scholarly journals Temporal Dynamics in Clinical and Laboratory Manifestations During COVID-19 Progression

2020 ◽  
Author(s):  
Lin-Lin Ye ◽  
Wen-Bei Peng ◽  
Xiao-Shan Wei ◽  
Xu Wang ◽  
Zi-Hao Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Temporal Dynamics ◽  
Early Stage ◽  
White Blood Cells ◽  
Smoking History ◽  
Stable Group ◽  
Laboratory Findings ◽  
Associated Risk Factors ◽  
D Dimer ◽  
Time Point

Abstract BAckground Severe COVID-19 patients account for most of the mortality of this disease. Early detection of severe cases of the disease remains a major challenge. Here, we performed clinical and laboratory profiling of COVID-19 to explore the early warning indicators of severe cases. Methods An analysis of the evolution during the hospitalization of clinical and laboratory findings from 78 confirmed COVID-19 patients and the associated risk factors. Results Of the 78 patients who were classified as un-severe at admission, 60 patients(stable group) were stable as mild cases until discharge, and the remaining 18 patients progressed to severe cases(exacerbated group) during hospitalization. Compared with stable patients, exacerbated patients exhibited older, higher BMI values and higher proportion of smokers. In the exacerbated patients, the median time from onset to deterioration was 7.5 days. Before the time point(days 0–7 from onset), we observed higher-levels of White blood cells(WBC), neutrophil, Neutrophi-Lymphocyte-Ratio(NLR), Lactose-dehydrogenase(LDH), D-dimer, and lower-levels of albumin in the exacerbated group, compared with the stable group. In the second week after the time point, the exacerbated patients displayed lower numbers of lymphocytes, CD3+, and CD8+T-cells, and higher-levels of C-reactive protein(CRP), erythrocyte-sedimentation-rate(ESR), Alanine-aminotransferase(ALT),Aspartate-aminotransferase(AST), and Interleukin-6. In the third week, the highest temperature and the proportion of febrile patients declined. All of the laboratory indicators gradually improved. Conclusions Advanced age and smoking history could be risk factors for COVID-19 progression. In the early stage, high-levels of WBC and neutrophils, with noticeably increased LDH and D-dimer, could be early indicators of the disease’s conversion from mild to severe, followed by elevated inflammatory markers, liver enzymes, and decreased T-lymphocytes in the next week.

Pressure ulcer incidence in acute care settings: a multicentre prospective study

2021 ◽  
Vol 30 (11) ◽  
pp. 930-938
Author(s):  
Ma'en Aljezawi
Keyword(s):  
Risk Factors ◽  
Acute Care ◽  
Pressure Ulcer ◽  
Conflicts Of Interest ◽  
White Blood Cells ◽  
Albumin Level ◽  
Advisory Panel ◽  
Hospitalised Patients ◽  
Acute Care Settings ◽  
Associated Risk Factors

Objective: Pressure ulcers (PUs) are one of the most commonly occurring complications in hospitalised patients. Knowing the size of the problem and its risk factors will help in preventing it. The aim of this study is to measure the incidence of PUs in acute care settings in Jordan and to explore associated risk factors. Method: A prospective incidence study for hospitalised patients in Jordan according to the European Pressure Ulcer Advisory Panel methodology. All patients admitted into four Jordanian hospitals over a period of six months were included. Results: The cumulative incidence rate was 0.48%. Using multivariate analysis, a low albumin level, elevated white blood cells, incontinence and having more chronic illnesses were significantly associated with acquiring PUs. Conclusion: Incidence of PUs in Jordan is lower when compared with other parts of the world; this could be related to the relatively younger Jordanian population compared with other populations. Declaration of interest: The author has no conflicts of interest to declare.

scholarly journals Investigation on the current situation of stroke patients in northernern Henan Province of China

2021 ◽  
Author(s):  
Zhenhua Li ◽  
Qingcheng Yang ◽  
Xiangdong Zhang ◽  
Yanping Guo ◽  
Jiangang Zhang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Drug Use ◽  
Antihypertensive Drugs ◽  
Early Stage ◽  
Henan Province ◽  
Smoking History ◽  
Stroke Patients ◽  
Rational Drug ◽  
Drinking History

