scholarly journals Characteristics and Clinical Course of Adult in-Patients With SARS-CoV-2 Pneumonia in Bogotá, Colombia.

2021 ◽  
Author(s):  
Javier Leonardo Galindo ◽  
Juan Ricardo Lutz ◽  
María Alejandra Izquierdo ◽  
Katherine Parra ◽  
Lina María Prieto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Critical Care ◽  
Invasive Mechanical Ventilation ◽  
Underlying Disease ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Icu Admission ◽  
Arterial Ph ◽  
Critical Care Admission

Abstract Background: SARS-CoV-2 virus has spread worldwide causing a crisis in healthcare systems. We aimed to describe the clinical characteristics and to explore risk factors of death, critical care admission and use of invasive mechanical ventilation in hospitalized patients with SARS-CoV-2 pneumonia in Bogotá, Colombia.Methods: We conducted a cross-sectional study of adult patients with laboratory-confirmed SARS-CoV-2 pneumonia. Demographic and clinical data were extracted from electronic records. Univariate and multivariable methods were performed to investigate the relationship between each variable and clinical outcomes at 28 days of follow-up.Results: Between March 20 and June 30, 2020, 377 adults (56.8% male) were included in the study, of whom 85 (22.6%) died. Non-survivors were older on average than survivors (mean age, 56.7 years [SD 15.8] vs. 70.1 years [SD 13.9]) and more likely male (28 [32.9%] vs. 57 [67.1%]). Most patients had at least one underlying disease (333 [88.3%]), including arterial hypertension (149 [39.5%]), overweight (145 [38.5%]) and obesity (114 [30.2%]). Critical care admission (158 [41.9%]) and invasive mechanical ventilation (123 [32.6%]) was high. Age over 65 years (OR 9.26, 95% CI 3.29-26.01; p=0.00), ICU admission (OR 12.37, 95% CI 6.08-25.18; p=0.00), and arterial pH higher than 7.47 (OR 0.25, 95% CI 0.08-0.74; p=0.01) were associated with in-hospital mortality.Conclusions: In this study of in-hospital patients with SARS-CoV-2 pneumonia frequency of death was similar to what has been reported. ICU admission and use of invasive mechanical ventilation was high. Risk factors as older age, ICU admission, and arterial pH were associated with mortality.

scholarly journals Characteristics and Clinical Course of Adult in-Patients With SARS-CoV-2 Pneumonia in Bogotá, Colombia.

2021 ◽  
Author(s):  
Javier Leonardo Galindo ◽  
Juan Ricardo Lutz ◽  
María Alejandra Izquierdo ◽  
Katherine Parra ◽  
Lina María Prieto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Critical Care ◽  
Invasive Mechanical Ventilation ◽  
Underlying Disease ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Icu Admission ◽  
Arterial Ph ◽  
Critical Care Admission

Abstract Background: SARS-CoV-2 virus has spread worldwide causing a crisis in healthcare systems. We aimed to describe the clinical characteristics and to explore risk factors of death, critical care admission and use of invasive mechanical ventilation in hospitalized patients with SARS-CoV-2 pneumonia in Bogotá, Colombia.Methods: We conducted a cross-sectional study of adult patients with laboratory-confirmed SARS-CoV-2 pneumonia. Demographic, clinical, and treatment data were extracted from electronic records. Univariate and multivariable methods were performed to investigate the relationship between each variable and clinical outcomes at 28 days of follow-up.Results: Between March 20 and June 30, 2020, 377 adults (56.8% male) were included in the study, of whom 85 (22.6%) died. Non-survivors were older on average than survivors (mean age, 56.7 years [SD 15.8] vs. 70.1 years [SD 13.9]) and more likely male (28 [32.9%] vs. 57 [67.1%]). Most patients had at least one underlying disease (333 [88.3%]), including arterial hypertension (149 [39.5%]), overweight (145 [38.5%]), obesity (114 [30.2%]) and diabetes mellitus (82 [21.8%]). Frequency of critical care admission (158 [41.9%]) and invasive mechanical ventilation (123 [32.6%]) was high. Age over 65 years (OR 9.26, 95% CI 3.29-26.01; p=0.00), ICU admission (OR 12.37, 95% CI 6.08-25.18; p=0.00), and arterial pH higher than 7.47 (OR 0.25, 95% CI 0.08-0.74; p=0.01) were independently associated with in-hospital mortality.Conclusions: In this study of in-hospital patients with SARS-CoV-2 pneumonia frequency of death was similar to what has been reported. ICU admission and use of invasive mechanical ventilation was high. Risk factors as older age, ICU admission, and arterial pH were associated with mortality.

