scholarly journals Spectrum of COVID-19 clinical characteristics among patients presenting to the primary healthcare in Qatar during the early stages of the pandemic: a retrospective multicentre cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e051999
Author(s):  
Mansoura Ismail ◽  
Anwar Joudeh ◽  
Ayman Al-Dahshan ◽  
Muna Mehdar Alsaadi ◽  
Samya Al Abdulla ◽  
...  

ObjectivesTo describe clinical characteristics and laboratory investigations of patients with COVID-19 diagnosed in primary care in Qatar and to assess predictors of hospitalisation.DesignA retrospective cross-sectional study.Setting and participants3515 confirmed patients with COVID-19 diagnosed in any of the 27 primary healthcare centres in Qatar between 9 April 2020 and 30 June 2020.Main outcome measuresDemographic characteristics, comorbidities, contact tracing, clinical and laboratory data, in addition to patient disposition at the time of diagnosisResultsMean age of patients was 35.5 years (±14.7). 2285 patients (65.0%) were males, 961 patients (27.3%) had a history of concomitant comorbidity and 640 patients (18.2%) were asymptomatic. Adult patients (19–64 years old) were more likely to report symptoms than children or elderly. Fever and cough were the most frequently documented symptoms affecting 1874 patients (46.7%) and 1318 patients (37.5%), respectively. Most patients had normal vital signs at presentation; however, patients who were subsequently hospitalised had higher median temperature than non-hospitalised patients (37.7°C, IQR: 37.0°C–38.4°C, and 37.2°C, IQR: 36.8°C–37.8°C, respectively). Hospitalised patients had significantly higher C reactive protein (CRP) (median CRP: 20 mg/L, IQR: 5.0–61.2 mg/L) than non-hospitalised patients (median CRP: 4.6 mg/L, IQR: 1.7–11.50 mg/L), and lower median absolute lymphocyte count (1.5×103/µL, IQR: 1.1×103/µL–2.1×103/µL, and 1.8×103/µL, IQR: 1.3×103/µL–2.4×103/µL, respectively). Predictors of hospitalisation were increasing age (adjusted OR (AOR): 2.614, 95% CI 1.281 to 5.332 for age between 50 years and 64 years, and AOR: 3.892, 95% CI 1.646 to 9.204 for age ≥65 years), presence of two or more comorbidities (AOR: 2.628; 95% CI 1.802 to 3.832) and presence of symptoms (AOR: 1.982: 95% CI 1.342 to 2.928).ConclusionThe majority of COVID-19 cases diagnosed in primary healthcare in Qatar were symptomatic. Most cases had normal vital signs and laboratory results at presentation. Predictors of hospitalisation were increasing age, the presence of symptoms and having two or more comorbidities.

2021 ◽  
Vol 31 (2) ◽  
Author(s):  
Menbeu Sultan ◽  
Desalegn Kene ◽  
Woldesenbet Waganew ◽  
Aschalew Worku ◽  
Aklilu Azazh ◽  
...  

BACKGROUND: Since the occurrence of COVID-19 in the world, it has claimed nearly 1.39 million human lives in the world and more than 1500 lives in Ethiopia. The number of deaths is increasing with variable distribution in the world. Despite its increasing fatality, the clinical characteristics of the deceased patients are not yet fully known. Analyzing the clinical characteristics of deceased patients will help to improve the outcome of infected patients. Hence, this study aimed to determine the clinical characteristics of patients who died due to COVID-19 in Ethiopia.METHODS: Hospital based multi-center cross-sectional study was conducted using chart review of deceased patients. Since the number of COVID-19 related deaths was limited, all consecutive COVID-19 related hospital deaths were analyzed. The data was entered into and analyzed using SPSS version 25.0. Descriptive statistics was used to explain the data collected from the survey.RESULT: A total of 92 deceased patient charts were analyzed. Of these patients, 65(71%) were males. Age ranged from 17 to 92 years (mean age being 59 years). On arrival vital signs, 60.5% of them had hypoxia, 49% had tachycardia and only 32% of patients had fever. Three fourth of the patients 64/85 had at least one comorbidity. Diabetes mellitus (DM) was the commonest comorbidity accounting for 445.9%, followed by hypertension, 23/85(27%), and HIV/ AIDS, 15/85 (17.5%).CONCLUSION: The results of this study showed that COVID-19 deceased patients presented with respiratory failure and hypoxia. However, less than a third of these patients had fever. In addition, the presence of comorbid illnesses and non-COVID-19 diseases like AIDS defining illness in significant amount needs further study to identify their level of contribution to the increasing burden of COVID-19 deaths in Ethiopia.


