Evaluation of Hospitalized Patient Outcomes in COVID-19 Infection for Continued versus Discontinued Use of Preadmission Antiplatelet Regimen

2021 ◽  
pp. 089719002110532
Author(s):  
Angela Antoniello ◽  
Alison Brophy ◽  
Yekaterina Opsha
Keyword(s):  
Mechanical Ventilation ◽  
World Health Organization ◽  
Disease Risk ◽  
Severe Disease ◽  
World Health ◽  
Ordinal Scale ◽  
Maximum Score ◽  
Secondary Endpoints ◽  
Potential Benefits ◽  
Health Organization

Objective In SARS-CoV-2 (COVID-19) infection, it is unclear if continuation of preadmission antiplatelet regimens upon hospitalization will improve hypercoagulability outcomes. Methods This retrospective cohort study analyzed adult patients hospitalized with confirmed COVID-19 infection for a 6-week period from March 13, 2020, to April 27, 2020. Preadmission antiplatelet regimen continuation for less than 75% of admission was compared to continuation for at least 75% of admission. Pregnancy, either death or withdrawal of care within 24 hours of admission, and admission beyond the studied timeframe were excluded. The primary endpoint was difference in World Health Organization COVID-19 Ordinal Scale for Clinical Improvement values (World Health Organization [WHO] scores) between maximum score during admission to that upon discharge. Secondary endpoints were mechanical ventilation requirement, mortality, radiologically confirmed venous thromboembolism, major bleeding, and length of stay. Results This study included 171 patients. Patients failing to continue antiplatelet regimens for at least 75% of admission (n = 76) had significantly worse WHO score differences than those who did (n = 95) (median −1 vs 2; P < .05). Mechanical ventilation requirement (57% vs 27%; P < .05) and mortality (58% vs 29%; P < .05) also favored antiplatelet continuation. All other endpoints were not significantly different. Conclusion Significantly improved WHO scores, mechanical ventilation requirement, and mortality occurred in patients continuing preadmission antiplatelet regimens in COVID-19 infection. Future prospective studies of COVID-19 patients with consistently collected baseline hypercoagulability markers (platelets, D-dimer, fibrinogen, and coagulation studies) and similar severe disease risk factors are required to confirm potential benefits of antiplatelet therapy during hospitalization.

Pregnancy risk assessment

ESC CardioMed ◽  
2018 ◽  
pp. 2850-2851 ◽  
Author(s):  
Petronella Pieper
Keyword(s):  
Risk Assessment ◽  
Heart Disease ◽  
World Health Organization ◽  
Disease Risk ◽  
Aortic Disease ◽  
World Health ◽  
Specific Information ◽  
Pregnancy Risk ◽  
Health Organization ◽  
Disease Specific

In all women with heart disease or aortic disease, risk assessment should be performed, preferably before conception. The recommended system for risk assessment is the modified World Health Organization classification. Additionally, disease-specific information should be used.

scholarly journals Clinical Outcomes of Hospitalized Patients with COVID-19 on Therapeutic Anticoagulants

2020 ◽  
Author(s):  
Niti G Patel ◽  
Ajay Bhasin ◽  
Joseph M Feinglass ◽  
Steven M Belknap ◽  
Michael P Angarone ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Critical Illness ◽  
Clinical Outcomes ◽  
Primary Outcome ◽  
Antiplatelet Agents ◽  
World Health ◽  
Ordinal Scale ◽  
Therapeutic Anticoagulation ◽  
Health Organization ◽  
Prophylactic Anticoagulation