scholarly journals Characteristics and Clinical Course of Adult in Patients with SARS-CoV-2 Pneumonia at High Altitude

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Javier Leonardo Galindo ◽  
Juan Ricardo Lutz ◽  
María Alejandra Izquierdo ◽  
Katherine Parra ◽  
Lina María Prieto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Critical Care ◽  
High Altitude ◽  
Invasive Mechanical Ventilation ◽  
Underlying Disease ◽  
Icu Admission ◽  
Arterial Ph ◽  
Hospital Patients ◽  
Critical Care Admission

Background. SARS-CoV-2 has spread worldwide with different dynamics in each region. We aimed to describe the clinical characteristics and to explore risk factors of death, critical care admission, and use of invasive mechanical ventilation in hospitalized patients with SARS-CoV-2 pneumonia in a high-altitude population living in Bogotá, Colombia. Methods. We conducted a concurrent cohort study of adult patients with laboratory-confirmed SARS-CoV-2 pneumonia. Demographic, clinical, and treatment data were extracted from electronic records. Univariate and multivariable methods were performed to investigate the relationship between each variable and outcomes at 28 days of follow-up. Results. 377 adults (56.8% male) were included in the study, of whom 85 (22.6%) died. Nonsurvivors were older on average than survivors (mean age, 56.7 years [SD 15.8] vs. 70.1 years [SD 13.9]; p ≤ 0.001 ) and more likely male (28 [32.9%] vs. 57 [67.1%]; p = 0.029 ). Most patients had at least one underlying disease (333 [88.3%]), including arterial hypertension (149 [39.5%]), overweight (145 [38.5%]), obesity (114 [30.2%]), and diabetes mellitus (82 [21.8%]). Frequency of critical care admission (158 [41.9%]) and invasive mechanical ventilation (123 [32.6%]) was high. Age over 65 years (OR 9.26, 95% CI 3.29–26.01; p ≤ 0.001 ), ICU admission (OR 12.37, 95% CI 6.08–25.18; p ≤ 0.001 ), and arterial pH higher than 7.47 (OR 0.25, 95% CI 0.08–0.74; p = 0.01 ) were independently associated with in-hospital mortality. Conclusions. In this study of in-hospital patients with SARS-CoV-2 pneumonia living at high altitude, frequency of death was similar to what has been reported. ICU admission and use of invasive mechanical ventilation were high. Risk factors as older age, ICU admission, and arterial pH were associated with mortality.

scholarly journals Combined association of obesity and other cardiometabolic diseases with severe COVID-19 outcomes: a nationwide cross-sectional study of 21,773 Brazilian adult and elderly inpatients

2021 ◽  
Author(s):  
Natanael J Silva ◽  
Rita C Ribeiro-Silva ◽  
Andrea JF Ferreira ◽  
Camila SS Teixeira ◽  
Aline S Rocha ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Dose Response ◽  
Invasive Mechanical Ventilation ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Icu Admission ◽  
Non Invasive ◽  
Elderly Inpatients

Objective: To investigate the combined association of obesity, diabetes mellitus (DM), and cardiovascular disease (CVD) with severe COVID-19 outcomes in adult and elderly inpatients. Design: Cross-sectional study based on registry data from Brazil's influenza surveillance system. Setting: Public and private hospitals across Brazil. Participants: Eligible population included 21,942 inpatients aged 20 years or older with positive RT-PCR test for SARS-CoV-2 until Jun 9th, 2020. Main outcome measures: Severe COVID-19 outcomes were non-invasive and invasive mechanical ventilation use, ICU admission, and death. Multivariate analyses were conducted separately for adults (20-59 years) and elders (>=60 years) to test the combined association of obesity (without and with DM and/or CVD) and degrees of obesity with each outcome. Results: A sample of 8,848 adults and 12,925 elders were included. Among adults, obesity with DM and/or CVD showed higher prevalence of invasive (PR 3.76, 95%CI 2.82-5.01) and non-invasive mechanical ventilation use (2.06, 1.58-2.69), ICU admission (1.60, 1.40-1.83), and death (1.79, 1.45-2.21) compared with the group without obesity, DM, and CVD. In elders, obesity alone (without DM and CVD) had the highest prevalence of ICU admission (1.40, 1.07-1.82) and death (1.67, 1.00-2.80). In both age groups, obesity alone and combined with DM and/or CVD showed higher prevalence in all outcomes than DM and/or CVD. A dose-response association was observed between obesity and death in adults: class I 1.32 (1.05-1.66), class II 1.41 (1.06-1.87), and class III 1.77 (1.35-2.33). Conclusions: The combined association of obesity, diabetes, and/or CVD with severe COVID-19 outcomes may be stronger in adults than in elders. Obesity alone and combined with DM and/or CVD had more impact on the risk of COVID-19 severity than DM and/or CVD in both age groups. The study also supports an independent relationship of obesity with severe outcomes, including a dose-response association between degrees of obesity and death in adults. These findings suggest important implications for the clinical care of patients with obesity and severe COVID-19 and support the inclusion of people with obesity in the high-risk and vaccine priority groups for protection from SARS-CoV-2.

