Clinical Features of 85 Fatal Cases of COVID-19 from Wuhan: A Retrospective Observational Study

2020 ◽  
Author(s):  
Yingzhen Du ◽  
Lei Tu ◽  
Pingjun Zhu ◽  
Mi Mu ◽  
Runsheng Wang ◽  
...  
Keyword(s):  
Observational Study ◽  
Clinical Features ◽  
Retrospective Observational Study

scholarly journals Hospitalised COVID-19 patients of the Mount Sinai Health System: a retrospective observational study using the electronic medical records

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e040441 ◽  
Author(s):  
Zichen Wang ◽  
Amanda Zheutlin ◽  
Yu-Han Kao ◽  
Kristin Ayers ◽  
Susan Gross ◽  
...  
Keyword(s):  
Observational Study ◽  
Health System ◽  
Clinical Features ◽  
White Cell Count ◽  
Tertiary Care ◽  
Significant Risk ◽  
Retrospective Observational Study ◽  
Markers Of Inflammation ◽  
Hospitalised Patients ◽  
Mount Sinai

ObjectiveTo assess association of clinical features on COVID-19 patient outcomes.DesignRetrospective observational study using electronic medical record data.SettingFive member hospitals from the Mount Sinai Health System in New York City (NYC).Participants28 336 patients tested for SARS-CoV-2 from 24 February 2020 to 15 April 2020, including 6158 laboratory-confirmed COVID-19 cases.Main outcomes and measuresPositive test rates and in-hospital mortality were assessed for different racial groups. Among positive cases admitted to the hospital (N=3273), we estimated HR for both discharge and death across various explanatory variables, including patient demographics, hospital site and unit, smoking status, vital signs, lab results and comorbidities.ResultsHispanics (29%) and African Americans (25%) had disproportionately high positive case rates relative to their representation in the overall NYC population (p<0.05); however, no differences in mortality rates were observed in hospitalised patients based on race. Outcomes differed significantly between hospitals (Gray’s T=248.9; p<0.05), reflecting differences in average baseline age and underlying comorbidities. Significant risk factors for mortality included age (HR 1.05, 95% CI 1.04 to 1.06; p=1.15e-32), oxygen saturation (HR 0.985, 95% CI 0.982 to 0.988; p=1.57e-17), care in intensive care unit areas (HR 1.58, 95% CI 1.29 to 1.92; p=7.81e-6) and elevated creatinine (HR 1.75, 95% CI 1.47 to 2.10; p=7.48e-10), white cell count (HR 1.02, 95% CI 1.01 to 1.04; p=8.4e-3) and body mass index (BMI) (HR 1.02, 95% CI 1.00 to 1.03; p=1.09e-2). Deceased patients were more likely to have elevated markers of inflammation.ConclusionsWhile race was associated with higher risk of infection, we did not find racial disparities in inpatient mortality suggesting that outcomes in a single tertiary care health system are comparable across races. In addition, we identified key clinical features associated with reduced mortality and discharge. These findings could help to identify which COVID-19 patients are at greatest risk of a severe infection response and predict survival.

scholarly journals Clinical profile of congenital hypothyroidism identified through new-born screening: a retrospective observational study

2020 ◽  
Vol 7 (10) ◽  
pp. 1968
Author(s):  
Sudhakar Palanisamy ◽  
Ramesh Srinivasan
Keyword(s):  
Observational Study ◽  
Clinical Features ◽  
Congenital Hypothyroidism ◽  
Screening Program ◽  
Tertiary Care ◽  
Growth Patterns ◽  
Retrospective Observational Study ◽  
Care Hospital ◽  
Common Etiology

