scholarly journals Clotting of Hemodialysis Access in Patients with COVID-19 in an Inner-City Hospital

Nephron ◽  
2021 ◽  
pp. 1-6
Author(s):  
Jie Ouyang ◽  
Siddhartha Bajracharya ◽  
Sabu John ◽  
John Wagner ◽  
Jiehui Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
New York ◽  
New York City ◽  
Clinical Manifestations ◽  
Kidney Injury ◽  
Dialysis Access ◽  
City Hospital ◽  
Kings County ◽  
Thrombotic Complications ◽  
High Bmi

<b><i>Background:</i></b> An increased incidence of thrombotic complications in patients with coronavirus disease 2019 (COVID-19) has been reported. Severe acute kidney injury (AKI) is one of the major clinical manifestations of COVID-19 with the need for renal replacement therapy. It was observed that hemodialysis (HD) accesses tended to thrombose more often in the COVID-19 population than in non-COVID-19 patients. We hypothesize that the hypercoagulable state of COVID-19 is associated with higher incidence of access clotting. <b><i>Method:</i></b> In this retrospective single-centered study at Kings County Hospital in New York City, 1,075 patients with COVID-19 were screened, and 174 patients who received HD from January 3, 2021 to May 15, 2020 were enrolled to examine the risk factors of dialysis access clotting in patients with COVID-19. <b><i>Results:</i></b> Of the 174 patients, 109 (63%) were COVID-19 positive. 39 (22.6%) patients had dialysis access clotting at least once during their hospitalization, and they had significantly higher body mass index (BMI) (<i>p</i> = 0.001), higher rates of COVID-19 (<i>p</i> = 0.015), AKI (<i>p</i> &#x3c; 0.001), higher platelet counts (<i>p</i> = 0.029), higher lactate dehydrogenase levels (<i>p</i> = 0.009), and lower albumin levels (<i>p</i> = 0.001) than those without access malfunctions. Low albumin levels (<i>p</i> = 0.008), AKI (<i>p</i> = 0.008), and high BMI (<i>p</i> = 0.018) were risk factors associated with HD access clotting among COVID-19 patients. <b><i>Conclusion:</i></b> Patients with COVID-19 who receive HD for AKI with high BMI are at a higher risk of clotting their HD access.

scholarly journals Thrombotic complications and anticoagulation in COVID-19 pneumonia: a New York City hospital experience

2020 ◽  
Vol 99 (10) ◽  
pp. 2323-2328 ◽  
Author(s):  
Ahmad Hanif ◽  
Sumera Khan ◽  
Nikhitha Mantri ◽  
Sana Hanif ◽  
Muhamed Saleh ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
City Hospital ◽  
Hospital Experience ◽  
Thrombotic Complications

scholarly journals Incidence of Thrombosis and Associated Risk Factors in Hospitalized COVID-19 Patients in a New York City Hospital System

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 32-33
Author(s):  
Poy P. Theprungsirikul ◽  
Sunil E. Saith
Keyword(s):  
Risk Factors ◽  
New York ◽  
New York City ◽  
York City ◽  
Smoking Status ◽  
Thrombotic Event ◽  
Case Series ◽  
Acute Limb Ischemia ◽  
City Hospital ◽  
Hospital System