Background: COVID-19 is associated with hypercoagulability and an increased incidence of thrombosis. We evaluated the clinical outcomes of adults hospitalized with COVID-19 who either continued therapeutic anticoagulants previously prescribed or who were newly started on anticoagulants during hospitalization. Methods: We performed an observational study of adult inpatients with COVID-19 at 10 hospitals affiliated with Northwestern Medicine in the Chicagoland area from March 9 to June 26, 2020. We evaluated clinical outcomes of subjects with COVID-19 who were continued on their outpatient therapeutic anticoagulation during hospitalization and those who were newly started on these medications compared to those who were on prophylactic doses of these medications based on the World Health Organization (WHO) Ordinal Scale for Clinical Improvement. The primary outcome was overall death while secondary outcomes were critical illness (WHO score >5), need for mechanical ventilation, and death among those subjects who first had critical illness adjusted for age, sex, race, body mass index (BMI), Charlson score, glucose on admission, and use of antiplatelet agents. Results: 1,716 subjects with COVID-19 were included in the analysis. 171 subjects (10.0%) were continued on their outpatient therapeutic anticoagulation and 201(11.7%) were started on new therapeutic anticoagulation during hospitalization. In subjects continued on home therapeutic anticoagulation, there were no differences in overall death, critical illness, mechanical ventilation, or death among subjects with critical illness compared to subjects on prophylactic anticoagulation. Subjects receiving new therapeutic anticoagulation for COVID-19 were more likely to die (OR 5.93; 95% CI 3.71-9.47), have critical illness (OR 14.51; 95% CI 7.43-28.31), need mechanical ventilation (OR 11.22; 95% CI 6.67-18.86), and die after first having critical illness. (OR 5.51; 95% CI 2.80 -10.87). Conclusions: Continuation of outpatient prescribed anticoagulant was not associated with improved clinical outcomes. Therapeutic anticoagulation for COVID-19 in absence of other indications was associated with worse clinical outcomes.

scholarly journals COVID-19 and Fungal Infection

2020 ◽  
pp. 47-50
Author(s):  
Ji Hyun Lee ◽  
Hwa Jung Yook
Keyword(s):  
Fungal Infection ◽  
Multiple Organ Failure ◽  
World Health Organization ◽  
Organ Failure ◽  
Fungal Infections ◽  
Severe Disease ◽  
Multiple Organ ◽  
World Health ◽  
The World ◽  
Health Organization

In November 2019, the coronavirus disease-2019 (COVID-19) outbreak was first reported. The infection of COVID-19 has rapidly spread worldwide. Some have unapparent or mild symptoms, but some patients have fatal forms including respiratory or multiple organ failure. In March 2020, the World Health Organization announced COVID-19 as pandemic disease. The COVID-19 pandemic is a sudden, difficult-to-control, and severe disease that can also appear to patients in dermatology. However, understanding disease and experience with it is still insufficient. Therefore, we would like to review patients with fungal infections in the COVID-19 pandemic era.

scholarly journals Prevalence of Underweight, Overweight and Obesity among Adults in Urban Bissau, Western Africa

Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4199
Author(s):  
Ruben Turé ◽  
Albertino Damasceno ◽  
Mouhammed Djicó ◽  
Nuno Lunet
Keyword(s):  
World Health Organization ◽  
Disease Risk ◽  
Population Based ◽  
Overweight And Obesity ◽  
World Health ◽  
Public Health Issue ◽  
Middle Income ◽  
Guinea Bissau ◽  
The World ◽  
Health Organization

Overweight and obesity affect a large proportion of the population and are important causes of death in both developed and low- and middle-income countries. In Guinea-Bissau, there are no previous population-based studies assessing this phenomenon. Therefore, we aimed to quantify the prevalence of underweight, overweight, and obesity among adults in Bissau. A stratified and cluster sample of 935 adults was assembled in 2021 and was evaluated using standardized questionnaires and anthropometric measurements, following the World Health Organization Stepwise Approach to Chronic Disease Risk Factor Surveillance. Underweight, obesity, and overweight were defined by body mass index based on the World Health Organization definitions. The prevalence of overweight and obesity was 48.7% among women and 25.0% among men. The proportion of women with abdominal obesity was 14 times higher than it was in men (35.3% vs. 2.5%). The prevalence of overweight and obesity increased with age and income. Underweight was more prevalent in the age group of 18 to 24 years (18.4% in women and 28.9% in men) and was less frequent among individuals with higher socioeconomic status. In conclusion, the prevalence of overweight and obesity is similar to the trends that are observed in many other urbanized populations in Africa and is already a major public health issue in urban Guinea-Bissau.

scholarly journals World Health Organization cardiovascular disease risk charts: revised models to estimate risk in 21 global regions

2019 ◽  
Vol 7 (10) ◽  
pp. e1332-e1345 ◽  
Author(s):  
Stephen Kaptoge ◽  
Lisa Pennells ◽  
Dirk De Bacquer ◽  
Marie Therese Cooney ◽  
Maryam Kavousi ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
World Health Organization ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
World Health ◽  
Risk Charts ◽  
Health Organization

