scholarly journals Clinical Characteristics And Analysis Of Risk Factors For Disease Progression Of COVID-19 Among Patients Within Wad Medani Isolation Centers, Gezira State: A Prospective Cohort Study From Sudan

Author(s):  
Mohammed Yousif Elnaeem Yousif ◽  
Moh.Mah.Fadel Allah Eljack ◽  
Osman Amir ◽  
Mohammed Alfatih ◽  
Akram Khalid Al Tigany Al Shiekh ◽  
...  

Abstract Background : (COVID-19) had a great impact on the world’s health systems since December 2019. A little is known about the clinical characteristics and risk factors associated with COVID-19 severity in Sudanese Patients; therefor it is necessary to summarize the clinical characteristics of patients with COVID-19 and to explore the risk factors associated with COVID-19 severity. Methods : A one-year retrospective cohort study (May 2020- May2021) was done at three isolation centers in Wad Medani. Sample contained all COVID-19 patients who are over 18 years old and were confirmed to be COVID-19 by nucleic acid testing or features Suggestive of Covid19 on Chest CT scan. Results : This study included 418 patients confirmed COVID-19 cases with a median age of 66.3±13years. 179 (64.2%) patients were men. Hypertension (n=195; 46.7%) and diabetes (n=187; 44.7%) were the most common comorbidities. The most common symptoms at COVID-19 onset were fever (n=303; 72.5%), cough (n=278; 66.5%) and dyspnea (n= 256; 61.2%). the overall mortality rate was 35.4% (n=148). The morality rate was 42.3% (n=118) among patients with severe disease. The Chi-square test and ANOVA analysis revealed that older age, anemia, neutrophilia and lymphcytopenia, higher glucose levels, HbA1c levels and creatinine levels were variables associated with severe COVID-19. In inflammatory markers, the levels of CRP and d-dimer were elevated in severe infection more than moderate and mild infections. Conclusion : Patients with these factors are more likely to deteriorate into severe infection and have higher mortality rate than those without these factors.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Miao Li ◽  
Xiao-Hua Han ◽  
Li-Yun Liu ◽  
Hui-Sheng Yao ◽  
Li-Li Yi

Abstract Background Atopy may be associated with disease severity and a poor prognosis of human adenovirus (HAdV) pneumonia in children. Our aim was to observe the clinical characteristics and pulmonary radiological changes in children with atopy and HAdV pneumonia in China. Methods Children hospitalised with HAdV pneumonia from June 2018 to December 2019 were analysed. All children were divided into atopic with HAdV, non-atopic with HAdV, and atopic without HAdV infection group. Each group was further divided into the mild and severe pneumonia groups according to disease severity. Standard treatment was initiated after admission, and regular follow-up evaluations were conducted at 1 month after discharge. Baseline and clinical characteristics and pulmonary radiological changes in children with and without atopy were evaluated. Risk factors associated with small airway lesions in patients with HAdV pneumonia were analysed. Results The eosinophil count in the atopic group was significantly higher than that in the non-atopic group (P < 0.05). Severe coughing, wheezing, and small airway lesions on chest high-resolution computed tomography (HRCT) upon admission, after discharge and 1 month after discharge were significantly higher in the atopic group (with or without HAdV infection) than in the non-atopic group (P < 0.05). There were significant differences in the number of patients with wheezing and small airway lesions during hospitalisation and after discharge among the three groups (P < 0.05). The risks of small airway lesions in children with a family or personal history of asthma, severe infection, atopy, and HAdV infection were 2.1-, 2.7-, 1.9-, 2.1-, and 1.4-times higher than those in children without these characteristics, respectively. Conclusions Children with atopy and HAdV pneumonia may experience severe coughing in mild cases and wheezing in mild and severe cases. Children with atopy are more susceptible to the development of small airway lesions, recurrent wheezing after discharge and slower recovery of small airway lesions as observed on pulmonary imaging than non-atopic children after HAdV infection. A family or personal history of asthma, atopy, severe infection, and HAdV infection are independent risk factors associated with the development of small airway lesion as observed on chest HRCT.


2021 ◽  
Vol 11 (5) ◽  
pp. 74-81
Author(s):  
Ayushi Rajkumar Jain ◽  
Doss Prakash ◽  
Sheetal Swamy

