Study of the effect of high blood pressure on the kidney in Children with COVID-19 (Preprint)

2021 ◽  
Author(s):  
Mir Hossain
Keyword(s):  
Blood Pressure ◽  
Pediatric Patients ◽  
Severe Hypertension ◽  
Comorbid Condition ◽  
The Novel ◽  
Antihypertensive Medications ◽  
Medical Practitioners ◽  
Blood Pressures ◽  
Novel Coronavirus ◽  
Time Of Admission

UNSTRUCTURED Hypertension is considered as a comorbid condition for the novel coronavirus 2019 (COVID-19). However, there are no reports of “Hypertension crisis” as a presentation or comorbidity of the COVID-19 infection in pediatric patients. In this retrospective observational study, we collected data from total six pediatric patients, diagnosed with confirmed COVID-19 positive who had presented with acute severe hypertension. The mean age of patients was 4.2 years. Four cases were with newly diagnosed nephrotic syndrome and two with chronic kidney disease who were on regular dialysis with no edema or sign of fluid overload, were enrolled. The lowest and highest systolic blood pressures at the time of admission were 160 mmHg and 200 mmHg, respectively. The diastolic blood pressures were between 100-155 mmHg. All patients treated with Labetalol infusion titrated to maximum dosage and continued for at least one week. Our reported children had resistant hypertension and their blood pressure had been controlled with four or five antihypertensive medications. It is crucial to consider the diagnosis of COVID-19 in a patient presenting with a hypertension crisis, even in the absence of classic signs of the virus. Thus from our study we strongly recommend the medical practitioners to consider the probability of COVID-19 infection in cases presenting to the hospital with acute severe hypertension.

Incidence and Risk Factors for Postpartum Severe Hypertension in Women with Underlying Chronic Hypertension

2018 ◽  
Vol 36 (07) ◽  
pp. 737-741
Author(s):  
Angelica V. Glover ◽  
Alan Tita ◽  
Joseph R. Biggio ◽  
Sarah B. Anderson ◽  
Lorie M. Harper
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Severe Hypertension ◽  
Care Center ◽  
Tertiary Care ◽  
Blood Pressure Level ◽  
Chronic Hypertension ◽  
Antihypertensive Medications ◽  
Time To Diagnosis ◽  
Blood Pressures

Objective To determine risk factors and time to diagnosis of postpartum severe hypertension (PHTN) in women with chronic hypertension (CHTN). Study Design Retrospective cohort of singleton pregnancies with CHTN at a tertiary care center. The primary outcome was PHTN, defined as hypertension ≥160/ ≥ 110 mm Hg during an emergency room (ER) or outpatient visit, or hospitalization within 8 weeks postpartum. Multivariable logistic regression was used to assess independent risk factors for PHTN. Results Two-hundred thirty-five women had CHTN: 30 (12.8%) were diagnosed with PHTN, and 17 (7.2%) were hospitalized or seen in the ER for PHTN. Women with PHTN had more severe superimposed pre-eclampsia (p < 0.05), higher average systolic blood pressures at discharge (141 vs. 135 mm Hg, p = 0.04), and required antihypertensives after delivery (p < 0.01). The number of antihypertensive medications (adjusted odds ratio [aOR] 1.78, 95% confidence interval [CI], 1.25–2.55) and a systolic blood pressure >135 mm Hg (aOR 4.55, 95% CI, 1.64–12.61) at discharge remained independently associated with PHTN. Median time to diagnosis of PHTN was 10 days (interquartile range [IQR] 6–32 days); time to diagnosis among women requiring readmission or ER evaluation was 8 days (IQR 5–11 days). Conclusion PHTN occurred in 13% of women with CHTN, and was associated with blood pressure level and number of medications at discharge.

scholarly journals Fibroblast Growth Factor 23 and Blood Pressure in Older Adults

