scholarly journals The association between biomarkers and clinical outcomes in novel coronavirus pneumonia in a US cohort

2020 ◽  
Vol 14 (12) ◽  
pp. 1091-1097 ◽  
Author(s):  
Shant Ayanian ◽  
Juan Reyes ◽  
Lei Lynn ◽  
Karolyn Teufel
Keyword(s):  
Clinical Outcomes ◽  
Clinical Deterioration ◽  
University Hospital ◽  
George Washington ◽  
Markers Of Inflammation ◽  
Medicine Service ◽  
Inpatient Medicine ◽  
Intensive Care Unit Transfer ◽  
Novel Coronavirus ◽  
Washington University

Aim: To describe the association between D-dimer, CRP, IL-6, ferritin, LDH and the clinical outcomes in a cohort of 299 COVID-19 patients treated on the inpatient medical service at a university hospital in the District of Columbia (DC, USA). Methodology & results: In this retrospective study, we included all laboratory confirmed COVID-19 adults admitted to the inpatient medicine service at the George Washington University Hospital between 12 March 2020 and 9 May 2020. We analyzed the association of biomarkers on intensive care unit transfer, intubation and mortality. Threshold values for all biomarkers were found to be statistically significant and independently associated with higher odds of clinical deterioration and death. Conclusion: Laboratory markers of inflammation and coagulopathy can help clinicians identify patients who are at high risk for clinical deterioration in COVID-19.

scholarly journals The Association Between Biomarkers and Clinical Outcomes in Novel Coronavirus (COVID-19) Pneumonia in a U.S. Cohort

2020 ◽  
Author(s):  
Shant Ayanian ◽  
Juan Reyes ◽  
Lei Lynn ◽  
Karolyn Teufel
Keyword(s):  
Clinical Outcomes ◽  
Laboratory Data ◽  
Clinical Deterioration ◽  
University Hospital ◽  
Risk Of Death ◽  
Markers Of Inflammation ◽  
Increased Risk ◽  
Icu Transfer ◽  
Novel Coronavirus ◽  
D Dimer

AbstractBackgroundThe global pandemic caused by COVID-19 remains poorly understood by clinicians. Identifying biologic markers associated with prognosis can help clinicians recognize disease severity.ObjectiveTo describe the association between D-dimer, CRP, IL-6, ferritin, LDH, and clinical outcomes in a cohort of COVID-19 patients treated on the inpatient medical service at a university hospital in Washington, DC.DesignIn this retrospective study, we included all adults admitted to the inpatient medicine service at George Washington University Hospital between March 12, 2020 and May 9, 2020 with laboratory confirmed COVID-19. Clinical and laboratory data were extracted from electronic medical records and compared between survivors not requiring ICU transfer, survivors requiring ICU transfer, survivors requiring intubation, and non-survivors.Key Results299 patients were included in our study, of whom 69 required transfer to the ICU, 39 required intubation, and 71 died. Threshold values for IL-6 (≥50 pg/mL), D-dimer (≥3 mcg/mL), ferritin (≥450 ng/mL), CRP (≥100 mg/L), and LDH (1,200 u/L) were found to be statistically significant and independently associated with higher odd of clinical deterioration and death. Hypertension, CVA and heart disease independently had an increased risk of all three outcomes, while CKD had only an increased risk of death. Patient co-morbidities had no effect on the different biomarkers’ significant association with poor patient clinical outcomes, except cancer.ConclusionLaboratory markers of inflammation and coagulopathy can help clinicians identify patients who are at high risk for clinical deterioration, independent of clinically significant medical comorbidities.

scholarly journals Rapid Prototyping of Reusable 3D-Printed N95 Equivalent Respirators at the George Washington University

2020 ◽  
Author(s):  
Destie Provenzano ◽  
Yuan James Rao ◽  
Konstantin Mitic ◽  
Sofian N. Obaid ◽  
Dominique Pierce ◽  
...  
Keyword(s):  
3D Model ◽  
Current Model ◽  
University Hospital ◽  
George Washington ◽  
Test Protocol ◽  
3D Printed ◽  
Filtration Unit ◽  
Novel Coronavirus ◽  
Washington University ◽  
George Washington University

