scholarly journals Pulmonary fibrosis and its related factors in discharged patients with new corona virus pneumonia: a cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Xiaohe Li ◽  
Chenguang Shen ◽  
Lifei Wang ◽  
Sumit Majumder ◽  
Die Zhang ◽  
...  
Keyword(s):  
Lung Function ◽  
Pulmonary Fibrosis ◽  
Prediction Model ◽  
Area Under The Curve ◽  
Related Factors ◽  
Factors Affecting ◽  
Virus Pneumonia ◽  
Logistic Regression Method ◽  
Discharged Patients

Abstract Background Thousands of Coronavirus Disease 2019 (COVID-19) patients have been discharged from hospitals Persistent follow-up studies are required to evaluate the prevalence of post-COVID-19 fibrosis. Methods This study involves 462 laboratory-confirmed patients with COVID-19 who were admitted to Shenzhen Third People’s Hospital from January 11, 2020 to April 26, 2020. A total of 457 patients underwent thin-section chest CT scans during the hospitalization or after discharge to identify the pulmonary lesion. A total of 287 patients were followed up from 90 to 150 days after the onset of the disease, and lung function tests were conducted about three months after the onset. The risk factors affecting the persistence of pulmonary fibrosis were identified through regression analysis and the prediction model of the persistence of pulmonary fibrosis was established. Results Parenchymal bands, irregular interfaces, reticulation and traction bronchiectasis were the most common CT features in all COVID-19 patients. During the 0–30, 31–60, 61–90, 91–120 and > 120 days after onset, 86.87%, 74.40%, 79.56%, 68.12% and 62.03% patients developed with pulmonary fibrosis and 4.53%, 19.61%, 18.02%, 38.30% and 48.98% patients reversed pulmonary fibrosis, respectively. It was observed that Age, BMI, Fever, and Highest PCT were predictive factors for sustaining fibrosis even after 90 days from onset. A predictive model of the persistence with pulmonary fibrosis was developed based-on the Logistic Regression method with an accuracy, PPV, NPV, Sensitivity and Specificity of the model of 76%, 71%, 79%, 67%, and 82%, respectively. More than half of the COVID-19 patients revealed abnormal conditions in lung function after 90 days from onset, and the ratio of abnormal lung function did not differ on a statistically significant level between the fibrotic and non-fibrotic groups. Conclusions Persistent pulmonary fibrosis was more likely to develop in patients with older age, higher BMI, severe/critical condition, fever, a longer viral clearance time, pre-existing disease and delayed hospitalization. Fibrosis developed in COVID-19 patients could be reversed in about a third of the patients after 120 days from onset. The pulmonary function of less than half of COVID-19 patients could turn to normal condition after three months from onset. An effective prediction model with an average area under the curve (AUC) of 0.84 was established to predict the persistence of pulmonary fibrosis in COVID-19 patients for early diagnosis.

scholarly journals Pulmonary fibrosis and its related factors in discharged patients with new coronavirus pneumonia: A cohort study

2021 ◽  
Author(s):  
Xiaohe Li ◽  
Chenguang Shen ◽  
Lifei Wang ◽  
Sumit Majumder ◽  
Die Zhang ◽  
...  
Keyword(s):  
Lung Function ◽  
Pulmonary Fibrosis ◽  
Prediction Model ◽  
Area Under The Curve ◽  
Related Factors ◽  
Factors Affecting ◽  
Logistic Regression Method ◽  
Long Time ◽  
Discharged Patients