Objectives: To analyze the basic situations and clinical characteristics of stroke patients in our hospital from May 2018 to April 2021, lay a foundation for the prevention and reasonable treatment of stroke patients in northern Henan Province. Methods: The basic information of 835 stroke patients in our hospital was collected and classified according to age, gender, bad habits, accompanied diseases and drug use before admission to hospital, and severity of the stroke patients were also evaluated according to mRS scoring standard. Results: A total of 835 stroke patients were collected from May 2018 to April 2021 in our hospital. The age range of stroke patients was 28-95 years old, 96.29% stroke patients was above 40 years old; there were 202 stroke patients with smoking history and 225 stroke patients with drinking history; Among the 835 stroke patients, hypertension, cerebral infarction and diabetes mellitus were the main accompanied diseases. Antihypertensive drugs (506 cases), antiplatelet drugs (208 cases), statins (173 cases) and antidiabetic drugs (143 cases) were the main therapeutic drugs in stroke patients before admission in the northern Henan Province; the results of mRS scoring standard showed that among 835 stroke patients, there were 609 cases with milder symptoms, accounting for 82.84% (there were 330 stroke patients with 1 points, 279 stroke patients with 2 points, and 83 stroke patients with 3 points), and 120 cases with severe symptoms, accounting for 14.37% (55 cases with 4 points, 65 cases with 5 points). Conclusion: The age of stroke patients in northern Henan Province was mainly over 40 years old, most of stroke patients were in the early stage of stroke; smoking, drinking, hypertension and diabetes mellitus were main risk factors of stroke. And there was a sex difference between male stroke patients and female stroke patients in stroke risk factors smoking and hypertension. those data may help us for active prevention and rational drug use for stroke in clinic.

Risk factors in lateral epicondylitis (tennis elbow): a case-control study

2012 ◽  
Vol 38 (2) ◽  
pp. 159-164 ◽  
Author(s):  
A. G. Titchener ◽  
A. Fakis ◽  
A. A. Tambe ◽  
C. Smith ◽  
R. B. Hubbard ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Tennis Elbow ◽  
Lateral Epicondylitis ◽  
Case Control ◽  
Smoking History ◽  
Health Improvement ◽  
Tunnel Syndrome ◽  
Associated Risk Factors ◽  
Control Study

Lateral epicondylitis is a common condition, but relatively little is known about its aetiology and associated risk factors. We have undertaken a large case-control study using The Health Improvement Network database to assess and quantify the relative contributions of some constitutional and environmental risk factors for lateral epicondylitis in the community. Our dataset included 4998 patients with lateral epicondylitis who were individually matched with a single control by age, sex, and general practice. The median age at diagnosis was 49 (interquartile range 42–56) years . Multivariate analysis showed that the risk factors associated with lateral epicondylitis were rotator cuff pathology (OR 4.95), De Quervain’s disease (OR 2.48), carpal tunnel syndrome (OR 1.50), oral corticosteroid therapy (OR 1.68), and previous smoking history (OR 1.20). Diabetes mellitus, current smoking, trigger finger, rheumatoid arthritis, alcohol intake, and obesity were not found to be associated with lateral epicondylitis.

scholarly journals Evaluation of stability of deep venous thrombosis of the lower extremities using Doppler ultrasound

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094209
Author(s):  
Shefang Zhang ◽  
Wen Chu ◽  
Hua Wang ◽  
Yajun Liang ◽  
Yajuan Fan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Body Mass ◽  
Doppler Ultrasound ◽  
Area Under The Curve ◽  
Lower Extremities ◽  
Smoking History ◽  
D Dimer

Objective This study aimed to assess using Doppler ultrasound for analyzing stability of deep venous thrombosis (DVT) of the lower extremities. Methods Patients with DVT of the lower extremities who were treated from August 2017 to December 2019 were selected. The patients were divided into stable and unstable groups according to whether thrombus was collected in a filter. Related ultrasound and blood test results were analyzed and compared. Results A total of 126 patients with DVT of the lower extremities were included, of whom 74 were in the stable group and 52 were in the unstable group. There were significant differences in the prothrombin time (PT), and lipoprotein alpha, D-dimer, and triglyceride levels between the groups. D-dimer levels >2800 ug/L, smoking, history of venous thrombosis, PT >13.15 s, and body mass index >24.45 kg/m2 were independent risk factors for stability of DVT of the lower extremities. The area under the curve with combined detection of DVT was significantly higher than that for body mass index, PT, and D-dimer alone. Conclusion Doppler ultrasound may be reliable for analyzing the stability of DVT of the lower extremities. Related strategies targeting risk factors are required for reducing DVT of the lower extremities.

