scholarly journals Clinical Features of Maintenance Hemodialysis Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China

2020 ◽  
Vol 15 (8) ◽  
pp. 1139-1145 ◽  
Author(s):  
Jun Wu ◽  
Jushuang Li ◽  
Geli Zhu ◽  
Yanxia Zhang ◽  
Zhimin Bi ◽  
...  
Keyword(s):  
Clinical Features ◽  
Troponin I ◽  
Clinical Laboratory ◽  
Cardiac Injury ◽  
Hemodialysis Patients ◽  
Hospitalized Patients ◽  
Maintenance Hemodialysis ◽  
Computed Tomographic ◽  
Risk Of Death ◽  
Novel Coronavirus

Background and objectivesPrevious reports on the outbreak of coronavirus disease 2019 were on the basis of data from the general population. Our study aimed to investigate the clinical features of patients on maintenance hemodialysis.Design, setting, participants, & measurements In this retrospective, single-center study, we included 49 hospitalized patients on maintenance hemodialysis and 52 hospitalized patients without kidney failure (controls) with confirmed coronavirus disease 2019 at Tongren Hospital of Wuhan University from January 30, 2020 to March 10, 2020. Demographic, clinical, laboratory, and radiologic characteristics and treatment and outcomes data were analyzed. The final date of follow-up was March 19, 2020.ResultsThe median age of 101 patients was 62 years (interquartile range, 49–72). All patients were local residents of Wuhan. In terms of common symptoms, there were differences between patients on hemodialysis and controls (fatigue [59% versus 83%], dry cough [49% versus 71%], and fever [47% versus 90%]). Lymphocyte counts were decreased (0.8×109/L [patients on hemodialysis] versus 0.9×109/L [controls], P=0.02). Comparing patients on hemodialysis with controls, creatine kinase–muscle and brain type, myoglobin, hypersensitive troponin I, B-type natriuretic peptide, and procalcitonin were increased, and the percentage of abnormalities in bilateral lung was higher in computed tomographic scan (82% versus 69%, P=0.15) and unilateral lung was lower (10% versus 27%, P=0.03). Common complications including shock, acute respiratory distress syndrome, arrhythmia, and acute cardiac injury in patients on hemodialysis were significantly higher. Compared with controls, more patients on hemodialysis received noninvasive ventilation (25% versus 6%, P=0.008). As of March 19, 2020, three patients on hemodialysis (6%) were transferred to the intensive care unit and received invasive ventilation. Seven patients on hemodialysis (14%) had died.ConclusionsThe main symptoms of coronavirus disease 2019 pneumonia, including fever and cough, were less common in patients on hemodialysis. Patients on hemodialysis with coronavirus disease 2019 were at higher risk of death.

scholarly journals Clinical characteristics of 41 patients with pneumonia due to 2019 novel coronavirus disease (COVID-19) in Jilin, China

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Qing Zhang ◽  
Qian Xu ◽  
Yi-yang Chen ◽  
Li-xin Lou ◽  
Li-he Che ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Clinical Characteristics ◽  
Troponin I ◽  
Clinical Laboratory ◽  
Ground Glass Opacity ◽  
Hospitalized Patients ◽  
Cardiac Troponin I ◽  
Interquartile Range ◽  
Strong Positive Correlation ◽  
Novel Coronavirus

Abstract Background The clinical characteristics of patients with confirmed 2019 novel coronavirus disease (COVID-19) in Jilin Province, China were investigated. Methods Clinical, laboratory, radiology, and treatment data of 41 hospitalized patients with confirmed COVID-19 were retrospectively collected. The population was stratified by disease severity as mild, moderate, or severe, based on guidelines of the National Health and Medical Commission of China. Results The 41 hospitalized patients with COVID-19 were studied, and the median age was 45 years (interquartile range [IQR], 31–53; range, 10–87 years) and 18 patients (43.9%) were female. All of the patients had recently visited Wuhan or other places (ie, Beijing, Thailand) or had Wuhan-related exposure. Common symptoms included fever (32[78%]) and cough (29[70.7%]). All patients were without hepatitis B/C virus hepatitis. CRP (C-reactive protein, 11.3 mg/L [interquartile range {IQR}, 2.45–35.2]) was elevated in 22 patients (53.7%), and cardiac troponin I (1.5 ng/mL [IQR, 0.8–5.0]) was elevated in 41 patients (100%). Chest computed tomographic scans showed bilateral ground glass opacity (GGO) or GGO with consolidation in the lungs of 27(65.9%) patients. 31(75.6%) patients had an abnormal electrocardiograph (ECG). Comparing the three groups, the levels of CRP and cardiac troponin I, GGO distribution in bilateral lungs, and electrocardiogram changes were statistically significant (p < 0.05). Cardiac troponin I had a strong positive correlation with CRP (r = 0.704, p = 0.042) and LDH (r = 0.738, p = 0.037). Conclusion Significant differences among the groups suggest that several clinical parameters may serve as biomarkers of COVID-19 severity at hospital admission. Elevated cTnI could be considered as a predictor of severe COVID-19, reflecting the prognosis of patients with severe COVID-19. The results warrant further inspection and confirmation.

