scholarly journals The novel coronavirus disease (COVID-19) in children with cancer, hematologic malignancies, and severe immunodeficiencies. Results of monocenter study

2021 ◽  
Vol 20 (4) ◽  
pp. 89-99
Author(s):  
G. G. Solopova ◽  
E. V. Tsyganova ◽  
A. V. Kondrashova ◽  
G. N. Gordeeva ◽  
E. V. Rozanceva ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Symptoms ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Hematologic Malignancies ◽  
Underlying Disease ◽  
Hematopoietic Stem ◽  
Female Ratio ◽  
Factors Associated

Data on clinical manifestations of COVID-19 in immunocompromised patients in Russia is lacking, which prompted us to conduct a study to investigate clinical manifestations, risk factors, and outcomes of SARS-CoV-2 infection in children with oncological and hematological diseases treated at the D. Rogachev NMRCPHOI (Center). In this retrospective-prospective, nonrandomized, non-interventional study we enrolled children under 18 years with cancer, hematologic malignancies, and primary immunodeficiencies (PIDs) who underwent treatment at the Center from April 2020 to October 2021. COVID-19 cases were confirmed by polymerase chain reaction testing and classified as asymptomatic, mild, moderate, severe and critical. The study was approved by the Independent Ethics Committee and the Scientific Council of the Center. The study included 89 patients with a median age of 9.7 years and almost equal gender distribution (the male-to-female ratio was 1.1:1). Most patients (74%) were infected in a family claster. The main underlying diseases were: hemoblastoses (43.8%), solid tumors (33.7%), PIDs (14.6%). The most common clinical symptoms were fever (29%) and respiratory symptoms (47%). In 79% of cases, patients were asymptomatic or had mild symptoms; 21% of patients had moderate and severe disease (16% and 5%, accordingly). Risk factors associated with severe COVID-19 included lymphopenia (p < 0.001) and hematopoietic stem cell transplantation (HSCT) (p = 0.002). Full recovery was documented in 84% of the patients, 16% died, however COVID-attributed mortality was 5.5%. The highest mortality was in patients with moderate/severe COVID-19 (47% vs 7%, p < 0.001), in those with progression/ relapse of the underlying disease (36.3% vs 6%, p = 0.02), in children who had received specific therapy within a year before the SARS-CoV-2 diagnosis (21% vs 0%, p = 0.02), among HSCT recipients (31.6% vs 12.1%, p = 0.02), and patients with concomitant infections (33% vs 9.2%, p < 0.01). Factors associated with poor prognosis were moderate or severe COVID-19, relapse/ progression of the underlying disease, specific treatment (HSCT in particular) within 1 year before the SARS-CoV-2 diagnosis, concomitant infections, and lymphopenia. Data obtained in this study can help physicians with management decisions at this population of patients. 

scholarly journals INCIDENCE OF DIARRHEA BY Clostridium difficile IN HEMATOLOGIC PATIENTS AND HEMATOPOIETIC STEM CELL TRANSPLANTATION PATIENTS: RISK FACTORS FOR SEVERE FORMS AND DEATH

2014 ◽  
Vol 56 (4) ◽  
pp. 325-331 ◽  
Author(s):  
Fernanda Spadão ◽  
Juliana Gerhardt ◽  
Thais Guimarães ◽  
Frederico Dulley ◽  
João Nóbrega de Almeida Junior ◽  
...  
Keyword(s):  
Risk Factors ◽  
Stem Cell ◽  
Clostridium Difficile ◽  
Underlying Disease ◽  
Severe Form ◽  
Cell Transplant ◽  
Hematopoietic Stem ◽  
Factors Associated ◽  
Potential Factors ◽  
Clostridium Difficile Associated Diarrhea

