scholarly journals Older age, comorbidity, glucocorticoid use and disease activity are risk factors for COVID-19 hospitalisation in patients with inflammatory rheumatic and musculoskeletal diseases

RMD Open ◽  
2021 ◽  
Vol 7 (1) ◽  
pp. e001464
Author(s):  
Rebecca Hasseli ◽  
Ulf Mueller-Ladner ◽  
Bimba F Hoyer ◽  
Andreas Krause ◽  
Hanns-Martin Lorenz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Risk Factor ◽  
Kidney Disease ◽  
Disease Activity ◽  
Independent Risk Factor ◽  
Musculoskeletal Diseases ◽  
Multivariable Analysis ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

IntroductionWhether patients with inflammatory rheumatic and musculoskeletal diseases (RMD) are at higher risk to develop severe courses of COVID-19 has not been fully elucidated. Aim of this analysis was to describe patients with RMD according to their COVID-19 severity and to identify risk factors for hospitalisation.MethodsPatients with RMD with PCR confirmed SARS-CoV-2 infection reported to the German COVID-19 registry from 30 March to 1 November 2020 were evaluated. Multivariable logistic regression was used to estimate ORs for hospitalisation due to COVID-19.ResultsData from 468 patients with RMD with SARS-CoV-2 infection were reported. Most frequent diagnosis was rheumatoid arthritis, RA (48%). 29% of the patients were hospitalised, 5.5% needed ventilation. 19 patients died. Multivariable analysis showed that age >65 years (OR 2.24; 95% CI 1.12 to 4.47), but even more>75 years (OR 3.94; 95% CI 1.86 to 8.32), cardiovascular disease (CVD; OR 3.36; 95% CI 1.5 to 7.55), interstitial lung disease/chronic obstructive pulmonary disease (ILD/COPD) (OR 2.79; 95% CI 1.2 to 6.49), chronic kidney disease (OR 2.96; 95% CI 1.16 to 7.5), moderate/high RMD disease activity (OR 1.96; 95% CI 1.02 to 3.76) and treatment with glucocorticoids (GCs) in dosages >5 mg/day (OR 3.67; 95% CI 1.49 to 9.05) were associated with higher odds of hospitalisation. Spondyloarthritis patients showed a smaller risk of hospitalisation compared with RA (OR 0.46; 95% CI 0.23 to 0.91).ConclusionAge was a major risk factor for hospitalisation as well as comorbidities such as CVD, ILD/COPD, chronic kidney disease and current or prior treatment with GCs. Moderate to high RMD disease activity was also an independent risk factor for hospitalisation, underlining the importance of continuing adequate RMD treatment during the pandemic.

scholarly journals Predictors Of The Development Of Chronic Kidney Disease In Patients With Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 03 (04) ◽  
pp. 178-183
Author(s):  
Kayumova Gulnoz Karimovna ◽  
◽  
Akhmedova Nilufar Sharipovna ◽  
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Pulmonary Disease ◽  
Right Atrial ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
High Incidence

The aim of the study was to identify predictors of decreased glomerular filtration in patients with chronic obstructive pulmonary disease (COPD). Materials and methods. We analyzed 145 case histories of patients diagnosed with COPD. The majority (84.1%, n = 122) of them are males (the average age of men is 60.7 ± 0.9 years, the average age of women is 62.0 ± 2.7 years). A comparative analysis of the prevalence of risk factors for chronic kidney disease (CKD) in patients with COPD: age, gender, smoking, arterial hypertension, overweight, etc. The glomerular filtration rate (GFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD – EPI) formula, according to which the patients were divided into 6 groups: group 1 - hyperfiltration, group 2 - GFR CKD – EPI ≥ 90 ml / min / 1 , 73 m2, 3rd - GFR CKD – EPI 60–89 ml / min / 1.73 m2, 4th - GFR CKD – EPI 45–59 ml / min / 1.73 m2, 5th - GFR CKD – EPI 30 - 44 ml / min / 1.73 m2 and 6th-GFR CKD-EPI <30 ml / min / 1.73 m2. Results. Patients with COPD have a high incidence of CKD risk factors. A correlation was found between the prevalence of CKD risk factors and the severity of COPD. The main predictors of the development of CKD in patients with COPD: duration of COPD> 9 years, body mass index> 26.5 kg / m2, smoking index> 51.3, albumin> 44.0 g / l, total protein> 70.0 g / L, forced expiratory volume in the first second ≤ 1.6 L, right atrial size> 35.5 mm, systolic pressure in the pulmonary artery> 36.6 mm Hg. Art., the thickness of the posterior wall of the left ventricle> 10.5 mm, Tiffno's index ≤ 62%. Conclusion. It was found that patients with COPD have a high incidence of both traditional and nonspecific risk factors for a decrease in GFR.

