Infants Hospitalized for Acute COVID-19: Disease Severity in a Multicenter Cohort Study

Abstract Age is the most important determinant of COVID-19 severity. Infectious disease severity by age is typically J-shaped, with infants and the elderly carrying a high burden of disease. We report on the comparative disease severity between infants and older children in a multicenter retrospective cohort study of children 0 to 17 year old admitted for acute COVID-19 February 2020 through May 2021 in 17 pediatric hospitals. We compare clinical and laboratory characteristics and estimate the association between age group and disease severity using ordinal logistic regression. We found that infants comprised one third of cases, but were admitted for a shorter period (median 3 days IQR 2-5 versus 4 days IQR 2-7), had a lower likelihood to have an increased C-reactive protein and had half the odds of older children of having severe or critical disease (OR 0.50 (95% Confidence Interval 0.32-0.78)).Conclusion: When compared to older children, there appeared to be a lower threshold to admit infants but their length of stay is shorter and they have a lower odds than older children of progressing to severe or critical disease.

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C-reactive protein is superior to white blood cell count for early detection of complications after pancreatoduodenectomy: a retrospective multicenter cohort study

HPB ◽

10.1016/j.hpb.2020.02.005 ◽

2020 ◽

Vol 22 (10) ◽

pp. 1504-1512

Author(s):

Jelle C. van Dongen ◽

F. Jasmijn Smits ◽

Hjalmar C. van Santvoort ◽

I. Quintus Molenaar ◽

Olivier R. Busch ◽

...

Keyword(s):

Cohort Study ◽

Early Detection ◽

Blood Cell ◽

Cell Count ◽

White Blood Cell Count ◽

C Reactive Protein ◽

Blood Cell Count ◽

Multicenter Cohort Study ◽

Reactive Protein ◽

Multicenter Cohort

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C-Reactive Protein and Lymphocyte are important indicators of severe coronavirus disease and poor prognosis in elderly patients

10.21203/rs.3.rs-21426/v3 ◽

2020 ◽

Author(s):

Qinglin He ◽

Xiafen Hu ◽

Xiaochen Xiang ◽

Siyang Chen ◽

Wanxin Liu ◽

...

Keyword(s):

Elderly Patients ◽

Disease Severity ◽

Area Under The Curve ◽

Reference Interval ◽

The Elderly ◽

C Reactive Protein ◽

Roc Curve Analysis ◽

Dynamic Changes ◽

Reactive Protein ◽

Risk Of Death

Abstract Objective：To explore the value of C-reactive protein (CRP) and lymphocyte (L) in the assessment of disease severity and prognosis of elderly COVID-19 patients.Methods: A total of 194 positive COVID-19 patients were collected from Tianyou Hospital and Puren Hospital, affiliated hospital of Wuhan University of Science and Technology. Their demographic characteristics were analyzed. The dynamic changes of CRP and L in peripheral blood were retrospectively studied.Results: (1) There were significant statistical differences in CRP, L in clinical typing and clinical outcome in patients over 60 years old compared with those under 60 years old. Survival analysis showed that the risk of death was greater in patients over 60 than in those under 60.（2）In 125 patients over 60 years old, the hospitalized patients with severe or critical types of disease had significantly higher CRP than those with moderate type (p<0.01). In the outcome of the elderly patients, the CRP of the patients with the outcomes of discharge, improvement, aggravation and death increased successively (p<0.01). According to the analysis of Logistic regression model, the increase of CRP constitutes a risk factor for death in elderly patients. (3) In the ROC curve analysis to distinguish the death outcome and non-death outcome of COVID-19 patients, the area under the curve (AUC) of CRP and L was 0.751 and 0.720 respectively. CRP and L had good diagnostic accuracy for the death outcome of patients. (4) Changes in CRP were correlated with changes in CT imaging and were consistent with changes in the course of the disease.Conclusions: (1) The data collected in this research showed that the cumulative survival rate of patients over 60 years old was lower than that of patients under 60 years old. With the increase of age, the CRP of patients showed an increasing trend, and the L of patients showed a characteristic lower than the normal reference interval. (2) CRP and L are important monitoring indicators of COVID-19 in elderly patients. Combined with CT examination and observation of their dynamic changes, CRP and L are of important clinical guiding value for the judgment of disease severity and the evaluation of prognosis.