scholarly journals High Frequency of SARS-CoV-2 RNAemia and Association With Severe Disease

2020 ◽  
Author(s):  
Catherine A Hogan ◽  
Bryan A Stevens ◽  
Malaya K Sahoo ◽  
ChunHong Huang ◽  
Natasha Garamani ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Severe Disease ◽  
Invasive Mechanical Ventilation ◽  
Tertiary Care ◽  
Prognostic Indicator ◽  
Cross Sectional Study ◽  
Clinical Severity ◽  
Plasma Samples ◽  
Cross Sectional ◽  
Icu Admission

Abstract Background Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in blood, also known as RNAemia, has been reported, but its prognostic implications are poorly understood. This study aimed to determine the frequency of SARS-CoV-2 RNA in plasma and its association with coronavirus disease 2019 (COVID-19) clinical severity. Methods An analytical cross-sectional study was performed in a single-center tertiary care institution and included consecutive inpatients and outpatients with confirmed COVID-19. The prevalence of SARS CoV-2 RNAemia and the strength of its association with clinical severity variables were examined and included intensive care unit (ICU) admission, invasive mechanical ventilation, and 30-day all-cause mortality. Results Paired nasopharyngeal and plasma samples were included from 85 patients. The median age was 55 years, and individuals with RNAemia were older than those with undetectable SARS-CoV-2 RNA in plasma (63 vs 50 years; P = .04). Comorbidities were frequent including obesity (37.6%), hypertension (30.6%), and diabetes mellitus (22.4%). RNAemia was detected in 28/85 (32.9%) of patients, including 22/28 (78.6%) who required hospitalization. In models adjusted for age, RNAemia was detected more frequently in individuals who developed severe disease including ICU admission (32.1 vs 14.0%; P = .04) and invasive mechanical ventilation (21.4% vs 3.5%; P = .02). All 4 deaths occurred in individuals with detectable RNAemia. An additional 121 plasma samples from 28 individuals with RNAemia were assessed longitudinally, and RNA was detected for a maximum duration of 10 days. Conclusions This study demonstrated a high proportion of SARS-CoV-2 RNAemia, and an association between RNAemia and clinical severity suggesting the potential utility of plasma viral testing as a prognostic indicator for COVID-19.

scholarly journals Combined association of obesity and other cardiometabolic diseases with severe COVID-19 outcomes: a nationwide cross-sectional study of 21 773 Brazilian adult and elderly inpatients

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e050739
Author(s):  
Natanael de Jesus Silva ◽  
Rita de Cássia Ribeiro-Silva ◽  
Andrêa Jacqueline Fortes Ferreira ◽  
Camila Silveira Silva Teixeira ◽  
Aline Santos Rocha ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Dose Response ◽  
Invasive Mechanical Ventilation ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Icu Admission ◽  
Non Invasive ◽  
Elderly Inpatients