Predictors of permanent menopause after chemotherapy for early-stage breast cancer in premenopausal women

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 575-575
Author(s):  
H. C. Moore ◽  
J. Kim ◽  
C. Rodriguez ◽  
G. T. Budd ◽  
L. Rybicki
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Endocrine Therapy ◽  
Early Stage ◽  
Menopausal Status ◽  
Early Stage Breast Cancer ◽  
Smoking History ◽  
Age At Menarche ◽  
Premenopausal Breast Cancer ◽  
Additional Risk

575 Background: Optimal choice of endocrine therapy for early-stage breast cancer differs with menopausal status. While amenorrhea is common during adjuvant chemotherapy, there is currently no available test to establish when menopause is permanent. The aim of this study was to determine the age cutoff after which resumption of menses is unlikely following chemotherapy and to assess what additional risk factors may predict for persistent menopause at 5 years after initiation of chemotherapy. Methods: One hundred patients treated with chemotherapy for early-stage premenopausal breast cancer and who remained alive and free of recurrence at least 5 years from the start of treatment were enrolled. Participants were evaluated for current menstrual status and for baseline potential risk factors for menopause: age at start of chemotherapy, race, BMI, smoking history, age at menarche, irregular menses prior to chemotherapy, presence of menses during chemotherapy, type of chemotherapy regimen, hormonal therapy, ovarian protection during chemotherapy, and number of doses of alkylating agent (cyclophosphamide). Recursive partitioning analysis (RPA) was used to identify the age cutoff that best predicts permanent menopause; additional risk factors were assessed using logistic regression analysis. Results: Median age at start of chemotherapy was 43 (range 26–49). RPA identified age >42 at the start of chemotherapy as a significant predictor of permanent menopause (p < 0.001). Cessation of menses during chemotherapy was also associated with permanent menopause (p < 0.001). Both variables remained significant in multivariate analysis (p < 0.001), with the combination of these factors being associated with a 95.4% chance of permanent menopause. Conclusions: In this series, fewer than 5% of premenopausal patients who were at least 42 years old and who experienced cessation of menses during chemotherapy experienced any return of menses over at least 5 years. Upfront use of aromatase inhibitors as adjuvant endocrine therapy for premenopausal hormone-receptor positive breast cancer warrants further investigation for those who are at least 42 years of age and who experience amenorrhea with chemotherapy. No significant financial relationships to disclose.

scholarly journals Prevalence and risk factors of thrombotic events on patients with COVID-19: a systematic review and meta‐analysis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Xiaoming Xiong ◽  
Jianhua Chi ◽  
Qinglei Gao
Keyword(s):  
Risk Factors ◽  
Web Of Science ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
White Blood Cells ◽  
Thromboembolism Prophylaxis ◽  
Risk Of Death ◽  
Coagulation Abnormalities ◽  
Male Sex ◽  
D Dimer

