scholarly journals Prognosis of Critically Ill Patients With Acute Respiratory Failure Due To The SARS-CoV-2 501Y.V2 Variant: A Multicenter Retrospective Matched Cohort Study

2021 ◽  
Author(s):  
Bérénice Puech ◽  
Antoine Legrand ◽  
Olivier Simon ◽  
Chloé Combe ◽  
Marie-Christine Jaffar-Bandjee ◽  
...  
Keyword(s):  
Cohort Study ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Invasive Mechanical Ventilation ◽  
University Hospital ◽  
Original Strain ◽  
Reunion Island ◽  
Matched Cohort ◽  
Matched Cohort Study ◽  
Réunion Island

Abstract Background The aim of this study was to compare the prognosis of patients with acute respiratory failure (ARF) due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant 501Y.V2 to that of patients with ARF due to the original strain. Methods This retrospective matched cohort study included all consecutive patients who were hospitalized for ARF due to SARS-CoV-2 in Reunion Island University Hospital between March 2020 and March 2021. Twenty-eight in hospital mortality was evaluated before and after matching. Results A total of 218 patients with ARF due to SARS-CoV-2 were enrolled in the study. Of these, 83 (38.1%) were infected with the 501Y.V2 variant. During intensive care unit stay, 104 (47.7%) patients received invasive mechanical ventilation and 20 (9.2%) patients were supported by venovenous extracorporeal membrane oxygenation. Patients infected with the 501Y.V2 variant were younger (58 [51–68] vs. 67 [56–74] years old, P = 0.003), had less hypertension (54.2% vs 68.1%, P = 0.04), and had less chronic kidney disease (13.3% vs. 31.9%, P = 0.002) than patients infected with the original strain. After controlling for confounding variables (62 matched patients in each group), 28-day mortality was higher in the group of patients infected with the 501Y.V2 variant (30.6%) than in the group of patients infected with the original strain (19.4%, P = 0.04). Conclusion In Reunion Island, where SARS-CoV-2 incidence remained low until February 2021 and the health care system was never saturated, mortality was higher in patients with ARF infected with the 501Y.V2 variant than in patients infected with the original strain.

scholarly journals Prognosis of Critically Ill Patients with Acute Respiratory Failure Due to the SARS-CoV-2 501Y.V2 Variant: A Multicenter Retrospective Matched Cohort Study

2021 ◽  
Author(s):  
bérénice Puech ◽  
Antoine legrand ◽  
Olivier Simon ◽  
Chloe Combe ◽  
marie-christine jaffarbandjee ◽  
...  
Keyword(s):  
Cohort Study ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Invasive Mechanical Ventilation ◽  
University Hospital ◽  
Original Strain ◽  
Reunion Island ◽  
Matched Cohort ◽  
Matched Cohort Study ◽  
Réunion Island

Abstract Background: The aim of this study was to compare the prognosis of patients with acute respiratory failure (ARF) due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant 501Y.V2 to that of patients with ARF due to the original strain. Methods: This retrospective matched cohort study included all consecutive patients who were hospitalized for ARF due to SARS-CoV-2 in Reunion Island University Hospital between March 2020 and March 2021. Twenty-eight in hospital mortality was evaluated before and after matching.Results: A total of 218 patients with ARF due to SARS-CoV-2 were enrolled in the study. Of these, 83 (38.1%) were infected with the 501Y.V2 variant. During intensive care unit stay, 104 (47.7%) patients received invasive mechanical ventilation and 20 (9.2%) patients were supported by venovenous extracorporeal membrane oxygenation. Patients infected with the 501Y.V2 variant were younger (58 [51-68] vs. 67 [56-74] years old, P=0.003), had less hypertension (54.2% vs 68.1%, P=0.04), and had less chronic kidney disease (13.3% vs. 31.9%, P=0.002) than patients infected with the original strain. After controlling for confounding variables (62 matched patients in each group), 28-day mortality was higher in the group of patients infected with the 501Y.V2 variant (30.6%) than in the group of patients infected with the original strain (19.4%, P=0.04).Conclusion: In Reunion Island, where SARS-CoV-2 incidence remained low until February 2021 and the health care system was never saturated, mortality was higher in patients with ARF infected with the 501Y.V2 variant than in patients infected with the original strain.

scholarly journals Ruxolitinib versus dexamethasone in hospitalized adults with COVID-19: multicenter matched cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
O. V. Stanevich ◽  
D. S. Fomina ◽  
I. G. Bakulin ◽  
S. I. Galeev ◽  
E. A. Bakin ◽  
...  
Keyword(s):  
Cohort Study ◽  
Respiratory Failure ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Hospitalized Patients ◽  
High Fever ◽  
Cytokine Therapy ◽  
Fatality Rate ◽  
Matched Cohort ◽  
Matched Cohort Study

