Serum Sodium, Patient Symptoms, and Clinical Outcomes in Hospitalized Patients with COVID-19

Introduction: Disorders of serum sodium (SNa) are common in hospitalized patients with COVID-19 and may reflect underlying disease severity. However, the association of SNa with patient-reported outcomes is not clear. Methods: The Brigham and Women’s Hospital COVID-19 Registry is a prospective cohort study of consecutively admitted adult patients with confirmed SARS-CoV-2 infection (n = 809). We examined the associations of SNa (continuous and tertiles) on admission with: (1) patient symptoms obtained from detailed chart review; and (2) in-hospital mortality, length of stay, and intensive care unit (ICU) admission using unadjusted and adjusted logistic regression models. Covariates included demographic data and comorbidities. Results: Mean age was 60 years, 48% were male, and 35% had diabetes. The most frequent symptoms were cough (64%), fever (60%), and shortness of breath (56%). In adjusted models, higher SNa (per mmol/L) was associated with lower odds of GI symptoms (OR 0.96; 95% CI 0.92-0.99), higher odds of confusion (OR 1.08; 95% CI 1.04-1.13), in-hospital mortality (OR 1.06; 95% CI 1.02-1.11), and ICU admission (OR 1.09; 95% CI 1.05-1.13). The highest sodium tertile (compared with the middle tertile) showed similar associations, in addition to lower odds of either anosmia or ageusia (OR 0.30; 95% CI 0.12-0.74). Conclusion: In this prospective cohort study of hospitalized patients with COVID-19, hypernatremia was associated with higher odds of confusion and in-hospital mortality. These findings may aid providers in identifying high-risk patients who warrant closer attention, thereby furthering patient-centered approaches to care.

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Determinants of in-hospital mortality in COVID-19; a prospective cohort study from Pakistan

10.1101/2020.12.28.20248920 ◽

2021 ◽

Author(s):

Samreen Sarfaraz ◽

Quratulain Shaikh ◽

Syed Ghazanfar Saleem ◽

Anum Rahim ◽

Fivzia Farooq Herekar ◽

...

Keyword(s):

Cohort Study ◽

Hospital Mortality ◽

Oxygen Saturation ◽

Hospital Stay ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Length Of Hospital Stay ◽

List Type ◽

Invasive Ventilation ◽

Icu Admission

SummaryA prospective cohort study was conducted at the Indus Hospital Karachi, Pakistan between March and June 2020 to describe the determinants of mortality among hospitalized COVID-19 patients. 186 adult patients were enrolled and all-cause mortality was found to be 36% (67/186). Those who died were older and more likely to be males (p<0.05). Temperature and respiratory rate were higher among non-survivors while Oxygen saturation was lower (p<0.05). Serum CRP, D-dimer and IL-6 were higher while SpO2 was lower on admission among non-survivors (p<0.05). Non-survivors had higher SOFA and CURB-65 scores while thrombocytopenia, lymphopenia and severe ARDS was more prevalent among them (p<0.05). Use of non-invasive ventilation in emergency room, ICU admission and invasive ventilation were associated with mortality in our cohort (p<0.05). Length of hospital stay and days of intubation were longer in non-survivors (p<0.05). Use of azithromycin, hydroxychloroquine, steroids, tocilizumab, antibiotics, IVIG or anticoagulation showed no mortality benefit (p>0.05). Multivariable logistic regression showed that age > 60 years, oxygen saturation <93% on admission, pro-calcitonin > 2 ng/ml, unit rise in temperature and SOFA score, ICU admission and sepsis during hospital stay were associated with higher odds of mortality. Larger prospective studies are needed to further strengthen these findings.Key FindingsAge greater than 60 years is associated with in-hospital mortality among COVID-19 patientsOxygen saturation less than 93% and ICU admission are associated with higher odds of mortalityInflammatory markers including CRP, Ferritin and IL-6 were significantly higher among non-survivorsSerum pro-calcitonin greater than 2 ng/ml and sepsis during hospital stay are associated with higher odds of mortality among COVID-19 patients

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Faculty Opinions recommendation of Decline in nutritional status is associated with prolonged length of stay in hospitalized patients admitted for 7 days or more: A prospective cohort study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.725348227.793523606 ◽

2016 ◽

Author(s):

Bruce Bistrian

Keyword(s):

Cohort Study ◽

Length Of Stay ◽

Nutritional Status ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Hospitalized Patients ◽

Prolonged Length

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Patient-reported Quality of Life following Stereotactic Body Radiation Therapy for Primary Kidney Cancer – Results from a Prospective Cohort Study

Clinical Oncology ◽

10.1016/j.clon.2021.03.002 ◽

2021 ◽

Author(s):

A. Swaminath ◽

P. Cheung ◽

R.M. Glicksman ◽

E.K. Donovan ◽

M. Niglas ◽

...

Keyword(s):

Quality Of Life ◽

Radiation Therapy ◽

Cohort Study ◽

Kidney Cancer ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Stereotactic Body Radiation Therapy ◽

Stereotactic Body Radiation ◽

Patient Reported

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Shoulder function after constraint-induced movement therapy assessed with 3D kinematics and clinical and patient reported outcomes: a prospective cohort study

Journal of Electromyography and Kinesiology ◽

10.1016/j.jelekin.2021.102547 ◽

2021 ◽

pp. 102547

Author(s):

Gunhild Mo Hansen ◽

Susanne Wulff Svendsen ◽

Asger Roer Pedersen ◽

Uwe Gustav Kersting ◽

Hanne Pallesen ◽

...

