scholarly journals Assessment of changes in blood urea and creatinine levels in patients with coronavirus disease 2019 (COVID-19)

2020 ◽  
Author(s):  
Hassan Mahmoudi ◽  
Mohammad Yousef Alikhani ◽  
Narges Mofrad Taheri ◽  
Alireza Behzadi
Keyword(s):  
Viral Infection ◽  
Biochemical Parameters ◽  
Respiratory Tract Infections ◽  
Clinical Presentation ◽  
Plasma Creatinine ◽  
Serum Urea ◽  
Creatinine Concentration ◽  
Urea Level ◽  
The Mean ◽  
Tract Infections

Abstract Background Coronavirus disease 2019 (COVID-19) is new respiratory tract infections disease with an evolving understanding of its epidemiology and clinical appearances. Kidney defect seems to be common in patients with Covid-19. Urea and creatinine level often occurs at the beginning or during the infection. This evidence shows that Covid-19 also attacks the kidneys. The aim of this study was to evaluate changes in biochemical parameters associated with kidney function, including urea and creatinine in patients with COVID-19.Methods We conducted a retrospective analysis of the plasma creatinine and urea levels of the 100 COVID-19 patients with normal plasma creatinine and urea at first clinical presentation of COVID-19.Results Among these 100 patients with COVID 19, total of 35 (35%) patients, increased BUN and creatinine levels occurred at duration of 2–4 days after the onset of viral infection. The mean serum urea level in first clinical presentation and at duration of 2, 3 and 4 days after the onset of viral infection were 34.75 ± 0.10 and 37.64 ± 0.32, 39.81 ± 0.10, 42.56 ± 0.35 mg/dl, respectively. The mean of creatinine concentration in first clinical presentation and at duration of 2, 3 and 4 days after the onset of viral infection were 1.50 ± 0.026 and 1.51 ± 0.016, 1.99 ± 0.012, 2.58 ± 0.020 mg/dl, respectively.

scholarly journals Prognosis and treatment of 46 Chinese pediatric cystic fibrosis patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qionghua Chen ◽  
Yuelin Shen ◽  
Hui Xu ◽  
Xiaolei Tang ◽  
Haiming Yang ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Lung Function ◽  
Respiratory Tract Infections ◽  
Adverse Reactions ◽  
Clinical Presentation ◽  
Public Awareness ◽  
Sputum Production ◽  
Tract Infections ◽  
Lost To Follow Up

Abstract Background Since public awareness of cystic fibrosis (CF) has increased, more children have been diagnosed with CF in China. This study aimed to investigate medical and other challenges faced by pediatric CF patients in China. Method Treatments and treatment outcomes were retrospectively analyzed for 46 pediatric CF patients diagnosed from August 2009 to June 2019. Pre- and post-treatment results were compared using independent samples t-test. Results Of 46 pediatric CF study patients, four died and five were lost to follow-up. Thirty-seven patients were monitored for 0.03 to 9.21 years; patients exhibited fewer attacks of respiratory tract infections after diagnosis (4.49 ± 2.13 episodes/year before diagnosis vs 1.97 ± 1.87 times/year after 1-year treatment, p < 0.05), significantly reduced sputum production and experienced 1.62 ± 1.71 exacerbations/year. Patient mean body mass index was 16.87 ± 3.53 and pancreatic malfunction persisted in 15 patients. For 17 children, no significant differences in lung function were found at follow-up as compared to lung function at diagnosis (FEV1: 82.45% ± 16.56% vs 75.26% ± 22.34%, FVC: 87.18% ± 13.64% vs 86.99% ± 19.95%, FEF75%: 46.51% ± 28.78% vs 36.63% ± 24.30%, P = 0.27, 0.97, 0.20, respectively). Pseudomonas aeruginosa (17/27) and bronchiectasis (22/22) were found during follow-up evaluation. Twenty-four patients (64.8%) maintained good adherence to therapies. Overall, azithromycin and tobramycin treatments were administered for 0.5–62 months and 0.5–48 months, respectively, and triggered no obvious adverse reactions. Conclusion No obvious declines in clinical presentation or lung function were found in Chinese pediatric CF patients after receiving standard therapeutic and active treatments, although malnutrition and low compliance were persistent challenges.