scholarly journals Analysis of Fatality of Cases by the New Coronavirus, in the Mexican State of Guanajuato: A Cross-sectional Study

2021 ◽  
pp. 110-121
Author(s):  
Nicolas Padilla-Raygoza ◽  
Gilberto Flores-Vargas ◽  
Efraín Navarro-Olivos ◽  
María de Jesús Gallardo-Luna ◽  
Francisco Javier Magos-Vazquez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Chronic Obstructive Pulmonary Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Pulmonary Disease ◽  
Case Fatality ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Case Fatality Ratio

Aims: COVID-19 has been a big public health challenge around the world in the past several months. The aim of this study is to describe the epidemic and report of fatality of confirmed cases of COVID-19 in the Mexican state of Guanajuato, until October 2, 2020. Study Design:  Cross-sectional, quantitative, analytical study. Place and Duration of Study: Registries of confirmed cases for COVID-19 in Mexican population from January until October 2, 2020, from National System of Epidemiological Surveillance/ General Direction of Epidemiology/ Secretary of Health, Mexico. Methodology: Based on the National Epidemiological Surveillance System Database from Mexico was used in this study. Data were collected on age, sex, comorbidities (i.e., diabetes, chronic obstructive pulmonary disease, asthma, hypertension, cardiovascular disease, immunosuppression, chronic kidney disease, obesity, and smoking), date of death, and real-time reverse transcription polymerase test results. Statistical analyses used were Case Fatality Ratio, Chi- squared test and P-value to show relationships among variables. Odds Ratio and confidence intervals at 95% were reported to show the effect of comorbidities on death due to COVID-19. Also, a Bayesian network model was fitted to assess the statistical dependence among risk factors, comorbidities, and death. Results: There were 100,109 suspected cases, of which 41.69% were positive for SARS-CoV-2. Being older than 60 and male had a higher effect on fatality by COVID-19. In Guanajuato state, 1,457 (48.68%) of deaths occurred in Mexican Institute of Social Security, with a case fatality ratio of 15.63%; meanwhile, in the Ministry of Health from Guanajuato State occurred 1,260 (42.10%) of the deaths with a case fatality ratio of 4.14%. Diabetes (OR 5.16, CI95% 4.77–5.59), chronic obstructive pulmonary disease (OR 6.34, CI95% 5.37–7.49), immunosuppression (OR 2.85, CI95% 2.17–3.76), cardiovascular disease (OR 4.20, CI95% 3.51–5.02), hypertension (OR 4.74, CI95% 4.39–5.11), chronic kidney disease (OR 6.27, CI95% 5.30–7.42), obesity (OR 1.87, CI95% 1.72–2.03), and smoking (OR 1.60, CI95% 1.41–1.81) had effect on death by COVID-19. Asthma had a preventive effect on death (OR=0.72, CI95% 0.54–0.97), but this effect is diluted after adjusting by sex and age. In all cases, age and sex, acted as confounder. Conclusion: Among the Guanajuato population with COVID-19, the main risk factor for dying were age and sex. However, diabetes, chronic obstructive pulmonary disease, immunosuppression, cardiovascular disease, chronic kidney disease, obesity, and smoking are risk factors for dying. Although, comorbidities and risk factors are highly correlated.  HIV/AIDS has no effect on fatality from SARS-CoV-2 disease and whereas asthma shows to be a protective factor.

scholarly journals CHRONIC KIDNEY DISEASE AS A MANIFESTATION OF COMORBIDITY IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

2018 ◽  
Vol 1 (69) ◽  
pp. 115-122 ◽  
Author(s):  
А Бакина ◽  
A Bakina ◽  
Валентина Павленко ◽  
Valentina Pavlenko
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Increased Risk