2017 ◽  
Vol 24 (2) ◽  
pp. 107-112 ◽  
Author(s):  
Jolanta Dadonienė ◽  
Gintarė Kumžaitė ◽  
Rimvydė Mačiulytė ◽  
Dalia Miltinienė

Objective. The goal of this study was to describe long-term patient survival and possible prognostic factors of a  group of patients diagnosed with granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) hospitalized at the  tertiary Rheumatology Centre in Vilnius. Material and Methods. A cross-sectional study of 27 patients hospitalized at the Rheumatology Centre of Santaros klinikos of Vilnius University Hospital from 1  January 2001 to 31  December 2015 with diagnoses of GPA and MPA were carried out. Data on demographics, clinical characteristics, laboratory data, and the Birmingham Vasculitis Activity Score were collected. Results. Seven (25.9%) patients during the  onset of the  disease received only oral glucocorticoids and 20 (74.1%) patients took additional medication. The BVAS median was 7 (minimum [min] – 2; maximum [max] – 23). The age median was 52 years (min  –  12; max  –  75). The  overall mortality rate was 18.5%. Mean survival time was 126.6 months (95% confidence interval [CI] = 104.5 to 148.6) limited to 154.6 months for the longest-surviving patient. Conclusions. Life expectancy during past 15  years for AAV patients increased from 99.4 to 126.6 months. A high BVAS score at the  onset of the  disease is a  bad prognostic factor related to shorter life expectancy. The growth of Staphylococcus aureus from nasopharynx might be associated with higher mortality rates and relapses in AAV patients.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Randa I. Farah ◽  
Mohammed Q. Al-Sabbagh ◽  
Munther S. Momani ◽  
Asma Albtoosh ◽  
Majd Arabiat ◽  
...  

Abstract Aim Diabetic kidney disease (DKD) is a major long-term complication of diabetes mellitus (DM). Given the paucity of data on DKD in Jordan, we aimed to evaluate the prevalence, characteristics and correlates of DKD in Jordanian patients with type 2 DM. Methods This cross-sectional study included 1398 adult patients with type 2 DM who sought medical advice in the endocrinology clinic between March and September 2019. Demographic, clinical and laboratory data were reviewed. DKD was defined as reduced eGFR, and/or albuminuria. Three regression models were constructed to identify factors associated with CKD stages, albuminuria and DKD. Results Overall, 701 (50.14%) patients had DKD, with a median age of 59.71 ± 11.36  years. Older age, high triglycerides, and low high-density lipoprotein were associated with DKD (multivariable odds ratio [OR]: 1.02, 95% confidence interval [CI]: 1.01–1.03, p < 0.01; OR: 1.1, 95% CI: 1.01–1.2; and OR: 0.98, 95% CI: 0.97–0.99, p < 0.01 respectively). Metformin and renin-angiotensin system blockers were negatively associated with albuminuria and chronic kidney disease stages (p < 0.01). Conclusion Our study demonstrated that approximately one half of patients with type 2 DM had DKD. Further studies are necessary to understand this high prevalence and the underlying factors. Future research are needed to assess implementing targeted community-based intervention.


2016 ◽  
Vol 28 (4) ◽  
pp. 389-396 ◽  
Author(s):  
Henry Namme Luma ◽  
Servais Albert Fiacre Bagnaka Eloumou ◽  
Ellis Atemlefeh Fualefeh-Morfaw ◽  
Agnes Malongue ◽  
Elvis Temfack ◽  
...  

While gastrointestinal disease is common among HIV infected individuals, the prevalence and distribution of ano-rectal pathology has not been well studied in our setting. The objective of this study therefore was to determine the prevalence and determinants of ano-rectal pathology in HIV infected patients attending the Douala General Hospital HIV treatment centre. A hospital-based cross-sectional study was undertaken. We collected socio-demographic, clinical and laboratory data using a structured questionnaire and patients’ files. Each study participant had a full physical and ano-rectal examination. We further studied factors associated with having at least one ano-rectal lesion by logistic regression reporting odds ratios (ORs) and their 95% confidence intervals (CI). We included 390 HIV infected patients. The mean age was 41 (SD: 8) years and 48% were men. Median duration since HIV diagnosis was 3 (interquartile range: 2–5) years and median CD4 cell count was 411 (interquartile range: 234–601) cells/mm3. Prevalence of ano-rectal pathology was 22.8% (95% CI: 18.7–27.3). Hemorrhoids and proctitis were most common lesions found; each in 10% of patients. From multivariate logistic regression, factors associated with ano-rectal pathology were CD4 < 350 cells/ml (OR: 2.1, 95% CI: 1.1–4.2), not on highly active antiretroviral therapy (OR: 2.2, 95% CI: 1.1–4.6), inpatient (OR: 2.3, 95% CI: 1.2–4.3), ano-rectal intercourse (OR: 5.0, 95% CI: 1.7–15.1), and more than one sexual partner (OR: 2.4, 95% CI: 1.3–4.2). Ano-rectal pathology is common amongst HIV infected patients. Care givers should actively investigate and treat them as this will improve the quality of life of people living with HIV/AIDS.


