scholarly journals A Longitudinal SARS-CoV-2 Biorepository for COVID-19 Survivors with and without Post-Acute Sequelae

2021 ◽  
Author(s):  
Stephanie M LaVergne ◽  
Stromberg Sophia ◽  
Bridget A Baxter ◽  
Tracy L Webb ◽  
Taru S Dutt ◽  
...  
Keyword(s):  
Demographic Data ◽  
Acute Infection ◽  
Exercise Intolerance ◽  
Future Research ◽  
Clinical Trial Registration ◽  
Targeted Interventions ◽  
Persistent Symptoms ◽  
Northern Colorado ◽  
History Of

Abstract BackgroundSARS-CoV-2 has swept across the globe, causing millions of deaths worldwide. Though most survive, many experience symptoms of COVID-19 for months after acute infection. Successful prevention and treatment of acute COVID-19 infection and its associated sequelae is dependent on in-depth knowledge of viral pathology across the spectrum of patient phenotypes and physiologic responses. Longitudinal biobanking provides a valuable resource of clinically integrated, easily accessed, and quality-controlled samples for researchers to study differential multi-organ system responses to SARS-CoV-2 infection, post-acute sequelae of COVID-19 (PASC), and vaccination. MethodsAdults with a history of a positive SARS-CoV-2 nasopharyngeal PCR are actively recruited from the community or hospital settings to enroll in the Northern Colorado SARS-CoV-2 Biorepository (NoCo-COBIO). Blood, saliva, stool, nasopharyngeal specimens, and extensive clinical and demographic data are collected at 4 time points over 6 months. Patients are assessed for PASC during longitudinal follow-up by physician led symptom questionnaires and physical exams. This clinical trial registration is NCT05603677.ResultsWe have enrolled and collected samples from 119 adults since July 2020, with 66% follow-up rate. Forty-nine percent of participants assessed with a symptom surveillance questionnaire (N=37 of 75) had PASC at any time during follow-up (up to 8 months post infection). Ninety-three percent of hospitalized participants developed PASC, while 23% of those not requiring hospitalization developed PASC. At 90-174 days post SARS-CoV-2 diagnosis, 67% of all participants had persistent symptoms (N=37 of 55), and 85% percent of participants who required hospitalization during initial infection (N=20) still had symptoms. The most common symptoms reported after 15 days of infection were fatigue, loss of smell, loss of taste, exercise intolerance, and cognitive dysfunction. ConclusionsPatients who were hospitalized for COVID-19 were significantly more likely to have PASC than those not requiring hospitalization, however 23% of patients who were not hospitalized also developed PASC. This patient-matched, multi-matrix, longitudinal biorepository from COVID-19 survivors with and without PASC will allow for current and future research to better understand the pathophysiology of disease and to identify targeted interventions to reduce risk for PASC. Registered 27 October 2020 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04603677.

scholarly journals A longitudinal SARS-CoV-2 biorepository for COVID-19 survivors with and without post-acute sequelae

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stephanie M. LaVergne ◽  
Sophia Stromberg ◽  
Bridget A. Baxter ◽  
Tracy L. Webb ◽  
Taru S. Dutt ◽  
...  
Keyword(s):  
Demographic Data ◽  
Acute Infection ◽  
Exercise Intolerance ◽  
Future Research ◽  
Clinical Trial Registration ◽  
Targeted Interventions ◽  
Persistent Symptoms ◽  
Link Type ◽  
History Of