Chronic obstructive pulmonary disease (COPD) has many systemic effects, one of which is impaired renal function. Existing studies prove that patients with COPD often have risk factors for developing chronic kidney disease (CKD). Many risk factors for developing COPD are common for the onset of CKD. However, in routine clinical practice, there is an underestimation of the incidence of renal dysfunction in COPD patients, while in-depth and targeted studies reveal changes in renal function in patients with COPD. Topical methods for identifying initial changes in renal function in COPD patients are the study of the glomerular filtration rate, the evaluation of the level of microalbuminuria, the study of the index of resistance of renal vessels. The importance of identifying CKD in the early stages in COPD patients is determined by the increased risk of cardiovascular events and the onset of cardiorenal syndrome in patients.

scholarly journals Effect of multiple comorbidities on mortality in chronic obstructive pulmonary disease among Korean population: a nationwide cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Youngmee Kim ◽  
Ye-Jee Kim ◽  
Won-Kyung Cho
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Risk Factor ◽  
Pulmonary Disease ◽  
Independent Risk Factor ◽  
Chronic Obstructive ◽  
Health Examination ◽  
Obstructive Pulmonary Disease ◽  
Respiratory Mortality ◽  
All Cause Mortality

Abstract Background The effects of comorbidities on chronic obstructive pulmonary disease (COPD) have been usually studied individually in the past. In this study, we aimed to investigate the comorbidities associated with mortality, the effect of multimorbidity on mortality and other factors associated with mortality among Korean COPD population. Methods The Korean National Health Insurance Service-National Sample Cohort version 2.0, collected between 2002 and 2015, was used. Among COPD patients [entire cohort (EC), N = 12,779], 44% of the participants underwent additional health examination, and they were analysed separately [health-screening cohort (HSC), N = 5624]. Fifteen comorbidities previously reported as risk factors for mortality were studied using Cox proportional hazards regression models. Results Total mortality rates were 38.6 per 1000 person-years (95% CI 37.32–40.01) and 27.4 per 1000 person-years (95% CI 25.68–29.22) in EC and HSC, respectively. The most common causes of death were disease progression, lung cancer, and pneumonia. Only some of the comorbidities had a direct impact on mortality. Multimorbidity, assessed by the number of comorbid diseases, was an independent risk factor of all-cause mortality in both cohorts and was a risk factor of respiratory mortality only in HSC. The Kaplan–Meier analysis showed significant differences in survival trajectories according to the number of comorbidities in all-cause mortality but not in respiratory mortality. Low BMI, old age and male sex were independent risk factors for both mortalities in both cohorts. Conclusions The number of comorbidities might be an independent risk factor of COPD mortality. Multimorbidity contributes to all-cause mortality in COPD, but the effect of multimorbidity is less evident on respiratory mortality.

scholarly journals Potential relation of cardiovascular risk factors to disease activity in patients with axial spondyloarthritis

2021 ◽  
Vol 13 ◽  
pp. 1759720X2110337
Author(s):  
Iván Ferraz-Amaro ◽  
Javier Rueda-Gotor ◽  
Fernanda Genre ◽  
Alfonso Corrales ◽  
Ricardo Blanco ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Axial Spondyloarthritis ◽  
Multivariable Analysis ◽  
Activity Score ◽  
Increased Risk ◽  
Activity Measurements ◽  
Beta Coefficient

