scholarly journals Abnormal immunity of non-survivors with COVID-19: predictors for mortality

2020 ◽  
Author(s):  
Zhao yang ◽  
Nie hanxiang ◽  
Hu ke ◽  
Wu xiaojun ◽  
Zhang yunting ◽  
...  
Keyword(s):  
Risk Factors ◽  
T Cells ◽  
Clinical Characteristics ◽  
Signs And Symptoms ◽  
Malignant Tumour ◽  
Hospital Death ◽  
Medical Illness ◽  
Specific Information ◽  
Laboratory Findings ◽  
Related Risk

Abstract Background The outbreak of coronavirus disease 2019 (COVID-19) has rapidly spread all over the world. The specific information about immunity of non-survivors with COVID-19 is scarce. We aimed to describe the clinical characteristics and abnormal immunity of the confirmed COVID-19 non-survivors.Methods In this single-centered, retrospective, observational study, we enrolled 125 patients with COVID-19 who were died between Jan, 13 and Mar 4, 2020 from Renmin Hospital of Wuhan University. 414 randomly recruited patients with confirmed COVID-19 who were discharged from the same hospital during the same period served as control. Demographic and clinical characteristics, laboratory findings and chest computed tomograph results at admission, and treatment were collected. The immunity-related risk factors associated with in-hospital death were detected.Results Non-survivors were older than survivors. More than half of non-survivors was male. Nearly half of the patients had chronic medical illness. The common signs and symptoms at admission of non-survivors were fever. Non-survivors had higher white blood cell (WBC) count, more elevated neutrophil count, lower lymphocytes and platelete count, raised concentration of procalcitonin and C-reactive protein (CRP) than survivors. The levels of CD3+ T cells, CD4+ T cells, CD8+ T cells, CD19+ T cells, and CD16+56+T cells were significantly decreased in non-survivors when compared with survivors. The concentrations of immunoglobulins (Ig) G, IgA and IgE were increased, whereas the levels of complement proteins (C)3 and C4 were decreased in non-survivors when compared with survivors. Non-survivors presented lower levels of oximetry saturation at rest and lactate. Old age, comorbidity of malignant tumour, neutrophilia, lymphocytopenia, low CD4+ T cells, decreased C3, and low oximetry saturation were the risk factors of death in patients with confirmed COVID-19. The frequency of CD4+ T cells positively correlated with the numbers of lymphocytes and the level of oximetry saturation, whereas CD4+ T cells were negatively correlated with age and the numbers of neutrophils.Conclusion Abnormal cellular immunity and humoral immunity were considerable in non-survivors with COVID-19. Neutrophilia, lymphocytopenia, low CD4+ T cells, and decreased C3 were the immunity-related risk factors predicting mortality of patients with COVID-19.

scholarly journals Clinical Characteristics on Admission Predict In-Hospital Fatal Outcome in Patients Aged ≥75 Years with novel coronavirus disease (COVID-19): A Retrospective Cohort Study

2020 ◽  
Author(s):  
Zhihua Yu ◽  
Yuhe Ke ◽  
Jiang Xie ◽  
Hao Yu ◽  
Wei Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Temperature ◽  
Clinical Characteristics ◽  
Troponin I ◽  
Fatal Outcome ◽  
High Sensitivity ◽  
Lactic Dehydrogenase ◽  
Hospital Death ◽  
Laboratory Findings ◽  
Novel Coronavirus