Abstract Background: Thousands of the Coronavirus Disease 2019 (COVID-19) patients have been discharged from hospitals, persistent follow-up studies are required to evaluate the prevalence of post-COVID-19 fibrosis.Methods: This study involves 462 laboratory confirmed patients with COVID-19 who were admitted to Shenzhen Third People’s Hospital from January 11, 2020 to April 26, 2020. A total of 457 patients underwent thin-section chest CT scans during the hospitalization or after discharge to identify the pulmonary lesion. A total of 287 patients were followed up from 90 days to 150 days after the onset of the disease, and lung function tests were conducted in about three months after the onset. The risk factors affecting the persistence of pulmonary fibrosis were identified through regression analysis and the prediction model of the persistence of pulmonary fibrosis was established.Results: Parenchymal bands, irregular interfaces, reticulation and traction bronchiectasis were the most common CT features in all COVID-19 patients. During the 0-30, 31-60, 61-90, 91-120 and >120 days after onset, 86.87%, 74.40%, 79.56%, 68.12% and 62.03% patients developed with pulmonary fibrosis and 4.53%, 19.61%, 18.02%, 38.30% and 48.98% patients reversed pulmonary fibrosis, respectively. It was observed that Age, BMI, Fever, and Highest PCT were predictive factors for sustaining fibrosis even after 90 days from onset. A predictive model of the persistence with pulmonary fibrosis was developed based-on the Logistic Regression method with an accuracy, PPV, NPV, Sensitivity and Specificity of the model of 76%, 71%, 79%, 67%, and 82%, respectively. More than half of COVID-19 patients revealed abnormal condition in lung function after 90 days from onset, and the ratio of abnormal lung function did not differ on a statistically significant level between the fibrotic and non-fibrotic groups.Conclusions: Persistent pulmonary fibrosis was more likely to develop in patients with older age, high BMI, severe/critical condition, fever, long time to turn the viral RNA negative, pre-existing disease and delay to admission. Fibrosis developed in COVID-19 patients could be reversed in about a third of the patients after 120 days from onset. The pulmonary function of less than half of COVID-19 patients could turn to normal condition after three months from onset. An effective prediction model with an average Area Under the Curve (AUC) of 0.84 was established to predict the persistence of pulmonary fibrosis in COVID-19 patients for early diagnosis.

scholarly journals Pulmonary fibrosis and its related factors in discharged patients with new coronavirus pneumonia: A cohort study of 90-150 days follow-up after onset

2020 ◽  
Author(s):  
Xiaohe Li ◽  
Chenguang Shen ◽  
Lifei Wang ◽  
Sumit Majumder ◽  
Die Zhang ◽  
...  
Keyword(s):  
Lung Function ◽  
Pulmonary Fibrosis ◽  
Area Under The Curve ◽  
Related Factors ◽  
Logistic Regression Method ◽  
Long Term Follow Up ◽  
Long Time ◽  
Discharged Patients

Abstract Background: Thousands of the Coronavirus Disease 2019 (COVID-19) patients have been discharged from hospitals, long-term follow-up studies are required to evaluate the prevalence of post-COVID-19 fibrosis.Methods: This study involves 462 laboratory confirmed patients with COVID-19 who were admitted to Shenzhen Third People’s Hospital from January 11, 2020 to April 26, 2020. A total of 457 patients underwent thin-section chest CT scans during the hospitalization or after discharge to identify the pulmonary lesion. A total of 289 patients were followed up from 90 days to 150 days after the onset of the disease.Results: Parenchymal bands, irregular interfaces, meshwork and traction bronchiectasis were the most common CT features in all COVID-19 patients. 86.87%, 74.40%, 79.56%, 68.12% and 62.03% patients developed with pulmonary fibrosis and 4.53%, 19.61%, 18.02%, 38.30% and 48.98% patients reversed pulmonary fibrosis during the 0-30, 31-60, 61-90, 91-120 and >120 days after onset, respectively. It was observed that Age, BMI, Fever, and Highest PCT were predictive factors for sustaining fibrosis even after 90 days from onset. A predictive model of the persistence with pulmonary fibrosis was developed based-on the Logistic Regression method with an accuracy, PPV, NPV, Sensitivity and Specificity of the model of 76%, 71%, 79%, 67%, and 82%, respectively. Only a fraction of COVID-19 patients suffered with abnormal lung function after 90 days from onset, and the ratio of abnormal lung function did not differ on a statistically significant level between the fibrotic and non-fibrotic groups.Conclusions: Long-term pulmonary fibrosis was more likely to develop in patients with older age, high BMI, severe/critical condition, fever, long time to turn the viral RNA negative, pre-existing disease and delay to admission. Fibrosis developed in COVID-19 patients could be reversed in about a half of the patients after 120 days from onset. The pulmonary function of most of COVID-19 patients with pulmonary fibrosis could turn to normal condition after three months from onset. An effective prediction model with an average Area Under the Curve (AUC) of 0.84 was established to predict the persistence of pulmonary fibrosis in COVID-19 patients for early diagnosis.

scholarly journals Gender differences at presentation of idiopathic pulmonary fibrosis in Sweden

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Dimitrios Kalafatis ◽  
Jing Gao ◽  
Ida Pesonen ◽  
Lisa Carlson ◽  
C. Magnus Sköld ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Gender Differences ◽  
Lung Function ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Poor Quality ◽  
Smoking History ◽  
Cross Sectional

