scholarly journals Statin Use and COVID-19 Infectivity and Severity in South Korea: Two Population-Based Nationwide Cohort Studies (Preprint)

2021 ◽  
Author(s):  
Seung Won Lee ◽  
So Young Kim ◽  
Sung Yong Moon ◽  
In Kyung Yoo ◽  
Eun-Gyong Yoo ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Stay ◽  
Clinical Outcomes ◽  
Length Of Hospital Stay ◽  
Population Based ◽  
Adjusted Relative Risk ◽  
Invasive Ventilation ◽  
Independent Population ◽  
Statin Use

BACKGROUND Basic studies suggest that statins as add-on therapy may benefit patients with COVID-19; however, real-world evidence of such a beneficial association is lacking. OBJECTIVE We investigated differences in SARS-CoV-2 test positivity and clinical outcomes of COVID-19 (composite endpoint: admission to intensive care unit, invasive ventilation, or death) between statin users and nonusers. METHODS Two independent population-based cohorts were analyzed, and we investigated the differences in SARS-CoV-2 test positivity and severe clinical outcomes of COVID-19, such as admission to the intensive care unit, invasive ventilation, or death, between statin users and nonusers. One group comprised an unmatched cohort of 214,207 patients who underwent SARS-CoV-2 testing from the Global Research Collaboration Project (GRCP)-COVID cohort, and the other group comprised an unmatched cohort of 74,866 patients who underwent SARS-CoV-2 testing from the National Health Insurance Service (NHIS)-COVID cohort. RESULTS The GRCP-COVID cohort with propensity score matching had 29,701 statin users and 29,701 matched nonusers. The SARS-CoV-2 test positivity rate was not associated with statin use (statin users, 2.82% [837/29,701]; nonusers, 2.65% [787/29,701]; adjusted relative risk [aRR] 0.97; 95% CI 0.88-1.07). Among patients with confirmed COVID-19 in the GRCP-COVID cohort, 804 were statin users and 1573 were matched nonusers. Statin users were associated with a decreased likelihood of severe clinical outcomes (statin users, 3.98% [32/804]; nonusers, 5.40% [85/1573]; aRR 0.62; 95% CI 0.41-0.91) and length of hospital stay (statin users, 23.8 days; nonusers, 26.3 days; adjusted mean difference –2.87; 95% CI –5.68 to –0.93) than nonusers. The results of the NHIS-COVID cohort were similar to the primary results of the GRCP-COVID cohort. CONCLUSIONS Our findings indicate that prior statin use is related to a decreased risk of worsening clinical outcomes of COVID-19 and length of hospital stay but not to that of SARS-CoV-2 infection.

scholarly journals Statin Use and COVID-19 Infectivity and Severity in South Korea: Two Population-Based Nationwide Cohort Studies

10.2196/29379 ◽  
2021 ◽  
Vol 7 (10) ◽  
pp. e29379
Author(s):  
Seung Won Lee ◽  
So Young Kim ◽  
Sung Yong Moon ◽  
In Kyung Yoo ◽  
Eun-Gyong Yoo ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Stay ◽  
Clinical Outcomes ◽  
Length Of Hospital Stay ◽  
Population Based ◽  
Adjusted Relative Risk ◽  
Invasive Ventilation ◽  
Independent Population ◽  
Statin Use

