Abstract 14559: Prognostic Utility of Cardiac Markers in Covid-19 Patients

Introduction: SARS-CoV-2 infection has been associated with a multiple cardiovascular complications. It is not known if cardiac markers can be used for outcome prediction in the US population. Methods: We conducted a retrospective study on patients ≥ 18 years old with confirmed COVID 19, who were admitted to our hospital between 03/15/2020 and 05/25/2020. Individuals were included if they had a baseline troponin and brain natriuretic peptide (BNP) available, and if their outcome by the end of the study period was well defined as discharge alive, or deceased. Univariate and multivariate logistic regression methods were employed to identify the cardiac markers associated with mortality in COVID-19 patients. Results: The total number of confirmed COVID-19 hospitalized patients during the study period was 348, after excluding patients who did not have cardiac markers available, 233 patients were included in the study, 75 (32%) expired, and 158 (68%) were discharged alive. The median age was 65 years old, and ranged from 22 to 101 years old. 140 males and 93 females. Comorbidities were present in 201 (86%) patients, with hypertension (65%) being the most common, followed by obesity (55%), diabetes mellitus (DM) (44%) and coronary artery disease (27%). Mechanical ventilation was required for 61 patients of whom 42 expired. In univariate analysis, we found a significant difference in history of chronic kidney disease defined by eGFR <45ml/min (p=0.046), DM (p=0.043), initial SOFA (p=0.017), troponin (p=0.001), BNP (p=0.043), CRP (p=<0.0001), LDH (p=<0.0001) and ferritin (p=<0.0001) between survivors and non-survivors. With multivariable logistic regression analysis, the only values that had an odds of survival were a low troponin (odds ratio [OR] 0.17; 95% confidence interval [CI], 0.04-0.52), a low SOFA (OR 0.72, CI 0.50-0.94) and a low CRP (OR 0.87, CI 0.87-0.94). Conclusions: This retrospective cohort study of hospitalized patients with COVID-19 suggests an independent association of increased troponin as risk factor for death in COVID-19 patients. Cardiac troponin has been reported as potential prognostic marker in the China cohort. To our knowledge, we are first to demonstrate the utilization of troponin as mortality predictor in the US population.

Download Full-text

2211. Impact of Early Fiberoptic Bronchoscopy on Microbiological Diagnostic Rate and Clinical Outcomes of Pneumonia in Acute Leukemia Patients

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1889 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S753-S754 ◽

Cited By ~ 1

Author(s):

Aki Sakurai ◽

Justin E Bala-Hampton ◽

Victor E Mulanovich ◽

William G Wierda ◽

Jorge E Cortes ◽

...

Keyword(s):

