scholarly journals Comparison of clinical characteristics and risk factors in hospitalized patients with SARS-CoV-2, MERS-CoV, and SARS-CoV infection

2020 ◽  
Author(s):  
Zhengtu Li ◽  
Xidong Wang ◽  
Guansheng Su ◽  
Zeguang Zheng ◽  
Shaoqiang Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Characteristics ◽  
Clinical Presentation ◽  
Data Sources ◽  
Smoking History ◽  
Clinical Feature ◽  
Chronic Medical Conditions ◽  
Ovid Medline ◽  
Male Patients ◽  
Common Risk Factors

Abstract Herein, we compared the risk factors, clinical presentation of patients hospitalized with SARS-CoV-2, SARS-CoV, or MERS-CoV infection. Our data sources include PubMed, Embase, CNKI, and Ovid/Medline. The proportion of male patients with COVID-19 was higher than who with SARS but lower than who with MERS (p<0.001). More patients with COVID-19 had coexisting chronic medical conditions than those with SARS (p<0.001) but fewer than those with MERS (p<0.001), and the prevalence of hypertension (17%) and smoking history (14%) was higher than in patients with SARS (p<0.001). Furthermore, the symptom of fever (53%), hemoptysis (1%), diarrhea (4%) and vomiting (3%) of COVID-19 were significantly lower than that in patients with SARS or MERS. The level of ALT and AST in COVID-19 was significantly lower (p<0.001), however, thrombocytopenia, high LDH were common. Summary, male, smoking history and hypertension were the most common risk factors for hospitalization with COVID-19; and the clinical feature was less severe in COVID-19.

scholarly journals Comparison of clinical characteristics and risk factors in hospitalized patients with SARS-CoV-2, MERS-CoV, and SARS-CoV infection

2020 ◽  
Author(s):  
Zhengtu Li ◽  
Xidong Wang ◽  
Guansheng Su ◽  
Shaoqiang Li ◽  
Yuwei Ye ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Characteristics ◽  
Clinical Presentation ◽  
Hospitalized Patients ◽  
Smoking History ◽  
Clinical Feature ◽  
Chronic Medical Conditions ◽  
Medical Conditions ◽  
Male Patients ◽  
Common Risk Factors

Abstract Herein, we compared the risk factors, clinical presentation of patients hospitalized with SARS-CoV-2, SARS-CoV, or MERS-CoV infection. The proportion of male patients with COVID-19 was higher than who with SARS but lower than who with MERS (p<0.001). More patients with COVID-19 had coexisting chronic medical conditions than those with SARS (p<0.001) but fewer than those with MERS (p<0.001), and the prevalence of hypertension (17%) and smoking history (14%) was higher than in patients with SARS (p<0.001). Furthermore,the symptom of fever (53%), hemoptysis (1%), diarrhea (4%) and vomiting (3%) of COVID-19 were significantly lower than that in patients with SARS or MERS. The level of ALT and AST in COVID-19 was significantly lower (p<0.001), however, thrombocytopenia, high LDH were common. Summary, male, smoking history and hypertension were the most common risk factors for hospitalization with COVID-19; and the clinical feature was less severe in COVID-19.

scholarly journals Incidence, clinical characteristics and prognostic factor of patients with COVID-19: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Chaoqun Ma ◽  
Jiawei Gu ◽  
Pan Hou ◽  
Liang Zhang ◽  
Yuan Bai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Disease Severity ◽  
Old Age ◽  
Clinical Characteristics ◽  
Early Stage ◽  
Meta Analysis ◽  
Blood Platelet ◽  
Clinical Feature ◽  
Chronic Obstructive ◽  
Medicine Research