Prothrombotic Changes in Hemostatic Parameters and C-reactive Protein in the Elderly with Winter Acute Respiratory Tract Infections

2001 ◽  
Vol 85 (02) ◽  
pp. 245-249 ◽  
Author(s):  
John Horan ◽  
Charles Francis ◽  
Ann Falsey ◽  
John Kolassa ◽  
Brian Smith ◽  
...  
Keyword(s):  
Older Adults ◽  
Heart Disease ◽  
Respiratory Tract ◽  
Ischemic Heart Disease ◽  
Respiratory Tract Infections ◽  
C Reactive Protein ◽  
Acute Respiratory Tract Infections ◽  
Reactive Protein ◽  
The Mean ◽  
Tract Infections

SummaryMortality rates attributable to cerebrovascular and ischemic heart disease increase among older adults during the winter. Prothrombotic changes in the hemostatic system related to seasonal factors, such as ambient temperature changes, and winter acute respiratory tract infections, may contribute to this excess seasonal mortality. A prospective nested case-control study was conducted to assess the impact of winter acute respiratory tract infections on fibrinogen, factor VII, factor VIIa, D-dimer, prothrombin fragment 1.2, PAI-1, soluble P-selectin and C-reactive protein (CRP) in older adults. The change in laboratory parameters from baseline (fall) to the time of infection in both middle-aged and elderly individuals was compared with matched non-infected controls. In older adult participants with winter acute respiratory tract infections, significant increases occurred in fibrinogen and C-reactive protein, but not in any other markers. The mean fibrinogen increased 1.52 g/L (38%) and the mean CRP increased 37 mg/L (370%) over baseline (both p < 0.001). In a multivariate analysis, both infection and season were associated with the increase in fibrinogen, but only infection was associated with the CRP increase. Old age magnified the increase in CRP but not in fibrinogen. Winter acute respiratory tract infections induce an exaggerated inflammatory response in older adults. The associated increase in fibrinogen, an independent risk factor for ischemic heart disease, may be partly responsible for the excess winter vascular mortality.

scholarly journals 2194. Procalcitonin-Guided Antibiotic Strategy for Lower Respiratory Tract Infections: Outcomes and Safety of Withholding Antibiotics

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S747-S747
Author(s):  
Don Bambino Geno Tai ◽  
Robert Goldstein
Keyword(s):  
Respiratory Tract ◽  
Hospital Mortality ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Standard Of Care ◽  
Lower Respiratory Tract Infections ◽  
Case Mix Index ◽  
Significant Difference ◽  
The Mean ◽  
Tract Infections

Abstract Background Procalcitonin (PCT) is a promising and well-studied marker in differentiating viral from bacterial lower respiratory tract infections (LRTI). Antibiotics are not recommended when PCT is normal (< 0.25 μg/L). Despite this, it has not been the standard of care due to safety concerns of relying on PCT to withhold antibiotics. Methods We retrospectively reviewed all non-critical LRTI patients with normal PCT admitted in our institution from October 2018 to March 2019. They were divided into adherent group in whom antibiotics were discontinued within 24 hours and non-adherent group in whom antibiotics were continued. Cases of Legionella, Mycoplasma, and other infectious syndromes necessitating antibiotics were excluded. Complexity of cases was measured based on Centers for Medicare and Medicaid Services (CMS) case-mix index (CMI). Outcomes compared were the length of stay (LOS), in-hospital mortality, and 30-day all-cause readmissions. Results A total of 78 patients were included in the analysis, 52% (n = 41) were in adherent group and 48% (n = 37) in the non-adherent group. The mean age was 74, and majority were females (59%, n = 46). The were no significant differences between the two groups in terms of age, gender, CMI, underlying COPD/asthma, CHF (see Table 1). The adherent group had statistically shorter LOS compared with the non-adherent group after adjusting for CMI. There was no significant difference in In-hospital mortality and readmissions (see Table 2). Furthermore, the adherent group’s LOS was statistically similar to CMS average LOS (5.08 vs. 3.8, P = 0.08); compared with the non-adherent group which had statistically longer LOS compared with CMS average LOS (8.3 vs. 4.6, p Conclusion PCT is a safe tool in deciding when to withhold antibiotics on LRTI patients. It shortens LOS with no difference in mortality or readmission. Disclosures All authors: No reported disclosures.

scholarly journals Study on Knowledge and Practices of Ayurvedic Preventive Measures for Respiratory Tract Infections

2021 ◽  
pp. 29-37
Author(s):  
B. L. Edirisinghe ◽  
W. M. S. S. K. Kulathunga
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Preventive Measures ◽  
Good Practice ◽  
World Health ◽  
Survey Study ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
The Mean ◽  
Tract Infections

Respiratory diseases have become world health burden. It has been estimated that 65 million people have moderate severe chronic obstructive pulmonary diseases from which about 3 million die each year. Objective of this survey study was to assess knowledge and practice of Intern medical officers on Ayurvedic preventive measures for managing respiratory tract infectious diseases. A cross sectional descriptive study was carried out among the Intern Medical Officers during their training program. 85 respondents out of 150 were assessed for their knowledge and practices on Ayurvedic preventive measures for Respiratory tract infections by using pre-structured questionnaire. Among the sampled students, most of them were female 92.9% (79) and unmarried 51.8% (44). The mean age and the standard deviation of the respondents were 28.25 + 0.815 years. There were 41(48.2%) Intern medical students with good knowledge, 42(49.4%) were with satisfactory knowledge and 2.4% of the study group was having the little knowledge. Most of the respondents 56(65.9%) were doing good practice on preventing RTI and 29 (34.1%) respondents were doing bad practice. Overall the respondents have good practice on prevention of RTI with the mean score of 19.9 + 2.589.