Abstract Background SARS-CoV-2 has swept across the globe, causing millions of deaths worldwide. Though most survive, many experience symptoms of COVID-19 for months after acute infection. Successful prevention and treatment of acute COVID-19 infection and its associated sequelae is dependent on in-depth knowledge of viral pathology across the spectrum of patient phenotypes and physiologic responses. Longitudinal biobanking provides a valuable resource of clinically integrated, easily accessed, and quality-controlled samples for researchers to study differential multi-organ system responses to SARS-CoV-2 infection, post-acute sequelae of COVID-19 (PASC), and vaccination. Methods Adults with a history of a positive SARS-CoV-2 nasopharyngeal PCR are actively recruited from the community or hospital settings to enroll in the Northern Colorado SARS-CoV-2 Biorepository (NoCo-COBIO). Blood, saliva, stool, nasopharyngeal specimens, and extensive clinical and demographic data are collected at 4 time points over 6 months. Patients are assessed for PASC during longitudinal follow-up by physician led symptom questionnaires and physical exams. This clinical trial registration is NCT04603677. Results We have enrolled and collected samples from 119 adults since July 2020, with 66% follow-up rate. Forty-nine percent of participants assessed with a symptom surveillance questionnaire (N = 37 of 75) had PASC at any time during follow-up (up to 8 months post infection). Ninety-three percent of hospitalized participants developed PASC, while 23% of those not requiring hospitalization developed PASC. At 90–174 days post SARS-CoV-2 diagnosis, 67% of all participants had persistent symptoms (N = 37 of 55), and 85% percent of participants who required hospitalization during initial infection (N = 20) still had symptoms. The most common symptoms reported after 15 days of infection were fatigue, loss of smell, loss of taste, exercise intolerance, and cognitive dysfunction. Conclusions Patients who were hospitalized for COVID-19 were significantly more likely to have PASC than those not requiring hospitalization, however 23% of patients who were not hospitalized also developed PASC. This patient-matched, multi-matrix, longitudinal biorepository from COVID-19 survivors with and without PASC will allow for current and future research to better understand the pathophysiology of disease and to identify targeted interventions to reduce risk for PASC. Registered 27 October 2020 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04603677.

scholarly journals Investigating phenotypes of pulmonary COVID-19 recovery: a longitudinal observational prospective multicenter trial

2021 ◽  
Author(s):  
Thomas Sonnweber ◽  
Piotr Tymoszuk ◽  
Sabina Sachanic ◽  
Anna Boehm ◽  
Alex Pizzini ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Features ◽  
Research Question ◽  
Acute Infection ◽  
Machine Learning Algorithms ◽  
Individual Risk ◽  
Clinical Trial Registration ◽  
Risk Class ◽  
Persistent Symptoms

Background: COVID-19 is associated with long-term pulmonary symptoms and may result in chronic pulmonary impairment. The optimal procedures to prevent, identify, monitor, and treat these pulmonary sequelae are elusive. Research question: To characterize the kinetics of pulmonary recovery, risk factors and constellations of clinical features linked to persisting radiological lung findings after COVID-19. Study design and methods: A longitudinal, prospective, multicenter, observational cohort study including COVID-19 patients (n = 108). Longitudinal pulmonary imaging and functional readouts, symptom prevalence, clinical and laboratory parameters were collected during acute COVID-19 and at 60-, 100- and 180-days follow-up visits. Recovery kinetics and risk factors were investigated by logistic regression. Classification of clinical features and study participants was accomplished by k-means clustering, the k-nearest neighbors (kNN), and naive Bayes algorithms. Results: At the six-month follow-up, 51.9% of participants reported persistent symptoms with physical performance impairment (27.8%) and dyspnea (24.1%) being the most frequent. Structural lung abnormalities were still present in 45.4% of the collective, ranging from 12% in the outpatients to 78% in the subjects treated at the ICU during acute infection. The strongest risk factors of persisting lung findings were elevated interleukin-6 (IL6) and C-reactive protein (CRP) during recovery and hospitalization during acute COVID-19. Clustering analysis revealed association of the lung lesions with increased anti-S1/S2 antibody, IL6, CRP, and D-dimer levels at the early follow-up suggesting non-resolving inflammation as a mechanism of the perturbed recovery. Finally, we demonstrate the robustness of risk class assignment and prediction of individual risk of delayed lung recovery employing clustering and machine learning algorithms. Interpretation: Severity of acute infection, and systemic inflammation is strongly linked to persistent post-COVID-19 lung abnormality. Automated screening of multi-parameter health record data may assist the identification of patients at risk of delayed pulmonary recovery and optimize COVID-19 follow-up management. Clinical Trial Registration: ClinicalTrials.gov: NCT04416100

