scholarly journals Predictors of severity and development of critical illness of Egyptian COVID-19 patients: A multicenter study

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0256203
Author(s):  
Dalia Omran ◽  
Mohamed Al Soda ◽  
Eshak Bahbah ◽  
Gamal Esmat ◽  
Hend Shousha ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Critical Illness ◽  
Oxygen Saturation ◽  
Clinical Laboratory ◽  
Present Report ◽  
Elevated Serum ◽  
Critical Group ◽  
Teaching Hospitals ◽  
Renal Diseases ◽  
Low Oxygen

Objectives We conducted the present multicenter, retrospective study to assess the epidemiological, clinical, laboratory, and radiological characteristics associated with critical illness among patients with COVID-19 from Egypt. Methods The present study was a multicenter, retrospective study that retrieved the data of all Egyptian cases with confirmed COVID-19 admitted to hospitals affiliated to the General Organization for Teaching Hospitals and Institutes (GOTHI) through the period from March to July 2020. The diagnosis of COVID-19 was based on a positive reverse transcription-polymerase chain reaction (RT-PCR) laboratory test. Results This retrospective study included 2724 COVID-19 patients, of whom 423 (15.52%) were critically ill. Approximately 45.86% of the critical group aged above 60 years, compared to 39.59% in the non-critical group (p = 0.016). Multivariate analysis showed that many factors were predictors of critically illness, including age >60 years (OR = 1.30, 95% CI [1.05, 1.61], p = 0.014), low oxygen saturation (OR = 0.93, 95% CI [0.91, 0.95], p<0.001), low Glasgow coma scale (OR = 0.75, 95% CI [0.67, 0.84], p<0.001), diabetes (OR = 1.62, 95% CI [1.26, 2.08], p<0.001), cancer (OR = 2.47, 95% CI [1.41, 4.35], p = 0.002), and serum ferritin (OR = 1.004, 95% CI [1.0003, 1.008], p = 0.031). Conclusion In the present report, we demonstrated that many factors are associated with COVID-19 critical illness, including older age groups, fatigue, elevated temperature, increased pulse, lower oxygen saturation, the preexistence of diabetes, malignancies, cardiovascular disease, renal diseases, and pulmonary disease. Moreover, elevated serum levels of ALT, AST, and ferritin are associated with worse outcomes. Further studies are required to identify independent predictors of mortality for patients with COVID-19.

scholarly journals Score for Predicting Active Cancer in Patients with Ischemic Stroke: A Retrospective Study

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Jiwei Jiang ◽  
Xiuli Shang ◽  
Jinming Zhao ◽  
Meihui Cao ◽  
Jirui Wang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Retrospective Study ◽  
Clinical Laboratory ◽  
Elevated Serum ◽  
Clinical Score ◽  
Predictive Score ◽  
Bayesian Decision ◽  
History Of ◽  
D Dimer ◽  
Active Cancer

Background. We aimed to examine the differences of clinical characteristics between patients with ischemic stroke with active cancer and those without cancer to develop a clinical score for predicting the presence of occult cancer in patients with ischemic stroke. Methods. This retrospective study enrolled consecutive adult patients with acute ischemic stroke who were admitted to our department between December 2017 and January 2019. The demographic, clinical, laboratory, and neuroimaging characteristics were compared between patients with ischemic stroke with active cancer and those without cancer. Multivariate analysis was performed to identify independent factors associated with active cancer. Subsequently, a predictive score was developed using the areas under the receiver operating characteristic curves based on these independent factors. Finally, Bayesian decision theory was applied to calculate the posterior probability of active cancer for finding the best scoring system. Results. Fifty-three (6.63%) of 799 patients with ischemic stroke had active cancer. The absence of a history of hyperlipidemia (odds ratio OR = 0.17 , 95% confidence interval (CI): 0.06–0.48, P < 0.01 ), elevated serum fibrinogen ( OR = 1.72 , 95% CI: 1.33–2.22, P < 0.01 ) and D-dimer levels ( OR = 1.43 , 95% CI: 1.24–1.64, P <0.01), and stroke of undetermined etiology ( OR = 22.87 , 95% CI: 9.91–52.78, P < 0.01 ) were independently associated with active cancer. A clinical score based on the absence of hyperlipidemia, serum fibrinogen level of ≥4.00 g/L, and D-dimer level of ≥2.00 μg/mL predicted active cancer with an area under the curve of 0.83 (95% CI: 0.77–0.89, P < 0.01 ). The probability of active cancer was 59% at a supposed prevalence of 6.63%, if all three independent factors were present in a patient with ischemic stroke. Conclusions. We devised a clinical score to predict active cancer in patients with ischemic stroke based on the absence of a history of hyperlipidemia and elevated serum D-dimer and fibrinogen levels. The use of this score may allow for early intervention. Further research is needed to confirm the implementation of this score in clinical settings.

