scholarly journals Features of management and vaccination of comorbid patients with rheumatic diseases in a pandemic of a new coronavirus infection

2021 ◽  
Vol 25 (3) ◽  
pp. 17-26
Author(s):  
Irina B. Belyaeva ◽  
Vadim I. Mazurov ◽  
Lyubov E. Sarantseva ◽  
Evgeny A. Trofimov
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Rheumatic Diseases ◽  
Dynamic Monitoring ◽  
Inflammatory Rheumatic Diseases ◽  
Public Organization ◽  
Long Period ◽  
Coronavirus Infection ◽  
High Doses

The review presents the results of scientific studies devoted to the features of the course and outcomes of a new coronavirus infection COVID-19 in patients with immuno-inflammatory rheumatic diseases (IIRD). It was noted that the risk of developing COVID-19 for patients with IVR, apparently, is similar to the population or slightly increased and mostly depends on the presence of established risk factors for its severe course (old age, obesity, diabetes mellitus, cardiovascular diseases). Patients receiving long-term immunosuppressive therapy and high doses of glucocorticoids may have a long period of positive viral replication and isolation of a viable virus, which requires dynamic monitoring of such patients and correction of anti-rheumatic therapy. The issues of post-COVID-19 joint syndrome, which can occur within the framework of post-viral arthritis or be the debut of an immuno-inflammatory rheumatic disease, are highlighted. The draft recommendations of the All-Russian Public Organization Association of Rheumatologists of Russia on the management and temporary recommendations of V.A. Nasonova Research Institute of Rheumatology for vaccination of patients with rheumatic diseases in the conditions of the COVID-19 pandemic are presented.

Features of the course of coronavirus infection in patients with diabetes mellitus

2022 ◽  
pp. 18-21
Author(s):  
Vladimir Anatolievich Klimov ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Human Population ◽  
Fatal Outcome ◽  
Significant Risk ◽  
Adverse Outcomes ◽  
Concomitant Disease ◽  
Patients With Diabetes ◽  
Coronavirus Infection ◽  
Population Mortality

Diabetesmellitus, overweight and the age of a patient over 65 years old are identified by clinicians as themain factors that can complicate the course of the coronavirus infection and increase the likelihood of fatal outcome. Although in the general human population mortality from coronavirus fluctuateswithin 3–5 %, sometimes very significantly differing in individual countries, this level can reach 15–25 % among patientswith diabetes, especially for those receiving insulin therapy. Diabetes mellitus as a concomitant disease in COVID-19 is considered one of the most significant risk factors for the development of adverse outcomes due to a more severe course of infection in conditions of hyperglycemia and other aggravating factors.

CLINICAL PROFILE OF PATIENTS OF YOUNG STROKE.

2021 ◽  
pp. 68-70
Author(s):  
Nitin Hiraman Suryawanshi ◽  
Amit Aggarwal ◽  
Abhijit Kadam
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Young Patients ◽  
Behavioural Pattern ◽  
Long Term Outcomes ◽  
Short Term ◽  
Traditional Risk Factors ◽  
The Individual ◽  
Stroke In Young

A study of stroke in young patients has recently become a subject of interest. This is due to a lot of impact on the individual and society. Study of stroke in young patients can lead to therapeutical results affecting both short term and long-term outcomes. Our study is hospital based retrospective study for duration of 1 year. Thi Methods: Results: s study revealed stroke in young in 25.16% of all stroke cases, with cerebral infarction in 56% and followed by intracerebral haemorrhage in 25.64%, and cerebral venous thrombosis in 18%. The most common presenting symptom was hemiparesis. The most prevalent risk factor for stroke in young was hypertension followed by diabetes mellitus, alcohol consumption and smoking. Stroke in young requires a differe Conclusion: nt approach to investigate and treat. This is due to different underlying etilogy as compared to elderly. Although traditional risk factors are associated with stroke, behavioural pattern such as smoking and alcohol may cause and promote development of stroke in young.

scholarly journals Risk Factors in and Long-Term Survival of Patients with Post-Transplantation Diabetes Mellitus: A Retrospective Cohort Study

2020 ◽  
Vol 17 (12) ◽  
pp. 4581
Author(s):  
Ching-Yao Cheng ◽  
Cheng-Hsu Chen ◽  
Ming-Fen Wu ◽  
Ming-Ju Wu ◽  
Jun-Peng Chen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
High Body Mass Index ◽  
Post Transplantation ◽  
Term Survival ◽  
Cardiovascular Morbidity And Mortality