We describe the rate of incidence of Clostridium difficile-associated diarrhea (CDAD) in hematologic and patients undergone stem cell transplant (HSCT) at HC-FMUSP, from January 2007 to June 2011, using two denominators 1,000 patient and 1,000 days of neutropenia and the risk factors associated with the severe form of the disease and death. The ELISA method (Ridascreen-Biopharm, Germany) for the detections of toxins A/B was used to identify C. difficile. A multivariate analysis was performed to evaluate potential factors associated with severe CDAD and death within 14 days after the diagnosis of CDAD, using multiple logistic regression. Sixty-six episodes were identified in 64 patients among 439 patients with diarrhea during the study period. CDA rate of incidence varied from 0.78 to 5.45 per 1,000 days of neutropenia and from 0.65 to 5.45 per 1,000 patient-days. The most common underlying disease was acute myeloid leukemia 30/64 (44%), 32/64 (46%) patients were neutropenic, 31/64 (45%) undergone allogeneic HSCT, 61/64 (88%) had previously used antibiotics and 9/64 (13%) have severe CDAD. Most of the patients (89%) received treatment with oral metronidazole and 19/64 (26%) died. The independent risk factors associated with death were the severe form of CDAD, and use of linezolid.

Molecular Epidemiology and Risk Factors for Colonization by Vancomycin-ResistantEnterococcusin Patients with Hematologic Malignancies

2011 ◽  
Vol 32 (5) ◽  
pp. 490-496 ◽  
Author(s):  
N. G. Almyroudis ◽  
A. J. Lesse ◽  
T. Hahn ◽  
G. Samonis ◽  
P. A. Hazamy ◽  
...  
Keyword(s):  
Risk Factors ◽  
Molecular Epidemiology ◽  
Hospital Admissions ◽  
Severity Of Illness ◽  
Hematologic Malignancies ◽  
Observation Time ◽  
Patient Specific ◽  
Common Source ◽  
Retrospective Case ◽  
Hematopoietic Stem

Objective.To study the molecular epidemiology of vancomycin-resistantEnterococcus(VRE) colonization and to identify modifiable risk factors among patients with hematologic malignancies.Setting.A hematology-oncology unit with high prevalence of VRE colonization.Participants.Patients with hematologic malignancies and hematopoietic stem cell transplantation recipients admitted to the hospital.Methods.Patients underwent weekly surveillance by means of perianal swabs for VRE colonization and, if colonized, were placed in contact isolation. We studied the molecular epidemiology in fecal and blood isolates by pulsed-field gel electrophoresis over a 1-year period. We performed a retrospective case-control study over a 3-year period. Cases were defined as patients colonized by VRE, and controls were defined as patients negative for VRE colonization. Case patients and control patients were matched by admitting service and length of observation time.Results.Molecular genotyping demonstrated the primarily polyclonal nature of VRE isolates. Colonization occurred at a median of 14 days. Colonized patients were characterized by longer hospital admissions. Previous use of ceftazidime was associated with VRE colonization (P< .001), while use of intravenous vancomycin and antibiotics with anaerobic activity did not emerge as a risk factor. There was no association with neutropenia or presence of colonic mucosal disruption, and severity of illness was similar in both groups.Conclusion.Molecular studies showed that in the majority of VRE-colonized patients the strains were unique, arguing that VRE acquisition was sporadic rather than resulting from a common source of transmission. Patient-specific factors, including prior antibiotic exposure, rather than breaches in infection control likely predict for risk of fecal VRE colonization.

scholarly journals Hospital Readmission in Patients With COVID-19

2021 ◽  
Author(s):  
Neda Rahimian ◽  
Mahshid Heidari ◽  
Nahid Hashemi-Madani ◽  
Nader Tavakoli ◽  
Moammad E Khamseh
Keyword(s):  
Risk Factors ◽  
Hospital Readmission ◽  
Underlying Disease ◽  
Control Groups ◽  
Factors Associated ◽  
Infection Age ◽  
Discharge Plan ◽  
Matched Case ◽  
And Control ◽  
Control Study