scholarly journals Score for Predicting Active Cancer in Patients with Ischemic Stroke: A Retrospective Study

2020 ◽  
Author(s):  
Jiwei Jiang ◽  
Jirui Wang ◽  
Meihui Cao ◽  
Jinming Zhao ◽  
Xiuli Shang
Keyword(s):  
Ischemic Stroke ◽  
Retrospective Study ◽  
Clinical Laboratory ◽  
Characteristic Curve ◽  
Elevated Serum ◽  
Area Under The Curve ◽  
Clinical Score ◽  
History Of ◽  
D Dimer ◽  
Active Cancer

Abstract Background: We aimed to examine the differences between the clinical characteristics of patients with ischemic stroke and active cancer and those without cancer and develop a clinical score for predicting occult cancer in patients with ischemic stroke.Methods: This retrospective study enrolled consecutive adult patients with acute ischemic stroke, who were admitted to our department between December 2017 and January 2019. The demographic, clinical, laboratory, and neuroimaging characteristics of patients with ischemic stroke with active cancer and those without cancer were compared. Multivariate analysis was performed to identify independent factors associated with active cancer. Subsequently, a predictive cancer-risk score was developed using the area under the receiver operating characteristic curve.Results: Fifty-three (6.63%) of 799 patients with ischemic stroke had active cancer. The absence of a history of hyperlipidemia [odds ratio (OR)=0.17, 95% confidence interval (CI): 0.06–0.48, P<0.01], elevated serum fibrinogen (OR=1.72, 95% CI: 1.33–2.22, P<0.01) and D-dimer levels (OR=1.43, 95% CI: 1.24–1.64, P<0.01), and stroke of undetermined etiology (OR=22.87, 95% CI: 9.91–52.78, P<0.01) were independently associated with active cancer. Thus, a score based on the absence of hyperlipidemia and serum fibrinogen ≥4.00 g/L and D-dimer ≥2.00 μg/mL predicted active cancer with an area under the curve of 0.83 (95% CI: 0.77–0.89, P<0.01). The probability of active cancer was 59% at a supposed prevalence of 6.63%, if all three independent factors were present in a patient with ischemic stroke.Conclusions: We devised a score to predict active cancer in patients with ischemic stroke based on the absence of a history of hyperlipidemia and elevated serum D-dimer and fibrinogen that highlights the importance of hypercoagulability in these patients and may help determine early intervention and management.

scholarly journals Breathing space: deoxygenation of aquatic environments can drive differential ecological impacts across biological invasion stages

2021 ◽  
Author(s):  
James W. E. Dickey ◽  
Neil E. Coughlan ◽  
Jaimie T. A. Dick ◽  
Vincent Médoc ◽  
Monica McCard ◽  
...  
Keyword(s):  
Climate Change ◽  
Oxygen Saturation ◽  
Ecological Impacts ◽  
Neogobius Melanostomus ◽  
Aquatic Environments ◽  
Relative Impact ◽  
Low Oxygen ◽  
Per Capita ◽  
The Impact ◽  
Prey Populations

AbstractThe influence of climate change on the ecological impacts of invasive alien species (IAS) remains understudied, with deoxygenation of aquatic environments often-overlooked as a consequence of climate change. Here, we therefore assessed how oxygen saturation affects the ecological impact of a predatory invasive fish, the Ponto-Caspian round goby (Neogobius melanostomus), relative to a co-occurring endangered European native analogue, the bullhead (Cottus gobio) experiencing decline in the presence of the IAS. In individual trials and mesocosms, we assessed the effect of high, medium and low (90%, 60% and 30%) oxygen saturation on: (1) functional responses (FRs) of the IAS and native, i.e. per capita feeding rates; (2) the impact on prey populations exerted; and (3) how combined impacts of both fishes change over invasion stages (Pre-invasion, Arrival, Replacement, Proliferation). Both species showed Type II potentially destabilising FRs, but at low oxygen saturation, the invader had a significantly higher feeding rate than the native. Relative Impact Potential, combining fish per capita effects and population abundances, revealed that low oxygen saturation exacerbates the high relative impact of the invader. The Relative Total Impact Potential (RTIP), modelling both consumer species’ impacts on prey populations in a system, was consistently higher at low oxygen saturation and especially high during invader Proliferation. In the mesocosm experiment, low oxygen lowered RTIP where both species were present, but again the IAS retained high relative impact during Replacement and Proliferation stages at low oxygen. We also found evidence of multiple predator effects, principally antagonism. We highlight the threat posed to native communities by IAS alongside climate-related stressors, but note that solutions may be available to remedy hypoxia and potentially mitigate impacts across invasion stages.

scholarly journals Correction to: General anaesthesia related mortality in a limited resource settings region: a retrospective study in two teaching hospitals of Butembo

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Furaha Nzanzu Blaise Pascal ◽  
Agnes Malisawa ◽  
Andreas Barratt-Due ◽  
Felix Namboya ◽  
Gregor Pollach
Keyword(s):  
Retrospective Study ◽  
General Anaesthesia ◽  
Limited Resource ◽  
Teaching Hospitals ◽  
Related Mortality

An amendment to this paper has been published and can be accessed via the original article.