Background: Congenital hypothyroidism is one of the most common preventable causes of mental retardation. The incidence and etiology of congenital hypothyroidism varies significantly across the globe.Methods: In this retrospective observational study we aimed to find out the incidence and etiology of congenital hypothyroidism identified by neonatal screening program. We included all neonates who had their thyroid stimulating hormone screening done in a tertiary care hospital of South India between January 2014 and June 2020 and were diagnosed as a case of congenital hypothyroidism. The growth patterns, clinical features, thyroxine dose requirement during follow-up were also studied.Results: There were 23 babies diagnosed with congenital hypothyroidism during the study period. The incidence rate was 1 in 917 live births for inborn babies, and dyshormogenesis (60%) was the most common etiology. Two babies had clinical features associated with congenital hypothyroidism. None of the babies had clinical features of congenital hypothyroidism during follow-up and their growth & development were normal for age. Babies who required dose increments of thyroxine supplement turned out to be permanent congenital hypothyroidism. Conclusion: Incidence of congenital hypothyroidism was high in our population. Dyshormogenesis was the most common etiology. Majority of congenital hypothyroidism babies were asymptomatic at diagnosis, so screening is a vital tool for early diagnosis. Babies who required thyroxine dose increment with age tend to be permanent congenital hypothyroidism.

scholarly journals Clinical features and outcomes of prolonged mechanical ventilation: a single-center retrospective observational study

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Isao Nagata ◽  
Tetsuhiro Takei ◽  
Junji Hatakeyama ◽  
Masafumi Toh ◽  
Hiroyuki Yamada ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Observational Study ◽  
Clinical Features ◽  
Prolonged Mechanical Ventilation ◽  
Tertiary Care ◽  
Extended Period ◽  
Nationwide Survey ◽  
Retrospective Observational Study ◽  
Multivariable Logistic Regression Analysis ◽  
Care Hospital

Abstract Background Information on epidemiology of prolonged mechanical ventilation (PMV) patients in the acute care setting in Japan is totally lacking. We aimed to investigate clinical features, impact, and long-term outcomes of PMV patients. Methods This was a retrospective observational study conducted in a tertiary care hospital. Adult patients who were admitted to our intensive care unit (ICU) from April 2009 to March 2014 and required mechanical ventilation (MV) for ≥ 2 days were included. PMV was defined as having MV for ≥ 21 consecutive days. Results Among 1282 MV patients, 93 (7.3%) required PMV, and median duration of MV was 37.0 days. Compared with the non-PMV patients, PMV patients had longer total ICU and high care unit (HCU) stay (34.0 vs. 7.0 days, p < 0.001), longer hospital stay (74.0 vs. 35.0 days, p < 0.001), and higher hospital mortality (54.8 vs. 21.4%, p < 0.001). In multivariable logistic regression analysis, emergency ICU admission and steroid use during MV were associated with PMV. The Kaplan–Meier curves for MV withdrawal and ICU/HCU discharge were almost identical. Among PMV patients, 52 (55.9%) died, 29 (31.2%) were successfully liberated from MV during hospitalization, and 12 (12.9%) still required MV at discharge. Conclusion In this investigation, 7.3% of the patients with MV required PMV. Most PMV patients were liberated from MV during hospitalization, while occupying critical care beds for an extended period. A nationwide survey is required to further elucidate the overall picture of PMV patients and to discuss whether specialized weaning centers to treat PMV patients are required in Japan.

scholarly journals Clinical Features of 85 Fatal Cases of COVID-19 from Wuhan. A Retrospective Observational Study

2020 ◽  
Vol 201 (11) ◽  
pp. 1372-1379 ◽  
Author(s):  
Yingzhen Du ◽  
Lei Tu ◽  
Pingjun Zhu ◽  
Mi Mu ◽  
Runsheng Wang ◽  
...  
Keyword(s):  
Observational Study ◽  
Clinical Features ◽  
Retrospective Observational Study

scholarly journals Clinical Features, Inpatient Trajectories and Frailty in Older Inpatients With COVID-19: A Retrospective Observational Study.