Abstract Background Idiopathic pulmonary fibrosis (IPF) is a disease with poor prognosis mainly affecting males. Differences in clinical presentation between genders may be important both for the diagnostic work-up and for follow-up. In the present study, we therefore explored potential gender differences at presentation in a Swedish cohort of IPF-patients. Methods We studied patients included in the Swedish IPF- registry over a three-year period from its launch in 2014. A cross-sectional analysis was performed for data concerning demographics, lung function, 6- min walking test (6MWT) and quality of life (QoL) (King’s Brief Interstitial Lung Disease (K-BILD) score). Results Three hundred forty- eight patients (250 (72%) males, 98 (28%) females, median age 72 years in both genders) were included in the registry during the study period. Smoking history (N = 169 (68%) vs. N = 53 (54%), p < 0.05), baseline lung function (Forced vital capacity, % of predicted (FVC%): 68.9% ± 14.4 vs. 73.0% ± 17.7, p < 0.05; Total lung capacity, % of predicted (TLC%): 62.2% ± 11.8 vs. 68.6% ± 11.3%, p < 0.001) were significantly different at presentation between males and females, respectively. Comorbidities such as coronary artery disease (OR: 3.5–95% CI: 1.6–7.6) and other cardiovascular diseases (including atrial fibrillation and heart failure) (OR: 3.8–95% CI: 1.9–7.8) also showed significant differences between the genders. The K- BILD showed poor quality of life, but no difference was found between genders in total score (54 ± 11 vs. 54 ± 10, p = 0.61 in males vs. females, respectively). Conclusions This study shows that female patients with IPF have a more preserved lung function than males at inclusion, while males have a significant burden of cardiovascular comorbidities. However, QoL and results on the 6MWT did not differ between the groups. These gender differences may be of importance both at diagnosis and follow- up of patients with IPF.

scholarly journals Computed tomography patterns predict clinical course of idiopathic pulmonary fibrosis

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Byoung Soo Kwon ◽  
Jooae Choe ◽  
Kyung Hyun Do ◽  
Hee Sang Hwang ◽  
Eun Jin Chae ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Function ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Exercise Capacity ◽  
Clinical Course ◽  
Usual Interstitial Pneumonia ◽  
The Other ◽  
Hrct Patterns

Abstract Background A new clinical guideline for idiopathic pulmonary fibrosis (IPF) uses high-resolution computed tomography (HRCT) patterns for diagnostic purposes. However, it is unknown how they relate to the IPF clinical course. We aimed to investigate whether HRCT patterns could be used to predict lung function changes and survival in patients with IPF. Methods Clinical data were retrospectively reviewed in 337 patients with IPF (all biopsy-proven cases). HRCT patterns were classified according to the 2018 IPF diagnostic criteria. Results The median follow-up was 46.9 months. The mean age was 62.5 years, and 74.2% were men. Among the HRCT patterns, usual interstitial pneumonia (UIP), probable UIP, indeterminate for UIP, and an alternative diagnosis were identified in 163 (48.4%), 110 (32.6%), 33 (9.8%), and 31 (9.2%) patients, respectively. The indeterminate for UIP group showed higher lung function and exercise capacity and better prognosis than the other groups. They also had a lesser decline in lung function than the other groups during follow-up. In the multivariate Cox analysis, which was adjusted by age, smoking status, lung function, exercise capacity, and use of antifibrotic agents, indeterminate for UIP pattern was found to be an independent prognostic factor (hazard ratio 0.559, 95% confidence interval 0.335–0.933, P = 0.026). However, the probable UIP group had similar lung function changes and prognosis when compared the UIP group. Conclusions Our results suggest that indeterminate for UIP pattern on HRCT may predict a more favorable clinical course in patients with IPF, supporting the validity of the new IPF diagnostic guidelines.

scholarly journals An updated approach to determine minimal clinically important differences in idiopathic pulmonary fibrosis

2021 ◽  
pp. 00142-2021
Author(s):  
Mohleen Kang ◽  
Srihari Veeraraghavan ◽  
Greg S. Martin ◽  
Jordan A. Kempker
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Short Form ◽  
Area Under The Curve ◽  
Receiver Operating Curve ◽  
Physical Component Score ◽  
Sf 36 ◽  
Patient Related Outcome ◽  
Randomised Controlled