Logistic Regression ◽

Acute Leukemia ◽

Antibacterial Therapy ◽

Univariate Analysis ◽

Pneumonia Severity Index ◽

Fiberoptic Bronchoscopy ◽

Admission Rate ◽

Cancer Center ◽

Multivariable Logistic Regression Analysis ◽

Significant Difference

Abstract Background Fiberoptic bronchoscopy with BAL (FOB) remains the cornerstone in the diagnosis of pneumonia in immunocompromised patients; however, there is no uniform agreement on the best timing for FOB, and its impact on microbiological diagnostic rate and clinical outcome has not been established. Methods Retrospective study (October 2017–December 2017, July 2018–January 2019) at MD Anderson Cancer Center. The medical records of adult patients with AML, MDS or ALL who developed pneumonia (CAP, HCAP, HAP excluding VAP) and underwent FOB were reviewed. By definition, patients who underwent FOB within 48 hours after the diagnosis of pneumonia were categorized as early FOB group. We compared demographic, clinical, microbiological data, and outcomes between two groups. Data were analyzed via χ 2, Fisher’s exact and Wilcoxon rank-sum test and logistic regression. Results Of 140 patients included, 33 patients (24%) had early FOB and 107 patients (76%) had late FOB. There was no significant difference between two groups in demographic features, radiological findings, ANC and pneumonia severity index. Microbiological diagnostic rate of FOB did not differ between early FOB and late FOB: identification of pathogenic microorganisms (33.3% vs. 36.5%, p = 0.837), bacteria (6.1% vs. 13.1%, P = 0.36), fungi (18.2% vs. 12.2%, P = 0.39) and respiratory virus (12.1% vs. 16.8%, P = 0.6), respectively (Figures 1 and 2). On univariate analysis, the duration of intravenous antibacterial therapy was shorter in early FOB, with a median duration of 8.5 days (IQR 6.5–12) in early FOB and 11 days (IQR 8–18) in late FOB (P = 0.0047) (Figure 3). Multivariable logistic regression analysis showed that late FOB (OR 3.26, 95% CI 1.41 to 7.53, P = 0.0057) and negative bacterial culture on FOB (OR 3.06, 95% CI 1.01 to 9.22, P = 0.048) were significantly associated with longer duration of intravenous antibacterial therapy (≥10 days). There was no significant difference in ICU admission, 30-day and 60-day mortality and re-admission rate. Conclusion Early FOB was associated with shorter duration of intravenous antibacterial therapy for pneumonia in acute leukemia patients, which has an important impact on both optimization of antimicrobial therapy for patients and improvement of antimicrobial stewardship. Disclosures All authors: No reported disclosures.

Download Full-text

Comparison of laparoscopic and hand-assisted laparoscopic nephrectomy for inflammatory renal disease: which is the preferred approach?

Therapeutic Advances in Urology ◽

10.1177/1756287220984046 ◽

2021 ◽

Vol 13 ◽

pp. 175628722098404

Author(s):

Xudong Guo ◽

Hanbo Wang ◽

Yuzhu Xiang ◽

Xunbo Jin ◽

Shaobo Jiang

Keyword(s):

Logistic Regression ◽

Renal Disease ◽

Complication Rate ◽

Adverse Outcomes ◽

Laparoscopic Nephrectomy ◽

Multivariable Logistic Regression Analysis ◽

Invasive Approach ◽

Intraoperative Complication ◽

Multivariable Logistic Regression ◽

Significant Difference

Aims: Management of inflammatory renal disease (IRD) can still be technically challenging for laparoscopic procedures. The aim of the present study was to compare the safety and feasibility of laparoscopic and hand-assisted laparoscopic nephrectomy in patients with IRD. Patients and methods: We retrospectively analyzed the data of 107 patients who underwent laparoscopic nephrectomy (LN) and hand-assisted laparoscopic nephrectomy (HALN) for IRD from January 2008 to March 2020, including pyonephrosis, renal tuberculosis, hydronephrosis, and xanthogranulomatous pyelonephritis. Patient demographics, operative outcomes, and postoperative recovery and complications were compared between the LN and HALN groups. Multivariable logistic regression analysis was conducted to identify the independent predictors of adverse outcomes. Results: Fifty-five subjects in the LN group and 52 subjects in the HALN group were enrolled in this study. In the LN group, laparoscopic nephrectomy was successfully performed in 50 patients (90.9%), while four (7.3%) patients were converted to HALN and one (1.8%) case was converted to open procedure. In HALN group, operations were completed in 51 (98.1%) patients and conversion to open surgery was necessary in one patient (1.9%). The LN group had a shorter median incision length (5 cm versus 7 cm, p < 0.01) but a longer median operative duration (140 min versus 105 min, p < 0.01) than the HALN group. There was no significant difference in blood loss, intraoperative complication rate, postoperative complication rate, recovery of bowel function, and hospital stay between the two groups. Multivariable logistic regression revealed that severe perinephric adhesions was an independent predictor of adverse outcomes. Conclusion: Both LN and HALN appear to be safe and feasible for IRD. As a still minimally invasive approach, HALN provided an alternative to IRD or when conversion was needed in LN.