Abstract Background：Novel coronavirus disease（COVID-19）has become a worldwide pandemic and precise fatality data by age group are needed urgently. This study to delineate the clinical characteristics and outcome of COVID-19 patients aged ≥75 years and identify the risk factors of in-hospital death.Methods：A total of 141 consecutive patients aged ≥75 years who were admitted to the hospital between 12th and 19th February 2020. In-hospital death, clinical characteristics and laboratory findings on admission were obtained from medical records. The final follow-up observation was 31st March 2020.Results：The median age was 81 years (84 female, 59.6%). Thirty-eight (27%) patients were classified as severe or critical cases. 18 (12.8%) patients had died in hospital and the remaining 123 were discharged. Patients who died were more likely to present with fever (38.9% vs. 7.3%); low percutaneous oxygen saturation(SpO2) (55.6% vs. 7.3%); reduced lymphocytes (72.2% vs. 35.8%) and platelets (27.8% vs. 4.1%); and increased D-dimer (94.4% vs. 42.3%), creatinine (50.0% vs. 22.0%), lactic dehydrogenase (LDH) (77.8% vs. 30.1%), high sensitivity troponin I (hs-TnI) (72.2% vs. 14.6%), and N-terminal pro-brain natriuretic peptide (NT-proBNP) (72.2% vs. 6.5%; all P<0.05) than patients who recovered. Male sex (odds ratio [OR]=13.1, 95% confidence interval[CI] 1.1 to 160.1, P=0.044), body temperature >37.3°C (OR=80.5, 95% CI 4.6 to 1407.6, P=0.003), SpO2≤90% (OR=70.1, 95% CI 4.6 to 1060.4, P=0.002), and NT-proBNP>1800ng/L (OR=273.5, 95% CI 14.7 to 5104.8, P<0.0001) were independent risk factors of in-hospital death. Conclusions：In-hospital fatality among COVID-19 patients can be estimated by sex and on-admission measurements of body temperature, SpO2, and NT-proBNP.

scholarly journals Clinical Characteristics on Admission Predict In-Hospital Fatal Outcome in Patients Aged ≥75 Years with novel coronavirus disease (COVID-19) :A Retrospective Cohort Study

2020 ◽  
Author(s):  
Zhihua Yu ◽  
Yuhe Ke ◽  
Jiang Xie ◽  
Hao Yu ◽  
Wei Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Temperature ◽  
Clinical Characteristics ◽  
Troponin I ◽  
Fatal Outcome ◽  
High Sensitivity ◽  
Lactic Dehydrogenase ◽  
Hospital Death ◽  
Laboratory Findings ◽  
Novel Coronavirus

Abstract Background：Novel coronavirus disease（COVID-19）has become a worldwide pandemic and precise fatality data by age group are needed urgently. This study to delineate the clinical characteristics and outcome of COVID-19 patients aged ≥75 years and identify the risk factors of in-hospital death.Methods：A total of 141 consecutive patients aged ≥75 years who were admitted to the hospital between 12th and 19th February 2020. In-hospital death, clinical characteristics and laboratory findings on admission were obtained from medical records. The final follow-up observation was 31st March 2020.Results：The median age was 81 years (84 female, 59.6%). Thirty-eight (27%) patients were classified as severe or critical cases. 18 (12.8%) patients had died in hospital and the remaining 123 were discharged. Patients who died were more likely to present with fever (38.9% vs. 7.3%); low percutaneous oxygen saturation(SpO2) (55.6% vs. 7.3%); reduced lymphocytes (72.2% vs. 35.8%) and platelets (27.8% vs. 4.1%); and increased D-dimer (94.4% vs. 42.3%), creatinine (50.0% vs. 22.0%), lactic dehydrogenase (LDH) (77.8% vs. 30.1%), high sensitivity troponin I (hs-TnI) (72.2% vs. 14.6%), and N-terminal pro-brain natriuretic peptide (NT-proBNP) (72.2% vs. 6.5%; all P<0.05) than patients who recovered. Male sex (odds ratio [OR]=13.1, 95% confidence interval[CI] 1.1 to 160.1, P=0.044), body temperature >37.3°C (OR=80.5, 95% CI 4.6 to 1407.6, P=0.003), SpO2≤90% (OR=70.1, 95% CI 4.6 to 1060.4, P=0.002), and NT-proBNP>1800ng/L (OR=273.5, 95% CI 14.7 to 5104.8, P<0.0001) were independent risk factors of in-hospital death. Conclusions：In-hospital fatality among COVID-19 patients can be estimated by sex and on-admission measurements of body temperature, SpO2, and NT-proBNP.

scholarly journals Clinical characteristics on admission predict in-hospital fatal outcome in patients aged ≥75 years with novel coronavirus disease (COVID-19): a retrospective cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Zhihua Yu ◽  
Yuhe Ke ◽  
Jiang Xie ◽  
Hao Yu ◽  
Wei Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Temperature ◽  
Clinical Characteristics ◽  
Troponin I ◽  
Fatal Outcome ◽  
High Sensitivity ◽  
Lactic Dehydrogenase ◽  
Hospital Death ◽  
Laboratory Findings ◽  
Novel Coronavirus