Abstract 13093: Clinical Features and Prognosis of Acute Cardiac Injury in Hospitalized Patients With Covid-19: A Retrospective Cohort Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Mingxing XIE ◽  
Li Zhang ◽  
yanting zhang ◽  
Wei Sun ◽  
CHUN WU ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Proportional Hazards ◽  
Troponin I ◽  
Clinical Laboratory ◽  
Invasive Mechanical Ventilation ◽  
Cardiac Injury ◽  
High Sensitivity ◽  
Final Analysis ◽  
Cox Proportional Hazards ◽  
Hospitalized Patients

Aims: The fatalities case due to coronavirus disease 2019 (COVID-19) is escalating. However, information on critical complications in hospitalized patients of COVID-19 is scant. We aimed to explore the prevalence of acute cardiac injury and its association with in-hospital mortality in COVID-19 patients. Methods: This retrospective study analyzed COVID-19 patients in Union Hospital (Wuhan, China) from Jan 24 to March 18, 2020. Clinical outcomes (discharge, or death) were monitored to April 9, 2020, the latest date of follow-up. Demographic, clinical, laboratory, echocardiographic data, treatment and prognosis were analyzed. Results: A total of 235 COVID-19 patients were included in the final analysis. Their median age was 66 years (interquartile range 57 - 73), and 131 (55.7%) were men. 98 (41.7%) patients were diagnosed with acute cardiac injury, of whom 60 (61.2%) died. There were more comorbidities in those who with acute cardiac injury than those without. A higher proportion of patients with acute cardiac injury received glucocorticoid therapy (68.0% vs 37.0%; P < 0.001), immunoglobulin (53.1% vs 30.1%; P < 0.001) and invasive mechanical ventilation (40.8% vs 6.6%; P < 0.001) than those without. The percentage of patients who were admitted to intensive care unit (39.8 % vs 8.0%; P < 0.001) or died during hospitalization (61.2% vs 8.0%, P < 0.001) were also higher in those with acute cardiac injury. Plasma high-sensitivity troponin I level correlated significantly with plasma interleukin -6, procalcitonin and C-reactive protein levels in COVID-19 patients. Echocardiography showed that cardiac function was attenuated in acute cardiac injury patients. Multivariable Cox proportional hazards regression analysis showed acute cardiac injury was an independent risk factor for higher in-hospital mortality in COVID-19 patients (HR, 3.393; 95% CI, 1.647- 6.987, P <0.001). Conclusions: Acute cardiac injury is a common condition and may be related to inflammatory response in COVID-19 patients. In addition, our study highlights an association between acute cardiac injury and a higher risk of in-hospital mortality. It is suggested that clinicians should be alert to acute cardiac injury in COVID-19 patients and take prompt treatments to improve outcomes.

scholarly journals Clinical features and outcomes of 2019 novel coronavirus–infected patients with cardiac injury

2020 ◽  
Author(s):  
Youbin Liu ◽  
Jinglong Li ◽  
Dehui Liu ◽  
Huafeng Song ◽  
Chunlin Chen ◽  
...  
Keyword(s):  
Clinical Features ◽  
Troponin I ◽  
Cardiac Injury ◽  
C Reactive Protein ◽  
Cardiac Biomarker ◽  
X Ray ◽  
Illness Onset ◽  
Reactive Protein ◽  
Chest X Ray ◽  
Novel Coronavirus