The alarming statistics of COVID-19 surges up in 2021 throwing an enormous burden on the healthcare system across the world. According to WHO reports on 14th April 2021, globally 136,996,364 confirmed COVID-19 cases are reported across the continents, including 2,951,832 deaths. The state of Maharashtra reported the maximum number of cases of India including high mortality rate. This study was conducted to identify and describe the relation of different predictors (Age, gender, duration of hospital stay, presence of co morbidities) of mortality among the COVID-19 deceased patients by retrospectively analyzing the medical case records of 121 patients from a dedicated COVID hospital at Aurangabad from July 2020 to December 2020. Chi-square test was performed to assess the association between causes of death with different cluster of variables and their significance. This study helps us to identify risk factors that show association between various predictors and mortality rate in COVID-19 patients. Out of 121 deaths, 96 (79%) were male, 61 (49.6%) were in age group between 60-79 years, ARDS was one of the major complication in the deceased patients accounting 29.8% and cardio respiratory arrest was the common cause of death among the deceased patients with 85%. It was also observed that mortality rate was very higher in the initial five days of hospitalization with critical care support. Our result findings provide clinical inferences for physicians to identify high-risk factors with COVID-19 at a very early stage. Key words: COVID-19, Mortality rate, Demographic predictors, Co-morbidities, Cardio respiratory arrest.


2020 ◽  
Vol 2 (4) ◽  
Author(s):  
David T Myemba ◽  
George M Bwire ◽  
Godfrey Sambayi ◽  
Betty A Maganda ◽  
Belinda J Njiro ◽  
...  

Abstract Background In Tanzania more than 28% of all multi-drug resistant tuberculosis (MDR-TB) cases occur in Dar es Salaam. However, information about management and clinical outcomes of patients with MDR-TB in the region is scarce, and hence the need for this study. Methods A 5-year retrospective cohort study was conducted in six centres in Dar es Salaam. Descriptive statistics were used to summarize social demographics and clinical characteristics. Associations between occurrence of adverse events, regimen change and cure were determined using the Chi-square test whereas factors associated with mortality were determined using the Log-ranking test and Cox regression model. Results Three-hundred patient files were found and reviewed. The majority were male 199 (66.3%), aged 25–44 years [176 (58.7%)] and 89 (30.1%) were HIV co-infected. 186 (62%) completed their treatment, 68 (22.0%) were on treatment and 9 (3.3%) were lost to follow-up. The majority, 152 (51.0%) were managed using long MDR-TB regimens. The overall mortality rate was 5.7 per 1000 MDR-TB patients. A higher mortality rate was associated with being ≥45 years [adjusted hazard ratio (AHR): 10.82, 95% CI: 1.14–102.74, P = 0.038), female (AHR: 5.92, 95% CI: 1.75–20.08, P = 0.004), on a short anti-TB regimen (AHR: 4.34, 95% CI: 1.41–13.35, P = 0.010), HIV co-infected [crude hazard ratio (CHR): 2.56, 95% CI: 1.01–6.50, P = 0.048), on concomitant long-term medication use (CHR: 2.99, 95% CI: 1.17–7.64, P = 0.022) and having other co-morbidities (CHR: 3.45, 95% CI: 1.32–9.02, P = 0.011). Conclusions MDR-TB mortality was associated with short anti-TB regimens, sex, age, concomitant long-term medication use and HIV coinfection. In this population, use of long and individualized regimens is recommended.


2018 ◽  
Vol 5 (8) ◽  
pp. 2899
Author(s):  
Prashanta Swami Pujar ◽  
K. B. Phuleker ◽  
Nagaraj Bhalki

Background: Prevention of Surgical site infection (SSI) remains a focus of attention because wound infections continue to be a major source of expense, morbidity, and even mortality. Three quarters of deaths of surgical patients with SSIs are attributed to nosocomial infections, nearly all of which are organ/space infections. The objective of the present study was to estimate the incidence of SSI and to study the various risk factors associated with SSI.Methods: This is a prospective study of 180 eligible cases eligible subjects, who underwent various surgeries in the department of General Surgery after applying inclusion and exclusion criteria. The study conducted at the Navodaya Medical College Hospital and Research Centre, Raichur. The tenure for the study was April 2017 to June 2017. Data was collected using pretested proforma. Data was analysed using SPSS version 16. Chi -square test and multiple logistic regression was applied to know the association between various risk factors and occurrence of SSI.Results: Among 180 patients 33 (18.33%) developed surgical site infections (SSI). Among 33 SSIs 25 (75.76%) were grade 3 and 8 (24.24%) were grade 4 infections. SSIs were found more commonly among patients over 50 years, diabetics, HIV infected patients, patients with longer duration of surgery and associations with these factors were found statistically significant.Conclusions: The incidence rate of SSI was quite high, and its end results will have a greater impact on patients as well as on healthcare systems. Prevention of SSI requires multipronged approach targeting both patient related and procedure related risk factors in pre- operative, intra-operative, and post-operative period.