Abstract Background Several anti-cytokine therapies were tested in the randomized trials in hospitalized patients with severe acute respiratory syndrome coronavirus 2 infection (COVID-19). Previously, dexamethasone demonstrated a reduction of case-fatality rate in hospitalized patients with respiratory failure. In this matched control study we compared dexamethasone to a Janus kinase inhibitor, ruxolitinib. Methods The matched cohort study included 146 hospitalized patients with COVID-19 and oxygen support requirement. The control group was selected 1:1 from 1355 dexamethasone-treated patients and was matched by main clinical and laboratory parameters predicting survival. Recruitment period was April 7, 2020 through September 9, 2020. Results Ruxolitinib treatment in the general cohort of patients was associated with case-fatality rate similar to dexamethasone treatment: 9.6% (95% CI [4.6–14.6%]) vs 13.0% (95% CI [7.5–18.5%]) respectively (p = 0.35, OR = 0.71, 95% CI [0.31–1.57]). Median time to discharge without oxygen support requirement was also not different between these groups: 13 vs. 11 days (p = 0.13). Subgroup analysis without adjustment for multiple comparisons demonstrated a reduced case-fatality rate in ruxolitnib-treated patients with a high fever (≥ 38.5 °C) (OR 0.33, 95% CI [0.11–1.00]). Except higher incidence of grade 1 thrombocytopenia (37% vs 23%, p = 0.042), ruxolitinib therapy was associated with a better safety profile due to a reduced rate of severe cardiovascular adverse events (6.8% vs 15%, p = 0.025). For 32 patients from ruxolitinib group (21.9%) with ongoing progression of respiratory failure after 72 h of treatment, additional anti-cytokine therapy was prescribed (8–16 mg dexamethasone). Conclusions Ruxolitinib may be an alternative initial anti-cytokine therapy with comparable effectiveness in patients with potential risks of steroid administration. Patients with a high fever (≥ 38.5 °C) at admission may potentially benefit from ruxolitinib administration. Trial registration The Ruxolitinib Managed Access Program (MAP) for Patients Diagnosed With Severe/Very Severe COVID-19 Illness NCT04337359, CINC424A2001M, registered April, 7, 2020. First participant was recruited after registration date

scholarly journals Distinguishing non severe cases of dengue from COVID-19 in the context of co-epidemics: a cohort study in a SARS-CoV-2 testing center on Reunion island

2020 ◽  
Author(s):  
Antoine Joubert ◽  
Fanny Andry ◽  
Antoine Bertolotti ◽  
Frédéric Accot ◽  
Yatrika Koumar ◽  
...  
Keyword(s):  
Cohort Study ◽  
Multinomial Logistic Regression ◽  
University Hospital ◽  
Severe Dengue ◽  
Delayed Presentation ◽  
Reunion Island ◽  
Orbital Pain ◽  
Réunion Island ◽  
Testing Center ◽  
Body Ache

AbstractBackgroundAs coronavirus (COVID-19) is spreading globally, several countries are handling dengue epidemics. As both infections are deemed to share similarities at presentation, it would be useful to distinguish COVID-19 from dengue in the context of co-epidemics. In this aim, we performed a cohort study to identify predictors of both infections.MethodsAll the subjects suspected of COVID-19 between March 23 and May 10, 2020, were screened for COVID-19 within the testing center of the University hospital of Saint-Pierre, Reunion island. The screening consisted in a questionnaire surveyed in face-to-face, a nasopharyngeal swab specimen for the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) reverse transcription polymerase chain-reaction and a rapid diagnostic orientation test for dengue. Factors independently associated with COVID-19 or with dengue were sought using multinomial logistic regression models, taking other febrile illnesses (OFIs) as controls.ResultsOver a two-month study period, we identified among 80 COVID-19, 60 non-severe dengue and 872 OFIs cases, delayed presentation (>3 days) since symptom onset (Odds ratio 1.89, 95% confidence interval 1.4-3.40), contact with a COVID-19 positive case (OR 3.81, 95%CI 2.12-6.82) and anosmia (OR 8.27, 95%CI 4.39-15.54) as independent predictors of COVID-19, body ache (OR 6.83, 95%CI 2.84-16.41), headache (OR 5.38, 95%CI 1.81-15.94) and retro-orbital pain (OR 7.45, 95%CI 3.17-17.50) as independent predictors of dengue, while smoking was less likely observed with COVID-19 (OR 0.27, 95%CI 0.10-0.74).ConclusionsAlthough prone to potential biases, these data suggest that non-severe dengue may be more symptomatic than COVID-19 in a co-epidemic setting with higher dengue attack rates.40-word summary of the article’s main pointIn the COVID-19 dengue co-epidemic setting of Reunion island, dengue was found more symptomatic than COVID-19 and associated with body ache, headache and retro-orbital pain, while COVID-19 was found associated with contact, anosmia, delayed presentation and absence of active smoking.

scholarly journals Distinguishing non severe cases of dengue from COVID-19 in the context of co-epidemics: A cohort study in a SARS-CoV-2 testing center on Reunion island

