scholarly journals The effect of sex hormone on COVID-19: analysis of laboratory-confirmed 5061 patients in South Korea

2020 ◽  
Author(s):  
Jae Hoon Lee ◽  
Yong Chan Kim ◽  
Si Hyun Cho ◽  
Jinae Lee ◽  
Seng Chan You ◽  
...  

Abstract Limited data describing the effect of sex hormone on coronavirus disease (COVID-19) is available. We evaluated the effect of sex hormone on prevalence and clinical outcomes of COVID-19. Retrospective cohort study was performed using the nationwide claims data of 5061 adult patients with laboratory-confirmed COVID-19 in South Korea, from January 20 to April 8, 2020. COVID-19 was most prevalent in women of the 20-39 age group (1250 [44.14%]). Men were more likely to receive oxygen therapy (144 [6.46%] vs 131 [4.63%], P=0.004), be admitted to the intensive care unit (60 [2.69%] vs 53 [1.87%], P=0.049), and stay longer after admission to the intensive care unit (19.70±11.80 vs 14.75±9.23, P=0.016). However, there was no significant difference in mortality rates between men and women. In multivariable Cox analysis, independent risk factors for mortality were older age and underlying co-morbidities, rather than sex. To evaluate the effect of HRT among women, subgroup analysis was implemented using age-matched case-control data with a 1:3 ratio of females receiving HRT to those who did not. HRT did not have statistically significant association with clinical outcomes. This study suggests that sex hormone may not affect prevalence and clinical outcome of COVID-19 in South Korea.

2021 ◽  
Vol 10 ◽  
Author(s):  
Mohammad Amin Valizade Hasanloei ◽  
Aidin Zeinaly ◽  
Mehran Rahimlou ◽  
Hadi Houshyar ◽  
Solma Moonesirad ◽  
...  

Abstract Today, trauma is known to be the third leading cause of death in most countries. Studies have demonstrated below-normal plasma levels of antioxidants in trauma patients. The present study aimed to assess the efficacy of Coenzyme Q10 (CoQ10) on oxidative stress, clinical outcomes and anthropometrical parameters in traumatic mechanical ventilated patients admitted to the intensive care unit. Patients were randomised to receive sublingual CoQ10 (400 mg/d) or placebo for 7 d. Primary and secondary outcomes were measured at the baseline and end of the study. We enrolled forty patients for this trial: twenty in the CoQ10 group and twenty in the placebo group. There was not any significant difference in the baseline variables (P > 0⋅05). At the end of the study, CoQ10 administration caused a considerable reduction in the Malondialdehyde (MDA) and Interleukin 6 (IL-6) concentrations (P < 0⋅001), Glasgow Coma Score (GCS; P = 0⋅02), ICU and hospital length of stay and mechanical ventilation (MV) duration (P < 0⋅001). We found that CoQ10 administration could increase Fat-Free Mass (P < 0⋅001) (FFM; P = 0⋅04), Skeletal Muscle Mass (SMM; P = 0⋅04) and Body Cell Mass (BCM) percent (P = 0⋅03). There was not any significant difference in other factors between the two groups (P > 0⋅05). CoQ10 administration has beneficial effects on patients with traumatic injury and has no side effects. However, since the possibility of the type II error was high, the outcomes on the duration of MV, ICU stay and hospital stay, and GCS may very well be false positives.


1993 ◽  
Vol 21 (1) ◽  
pp. 85-88 ◽  
Author(s):  
M. Levinson ◽  
A. Bryce

In this prospective study we aimed to determine whether there is any relationship between enteral feeding, gastric colonisation and diarrhoea in the critically ill patient. Sixty-two critically ill patients from an intensive care unit of a major teaching hospital, who satisfied the usual criteria for enteral feeding, were randomised to receive enteral feeding or not for three days followed by a second randomisation to enterally feed or not for three days. Diarrhoea was recorded and cultures taken of both gastric aspirates and stool. There was no significant difference in the incidence of diarrhoea between the groups. Gastric colonisation was unrelated to feeding practice and to the development of diarrhoea. We conclude that in the critically ill patient, enteral feeding does not cause or promote diarrhoea.


2016 ◽  
Vol 48 (3) ◽  
pp. 170
Author(s):  
Cahya Dewi ◽  
Purnomo Suryantoro ◽  
Roni Naning

Background NP (NP) especially YAP (ventilator-associated pneu-monia) is the most common infection in intensive care unit, whichcorrelates with the increasing of morbidity and mortality. Thereare some risk factors for development ofNP, the most importantone is duration of mechanical ventilator and reintubation.Objective To determine the correlation between NP and use ofmechanical ventilator in pediatric intensive care unit (PICU).Methods A matched case control study was conducted at Dr.Sardjito Hospital on all patients admitted to the PICU from2004 until 2006. Case group was defined as all patients who hadNP; age and sex matched control group included all patients notdiagnosed as NP. Statistical analysis was done by using chi-squareand t-tests as appropriate. Logistic regression analysis was doneto determine the role of risk factors.Results One-hundred and forty-one patients were included inthis study. The incidence of NP was 25. 7%. There was associa-tion between using mechanical ventilator (OR 1.08; 95%CI 1.07;8.20, P=0.036) and duration of using mechanical ventilator morethan four days (OR 1.75, 95%CI 1.87;18.02) with developmentof NP. There was a significant difference in event free survival ofNP between those using mechanical ventilator group and thosenot using mechanical ventilator group (P<O.OOl).Conclusion There is an association between the use of mechani-cal ventilator and duration of use of mechanical ventilator morethan four days with the development of NP


2020 ◽  
Author(s):  
Fahad Marmarchi ◽  
Michael Liu ◽  
Srikant Rangaraju ◽  
Sara C Auld ◽  
Maria Christina Creel-Bulos ◽  
...  

