scholarly journals Prevalence of co-morbidities in hospitalized patients with COVID-19 in a COVID dedicated hospital

2021 ◽  
Vol 8 (11) ◽  
pp. 5293
Author(s):  
Kirti Vinayak Kinge ◽  
Smita Santosh Chavan ◽  
Balkrishna Adsul ◽  
Maharudra Kumbhar
Keyword(s):  
Public Health ◽  
Diabetes Mellitus ◽  
Clinical Outcome ◽  
Sampling Technique ◽  
Ethics Committee ◽  
Public Health Emergency ◽  
The Other ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Institutional Ethics

Background: A novel corona virus causing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection become a public health emergency of international concern. The infection has increased and caused pandemic. Underlying co-morbidities may worsen the clinical outcome. So, more attention is to be given to COVID patients with co-morbidities. Few studies have been conducted on the prevalence of predominant chronic diseases with COVID-19. Taking into consideration the above factors, a study has been undertaken to assess the prevalence of co-morbidities in a COVID dedicated hospital.Methods: A centre based retrospective study was carried out at a COVID dedicated hospital, Mumbai. All admitted patients of COVID 19 in a COVID dedicated hospital, Mumbai were selected in 4 and half months (19th March 2020 to 31st July 2020) by universal sampling technique. Patients above 20 years were included in the study and patients below 20 years were excluded from the study. Ethics Committee approval taken from an institutional ethics committee.Results: All 6072 patients who were above 20 years were included in the study. Mean age was 48 years and 67.7% were male. The prevalence of various co-morbidities was 25% for hypertension, 22.3% for diabetes mellitus, 5.2% for chronic kidney disease, 1.7% for chronic obstructive pulmonary disease, 0.9% for cerebrovascular disease and 0.3% for one or the other malignancy.Conclusions: It has been concluded that various co-morbidities are present in patients with COVID-19 which may worsen the clinical outcome. So, more attention is to be given to COVID patients with co-morbidities.

scholarly journals How the Heart Was Involved in COVID-19 during the First Pandemic Phase: A Review

Epidemiologia ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 124-139
Author(s):  
Andrea Canalella ◽  
Ermanno Vitale ◽  
Francesca Vella ◽  
Paola Senia ◽  
Emanuele Cannizzaro ◽  
...  
Keyword(s):  
Public Health ◽  
Diabetes Mellitus ◽  
Scientific Community ◽  
Respiratory Virus ◽  
Clinical Manifestations ◽  
Hubei Province ◽  
Public Health Emergency ◽  
Converting Enzyme ◽  
Pathophysiological Mechanisms ◽  
Cardiovascular Involvement

Coronavirus disease (COVID-19) was first observed in Wuhan, Hubei Province (China) in December 2019, resulting in an acute respiratory syndrome. Only later was COVID-19 considered a public health emergency of international concern and, on 11 March 2020, the WHO classified it as pandemic. Despite being a respiratory virus, the clinical manifestations are also characterized by cardiological involvement, especially in patients suffering from previous comorbidities such as hypertension and diabetes mellitus, its complications being potentially serious or fatal. Despite the efforts made by the scientific community to identify pathophysiological mechanisms, they still remain unclear. A fundamental role is played by the angiotensin 2 converting enzyme, known for its effects at the cardiovascular level and for its involvement in COVID-19 pathogenesis. The goal of this paper was to highlight the mechanisms and knowledge related to cardiovascular involvement during the first pandemic phase, as well as to emphasize the main cardiological complications in infected patients.

The role of beta-agonist therapy for chronic obstructive airway disease in patients with coexistent atrial fibrillation: Literature review

2021 ◽  
Vol 2 (6) ◽  
Author(s):  
Rodríguez Miguel ◽  
◽  
Chinta Siddharth ◽  
Vittorio Timothy ◽  
◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Airway Disease ◽  
The Other ◽  
Beta Agonist ◽  
Beta Blockade ◽  
Chronic Obstructive ◽  
Agonist Therapy ◽  
Obstructive Pulmonary Disease