Effectiveness of a Modified Version of Airflow Therapy

1982 ◽  
Vol 47 (2) ◽  
pp. 160-164
Author(s):  
Glenn L. Falkowski ◽  
Arthur M. Guilford ◽  
Jack Sandler
Keyword(s):  
Success Rate ◽  
Scientific Literature ◽  
Future Research ◽  
Relative Importance ◽  
Differential Effectiveness ◽  
History Of ◽  
One Year ◽  
Main Components

Utilizing airflow therapy, Schwartz (1976) has claimed an 89% success rate with stutterers following treatment and an 83% success rate at one year follow-up. Such claims have yet to be documented in the scientific literature. The purposes of this study were: (a) to investigate the effectiveness of a modified version of airflow therapy; (b) to examine the relative importance of its two main components—passive airflow and elongation of the first vowel spoken. The speech of two adult male stutterers with a lengthy history of stuttering, was assessed with spontaneous speaking and reading tasks. Results indicated marked improvement in both subjects' speech on the reading task was maintained at follow-up 10 weeks later. For spontaneous speech, results were generally weaker and less durable. Effects of the two treatment components were cumulative and did not allow determination of any differential effectiveness between components. Implications of these findings were considered and directions for future research discussed.

scholarly journals Nuss Procedure for a Patient with Negative Haller Index

2018 ◽  
Vol 06 (01) ◽  
pp. e18-e22 ◽  
Author(s):  
Mariela Dore ◽  
Paloma Triana Junco ◽  
Carlos De La Torre ◽  
Alejandra Vilanova-Sánchez ◽  
Monserrat Bret ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Pectus Excavatum ◽  
Vena Cava ◽  
Forced Expiratory Volume ◽  
Exercise Intolerance ◽  
Nuss Procedure ◽  
Invasive Approach ◽  
History Of ◽  
Ventilation Pattern

Introduction Minimally invasive repair for pectus excavatum (MIRPE) is controversial in extremely severe cases of pectus excavatum (PE) and an open repair is usually favored. Our aim is to describe a case of a patient with an extremely severe PE that underwent a minimally invasive approach. Case report An 8-year-old girl with severe sternum depression was assessed. She had a history of exercise intolerance, nocturnal dyspnea, fatigue, and shortness of breath. Chest computed tomography showed that sternum depression was posterior to the anterior vertebral column; therefore, Haller and correction index could not be measured. Spirometry indicated an obstructive ventilation pattern (forced expiratory volume in 1 second = 74.4%), and echocardiogram revealed a dilated inferior vena cava, mitral valve prolapse with normal ventricular function. After multidisciplinary committee evaluation, a MIRPE approach was performed.All symptoms had disappeared at the 3-month postoperative follow-up; the desired sternum shape was achieved and normalization of cardiopulmonary function was observed. The Nuss bars were removed after a 2-year period. After 18-month follow-up, the patient can carry out normal exercise and is content with the cosmetic result. Conclusion Nuss procedure is feasible in our 8-year-old patient. In this case, both the Haller and correction index were not useful to assess the severity of PE. Therefore, under these circumstances, other radiologic parameters have to be taken into consideration for patient evaluation.

Abstract 13274: Predictors of Mortality in Critically Ill Covid-19 Patients - A Multicenter Prospective Analysis of 159 Patients

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Randy Ip ◽  
Zulfiqar Qutrio Baloch ◽  
manel boumegouas ◽  
Abdullah Al abcha ◽  
Steven Do ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Critically Ill ◽  
Demographic Data ◽  
Prior History ◽  
Multivariable Logistic Regression Analysis ◽  
Elevated Troponin ◽  
Ischemic Disease ◽  
Patient Status ◽  
History Of