Background: Studies of COVID-19 have shown that African Americans have been affected by the virus at a higher rate compared to other races. This cohort study investigated comorbidities and clinical outcomes by race among COVID-19 patients admitted to the intensive care unit. Methods: This is a case series of critically ill patients admitted with COVID-19 to a tertiary referral teaching hospital in Atlanta, Georgia. The study included all critically ill hospitalized patients between March 6, 2020 and May 5, 2020. Clinical outcomes during hospitalization included mechanical ventilation, renal replacement therapy and mortality stratified by race. Results Of 288 patients included (mean age, 63 +/- 16 years; 45% female), 210 (73%) were African American. African Americans had significantly higher rates of comorbidities compared to other races, including hypertension (80% vs 59%, p=0.001), diabetes (49% vs 34%, p=0.026) and mean BMI (33 kg/m2vs 28 kg/m2, p<0.001). Despite African Americans requiring continuous renal replacement therapy during hospitalization at higher rates than other races (27% vs 13%, p=0.011), rates of intubation, intensive care unit length of stay, and overall mortality (30% vs 24%, p=0.307) were similar. Conclusion This racially diverse series of critically ill COVID-19 patients shows that despite higher rates of comorbidities at hospital admission in African Americans compared with other races, there was no significant difference in mortality.


2021 ◽  
Vol 49 (1) ◽  
pp. 23-34
Author(s):  
Katherine P Hooper ◽  
Matthew H Anstey ◽  
Edward Litton

Reducing unnecessary routine diagnostic testing has been identified as a strategy to curb wasteful healthcare. However, the safety and efficacy of targeted diagnostic testing strategies are uncertain. The aim of this study was to systematically review interventions designed to reduce pathology and chest radiograph testing in patients admitted to the intensive care unit (ICU). A predetermined protocol and search strategy included OVID MEDLINE, OVID EMBASE and the Cochrane Central Register of Controlled Trials from inception until 20 November 2019. Eligible publications included interventional studies of patients admitted to an ICU. There were no language restrictions. The primary outcomes were in-hospital mortality and test reduction. Key secondary outcomes included ICU mortality, length of stay, costs and adverse events. This systematic review analysed 26 studies (with more than 44,00 patients) reporting an intervention to reduce one or more diagnostic tests. No studies were at low risk of bias. In-hospital mortality, reported in seven studies, was not significantly different in the post-implementation group (829 of 9815 patients, 8.4%) compared with the pre-intervention group (1007 of 9848 patients, 10.2%), (relative risk 0.89, 95% confidence intervals 0.79 to 1.01, P = 0.06, I2 39%). Of the 18 studies reporting a difference in testing rates, all reported a decrease associated with targeted testing (range 6%–72%), with 14 (82%) studies reporting >20% reduction in one or more tests. Studies of ICU targeted test interventions are generally of low quality. The majority report substantial decreases in testing without evidence of a significant difference in hospital mortality.


PEDIATRICS ◽  
1983 ◽  
Vol 71 (5) ◽  
pp. 835-838
Author(s):  
Fred Schwab ◽  
Brenda Tolbert ◽  
Stephen Bagnato ◽  
M. Jeffrey Maisels

The effect of sibling visiting in a neonatal intensive care unit was studied. Sixteen siblings of 13 infants were randomly assigned to a visiting or nonvisiting group. Behavioral patterns were measured by questionnaires administered to the parents and by direct observation and interviews with the children. There were no significant changes in the behavior of the children following the birth of their sibling, and there was no significant difference between the behavior scores of the two groups 1 week after the experimental (or control) intervention. The visiting children did not show signs of fear or anxiety during the visit. These data suggest that sibling visiting to a neonatal intensive care unit is not likely to be harmful and might be beneficial to the siblings and their families.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohammed N Al Shafi'i ◽  
Doaa M. Kamal El-din ◽  
Mohammed A. Abdulnaiem Ismaiel ◽  
Hesham M Abotiba

Abstract Background Noninvasive positive pressure ventilation (NIPPV) has been increasingly used in the management of respiratory failure in intensive care unit (ICU). Aim of the Work is to compare the efficacy and resource consumption of NIPPMV delivered through face mask against invasive mechanical ventilation (IMV) delivered by endotracheal tube in the management of patients with acute respiratory failure (ARF). Patients and Methods This prospective randomized controlled study included 78 adults with acute respiratory failure who were admitted to the intensive care unit. The enrolled patients were randomly allocated to receive either noninvasive ventilation or conventional mechanical ventilation (CMV). Results Severity of illness, measured by the simplified acute physiologic score 3 (SAPS 3), were comparable between the two patient groups with no significant difference between them. Both study groups showed a comparable steady improvement in PaO2:FiO2 values, indicating that NIPPV is as effective as CMV in improving the oxygenation of patients with ARF. The PaCO2 and pH values gradually improved in both groups during the 48 hours of ventilation. 12 hours after ventilation, NIPPMV group showed significantly more improvement in PaCO2 and pH than the CMV group. The respiratory acidosis was corrected in the NIPPV group after 24 hours of ventilation compared with 36 hours in the CMV group. NIPPV in this study was associated with a lower frequency of complications than CMV, including ventilator acquired pneumonia (VAP), sepsis, renal failure, pulmonary embolism, and pancreatitis. However, only VAP showed a statistically significant difference. Patients who underwent NIPPV in this study had lower mortality, and lower ventilation time and length of ICU stay, compared with patients on CMV. Intubation was required for less than a third of patients who initially underwent NIV. Conclusion Based on our study findings, NIPPV appears to be a potentially effective and safe therapeutic modality for managing patients with ARF.


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