle of the heart as a response to increased vascular resistance or increased pulmonary artery pressure. Hypoxic pulmonary vasoconstriction, hypercapnia, respiratory acidosis and pulmonary vascular remodeling in COPD can cause an increase in right ventricular (RV) after load, which in turn, results in RVfailure leading to COR PULMONALE AIM:The purpose of the study is to compare the ABG pattern in patients of COPD with or without COR PULMONALE. MATERIALS AND METHODS: This prospective observational study was conducted in the Department of Medicine of DMCH, Laheriasarai, Bihar. The study was conducted with duration of 2 years. Atotal of 100 patients admitted as a case of COPD with or without COR PULMONALE. The patients were put into two subgroups, COPD with and without COR PULMONALE. RESULT: The mean duration was 10.17 years and 9.20 years respectively in patients with and without COR PULMONALE. There was no statistically signicant difference regarding mean duration of disease (p value =0.304). Mean CAT score was 16.59 ± 6.26 and mean mMRC was 3.19± 0.45 in COPD patients with COR PULMONALE group. Mean CAT score was 14.06 ± 4.46 and mean mMRC was 3.10 ± 0.44 in COPD patients without COR PULMONALE group. We found no signicant difference among these variables between groups. Although COR PULMONALE patients had higher CATscore and mMRC score, the difference was not signicant (p value = >0.05). CONCLUSION:ABG ANALYSIS should be recommended for all patients of COPD with or without COR PULMONALE to assess the degree of hypoxemia, hypercapnea, respiratory acidosis and also, we can identify individuals who need more close monitoring and intensive treatment.

scholarly journals Effect of Pharmacy Counseling on Readmissions in Patients with Acute Exacerbations of COPD: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Narachai Prasungriyo ◽  
Nungruthai Sooksai
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Direct Costs ◽  
Disease Assessment ◽  
Chronic Obstructive ◽  
P Value ◽  
Intervention Period ◽  
Obstructive Pulmonary Disease ◽  
Significant Difference ◽  
Acute Exacerbations

Objective: To investigate the effects of pharmacy counseling on clinical and economic outcomes in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) patients.Material and Methods: The outcomes consisted of 28-day hospital readmissions related to AECOPD, direct costs, medication adherence calculated by proportion of days covered (PDC), and health-related quality of life (HRQoL) measured by chronic obstructive pulmonary disease assessment test (CAT). The data derived from the intervention group, for which pharmacy counseling was provided, was compared with that obtained from the control group provided with usual pharmaceutical care. The study also drew comparisons between the PDC and CAT scores of pre- and postintervention periods.Results: Forty-four patients (23 intervention and 21 control) were included in the analysis. There were no significant differences in the readmission rate (13% vs 19%, p-value>0.050), nor the number of readmitted patients (3 vs 3, p-value >0.050). A decrease in direct costs did not reach statistical significance (p-value>0.050). In addition, no difference between the PDC scores was found (96.67 vs 100.00, p-value>0.050). Intervention patients obtained significantly lower CAT scores than the control patients did (9 vs 19, p-value<0.050). Compared with the pre-intervention period, PDC scores were identical; however, CAT scores measured during the post-intervention period were significantly different.Conclusion: Pharmacy counseling for AECOPD patients could enhance HRQoL. Drug therapy and pulmonary rehabilitation may cause such improvement. Further work, which has adequate participants, is required to detect a significant difference in readmissions between the two groups.

Pharmacist-Led Transition of Care Pilot Targeting Older People After Emergency Department Discharge

2020 ◽  
Vol 35 (6) ◽  
pp. 273-282
Author(s):  
Scott M. Pearson ◽  
Anushka Tandon ◽  
Danielle R. Fixen ◽  
Sunny A. Linnebur ◽  
Gretchen M. Orosz ◽  
...  
Keyword(s):  
Emergency Department ◽  
Older People ◽  
Primary Outcome ◽  
Transitional Care ◽  
Intervention Group ◽  
Chronic Obstructive ◽  
P Value ◽  
Historical Cohort ◽  
Obstructive Pulmonary Disease ◽  
The Impact

OBJECTIVE: To evaluate the impact of a pharmacist-led transitional care intervention targeting high-risk older people after an emergency department (ED) visit.<br/> DESIGN: Retrospective cohort study of older people with ED visits prior to and during a pharmacist-led intervention.<br/> SETTING: Patients receiving primary care from the University of Colorado Health Seniors Clinic.<br/> PARTICIPANTS: The intervention cohort comprised 170 patients with an ED visit between August 18, 2018, and February 19, 2019, and the historical cohort included 166 patients with an ED visit between August 18, 2017, and February 19, 2018. All included patients either had a historical diagnosis of heart failure or chronic obstructive pulmonary disease, or they had an additional ED visit in the previous six months.<br/> INTERVENTIONS: The pilot intervention involved postED discharge telephonic outreach and assessment by a clinical pharmacist, with triaging to other staff if necessary.<br/> MAIN OUTCOME MEASURE: The primary outcome was the proportion of patients with at least one repeat ED visit, hospitalization, or death within 30 days of ED discharge. Outcome rates were also assessed at 90 days postdischarge.<br/> RESULTS: The primary outcome occurred in 21% of the historical cohort and 25% of the intervention cohort (adjusted P-value = 0.48). The incidence of the composite outcome within 90 days of ED discharge was 43% in the historical group compared with 38% in the intervention group (adjusted P-value = 0.29).<br/> CONCLUSION: A pharmacist-led telephonic intervention pilot targeting older people did not appear to have a significant effect on the composite of repeat ED visit, hospitalization, or death within 30 or 90 days of ED discharge. A limited sample size may hinder the ability to make definitive conclusions based on these findings.