2019 ◽  
Vol 19 (1) ◽  
pp. 63-70
Author(s):  
Cristiane de Souza Gonçalves ◽  
Juraci Almeida Cesar ◽  
Luana Patrícia Marmitt ◽  
Carla Vitola Gonçalves

Abstract Objectives: to identify the frequency and factors associated with the non-realization of puerperal consultations in women resident of a medium-sized municipality in Brazil. Methods: a prospective cohort study based on data collected in two time points, the first 48h and after the 42nd day post-childbirth. In order to analyze data, proportions were compared using the chi-square test, and the adjusted analysis was performed using Poisson regression, according to a predetermined hierarchical model. Significance level was set at 5%. Results: of the 572 women included in the study, 24.8% did not perform puerperal consul-tations. The factors associated with the non-realization of puerperal consultations were: lower income (1 st tercile PR= 2.01; CI95%= 1.21-3.33 – 2 nd tercile PR= 1.94; CI95%=1.17-3.20) and schooling (≤ 8 years PR= 2.00; CI95%= 1.24-3.24), comorbidities during preg-nancy (PR= 1.45; CI95%= 1.01-2.09), realization of antenatal care in the public service (PR= 1.74; CI95%= 1.18-2.58) and non-use of contraceptive methods (PR= 3.10; CI95%=1.86-5.16). Conclusions: puerperal revision does not seem to be valued in the antenatal care, mainly in the public health system. An important inequality was identified in the provision of this service, since women more prone to recurring pregnancy and with lower income and schooling were the ones that least returned to the puerperal consultation.


2021 ◽  
Vol 51 (8) ◽  
Author(s):  
Ana Carolina Nunes de Morais ◽  
Danielle Regis Pires ◽  
Nathalie Costa da Cunha ◽  
Leandro dos Santos Machado ◽  
Michel Abdalla Helayel ◽  
...  

ABSTRACT: Bacteria of Mollicutes Class are associated with intramammary infection and decrease in milk production. This study investigated the occurrence of Mollicutes and elucidated their risk factors in dairy herds from Southeast Brazil. For this, milk samples from 387 lactation cows from Minas Gerais, Rio de Janeiro and São Paulo States were subjected to the polymerase chain reaction (PCR) to detect Mollicutes. Species of Mycoplasma were investigated in Mollicutes positive samples by PCR, including Mycoplasma bovis, M. alkalescens, M. bovigenitalium, M. bovirhinis, M. arginini and A. laidlawii. An epidemiological questionnaire was applied to collect data on possible risk factors, which were assessed using Pearson’s Chi-square test followed by odds ratio (P≤0.05). Mollicutes were reported in 21% (4/19) of the herds and 4% (16/387) of the animals, while 1% (5/387) were positive for M. bovis and 3% (11/387) for M. arginini. All samples were negative to the other agents. Herds with more than 150 animals [OR=3.51 (95% CI 1.11-11.08)], manual milking [OR=9.97 (95% CI 2.80-35.49)] and not-milking animals with mastitis last [OR=6.54 (95% CI 1.92-22.29)] were risk factors. The presence of these conditions may favor intramammary infection by Mollicutes in dairy herds from Southeast Brazil. This is the first report of M. bovis in Rio de Janeiro and M. arginini in the studied states.


PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241849
Author(s):  
Fernanda Raphael Escobar Gimenes ◽  
Flávia Fernanda Luchetti Rodrigues Baracioli ◽  
Adriane Pinto de Medeiros ◽  
Patricia Rezende do Prado ◽  
Janine Koepp ◽  
...  

Aims To identify the types of nasogastric/nasoenteric tube (NGT/NET)-related adverse events and to analyze the degree of harm and the factors associated with mechanical device-related complications. Materials and methods A prospective cohort study was conducted from October 2017 to April 2019 in seven Brazilian hospitals. Data from 447 adult patients with NGT/NET were collected through electronic forms. Three methods were used to assess the NGT/NET-related adverse events: (1) encouraging spontaneous reports; (2) regular visits to the wards; and (3) review of medical records. The events were classified as mechanical device-related complications and other events. The degree of harm was classified according to the World Health Organization’s International Classification for Patient Safety. Data were analyzed using the R program, version 3.5.3. The following tests were applied to identify associations between the explanatory and response variables: Cochran-Armitage Chi-Square test, Fisher’s exact test, and Linear-by-linear Chi-Square test. Logistic regression analysis was performed to verify the predictors of mechanical device-related complications. All analyses were performed considering a 5% significance level. Results 191 NGT/NET-related adverse events were identified in 116 patients; the majority were mechanical device-related complications and resulted in mild harm to the patient. At the moment of the event, patients had a mean of 3.27 comorbidities, were highly dependent on nursing care, with high risk of death and altered level of consciousness. There was no association between the degree of harm and the care complexity, disease severity or level of consciousness. Intensive care was the strongest predictor for mechanical device-related complications and critical patients had a four times greater likelihood of presenting this type of event when compared to patients receiving minimal care. Conclusion Intensive care patients should receive special attention as the complexity of care is an important predictor for mechanical device-related complications in tube fed patients.