Background: Axial spondyloarthritis (axSpA) patients are known to have a higher prevalence of several comorbidities, including, among others, an increased risk of atherosclerosis, hypertension, dyslipidemia, and diabetes. The purpose of the present study was to determine whether the sum of traditional cardiovascular (CV) risk factors is related to disease characteristics, such as disease activity, in patients with axSpA. Methods: A cross-sectional study that encompassed 804 patients with axSpA was conducted. Patients were assessed for the presence of five traditional CV risk factors (diabetes mellitus, dyslipidemia, hypertension, obesity, and smoking status), and disease activity measurements. A multivariable regression analysis was performed to evaluate whether the number of classic CV risk factors was independently associated with specific features of the disease, to include disease activity. Results: A multivariable analysis showed that Ankylosing Spondylitis Disease Activity Score–C reactive protein (ASDAS-CRP) activity score was significantly higher in patients with 1 [beta coefficient 0.3 (95% confidence interval (CI) 0.1–0.5), p = 0.001] and ⩾2 [beta coefficient 0.5 (95% CI 0.3–0.7), p = 0.000] CV risk factors compared with those without CV risk factors. Similarly, patients with 1 [OR 2.00 (95%CI 0.99–4.02), p = 0.053] and ⩾2 [OR 3.39 (95%CI 1.82–6.31), p = 0.000] CV risk factors had a higher odds ratio for the presence of high disease activity compared with the zero CV category. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) activity score was significantly associated with the number of CV risk factors, being higher in patients with more CV risk factors. These relationships showed a CV risk factor-dependent effect being beta coefficients and ORs higher for the effect of ⩾2 over 1 CV risk factor. Conclusion: Among patients with axSpA, as the number of traditional CV risk factors increased, disease activity similarly increases in an independent manner.

Abstract MP74: Long Term Risk-Factor Profiles for Chronic Kidney Disease in the Framingham Heart Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Gearoid M McMahon ◽  
Sarah R Preis ◽  
Shih-Jen Hwang ◽  
Caroline S Fox
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Risk Factor ◽  
Kidney Disease ◽  
Framingham Heart Study ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Standard Deviation Increase ◽  
Heart Study ◽  
Increased Risk

Background: Chronic Kidney Disease (CKD) is an important public health issue and is associated with an increased risk of cardiovascular disease. Risk factors for CKD are well established, but most are typically assessed at or near the time of CKD diagnosis. Our hypothesis was that risk factors for CKD are present earlier in the course of the disease. We compared the prevalence of risk factors between CKD cases and controls at time points up to 30 years prior to CKD diagnosis. Methods: Participants were drawn from the Framingham Heart Study Offspring cohort. CKD was defined as an estimated glomerular filtration rate of ≤60ml/min/1.73m2. Incident CKD cases occurring at examination cycles 6, 7, and 8 were age- and sex-matched 1:2 to controls. Risk factors including systolic blood pressure (SBP), hypertension, lipids, diabetes, smoking status, body mass index (BMI) and dipstick proteinuria were measured at the time of CKD diagnosis and 10, 20 and 30 years prior. Logistic regression models, adjusted for age, sex, and time period, were constructed to compare risk factor profiles at each time point between cases and controls Results: During follow-up, 441 new cases of CKD were identified and these were matched to 882 controls (mean age 69.2 years, 52.4% women). Up to 30 years prior to CKD diagnosis, those who ultimately developed CKD were more likely to have hypertension (OR 1.74, CI 1.21-2.49), be obese (OR 1.74, CI 1.15-2.63) and have higher triglycerides (OR 1.43, CI 1.12-1.84, p=0.005 per 1 standard deviation increase). Each 10mmHg increase in SBP was associated with an OR of 1.22 for future CKD (95% CI 1.10-1.35) Additionally, cases were more likely to have diabetes (OR 2.90, CI 1.59-5.29) and be on antihypertensive therapy (OR 1.65, CI 1.14-2.40, p=0.009) up to 20 years prior to diagnosis. Increasing HDLc was associated with a lower risk of CKD (OR 0.84, CI 0.81-0.97 per 10mg/dl). Conclusions: As many as 30 years prior to diagnosis, risk factors for CKD are identifiable. In particular, modifiable risk factors such as obesity, hypertension and dyslipidemia are present early in the course of the disease. These findings demonstrate the importance of early identification of risk factors in patients at risk of CKD through a life-course approach.