AbstractAimsTo explore the epidemiological and clinical features of 2019 novel coronavirus(2019-nCoV)-infected patients with cardiac injury.Methods and resultsData were collected from patients’ medical records, and we defined cardiac injury according to cardiac biomarker troponin I level > 0.03 μg/L. Among the 291 patients, 15 (5.2%) showed evidence of cardiac injury. Of 15 hospitalized patients with cardiac injury, the median age was 65 years, and 11/15 (73.3%) were men. Underlying cardiovascular diseases in some patients were hypertension (n=7, 46.7%), coronary heart disease (n=3, 20%) and diabetes (n=3, 20%). The most common symptoms at illness onset in patients with cardiac injury were fever (n=11, 73.3%), cough (n=7, 46.7%), headache or fatigue (n=5, 33.3%) and dyspnea (n=4, 26.7%). These patients had higher systolic pressures, white blood cell count, neutrophil count, troponin I, brain natriuretic peptide, D-dimer and lower lymphocyte count, and platelet count, compared with patients without cardiac injury, respectively. Bilateral infiltrates on chest X-ray and elevated C-reactive protein occurred in all patients with cardiac injury. Compared with patients without cardiac injury, patients with cardiac injury were more likely to develop acute respiratory distress syndrome, and receive mechanical ventilation, continuous renal replacement therapy, extracorporeal membrane oxygenation and vasopressor therapy and be admitted to the intensive care unit.ConclusionCardiac injury is a common condition among patients infected with 2019-nCoV. Compared with patients without cardiac injury, the clinical outcomes of patients with cardiac injury are relatively worse.

Abstract 15633: Clinical Features and Prognosis of Acute Cardiac Injury in Hospitalized Patients With Covid-19: A Retrospective Cohort Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Mingxing XIE ◽  
Li Zhang ◽  
Yuji Xie ◽  
yanting zhang ◽  
Wei Sun ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Proportional Hazards ◽  
Troponin I ◽  
Clinical Laboratory ◽  
Invasive Mechanical Ventilation ◽  
Cardiac Injury ◽  
Final Analysis ◽  
Cox Proportional Hazards ◽  
Hospitalized Patients ◽  
High Flow Oxygen

Background: The number of fatalities due to coronavirus disease 2019 (COVID-19) is escalating. However, information on critical complications in hospitalized patients of COVID-19 is scant. We aimed to explore the prevalence of acute cardiac injury and its association with in-hospital mortality in COVID-19 patients. Method: This retrospective study analyzed patients confirmed with COVID-19 in Union Hospital (Wuhan, China) from Jan 24 to March 18, 2020. Clinical outcomes (discharge, or death) were monitored to April 9, 2020, the latest date of follow-up. Demographic, clinical, laboratory, echocardiographic data as well as treatment and prognosis were analyzed. Comparisons were made between patients with acute cardiac injury and those without. An association of acute cardiac injury and in-hospital mortality was identified. Results: A total of 235 COVID-19 patients were included in the final analysis. Their median age was 66 years (interquartile range 57 - 73 years), and 131 (55.7%) were men. 98 (41.7%) patients were diagnosed with acute cardiac injury, of whom 60 (61.2%) died. There were more comorbidities in those who had acute cardiac injury than those who did not have. A higher proportion of patients with acute cardiac injury received glucocorticoid therapy (68.0% vs 37.0%; P < 0.001), immunoglobulin (53.1% vs 30.1%; P < 0.001), high-flow oxygen (79.6% vs 43.1%; P < 0.001), and invasive mechanical ventilation (40.8% vs 6.6%; P < 0.001) than those without acute cardiac injury. The percentage of patients who were admitted to intensive care unit (39.8 % vs 8.0%; P < 0.001) or died during hospitalization (61.2% vs 8.0%, P < 0.001) were also higher in those with acute cardiac injury. Plasma high-sensitivity troponin I levels correlated significantly with plasma interleukin -6, procalcitonin and C-reactive protein levels in COVID-19 patients. Echocardiography showed the cardiac function was attenuated in acute cardiac injury patients. Multivariable Cox proportional hazards regression analysis showed acute cardiac injury was an independent risk factor for higher in-hospital mortality in COVID-19 patients (HR, 3.393; 95% CI, 1.647- 6.987, P <0.001).

scholarly journals Cardiac biomarkers in acute respiratory distress syndrome: a systematic review and meta-analysis

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Dilip Jayasimhan ◽  
Simon Foster ◽  
Catherina L. Chang ◽  
Robert J. Hancox
Keyword(s):  
Systematic Review ◽  
Acute Respiratory Distress Syndrome ◽  
Intensive Care ◽  
Cardiac Dysfunction ◽  
Distress Syndrome ◽  
Troponin I ◽  
Meta Analysis ◽  
Cardiac Injury ◽  
Cardiac Biomarkers ◽  
Risk Of Death