Hypertension ◽  
2020 ◽  
Vol 76 (1) ◽  
pp. 236-243
Author(s):  
David A. Drew ◽  
Ronit Katz ◽  
Stephen Kritchevsky ◽  
Joachim H. Ix ◽  
Michael G. Shlipak ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Growth Factor ◽  
Fibroblast Growth Factor 23 ◽  
Fibroblast Growth ◽  
Antihypertensive Medications ◽  
Incident Hypertension ◽  
Blood Pressures ◽  
The Mean ◽  
Fgf 23

FGF-23 (fibroblast growth factor 23) regulates phosphorus and vitamin D. Elevated FGF-23 is associated with incident hypertension in young- and middle-aged adults, but there is limited data in older adults. Serum FGF-23 was measured using an intact ELISA assay in 2496 participants of the Healthy Aging and Body Composition Study. The association between FGF-23 and prevalent hypertension (self-reported and confirmed by use of antihypertensive medications) and number of antihypertensive medications was determined. The associations between FGF-23 and incident hypertension, and diastolic and systolic blood pressure trajectories were evaluated over 10 years. Models were adjusted for demographics, estimated glomerular filtration rate and albuminuria, cardiovascular disease risk factors, and measures of mineral metabolism. The mean (SD) age was 75 (3) years, with 51% women, and 40% black participants. The prevalence of hypertension at baseline was 75% and the mean systolic and diastolic blood pressures were 134 (21) mm Hg and 70 (12) mm Hg, respectively. The majority of participants without hypertension at baseline developed incident hypertension (576 of 1109 or 52%). In adjusted models, each 2-fold higher FGF-23 was associated with prevalent baseline hypertension (odds ratio=1.46 [1.24–1.73]) and greater number of blood pressure medications (IRR=1.14 [1.08–1.21]) but not with baseline diastolic or systolic blood pressure. In fully adjusted longitudinal analyses, a 2-fold higher FGF-23 was associated with incident hypertension (hazard ratio=1.18 [1.03–1.36]) and worsening systolic blood pressures (β=0.24 [0.08–0.40] mm Hg per year increase), but not with diastolic blood pressures (β=0.04 [−0.04 to 0.12] mm Hg per year increase). Higher FGF-23 concentrations are associated with prevalent and incident hypertension as well as rising systolic blood pressures in community-living older adults.

scholarly journals Coronavirus Disease 2019 (COVID-19): Future Challenges and Recommendations for Dental Settings

2021 ◽  
Vol 4 (11) ◽  
pp. RV1-RV5
Author(s):  
Najmus Sahar ◽  
Pradeep Tangade ◽  
Vikas Singh ◽  
Surbhi Priyadarshini ◽  
Debashis Roy
Keyword(s):  
Health Care Workers ◽  
Preventive Measures ◽  
Clinical Manifestations ◽  
Virus Transmission ◽  
Review Article ◽  
The Novel ◽  
Medical Practitioners ◽  
Care Workers ◽  
Future Challenges ◽  
Novel Coronavirus

The novel coronavirus outbreak is a contagious disease affecting the countries around the world. The quick advancing nature of pandemic has gripped the entire community making it a public health emergency. Infection control preventive measures are necessary to prevent it from further spreading. Medical practitioners, health care workers and Dentists are at high risk of acquiring and transmission of infection. The virus transmission occurs through respiratory tract, aerosols and droplets. Clinical manifestations of virus vary from mild to severe sickness. This review article mainly emphasizes on all the information collected to date on the virus, and future recommendations for dental settings to manage the further spread of this virus.

scholarly journals Management of the Index COVID -19 Obstetric Patient at the University of Benin Teaching Hospital

2021 ◽  
pp. 16-21
Author(s):  
Okojie Nkechiyerim Quincy ◽  
Ehiarimwian Oisamoje Ruth ◽  
Nte Stanley
Keyword(s):  
Blood Pressure ◽  
Chronic Hypertension ◽  
The Novel ◽  
Strict Adherence ◽  
Pedal Oedema ◽  
Clinical Presentations ◽  
Full Complement ◽  
History Of ◽  
Novel Coronavirus ◽  
The University