Introduction: Certain patient demographics and biomarkers have been shown to predict survival in patients infected with COVID-19. However, predictors of outcome in patients who are critically ill and require advanced respiratory support are unclear. Methods: We performed a multicenter analysis of 159 consecutive patients with confirmed COVID-19 who were admitted to Intensive Care Unit (ICU) between March 01, 2020 and April 30, 2020. Patients were then followed until May 23, 2020. Demographic data (age, sex, race, BMI) and past medical history (hypertension, diabetes, COPD, CKD, history of cardiac ischemic disease, atrial fibrillation and heart failure) were recorded. Laboratory values (troponin, CPK, pro-BNP, ferritin, LDH and d-dimer) were analyzed. Patient status was classified as either alive or deceased at hospital discharge or the end of follow up period. Results: Mean patient age was 66+/-15 and 53% were male. Mean BMI was 31+/- 9. Mean hospital ICU stay was 11+/-8 days. Mortality rate of this ICU cohort at the end of follow-up was 63%. Fifty-five (34%) patients were discharged from the hospital. A multivariable logistic regression analysis identified four factors (age, prior history of diabetes, prior history of atrial fibrillation and elevated troponin) that had significant and independent contributions to the likelihood of survival. Each increase in decade of age above 40 (p = 0.010) was predicted to reduce survival by 30%, the presence of diabetes (p = 0.041) by 57%, a prior history of atrial fibrillation (p= 0.011) by 75%, and each increase of 0.1 ng/mL of troponin above 0.05 ng/ml (p = 0.001) by 55%. Conclusion: Mortality of critically ill COVID-19 patients is high. Early aggressive treatment of high-risk patients identified in this study (advanced age, history of diabetes and atrial fibrillation and elevated troponin) could improve clinical outcome. The highly predictive value of elevated troponin levels on survival may indicate cardiac involvement of COVID-19 infection as a determinant of mortality. Additionally, of available published literature at this time, this is the first study that suggests a relationship between atrial fibrillation and increased mortality from COVID-19. Larger studies are needed to confirm these findings.

scholarly journals LO95: A prospective evaluation of mild traumatic brain injuries in a working population in Edmonton, AB

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S61
Author(s):  
L. Gaudet ◽  
L. Eliyahu ◽  
J. Lowes ◽  
J. Beach ◽  
M. Mrazik ◽  
...  
Keyword(s):  
Return To Work ◽  
Attention Deficit Disorder ◽  
Brain Injuries ◽  
Work Outcomes ◽  
Continuous Variables ◽  
Chi Square ◽  
Work Related ◽  
Persistent Symptoms ◽  
History Of

Introduction: Patients with mild traumatic brain injury (mTBI) frequently present to the emergency department (ED); however, wide variation in diagnosis and management has been demonstrated in this setting. Sub-optimal mTBI management can contribute to post-concussion syndrome (PCS), affecting vocational outcomes like return to work. This study documented the work-related events, ED management, discharge advice, and outcomes for employed patients presenting to the ED with mTBI. Methods: Adult (>17 years) patients presenting to one of three urban EDs in Edmonton, Alberta with Glasgow coma scale score ≥13 within 72 hours of a concussive event were recruited by on-site research assistants. Follow-up calls ascertained outcomes, including symptoms and their severity, advice received in the ED, and adherence to discharge instructions, at 30 and 90 days after ED discharge. Dichotomous variables were analyzed using chi-square testing; continuous variables were compared using t-tests or Mann-Whitney tests, as appropriate. Work-related injury and return to work outcomes were modelled using logistic or linear regression, as appropriate. Results: Overall, 250 patents were enrolled; 172 (69%) were employed at the time of their injury and completed at least one follow-up. The median age was 37 years (interquartile range [IQR]: 24, 49.5), both sexes were equally represented (48% male), and work-related concussions were uncommon (16%). Work-related concussion was related to manual labor jobs and self-reported history of attention deficit disorder. Patients often received advice to avoid sports (81%) and/or work (71%); however, the duration of recommended time off varied. Most employed patients (80%) missed at least one day of work (median=7 days; IQR: 3, 14); 91% of employees returned to work by 90 days, despite 41% reporting persistent symptoms. Increased days of missed work were linked to divorce, history of sleep disorder, and physician’s advice to avoid work. Conclusion: While work-related concussions are uncommon, most employees who sustain a mTBI at any time miss some work. Many patients experience mTBI symptoms past 90 days, which has serious implications for workers’ abilities to fulfill their work duties and risk of subsequent injury. Workers, employers, and the workers compensation system should take the necessary precautions to ensure that workers return to work safely and successfully following a concussion.