Introduction: As of August 10, 2020, there have been over 5 million cases of the 2019 novel coronavirus disease (COVID-19) in the United States, resulting in 162,000 deaths. New York City became the first epicenter, with several case series based on over 56,000 hospitalizations and 18,900 deaths. These case series expanded our understanding of a broader clinical spectrum of COVID-19, extending beyond the initial descriptions of a viral pneumonia. This clinical spectrum has included arterial and venous thrombotic events. Factors upon admission, which are associated with development of thrombosis in hospitalized COVID-19 patients is less well defined. Our aim is to characterize the incidence of thrombosis and the associated clinical and demographic risk factors of patients hospitalized across a New York City hospital system. Methods: We conducted a retrospective observational study of all patients, age 18 and older, hospitalized with a reverse transcriptase-polymerase chain reaction (RT-PCR) confirming severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection between March 13 and April 4, 2020 in two hospitals in New York City. Clinical demographics, admission labs and medications prior to admission were collected. Thrombotic events were identified manually by chart review and were defined as experiencing arterial and/or venous thrombotic events, including pulmonary embolism (PE), deep vein thrombosis (DVT), cerebrovascular accident (CVA), myocardial infarction (MI), acute limb ischemia, and splenic infarct, among others. Results: There were 1,352 patients hospitalized during the study period. Overall median age was 62 years (IQR: 49-72), with 455 females (33.7%). There were 160 (11.8%) thrombotic events, including 102 with venous thromboembolism (VTE), 45 with PE, 69 with DVT, 32 with CVA and 55 with other thrombotic events (e.g. MI, acute limb ischemia, and splenic infarct). Females were 46% less likely than males to experience a thrombotic event (OR: 0.54 [CI: 0.36-0.79]). Patients who racially self-identify as Asian or Pacific Islander were observed to have a 2.06 odds compared to other races of having a thrombotic event with COVID-19 (95%[CI: 1.27-3.34]). Age, admission BMI, ethnicity, smoking status, and comorbidities were not associated with the incidence of thrombosis during hospitalization. Thrombotic events were associated with higher mortality in hospitalized COVID-19 patients (35% vs 25.3%, p = 0.009). Conclusion: Traditional risk factors (age, obesity, ethnicity, smoking status, and comorbidities) were not associated with an increased risk for thrombotic events in COVID-19 patients, while admission laboratory values (d-dimer, ESR, CRP, and ferritin) among patients experiencing an event were significantly different, highlighting the impact of the cytokine storm in mediating thrombotic events. Since the incidence of thrombosis associated with COVID-19 infection may vary according to clinical demographics, further investigation to identify high risk patients may enable us to consider the role of adjunctive treatment, such as therapeutic coagulation. Disclosures No relevant conflicts of interest to declare.

scholarly journals A risk index for COVID-19 severity is associated with COVID-19 mortality in New York City

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wil Lieberman-Cribbin ◽  
Naomi Alpert ◽  
Raja Flores ◽  
Emanuela Taioli
Keyword(s):  
Risk Factors ◽  
New York ◽  
New York City ◽  
York City ◽  
Underserved Populations ◽  
Risk Index ◽  
Data Repository ◽  
Severe Illness ◽  
Mortality Data ◽  
Cross Sectional

Abstract Background New York City (NYC) was the epicenter of the COVID-19 pandemic, and is home to underserved populations with higher prevalence of chronic conditions that put them in danger of more serious infection. Little is known about how the presence of chronic risk factors correlates with mortality at the population level. Here we determine the relationship between these factors and COVD-19 mortality in NYC. Methods A cross-sectional study of mortality data obtained from the NYC Coronavirus data repository (03/02/2020–07/06/2020) and the prevalence of neighborhood-level risk factors for COVID-19 severity was performed. A risk index was created based on the CDC criteria for risk of severe illness and complications from COVID-19, and stepwise linear regression was implemented to predict the COVID-19 mortality rate across NYC zip code tabulation areas (ZCTAs) utilizing the risk index, median age, socioeconomic status index, and the racial and Hispanic composition at the ZCTA-level as predictors. Results The COVID-19 death rate per 100,000 persons significantly decreased with the increasing proportion of white residents (βadj = − 0.91, SE = 0.31, p = 0.0037), while the increasing proportion of Hispanic residents (βadj = 0.90, SE = 0.38, p = 0.0200), median age (βadj = 3.45, SE = 1.74, p = 0.0489), and COVID-19 severity risk index (βadj = 5.84, SE = 0.82, p <  0.001) were statistically significantly positively associated with death rates. Conclusions Disparities in COVID-19 mortality exist across NYC and these vulnerable areas require increased attention, including repeated and widespread testing, to minimize the threat of serious illness and mortality.