IntroductionCurrent medications for idiopathic pulmonary fibrosis (IPF) have not been shown to have impact on patient related outcome measures (PROMs) highlighting the need for accurate Minimal Clinically Important Differences (MCID) values. Recently published consensus standards for MCID studies support using anchor-based over distribution-based methods. The aim of this study was to estimate MCID values for worsening in IPF using only an anchor-based approach.MethodsWe conducted secondary analyses of three randomised controlled trials with different inclusion criteria and follow-up intervals. The Health Transition question in the Short Form Health Survey 36 (SF-36) questionnaire was used as the anchor. We used receiver operating curve to assess responsiveness between the anchor and ten variables (four physiologic measures and six PROMs). We used an anchor-based method to determine the MCID values of variables that met the responsiveness criteria (area under the curve≥0.70).ResultsSix minute walk distance (6 MWD), the St. George's Respiratory Questionnaire (SGRQ), physical component score of SF-36 (SF-36 PCS), and University of California, San Diego, Shortness of Breath Questionnaire (UCSD SOBQ) met the responsiveness criteria. The MCID value for 6 MWD was −75 meters. The MCID value for SF-36 PCS was −7 points. MCID value for SGRQ was 11points. MCID value for the UCSD SOBQ was 11 points.ConclusionsThe MCID estimates of 6 MWD, SGRQ, SF-36, UCSD SOBQ using only anchor-based methods were considerably higher compared to previously proposed values. A single MCID value may not be applicable across all classes of disease severity or durations of follow-up time.

scholarly journals Statistical Analysis on Factors That Hinders the Effectiveness of Junior Athletics Projects in North Wollo Zone, Ethiopia

2021 ◽  
Author(s):  
Ashenafi Nega ◽  
Simenew Amare
Keyword(s):  
Cross Sectional Study ◽  
Secondary Source ◽  
Research Approach ◽  
Related Factors ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Training Plan ◽  
Mixed Types ◽  
North Wollo

Abstract Background: This study was conducted to assess factors that affect the effectiveness of junior athletics projects in north Wollo zone. The main objective of the study was identifying factors affecting the effectiveness of junior athletics projects in north Wollo zone. Methods: The study used stratified sampling method to select the samples. Both primary and secondary source of data were used to gather reliable data. Mixed types of research approach (quantitative and qualitative) were employed. To achieve the objective of the study, cross-sectional study designed were employed. The collected data was organized, tabulated, and analyzed using descriptive and inferential method of data analysis. Results: The results of Proportional Odds Model reveal that training year or duration on the training of the athlete, that are trained between 2.1 to 3 year and 3.1 to 4 years are 0.855 and 0.985 times respectively smaller in performance than those athletes who trained in the project for less than 1 year. The result showed that athletes who haven’t the training field are 0.792 times less in performance than those athletes who have training field. In this study, those athletes who have well, bad and very bad relationship with their coach are 0.707, 0.989 and 0.979 times respectively lower in performance than athletes having very good relationship with their coach. In addition athletes who don’t participate in planning with their coach are 0.849 times lower in performance as compare to those athletes who participate. Those athletes who don’t get payment in the project are 0.952 times low in performance than athletes who get payment. Conclusion: The study identified factors related to sport offices related, coach related factors, athlete related. Regarding to sport office related factors such as shortage of training equipment and facilities, non-availability of training fields, lack of supervision and follow up for coaches and athletics projects, shortage of competition opportunities for athletes. Among coach related factors inability to prepaid peridized and scientific training plan, lack of providing proper demonstration for athletes, not recruiting the athletes based on talent identification. Considering athlete related factors lack of motivation on athletics sport.

scholarly journals Development and Validation of a Prediction Model for Survival in Diabetic Patients With Acute Kidney Injury

2021 ◽  
Vol 12 ◽  
Author(s):  
Manqiu Mo ◽  
Ling Pan ◽  
Zichun Huang ◽  
Yuzhen Liang ◽  
Yunhua Liao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Survival Rate ◽  
Prediction Model ◽  
Validation Cohort ◽  
Kidney Injury ◽  
Calibration Plot ◽  
Diabetic Patients ◽  
Factors Affecting