Introduction: The novel coronavirus (COVID-19) was first identified in Wuhan City, Hubei province of China, November 2019. As at September 2020, over 28 million infections have been identified with almost a million deaths worldwide causing an alarming pandemic. Clinical presentations in pregnant patients with COVID-19 could be atypical with normal temperature (56%) and leukocytosis. This is further masked by the features of pregnancy. We present the management of a COVID-19 parturient in our obstetric unit. Case Report: A 32 year old unbooked G₃P₁⁺1 lady at 32 weeks who presented via referral from a private facility with a history of elevated blood pressure and ++ of protein in urine. Also, complaints of cough and difficulty with breathing. On examination she was noted to be anxious, afebrile, not pale, anicteric, acyanosed, not dehydrated. Had bilateral pedal oedema. Tachypnic with a respiratory rate of 28 cycles per min with basal crepitations. Pulse rate was 96bpm full and regular. Blood pressure was 180/100 mmHg. Heart sounds S₁S₂only.An impression of Chronic hypertension with superimposed pre-eclampsia at 32 wks GA in a primipara with one previous CS with pulmonary edema. Keep in view COVID-19. She was managed with oxygen, antihypertensives, steroids, while observing strict infection control protocol. She had an emergency caesarean section under subarachnoid block and was delivered of a live female neonate. A confirmatory positive result for covid-19 was obtained 24hrs later. Neonate was however negative. None of the staff became positive also. Conclusion: The management of suspected cases of COVID-19 infection should be same as cases already confirmed. As the epidemic persists, numbers will continue to rise andhence our index of suspicion should be heightened. Pregnant women will also present with symptoms masked by the features of a sick parturient. Full complement of PPE must be worn by all staff attending to both confirmed and suspicious cases of COVID-19 infection and strict adherence to stated protocols must be observed.

scholarly journals COVID-19 in Egyptian Children: A Multicenter Study

2021 ◽  
Vol 16 (02) ◽  
pp. 057-061
Author(s):  
Amin Abdel Baki ◽  
Samy Zaky ◽  
Hossam Hosny ◽  
Gehan Elassal ◽  
Akram Abdelbary ◽  
...  
Keyword(s):  
Retrospective Cohort ◽  
Clinical Characteristics ◽  
Pediatric Patients ◽  
The Novel ◽  
Limited Information ◽  
Significant Morbidity ◽  
Egyptian Children ◽  
Novel Coronavirus ◽  
Epidemiological Characteristics ◽  
Benign Course

Abstract Objective The novel coronavirus disease 2019 (COVID-19) has made its worldwide spread since its outbreak in December 2019. Limited information is available about the epidemiology and clinical characteristics of COVID-19, especially in Africa and Egypt. Methods We aimed to study the clinical and epidemiological characteristics of COVID-19 in Egyptian children. This is an observational retrospective cohort study performed at two specialized COVID-19 isolation hospitals in Egypt. All admitted COVID-19 pediatric patients between March 20, 2020, and May 1, 2020, were included in the study. Discussion This study included 40 COVID-19 confirmed cases (mean age, 9.4 years), 67.5% were male, 85% were asymptomatic, and 15% had mild symptoms. There were no confirmed severe or critically ill cases among the patients. Conclusion COVID-19 runs in a benign course in Egyptian children with no mortality and no significant morbidity.

scholarly journals Uncommon Presentation of COVID-19 in Pediatric Patients: Anosmia

2021 ◽  
Vol 16 (02) ◽  
pp. 080-084
Author(s):  
Hatice Y. Dağlı ◽  
Özge M. Akcan ◽  
Sevgi Pekcan ◽  
Mustafa Gençeli ◽  
Hüseyin S. Özdemir ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Early Stage ◽  
Clinical Findings ◽  
World Health ◽  
The Novel ◽  
Uncommon Presentation ◽  
Novel Coronavirus ◽  
Health Organization ◽  
Epidemiological Characteristics