Post-transplant diabetes mellitus (PTDM) is associated with infection, cardiovascular morbidity, and mortality. A retrospective cohort study involving patients who underwent renal transplantation in a transplantation center in Taiwan from January 2000 to December 2018 was conducted to investigate the incidence and risk factors of PTDM and long-term patient and graft survival rates. High age (45–65 vs. <45 years, adjusted odds ratio (aOR) = 2.90, 95% confidence interval (CI) = 1.64–5.13, p < 0.001), high body mass index (>27 vs. <24 kg/m2, aOR = 5.35, 95% CI = 2.75–10.42, p < 0.001), and deceased organ donor (cadaveric vs. living, aOR = 2.01, 95% CI = 1.03–3.93, p = 0.04) were the three most important risk factors for the development of PTDM. The cumulative survival rate of patients and allografts was higher in patients without PTDM than in those with PTDM (p = 0.007 and 0.041, respectively). Concurrent use of calcineurin inhibitors and mammalian target of rapamycin inhibitors (mTORis) decreased the risk of PTDM (tacrolimus vs. tacrolimus with mTORi, aOR = 0.28, 95% CI = 0.14–0.55, p < 0.001). Investigating PTDM risk factors before and modifying immunosuppressant regimens after transplantation may effectively prevent PTDM development.

scholarly journals Risk factors for hospital admissions related to COVID-19 in patients with autoimmune inflammatory rheumatic diseases

2020 ◽  
Vol 79 (11) ◽  
pp. 1393-1399 ◽  
Author(s):  
Dalifer D Freites Nuñez ◽  
Leticia Leon ◽  
Arkaitz Mucientes ◽  
Luis Rodriguez-Rodriguez ◽  
Judit Font Urgelles ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Admission ◽  
Rheumatic Diseases ◽  
Hospital Admissions ◽  
Tertiary Hospital ◽  
Inflammatory Rheumatic Diseases ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Multivariable Logistic Regression Model ◽  
Disease Modifying

ObjectivesTo describe patients with autoimmune inflammatory rheumatic diseases (AIRD) who had COVID-19 disease; to compare patients who required hospital admission with those who did not and assess risk factors for hospital admission related to COVID-19.MethodsAn observational longitudinal study was conducted during the pandemic peak of severe acute respiratory syndrome coronavirus 2 (1 March 2020 to 24 April). All patients attended at the rheumatology outpatient clinic of a tertiary hospital in Madrid, Spain with a medical diagnosis of AIRD and with symptomatic COVID-19 were included. The main outcome was hospital admission related to COVID-19. The covariates were sociodemographic, clinical and treatments. We ran a multivariable logistic regression model to assess risk factors for the hospital admission.ResultsThe study population included 123 patients with AIRD and COVID-19. Of these, 54 patients required hospital admission related to COVID-19. The mean age on admission was 69.7 (15.7) years, and the median time from onset of symptoms to hospital admission was 5 (3–10) days. The median length of stay was 9 (6–14) days. A total of 12 patients died (22%) during admission. Compared with outpatients, the factors independently associated with hospital admission were older age (OR: 1.08; p=0.00) and autoimmune systemic condition (vs chronic inflammatory arthritis) (OR: 3.55; p=0.01). No statistically significant findings for exposure to disease-modifying antirheumatic drugs were found in the final model.ConclusionOur results suggest that age and having a systemic autoimmune condition increased the risk of hospital admission, whereas disease-modifying antirheumatic drugs were not associated with hospital admission.

scholarly journals Risk Factor Burden and Long‐Term Prognosis of Patients With Premature Coronary Artery Disease

2020 ◽  
Vol 9 (24) ◽  
Author(s):  
Michel Zeitouni ◽  
Robert M. Clare ◽  
Karen Chiswell ◽  
Jawan Abdulrahim ◽  
Nishant Shah ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Coronary Artery Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Premature Cad ◽  
Artery Disease ◽  
Long Term Prognosis