ObjectiveWe aimed to analyze the risk factors affecting all-cause mortality in diabetic patients with acute kidney injury (AKI) and to develop and validate a nomogram for predicting the 90-day survival rate of patients.MethodsClinical data of diabetic patients with AKI who were diagnosed at The First Affiliated Hospital of Guangxi Medical University from April 30, 2011, to April 30, 2021, were collected. A total of 1,042 patients were randomly divided into a development cohort and a validation cohort at a ratio of 7:3. The primary study endpoint was all-cause death within 90 days of AKI diagnosis. Clinical parameters and demographic characteristics were analyzed using Cox regression to develop a prediction model for survival in diabetic patients with AKI, and a nomogram was then constructed. The concordance index (C-index), receiver operating characteristic curve, and calibration plot were used to evaluate the prediction model.ResultsThe development cohort enrolled 730 patients with a median follow-up time of 87 (40–98) days, and 86 patients (11.8%) died during follow-up. The 90-day survival rate was 88.2% (644/730), and the recovery rate for renal function in survivors was 32.9% (212/644). Multivariate analysis showed that advanced age (HR = 1.064, 95% CI = 1.043–1.085), lower pulse pressure (HR = 0.964, 95% CI = 0.951–0.977), stage 3 AKI (HR = 4.803, 95% CI = 1.678–13.750), lower 25-hydroxyvitamin D3 (HR = 0.944, 95% CI = 0.930–0.960), and multiple organ dysfunction syndrome (HR = 2.056, 95% CI = 1.287–3.286) were independent risk factors affecting the all-cause death of diabetic patients with AKI (all p &lt; 0.01). The C-indices of the prediction cohort and the validation cohort were 0.880 (95% CI = 0.839–0.921) and 0.798 (95% CI = 0.720–0.876), respectively. The calibration plot of the model showed excellent consistency between the prediction probability and the actual probability.ConclusionWe developed a new prediction model that has been internally verified to have good discrimination, calibration, and clinical value for predicting the 90-day survival rate of diabetic patients with AKI.

scholarly journals Delay and inequalities in the treatment of idiopathic pulmonary fibrosis: the case of two Nordic countries

2019 ◽  
Vol 13 ◽  
Author(s):  
Ida Pesonen ◽  
Lisa Carlson ◽  
Nicola Murgia ◽  
Riitta Kaarteenaho ◽  
Carl Magnus Sköld ◽  
...  
Keyword(s):  
Lung Function ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Lung Transplantation ◽  
Study Data ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Significant Difference ◽  
Antifibrotic Drugs

Background: Idiopathic pulmonary fibrosis (IPF) is characterized by progressive loss of lung function with high mortality within the first 5 years from diagnosis. In 2011–2014, two drugs, pirfenidone and nintedanib, have been approved worldwide for prevention of IPF progression. National IPF-registries have been established in both Finland and Sweden. Our study explored potential differences in the care of IPF in these two countries. Methods: Patients included consecutively in the Finnish and Swedish IPF-registries from January 1, 2014 through December 31, 2016 were included in the study. Data on demographics and lung function at the time of inclusion were collected. Access to antifibrotic drugs and data on disease outcomes, mortality and the proportion of patients who underwent lung transplantation, was collected during a 3-year follow up. Results: One-hundred and fifty-two patients from the Finnish and 160 patients from the Swedish IPF-cohorts were included in the study. At inclusion, Finnish patients were significantly older than the Swedish patients (74.6 years vs 72.5 years, p = 0.017). The proportion of non-smokers was significantly higher in the Finnish cohort (41.7% vs 26.9%, p = 0.007). Forced vital capacity (FVC), % of predicted (78.2 vs 71.7 for Finnish and Swedish patients, respectively, p = 0.01) and diffusion capacity for carbon monoxide (DLCO), % of predicted (53.3 vs 48.2 for Finnish and Swedish patients, respectively, p = 0.002) were significantly higher in the Finnish cohort compared to the Swedish cohort at the time of inclusion. During the 3-year follow up period, 45 (29.6%) Finnish and 111 (69.4%) Swedish patients, respectively, were initiated on treatment with an antifibrotic drug (pirfenidone or nintedanib) (p < 0.001). When comparing possible determinants of treatment, patients with higher FVC % were less likely to start antifibrotic drugs (OR 0.96, 95%CI 0.93–1.00, p < 0.024). To be resident in Sweden was the main determinant for receiving antifibrotic drugs (OR 5.48, 95%CI 2.65–11.33, p < 0.0001). No significant difference in number of deaths and lung transplantation during the follow up period was found. Conclusions: This study highlights differences concerning how IPF patients are treated in Finland and Sweden. How these differences will influence the long-term outcome of these patients is unknown.

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