Clinical and Demographic Risk Factors for COVID-19 during Delivery Hospitalizations in New York City

2021 ◽  
Author(s):  
Desmond Sutton ◽  
Timothy Wen ◽  
Anna P. Staniczenko ◽  
Yongmei Huang ◽  
Maria Andrikopoulou ◽  
...  
Keyword(s):  
Risk Factors ◽  
New York ◽  
New York City ◽  
Logistic Regression ◽  
York City ◽  
Demographic Data ◽  
Outcome Data ◽  
Demographic Risk ◽  
Demographic Risk Factors ◽  
Zip Code

Objective This study was aimed to review 4 weeks of universal novel coronavirus disease 2019 (COVID-19) screening among delivery hospitalizations, at two hospitals in March and April 2020 in New York City, to compare outcomes between patients based on COVID-19 status and to determine whether demographic risk factors and symptoms predicted screening positive for COVID-19. Study Design This retrospective cohort study evaluated all patients admitted for delivery from March 22 to April 18, 2020, at two New York City hospitals. Obstetrical and neonatal outcomes were collected. The relationship between COVID-19 and demographic, clinical, and maternal and neonatal outcome data was evaluated. Demographic data included the number of COVID-19 cases ascertained by ZIP code of residence. Adjusted logistic regression models were performed to determine predictability of demographic risk factors for COVID-19. Results Of 454 women delivered, 79 (17%) had COVID-19. Of those, 27.9% (n = 22) had symptoms such as cough (13.9%), fever (10.1%), chest pain (5.1%), and myalgia (5.1%). While women with COVID-19 were more likely to live in the ZIP codes quartile with the most cases (47 vs. 41%) and less likely to live in the ZIP code quartile with the fewest cases (6 vs. 14%), these comparisons were not statistically significant (p = 0.18). Women with COVID-19 were less likely to have a vaginal delivery (55.2 vs. 51.9%, p = 0.04) and had a significantly longer postpartum length of stay with cesarean (2.00 vs. 2.67days, p < 0.01). COVID-19 was associated with higher risk for diagnoses of chorioamnionitis and pneumonia and fevers without a focal diagnosis. In adjusted analyses, including demographic factors, logistic regression demonstrated a c-statistic of 0.71 (95% confidence interval [CI]: 0.69, 0.80). Conclusion COVID-19 symptoms were present in a minority of COVID-19-positive women admitted for delivery. Significant differences in obstetrical outcomes were found. While demographic risk factors demonstrated acceptable discrimination, risk prediction does not capture a significant portion of COVID-19-positive patients. Key Points

scholarly journals Estimation of HIV Prevalence, Risk Factors, and Testing Frequency among Sexually Active Men Who Have Sex with Men, Aged 18–64 Years—New York City, 2002

2007 ◽  
Vol 84 (2) ◽  
pp. 212-225 ◽  
Author(s):  
Susan E. Manning ◽  
Lorna E. Thorpe ◽  
Chitra Ramaswamy ◽  
Anjum Hajat ◽  
Melissa A. Marx ◽  
...  
Keyword(s):  
Risk Factors ◽  
New York ◽  
New York City ◽  
York City ◽  
Hiv Prevalence ◽  
Sexually Active ◽  
Testing Frequency ◽  
Sex With Men

Cardiovascular Disease Risk Factors Among Immigrant and US-Born Adults in New York City

2021 ◽  
pp. 003335492110075
Author(s):  
Claudia Chernov ◽  
Lisa Wang ◽  
Lorna E. Thorpe ◽  
Nadia Islam ◽  
Amy Freeman ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
New York ◽  
New York City ◽  
Health Insurance ◽  
York City ◽  
The United States ◽  
Nutrition Examination Survey ◽  
Health And Nutrition

Objectives Immigrant adults tend to have better health than native-born adults despite lower incomes, but the health advantage decreases with length of residence. To determine whether immigrant adults have a health advantage over US-born adults in New York City, we compared cardiovascular disease (CVD) risk factors among both groups. Methods Using data from the New York City Health and Nutrition Examination Survey 2013-2014, we assessed health insurance coverage, health behaviors, and health conditions, comparing adults ages ≥20 born in the 50 states or the District of Columbia (US-born) with adults born in a US territory or outside the United States (immigrants, following the National Health and Nutrition Examination Survey) and comparing US-born adults with (1) adults who immigrated recently (≤10 years) and (2) adults who immigrated earlier (>10 years). Results For immigrant adults, the mean time since arrival in the United States was 21.8 years. Immigrant adults were significantly more likely than US-born adults to lack health insurance (22% vs 12%), report fair or poor health (26% vs 17%), have hypertension (30% vs 23%), and have diabetes (20% vs 11%) but significantly less likely to smoke (18% vs 27%) (all P < .05). Comparable proportions of immigrant adults and US-born adults were overweight or obese (67% vs 63%) and reported CVD (both 7%). Immigrant adults who arrived recently were less likely than immigrant adults who arrived earlier to have diabetes or high cholesterol but did not differ overall from US-born adults. Conclusions Our findings may help guide prevention programs and policy efforts to ensure that immigrant adults remain healthy.