Download Full-text

387. Markers for Mortality in COVID-19 Patients with Atrial Fibrillation or Flutter

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.582 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S262-S262

Author(s):

Kok Hoe Chan ◽

Bhavik Patel ◽

Iyad Farouji ◽

Addi Suleiman ◽

Jihad Slim

Keyword(s):

Atrial Fibrillation ◽

Logistic Regression ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Prognostic Markers ◽

Univariate Analysis ◽

Laboratory Data ◽

Significant Difference ◽

New Onset

Abstract Background Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection can lead to many different cardiovascular complications, we were interested in studying prognostic markers in patients with atrial fibrillation/flutter (A. Fib/Flutter). Methods A retrospective cohort study of patients with confirmed COVID-19 and either with existing or new onset A. Fib/Flutter who were admitted to our hospital between March 15 and May 20, 2020. Demographic, outcome and laboratory data were extracted from the electronic medical record and compared between survivors and non-survivors. Univariate and multivariate logistic regression were employed to identify the prognostic markers associated with mortality in patients with A. Fib/Flutter Results The total number of confirmed COVID-19 patients during the study period was 350; 37 of them had existing or new onset A. Fib/Flutter. Twenty one (57%) expired, and 16 (43%) were discharged alive. The median age was 72 years old, ranged from 19 to 100 years old. Comorbidities were present in 33 (89%) patients, with hypertension (82%) being the most common, followed by diabetes (46%) and coronary artery disease (30%). New onset of atrial fibrillation was identified in 23 patients (70%), of whom 13 (57%) expired; 29 patients (78%) presented with atrial fibrillation with rapid ventricular response, and 2 patients (5%) with atrial flutter. Mechanical ventilation was required for 8 patients, of whom 6 expired. In univariate analysis, we found a significant difference in baseline ferritin (p=0.04), LDH (p=0.02), neutrophil-lymphocyte ratio (NLR) (p=0.05), neutrophil-monocyte ratio (NMR) (p=0.03) and platelet (p=0.015) between survivors and non-survivors. With multivariable logistic regression analysis, the only value that had an odds of survival was a low NLR (odds ratio 0.74; 95% confidence interval 0.53–0.93). Conclusion This retrospective cohort study of hospitalized patients with COVID-19 demonstrated an association of increase NLR as risk factors for death in COVID-19 patients with A. Fib/Flutter. A high NLR has been associated with increased incidence, severity and risk for stroke in atrial fibrillation patients but to our knowledge, we are first to demonstrate the utilization in mortality predictions in COVID-19 patients with A. Fib/Flutter. Disclosures Jihad Slim, MD, Abbvie (Speaker’s Bureau)Gilead (Speaker’s Bureau)Jansen (Speaker’s Bureau)Merck (Speaker’s Bureau)ViiV (Speaker’s Bureau)

Download Full-text

60. New Prognostic Markers for COVID-19 Disease

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.370 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S161-S162

Author(s):

Amr Ramahi ◽

Kok Hoe Chan ◽

Laxminarayan Prabhakar ◽

Iyad Farouji ◽

Divya Thimmareddygari ◽

...

Keyword(s):