Keyword(s):

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Patient Reported Outcomes ◽

Movement Therapy ◽

Shoulder Function ◽

3D Kinematics ◽

Constraint Induced Movement Therapy ◽

Patient Reported

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The INTREST registry: protocol of a multicenter prospective cohort study of predictors of women’s response to integrative breast cancer treatment

BMC Cancer ◽

10.1186/s12885-021-08468-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Heidemarie Haller ◽

Petra Voiß ◽

Holger Cramer ◽

Anna Paul ◽

Mattea Reinisch ◽

...

Keyword(s):

Breast Cancer ◽

Clinical Trial ◽

Cohort Study ◽

Cancer Treatment ◽

Prospective Cohort Study ◽

Cancer Care ◽

Prospective Cohort ◽

Breast Cancer Treatment ◽

Cancer Data ◽

Patient Reported

Abstract Background Cancer registries usually assess data of conventional treatments and/or patient survival. Beyond that, little is known about the influence of other predictors of treatment response related to the use of complementary therapies (CM) and lifestyle factors affecting patients’ quality and quantity of life. Methods INTREST is a prospective cohort study collecting register data at multiple German certified cancer centers, which provide individualized, integrative, in- and outpatient breast cancer care. Patient-reported outcomes and clinical cancer data of anticipated N = 715 women with pTNM stage I-III breast cancer are collected using standardized case report forms at the time of diagnosis, after completing neo−/adjuvant chemotherapy, after completing adjuvant therapy (with the exception of endocrine therapy) as well as 1, 2, 5, and 10 years after baseline. Endpoints for multivariable prediction models are quality of life, fatigue, treatment adherence, and progression-based outcomes/survival. Predictors include the study center, sociodemographic characteristics, histologic cancer and comorbidity data, performance status, stress perception, depression, anxiety, sleep quality, spirituality, social support, physical activity, diet behavior, type of conventional treatments, use of and belief in CM treatments, and participation in a clinical trial. Safety is recorded following the Common Terminology Criteria for Adverse Events. Discussion This trial is currently recruiting participants. Future analyses will allow to identify predictors of short- and long-term response to integrative breast cancer treatment in women, which, in turn, may improve cancer care as well as quality and quantity of life with cancer. Trial registration German Clinical Trial Register DRKS00014852. Retrospectively registered at July 4th, 2018.

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Australia IBD Microbiome (AIM) Study: protocol for a multicentre longitudinal prospective cohort study

BMJ Open ◽

10.1136/bmjopen-2020-042493 ◽

2021 ◽

Vol 11 (2) ◽

pp. e042493

Author(s):

Astrid-Jane Williams ◽

Ramesh Paramsothy ◽

Nan Wu ◽

Simon Ghaly ◽

Steven Leach ◽

...

Keyword(s):

Cohort Study ◽

Environmental Factors ◽

Prospective Cohort Study ◽

Clinical Data ◽

Prospective Cohort ◽

Response To Therapy ◽

Psychological State ◽

Local Health ◽

Microbial Composition ◽

Patient Reported

IntroductionCrohn’s disease and ulcerative colitis are common chronic idiopathic inflammatory bowel diseases (IBD), which cause considerable morbidity. Although the precise mechanisms of disease remain unclear, evidence implicates a strong multidirectional interplay between diet, environmental factors, genetic determinants/immune perturbations and the gut microbiota. IBD can be brought into remission using a number of medications, which act by suppressing the immune response. However, none of the available medications address any of the underlying potential mechanisms. As we understand more about how the microbiota drives inflammation, much interest has focused on identifying microbial signals/triggers in the search for effective therapeutic targets. We describe the establishment of the Australian IBD Microbiota (AIM) Study, Australia’s first longitudinal IBD bioresource, which will identify and correlate longitudinal microbial and metagenomics signals to disease activity as evaluated by validated clinical instruments, patient-reported surveys, as well as biomarkers. The AIM Study will also gather extensive demographic, clinical, lifestyle and dietary data known to influence microbial composition in order to generate a more complete understanding of the interplay between patients with IBD and their microbiota.MethodsThe AIM Study is an Australian multicentre longitudinal prospective cohort study, which will enrol 1000 participants; 500 patients with IBD and 500 healthy controls over a 5-year period. Assessment occurs at 3 monthly intervals over a 24-month period. At each assessment oral and faecal samples are self-collected along with patient-reported outcome measures, with clinical data also collected at baseline, 12 and 24 months. Intestinal tissue will be sampled whenever a colonoscopy is performed. Dietary intake, general health and psychological state will be assessed using validated self-report questionnaires. Samples will undergo metagenomic, transcriptomic, proteomic, metabolomic and culturomic analyses. Omics data will be integrated with clinical data to identify predictive biomarkers of response to therapy, disease behaviour and environmental factors in patients with IBD.Ethics and disseminationEthical approval for this study has been obtained from the South Eastern Sydney Local Health District Research Ethics Committee (HREC 2019/ETH11443). Findings will be reported at national and international gastroenterology meetings and published in peer-reviewed journals.Trial registration numberACTRN12619000911190.

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