Author(s):  
Vijay Pratap Singh Tomar ◽  
Sandeep Sharma ◽  
Rahul Bhardwaj ◽  
Sindhuja Singh ◽  
Virendra Kumar Pal ◽  
...  

Introduction: Pigmentary Glaucoma (PG) and Pigment Dispersion Syndrome (PDS) are two different spectrums of a single disease. Since the disease is seen in younger population and is rapidly progressive blinding disease, therefore early diagnosis and treatment will reduce the burden of the disease and improve the quality of life. Aim: To evaluate clinical characteristics of PDS and PG patients in eastern part of Uttar Pradesh. Materials and Methods: This was a two years (1st January 2018 to 31st December 2019) hospital‑based retrospective cross‑sectional study of patients who attended the glaucoma clinic. Diagnosis of PDS was made when they had normal optic disc, normal visual field {with or without increased Intra Ocular Pressure (IOP)} and at least two of the following three signs were found clinically: Krukenberg spindle, homogenous moderate‑to‑heavy (≥Spaeth 2+) Trabecular Meshwork (TM) pigmentation, and any degree of zonular and/or lenticular pigment granule dusting. Patients with PDS were diagnosed with PG, if they had two or more of the following findings: initial IOP >21 mmHg, glaucomatous optic nerve damage or glaucomatous visual field loss. Various parameters such as influence of demographics, IOP, Best‑Corrected Visual Acuity (BCVA), Central Corneal Thickness (CCT), Mean Deviation (MD), Visual Field Index (VFI %), spherical equivalent and clinical finding of anterior segment of study patients were analysed. Mean, standard deviation and percentage were calculated using GraphPad Instat version 3.0. Results: Among 40 patients, nine eyes of the six patients had myopia of ‑0.5D or greater, with mean refractive error of ‑3.55±4.72 spherical equivalent. The average baseline IOP in study patients (PDS+PG), was 30.21±11.42 mmHg. Twenty four (60%) patients, either in one or both eyes had glaucoma, secondary to PDS at the initial diagnosis. Thirty three (82.5%) patients had Krukenberg spindles. Homogeneous TM pigmentation was seen in all patients. Typical spoke‑like radial Iris Transillumination Defects (ITDs) were not observed in any of the patients except in one patient, who had isolated short slit‑like trans‑illumination defects in iris crypts. Conclusion: PDS patients with normal optic disc and visual field and raised IOP, should be started prophylactic treatment and needs to be monitored more closely. Thus, the finding of PDS in Indians should alert the ophthalmologist to look for glaucoma during the initial examination.


2020 ◽  
Author(s):  
Rehab A. Rayan

For improving accomplished attempts to stop smoking, it is necessary to learn about the qualities of individuals who can willingly stop smoking. This study seeks to discover the willingness degree and associated determinants to stop smoking between adult visitors of a primary healthcare centre in an urban area of Alexandria in Egypt. In this single point and descriptive cross-sectional study, a semi-structured questionnaire was distributed to a sample of 53 adults aged ≥18 years in May 2019. Descriptive statistical analyses were conducted to evaluate the determinants influencing the willingness to stop smoking. Of the 53 respondents (with a mean age of 38.7 years old), 41.5% of them were males. Almost 18.9% of the respondents were ongoing smokers (36.4% of males and 6.5% of females), though 83.7% of those smokers were willing to stop smoking. The number of male smokers was significantly greater than female smokers (Pearson Chi-Square = 7.52, p-value = 0.006). Determinants, which can favourably influence the willingness to stop smoking, were believing that smoking is a health risk to them (100%) and the others around (94.3%). A bulk of participants (56.6%) doubted the need for nicotine supplements to help in smoking cessation. Smoker respondents were willing to stop smoking. Understanding that smoking is a health hazard for both smokers and the others around can motivate smoking cessation. Relying on nicotine supplements alone might not add favourably to a strong smoking cessation decision. Tailoring campaigns to raise awareness about smoking health hazards’ would support and sustain smoking cessation.


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