Abstract Background Coagulation abnormalities in COVID-19 patients accompanied with poor prognosis. This study aimed to determine the prevalence and risk factors of thrombotic events on COVID-19 patients. Methods. We systematically reviewed all the studies about thrombotic events on COVID-19 patients in PubMed, Embase, Web of Science, MedRxiv, bioRxiv, from Dec 1, 2019 to July 5, 2020. The weighted mean difference (MD) or odds ratio (OR) or relative risk (RR) with 95 % confidence intervals (CI) for clinical data in COVID-19 patients with or without thrombotic events was calculated. Results 12 articles contained 1083 patients were included for meta-analysis. The prevalence of thrombosis was 22 % (95 % CI 0.08–0.40) in COVID-19 patients and increased to 43 % (95 % CI 0.29–0.65) after admission to the intensive care unit (ICU). Compared with non-thrombotic patients, thrombotic patients had higher levels of D-dimer (MD = 2.79 μg/ml, 95 % CI 2.27–3.31 μg/ml), lactate dehydrogenase (LDH) (MD = 112.71 U/L, 95 % CI 62.40–163.02 U/L), and white blood cells (WBC) (MD = 1.14 *109/L, 95 % CI 0.47–1.81*109/L) while decreased lymphocytes (MD= -0.20*109/L, 95 % CI -0.38 – -0.02*109/L). Age, platelet counts, and male sex tended to be risks while diabetes tended to be a protection for thrombosis for COVID-19 patients, although no statistical difference was achieved. Finally, patients with thrombosis were at a higher risk of death (OR = 2.39, 95 % CI 1.36–4.20). Conclusions Prevalence of thrombosis in COVID-19 patients was high, especially in ICU, though pharmacologic thromboembolism prophylaxis was applied. Therefore, higher levels of D-dimer, LDH, WBC, and decreased lymphocytes needed to be paid close attention to in patients with COVID-19.

scholarly journals Laboratory Findings from 100 Patients with COVID-19 Pneumonia in Madinah, Saudi Arabia

2020 ◽  
pp. 94-103
Author(s):  
Al-ahmadey Ziab
Keyword(s):  
Saudi Arabia ◽  
Complete Blood Count ◽  
Early Stage ◽  
Asymptomatic Group ◽  
Laboratory Findings ◽  
Reactive Protein ◽  
Significant Difference ◽  
Potential Risk Factors ◽  
Group 2 ◽  
D Dimer

The coronavirus disease 2019 (COVID-19) virus, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is spreading rapidly. The purpose of this study is to explore high risk patients and guiding future management and summarize the results of routine laboratory testing of asymptomatic, mild to moderate, severe and critical COVID-19 in order to define practical indicators for the diagnosis and treatment of COVID-19. A total of 100 confirmed COVID-19 patients from Madinah city, Saudi Arabia, hospitalized between March to June, 2020 were included, and categorized into asymptomatic, mild to moderate, severe and critically ill patients. Fasting blood samples were withdrawn from all patients for estimation of complete blood count, coagulation profile, biochemistry and serology. Patients were grouped on the basis of the interval between symptom onset: group 1 (asymptomatic), group 2 (mild to moderate), group 3 (severe), and group 4 (critical). Laboratory features and their distribution were analysed and compared across the four groups. Combining assessment of clinical and laboratory findings could facilitate early diagnosis of COVID-19 pneumonia. Median age was 51 years old and 85% of the patients were men. Overall, all patients were admitted to hospitals and 42% required ICU treatment. The majority of patients (29%) were diagnosed with mild to moderate disease, 28% of patients were critical, 26% of patients were severe and 17% of patients were asymptomatic. The comparison COVID-19 patients’ four parameters, using Kusakal-Wallis test, showed a significant difference in the levels of lymphocytes, ESR, PT, INR, d-dimer, CK, BUN and ferritin (P <0.05). C-reactive protein greater than 2.97 (0.84-9.18; p<0.0001). The potential risk factors of older age, lymphopenia, d-dimer greater than 1µg/mL and ferritin greater than 500ng/mL could help physicians to identify patients with a poor prognosis at an early stage.

scholarly journals Covid-19 Disease Is Not Associated with Venous Thromboembolism in a Cohort of Patients in Jeddah, Saudi Arabia

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 24-24
Author(s):  
Fatemah Kamel ◽  
Rania Magadmi ◽  
Sulafa Alqutub ◽  
Maha A. Badawi ◽  
Fatin Al-Sayes ◽  
...  
Keyword(s):  
Risk Factors ◽  
Saudi Arabia ◽  
Venous Thromboembolism ◽  
Conflicts Of Interest ◽  
Demographic Data ◽  
White Blood Cells ◽  
Gastrointestinal Symptoms ◽  
University Hospital ◽  
Retrospective Case ◽  
D Dimer