scholarly journals Patient outcomes after hospitalisation with COVID-19 and implications for follow-up: results from a prospective UK cohort

Thorax ◽  
2020 ◽  
pp. thoraxjnl-2020-216086
Author(s):  
David T Arnold ◽  
Fergus W Hamilton ◽  
Alice Milne ◽  
Anna J Morley ◽  
Jason Viner ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Acute Infection ◽  
Holistic Approach ◽  
Well Being ◽  
Supplementary Oxygen ◽  
Exercise Tests ◽  
Persistent Symptoms ◽  
Blood Tests ◽  
Clinically Significant

The longer-term consequences of SARS-CoV-2 infection are uncertain. Consecutive patients hospitalised with COVID-19 were prospectively recruited to this observational study (n=163). At 8–12 weeks postadmission, survivors were invited to a systematic clinical follow-up. Of 131 participants, 110 attended the follow-up clinic. Most (74%) had persistent symptoms (notably breathlessness and excessive fatigue) and limitations in reported physical ability. However, clinically significant abnormalities in chest radiograph, exercise tests, blood tests and spirometry were less frequent (35%), especially in patients not requiring supplementary oxygen during their acute infection (7%). Results suggest that a holistic approach focusing on rehabilitation and general well-being is paramount.

scholarly journals An Observational Study of Follow Up of MDR Tuberculosis Patients after Successful Completion of Category 4 Treatment under RNTCP (PMDT) in Allahabad District

2019 ◽  
Vol 17 (1) ◽  
pp. 1-7
Author(s):  
Tariq Mahmood ◽  
P. Dwivedi ◽  
A.D. Shukla ◽  
A.K. Jain ◽  
A.K. Verma
Keyword(s):  
Observational Study ◽  
Demographic Data ◽  
Multidrug Resistant ◽  
Physical Parameters ◽  
Chronic Disability ◽  
Arm Circumference ◽  
Standardized Treatment ◽  
Mdr Tb ◽  
History Of

Introduction: Drug-resistant TB is a persistent threat, with 490 000 million cases of multidrug-resistant TB emerging in 2016.The countries with the largest numbers of MDR/RR-TB cases were China, India and the Russian Federation. Given the prolonged nature of MDR-TB, one might expect higher rates of chronic disability among cured patients with MDR-TB. To explore these questions, we conducted an observational study focusing on: clinical, bacteriological, biochemical and various health parameter status of successfully treated MDR-TB patients. Methods: Subjects enrolled in study as per inclusion and exclusion criteria were assessed by recording of demographic data and were subjected to a predetermined set of questions for determining the history of previous anti tubercular treatment and exposure to various type of risk factor for development of MDR TB. Physical parameters of health were determined and recorded. Results: Total of 84 patients were enrolled in our study (57-males, 27 females).69 subjects (46-males, 23-Females) were found apparently healthy. 25 subjects migrated outside.6 patients (male-6, Female-2) died.7 patients were diagnosed as XDR-TB (5-Males,2-Females).34 subjects (18- males, 16-females) (44.73%) were very under weight. Total 13 (Males-12, Females-1) out of 76 subjects (17.10%) were under weight. Mid arm circumference (MAC) of 35 out of 76(21- males, 18-females) subjects (46.05%) was below 5th percentile. Majority of subjects showed moderate & severe obstruction in PEFR. Conclusion: This study shows that the community based standardized treatment regimen is effective as only one of the patients was bacteriologically positive on follow up. However, significant numbers of treated MDR-TB patients suffer from clinical, nutritional and functional post-treatment adverse events leading to some morbidity.