The 2019 Novel Coronavirus (COVID-19) has caused an acute reduction in world supplies of personal protective equipment (PPE) due to increased demand. To combat the impending shortage of equipment including N95 masks, the George Washington University Hospital (GWUH) developed a 3D printed reusable N95 comparable respirator that can be used with multiple filtration units. We evaluated several candidate prototype respirator models, 3D printer filaments, and filtration units detailed here. Our most recent working model was based on a respirator found on an open source maker website and was developed with PLA (printer filament), a removable cap, a removable filtration unit consisting of two layers of MERV 16 sandwiched between MERV 13, and removable elastic bands to secure the mask. Our candidate mask passed our own suction test protocol to evaluate leakage and passed a qualitative Bitrix N95 fit test at employee health at GWUH. Further efforts are directed at improving the current model for seal against face, comfort, and sizing. The 3D model is available upon request and in the supplement of this paper. We welcome collaboration with other institutions and suggest other facilities consider mask fit for their own population when exploring this concept.

BEDSIDE CABINET FOR THE NEWBORN INFANT DESIGNED FOR ROOMING-IN FACILITIES

PEDIATRICS ◽  
1949 ◽  
Vol 4 (1) ◽  
pp. 106-107
Author(s):  
PRESTON A. MCLENDON ◽  
JOHN PARKS
Keyword(s):  
Newborn Infant ◽  
University Hospital ◽  
Maternity Service ◽  
Selective Feeding ◽  
George Washington ◽  
Daily Care ◽  
Important Link ◽  
Infant Handling ◽  
Clear Plastic ◽  
Washington University

IT IS necessary to provide convenient and practical methods of infant handling in adopting the principle of rooming-in and selective feeding procedures. This is important, since the mother plays a prominent role in the daily care of her infant. The infant must be available to her for a greater part of the day. She deserves consideration in the ease with which she can handle her infant. The carriage for the newborn infant, therefore, becomes an all important link in this service. The bassinet in use on the maternity service at the George Washington University Hospital fills most of these requirements. In the over-all planning of this service, the bassinet was designed to fulfill the following demands: 1. simplicity; 2. ease of cleaning; 3. mobility—to move to and from the mother's room; 4. drawers and compartments to store bedside and nursery equipment sufficient for complete care of the infant; 5. foolproof attachment to the mother's bed in adjustable positions; 6. moveable bassinet on top of the cabinet for convenient and easy lifting-out and replacing the infant; 7. clear plastic bassinet for observation of the infant by nurse and mother. The cabinet-bassinet is easily moveable and is provided with 5 inch casters. The cabinet is 19 inches wide, 28½ inches long and 30 inches deep (legs included) surmounted by the bassinet held in a frame which can be pulled laterally for a distance of 18 inches, just clearing the top of the mother's bed. This places the infant in such a position that, without strain or awkwardness, he can be lifted out by the mother.

Current Experience With the Vaginal Breech Initiative at the George Washington University Hospital [1E]

2019 ◽  
Vol 133 (1) ◽  
pp. 53S-51S ◽  
Author(s):  
Kathryn I. Marko ◽  
Alexis C. Gimovsky ◽  
Amr Madkour ◽  
Dina Daines ◽  
Annam Hafeez Abbasi ◽  
...  
Keyword(s):  
University Hospital ◽  
George Washington ◽  
Washington University ◽  
Current Experience ◽  
George Washington University

scholarly journals ­­A Radiation Oncology Departmental Policy for the 2019 Novel Coronavirus (COVID-19) Pandemic

2020 ◽  
Author(s):  
Yuan James Rao ◽  
Destie Provenzano ◽  
Hiram A. Gay ◽  
Paul W. Read ◽  
Martin Ojong ◽  
...  
Keyword(s):  
Radiation Oncology ◽  
Action Plan ◽  
Washington Dc ◽  
George Washington ◽  
First Case ◽  
Critical Patients ◽  
Novel Coronavirus ◽  
Washington University ◽  
George Washington University

The COVID-19 pandemic is placing unprecedented stress on healthcare systems around the world. Although Radiation Oncology Departments are not at the frontline of fighting this infectious disease, it is important to implement COVID-19 policies to reduce risk of staff and patient exposure, and to limit the risk of department shutdown or downtime. This brief report describes the policy implemented at George Washington University Radiation Oncology to manage the risks of COVID-19. This includes a General Statement related to the priorities of the Radiation Oncology department, a screening procedure for new and follow-up patients, management policies for critical and non-critical patients with COVID-19 or under quarantine, a policy for the management of patients currently under treatment who are diagnosed or placed in quarantine, a clinical escalation action plan, guidelines for staff meetings and travel, and procedure management. This policy was implemented at George Washington University Radiation Oncology after the first case of COVID-19 was reported in Washington DC on March 7, 2020.

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