Background: Coronavirus disease 2019 (COVID-19) caused by acute respiratory syndrome coronavirus 2 (SARS2), is associated with significant morbidity and mortality. The aim of this study is to characterize risk factors and clinical features of COVID-19 disease in an adult cohort in Jeddah, Saudi Arabia. Methods: A retrospective case control study was conducted at King Abdulaziz University hospital (KAUH) in Jeddah, Saudi Arabia. Clinical and demographic data on patients presenting at KAUH with concern for COVID-19 disease between March 18 and May 18, 2020 were collected and analyzed. Results: Electronic medical records on 297 patients presenting at KAUH were reviewed. Of these, 175 (59%) tested positive for COVID-19 by polymerase chain reaction (PCR) and 122 (41%) tested negative. COVID-19 positive patients were more likely to be males (OR=1.59; 95% CI=1.22-2.07), and non-health care workers (OR=1.53; 95% CI=1.13-2.08). Hypertension (10%), diabetes (10%), and two or more concurrent co-morbid conditions (54.4%), were more prevalent among COVID-19 positive patients. Patients presenting with fever, cough, and loss of sense of taste or smell were more likely to test positive for COVID-19 (p=0.001, 0.008, 0.008, respectively. Radiological evidence of pneumonia was associated with confirmed COVID-19 disease. Dyspnea, cough and gastrointestinal symptoms were not associated with risk of COVID-19 at presentation. On admission, white blood cells, neutrophils, lymphocytes, eosinophils, basophils, and platelets were significantly lower among COVID-19 positive patients compared to controls. Surprisingly, D-dimer levels were lower among COVID-19 positive patients. Furthermore, only two patients developed thrombosis; one with pulmonary embolism and one with coronary artery thrombosis. Conclusion: Male gender, hypertension and diabetes were associated with risk of COVID-19 disease in this study population. D-dimer levels were not elevated in COVID-19 patients, and venous thromboembolism was not prevalent in cases, compared to controls. This is in contrast to previous reports on the association of COVID-19 disease with venous thromboembolism in other populations. Thus, individual and environmental risk factors may play an important role in the pathophysiology of thrombosis in COVID-19 disease. Disclosures No relevant conflicts of interest to declare.

scholarly journals The timeline and risk factors of clinical progression of COVID-19 in Shenzhen, China

2020 ◽  
Author(s):  
Fang Wang ◽  
Mengyuan Qu ◽  
Xuan Zhou ◽  
kai zhao ◽  
Changxiang Lai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Critically Ill ◽  
Early Stage ◽  
Clinical Progression ◽  
Stable Group ◽  
Progressive Group ◽  
Potential Risk Factors ◽  
Novel Coronavirus ◽  
High Level ◽  
Clinical Records

Abstract Background The novel coronavirus disease 2019(COVID-19) broke out globally. Early prediction of the clinical progression was essential but still unclear. We aimed to evaluate the timeline of COVID-19 development and analyze risk factors of disease progression.Methods In this retrospective study, we included 333 patients with laboratory-confirmed COVID-19 infection hospitalized in the Third People's Hospital of Shenzhen from 10 January to 10 February 2020. Epidemiological feature, clinical records, laboratory and radiology manifestations were collected and analyzed. 323 patients with mild-moderate symptoms on admission were observed to determine whether they exacerbated to severe-critically ill conditions (progressive group) or not (stable group). We used logistic regression to identify the risk factors associated with clinical progression.Results Of all the 333 patients, 70(21.0%) patients progressed into severe-critically ill conditions during hospitalization and assigned to the progressive group, 253(76.0%) patients belonged to the stable group, another 10 patients were severe before admission. we found that the clinical features of aged over 40 (3.80[1.72, 8.52]), males (2.21[1.20, 4.07]), with comorbidities (1.78[1.13, 2.81]) certain exposure history (0.38[0.20, 0.71]), abnormal radiology manifestations (3.56[1.13, 11.40]), low level of T lymphocytes (0.99[0.997, 0.999]), high level of NLR (0.99[0.97, 1.01]), IL-6 (1.05[1.03, 1.07]) and CRP (1.67[1.12, 2.47]) were the risk factors of disease progression by logistic regression.Conclusions the potential risk factors of males, older age, with comorbidities, low T lymphocyte level and high level of NLR, CRP, IL-6 can help to predict clinical progression of COVID-19 at an early stage.

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