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A high Gas6 level in plasma predicts venous thromboembolism recurrence, major bleeding and mortality in the elderly: a prospective multicenter cohort study

Journal of Thrombosis and Haemostasis ◽

10.1111/jth.14365 ◽

2019 ◽

Vol 17 (2) ◽

pp. 306-318

Author(s):

Annatina Schnegg‐Kaufmann ◽

Sara Calzavarini ◽

Andreas Limacher ◽

Marie Mean ◽

Marc Righini ◽

...

Keyword(s):

Cohort Study ◽

Venous Thromboembolism ◽

Major Bleeding ◽

The Elderly ◽

Multicenter Cohort Study ◽

Multicenter Cohort ◽

Venous Thromboembolism Recurrence

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Management and prognosis of hepatocellular carcinoma in the elderly: Results of an in-field multicenter cohort study

Liver International ◽

10.1111/liv.13392 ◽

2017 ◽

Vol 37 (8) ◽

pp. 1184-1192 ◽

Cited By ~ 4

Author(s):

Mauro Borzio ◽

Elena Dionigi ◽

Alessandro Vitale ◽

Angelo Rossini ◽

Massimo Marignani ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Cohort Study ◽

The Elderly ◽

Multicenter Cohort Study ◽

Multicenter Cohort

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Clinical Characteristics, Care Trajectories and Mortality Rate of SARS-CoV-2 Infected Cancer Patients: A Multicenter Cohort Study

Cancers ◽

10.3390/cancers13194749 ◽

2021 ◽

Vol 13 (19) ◽

pp. 4749

Author(s):

Marc-Antoine Benderra ◽

Ainhoa Aparicio ◽

Judith Leblanc ◽

Demian Wassermann ◽

Emmanuelle Kempf ◽

...

Keyword(s):

Cohort Study ◽

Mortality Rate ◽

Cancer Patients ◽

Multicenter Cohort Study ◽

Related Factors ◽

Reactive Protein ◽

Multicenter Cohort ◽

All Cause Mortality ◽

Male Sex ◽

Metabolic Comorbidities

Background: COVID-19 may be more frequent and more severe in cancer patients than in other individuals. Our aims were to assess the rate of COVID-19 in hospitalized cancer patients, to describe their demographic characteristics, clinical features and care trajectories, and to assess the mortality rate. Methods: This multicenter cohort study was based on the Electronic Health Records of the Assistance Publique-Hôpitaux de Paris (AP-HP). Cancer patients with a diagnosis of COVID-19 between 3 March and 19 May 2020 were included. Main outcome was all-cause mortality within 30 days of COVID-19 diagnosis. Results: A total of 29,141 cancer patients were identified and 7791 (27%) were tested for SARS-CoV-2. Of these, 1359 (17%) were COVID-19-positive and 1148 (84%) were hospitalized; 217 (19%) were admitted to an intensive care unit. The mortality rate was 33% (383 deaths). In multivariate analysis, mortality-related factors were male sex (aHR = 1.39 [95% CI: 1.07–1.81]), advanced age (78–86 y: aHR = 2.83 [95% CI: 1.78–4.51] vs. <66 y; 86–103 y: aHR = 2.61 [95% CI: 1.56–4.35] vs. <66 y), more than two comorbidities (aHR = 2.32 [95% CI: 1.41–3.83]) and C-reactive protein >20 ng/mL (aHR = 2.20 [95% CI: 1.70–2.86]). Primary brains tumors (aHR = 2.19 [95% CI: 1.08–4.44]) and lung cancer (aHR = 1.66 [95% CI: 1.02–2.70]) were associated with higher mortality. Risk of dying was lower among patients with metabolic comorbidities (aHR = 0.65 [95% CI: 0.50–0.84]). Conclusions: In a hospital-based setting, cancer patients with COVID-19 had a high mortality rate. This mortality was mainly driven by age, sex, number of comorbidities and presence of inflammation. This is the first cohort of cancer patients in which metabolic comorbidities were associated with a better outcome.

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C-Reactive Protein and Lymphocyte are important indicators of severe coronavirus disease and poor prognosis in elderly patients

10.21203/rs.3.rs-67738/v1 ◽

2020 ◽

Author(s):

Qinglin He ◽

Xiafen Hu ◽

Xiaochen Xiang ◽

Siyang Chen ◽

Wanxin Liu ◽

...