Stunting and its associated factors in children aged 6–59 months in Ilubabor zone, Southwest Ethiopia

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Asrat Zewdie ◽  
Efrem Negash ◽  
Dereje Tsegaye
Keyword(s):  
World Health Organization ◽  
Dietary Diversity ◽  
Disease Risk ◽  
World Health ◽  
Nutritional Deficiencies ◽  
Southwest Ethiopia ◽  
Content Type ◽  
Factors Associated ◽  
Increased Risk ◽  
Health Organization

Purpose Stunting, which refers to low height-for-age, is one of the most important public health problems in Ethiopia, and it more accurately reflects nutritional deficiencies and illness that occur during the most critical periods for growth and development in early life. Given this, this paper aims at determining the magnitude and factors associated with stunting among 6–59 month old children in Ilubabor Zone, Southwest Ethiopia. Design/methodology/approach This paper opted for a descriptive study using an interviewer-administered questionnaire and anthropometric measurements of 617 children aged 6–59 months. A systematic random sampling technique was used to select the study participants. Data was analyzed using Statistical Package for Social Sciences (SPSS) version 25 and World Health Organization (WHO) Anthro software. Multivariate logistic regression analysis was used to identify independent predictors of stunting. Findings About 33.7% of children aged 6–59 months included in this study were stunted. The proportion of moderate and severe stunting among the stunted children was 26.4% and 7.3%, respectively. Large family size (AOR = 4.0; 95% confidence interval [CI]: 2.5, 6.4), low dietary diversity score (AOR = 7.8; 95% CI: 4.6, 13.0) and household food insecurity (AOR = 16.4; 95% CI: 10.0, 26.7) were independent predictors of stunting. Research limitations/implications Reporting and recall bias related to food groups consumed over the past seven days and seasonal variation may affect the findings related to factors associated with stunting. Practical implications Globally, it is estimated that nearly 165 million children under the age of five are stunted. Outcomes associated with stunting include increased risk of mortality, increased disease risk, developmental delays, diminished ability to learn and lower school achievement and reduced lifelong productivity. So, determining the level of stunting in a particular community is important to design strategies for curbing the contributing factors. Originality/value This study’s community-based design yields a representative sample of study subjects in the Hurumu district, which is valuable for intervention methods and actions. Standardized tools that are validated for use by the World Health Organization are used. Besides, anthropometric data were analyzed using the updated WHO Anthro software.

The Platelet Role in Severe and Fatal Forms of COVID-19.

2021 ◽  
Vol 21 ◽  
Author(s):  
Edgar L. Esparza-Ibarra ◽  
Jorge L. Ayala-Luján ◽  
Brenda Mendoza-Almanza ◽  
Irma González-Curiel ◽  
Susana Godina-González ◽  
...  
Keyword(s):  
World Health Organization ◽  
Causes Of Death ◽  
Distress Syndrome ◽  
Severe Disease ◽  
World Health ◽  
Cytokine Storm ◽  
The World ◽  
Critical Patients ◽  
Health Organization ◽  
Coagulation Dysfunction

: On December 31, 2019, the World Health Organization received a report of several pneumonia cases in Wuhan, China. The causative agent was later confirmed as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Since then, the SARS-CoV-2 virus has spread throughout the world, giving rise in 2020 to the 2019 coronavirus (COVID-19) pandemic, which, according to the world map of the World Health Organization, has, until May 18, 2021, infected 163,312,429 people and caused 3,386,825 deaths throughout the world. Most critical patients progress rapidly to acute respiratory distress syndrome (ARDS) and, in underlying form, to septic shock, irreversible metabolic acidosis, blood coagulation dysfunction, or hemostatic and thrombotic anomalies have been reported as the leading causes of death due to COVID-19. The main findings in severe and fatal COVID-19 patients make it clear that platelets play a crucial role in developing severe disease cases. Platelets are the enucleated cells responsible for hemostasis and thrombi formation; thus, platelet hyperreactivity induced by pro-inflammatory microenvironments contributes to the "cytokine storm" that characterizes the more aggressive course of COVID- 19.

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