Abstract Background Novel coronavirus disease 2019 (COVID-19) has become a worldwide pandemic and precise fatality data by age group is needed urgently. This study to delineate the clinical characteristics and outcome of COVID-19 patients aged ≥75 years and identify the risk factors of in-hospital death. Methods A total of 141 consecutive patients aged ≥75 years who were admitted to the hospital between 12th and 19th February 2020. In-hospital death, clinical characteristics and laboratory findings on admission were obtained from medical records. The final follow-up observation was on the 31st March 2020. Results The median age was 81 years (84 female, 59.6%). Thirty-eight (27%) patients were classified as severe or critical cases. 18 (12.8%) patients had died in hospital and the remaining 123 were discharged. Patients who died were more likely to present with fever (38.9% vs. 7.3%); low percutaneous oxygen saturation (SpO2) (55.6% vs. 7.3%); reduced lymphocytes (72.2% vs. 35.8%) and platelets (27.8% vs. 4.1%); and increased D-dimer (94.4% vs. 42.3%), creatinine (50.0% vs. 22.0%), lactic dehydrogenase (LDH) (77.8% vs. 30.1%), high sensitivity troponin I (hs-TnI) (72.2% vs. 14.6%), and N-terminal pro-brain natriuretic peptide (NT-proBNP) (72.2% vs. 6.5%; all P < 0.05) than patients who recovered. Male sex (odds ratio [OR] = 13.1, 95% confidence interval [CI] 1.1 to 160.1, P = 0.044), body temperature > 37.3 °C (OR = 80.5, 95% CI 4.6 to 1407.6, P = 0.003), SpO2 ≤ 90% (OR = 70.1, 95% CI 4.6 to 1060.4, P = 0.002), and NT-proBNP> 1800 ng/L (OR = 273.5, 95% CI 14.7 to 5104.8, P < 0.0001) were independent risk factors of in-hospital death. Conclusions In-hospital fatality among elderly COVID-19 patients can be estimated by sex and on-admission measurements of body temperature, SpO2, and NT-proBNP.

scholarly journals Clinical Characteristics on Admission Predict In-Hospital Fatal Outcome in Patients Aged ≥75 Years with novel coronavirus disease (COVID-19) :A Retrospective Cohort Study

2020 ◽  
Author(s):  
Zhihua Yu ◽  
Yuhe Ke ◽  
Jiang Xie ◽  
Hao Yu ◽  
Wei Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Temperature ◽  
Clinical Characteristics ◽  
Troponin I ◽  
Fatal Outcome ◽  
High Sensitivity ◽  
Lactic Dehydrogenase ◽  
Hospital Death ◽  
Laboratory Findings ◽  
Novel Coronavirus

Abstract Background ： Novel coronavirus disease（COVID-19）has become a worldwide pandemic and precise fatality data by age group are needed urgently. This study to delineate the clinical characteristics and outcome of COVID-19 patients aged ≥75 years and identify the risk factors of in-hospital death. Methods ： A total of 141 consecutive patients aged ≥75 years who were admitted to the hospital between 12 th and 19 th February 2020. In-hospital death, clinical characteristics and laboratory findings on admission were obtained from medical records. The final follow-up observation was 31 st March 2020. Results ： The median age was 81 years (84 female, 59.6%). Thirty-eight (27%) patients were classified as severe or critical cases. 18 (12.8%) patients had died in hospital and the remaining 123 were discharged. Patients who died were more likely to present with fever (38.9% vs. 7.3%); low percutaneous oxygen saturation(SpO 2 ) (55.6% vs. 7.3%); reduced lymphocytes (72.2% vs. 35.8%) and platelets (27.8% vs. 4.1%); and increased D-dimer (94.4% vs. 42.3%), creatinine (50.0% vs. 22.0%), lactic dehydrogenase (LDH) (77.8% vs. 30.1%), high sensitivity troponin I (hs-TnI) (72.2% vs. 14.6%), and N-terminal pro-brain natriuretic peptide (NT-proBNP) (72.2% vs. 6.5%; all P<0.05) than patients who recovered. Male sex (odds ratio [OR]=13.1, 95% confidence interval[CI] 1.1 to 160.1, P=0.044), body temperature >37.3°C (OR=80.5, 95% CI 4.6 to 1407.6, P=0.003), SpO 2 ≤90% (OR=70.1, 95% CI 4.6 to 1060.4, P=0.002), and NT-proBNP>1800ng/L (OR=273.5, 95% CI 14.7 to 5104.8, P<0.0001) were independent risk factors of in-hospital death. Conclusions： In-hospital fatality among COVID-19 patients can be estimated by sex and on-admission measurements of body temperature, SpO 2 , and NT-proBNP. Key words ： Coronavirus disease; SARS-CoV-2; elderly; death; prediction