Low-Oxygen-Saturation Quantification in Human Arterial and Venous Circulation

2009 ◽  
Vol 56 (3) ◽  
pp. 846-854 ◽  
Author(s):  
J. Schoevers ◽  
C. Scheffer ◽  
R. Dippenaar
Keyword(s):  
Oxygen Saturation ◽  
Low Oxygen ◽  
Venous Circulation

scholarly journals Mortality Risk Factors in Tetralogy of Fallot Patients Undergoing Total Correction

2021 ◽  
Vol 57 (2) ◽  
pp. 151
Author(s):  
Juliana Juliana ◽  
Yan Efrata Sembiring ◽  
Mahrus Abdur Rahman ◽  
Heroe Soebroto
Keyword(s):  
Risk Factors ◽  
Developing Countries ◽  
Oxygen Saturation ◽  
Tetralogy Of Fallot ◽  
Mortality Risk ◽  
Operative Risk ◽  
Average Height ◽  
Low Oxygen ◽  
Total Correction ◽  
Ventilator Time

A total correction is a preferred treatment for Tetralogy of Fallot patients in every part of the world. However, the mortality in developing countries was as high as 6.9% to 15.3%. This was a retrospective analytic study that analyzed pre and post-operative risk factors that affected mortality on TOF patients that were performed total correction in Indonesia. A total of 47 TOF patients that were performed total correction from January 2016 to September 2019 were enrolled in this study based on the inclusion criteria. Preoperative and post-operative data were obtained from medical records. In this research, the majority of mortality was found in male patients (39.3%), while the female’s rate was lower (36.8%). Overall mortality was 38.3% and one operative death was found. The average age of patients was 84.12 months (12-210 months), whereas the average height (85.56 ± 36.17cm vs. 112.93 ± 21.73) and weight (17.22kg vs. 28.21kg) were lower for mortality patients. Some significant preoperative variables were identified as mortality risk factors such as: age below 60 months (p=0.047), smaller weight and height (p=0.008; p=0.002), abnormal hematocrit (p=0.002), and oxygen saturation below 75% (p=0.018). Significant post-operative risk factors included: temperature above 38.5⁰C (p=0.000), and ventilator time of more than 48 hours (p=0.033). In conclusion, the mortality of TOF patients undergoing a total correction in developing countries was quite high. It was associated with some risk factors, such as younger age, lower weight and height, low oxygen saturation, post-operative fever, and prolonged ventilator time.

scholarly journals COVID-19 in Northeast Bosnia and Herzegovina and patients length of hospitalization

2020 ◽  
Author(s):  
Alma Trnacevic ◽  
Amer Mujkanovic ◽  
Noura Al-Salloum ◽  
Amra Sakusic ◽  
Emir Trnacevic ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Bosnia And Herzegovina ◽  
Clinical Factors ◽  
Low Oxygen ◽  
The World ◽  
The Mean ◽  
Elevated Creatinine ◽  
Underlying Diseases ◽  
Time Of Admission ◽  
Length Of Hospitalization

Abstract Background Since outbreak of COVID-19 pandemic clinical data from various parts of the world have been reported, until now there has been no provide data from Bosnia and Herzegovina (B&H) about COVID-19. Aim was to report on the first cohort of patients from B&H and to analyze clinical factors of COVID-19 patients that influence the length of hospitalization. Methods Retrospective cohort study conducted at UKC Tuzla. The study included 25 COVID-19 positive patients that were hospitalized between March 28th and April 27th 2020. The LOH was measured from the time of admission to discharge. Hospitalization greater than 10 days was considered as prolonged. Factors analyzed induced age, BMI, comorbidities, serum creatinine and oxygen saturation upon admission.Results The mean age was 52.92±19.15 years and BMI 28.80±4.22. LOH for patients with normal BMI was 9±SE2.646 days (CI 95% 3.814-14.816) vs 14.182 ±SE .937 (CI 95% 12.346-16.018; p<0.05) for ≥25 BMI. Patients without underlying diseases had a LOH of 11.70 ±SE1.075 (CI 95% 9.592-13.808), while those with comorbidities 14.8 ±SE1.303 (CI95% 12.247-17.353; p<0.05). Conclusion LOH varied among COVID-19 patients and was prolonged when clinical characteristics such as elevated BMI, comorbidities, elevated creatinine and low oxygen saturation levels were taken into consideration. Furthermore, risk factors for COVID-19 patients in B&H do not deviate from data reported in other countries.

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