scholarly journals Clinical and Microbiological Evaluation of Travel-Associated Respiratory Tract Infections in Travelers Returning From Countries Affected by Pandemic A(H1N1) 2009 Influenza

2011 ◽  
Vol 19 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Stéphane Jauréguiberry ◽  
David Boutolleau ◽  
Eric Grandsire ◽  
Tomek Kofman ◽  
Claire Deback ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Influenza A ◽  
Respiratory Tract Infections ◽  
Clinical Presentation ◽  
Univariate Analysis ◽  
Influenza Viruses ◽  
Diagnostic Tools ◽  
Throat Culture ◽  
Influenza A H1n1 ◽  
Tract Infections

Abstract Background Although acute respiratory tract infections (RTI) have been recognized as a significant cause of illness in returning travelers, few studies have specifically evaluated the etiologies of RTI in this population. Methods This prospective investigation evaluated travelers returning from countries with endemic influenza A(H1N1) 2009, and who were seen in our department at the onset of the outbreak (April–July 2009). Patients were included if they presented with signs of RTI that occurred during travel or less than 7 days after return from overseas travel. Patients were evaluated for microbial agents with RespiFinder plus assay, and throat culture according to clinical presentation. Results A total of 113 travelers (M/F ratio 1.2:1; mean age 39 y) were included. They were mainly tourists (n = 50; 44.2%) mostly returning from North America (n = 65; 58%) and Mexico (n = 21; 18.5%). The median duration of travel was 23 days (range 2–540 d). The median lag time between return and onset of illness was 0.2 days (range 10 d prior to 7 d after). The main clinical presentation of RTI was influenza-like illness (n = 76; 67.3%). Among the 99 microbiologically evaluated patients, a pathogen was found by polymerase chain reaction (PCR) or throat culture in 65 patients (65.6%). The main etiological agents were influenza A(H1N1) 2009 (18%), influenza viruses (14%), and rhinovirus (20%). A univariate analysis was unable to show variables associated with influenza A(H1N1) 2009, whereas rhinorrhea was associated with viruses other than influenza (p = 0.04). Conclusion Despite the A(H1N1) 2009 influenza pandemic, rhinovirus and other influenza viruses were also frequent causes of RTI in overseas travelers. Real-time reverse transcription-PCR and nasopharyngeal swab cultures are useful diagnostic tools for evaluating travelers with RTI.

Viral, Fungal, and Atypical Infections

2017 ◽  
Author(s):  
Daniel Caroff ◽  
Chanu Rhee
Keyword(s):  
Respiratory Tract Infections ◽  
Clinical Presentation ◽  
Invasive Pulmonary Aspergillosis ◽  
Infectious Agents ◽  
Pulmonary Aspergillosis ◽  
Clinical Syndromes ◽  
Immunosuppressed Patients ◽  
Candida Infections ◽  
Tract Infections ◽  
Immunocompetent Patients

Viral, fungal, and “atypical” bacterial pathogens are important causes of infections in critically ill patients. Many of these pathogens predominantly cause disease in immunosuppressed patients, but immunocompetent patients can also face serious illness or death. Understanding the risk factors and clinical syndromes caused by these pathogens is necessary to quickly identify patients who may need specialized diagnostics and treatment and is an essential component of training for any provider who practices in the intensive care unit. In this review, we discuss the most relevant aspects of clinical presentation, epidemiology, diagnosis, and management of these infectious agents, with a particular focus on respiratory tract infections. New advances in the diagnosis and treatment of influenza, invasive Candida infections, aspergillosis, and Legionella are highlighted. This review contains 3 figures, 5 tables, and 94 references. Key words: Candida, influenza, invasive pulmonary aspergillosis, Legionella pneumophilia, viral pneumonia

scholarly journals Respiratory adenovirus infections in immunocompetent and immunocompromised adult patients

2019 ◽  
Vol 147 ◽  
Author(s):  
S. Cederwall ◽  
L. I. Påhlman
Keyword(s):  
Respiratory Tract Infections ◽  
Clinical Presentation ◽  
Respiratory Infections ◽  
Antiviral Treatment ◽  
Adult Patients ◽  
Immunocompromised Patients ◽  
Severe Infections ◽  
Tract Infections ◽  
Immunocompetent Adults ◽  
Underlying Risk