Abstract Objective: During the COVID-19 pandemic, the demand for hospital beds has exceeded substantially. Thus, we aimed to conduct this study to identify factors associated with the risk of readmission in order to introduce the best discharge plan for patients with high risk of hospital readmission. Method: This is a multicenter, case-control study included 1357 patients hospitalized with COVID-19 infection. Age-sex-matched case and control groups were paired at 1:2 ratios. COVID-19 readmission rate was assessed. Moreover, Logistic regression analysis was applied to determine the factors associated with readmission. Results: Of the 1357 patients, 99 (7.29%) subjects were readmitted. The most common cause of readmission was respiratory distress. The median (IQR) of the interval between hospital discharge and the second admission was 5 (2-16) days. Upon adjusting with the main risk factors, having at least one underlying disease and being treated with the corticosteroid (GC) were significantly associated with a higher rate of readmission (OR: 2.76, 95% CI :1.30- 5.87) and (OR:8.24, 95% CI :3.72- 18.22), respectively.Conclusion: Identification of Risk factors of COVID 19 readmission will improve resource utilization and patient care.

scholarly journals Animais Venenosos em Território Português: Abordagem Clínica de Picadas e Mordeduras

2021 ◽  
Vol 34 (11) ◽  
pp. 784
Author(s):  
Sofia R. Valdoleiros ◽  
Inês Correia Gonçalves ◽  
Carolina Silva ◽  
Diogo Guerra ◽  
Lino André Silva ◽  
...  
Keyword(s):  
Native Species ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Hospital Setting ◽  
Marine Species ◽  
Symptomatic Treatment ◽  
Thaumetopoea Pityocampa ◽  
Hermodice Carunculata ◽  
Spider Bites

There are many native species of animals with the potential to cause severe disease in Portugal. Of the four clinically relevant snake species, the vipers (Vipera latastei and Vipera seoanei) are the most concerning. They can cause severe disease and require in-hospital management, monitoring and specific treatment, including the administration of anti-snake venom serum. The Malpolon monspessulanus and Macroprotodon brevis snakes cause mostly localized clinical manifestations, which do not require specific treatment. Only a minority of the spider species in Portugal possess chelicerae (mouthparts of the Chelicerata, shaped as either articulated fangs or pincers, which may contain venom or be connected to the venom glands and are used for predation or capture of food) long enough to perforate the human skin. Nevertheless, Latrodectus tredecimguttatus and Loxosceles rufescens spider bites may require specialized treatment in a hospital setting, as well as careful active symptom surveillance. Diversely, the treatment for Scolopendra cingulata and Scolopendra oraniensis centipedes’ bites is merely symptomatic. The only existing scorpion species in Portugal is the Buthus ibericus; its sting typically causes local symptoms with intense pain, and its treatment consists essentially of analgesia. The insects of the Hymenoptera order, such as bees and wasps, have the ability to inject venom into the skin. Most people present only with local or regional inflammatory response, and symptomatic treatment is usually effective. Even so, individuals with hypersensitivity to bee venom may develop anaphylaxis. Several marine species in the Portuguese coast are venomous to humans, including weeverfish (Trachinidae family), stingrays (Dasyatis pastinaca, Taeniura grabata, Myliobatis aquila), red scorpion fish (Scorpaena scrofa), cnidaria (Pelagia noctiluca, Chrysaora hysoscella, Physalia physalis) and bearded fireworm (Hermodice carunculata); treatment is symptomatic. Contact with the larvae or bristles (chitinous structures with locomotor or tactile functions) of Thaumetopoea pityocampa (pine processionary) can cause cutaneous, ocular and, rarely, respiratory reactions; its management is also symptomatic.

scholarly journals Comparative Analysis of Pediatric COVID-19 Infection in Southeast Asia, South Asia, Japan, and China

2021 ◽  
Author(s):  
Judith Ju Ming Wong ◽  
Qalab Abbas ◽  
Soo Lin Chuah ◽  
Ririe Fachrina Malisie ◽  
Kah Min Pon ◽  
...  
Keyword(s):  
Risk Factors ◽  
South Asia ◽  
Cultural Practices ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
World Health ◽  
Logistic Regression Models ◽  
Clinical Presentations ◽  
The Common ◽  
Health Organization