scholarly journals Comparison of Survivors and Nonsurvivors of Diffuse Alveolar Hemorrhage: Risk Factors for In-hospital Death

2021 ◽  
Author(s):  
Swathi Sangli ◽  
Misbah Baqir ◽  
Jay Ryu
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Distress Syndrome ◽  
Signs And Symptoms ◽  
Diffuse Alveolar Hemorrhage ◽  
Alveolar Hemorrhage ◽  
Hospital Death ◽  
P Value ◽  
Steroid Use ◽  
Hemorrhage Risk

Abstract ObjectiveThe objective of this study was to identify the predictors of in-hospital mortality among patients with diffuse alveolar hemorrhage (DAH).Patients and MethodsWe conducted a retrospective review of 89 patients hospitalized for DAH at our institution between 2001 and 2017: 49 patients who died during hospitalization and 40 patients who survived were compared. We reviewed their presenting signs and symptoms, clinical course, radiologic and pathologic findings, along with medical management. We then performed univariate and multivariate analyses to identify the risk factors associated with in-hospital mortality.ResultsWe identified 12 factors to be associated with mortality when comparing survivor vs non-survivor cohorts: smoking (27 [67%] vs 21 [42%], p = 0.02), malignancy (7 [17%] vs 24 [49%], p = 0.002), interstitial lung disease (0 vs 7 [14%], p = 0.01), liver failure (1 [2%] vs 14 [28%], p = 0.001), autoimmune diseases (16 [40%] vs 4 [8%], p =0.0006), thrombocytopenia (3 [7%] vs 35 [71%], p <0.0001), ICU admission (23 [57%] vs 40 [85%], p=0.004), mean duration of ICU stay (3.5 days [± 6.7] vs 5.5 days [± 5.5], p = 0.4), steroid use (36 [90%] vs 31 [63%], p = 0.003), use of plasma exchange (6 [15%] vs 0, p = 0.005), use of mechanical ventilation (15 [37%] vs 36 [75%], p value = 0.0007) and development of acute respiratory distress syndrome (ARDS) (9 [22%] vs 37 [77%], p <0.0001), respectively. On multivariate analysis, thrombocytopenia (OR 52.08: 95% CI, 8.59-315.71; p <0.0001) and ARDS (OR 11.71: 95% CI, 2.60-52.67; p = 0.0013) were associated with higher odds of mortality in DAH while steroid use (OR 0.05: 95% CI, 0.007-0.39; p = 0.0004) was associated with a lower risk of in-hospital mortality in patients with DAH.ConclusionIn DAH, thrombocytopenia and ARDS were predictors of in-hospital mortality whereas the use of steroid was associated with a more favorable prognosis.