2021 ◽  
Author(s):  
Christopher N Osuafor ◽  
Catriona Davidson ◽  
Alistair J Mackett ◽  
Marie Goujon ◽  
Lelane Van Der Poel ◽  
...  
Keyword(s):  
Older Adults ◽  
Observational Study ◽  
Clinical Features ◽  
Proportional Hazards ◽  
Patient Characteristics ◽  
Cox Proportional Hazards ◽  
University Hospital ◽  
Retrospective Observational Study ◽  
Clinical Frailty Scale ◽  
Frail Patients

Introduction: We describe the clinical features and inpatient trajectories of older adults hospitalized with COVID-19, and explore relationships with frailty. Methods: This retrospective observational study included older adults admitted as an emergency to a University Hospital who were diagnosed with COVID-19. Patient characteristics and hospital outcomes, primarily inpatient death or death within 14 days of discharge, were described for the whole cohort and by frailty status. Associations with mortality were further evaluated using Cox Proportional Hazards Regression (Hazard Ratio [HR], 95% Confidence Interval). Results: 214 patients (94 women) were included of whom 142 (66.4%) were frail with a median Clinical Frailty Scale (CFS) score of 6. Frail compared to non-frail patients were more likely to present with atypical symptoms including new or worsening confusion (45.1% vs 20.8%, p&lt;0.001) and were more likely to die (66% vs 16%, p=0.001). Older age, being male, presenting with high illness acuity and high frailty were independent predictors of death and a dose-response association between frailty and mortality was observed (CFS 1-4: reference; CFS 5-6: HR 1.78, 95% CI 0.90, 3.53; CFS 7-8: HR 2.57, 95% CI 1.26, 5.24). Conclusions: Clinicians should have a low threshold for testing for COVID-19 in older and frail patients during periods of community viral transmission and diagnosis should prompt early advanced care planning.

scholarly journals Clinical features and inpatient trajectories of older inpatients with COVID-19: a retrospective observational study.

2020 ◽  
Author(s):  
Christopher N Osuafor ◽  
Catriona Davidson ◽  
Alistair J Mackett ◽  
Marie Goujon ◽  
Lelane Van Der Poel ◽  
...  
Keyword(s):  
Older Adults ◽  
Observational Study ◽  
Clinical Features ◽  
University Hospital ◽  
Retrospective Observational Study ◽  
Clinical Frailty Scale ◽  
Atypical Symptoms ◽  
Risk Of Death ◽  
Frail Patients ◽  
Older Inpatients

Abstract Background: A comprehensive description of the clinical characteristics, inpatient trajectory and relationship with frailty of older inpatients admitted with COVID-19 is essential in the management of older adults during the COVID-19 pandemic. The aim of this study was to describe the clinical features and inpatient trajectory of older inpatients with confirmed COVID -19.Methods: This was a retrospective observational study of hospitalised older adults. Subjects include unscheduled medical admissions of older inpatients to a University Hospital with laboratory and clinically confirmed COVID-19. The primary outcome was death during the inpatient stay or within 14 days of discharge after a maximum follow up time of 45 days. The characteristics of the cohort were described in detail as a whole and by frailty status.Results: 214 patients were included in this study with a mean length of stay of 11 days (Range 6 to 18 days), of whom 140 (65.4%) patients were discharged and 74 (34.6%) patients died in hospital. 142 (66.4%) patients were frail with median Clinical Frailty Scale (CFS) score of 6. Frail patients were more likely to present with atypical symptoms including new or worsening confusion compared to non-frail patients (20.8% vs 45.1%, p<0.001) and were more likely to die in hospital or within 14 days of discharge (66% vs 16%, p=0.001). Older age, being male, presenting with high illness acuity and high frailty were all independently associated with higher risk of death and a dose response association between higher frailty and higher mortality was observed.Conclusions: Older adult inpatients with COVID-19 infection are likely to present with atypical symptoms, experience delirium and have a high mortality, especially if they are also living with frailty. Clinicians should have a low threshold for testing for COVID-19 in older and frail patients presenting to hospital as an emergency during periods when there is community transmission of COVID-19 and, when diagnosed, this should prompt early advanced care planning with the patient and family.

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