scholarly journals Variable effects of underlying diseases on the prognosis of patients with COVID-19

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254258
Author(s):  
Yong Jun Choi ◽  
Ju-Young Park ◽  
Hye Sun Lee ◽  
Jin Suh ◽  
Jeung Yoon Song ◽  
...  

Underlying diseases might be risk factors for poor prognosis in patients with coronavirus disease (COVID-19); however, we still do not know whether these diseases are independent factors affecting prognosis, which type of underlying diseases are risk factors, and which type of clinical outcomes are affected. We retrospectively reviewed cohort data from 7,590 de-identified patients with COVID-19 who were diagnosed using severe acute respiratory syndrome-coronavirus-2 RNA polymerase chain reaction test up to May 15, 2020. We used linked-medical claims data provided by the Health Insurance Review and Assessment Service in South Korea. Underlying diseases were identified using the diagnostic codes in the patients’ files from January 1, 2019 to December 31, 2019. The total mortality rate was 3.0% in patients with COVID-19. After adjusting for age, sex, and concomitant chronic conditions, we found that congestive heart failure, chronic pulmonary diseases, diabetes without chronic complications, renal diseases, and malignancy were factors that significantly increased the cost of treatment. Cerebrovascular disease, chronic pulmonary disease, and paralysis were found to be independent factors significant in prolonging hospital stay. Diabetes with chronic complications was independently associated with intensive care unit admission. In addition, underlying congestive heart failure (odds ratio [OR], 1.724; P = 0.003), dementia (OR, 1.598; P = 0.012), diabetes with and without chronic complications (OR, 1.821; P = 0.002 and OR, 1.518; P = 0.022, respectively), renal disease (OR, 2.299; P = 0.002), and malignancy (OR, 1.529; P = 0.039) were significant factors associated with death, even after adjustments. Underlying diseases were significant independent factors of the poor prognosis in patients with COVID-19. The effects were variable according to the type of underlying disease and clinical outcome. Therefore, patients with COVID-19 with underlying diseases should be monitored more closely because they are more at risk of a poor prognosis.

2016 ◽  
Vol 26 (2) ◽  
pp. 205 ◽  
Author(s):  
O'Dene Lewis ◽  
Julius Ngwa ◽  
Richard F. Gillum ◽  
Alicia Thomas ◽  
Wayne Davis ◽  
...  

<p><strong>Purpose</strong>: New onset supraventricular arrhythmias (SVA) are commonly reported in mixed intensive care settings. We sought to determine the incidence, risk factors and outcomes of new onset SVA in African American (AA) patients with severe sepsis admitted to medical intensive care unit (MICU).</p><p><strong>Methods:</strong> Patients admitted to MICU between January 2012 through December 2012 were studied. Patients with a previous history of arrhythmia or with new onset of ventricular arrhythmia were excluded. Data on risk factors, critical care interventions and outcomes were obtained.</p><p><strong>Results:</strong> One hundred and thirty-one patients were identified. New onset SVA occurred in 34 (26%) patients. Of those 34, 20 (59%) had atrial fibrillation (AF), 6 (18%) had atrial flutter and 8 (24%) had other forms of SVA. Compared with patients without SVA, patients with new onset SVA were older (69 ± 12 yrs vs 59 ± 13 yrs, P=.003), had congestive heart failure (47% vs 24%, P=.015) and dyslipidemia (41% vs 15%, P=.002). Additionally, they had a higher mean mortality prediction model (MPM II) score (65 ± 25 vs 49 ± 26, P=.001) and an increased incidence of respiratory failure (85% vs 55%, P=.001). Hospital mortality in patients with new onset SVA was 18 (53%) vs 30 (31%); P=.024; however, in a multivariate analysis, new onset SVA was associated with nonsignificantly increased odds (OR 2.58, 95% CI 0.86-8.05) for in-hospital mortality.</p><p><strong>Conclusion:</strong> New onset SVA was prevalent in AA patients with severe sepsis and occurred more frequently with advanced age, increased severity of illness, congestive heart failure, and acute respiratory failure; it was associated with higher unadjusted in hospital mortality. However, after multiple adjustments, new onset SVA did not remain an independent predictor of mortality. <em>Ethn Dis.</em>2016;26(2):205-212; doi:10.18865/ ed.26.2.205</p>