There is a scarcity of data regarding coronavirus disease 2019 (COVID-19) infection in children from southeast and south Asia. This study aims to identify risk factors for severe COVID-19 disease among children in the region. This is an observational study of children with COVID-19 infection in hospitals contributing data to the Pediatric Acute and Critical Care COVID-19 Registry of Asia. Laboratory-confirmed COVID-19 cases were included in this registry. The primary outcome was severity of COVID-19 infection as defined by the World Health Organization (WHO) (mild, moderate, severe, or critical). Epidemiology, clinical and laboratory features, and outcomes of children with COVID-19 are described. Univariate and multivariable logistic regression models were used to identify risk factors for severe/critical disease. A total of 260 COVID-19 cases from eight hospitals across seven countries (China, Japan, Singapore, Malaysia, Indonesia, India, and Pakistan) were included. The common clinical manifestations were similar across countries: fever (64%), cough (39%), and coryza (23%). Approximately 40% of children were asymptomatic, and overall mortality was 2.3%, with all deaths reported from India and Pakistan. Using the multivariable model, the infant age group, presence of comorbidities, and cough on presentation were associated with severe/critical COVID-19. This epidemiological study of pediatric COVID-19 infection demonstrated similar clinical presentations of COVID-19 in children across Asia. Risk factors for severe disease in children were age younger than 12 months, presence of comorbidities, and cough at presentation. Further studies are needed to determine whether differences in mortality are the result of genetic factors, cultural practices, or environmental exposures.

Prevalence and Risk Factors Associated with First-Line Anti-Tuberculosis Induced Hepatotoxicity in Suratthani Hospital, Thailand

2021 ◽  
Vol 104 (2) ◽  
pp. 233-239
Keyword(s):  
Risk Factors ◽  
Serum Albumin ◽  
Clinical Symptoms ◽  
Significant Risk ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
First Line ◽  
Drug Induced ◽  
Factors Associated ◽  
Drug Risk

ackground: Tuberculosis (TB) is a major public health problem, including Thailand. Anti-TB drugs are very effective treatment, but they can cause hepatotoxicity. Data on the prevalence of anti-TB drug-induced hepatotoxicity (DIH), as well as the contributing risk factors, are scarce in Thailand. Objective: To measure the prevalence and identify risk factors associated with first-line drugs (FLD) induced hepatoxicity in TB patients. Materials and Methods: The present study was a retrospective study design in TB clinic of Suratthani Hospital, in Southern Thailand. All patients diagnosed with TB and received FLD between January and December 2017, were eligible for the study. Hepatoxicity defined as the following criteria: serum aspartate aminotransferase (AST) or alanine aminotransferase (ALT) levels >5x upper limit of normal (ULN) without symptoms, or AST or ALT >3x ULN with clinical symptoms. Results: Of all the 198 TB cases, 18 were identified as DIH. Prevalence of DIH was 9.1%. Hepatitis after FLD was independently associated with age>60 years (adjusted OR [aOR] 28.49, 95% CI 2.68 to 302.95, p=0.005) and serum albumin <3.5 g/dL (aOR 20.97, 95% CI 2.11 to 208.51, p=0.009). Conclusion: Age of more than 60 years and low serum albumin of less than 3.5 g/dL were significant risk factors associated with first-line anti-TB drugs induced hepatoxicity. Keywords: Hepatoxicity, Anti-tuberculosis drug, Risk factor, Thailand

PARK2 and PARK7 Gene Polymorphisms as Risk Factors Associated with Serum Element Concentrations and Clinical Symptoms of Parkinson’s Disease

2019 ◽  
Vol 40 (3) ◽  
pp. 357-367
Author(s):  
Jaya Sanyal ◽  
Athira Anirudhan ◽  
Tapas Kumar Banerjee ◽  
Gautam Guha ◽  
Ramakrishnan Veerabathiran ◽  
...  
Keyword(s):  
Risk Factors ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Gene Polymorphisms ◽  
Clinical Symptoms ◽  
Factors Associated ◽  
Element Concentrations
Sign in / Sign up

Export Citation Format

Share Document