Keyword(s):

Elderly Patients ◽

Disease Severity ◽

Area Under The Curve ◽

Reference Interval ◽

The Elderly ◽

C Reactive Protein ◽

Roc Curve Analysis ◽

Dynamic Changes ◽

Reactive Protein ◽

Risk Of Death

Abstract Objective：To explore the value of C-reactive protein (CRP) and lymphocyte (L) in the assessment of disease severity and prognosis of elderly COVID-19 patients.Methods: A total of 194 positive COVID-19 patients were collected from Tianyou Hospital and Puren Hospital, affiliated hospital of Wuhan University of Science and Technology. Their demographic characteristics were analyzed. The dynamic changes of CRP and L in peripheral blood were retrospectively studied.Results: (1) There were significant statistical differences in CRP, L in clinical typing and clinical outcome in patients over 60 years old compared with those under 60 years old. Survival analysis showed that the risk of death was greater in patients over 60 than in those under 60.（2）In 125 patients over 60 years old, the hospitalized patients with severe or critical types of disease had significantly higher CRP than those with moderate type (p<0.01). In the outcome of the elderly patients, the CRP of the patients with the outcomes of discharge, improvement, aggravation and death increased successively (p<0.01). According to the analysis of Logistic regression model, the increase of CRP constitutes a risk factor for death in elderly patients. (3) In the ROC curve analysis to distinguish the death outcome and non-death outcome of COVID-19 patients, the area under the curve (AUC) of CRP and L was 0.751 and 0.720 respectively. CRP and L had good diagnostic accuracy for the death outcome of patients. (4) Changes in CRP were correlated with changes in CT imaging and were consistent with changes in the course of the disease.Conclusions: (1) The cumulative survival rate of patients over 60 years old was lower than that of patients under 60 years old. With the increase of age, the CRP of patients showed an increasing trend, and the L of patients showed a characteristic lower than the normal reference interval. (2) CRP and L are important monitoring indicators of COVID-19 in elderly patients. Combined with CT examination and observation of their dynamic changes, CRP and L are of important clinical guiding value for the judgment of disease severity and the evaluation of prognosis.

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Phenotype, disease severity and pain are major determinants of quality of life in Fabry disease: results from a large multicenter cohort study

Journal of Inherited Metabolic Disease ◽

10.1007/s10545-017-0095-6 ◽

2017 ◽

Vol 41 (1) ◽

pp. 141-149 ◽

Cited By ~ 15

Author(s):

Maarten Arends ◽

Simon Körver ◽

Derralynn A. Hughes ◽

Atul Mehta ◽

Carla E. M. Hollak ◽

...

Keyword(s):

Quality Of Life ◽

Cohort Study ◽

Fabry Disease ◽

Disease Severity ◽

Multicenter Cohort Study ◽

Multicenter Cohort

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Procalcitonin Use: Variation Across Hospitals and Trends Over Time

Hospital Pediatrics ◽

10.1542/hpeds.2021-005992 ◽

2021 ◽

Author(s):

Jillian M. Cotter ◽

Isabel Hardee ◽

Angela Moss ◽

Amanda Dempsey ◽

Lilliam Ambroggio

Keyword(s):

Health Information System ◽

C Reactive Protein ◽

Multicenter Cohort Study ◽

Reactive Protein ◽

Pediatric Hospitals ◽

Young Infants ◽

Baseline Testing ◽

Trends Over Time ◽

The Impact ◽

Over Time

OBJECTIVES: Procalcitonin (PCT) is a relatively novel biomarker that may be superior to C-reactive protein (CRP) in identifying bacterial infection. PCT use in pediatric hospitals is relatively unknown. We aimed to evaluate PCT and CRP use, describe PCT testing variability across children’s hospitals, and compare temporal rates of PCT and CRP testing for patients admitted with pneumonia, sepsis, or fever in young infants. METHODS: In this multicenter cohort study, we identified children ≤18 years old hospitalized from 2014–2018 with pneumonia, sepsis, or fever in infants <2 months by using the Pediatric Health Information System. To determine use, we evaluated the proportion of encounters with PCT or CRP testing from 2017-2018. We generated heat maps to describe PCT use across hospitals. We also compared PCT and CRP rates over time from 2014 to 2018. RESULTS: From 2017–2018, PCT testing occurred in 3988 of 34c231 (12%) hospitalizations. Febrile infants had the highest PCT testing proportion (18%), followed by sepsis (15%) and pneumonia (9%). There was across-hospital variability in PCT testing, particularly for febrile infants. Over time, the odds of PCT testing increased at a significantly greater rate than that of CRP. CONCLUSIONS: Despite limited guideline recommendations for PCT testing during the study period, PCT use increased over time with across-hospital variability. For pneumonia and sepsis, given the importance of high-value care, we need to understand the impact of PCT on patient outcomes. With recent guidelines recommending PCT in the evaluation of febrile infants, we identified baseline testing behaviors for future studies on guideline impact.

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