Clinical characteristics, evolution, and treatment-related risk factors for mortality among immunosuppressed patients with influenza A (H1N1) virus admitted to the intensive care unit

2018 ◽  
Vol 48 ◽  
pp. 172-177 ◽  
Author(s):  
José Garnacho-Montero ◽  
Cristina León-Moya ◽  
Antonio Gutiérrez-Pizarraya ◽  
Angel Arenzana-Seisdedos ◽  
Loreto Vidaur ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Influenza A ◽  
Clinical Characteristics ◽  
H1n1 Virus ◽  
Related Risk ◽  
Influenza A H1n1 ◽  
Immunosuppressed Patients

scholarly journals Clinical and cell surface marker characterization of the early phase of chronic lymphocytic leukemia

Blood ◽  
1978 ◽  
Vol 52 (1) ◽  
pp. 25-35 ◽  
Author(s):  
RA Rudders ◽  
JP Howard
Keyword(s):  
Cell Proliferation ◽  
T Cells ◽  
B Cell ◽  
Clinical Characteristics ◽  
Surface Marker ◽  
Lymphocytic Leukemia ◽  
Surface Markers ◽  
Laboratory Findings ◽  
Absolute Lymphocyte Counts

Abstract The immunologic surface markers on lymphocytes and clinical characteristics of 35 patients with established (stages 0–4) CLL with absolute lymphocyte counts greater than 15,000/cu mm were compared to those of a group of 25 patients with CLL in an early or preleukemic phase (counts of less than 15,000/cu mm). We found a monoclonal B cell proliferation in most cases in the latter group, in spite of the paucity of clinical and laboratory findings. Furthermore, early CLL can readily be distinguished from benign lymphocytosis by surface marker criteria. In untreated CLL, surface marker characteristics are stable with time and predominantly reflect expansion of clones expressing only B cell markers; however, small increase of blood T cells are often seen. Surface markers are a simple and clinically useful tool for definding and characterizing the preleukemic phase of CLL and its ultimate progression to established CLL.

scholarly journals The Clinical Characteristics of Acute Myocardial Infarction with Ventricular Septal Perforation and the Prognosis Comparison of Different Treatment Methods

2020 ◽  
Author(s):  
Chun Fu ◽  
Zhou Zhao ◽  
Yu Chen ◽  
Youzhong An ◽  
Jian Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Characteristics ◽  
Complete Revascularization ◽  
Septal Perforation ◽  
Survival Group ◽  
Term Survival ◽  
Related Risk ◽  
Incomplete Revascularization ◽  
Independent Risk Factors

Abstract Background: To explore the clinical characteristics of acute myocardial infarction (AMI) with ventricular septal perforation (VSR) and the prognosis comparison of different treatment methods, as well as the analysis of related risk factors.Methods: From January 2006 to February 2020, 29 patients with AMI and VSR diagnosed in the people's Hospital of Peking University were selected as the study object, among them, 16 cases were male (55.2%), 13 cases were female (44.8%), the average age was 64.69 ± 10.32 years old, and they were divided into survival group (n=16) and non-survival group (n=13) according to whether they survive within 30 days of surgical or drug conservative treatment.The clinical characteristics, coronary angiography and treatment of the two groups were summarized, and the prognosis and related risk factors were analyzed.Results: There was no significant difference in the basic clinical characteristics between the two groups(P>0.05)；Compared with the results of coronary angiography in the two groups, the proportion of the culprit vessel which was a simple anterior descending branch in the non-survival group was higher than that in the survival group, there was a statistical difference between the two groups(P<0.05)；The peri-operative data of the two groups showed that the proportion of patients with complete revascularization, simultaneous bypass and recanalization of culprit vessels in the survival group was significantly higher than that in the non- survival group (P < 0.05)；However, the incidence of postoperative low cardiac output and mortality during hospitalization in the survival group were significantly lower than those in the non-survival group (P < 0.05)；Logistic regression analysis showed that complete revascularization (OR = 0.021, 95% CI 0.001-0.374, P = 0.009), recanalization of culprit vessels (OR = 0.045, 95% CI 0.004-0.548, P = 0.015) were independent risk factors for 30 day mortality。Kaplan-Meier survival curve showed that during the follow-up period, the long-term survival rate of patients with operation and complete revascularization was significantly higher than that of patients with drug conservative treatment and incomplete revascularization, there was a statistical difference between the two groups (P < 0.05).Conclusions: Whether complete revascularization and recanalization of culprit vessels or not are independent risk factors for 30 day mortality in patients with AMI and VSR；the long-term survival rate of patients after surgery and complete revascularization is significantly higher than that of patients with conservative medical treatment and incomplete revascularization. Surgery and complete revascularization are important factors affecting the long-term prognosis of patients with AMI and VSR.

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.

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