scholarly journals Association of bone mineral density with lung function in a Chinese general population: the Xinxiang rural cohort study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Xiang Zeng ◽  
Dongling Liu ◽  
Xiangmei Zhao ◽  
Ling Chao ◽  
Yuchun Li ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lung Function ◽  
General Population ◽  
Bone Mineral ◽  
Chronic Obstructive ◽  
Reference Area ◽  
Mineral Density ◽  
Obstructive Pulmonary Disease ◽  
Lower Lung ◽  
The Relationship

Abstract Background Bone mineral density (BMD) has been positively associated with lung function in patients diagnosed with respiratory diseases such as chronic obstructive pulmonary disease (COPD) and cystic fibrosis. However, the relationship between BMD and lung function is inconsistent in the general population. Methods To investigate the association between BMD and lung function in a Chinese general population, a total of 1024 adults aged 40–70 years old from Qiliying (an industrial polluted exposure area) and Langgongmiao (the reference area with non-industrial pollution) were recruited and underwent BMD and spirometry tests. Results Both BMD and lung function levels were lower in the exposed area compared to the reference area. In addition, BMD and lung function levels were also lower in females compared to males. Both Spearman and partial correlation analyses showed that BMD was positively correlated with FVC and FEV1. After adjusting linear regression analyses for potential confounding factors, every 0.1 g/cm2 drop in BMD was associated with 53.0 mL decrease in FVC and 33.5 mL decrease in FEV1. Conclusions A reduction of BMD is associated with lower lung function in a general population from China.

Chronic Pain Increases the Risk for Major Adverse Cardiac and Cerebrovascular Events: A Nationwide Population-Based Study in Asia

Pain Medicine ◽  
2020 ◽  
Vol 21 (9) ◽  
pp. 1985-1990 ◽  
Author(s):  
Kun-Ming Chung ◽  
Chung-Han Ho ◽  
Yi-Chen Chen ◽  
Chien-Chin Hsu ◽  
Chong-Chi Chiu ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Asian Population ◽  
Population Based ◽  
Renal Diseases ◽  
Chronic Obstructive ◽  
Research Database ◽  
Obstructive Pulmonary Disease ◽  
Cerebrovascular Events ◽  
Increased Risk ◽  
Taiwan National Health Insurance

Abstract Objective Chronic pain (CP) may increase the risk for major adverse cardiac and cerebrovascular events (MACCEs); however, this issue is still unclear in the Asian population. We conducted this study to delineate it. Design From the Taiwan National Health Insurance Research Database, we identified 17,614 participants (&lt;65 years) with CP and matched them by age and sex at a 1:2 ratio to participants without CP, who made up the comparison cohort. Several causes of CP and its underlying comorbidities were also analyzed. Outcome Measure A comparison of MACCE occurring in the two cohorts was performed via follow-up until 2015. Results The mean age (SD) was 50.2 (11.5) years and 50.4 (11.7) years in participants with and without CP, respectively. In both cohorts, the percentage of female participants was 55.5%. Common causes of CP were spinal disorders (23.9%), osteoarthritis (12.4%), headaches (11.0%), gout (10.2%), malignancy (6.2%), and osteoporosis (4.5%). After adjusting for hypertension, diabetes, chronic obstructive pulmonary disease, renal diseases, hyperlipidemia, liver diseases, dementia, and depression, participants with CP had a higher risk for MACCE than those without CP (adjusted hazard ratio [AHR] = 1.3, 95% confidence interval [CI] = 1.3 − 1.4). After conducting subgroup analyses, an increased risk was also found for all-cause mortality (AHR = 1.4, 95% CI = 1.1 − 1.8), acute myocardial infarction (AHR = 1.2, 95% CI = 1.0 − 1.4), and stroke (AHR = 1.3, 95% CI = 1.3 − 1.4). Conclusions CP is associated with increased occurrence of MACCE. Early detection and interventions for CP are suggested.

scholarly journals Chronic obstructive pulmonary disease and rheumatic diseases: A systematic review on a neglected comorbidity

2019 ◽  
Vol 9 ◽  
pp. 2235042X1882020 ◽  
Author(s):  
Irini Gergianaki ◽  
Ioanna Tsiligianni
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Primary Sjögren Syndrome ◽  
Copd Patients ◽  
Increased Risk ◽  
Health Quality

Background: Although, both chronic obstructive pulmonary disease (COPD) and rheumatic diseases (RDs) are common, and each has significant impact on patients’ overall health/quality of life, their co-occurrence has received little attention, while 15% of COPD remains undiagnosed in RDs. Objective: To update the information regarding the comorbid state of RD/COPD (prevalence, incidence), to examine whether patients with RD have increased risk of developing COPD and vice versa, and what implications this comorbidity has on patients’ outcomes (mortality, hospitalizations, exacerbations). Methods: We performed a systematic literature review regarding the comorbidity of an RD (rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PsA), systemic lupus erythematosus (SLE), primary Sjogren syndrome disease (pSS), and systemic sclerosis (SSc)) with COPD. From 2803 reports retrieved, 33 articles were further screened. Finally, 27 articles were included. Results: Robust evidence supports that COPD develops up to 68% more frequently in patients with RA, as compared to the general population. Similarly, COPD is increased in every other RD that was studied. Further, self-referred arthritis is more common in COPD patients versus non-COPD controls and a predictor of worst self-rated health status. Patients with inflammatory arthritis/COPD have increased mortality (threefold in RA-COPD, irrespectively of which is first diagnosed), hospitalizations, and emergency visits. Conclusion: COPD is more common in patients with RA, AS, PsA, SLE, pSS, and SSc; yet, the association, vice versa, warrants further investigation. Nevertheless, COPD/RDs coexistence has significant prognostic value for worst outcomes; therefore, awareness is required to track early identification, especially in primary care.

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