Risk Factors for New Neurological Diagnoses in Hospitalized COVID-19 Patients: A Case-Control Study in New York City

2021 ◽  
Author(s):  
Kiran Thakur ◽  
Victoria T. Chu ◽  
Christine Hughes ◽  
Carla Y. Kim ◽  
Shannon Fleck-Dardarian ◽  
...  
Keyword(s):  
Risk Factors ◽  
New York ◽  
New York City ◽  
York City ◽  
Case Control Study ◽  
Case Control ◽  
Control Study

MO412THE RISK FACTORS OF ACUTE KIDNEY INJURY CAUSED BY HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Siwen Wang ◽  
Jia Yang ◽  
Chen Xuelian ◽  
Jiaojiao Zhou ◽  
Lichuan Yang
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Strong Predictor ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Kidney Injury ◽  
Total Bilirubin Level ◽  
Risk Of Death

Abstract Background and Aims Hemophagocytic lymphohistiocytosis (HLH) is a syndrome characterized by overproduction of proinflammatory cytokines and hemophagocytosis. Acute kidney injury (AKI) is the most common complication of HLH in the kidney, which is a strong predictor of poor prognosis. In this retrospective study, we aimed to find the risk factors of AKI in patients with HLH. Method We screened all adult patients with HLH admitted to West China Hospital of Sichuan University from January 2009 to June 2019. Patients in this study were secondary HLH according to the HLH diagnostic criteria revised by the Histocyte Society in 2004. Patients with HLH were excluded from the study if they had a functioning kidney transplant, received renal replacement therapy (RRT) in the past month, suffered from end-stage renal disease (ESRD), or had the renal malignant tumor. We collected basic information, clinical manifestations, and laboratory data of patients from electronic medical records. Results A total of 600 patients with confirmed diagnosis of secondary HLH are included in our analysis. There are 199(33.2%)HLH-induced AKI patients, among whom 37.2%, 32.7%, and 30.2% are classified as AKI I, II, and III, respectively, according to the 2012 KDIGO (Kidney Disease: Improving Global Outcomes) guideline. Overall hospital mortality is 176(29.3%), and the number of deaths in patients with AKI was much higher than that in patients without AKI (53.3% versus 17.5%, P &lt; 0.001). The risk factors of AKI in patients with HLH were hyperphosphatemia (P&lt;0.001, OR 5.448, 95%CI 2.951-10.059) , vasopressor(P&lt;0.001, OR 3.485, 95%CI 2.114-5.746), heart failure (P=0.044, 0R 2.336, 95%CI 1.022-5.340), gastrointestinal symptoms (P=0.043, OR 1.877, 95%CI 1.021-3.453), increased heart rate (P=0.005, OR 1.017, 95%CI 1.005-1.029), elevated total bilirubin level(P&lt;0.001, OR 1.004, 95%CI 1.002-1.007), and hypoproteinemia (P=0.034, OR 0.939, 95%CI 0.886-0.995). Conclusion The incidence of AKI was higher in patients with HLH, and the risk of death was significantly higher in HLH patients with AKI. A variety of risk factors are related to the occurrence of HLH-induced AKI. Identifying and correcting them early in clinical diagnosis and treatment may reduce the incidence of AKI in patients with HLH and improve the prognosis of them.

The New York City Hospital Story

1966 ◽  
Vol 66 (7) ◽  
pp. 1526 ◽  
Author(s):  
Edith P. Lewis
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
City Hospital
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