Intra-Abdominal Hypertension is a Risk Factor for Increased VAP Incidence: A Prospective Cohort Study in the ICU of a Tertiary Hospital

2018 ◽  
Vol 35 (7) ◽  
pp. 700-707 ◽  
Author(s):  
Eleni Papakrivou ◽  
Demosthenes Makris ◽  
Efstratios Manoulakas ◽  
Marios Karvouniaris ◽  
Epaminondas Zakynthinos
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cohort Study ◽  
Cox Regression ◽  
Tertiary Hospital ◽  
University Hospital ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Cox Regression Analysis ◽  
Abdominal Hypertension

Background: Ventilator-associated pneumonia (VAP) might be increased in cases with intra-abdominal hypertension (IAH). However, despite animal experimentation and physiological studies on humans in favor of this hypothesis, there is no definitive clinical data that IAH is associated with VAP. We therefore aimed to study whether IAH is a risk factor for increased incidence of VAP in critical care patients. This 1-center prospective observational cohort study was conducted in the intensive care unit of the University Hospital of Larissa, Greece, during 2013 to 2015. Consecutive patients were recruited if they presented risk factors for IAH at admission and were evaluated systematically for IAH and VAP for a 28-day period. Results: Forty-five (36.6%) of 123 patients presented IAH and 45 (36.6%) presented VAP; 24 patients presented VAP following IAH. Cox regression analysis showed that VAP was independently associated with IAH (1.06 [1.01-1.11]; P = .053), while there was an indication for an independent association between VAP and abdominal surgery (1.62 [0.87-3.03]; P = .11] and chronic obstructive pulmonary disease (1.79 [0.96-3.37]; P = .06). Conclusions: Intra-abdominal hypertension is an independent risk factor for increased VAP incidence in critically ill patients who present risk factors for IAH at admission to the ICU.

Abstract 237: Prevalence of Cardiovascular Risk Factors and Cardiovascular Disease in Transgender Persons in The United States

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Aditi Malhotra ◽  
Hal A Skopicki ◽  
Smadar Kort ◽  
Noelle Mann ◽  
Puja Parikh
Keyword(s):  
Diabetes Mellitus ◽  
United States ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Chronic Obstructive Pulmonary Disease ◽  
Chronic Kidney Disease ◽  
The United States ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Transgender Persons

Background: There is a paucity of data regarding prevalence of cardiovascular disease (CVD) and corresponding cardiovascular (CV) risk factors in transgender individuals. We sought to assess the prevalence of CV risk factors and CVD in transgender persons in the United States. Methods: The 2018 Centers for Disease Control’s Behavioral Risk Factor Surveillance Survey was utilized to identify a cohort of 1,038 transgender individuals in the United States. Presence of CVD was noted with a single affirmative response to the following questions: “Has a health care professional ever told you that you had any of the following:” (1) a heart attack or myocardial infarction, (2) angina or coronary heart disease, (3) a stroke? Results: Among the 1,038 transgender individuals studied, a total of 145 (14.0%) had CVD while 893 (86.0%) did not. No differences in prevalence of CVD was noted in transgender individuals who transitioned from male-to-female (n=387), female-to-male (n=400), and gender nonconforming status (n=251) (15.0% vs 13.8% vs 12.7%, p=0.72). Transgender individuals with CVD were older, had lower annual income, higher rates of smoking (28.4% vs 18.1%, p=0.004), and higher rates of multiple co-morbidities including asthma (26.6% vs 17.4%, p = 0.009), skin cancer (21.8% vs 5.0%, p <0.001), non-skin cancers (16.8% vs 6.8%, p <0.001), chronic obstructive pulmonary disease (27.5% vs 7.0%, p <0.001), arthritis (65.3% vs 28.7%, p<0.001), depressive disorder (42.7% vs 31.0%, p= 0.006), chronic kidney disease (16.2% vs 3.3%, p< 0.001), and diabetes mellitus (42.0% vs 12.7%, p <0.001). No significant differences in race, health insurance status, or body mass index was noted between transgender individuals with CVD versus those without. In multivariable analysis, independent predictors of CVD in transgender individuals included older age, diabetes mellitus [odds ratio (OR) 2.82, 95% confidence interval (CI) 1.73 - 4.58], chronic kidney disease (OR 3.69, 95% CI 1.80 - 7.57), chronic obstructive pulmonary disease (OR 2.18, 95% CI 1.19 - 3.99), and depressive disorder (OR 1.82, 95% CI 1.09 - 3.03). Conclusions: In this observational contemporary study, CVD was prevalent in 14% of transgender individuals in the United States. Predictors of CVD in the transgender population exist and transgender persons should be appropriately screened for CV risk factors so as to minimize their risk of CVD.

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