Logistic Regression ◽

Cohort Study ◽

Prognostic Markers ◽

Univariate Analysis ◽

Laboratory Data ◽

Hospitalized Patients ◽

Prognostic Indicators ◽

Blood Profile ◽

New Model ◽

D Dimer

Abstract Background A few COVID-19 related retrospective studies have established that older age, elevated neutrophil-lymphocyte ratio (NLR), and decreased lymphocyte-CRP ratio (LCR) were associated with worse outcome. Herein, we aim to identify new prognostic markers associated with mortality. Methods We conducted a retrospective hospital cohort study on patients ≥ 18 years old with confirmed COVID-19, who were admitted to our hospital between 03/15/2020 and 05/25/2020. Study individuals were recruited if they had a complete CBC profile and inflammatory markers such as CRP, ferritin, D-dimer and LDH, as well as a well-defined clinical outcomes (discharged alive or expired). Demographic, clinical and laboratory data were reviewed and retrieved. Univariate and multivariate logistic regression methods were employed to identify prognostic markers associated with mortality. Results Out of the 344 confirmed COVID-19 hospitalized patients during the study period, 31 who did not have a complete blood profile were excluded; 303 patients were included in the study, 89 (29%) expired, and 214 (71%) were discharged alive. Demographic analysis was tabulated in Table 1. The univariate analysis showed a significant association of death with absolute neutrophil count (ANC, p=0.022), NLR (p=002), neutrophil-monocyte ratio (NMR, p=< 0.0001), LCR (p=0.007), lymphocyte-LDH ratio (LLR, p=< 0.0001), lymphocyte-D-dimer ratio (LDR, p=< 0.0001), lymphocyte-ferritin ratio (LFR, p=< 0.0001), and platelets (p=0.037) with mortality. With multivariable logistic regression analysis, the only values that had an odds of survival were high LDR (odds ratio [OR] 1.763; 95% confidence interval [CI], 1.20–2.69), and a high LFR (OR 1.136, CI 1.01–1.34). We further build up a model which can predict >85% mortality in our cohorts with the utilization of D-dimer (>500 ng/ml), Ferritin (>200 ng/ml), LDR (< 1.6), LFR (< 4) and ANC (>2.5). This new model has a ROC of 0.68 (p< 0.0001). Conclusion This retrospective cohort study of hospitalized patients with COVID-19 suggests LDR and LFR as potential independent prognostic indicators. A new model with combination of D-dimer, Ferritin, LDR, LFR and ANC, was able to predict >85% mortality in our cohort with ROC of 0.68, it will need to be validated in a prospective cohort study. Disclosures Jihad Slim, MD, Abbvie (Speaker’s Bureau)Gilead (Speaker’s Bureau)Jansen (Speaker’s Bureau)Merck (Speaker’s Bureau)ViiV (Speaker’s Bureau)

Download Full-text

Abstract TP50: A Critical Assessment of the Golden Hour and the Impact of Procedural Timing in Stroke Thrombectomy: A Single-Center Study

Stroke ◽

10.1161/str.51.suppl_1.tp50 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Aaron P Wessell ◽

Helio De Paula Carvahlo ◽

Elizabeth Le ◽

Gregory Cannarsa ◽

Matthew J Kole ◽

...

Keyword(s):

Logistic Regression ◽

Mechanical Thrombectomy ◽

Univariate Analysis ◽

Multivariable Logistic Regression Analysis ◽

Procedure Time ◽

Golden Hour ◽

Poor Outcome ◽

Multivariable Logistic Regression ◽

Scale Scores ◽

The Impact

Background: Previous studies have demonstrated the importance keeping thrombectomy procedure times ≤60 min., termed the ‘golden hour’. In the current study, we further investigate the significance of the ‘golden hour’ and the impact of procedural timing on clinical outcomes after mechanical thrombectomy. Methods: We performed an analysis of 319 consecutive mechanical thrombectomy patients at a single Comprehensive Stroke Center from April 2012 through February 2019. Bivariate analyses compared patients grouped according to procedure time ≤60 min. or >60 min. and time of stroke onset-to-endovascular therapy (OTE) ≤6 hours or >6 hours. Logistic regression was used to determine independent predictors of poor outcome at 90-days defined by modified Rankin Scale (mRS) scores of 3-6. Results: A procedure time ≤60 min. was associated with increased revascularization rates (88% vs. 67%; p<0.001) and a greater percentage of good outcomes at 90-days (47% vs. 31%; p=0.003). Multivariable logistic regression revealed that greater age (OR 1.03, 95% CI 1.004-1.051; p=0.023), higher admission NIHSS score (OR 1.10, 95% CI 1.038-1.159; p=0.001), and history of diabetes mellitus (OR 1.94, 95% CI 1.049-3.580; p=0.035) were independently associated with a greater odds of poor outcome. Modified TICI scale scores of 2C (OR 0.12, 95% CI 0.047-0.313; p<0.001) and 3 (OR 0.19, 95% CI 0.079-0.445; p<0.001) were associated with a reduced odds of poor outcome. Although not statistically significant on univariate analysis, OTE ≤6 hrs. was independently associated with a reduced odds of poor outcome (OR 0.41, 95% CI 0.212-0.809; p=0.010) in the final multivariate model (AUC 0.800). Procedure time ≤60 min. did not have a significant independent association with clinical outcome on multivariate analysis (p=0.095). Conclusions: Thrombectomy procedure times beyond 60 min. are associated with lower overall revascularization rates and worse 90 day functional outcomes when compared to faster thrombectomy procedures. However, thrombectomy procedure time was not predictive of outcome on multivariable logistic regression analysis. Our study emphasizes the significance of achieving revascularization despite the requisite procedure time.