Abstract Objective The novel coronavirus disease 2019 (COVID-19) infection was declared as a pandemic by the World Health Organization on March 11, 2020. Although the complaint of anosmia is well described in adult patients, there is limited knowledge in pediatric patients. We aim to evaluate the epidemiological characteristics and clinical findings of children with anosmia in COVID-19-positive pediatric patients. Methods Patients diagnosed with COVID-19 infection at 1 month to 18 years of age, who admitted to Meram Faculty of Medicine of Necmettin Erbakan University between March and June 2020, were retrospectively reviewed, and the patients who had anosmia or developed anosmia during follow-up were then included in the study. The diagnosis was established by polymerase chain reaction (PCR). Results A total of 71 patients were diagnosed with COVID-19 and 14 (19.7%) of them had anosmia. Mean patient age was 14.07 (range: 10–16) years. Six of our 14 (42.8%) patients had anosmia at the time of diagnosis and anosmia developed in the follow-up among eight patients. The mean duration of anosmia in our patients was 6.9 ± 3.8 days. Recovery time was 1 to 4 days in four patients (28.5%), 5 to 8 days in four patients (28.5%), and 9 to 14 days in six patients (42.8%). Conclusion In this article, it was emphasized that anosmia can be the sole manifestation or concomitant with other symptoms in children with COVID-19 disease. Care and attention is important to identify COVID-19 patients at an early stage of the disease and limit the spread of the virus.

scholarly journals Pediatric Emergency Department Responses to COVID-19: Transitioning From Surge Preparation to Regional Support

2020 ◽  
pp. 1-7
Author(s):  
Emily A. Hartford ◽  
Ashley Keilman ◽  
Hiromi Yoshida ◽  
Russell Migita ◽  
Todd Chang ◽  
...  
Keyword(s):  
United States ◽  
Emergency Department ◽  
Pediatric Patients ◽  
The United States ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
The Novel ◽  
Global Pandemic ◽  
The World ◽  
Novel Coronavirus

ABSTRACT In the midst of a global pandemic, hospitals around the world are working to meet the demand for patients ill with the 2019 coronavirus disease (COVID-19) caused by the novel coronavirus first identified in Wuhan, China. As the crisis unfolds, several countries have reported lower numbers as well as less morbidity and mortality for pediatric patients. Thus, pediatric centers find themselves pivoting from preparing for a patient surge to finding ways to support the regional response for adults. This study describes the response from 2 West Coast freestanding academic children’s hospitals that were among the first cities in the United States impacted during this pandemic.

scholarly journals A PRE - EXPERIMENTAL STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAM ON KNOWLEDGE REGARDING DOMICILIARY CARE IN POST COVID -19 PATIENTS AMONG PRIMARY CAREGIVER AT SELECTED AREA OF NAINITAL

2021 ◽  
Vol 9 (10) ◽  
pp. 225-226
Author(s):  
Chanchal Chaukrayat ◽  
G. Ramalakshmi ◽  
Renjith Thomas
Keyword(s):  
Experimental Study ◽  
Immune System ◽  
High Risk ◽  
Preventive Measures ◽  
Face Mask ◽  
The Novel ◽  
Teaching Program ◽  
Medical Practitioners ◽  
The World ◽  
Novel Coronavirus

Coronavirus disease 2019 (COVID-19) is a contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The first known case was identified in Wuhan, China in December 2019. The disease has since spread worldwide, leading to an ongoing pandemic.After COVID-19 infection, most people form adequate antibodies which prevents them from contracting the virus again. Nonetheless, its an unknown territory for the medical practitioners across the world, as to how long can that immunity stand. Cases where patients had the novel coronavirus again, have been reported too. More in this way, for individuals who are at a high risk of reinfection are either old or dont take enough preventive measures to additionally protect their immune system which makes post-COVID care important for them. While the standard laws of staying safe suggest everyone to cover their face with a face mask, wash hands regularly and practice social distancing.

scholarly journals Perception of telemedicine among medical practitioners in Malaysia during COVID-19