AbstractBackgroundRecently, Coronavirus Disease 2019 (COVID-19) outbreak started in Wuhan, China. Although the clinical features of COVID-19 have been reported previously, data regarding the risk factors associated with the clinical outcomes are lacking.ObjectivesTo summary and analyze the clinical characteristics and identify the predictors of disease severity and mortality.MethodsThe PubMed, Web of Science Core Collection, Embase, Cochrane and MedRxiv databases were searched through February 25, 2020. Meta-analysis of Observational Studies in Epidemiology (MOOSE) recommendations were followed. We extracted and pooled data using random-e□ects meta-analysis to summary the clinical feature of the confirmed COVID-19 patients, and further identify risk factors for disease severity and death. Heterogeneity was evaluated using the I2 method and explained with subgroup analysis and meta-regression.ResultsA total of 30 studies including 53000 patients with COVID-19 were included in this study, the mean age was 49.8 years (95% CI, 47.5-52.2 yrs) and 55.5% were male. The pooled incidence of severity and mortality were 20.2% (95% CI, 15.1-25.2%) and 3.1% (95% CI, 1.9-4.2%), respectively. The predictor for disease severity included old age (≥ 50 yrs, odds ratio [OR] = 2.61; 95% CI, 2.29-2.98), male (OR =1.348, 95% CI, 1.195-1.521), smoking (OR =1.734, 95% CI, 1.146-2.626) and any comorbidity (OR = 2.635, 95% CI, 2.098-3.309), especially chronic kidney disease (CKD, OR = 6.017; 95% CI, 2.192-16.514), chronic obstructive pulmonary disease (COPD, OR = 5.323; 95% CI, 2.613-10.847) and cerebrovascular disease (OR = 3.219; 95% CI, 1.486-6.972). In terms of laboratory results, increased lactate dehydrogenase (LDH), C-reactive protein (CRP) and D-dimer and decreased blood platelet and lymphocytes count were highly associated with severe COVID-19 (all for P < 0.001). Meanwhile, old age (≥ 60 yrs, RR = 9.45; 95% CI, 8.09-11.04), followed by cardiovascular disease (RR = 6.75; 95% CI, 5.40-8.43) hypertension (RR = 4.48; 95% CI, 3.69-5.45) and diabetes (RR = 4.43; 95% CI, 3.49-5.61) were found to be independent prognostic factors for the COVID-19 related death.ConclusionsTo our knowledge, this is the first evidence-based medicine research to explore the risk factors of prognosis in patients with COVID-19, which is helpful to identify early-stage patients with poor prognosis and adapt effective treatment.

scholarly journals T195. PSYCHOTIC DISORDERS IN PATIENTS WHO USE SYNTHETIC CANNABINOIDS: CLINICAL CHARACTERISTICS AND PATIENT PROFILE

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S305-S306
Author(s):  
Valentin Skriabin ◽  
Maria Vinnikova
Keyword(s):  
Clinical Characteristics ◽  
Psychotic Disorders ◽  
Clinical Presentation ◽  
Violent Behavior ◽  
Synthetic Cannabinoids ◽  
Psychotic Episode ◽  
Patient Profile ◽  
Observational Cohort ◽  
Male Patients