ObjectivesTo investigate the combined association of obesity, diabetes mellitus (DM) and cardiovascular disease (CVD) with severe COVID-19 outcomes in adult and elderly inpatients.DesignCross-sectional study based on registry data from Brazil’s influenza surveillance system.SettingPublic and private hospitals across Brazil.ParticipantsEligible population included 21 942 inpatients aged ≥20 years with positive reverse transcription-PCR test for SARS-CoV-2 until 9 June 2020.Main outcome measuresSevere COVID-19 outcomes were non-invasive and invasive mechanical ventilation use, intensive care unit (ICU) admission and death. Multivariate analyses were conducted separately for adults (20–59 years) and elders (≥60 years) to test the combined association of obesity (without and with DM and/or CVD) and degrees of obesity with each outcome.ResultsA sample of 8848 adults and 12 925 elders were included. Among adults, obesity with DM and/or CVD showed higher prevalence of invasive (prevalence ratio 3.76, 95% CI 2.82 to 5.01) and non-invasive mechanical ventilation use (2.06, 1.58 to 2.69), ICU admission (1.60, 1.40 to 1.83) and death (1.79, 1.45 to 2.21) compared with the group without obesity, DM and CVD. In elders, obesity alone (without DM and CVD) had the highest prevalence of ICU admission (1.40, 1.07 to 1.82) and death (1.67, 1.00 to 2.80). In both age groups, obesity alone and combined with DM and/or CVD showed higher prevalence in all outcomes than DM and/or CVD. A dose–response association was observed between obesity and death in adults: class I 1.32 (1.05 to 1.66), class II 1.41 (1.06 to 1.87) and class III 1.77 (1.35 to 2.33).ConclusionsThe combined association of obesity, diabetes and/or CVD with severe COVID-19 outcomes may be stronger in adults than in elders. Obesity alone and combined with DM and/or CVD had more impact on the risk of COVID-19 severity than DM and/or CVD in both age groups. The study also supports an independent relationship of obesity with severe outcomes, including a dose–response association between degrees of obesity and death in adults.

Nosocomial Sepsis and its Risk Factors: A Cross-Sectional Study in a Neonatal Intensive Care Unit

2019 ◽  
Vol 2 (1) ◽  
pp. 52-59
Author(s):  
Sunil Kumar Yadav ◽  
SP Yadav ◽  
P Kanodia ◽  
N K Bhatta ◽  
R R Singh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nosocomial Sepsis

Introduction: Nosocomial sepsis is a common and serious infection of neonates who are admitted in intensive care unit. They lead to significant morbidity and mortality in both developed and resource limited countries. The neonatal intensive care unit (NICU) is a suitable environment for disseminating the infections and, hence, needs preventive intervention. The study was carried out to determine the risk factors for nosocomial sepsis in neonatal intensive care unit. Material and Methods: This was a cross-sectional study conducted in a seven bedded teaching and referral hospital NICU. All neonates in NICU who did not have any sign of infection at admission and remained hospitalized for at least 48 hours were observed. Nosocomial sepsis was diagnosed according to the CDC criteria. Risk factors for nosocomial sepsis were analyzed with Chi-square test and Logistic regression model. P-value of <0.05 was considered significant. Results: Low birth weight (both preterm and IUGR) and mechanical ventilation were found to be related with nosocomial sepsis. Conclusions: Low birth weight and mechanical ventilation were the most important risk factors fornosocomial sepsis.

scholarly journals Clinical and paraclinical predictive factors for in-hospital mortality in adult patients with COVID-19

2021 ◽  
Author(s):  
Seyed Alireza Mousavi ◽  
Reyhaneh Sadat Mousavi-Roknabadi ◽  
Fateme Nemati ◽  
Somaye Pourteimoori ◽  
Arefeh Ghorbani ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Hospital Mortality ◽  
Ct Scan ◽  
Predictive Factors ◽  
Invasive Mechanical Ventilation ◽  
Cross Sectional Study ◽  
Study Data ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Non Invasive

Abstract Background Since December 2019, a type of coronavirus has emerged in Wuhan, China, which has become the focus of global attention due to an epidemic of pneumonia of unknown cause, called COVID-19. This study aimed to investigate the factors affecting in-hospital mortality of patients with COVID-19 hospitalized in one of the main hospital in central Iran. Methods This retrospective cross-sectional study (February 2019-May 2020) was conducted on patients with confirmed diagnosis COVID-19, who were admitted in Yazd Shahid Sadoughi Hospital, in middle of Iran. The patients with uncompleted or missed medical files were excluded from the study. Data were extracted from the patients' medical files and then analyzed. The patients were categorized as survivors and non-survivors groups, and they were compared. Results Totally, 573 patients were enrolled, that 356 (62.2%) were male. The mean ± SD of age was 56.29 ± 17.53 years, and 93 (16.23%) were died. All the complications were more in non-survivors. Intensive care unit (ICU) admission was in 20.5% of the patients which was more in non-survivors (P < 0.001). The results of multivariate logistic regression test showed that plural effusion in lung computed tomography (CT) scan (OR = 0.055, P = 0.009), white blood cell (WBC) (OR = 1.417, P = 0.022), serum albumin (OR = 0.009, P < 0.001), non-invasive mechanical ventilation (OR = 34.315, P < 0.001), and acute respiratory distress syndrome (ARDS) (OR = 66.039, P = 0.001) were achieved as the predictive factors for in-hospital mortality were the predictive factors for in-hospital mortality. Conclusion In-hospital mortality in patients with COVID-19 was about 16%. Plural effusion in lung CT scan, WBC, albumin, non-invasive mechanical ventilation, and ARDS were obtained as the predictive factors for in-hospital mortality.