Background: New advances have been made in medicine, but the incidence and prevalence of Chronic Obstructive Pulmonary Disease (COPD) are evident, and it is established as the fourth cause of death in the United States representing a high cost for the healthcare system. This condition has been related to atrial fibrillation due to the changes in the lungs and vasculature. Based on this history, we seek to evaluate the outcome of AF in the patients with COPD and its relationship with medical therapy utilized to treat this pulmonary condition with the objective of establishing the relationship between the use of beta-agonist therapy for obstructive airway disease in patients with AF. Discussion: Cell receptors participate in multiple reactions and the sympathetic response is received via the alpha- and beta-receptors are related to the hemodynamic of the vasculature of the lungs and cardiovascular system. The beta-blockade agents are one of the most common medication classes used for rate control in cardiac arrhythmias, but the side effect could be COPD exacerbation; on the other hand, beta-adrenergic or beta-agonist as a therapy for this pulmonary condition could increase the heart rate leading to AF decompensation. There is a clear dilemma in our patients who have airway disease and AF since the treatment for one might worsen the other. The clear benefit in morbidity and mortality of beta-blocker therapy, especially beta1-selective, outweighs the potential for any pulmonary side-effects related to ex-acerbation of COPD or airway disease. Conclusion: There is clear data showing the evidence of the potential paradoxical side-effect between COPD and AF therapies, given the exacerbation of one due to treatment of the other, benefits versus risks should be discussed and the medical decision should be made based on them. The deteriorated cardiac condition can rapidly predispose to critical complications leading to death, which is why the use of beta-blockade agents will be chosen over possible complications with pulmonary disease. In other words, the benefit should outweigh the risk based on the best outcome for the patient. Keywords: atrial fibrillation; pulmonary disease; obstructive pulmonary disease; chronic obstructive pulmonary disease (COPD); B-Agonist; B-Block (selective; non-selective); digitalis; other antiarrhythmic.

scholarly journals ATRIAL FIBRILLATION IN COMORBID PATIENTS DEPENDING ON THE TREATMENT REGIMEN

2019 ◽  
Vol 8 (2) ◽  
pp. 21-29 ◽  
Author(s):  
L. D. Khidirova ◽  
D. A. Yakhontov ◽  
S. A. Zenin
Keyword(s):  
Diabetes Mellitus ◽  
Atrial Fibrillation ◽  
Chronic Obstructive Pulmonary Disease ◽  
Arterial Hypertension ◽  
Pulmonary Disease ◽  
Abdominal Obesity ◽  
Blood Pressure Monitoring ◽  
Clinical Status ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

Aim. To study the clinical course of atrial fibrillation in patients with arterial hypertension and extracardiac comorbid pathology depending on the administered therapy.Methods. 207 men aged 45–65 years with atrial fibrillation (paroxysmal and persistent) and arterial hypertension in combination with diabetes mellitus (n = 40), abdominal obesity (n = 64) and chronic obstructive pulmonary disease (n = 47) were recruited to a observational cohort study. 56 patients with atrial fibrillation and arterial hypertension but without any extracardiac diseases were included in the comparison group. Clinical and anthropometric parameters were assessed in all patients. Adherence to therapy was estimated with the Morisky-Green test. All patients underwent ECG; electrocardiographic holter monitoring, 24-hour blood pressure monitoring with the Daily Monitoring Systems SCHILLER (Schiller, Switzerland), 2D and M-mode echocardiography using a Vivid 7 device (General Electric, USA). The statistical analysis was performed in the Rstudio software (version 0.99.879, RStudio, Inc., MA, USA).Results. 66% of patients with atrial fibrillation and arterial hypertension had concomitant extracardiac comorbid pathology, of them 20% of had diabetes mellitus, 22% with chronic obstructive pulmonary disease, and 24% with abdominal obesity. The clinical groups were comparable in electro impulse and drug therapy. Patients who received medical treatment were frequently admitted to hospitals for atrial fibrillation recurrence (p<0.001), compared with those who underwent electro impulse therapy. Adherence to antiarrhythmic therapy was low in the entire cohort of patients. There were no significant differences found between the clinical groups.Conclusion. Early diagnosis of the factors contributing to the progression of AF, the prescription of additional therapy for the secondary prevention of arrhythmia and the choice of its optimal treatment strategy may slow the progression of arrhythmia and the development of CHF, which will improve not only the clinical status of patients, but also their prognosis.

scholarly journals Diabetes mellitus type 2 in hospitalized patients with chronic obstructive pulmonary disease

2015 ◽  
Author(s):  
Evgeni Mekov ◽  
Yanina Slavova ◽  
Marianka Genova ◽  
Adelina Tsakova ◽  
Dimitar Kostadinov ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Obstructive Pulmonary Disease ◽  
Hospital Stay ◽  
Pulmonary Disease ◽  
Smoking Status ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Bulgarian Population

Diabetes mellitus (DM) affects 2-37% of patients with chronic obstructive pulmonary disease (COPD), with results being highly variable between studies. DM may also correlate with disease characteristics.The aim of this study was to examine the prevalence of DM and its correlation with comorbidities and COPD characteristics in patients with COPD admitted for exacerbation. 152 patients were studied for presence of DM. All of them were also assessed for vitamin D status and metabolic syndrome (MS). Data were gathered for smoking status and exacerbations during the last year. All patients completed CAT (COPD assessment test) and mMRC (Modified Medical Research Council Dyspnea scale) questionnaires and underwent spirometry. Duration of current hospital stay was recorded. 13.2% (20/152) of patients are taking medications for DM. Additional 21.7% (33/152) have newly discovered DM and 30.9% (47/152) have prediabetes. Only 34.2% of the studied patients do not have DM or prediabetes. 37% (40/108) of males have DM vs. 29,5% (13/44) of females (p=0.379). The prevalence of DM in this study is significantly higher when compared to an unselected Bulgarian population (12,8% in subjects over 45 years). 91% of patients with newly discovered diabetes had glycated hemoglobin (HbA1c)≥6,5% suggesting prolonged hyperglycemia. There is a correlation between the presence of DM and MS (p=0.008). The presence of DM is associated with more severe exacerbations (hospitalizations) during the previous year (p=0.003) and a longer hospital stay (p=0.006). DM is not associated with reduced quality of life and worse pulmonary function. The patients with COPD admitted for exacerbation are at great risk for impaired glucose metabolism which is associated with worse COPD characteristics. The majority of the patients in this study are unaware of having DM.