Abstract Background Cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC) are the two principal ingredients of natural cannabis with counteracting functions. Synthetic cannabinoids (SCs) are much more potent than natural cannabis, since they act as a more potent full agonist at the cannabinoid subtype 1 receptor than THC, and they also lack cannabinoids such as CBD that may otherwise counteract psychoactive properties of THC. Therefore, SCs may induce a more severe clinical presentation than natural cannabis does: the use of SCs may be associated with agitation, anxiety, tachycardia, hallucinations, irritability, memory and cognitive impairment, violent behavior, unresponsiveness, and psychosis. Clinical characteristics, specificity of the disease course and patient profile of the SC-induced psychoses are still poorly characterized in the scientific literature. The present study was therefore designed to evaluate the psychotic disorders in patients with synthetic cannabinoid use disorder in terms of patient profile and clinical characteristics with reference to their follow-up. Methods A total of 60 male patients (n=60; mean (standard deviation [SD]) age: 23.6 (3.5) years) diagnosed with psychotic disorder induced by the SC use who were hospitalized at the intensive care unit or emergency department of the Moscow Research and Practical Centre on Addictions of the Moscow Department of Healthcare were included in this single-centre, longitudinal, observational cohort study. The catamnestic follow-up period was up to 2 years. Results We evaluated different clinical cases of SC-induced psychoses and identified four clinical types of them on the ground of leading psychopathological syndrome during the patient’s entire length of hospitalization: Then we performed a catamnestic follow-up of patients to reveal the possible schizophrenic process manifestation in patients who use SC. Catamnestic follow-up revealed that manifestation of the schizophrenic process was present in 8 patients (13% of cases). Discussion Our results revealed that SC-induced psychoses affect young adults primarily. Consistent with the statement that the majority of first-time SC users are experienced marijuana smokers, SC was used following other transitional substances rather than as the first substance in the majority of our patients, with cannabis being the most popular antecedent substance. SC was not the first substance used in the majority of our patients, and it had been preceded by use of other transitional substances, such as cannabis in most cases. Despite the exogenous nature, structurally such psychoses are often endoformic. For instance, even the delirium is atypical and includes the elements of Kandinsky-Clerambault’s syndrome. Psychopathologically hallucinations and delusions dominate in the clinical presentation of the psychoses (with predominant hallucinatory symptoms or affective paranoid symptoms). Development of substance-induced psychoses is often associated with the manifestation of the schizophrenic process (in our study it was revealed in 13% of cases). It is extremely difficult to create a differential diagnosis between such psychotic disorders and a primary endogenous psychotic episode. In such cases the appearance of deficit symptoms specific for schizophrenia becomes crucial.

Repetition of Parasiticide: An Epidemiological and Clinical Study

1988 ◽  
Vol 153 (6) ◽  
pp. 792-800 ◽  
Author(s):  
Norman Kreitman ◽  
Patricia Casey
Keyword(s):  
Risk Factors ◽  
Clinical Study ◽  
Social Class ◽  
Epidemiological Study ◽  
Clinical Characteristics ◽  
Clinical Presentation ◽  
Treatment Centre ◽  
The Stability ◽  
Over Time ◽  
Repetitive Pattern

The dramatic clinical presentation of parasuicide tends to deflect attention from the repetitive pattern of this behaviour in many patients. In an epidemiological study of annual cohorts of parasuicides for 1972, 1977, and 1982 admitted to the Regional Poisoning Treatment Centre, Edinburgh, it was found that for certain subgroups of the population ‘repeaters' were actually commoner than ‘first-ever’ patients, and a number of risk factors were identified, of which social class was particularly important. The clinical characteristics of patients distinguished by their frequency of repetition were also described, with special attention to the stability of these differentiating features over time. It is suggested that the habitual repeater requires closer study, and that the factors which lead to initiation into a parasuicidal ‘career’ are not necessarily those which conduce to repetition.

scholarly journals Clinical Characteristics and Outcomes of Coronary Artery Disease among South Indian Women- A Retrospective Study

2021 ◽  
Author(s):  
Ramesh Sankaran ◽  
Nagendra Boopathy Senguttuvan ◽  
Vinod Kumar Balakrishnan ◽  
Muralidharan Thoddi Ramamurthy ◽  
ManoVikash Vallivedu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chest Pain ◽  
Coronary Artery ◽  
Clinical Presentation ◽  
Chronic Stable Angina ◽  
Coronary Angiogram ◽  
Atypical Chest Pain ◽  
Indian Women ◽  
Common Risk Factors ◽  
Artery Disease