scholarly journals Adaptation, translation and reliability of the Australian ‘Juniors Enjoying Cricket Safely’ injury risk perception questionnaire for Sri Lanka

2018 ◽  
Vol 4 (1) ◽  
pp. e000289 ◽  
Author(s):  
Prasanna J Gamage ◽  
Lauren V Fortington ◽  
Caroline F Finch
Keyword(s):  
Risk Perception ◽  
Sri Lanka ◽  
Risk Perceptions ◽  
Injury Risk ◽  
Demographic Data ◽  
Future Research ◽  
Sri Lankan ◽  
Back Translation ◽  
History Of ◽  
Test Retest Reliability

ObjectivesCricket is a very popular sport in Sri Lanka. In this setting there has been limited research; specifically, there is little knowledge of cricket injuries. To support future research possibilities, the aim of this study was to cross-culturally adapt, translate and test the reliability of an Australian-developed questionnaire for the Sri Lankan context.MethodsThe Australian ‘Juniors Enjoying Cricket Safely’ (JECS-Aus) injury risk perception questionnaire was cross-culturally adapted to suit the Sri Lankan context and subsequently translated into the two main languages (Sinhala and Tamil) based on standard forward-back translation. The translated questionnaires were examined for content validity by two language schoolteachers. The questionnaires were completed twice, 2 weeks apart, by two groups of school cricketers (males) aged 11–15 years (Sinhala (n=24), Tamil (n=30)) to assess reliability. Test–retest scores were evaluated for agreement. Where responses were <100% agreement, Cohen’s kappa (κ) statistics were calculated. Questions with moderate-to-poor test–retest reliability (κ<0.6) were reconsidered for modification.ResultsBoth the Sinhala and Tamil questionnaires had 100% agreement for questions on demographic data, and 88%–100% agreement for questions on participation in cricket and injury history. Of the injury risk perception questions, 72% (Sinhala) and 90% (Tamil) questions showed a substantial (κ=0.61–0.8) and almost perfect (κ=0.81–1.0) test–retest agreement.ConclusionThe adapted and translated JECS-SL questionnaire demonstrated strong reliability. This is the first study to adapt the JECS-Aus questionnaire for use in a different population, providing an outcome measure for assessing injury risk perceptions in Sri Lankan junior cricketers.

scholarly journals A Pilot Study of Tobacco Screening and Referral for Smoking Cessation Program among HIV-Infected Patients in France

2017 ◽  
Vol 16 (5) ◽  
pp. 467-474 ◽  
Author(s):  
Jean-Jacques Parienti ◽  
Zine Merzougui ◽  
Arnaud de la Blanchardière ◽  
Sylvie Dargère ◽  
Philippe Feret ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Tobacco Smoking ◽  
Smoking Cessation Program ◽  
Intravenous Drug Use ◽  
Active Smoking ◽  
Targeted Interventions ◽  
History Of ◽  
Living With Hiv ◽  
History Of Depression

Background: The prevalence of tobacco smoking is high among patients living with HIV, supporting the need for effective targeted interventions. Materials and Methods: All current smokers at our outpatient HIV clinic were invited to participate in a smoking cessation program. Results: Of the 716 patients living with HIV, 280 (39%) reported active smoking and were younger, more recently HIV infected and more frequently infected due to intravenous drug use (IDU). One hundred forty-seven (53%) smokers agreed to participate in the smoking cessation program and had a higher Fagerström score and were less likely IDU. During follow-up, 41 (28%) smokers withdrew from the program. After 6 months, 60 (57%) of the 106 smokers who completed the intervention had stopped tobacco smoking and were more likely to use varenicline, adjusting for a history of depression. Conclusion: Our smoking cessation program was feasible. However, strategies to reach and retain in smoking cessation program specific groups such as IDU are needed to improve the smoking cessation cascade.

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