Download Full-text

Cardiovascular Deaths among CAPD Patients

Peritoneal Dialysis International ◽

10.1177/089686088300303s07 ◽

1983 ◽

Vol 3 (3_suppl) ◽

pp. 23-26 ◽

Cited By ~ 23

Author(s):

George Wu

Keyword(s):

Heart Disease ◽

De Novo ◽

Plasma Cholesterol ◽

Hypertensive Heart Disease ◽

Cardiovascular Complications ◽

First Year ◽

Antihypertensive Medications ◽

Significant Difference ◽

Artery Disease ◽

Similar Risk

Forty-four of the 508 CAPD patients in Toronto died of cardiovascular complications during the period september 1977 -October 1982. More than 80% of these patients had evidence of ischemic or hypertensive heart disease before commencement of CAPD. The survival of CAPD patients, who were free of cardiac problems before starting CAPD, was significantly better than those who had angina pectoris, myocardial infarction or cardiomegaly at the onset of CAPD. The de novo incidence of ischemic heart disease in patients between ages 40 and 59 (n = 70) was 8.8% at the end of the first year, and 15%() at the end of the second year. These figures were comparable to those reported for hemodialysis patients but worse than those in nonuremic patients with similar risk factors. After starting CAPD, 68.2% of the initially hypertensive patients became normotensive without taking any medication, and 25.8%() became normotensive with a reduced dose of antihypertensive medications. There was no statistically significant difference between the mean fasting plasma cholesterol and triglyceride levels of patients with and those without coronary artery disease.

Download Full-text

Clinical Factors Associated with the Diagnosis of Granulomatosis with Polyangiitis

Otolaryngology ◽

10.1177/0194599816685696 ◽

2017 ◽

Vol 156 (3) ◽

pp. 484-488 ◽

Cited By ~ 4

Author(s):