Abstract Adenovirus (AdV) can cause severe respiratory infections in children and immunocompromised patients, but less is known about severe AdV pneumonia in immunocompetent adults. In this retrospective study, we compared respiratory tract infections and pneumonia caused by AdV in immunocompromised and immunocompetent adult patients regarding clinical presentation and severity of infection. The results show that AdV can cause severe infections in both immunocompetent and immunocompromised patients, and the clinical presentation and need for hospitalisation, mechanical ventilation and antiviral treatment were equal in both groups. No underlying risk factors for severe AdV infection in healthy individuals were identified.

scholarly journals Time-course of upper respiratory tract viral infection and COPD exacerbation

2019 ◽  
Vol 54 (4) ◽  
pp. 1900407 ◽  
Author(s):  
Daiana Stolz ◽  
Eleni Papakonstantinou ◽  
Leticia Grize ◽  
Daniel Schilter ◽  
Werner Strobel ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Viral Infection ◽  
Respiratory Tract Infections ◽  
Viral Infections ◽  
Nucleic Acid Amplification ◽  
Chronic Obstructive ◽  
Upper Respiratory Tract ◽  
Stable Period ◽  
Upper Respiratory ◽  
Tract Infections

Viral respiratory tract infections have been implicated as the predominant risk factor for acute exacerbations of chronic obstructive pulmonary disease (AECOPD). We aimed to evaluate, longitudinally, the association between upper respiratory tract infections (URTI) caused by viruses and AECOPD.Detection of 18 viruses was performed in naso- and orοpharyngeal swabs from 450 COPD patients (Global Initiative for Chronic Obstructive Lung Disease stages 2–4) who were followed for a mean of 27 months. Swabs were taken during stable periods (n=1909), at URTI onset (n=391), 10 days after the URTI (n=356) and during an AECOPD (n=177) and tested using a multiplex nucleic acid amplification test.Evidence of at least one respiratory virus was significantly higher at URTI onset (52.7%), 10 days after the URTI (15.2%) and during an AECOPD (38.4%), compared with the stable period (5.3%, p<0.001). During stable visits, rhinovirus accounted for 54.2% of all viral infections, followed by coronavirus (20.5%). None of the viruses were identified in two consecutive stable visits. Patients with a viral infection at URTI onset did not have a higher incidence of exacerbation than patients without viral infection (p=0.993). Τhe incidence of any viral infection during an AECOPD was similar between URTI-related AECOPD and non-URTI-related AECOPD (p=0.359). Only 24% of the patients that had a URTI-related AECOPD had the same virus at URTI onset and during an AECOPD. Detection of parainfluenza 3 at URTI onset was associated with a higher risk of an AECOPD (p=0.003). Rhinovirus and coronavirus were the most frequently detected viruses during AECOPD visits, accounting for 35.7% and 25.9% of all viral infections, respectively.The prevalence of viral infection during the stable period of COPD was low. The risk of exacerbation following the onset of URTI symptoms depends on the particular virus associated with the event and was significant only for parainfluenza 3.

scholarly journals Hospitalisation for lower respiratory tract infection in children in the province of Quebec, Canada, before and during the pneumococcal conjugate vaccine era

2017 ◽  
Vol 145 (13) ◽  
pp. 2770-2776 ◽  
Author(s):  
G. ANDERSON ◽  
G. DECEUNINCK ◽  
Z. ZHOU ◽  
F. D. BOUCHER ◽  
Y. BONNIER VIGER ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Hospital Admissions ◽  
Community Acquired Pneumonia ◽  
Main Diagnosis ◽  
Lower Respiratory Tract Infections ◽  
Study Population ◽  
The Mean ◽  
Tract Infections

SUMMARYStreptococcus pneumoniaeis an important cause of community-acquired pneumonia and pneumococcal conjugate vaccines (PCVs) may reduce this burden. This study's goal was to analyse trends in lower respiratory tract infections (LRTI) hospitalisations before and during a routine vaccination programme targeting all newborns with PCV was started in the province of Quebec, Canada in December 2004. The study population included hospital admissions with a main diagnosis of LRTI among 6–59 month-old Quebec residents from April 2000 to December 2014. Trends in proportions and rates were analysed using Cochran-Armitage tests and Poisson regression models. We observed a general downward trend in all LTRI hospitalisations rate: from 11·55/1000 person-years in 2000–2001 to 9·59/1000 in 2013–2014, a 17·0% reduction, which started before the introduction of PCV vaccination. Downward trends in hospitalisation rates were more pronounced for all-cause of pneumonia (minus 17·8%) than for bronchiolitis (minus 15·4%). There was also a decrease in the mean duration of hospital stay. There was little evidence that all-cause pneumonia decreased over the study period due mainly to the introduction of PCVs. Trends may be related to changes in clinical practice. This study casts doubt on the interpretation of ecological analyses of the implementation of PCV vaccination programmes.

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