scholarly journals Pola Penggunaan Obat Antidiabetes di Puskesmas Grabag Magelang

2021 ◽  
Vol 3 (1) ◽  
pp. 51-59
Author(s):  
Nurul Maulidya ◽  
Dian Oktianti
Keyword(s):  
Public Health ◽  
Diabetes Mellitus ◽  
Combination Therapy ◽  
Health Center ◽  
Medical Record ◽  
Sampling Technique ◽  
Antidiabetic Drugs ◽  
Medical Record Data ◽  
Public Health Center ◽  
Record Data

Diabetes Mellitus (DM) is a long-term or chronic disease which continues to increase every year. Indonesia itself is ranked 7th for the most DM sufferers in the world. The purpose of this study was to determine the profile of the use of antidiabetic drugs in DM patients at the Grabag Public Health Center. The method used in this research is descriptive method, with retrospective data collection. The population of DM sufferers at the Grabag Public Health Center was 50 patients, with the sampling technique using the total sampling method. The inclusion criteria were medical record data for outpatient type 2 diabetes mellitus, and the exclusion criteria incomplete medical record data. The results of this study were the use of oral antidiabetic drugs (OAD) with single therapy, metformin 32% and acarbose 2%, and with combination therapy are metformin + glimepirid 58%, acarbose + glimepiride 2%, and metformin + glimepiride+acarbose 6%. Based on the duration of suffering from diabetes, for 1 year the most people used metformin by 26%, for 2 and 3 years the most used metformin + glimepiride by 38% and 8%, while for 4 years using a combination of metformin + glimepiride + acarbose by 2%. Most of the patients are accompanied by hypertension complications. The most widely used single therapy oral OAD is metformin and the combination therapy is metformin + glimepiride. Patients suffering from diabetes for 1 year of treatment used metformin single therapy, for 2 and 3 years the most treatment used 2 combination therapy, glimepiride + metformin, while for 4 years of treatment using 3 combination therapy metformin + glimepiride + acarbose. Abstrak Diabetes Mellitus (DM) merupakan penyakit jangka panjang atau kronis yang pada setiap tahunnya terus mengalami peningkatan. Indonesia sendiri menduduki peringkat ke-7 untuk penderita DM terbanyak didiunia. Tujuan penelitian ini adalah untuk mengetahui profil penggunaan obat antidiabetes pada pasien DM di Puskesmas Grabag. Metode yang digunakan pada penelitian ini adalah metode deskriptif, dengan pengambilan data secara retrospektif. Populasi penderita DM di puskesmas Grabag sebanyak 50 pasien dengan teknik pengambilan sampel menggunakan metode total sampling. Kriteria inklusi berupa data rekam medik pasien DM tipe 2 rawat jalan, dan kriteria eksklusi berupa data rekam medik yang tidak lengkap. Hasil dari penelitian ini adalah penggunaan obat antidiabetes (OAD) oral dengan terapi tunggal yaitu metformin 32% dan acarbose 2%, dan dengan terapi kombinasi adalah metformin + glimepirid 58%, acarbose + glimepiride 2%, dan metformin+glimepiride + acarbose 6%. Berdasarkan lamanya menderita DM, selama 1 tahun terbanyak menggunakan metformin sebesar 26%, selama 2 dan 3 tahun terbanyak menggunakan metformin + glimepiride sebesar 38% dan 8%, sedangkan selama 4 tahun menggunakan kombinasi metformin + glimepiride + acarbose sebesar 2%. Sebagian besar pasien disertai dengan komplikasi hipertensi. Penggunaan OAD oral terapi tunggal terbanyak adalah metformin dan terapi kombinasi adalah metformin+glimepiride. Pasien yang menderita DM selama 1 tahun pengobatan terbanyak menggunakan terapi tunggal metformin, selama 2 dan 3 tahun pengobatan terbanyak menggunakan terapi 2 kombinasi yaitu glimepiride + metformin, sedangkan selama 4 tahun pengobatannya menggunakan terapi 3 kombinasi yaitu metformin + glimepiride + acarbose.

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