Background Basic studies suggest that statins as add-on therapy may benefit patients with COVID-19; however, real-world evidence of such a beneficial association is lacking. Objective We investigated differences in SARS-CoV-2 test positivity and clinical outcomes of COVID-19 (composite endpoint: admission to intensive care unit, invasive ventilation, or death) between statin users and nonusers. Methods Two independent population-based cohorts were analyzed, and we investigated the differences in SARS-CoV-2 test positivity and severe clinical outcomes of COVID-19, such as admission to the intensive care unit, invasive ventilation, or death, between statin users and nonusers. One group comprised an unmatched cohort of 214,207 patients who underwent SARS-CoV-2 testing from the Global Research Collaboration Project (GRCP)-COVID cohort, and the other group comprised an unmatched cohort of 74,866 patients who underwent SARS-CoV-2 testing from the National Health Insurance Service (NHIS)-COVID cohort. Results The GRCP-COVID cohort with propensity score matching had 29,701 statin users and 29,701 matched nonusers. The SARS-CoV-2 test positivity rate was not associated with statin use (statin users, 2.82% [837/29,701]; nonusers, 2.65% [787/29,701]; adjusted relative risk [aRR] 0.97; 95% CI 0.88-1.07). Among patients with confirmed COVID-19 in the GRCP-COVID cohort, 804 were statin users and 1573 were matched nonusers. Statin users were associated with a decreased likelihood of severe clinical outcomes (statin users, 3.98% [32/804]; nonusers, 5.40% [85/1573]; aRR 0.62; 95% CI 0.41-0.91) and length of hospital stay (statin users, 23.8 days; nonusers, 26.3 days; adjusted mean difference –2.87; 95% CI –5.68 to –0.93) than nonusers. The results of the NHIS-COVID cohort were similar to the primary results of the GRCP-COVID cohort. Conclusions Our findings indicate that prior statin use is related to a decreased risk of worsening clinical outcomes of COVID-19 and length of hospital stay but not to that of SARS-CoV-2 infection.

Lack of Association between Preoperative Statin Use and Respiratory and Neurologic Complications after Cardiac Surgery

2017 ◽  
Vol 126 (5) ◽  
pp. 799-809 ◽  
Author(s):  
Ryu Komatsu ◽  
Huseyin Oguz Yilmaz ◽  
Jing You ◽  
C. Allen Bashour ◽  
Shobana Rajan ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Odds Ratio ◽  
Hospital Length Of Stay ◽  
Neurologic Complications ◽  
Prolonged Ventilation ◽  
Statin Use

Abstract Background Statins may reduce the risk of pulmonary and neurologic complications after cardiac surgery. Methods The authors acquired data for adults who had coronary artery bypass graft, valve surgery, or combined procedures. The authors matched patients who took statins preoperatively to patients who did not. First, the authors assessed the association between preoperative statin use and the primary outcomes of prolonged ventilation (more than 24 h), pneumonia (positive cultures of sputum, transtracheal fluid, bronchial washings, and/or clinical findings consistent with the diagnosis of pneumonia), and in-hospital all-cause mortality, using logistic regressions. Second, the authors analyzed the collapsed composite of neurologic complications using logistic regression. Intensive care unit and hospital length of stay were evaluated with Cox proportional hazard models. Results Among 14,129 eligible patients, 6,642 patients were successfully matched. There was no significant association between preoperative statin use and prolonged ventilation (statin: 408/3,321 [12.3%] vs. nonstatin: 389/3,321 [11.7%]), pneumonia (44/3,321 [1.3%] vs. 54/3,321 [1.6%]), and in-hospital mortality (52/3,321 [1.6%] vs. 43/3,321 [1.3%]). The estimated odds ratio was 1.06 (98.3% CI, 0.88 to 1.27) for prolonged ventilation, 0.81 (0.50 to 1.32) for pneumonia, and 1.21 (0.74 to 1.99) for in-hospital mortality. Neurologic outcomes were not associated with preoperative statin use (53/3,321 [1.6%] vs. 56/3,321 [1.7%]), with an odds ratio of 0.95 (0.60 to 1.50). The length of intensive care unit and hospital stay was also not associated with preoperative statin use, with a hazard ratio of 1.04 (0.98 to 1.10) for length of hospital stay and 1.00 (0.94 to 1.06) for length of intensive care unit stay. Conclusions Preoperative statin use did not reduce pulmonary or neurologic complications after cardiac surgery.

The Impact of Resident Holdover Admissions on Length of Hospital Stay and Risk of Transfer to an Intensive Care Unit

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Deepshikha Charan Ashana ◽  
Vincent K. Chan ◽  
Sitaram Vangala ◽  
Douglas S. Bell
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
The Impact

scholarly journals Clinical and prognostic significance of emergency MRI findings in neck infections

2021 ◽  
Author(s):  
Jaakko Heikkinen ◽  
Janne Nurminen ◽  
Jarno Velhonoja ◽  
Heikki Irjala ◽  
Tatu Happonen ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Stay ◽  
Prognostic Significance ◽  
Length Of Hospital Stay ◽  
C Reactive Protein ◽  
Mri Findings ◽  
Neck Infection ◽  
Reactive Protein ◽  
Icu Treatment