Background Coronary artery disease (CAD) is increasing among young adults. We aimed to describe the cardiovascular risk factors and long‐term prognosis of premature CAD. Methods and Results Using the Duke Databank for Cardiovascular Disease, we evaluated 3655 patients admitted between 1995 and 2013 with a first diagnosis of obstructive CAD before the age of 50 years. Major adverse cardiovascular events (MACEs), defined as the composite of death, myocardial infarction, stroke, or revascularization, were ascertained for up to 10 years. Cox proportional hazard regression models were used to assess associations with the rate of first recurrent event, and negative binomial log‐linear regression was used for rate of multiple event recurrences. Past or current smoking was the most frequent cardiovascular factor (60.8%), followed by hypertension (52.8%) and family history of CAD (39.8%). Within a 10‐year follow‐up, 52.9% of patients had at least 1 MACE, 18.6% had at least 2 recurrent MACEs, and 7.9% had at least 3 recurrent MACEs, with death occurring in 20.9% of patients. Across follow‐up, 31.7% to 37.2% of patients continued smoking, 81.7% to 89.3% had low‐density lipoprotein cholesterol levels beyond the goal of 70 mg/dL, and 16% had new‐onset diabetes mellitus. Female sex, diabetes mellitus, chronic kidney disease, multivessel disease, and chronic inflammatory disease were factors associated with recurrent MACEs. Conclusions Premature CAD is an aggressive disease with frequent ischemic recurrences and premature death. Individuals with premature CAD have a high proportion of modifiable cardiovascular risk factors, but failure to control them is frequently observed.

Abstract 9406: ST-Segment Elevation in Lead AVR Strongly Predicts Long-Term Adverse Outcomes in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Masami Kosuge ◽  
Toshiaki Ebina ◽  
Kiyoshi Hibi ◽  
Kengo Tsukahara ◽  
Noriaki Iwahashi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Adverse Outcomes ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Lead Avr ◽  
Timi Risk Score

Introduction: In non-ST-segment elevation acute coronary syndrome (NSTE-ACS), ST-elevation in lead aVR (ST↑aVR) on admission ECG has been shown to be associated with severe coronary artery disease, but its impact on long-term clinical outcomes is unclear. Methods: We studied 454 patients with NSTE-ACS who underwent coronary angiography during initial hospitalization. Patients were divided into the 3 groups according to the degree of ST↑aVR on admission ECG: no ST↑aVR (n=301, G-A); ST↑aVR <1.0 mm (n=82, G-B); and ST↑aVR ≥1.0 mm (n=71, G-C). Troponin T (TnT), hemoglobin (Hb), estimated glomerular filtration rate (eGFR), brain natriuretic peptide (BNP), high-sensitivity C-reactive protein (hsCRP), TIMI risk score, and summed ST-segment depression in other leads were also measured on admission. Results: There were no differences in sex or coronary risk factors except for diabetes mellitus in the 3 groups. In G-A, G-B, and G-C, age was 66±11, 68±11, and 70±11 years; the rates of diabetes mellitus were 30%, 48%, and 51%; Killip class ≥2 was 7%, 20%, and 34%; positive TnT was 30%, 46%, and 56%; TIMI risk score was 2.8±1.4, 3.6±1.3, and 3.8±1.2; the levels of Hb were 13.4±1.9, 13.2±1.9, and 12.2±2.3 g/dl; eGFR was 65±24, 59±27, and 53±28 ml/min/1.73 m2; BNP was 155±249, 386±338, and 455±507 pg/ml; hsCRP was 0.339±1.499, 0.654±1.899, and 0.842±1.788 mg/dl; summed ST-segment depression was 2.0±2.6, 5.6±3.5, and 13.0±6.6 mm; the rates of left main or 3-vessel disease were 9%, 44%, and 75%; and major adverse events (death, [re]infarction, urgent revascularization, or heart failure requiring hospitalization) at 5 years were 19%, 43%, and 58%, respectively (all p<0.01). After adjusting for baseline characteristics, multivariate analysis showed that as compared with no ST↑aVR, the hazard ratios (95% CI) for 5-year adverse events associated with ST↑aVR <1.0 mm and ST↑aVR ≥1.0 mm were 2.16 (1.10-5.59; p=0.019) and 3.90 (1.44-9.76; p=0.001), respectively. Conclusions: In patients with NSTE-ACS, greater ST↑aVR on admission ECG strongly predicted 5-year adverse outcomes, even after adjusting for traditional risk factors, biomarker profiles, and ST-segment depression in other leads. Our findings suggest the importance of ST↑aVR in risk stratification for NSTE-ACS.

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