Introduction: The prevalence of Coronary Artery Disease (CAD) is increasing among Indian women and is the leading cause of death. Clinical presentation of CAD in women can widely vary from atypical chest pain, silent ischemia to massive myocardial infarction and death. Women have poor prognosis than men after myocardial infarction and are less likely to undergo revascularisation compared to men. Aim: To study the risk factors, clinical characteristics, severity of CAD and to evaluate the outcomes in women undergoing coronary angiogram. Materials and Methods: This retrospective study included 912 women who had undergone coronary angiogram in our hospital from January 2018 to December 2018. The patients were divided into three groups- Group A consisted of 230 (25%) women with age <50 years. Group B consisted of 591 (65%) women with age between 50 to 69 years. Group C consisted of 91 (10%) women with age >70 years. Continuous variables were analysed by paired t-test and categorical variables were analysed by chi-square test. Results: Most women were post menopausal (73.6%). Common risk factors were diabetes mellitus (63%) hypertension (56%), and hypothyroidism (16.8%). Out of the total study population, 51% (n=466) presented with a diagnosis of chronic stable angina, 34.7% (n=317) presented with acute coronary syndrome, and 7% (n=66) had atypical chest pain. Out of 500 patients with significant CAD, requiring revascularisation only 316 (63.2%) had undergone interventions out of which 193 (61%) had undergone percutaneous coronary intervention and 123 (39%) had undergone Coronary Artery Bypass Grafting (CABG) as the modality of revascularisation. conclusion: Clinical presentation of CAD in women varies widely from atypical chest pain to acute infarction. Diabetes and hypertension are the most common risk factors for CAD in our study. Chronic stable angina was the most common spectrum of presentation. Single vessel disease is the most common finding on coronary angiogram.

scholarly journals Chronic pancreatitis: Risk Factors and Clinico-Radiological Profile

2021 ◽  
Vol 23 (2) ◽  
pp. 153-158
Author(s):  
Jiwan Thapa ◽  
Ramila Shrestha ◽  
Ram Krishna Tamang ◽  
Shankar Baral ◽  
Bhuwneshwer Yadav
Keyword(s):  
Risk Factors ◽  
Computed Tomography ◽  
Chronic Pancreatitis ◽  
Structural Changes ◽  
Clinical Presentation ◽  
Pain Abdomen ◽  
Disease Condition ◽  
Radiological Changes ◽  
Male Patients ◽  
Associated Risk Factors

Chronic pancreatitis is a disease condition characterized by progressive inflammation and fibrosis of pancreas. It manifests with pain abdomen, endocrine and exocrine dysfunction. Diagnosis is often difficult and is relied mostly on radiological examination. The aim of this study was to identify associated risk factors and correlate the clinical presentation with various radiological changes of the pancreas.We conducted a prospective hospital based observational study in patients presenting with abdominal pain and evaluated the etiology, clinical presentation and radiological changes of pancreas among 68 chronic pancreatitis patients visiting Gastroenterology Unit, Department of Medicine, National Academy of Medical Sciences, Bir Hospital during 1 year period (November 2019 to October 2020 AD). The results showed mean age of 35.75 ± 11.43 years with predominant male patients (76.4%). Pain abdomen was present in all patients with mean duration of 16.5 months, followed by diabetes in 27.9%. Alcohol was the major risk (n=42, 61.8%) and no cause was identified in 22 (32.3%) patients. Pancreatic parenchymal calcification in 65 (95.6%), duct dilation in 61 (89.7%) and gland atrophy in 39 (57.3%) were major structural changes detected in computed tomography scan, more reliably than ultrasonography. One third of patients had diabetes mellitus, which was significantly higher in female (63.2%) and had major radiological changes of chronic pancreatitis at diagnosis. Alcohol was the common risk of chronic pancreatitis. Structural changes suggestive of disease was demonstrated better by computed tomography.

scholarly journals Acute myocardial infarction at an early age – importance of acute chest pain fast track in patient management

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
D Carvalho ◽  
J M Bastos ◽  
V Viegas ◽  
A Pacheco ◽  
L Ferraz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chest Pain ◽  
Coronary Angiography ◽  
Clinical Characteristics ◽  
Statistical Difference ◽  
Fast Track ◽  
Acute Chest Pain ◽  
Smoking History ◽  
Younger Patients ◽  
Percutaneous Coronary