Abstract Objectives Due to its superior soft-tissue contrast and ability to delineate abscesses, MRI has high diagnostic accuracy in neck infections. Whether MRI findings can predict the clinical course in these patients is unknown. The purpose of this study was to determine the clinical and prognostic significance of various MRI findings in emergency patients with acute neck infections. Materials and methods We retrospectively reviewed the 3-T MRI findings of 371 patients with acute neck infections from a 5-year period in a single tertiary emergency radiology department. We correlated various MRI findings, including retropharyngeal (RPE) and mediastinal edema (ME) and abscess diameter, to clinical findings and outcomes, such as the need for intensive care unit (ICU) treatment and length of hospital stay (LOS). Results A total of 201 out of 371 patients (54%) with neck infections showed evidence of RPE, and 81 out of 314 patients (26%) had ME. Both RPE (OR = 9.5, p < 0.001) and ME (OR = 5.3, p < 0.001) were more prevalent among the patients who required ICU treatment than among those who did not. In a multivariate analysis, C-reactive protein (CRP) levels, RPE, and maximal abscess diameter were independent predictors of the need for ICU treatment, and CRP, ME, and maximal abscess diameter were independent predictors of LOS. Conclusion In patients with an acute neck infection that requires emergency imaging, RPE, ME, and abscess diameter, as shown by MRI, are significant predictors of a more severe illness. Key Points • Two hundred one out of 371 patients (54%) with neck infection showed evidence of retropharyngeal edema (RPE), and 81 out of 314 patients (26%) had mediastinal edema (ME). • Maximal abscess diameter, RPE, and C-reactive protein (CRP) were independent predictors of the need for intensive care unit (ICU) treatment, and maximal abscess diameter, ME, and CRP were independent predictors of length of hospital stay. • Prognostic significance of MRI findings was evident also while controlling for CRP values.

scholarly journals 557. Trends in Remdesivir Treatment Over the Course of the COVID-19 Pandemic

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S380-S381
Author(s):  
J Xin Liao ◽  
Vrishali Lopes ◽  
Aisling Caffrey
Keyword(s):  
Intensive Care ◽  
Hospital Stay ◽  
Clinical Outcomes ◽  
Medical Center ◽  
Length Of Hospital Stay ◽  
The United States ◽  
Inpatient Mortality ◽  
Real World Data ◽  
Pcr Test ◽  
Research Grant

Abstract Background Remdesivir is approved for use in the United States for treatment of COVID-19 requiring hospitalization. Real-world data on trends in remdesivir use may elucidate its benefits and place in therapy. Methods Hospitalized Veterans with a positive SARS-CoV-2 polymerase chain reaction (PCR) test that were treated with remdesivir at a Veterans Affairs Medical Center from May 2020 to April 2021 were included. Monthly trends in remdesivir treatment, as well as patient characteristics and clinical outcomes among patients treated with remdesivir, were assessed with joinpoint regression to calculate average monthly percent change and corresponding 95% confidence intervals (CI). Results A total of 30,333 Veterans were hospitalized with a positive PCR test over the study period, and 13,639 were treated with remdesivir (45%). Throughout the study period, the proportion of Veterans treated with remdesivir increased significantly (4.5% per month, 95% CI 0.5%-8.6%) and median time to remdesivir initiation decreased significantly (12% per month, 95% CI -15.8% to -8.0%). Though demographic characteristics of Veterans treated with remdesivir remained stable, including age, race, and obesity, improvement in clinical outcomes were observed, including median length of hospital stay which decreased by 6.5% per month (95% CI -9.1% to -3.8%), intensive care admissions which decreased by 4.6% per month (95% CI -6.3% to -2.8%) and inpatient mortality which decreased by 6.3% per month (95% CI -9.4% to -3.1%). By April 2021, most patients initiated remdesivir on the day of admission, and the inpatient mortality rate decreased to 7.9% from 19.2% in May 2020. Conclusion Over the course of the COVID-19 pandemic, utilization of remdesivir increased while initiation of remdesivir occurred earlier in the hospital admission, with concurrent reductions in length of hospital stay, intensive care admissions, and inpatient mortality. Disclosures Aisling Caffrey, PhD, Merck (Research Grant or Support)Pfizer (Research Grant or Support)Shionogi, Inc (Research Grant or Support)

scholarly journals COVID in women in Brazil: length of stay and outcomes of first hospitalizations