2010 ◽  
Vol 63 (5-6) ◽  
pp. 387-392
Author(s):  
Radomir Matunovic ◽  
Zdravko Mijailovic ◽  
Milorad Rabrenovic ◽  
Violeta Rabrenovic

Introduction. In the regular clinic practice, the assessment of the cause of dispnea is a dilemma which has a significant implication in both the estimation of prognosis and treatment of the patient. In emergency cases, when most necessary, it is often very difficult to determine whether dispnea was caused by a heart or lung disease. Role of natriuretic peptide in patients with dispnea. An acute patient with dispnea might suffer serious consequences of inadequately established diagnosis so congestive heart failure (CHF) has to be diagnosed quickly and precisely in the ER. Unfortunately, symptoms and signs of CHF are unspecific, it is sometimes impossible to obtain an adequate anamnesis and diagnosic procedures currently applied are either insufficiently precise or provide scarce information or can not always be performed under appropriate conditions. On the basis of previous findings, it has been proved that brain natriuretic peptide (BNP) can considerably contribute to the establishment of correct diagnosis as well as to the possibility of introducing an adequate therapy for those patients. However, the real value of those peptides should be estimated in relation to other clinical manifestations and indicators and the specifics of examined patients including the age, gender and the presence or absence of pulmonary or renal diseases. Natriuretic peptide in accessement gradient of heart failure. Determination of natriuretic peptide has represented most probably the greatest progress in diagnosing the heart failure since the introduction of echocardiography into practice. Its high sensitivity and negative predicted value makes it a valid test for excluding congestive heart failure with a very high degree of certainty.


Global Heart ◽  
2014 ◽  
Vol 9 (1) ◽  
pp. e58
Author(s):  
Jiang He ◽  
Wei Yang ◽  
Amanda Anderson ◽  
Harold Feldman ◽  
John Kusek ◽  
...  

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Fumiaki Imamura ◽  
Rozenn N Lemaitre ◽  
Lyn M Steffen ◽  
Aaron R Folsom ◽  
David S Siscovick ◽  
...  

Background: Animal experiments in 1970s demonstrated direct cardiotoxicity of long-chain monounsaturated fatty acid (LCMUFA, 22:1 and 24:1 fatty acids) consumption. We recently found plasma phospholipid 22:1 and 24:1 to be associated with 34% and 75% higher risk (quintiles 5 vs. 1), respectively, of congestive heart failure (CHF) among older adults in the Cardiovascular Health Study. We wished to validate these results in a second independent cohort of middle-aged adults. Methods: We evaluated 3,577 adults free of CHF at baseline (age=54.1±5.8) in the Minnesota subcohort of the Atherosclerosis Risk in Communities Study (ARIC) in whom plasma phospholipid LCMUFA were measured. Incident CHF was ascertained from 1988 to 2008 by annual phone contacts, hospitalization discharge codes, and death certificates. Using multivariate Cox models, we evaluated prospective association of each LCMUFA with incident CHF, and potential mediation via CHF risk factors, including ECG left ventricular hypertrophy, and incident coronary heart disease (CHD). As a negative control, we also evaluated incident stroke, given its many shared risk factors for CHF but no link to potentially direct cardiotoxicity. Results: Mean±SD plasma phospholipid levels (% of total fatty acids) of 22:1 and 24:1 were 0.01±0.03 and 0.58±0.17. Over the 64,438 person-years of follow-up, 330 CHF events occurred. After multivariable adjustment, higher levels of 22:1 and 24:1 were associated with higher risk of CHF (Figure). Hazard ratios (95%CI) for quintiles 5 vs. 1 of 22:1 and 24:1 levels were 1.57 (1.11–2.23) and 1.92 (1.22–3.03) (p trend=0.03 and 0.002), respectively. These associations were only partly attenuated by potential mediators, including incident CHD. Neither LCMUFA was associated with incident stroke (not shown). Conclusions: Higher 22:1 and 24:1 LCMUFA levels were associated with CHF risk in middle-aged adults, consistent with our prior findings in older adults. These findings support the possibility of clinical cardiotoxicity of LCMUFA in humans.


2001 ◽  
Vol 161 (7) ◽  
pp. 996 ◽  
Author(s):  
Jiang He ◽  
Lorraine G. Ogden ◽  
Lydia A. Bazzano ◽  
Suma Vupputuri ◽  
Catherine Loria ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document