2021 ◽  
Vol 14 (4) ◽  
pp. 468-480
Author(s):  
How Kit Thong ◽  
◽  
Danny Kit Chung Wong ◽  
Hardip Singh Gendeh ◽  
Lokman Saim ◽  
...  
Keyword(s):  
Daily Practice ◽  
The Novel ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical Practitioners ◽  
Healthcare Facilities ◽  
Insurance Reimbursement ◽  
Barriers To Implementation ◽  
Conventional Health Care ◽  
Novel Coronavirus

The novel Coronavirus Disease 2019 (COVID-19) has brought unprecedented changes in the way conventional health care is delivered. This study examined if clinicians’ perceptions regarding telemedicine and its barriers to implementation in Malaysia have changed during this pandemic. A cross-sectional survey was conducted among Malaysian medical doctors of various specialties in four urban healthcare facilities between June 2020 and July 2020. A total of 146 (41.7%) out of 350 responses were obtained. 62% of doctors reported a reduction greater than 50% in outpatient visits during the COVID-19 pandemic. The majority of doctors either found telemedicine useful in situations similar to COVID-19 (34.2%) or that it is essential to their daily practice (42.5%). However, only 22% reported using telemedicine for consultation during the COVID-19 pandemic. 74% of doctors felt that telemedicine would only benefit up to 30% of their patient population. Significantly more female doctors (80%) felt that telemedicine would benefit their patients compared to male doctors (45.8%) (P=0.03). Physicians (51.3%) were more inclined to adopt telemedicine in comparison to surgeons (32.4%) (P=0.03). The majority cited medico-legal issues and consent (80.6%), billing and charges (66.7%) and insurance reimbursement (62.5%), technical difficulties (62.5%) as their barrier to the adoption of telemedicine. Female doctors and physicians were more willing to adopt telemedicine when compared to male doctors and surgeons. Although the COVID-19 pandemic appeared to improve the perception, significant barriers should be resolved before many can incorporate it into their practice.

scholarly journals Adherence to drug therapy among hypertensive patients attending two district hospitals in Ghana

2020 ◽  
Vol 20 (3) ◽  
pp. 1355-1367
Author(s):  
Emmanuel Sarkodie ◽  
Daniel Kwame Afriyie ◽  
Araba Hutton-Nyameaye ◽  
Seth Kwabena Amponsah
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Drugs ◽  
Patient Adherence ◽  
Antihypertensive Medications ◽  
Major Drawback ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Medical Practitioners ◽  
District Hospitals ◽  
Predictors Of Adherence

Background: A major drawback to the management of hypertension among patients is poor adherence to pharmacother- apy. Factors that influence non-adherence to antihypertensive drugs could vary, depending on the prevailing condition of patient and setting. Knowledge of adherence patterns and behavior of hypertensive patients to pharmacotherapy could improve health-directed policies towards hypertension management. Objective: The objective of this study was to determine factors that influence adherence to oral antihypertensive drugs among patients attending two district hospitals in the Volta Region of Ghana. Methods: The study was cross-sectional. Respondents were hypertensive patients attending Krachi West District (n=187) and Hohoe Municipal (n=183) hospitals between March 2016 to May 2016. Data was collected using a structured question- naire and Morisky 8 Item Measurement of adherence scale. Results: Adherence to oral antihypertensive drugs was 89.2%. However, more than half of these respondents appeared to have uncontrolled blood pressure; and this may be due to self-response bias, blood pressure being measured only on the day of the interview or use of fake drugs (which was not assessed in this study). The strongest predictors of adherence were; knowledge on hypertension, perception of severity of condition and the amount of alcohol consumed in a day by respondents. Conclusion: Good adherence to oral antihypertensive drugs was observed in this population despite uncontrolled hyper- tension in a number of the respondents. The three independent predictors of adherence to antihypertensive medications in this study were respondent’s knowledge about hypertension, perception of severity of their condition and the amount of alcohol consumed in a day. Regular patient education and counseling by medical practitioners should be encouraged in these settings to improve patient adherence. Keywords: Adherence; antihypertensive drug; hypertension; Ghana.

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