2017 ◽  
Vol 4 (2) ◽  
Author(s):  
Carlos Víctor Hernández Ramírez ◽  
Soila Maribel Gaxiola Camacho ◽  
Ignacio Osuna Ramirez ◽  
Idalia Enríquez Verdugo ◽  
Nohemí Castro del Campo ◽  
...  

Veterinaria México OA ISSN: 2448-6760Cite this as:Hernández Ramírez CV, Gaxiola Camacho SM, Osuna Ramirez I, Enríquez Verdugo I, Castro del Campo N, López Moreno HS. Prevalence and risk factors associated with serovars of Leptospira in dogs from Culiacan, Sinaloa. Veterinaria México OA 2017;4(2).doi: 10.21753/vmoa.2.2.369Domestic dogs transmit Leptospira spp. to humans, and determining the health risk that they represent is of paramount importance. To determine the seroprevalence and main risk factors associated with serovars of Leptospira in dogs from Culiacan, Sinaloa, we obtained serum samples from 165 dogs. The samples were stored at -40 °C and were analysed by the microbiology laboratory at Centro Nacional de Sanidad Animal using the leptospirosis microscopic agglutination test. Additionally, a survey was performed to identify epidemiological risk factors, and statistical inference was determined using chi-square test, odd ratios, and logistic regression with a statistical significance set at P < 0.05. The prevalence of Leptospira was 9 % (15/165), and we identified seven serovars: canicola 17 (46 %), icterohaemorrhagiae (40 %), bratislava (40 %), grippotyphosa (33 %), shermani (33 %), pyrogenes (20 %) and ballum (13 %). Based on our epidemiological survey, the risk factors associated with the detection of antibodies against Leptospira include the permanent habitation of pets in courtyards (OR = 4.6, P < 0.05) and presence of water stored in drums and basins (OR = 3.25, P < 0.05). The prevalence of leptospirosis in dogs indicates that the disease is present in the city of Culiacan and that leptospiral antibodies in dogs increase in poor sanitary conditions with stored water, which increases the potential risk of infection for both humans and animals.Figure 1. Frequency of observed serovars of Leptospira


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S604-S605
Author(s):  
Evelyn Villacorta Cari ◽  
Nicole Leedy ◽  
Julie A Ribes ◽  
Jaime Soria ◽  
Thein Myint

Abstract Background Blastomycosis is an endemic dimorphic fungal infection caused by Blastomyces dermatitidis. The risk factors associated with severe presentation are not well defined. Methods Retrospective study of patients treated for blastomycosis at the University of Kentucky Hospital from 2004-2019. Statistical analyses were performed with STATA version 12.0 (College Station, Texas). Logistic regression was used to identify variables associated with severe infections. Results Among 82 patients, median age was 48 years old (range: 16 - 89); 66 (80.5%) were male and 71 (92.2%) were white, 25/77 (32.4%) were obese, 24 (29.2%) were diabetic, 21 (25.6%) had COPD, 26 (31.7%) had at least one immunosuppressive condition. The median duration of illness was 86 (3-365) days. 37 (45.1%) had cough and 35 (42.6%) had dyspnea 19 (23.1%) patients were treated in the ICU, 42 (51.3%) in non-ICU inpatient wards, and 21 (25.6%) in an outpatient setting. Cultures were obtained in 69 cases, 59 (85.5%) reported as positive, KOH stain positive in 30/61 (49.1%). Histopathology was positive in 48/66 (72.7%) samples. Urine Histoplasma or Blastomyces antigen was positive in 41/58 (70.6%), and Serum Histoplasma or Blastomyces antigen was positive in 22/34 (64.7%). Among 64 (78.0%) patients with pulmonary blastomycosis, acute and chronic pneumonia were 16 (25.0%) and 12 (18.7%) cases respectively, and nodular lung lesions were reported in 36 (56.2%). Initial antifungal treatment was amphotericin B liposomal in 38/80 (47.5%), overall mortality was 11 (13.4%). A multivariable analysis was performed to find predictors of severe blastomycosis infection, no association was seen with factors as male sex (IRR 1.96; 95%CI 0.84 – 4.55), and was confirmed that significant independent associated risk factors for severe infection were age older than 50 (IRR 3.5; 95%CI 1.42-8.83), obesity (IRR 3.1; 95% CI 1.41-6.87), diabetes (IRR 2.5; 95% CI 1.16-5.50), leukocytosis (IRR 1.03; 95%CI 1.00-1.07) and anemia (IRR 3.0; 95% CI 1.55-5.85). Conclusion Pulmonary Blastomycosis is the most common presentation. Culture and histopathology are more sensitive than antigen assay. Independent factors associated to severe disease were older age, obesity, diabetes, and anemia at admission. Disclosures All Authors: No reported disclosures


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