Abstract Background Acute respiratory distress syndrome (ARDS) is a leading cause of morbidity and mortality in the intensive care unit. Biochemical markers of cardiac dysfunction are associated with high mortality in many respiratory conditions. The aim of this systematic review is to examine the link between elevated biomarkers of cardiac dysfunction in ARDS and mortality. Methods A systematic review of MEDLINE, EMBASE, Web of Science and CENTRAL databases was performed. We included studies of adult intensive care patients with ARDS that reported the risk of death in relation to a measured biomarker of cardiac dysfunction. The primary outcome of interest was mortality up to 60 days. A random-effects model was used for pooled estimates. Funnel-plot inspection was done to evaluate publication bias; Cochrane chi-square tests and I2 tests were used to assess heterogeneity. Results Twenty-two studies were included in the systematic review and 18 in the meta-analysis. Biomarkers of cardiac stretch included NT-ProBNP (nine studies) and BNP (six studies). Biomarkers of cardiac injury included Troponin-T (two studies), Troponin-I (one study) and High-Sensitivity-Troponin-I (three studies). Three studies assessed multiple cardiac biomarkers. High levels of NT-proBNP and BNP were associated with a higher risk of death up to 60 days (unadjusted OR 8.98; CI 4.15-19.43; p<0.00001). This association persisted after adjustment for age and illness severity. Biomarkers of cardiac injury were also associated with higher mortality, but this association was not statistically significant (unadjusted OR 2.21; CI 0.94-5.16; p= 0.07). Conclusion Biomarkers of cardiac stretch are associated with increased mortality in ARDS.

scholarly journals CLINICAL FEATURES OF NOVEL CORONAVIRUS 2019-INFECTED CASES WITH PRE-EXISTING CARDIOVASCULAR DISEASE, DISAGGREGATED BY GENDER

2021 ◽  
Vol 54 (2) ◽  
pp. 180-185
Author(s):  
Elham Mohammadyari ◽  
Mohammad Reza Kaffashian ◽  
Iraj Ahmadi ◽  
Azra Kenarkoohi ◽  
Askar Soufinia ◽  
...  
Keyword(s):  
Clinical Features ◽  
Clinical Laboratory ◽  
Renin Angiotensin System ◽  
Angiotensin System ◽  
Men And Women ◽  
Blood Pressures ◽  
Males And Females ◽  
The Mean ◽  
Novel Coronavirus ◽  
Common Laboratory

Objectives: This study was conducted to evaluate the clinical features of 68 coronavirus 2019-infected cardiac cases on gender basis. Methodology: Clinical, laboratory and electrocardiographic data of 68 COVID-19 patients with pre-existing cardiovascular diseases, analyzed and compared by gender-wise. Results: Dry cough (78% of male, 80% females) and fever (62% of male, 75% females) were the most common symptoms. Out of these 97% of them needed O2 supplementation. O2 saturation in patients with O2 therapy was 85%; 31% of men and 11% of women experienced intubation. The most common laboratory abnormalities, were neutrophilia, leukocytosis, lymphopenia, thrombocytopenia, decreased hemoglobin level, increased creatinine and urea, in men and women. Troponin level was different between male and female. Pneumonia was found in 86-87% patients. Approximately, Males and female, respectively53.10 and 52.8%, shown sinus tachycardia (ST arrythmia). PVC arrythmia was found in 2.9% of total patients. BBB arrythmia was found in 31.20% of males vs. 11.10% of females. The mean systole/diastole blood pressures respectively were 130±4/79.7 ±2 in males and 134±4/81±3 in females. Heart axis changes was identified in 43.8% and 27.8% of males and females respectively. Conclusion: Severity of symptoms and outcomes of COVID-19 in cardiac patients showed some differences between men and women which could be associated with differences in immune responses, respiratory tract properties, renin angiotensin system, sex hormones and lifestyle.  However, more studies to categorize gender differences are required.

scholarly journals Clinical features and outcome of maintenance hemodialysis patients with COVID-19 from a tertiary nephrology care center in Romania