Erdem Eren ◽

Toygar Kalkan ◽

Seçil Arslanoğlu ◽

Mustafa Özmen ◽

Kazım Önal ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Nasal Mucosa ◽

Odds Ratio ◽

Granulomatosis With Polyangiitis ◽

Univariate Analysis ◽

Binary Logistic Regression ◽

Binary Logistic Regression Analysis ◽

Significant Difference ◽

History Of

Objective To determine the predictive value of nasal endoscopic findings and symptoms in the diagnosis of granulomatosis with polyangiitis (GPA). Study Design A cross-sectional study. Setting A tertiary university hospital. Subjects and Methods A total of 116 adults were enrolled in the study: 19 patients with GPA, 29 patients with other rheumatic diseases, and 68 healthy volunteers. All patients were examined with a flexible endoscope, and nasal endoscopic images were recorded and evaluated blindly. The medical history of each patient was taken by a physician blinded to the patient’s diagnosis. Results Univariate analysis indicated a statistically significant difference in rhinorrhea ( P = .002), postnasal drip ( P = .015), epistaxis ( P < .001), and saddle nose ( P = .017). However, binary logistic regression analysis demonstrated that only history of epistaxis ( P = .012; odds ratio, 5.6) was statistically significant in predicting GPA. Univariate analysis showed a statistically significant difference in nasal secretion ( P = .028), nasal septal perforation ( P < .017), nasal crusting ( P < .001), nasal adhesion ( P < .001), nasal granuloma ( P = .017), and hemorrhagic fragile nasal mucosa ( P < .001). A binary logistic regression analysis demonstrated that only hemorrhagic fragile nasal mucosa ( P < .001; odds ratio, 52.9) was a statistically significant predictor of GPA. Conclusions Given the results of this study, we believe that hemorrhagic fragile nasal mucosa and history of recurrent epistaxis may put patients at risk for GPA and should be investigated accordingly.

Download Full-text

Anesthetic Agents and Cardiovascular Outcomes of Noncardiac Surgery after Coronary Stent Insertion

Journal of Clinical Medicine ◽

10.3390/jcm9020429 ◽

2020 ◽

Vol 9 (2) ◽

pp. 429

Author(s):

Hyun-Kyu Yoon ◽

Kwanghoon Jun ◽

Sun-Kyung Park ◽

Sang-Hwan Ji ◽

Young-Eun Jang ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Volatile Anesthetics ◽

Noncardiac Surgery ◽

Coronary Stent ◽

Multivariable Logistic Regression Analysis ◽

Volatile Agent ◽

Anesthetic Agents ◽

Coronary Stent Implantation ◽

Significant Difference

Patients undergoing noncardiac surgery after coronary stent implantation are at an increased risk of thrombotic complications. Volatile anesthetics are reported to have organ-protective effects against ischemic injury. Propofol has an anti-inflammatory action that can mitigate ischemia-reperfusion injury. However, the association between anesthetic agents and the risk of major adverse cardiovascular and cerebral event (MACCE) has never been studied before. In the present study, a total of 1630 cases were reviewed. Four different propensity score matchings were performed to minimize selection bias (propofol-based total intravenous anesthesia (TIVA) vs. volatile anesthetics; TIVA vs. sevoflurane; TIVA vs. desflurane; and sevoflurane vs. desflurane). The incidence of MACCE in these four propensity score-matched cohorts was compared. As a sensitivity analysis, a multivariable logistic regression analysis was performed to identify independent predictors for MACCE during the postoperative 30 days both in total and matched cohorts (TIVA vs. volatile agent). MACCE occurred in 6.0% of the patients. Before matching, there was a significant difference in the incidence of MACCE between TIVA and sevoflurane groups (TIVA 5.1% vs. sevoflurane 8.2%, p = 0.006). After matching, there was no significant difference in the incidence of MACCE between the groups of any pairs (TIVA 6.5% vs. sevoflurane 7.7%; p = 0.507). The multivariable logistic regression analysis revealed no significant association of the volatile agent with MACCE (odds ratio 1.48, 95% confidence interval 0.92–2.37, p = 0.104). In conclusion, the choice of anesthetic agent for noncardiac surgery did not significantly affect the development of MACCE in patients with previous coronary stent implantation. However, further randomized trials are needed to confirm our results.

Download Full-text

Neutrophil-lymphocyte Ratio as a Predictor of Delirium in Older Hospitalized Patients: A Prospective Cohort Study

10.21203/rs.3.rs-64372/v1 ◽

2020 ◽

Author(s):

Yanli Zhao ◽

Jirong Yue ◽

Taiping Lin ◽

Xuchao Peng ◽

Dongmei Xie ◽

...