2021 ◽  
Vol 15 (4) ◽  
pp. e0008879
Author(s):  
Antoine Joubert ◽  
Fanny Andry ◽  
Antoine Bertolotti ◽  
Frédéric Accot ◽  
Yatrika Koumar ◽  
...  
Keyword(s):  
Cohort Study ◽  
Multinomial Logistic Regression ◽  
University Hospital ◽  
Severe Dengue ◽  
Nasopharyngeal Swab ◽  
Delayed Presentation ◽  
Reunion Island ◽  
Upper Respiratory Tract ◽  
Réunion Island ◽  
Testing Center

Background As coronavirus 2019 (COVID-19) is spreading globally, several countries are handling dengue epidemics. As both infections are deemed to share similarities at presentation, it would be useful to distinguish COVID-19 from dengue in the context of co-epidemics. Hence, we performed a retrospective cohort study to identify predictors of both infections. Methodology/Principal findings All the subjects suspected of COVID-19 between March 23 and May 10, 2020, were screened for COVID-19 within the testing center of the University hospital of Saint-Pierre, Reunion island. The screening consisted in a questionnaire surveyed in face-to-face, a nasopharyngeal swab specimen for the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) reverse transcription polymerase chain-reaction and a rapid diagnostic orientation test for dengue. Factors independently associated with COVID-19 or with dengue were sought using multinomial logistic regression models, taking other febrile illnesses (OFIs) as controls. Adjusted Odds ratios (OR) and 95% Confidence Intervals (95%CI) were assessed. Over a two-month study period, we diagnosed 80 COVID-19, 61 non-severe dengue and 872 OFIs cases eligible to multivariate analysis. Among these, we identified delayed presentation (>3 days) since symptom onset (Odds ratio 1.91, 95% confidence interval 1.07–3.39), contact with a COVID-19 positive case (OR 3.81, 95%CI 2.21–6.55) and anosmia (OR 7.80, 95%CI 4.20–14.49) as independent predictors of COVID-19, body ache (OR 6.17, 95%CI 2.69–14.14), headache (OR 5.03, 95%CI 1.88–13.44) and retro-orbital pain (OR 5.55, 95%CI 2.51–12.28) as independent predictors of dengue, while smoking was less likely observed with COVID-19 (OR 0.27, 95%CI 0.09–0.79) and upper respiratory tract infection symptoms were associated with OFIs. Conclusions/Significance Although prone to potential biases, these data suggest that non-severe dengue may be more symptomatic than COVID-19 in a co-epidemic setting with higher dengue attack rates. At clinical presentation, nine basic clinical and epidemiological indicators may help to distinguish COVID-19 or dengue from each other and other febrile illnesses.

scholarly journals Emergency air evacuation of patients with acute respiratory failure due to SARS-CoV-2 from Mayotte to Reunion Island

Medicine ◽  
2021 ◽  
Vol 100 (48) ◽  
pp. e27881
Author(s):  
Hamza Berguigua ◽  
Ludovic Iche ◽  
Philippe Roche ◽  
Cyril Aubert ◽  
Renaud Blondé ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Reunion Island ◽  
Réunion Island

scholarly journals Mode of conception in relation to nausea and vomiting of pregnancy: a nested matched cohort study in Sweden

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Farnaz Bazargani ◽  
S. I. Iliadis ◽  
E. Elenis
Keyword(s):  
Cohort Study ◽  
Large Scale ◽  
Nausea And Vomiting ◽  
University Hospital ◽  
Matched Cohort ◽  
Chi Square ◽  
Study Objective ◽  
Matched Cohort Study ◽  
Chi Square Test

AbstractNausea and vomiting of pregnancy (NVP) is a common condition reported however inconclusively among pregnancies after assisted conception. The study objective was thus to explore whether NVP is associated to mode of conception or other in vitro fertilization (IVF)-related variables. This nested matched cohort study, originating from the BASIC-project, was conducted at the Uppsala University Hospital in Sweden between 2010 and 2016. IVF pregnancies (n = 210) and age and parity-matched women with spontaneous pregnancies (n = 420) comprised the study sample. The study outcome was self-reported NVP at gestational week 17. IVF treatment and pregnancy data were obtained after scrutinization of the medical records. NVP with or without medications was not associated with mode of conception (chi-square test, p = 0.889), even after adjusting for potential confounders. In a subgroup analysis among IVF pregnancies, NVP without medication was more frequently seen in the group who received cleavage stage embryos vs blastocysts (chi-square test, p = 0.019), exhibiting a marginally significant but strongly increased effect even after adjustment [crude RRR 3.82 (95% CI 1.23–11.92) and adjusted RRR 3.42 (95% CI 0.96–12.11)]. No difference in the rate of NVP with or without medication between women that underwent fresh and frozen/thawed embryo transfers as well as IVF or ICSI was observed. Conception through IVF is not associated with NVP. Transfer of a blastocyst may decrease the risk of developing NVP and further, large-scale prospective studies are required to validate this finding.

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