Abstract Background Acute coronary syndrome (ACS) has a higher incidence in middle-aged and elderly patients but 2% to 6% of ACS cases occur in people younger than 45 years of age (Y). Younger patients have different clinical characteristics when compared to older patients. Acute chest pain fast track led to a reduction in the time required for the diagnosis of acute coronary syndromes, particularly those with ST segment elevation (STEMI). Aim This study aims to assess the differences in risk factors and clinical characteristics between young and older ACS patients. Besides that, we try to determine if the benefits of acute chest pain fast track have extended to this younger population. Material and methods Retrospective observational study carried out through the analysis of the clinical process. Clinical data were collected from ACS patients under 45Y from 2010 to 2019 and from ACS patients over 45Y from 2010 to 2012. Statistical analysis was made using R software and RStudio. Results This study included 93 patients with ACS under 45Y and 172 patients with ACS over 45Y. A total of 265 patients were included. The male gender was predominant in both groups but with a higher prevalence in the younger ones (88% vs 73%, p&lt;0,005). The prevalence of hypertension was higher in older ACS patients but the younger ones had more overweight (39.8% vs 17.4%, p&lt;0,001), smoking history (84.9% vs 38.4%, p&lt;0,001) and family history of sudden death (25.8% vs 5.8%, p&lt;0,01). Diabetes had no statistical difference. Dyslipidemia as previous known risk factor had no statistical difference but LDL was higher in patients with less than 45Y (147.2 vs 120.7 mg/dL, p&lt;0,001). STEMI were tendentially more prevalent in patients under 45Y (55.9% vs 44.8%, p 0.09). The anterior wall was the most frequently involved in both groups (52% vs 63%, p 0.28), followed by the inferior wall (42% vs 36%). Accordantly, anterior descending artery was the artery most frequently involved in both groups (44.1% vs 48.3%), followed by right coronary artery (24.7 vs 26.7%). STEMI patients under 45Y were submitted to an emergent coronary angiography in 89% of cases and STEMI patients over than 45Y were submitted in 70.1% of cases. Particularly for patients under 45Y, all STEMI patients were submitted to an emergent coronary angiography after 2014, which emphasis the importance of acute chest pain fast track in the emergency room. Finally, ACS patients under 45Y were less submitted to percutaneous coronary angiography compared to patients over 45Y (15.1% vs 4.7%, p&lt;0,001). Conclusions Cardiovascular risk factors differ accordingly the age of ACS patients. Younger patients had more overweight and smoking history. They probably have alternative pathophysiologic mechanisms that explain differences in percutaneous coronary angiography. Acute chest pain fast track had an important role reducing morbimortality related to ACS by reducing the time until STEMI diagnose. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals T150. SEX DIFFERENCES IN PEOPLE WITH PSYCHOSIS: FINDINGS FROM A REPRESENTATIVE SAMPLE IN KOSOVO

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S288-S288
Author(s):  
Manuela Russo ◽  
Fitim Uka ◽  
Jon Konjufca ◽  
Fjolla Ramadani ◽  
Dashamir Berxulli ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychosocial Intervention ◽  
Clinical Characteristics ◽  
Negative Symptoms ◽  
Clinical Presentation ◽  
Psychosocial Treatment ◽  
Clinical Population ◽  
Male And Female ◽  
Female Patients ◽  
Male Patients