Keyword(s):

Logistic Regression ◽

Hospitalized Patients ◽

Youden Index ◽

Multivariable Logistic Regression Analysis ◽

Characteristic Analysis ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Cut Point ◽

Index Sensitivity ◽

Sensitivity Specificity

Abstract Background: Delirium is a common neuropsychiatric syndrome in older hospitalized patients. Previous studies have suggested that inflammation and oxidative stress contribute to the pathophysiology of delirium. However, it remains unclear whether neutrophil-lymphocyte ratio (NLR), an indicator of systematic inflammation, is associated with delirium. This study aimed to investigate the value of NLR as a predictor of delirium among older hospitalized patients.Methods: We conducted a prospective study of 740 hospitalized patients aged 70 years at the West China Hospital of Sichuan University. Neutrophil and lymphocyte counts were collected within 24 hours after hospital admission. Delirium was assessed on admission and every 48 hours thereafter. We used the Receiver operating characteristic analysis to assess the ability of the NLR for predicting delirium. The optimal cut-point value of the NLR was determined based on the highest Youden index (sensitivity + specificity - 1). Patients were categorized according to the cut-point value and quartiles of NLR, respectively. We then used logistic regression to identify the unadjusted and adjusted associations between NLR as a categorical variable and delirium. Results: The optimal cut-point value of NLR for predicting delirium was 3.626 (sensitivity: 75.2%; specificity: 63.4%; Youden index: 0.386). The incidence of delirium was significantly higher in patients with NLR >3.626 than NLR ≤3.626 (24.5% vs 5.8%; P<0.001). Significantly fewer patients in the first quartile of NLR experienced delirium than in the 3rd (4.3% vs 20.0%; P<0.001) and 4th quartiles of NLR (4.3% vs 24.9%; P<0.001). Multivariable logistic regression analysis showed that NLR was independently associated with delirium.Conclusions: NLR is a simple and practical marker that can predict the development of delirium in older hospitalized patients.

Download Full-text

Frequency of Cardiovascular Complications and Its Association with Prognosis of COVID-19 Patients

BioMed Research International ◽

10.1155/2021/7073348 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Hossein Mazaherpour ◽

Masoumeh Soofian ◽

Elham Farahani ◽

Fatemeh Masfari Farahani ◽

Ehsanollah Ghaznavi Rad ◽

...

Keyword(s):

Diabetes Mellitus ◽

Troponin I ◽

Cardiovascular Complications ◽

Cardiac Complications ◽

Age Difference ◽

Creatine Kinase Mb ◽

Significant Difference ◽

Artery Disease ◽

Underlying Diseases ◽

Electrocardiogram Ecg

Coronavirus disease 2019 (COVID-19) may lead to acute respiratory disease; cardiovascular, gastrointestinal, and coagulation complications; and even death. One of the major complications is cardiovascular disorders, including arrhythmias, myocarditis, pericarditis, and acute coronary artery disease. The aim of this study was to evaluate the frequency of cardiovascular complications and to determine its association with the prognosis of COVID-19 patients. In a prospective analytic study, 137 hospitalized COVID-19 patients were enrolled. During hospitalization, an electrocardiogram (ECG) was performed every other day, and laboratory tests such as cardiac troponin I (cTnI) and creatine kinase-MB (CK-MB) were done 0, 6, and 12 hours after admission. These tests were repeated for patients with chest pain or ECG changes. Patients were categorized into three groups (improved, complicated, and expired patients) and assessed for the rate and type of arrhythmias, cardiac complications, lab tests, and outcomes of treatments. There was no significant relationship among the three groups related to primary arrhythmia and arrhythmias during treatment. The most common arrhythmia during hospitalization and after treatment was ST-T fragment changes. There was a significant age difference between the three groups ( P = 0.001 ). There was a significant difference among the three groups for some underlying diseases, including diabetes mellitus ( P = 0.003 ) and hyperlipidemia ( P = 0.004 ). In our study, different types of arrhythmias had no association with patients’ outcomes but age over 60 years, diabetes mellitus, and hyperlipidemia played an important role in the prognosis of COVID-19 cases.

Download Full-text