Rev Rene ◽  
2021 ◽  
Vol 22 ◽  
pp. e61049
Author(s):  
Erica de Brito Pitilin ◽  
Maicon Henrique Lentsck ◽  
Vanessa Aparecida Gasparin ◽  
Larissa Pereira Falavina ◽  
Vander Monteiro da Conceição ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Hospital Stay ◽  
Ecological Study ◽  
Length Of Hospital Stay ◽  
Secondary Diagnosis ◽  
Chi Square ◽  
Hospital Stays ◽  
Underlying Diseases

Objective: to analyze the length of hospital stay and outcomes of the first hospitalizations due to COVID-19 of women at the beginning of the pandemic. Methods: ecological study with data on COVID-19 hospitalizations of women. Data classification was done by states, regions, age, length of hospital stay, main and secondary diagnosis (underlying diseases), and outcome. Kruskal-Wallis, Mann-Whitney, and chi-square tests were used for the analysis. Results: the Southeast region had the highest number of hospitalizations (0.6%). Of the total number of hospitalizations, 14.6% required an intensive care unit. The length of hospital stay of women over 50 years was significant for Brazil (p<0.001). There was an association between length of hospital stay and levels 2 and 3 of comorbidity. Deaths in women over 50 years old were significant in Brazil, Northeast, and Southeast (p<0.001). Conclusion: women over 50 years old with comorbidities are associated with longer hospital stays and deaths.

scholarly journals BACTERIAL AND SENSITIVITY PATTERN OF PATHOGENS CAUSING VENTILATOR-ASSOCIATED PNEUMONIA IN INTENSIVE CARE UNIT

2022 ◽  
Vol 32 (1) ◽  
pp. 22
Author(s):  
Marsheila Harvy Mustikaningtyas ◽  
Bambang Pujo Semedi ◽  
Kuntaman Kuntaman
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Stay ◽  
High Mortality ◽  
Length Of Hospital Stay ◽  
Resistant Bacteria ◽  
Ventilator Associated Pneumonia ◽  
E Coli ◽  
Sensitivity Pattern ◽  
Sensitivity Rate

Highlight:1. Antimicrobial resistance bacteria isolated from VAP patients are often associated with high mortality and length of hospital stay. 2. Mortality in VAP patients was 33.3% and the VAP group had a longer hospital stay compared to the non-VAP group. 3. The three most predominant bacteria that were found were A. baumannii, P. aeruginosa, K. pneumoniae. Cefoperazone-sulbactam, meropenem and amikacin were more than 70% sensitive against these bacteria.Abstract:Background: Ventilator-Associated Pneumonia (VAP) is the most common nosocomial infection in Intensive Care Unit (ICU). Antimicrobial resistant bacteria isolated from VAP patients are often associated with high mortality and length of hospital stay. Objective: This study aimed to analyze the pattern and sensitivity among pathogens that caused VAP in ICU. Materials and Methods: The study was conducted retrospectively by extracting the data of bacterial isolates from sputum specimens in the Laboratory of Clinical Microbiology, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia and confirming the clinical data on patients suffering from VAP in ICU ward. The study started from January until December 2017. Results: The total 148 pathogens were isolated, 18 of them were diagnosed as VAP, and 130 were not VAP. The most predominant isolates in the VAP group were Acinetobacter baumannii as many as 38 (9%) followed by Pseudomonas aeruginosa 22 (2%), E. coli 16 (7%), and Klebsiella pneumoniae 11 (1%). The pathogens showed a sensitivity rate above 70% to cefoperazone-sulbactam (SCF), meropenem (MEM) and amikacin (AK). Mortality in VAP patients was 33.3% and the VAP group had a longer hospital stay compared to non-VAP group. Conclusion: The three most predominant bacteria that were found were A. baumannii, P. aeruginosa, K. pneumoniae. The pathogens had sensitivity rate above 70% to cefoperazone-sulbactam, meropenem, and amikacin.

Sign in / Sign up

Export Citation Format

Share Document