Abstract Background The need for mental health care services is particularly high in low and middle income countries (LMICs) where socio-economic factors have a deep impact on treatment and management of psychosis. Lack of funds and qualified professional represent the main challenge to treatment gap leaving between 36% and 45% of people with psychosis without care for their condition thus having a huge impact at individual and societal level. Although data from epidemiological research show that prevalence of psychosis is equal between sexes, some differences in terms of needs for care might be relevant, particularly in a context that has been affected by dramatic socio-economic and cultural changes. In this study we explore in a representative sample of people with psychosis from Kosovo*, as part of a large multi-country study (EU-funded IMPULSE project), whether demographic, socio-economic and clinical differences exist between male and female patients. Methods Data on demographic, socio-economic characteristics, use of psychosocial treatment and medication was collected; general level of psychopathology and negative symptoms were assessed through the Brief Psychiatric Rating Scale, Brief Symptom Inventory and Clinical Assessment Interview for Negative Symptoms. Male and female patients were compared in terms of demographic, socio-economic and clinical characteristics using Chi-square and independent sample t- test as appropriate. Results The sample (n=103) was composed by 33 female and 70 male patients with psychosis. The two groups did not show any statistically significant difference in age, employment, level of education; however, marital status seems to differ with higher proportion of women being separated (p=0.009). No differences emerged in monthly income, while a trend of significance (p=0.079) suggested that female patients had slightly higher financial benefits than their male counterpart. While there was no difference in terms of psychiatric diagnosis, higher depressive (p=0.017) and paranoid symptoms (at trend level, p=0.054) were reported by females patients. There were no differences on antipsychotic medication. Attendance of a psychosocial treatment was higher in male than in female patients (80% vs 57.6%; p=0.017) without any difference though in the type of approach. Overall, patients who attended a psychosocial treatment had lower negative symptoms (p&lt;0.001) compared to those who did not. Discussion Female patients with psychosis were found to have a worse clinical presentation compared to male patients, and to have a lower attendance to psychosocial treatment. Regardless of sex, psychosocial treatment seems to be associated to less negative symptomatology. More research is needed to better characterise clinical presentation of people with psychosis in LMICs and to understand whether access to mental health service, particularly psychosocial intervention, is accountable to clinical characteristics or to contextual factors, social and/or economic in nature. Offering psychosocial intervention to this clinical population could alleviate burden of the illness in this clinical population.

Depression and Diabetic Peripheral Neuropathy: Birds of a Feather, But When do They Flock Together?

2018 ◽  
Vol 128 (05) ◽  
pp. 347-349 ◽  
Author(s):  
Prashanth R.J. Vas ◽  
Nikolaos Papanas
Keyword(s):  
Risk Factors ◽  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Clinical Characteristics ◽  
Temporal Trends ◽  
Epidemiological Data ◽  
Causal Pathways ◽  
High Prevalence ◽  
Common Risk Factors ◽  
Insight Into

AbstractThe association between diabetes and depression is well recognised. Similarly, diabetic peripheral neuropathy (DPN) is a frequent complication of diabetes. Given the high prevalence of these conditions individually, it is hardly surprising they frequently interact, conferring additional morbidity and a higher mortality risk. Despite this, the specific clinical characteristics that underpin co-morbid depression and DPN remain unclear. Additionally, there is insufficient insight into causal pathways and temporal trends. High-quality epidemiological data is limited, but they suggest that these conditions may share certain common risk factors, although there are also distinct differences such as gender. Improved insights into the risk factors for the co-existence of DPN and depression may help towards improved screening for and treatment of these conditions.

Gender Differences in the Presentation and Outcomes of Hospitalized Patients With COVID-19

2021 ◽  
Vol 16 (6) ◽  
Author(s):  
Carloalberto Biolè ◽  
Matteo Bianco ◽  
Iván J Núñez-Gil ◽  
Enrico Cerrato ◽  
Amanda Spirito ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gender Differences ◽  
Renal Failure ◽  
Cardiovascular Risk ◽  
Laboratory Tests ◽  
Clinical Presentation ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
International Registry ◽  
Male Patients

Gender-related differences in COVID-19 clinical presentation, disease progression, and mortality have not been adequately explored. We analyzed the clinical profile, presentation, treatments, and outcomes of patients according to gender in the HOPE-COVID-19 International Registry. Among 2,798 enrolled patients, 1,111 were women (39.7%). Male patients had a higher prevalence of cardiovascular risk factors and more comorbidities at baseline. After propensity score matching, 876 men and 876 women were selected. Male patients more often reported fever, whereas female patients more often reported vomiting, diarrhea, and hyposmia/anosmia. Laboratory tests in men presented alterations consistent with a more severe COVID-19 infection (eg, significantly higher C-reactive protein, troponin, transaminases, lymphocytopenia, thrombocytopenia, and ferritin). Systemic inflammatory response syndrome, bilateral pneumonia, respiratory insufficiency, and renal failure were significantly more frequent in men. Men more often required pronation, corticosteroids, and tocilizumab administration. A significantly higher 30-day mortality was observed in men vs women (23.4% vs 19.2%; P = .039). Trial Numbers: NCT04334291/EUPAS34399.

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