Renal Failure ◽  
2020 ◽  
Vol 43 (1) ◽  
pp. 49-57
Author(s):  
Gabriel Stefan ◽  
Ana Maria Mehedinti ◽  
Iuliana Andreiana ◽  
Adrian Dorin Zugravu ◽  
Simona Cinca ◽  
...  
Keyword(s):  
Clinical Features ◽  
Care Center ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Nephrology Care ◽  
Maintenance Hemodialysis Patients

scholarly journals Original Paper Relationships Between Indices of Arm Anthropometry, Bioimpedance, and Laboratory in Maintenance Hemodialysis Patients

2020 ◽  
Author(s):  
Jenn-Yeu Wang ◽  
Shu- Chin Chen ◽  
Betau Hwang
Keyword(s):  
Bioelectrical Impedance Analysis ◽  
Clinical Laboratory ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Hemodialysis Patients ◽  
Fat Free Mass ◽  
Single Frequency ◽  
Maintenance Hemodialysis ◽  
Upper Arm ◽  
Muscle Area

Abstract Background Maintenance hemodialysis patients often experience protein- calorie malnutrition. Our aim is to evaluate the independent prediction accuracy of bioelectrical impedance analysis derived variables by the measurements of upper arm anthropometry and clinical laboratory indexes for evaluation of nutritional status of hemodialysis patients. Furthermore, the relationship between measurements of upper arm anthropometry and clinical laboratory indexes and cross –sectional evaluation of the prevalence of malnutrition with the use of the norms and thresholds were done. Methods In a cross- sectional survey of 32 stable hemodialysis patients (aged 28 to 82 years) in hemodialysis unit of Taipei Municipal Zhongxiao Hospital, we evaluated measurements of upper arm anthropometry with measurements of single frequency bioelectrical impedance analysis and clinical laboratory indexes. Results The comparisons between measurements of upper arm anthropometry with measurements of single frequency bioelectrical impedance analysis and some of clinical laboratory indexes were statistically significant. This study further found that both mid-arm fat area and triceps skin-fold thickness were independent contributors to percent fat mass after adjustment for body mass index and gender in the multiple regression models. This study also demonstrated that mid-arm muscle circumference, or mid-arm muscle area, or corrected mid-arm muscle area independently predicted height normalized indices of fat-free mass respectively after adjustment for body mass index and gender in the multiple regression models. The prevalence of protein wasting measured by mid-arm muscle circumference (50%) appears to be equivalent to that measured by serum albumin concentration (50%). Conclusions Mid-arm muscle and fat variables by upper arm anthropometry correlated with nutritional variables of single frequency bioelectrical impedance analysis and clinical laboratory indexes. Mid-arm muscle and fat variables by upper arm anthropometry were independent predictors of body composition regarding height-normalized indices of fat-free mass and percent fat mass of hemodialysis patients even after adjustment of gender and BMI.

scholarly journals A comparative study on clinical features and outcomes of acute pancreatitis between diabetic and non-diabetic hospitalized patients

2020 ◽  
Vol 10 (3) ◽  
pp. 172-181
Author(s):  
Mostaque Hossain ◽  
Zubaer Hosen ◽  
Isabela Kabir ◽  
Md Rezaul Karim ◽  
Muhammad Abdur Rahim ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Clinical Features ◽  
Clinical Laboratory ◽  
Severe Form ◽  
Hospitalized Patients ◽  
Diabetic Mellitus ◽  
Exclusion Criteria ◽  
Medical College ◽  
Laboratory Markers ◽  
Tertiary Hospitals

Background: Pancreatitis is a serious disorder of pancreas. This study was designed to investigate the clinical features and outcomes of the hospitalized patients with acute pancreatitis (AP) with or without diabetic mellitus (DM). Methods: A total of 90 adult hospitalized patients with AP diagnosed in three different tertiary hospitals were evaluated for inclusion in prospective study on clinical, laboratory and outcome parameters. After exclusion according to exclusion criteria, 68 patients were enrolled finally, and out of 68 patients 34 were diabetic with AP from BIRDEM and 34 AP patients were non-diabetic from Dhaka Medical College and BSMMU. Results: The major clinical features, laboratory markers were significantly (p<0.05) higher whereas serum albumin levels was significantly (p<0.05) lower in diabetic AP group as compared to the non-diabetic AP group. DM was associated with severe form of AP compared to the non-diabetic group (p<0.05). Conclusions: The results of the present study suggest that DM increases the disease severity of AP. Therefore, clinicians should pay more attention in the treatment and management of acute pancreatitis if the patients have DM. Birdem Med J 2020; 10(3): 172-181

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