scholarly journals Risk factors associated with COVID-19 Intensive Care Unit hospitalisation in Guyana: A cross-sectional study

2021 ◽  
Author(s):  
Steven A. Seepersaud
Keyword(s):  
Risk Factors ◽  
Retrospective Chart Review ◽  
Binary Logistic Regression ◽  
Signs And Symptoms ◽  
Cross Sectional Study ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
Factors Associated ◽  
Independent Variables ◽  
Icu Admission

Objective The purpose of the study was to determine risk factors associated with COVID-19 ICU hospitalisation at Georgetown Public Hospital Corporation (GPHC), Guyana. Methods A retrospective chart-review was conducted on all COVID-19 admissions from March to September 2020. The predictive factors were demographics, comorbidities, signs and symptoms of COVID-19 and laboratory findings on admission. Descriptive frequency analysis was done for all independent variables and the Chi-square test was used to compare differences between groups where suitable. Univariate and multivariate binary logistic regression was used to examine the association between the independent variables and the risk for ICU hospitalisation. Results There were 136 patients with COVID-19 at GPHC during March to September 2020 and after exclusion, 135 patients were used in the study. There were 72 (53.4%) patients who required non-ICU care, while 63 (46.6%) ICU care and average age ± SD (median) was 51 ±16 (n= 49) and 56 ±18 (n= 60), respectively. In the multivariate regression model, the odds of ICU admission for those aged 40-65 was 0.14 (p <.01) compared to those > 65 years. Patients with class 2 and above obesity had higher odds of ICU admission compared to non-obese patients OR 11.09 (p= .006). Patients with 2 and 3 or more comorbidities also had higher odds of ICU admission compared to those with no comorbidities OR 7.83 (p= .03) and 132 (p <.001), respectively. Patients with LDH 228-454 U/L and > 454 U/L on admission had higher odds of ICU admission compared to those with normal LDH OR 19.88 (p= .001) and 23.32 (p= .001), respectively. Patients with albumin < 3.50 mg/dL on admission also had higher odds of ICU admission compared to those with normal albumin OR 5.78 (p= .005). Conclusion Risk factors associated with ICU hospitalisation were advanced age, obesity, multiple comorbidities, elevated LDH and low albumin. Protecting the population at risk for ICU admission and prioritizing them for vaccination is recommended to reduce the risk of running out of ICU capacity.

scholarly journals Etiology and Risk Factors Associated With Infertility

2019 ◽  
Vol 7 (3) ◽  
pp. 346-353 ◽  
Author(s):  
Azam Moridi ◽  
Nasibeh Roozbeh ◽  
Halimeh Yaghoobi ◽  
Shirin Soltani ◽  
Sareh Dashti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Medical Science ◽  
Underlying Disease ◽  
Cross Sectional Study ◽  
Male Factor ◽  
Cross Sectional ◽  
Factors Associated ◽  
Validated Questionnaire ◽  
Pregnancy And Postpartum ◽  
Common Causes

Objectives: Infertility is one of the important complications in gynecology and the aim of the present study was to investigate the etiology and risk factors associated with infertility in the southern region of Iran. Materials and Methods: This cross-sectional study was conducted in infertility centers of Hormozgan University of Medical Science (HUMS). Totally, 250 infertile couples were included. The variables including socio-demographic characteristics, smoking, body mass index (BMI), and infertility status (e.g., type of fertility, duration, etc.) were assessed by a self-administered and validated questionnaire. Data analysis was carried out using SPSS version 22.0. Results: The most common causes of male and female infertility were varicocele (49.4%) and ovulation disorders (57.5%), respectively. There was a significant association between female factor infertility and level of education, age of women, women’s age at marriage, number of abortions, alcohol consumption, presence of an underlying disease, and BMI (P<0.005). There was also a significant relationship between male factor infertility and men’s job, addiction, smoking, and presence of an underlying disease (P<0.005). Conclusions: Considering various risk factors for infertility, an important step forward can be taken towards reducing the incidence of these risk factors by providing different education classes during pre-marriage, pre-partum, pregnancy and postpartum periods so as to inform couples of controllable risk factors.

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