scholarly journals Presence of Anti-MDA5 Antibody and Its Value for the Clinical Assessment in Patients With COVID-19: A Retrospective Cohort Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Geng Wang ◽  
Qian Wang ◽  
Yeming Wang ◽  
Changzheng Liu ◽  
Linghang Wang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clinical Assessment ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Adverse Outcome ◽  
High Titer ◽  
Severe Disease ◽  
Time Points ◽  
Laboratory Features ◽  
Positive Rate

BackgroundStriking similarities have been found between coronavirus disease 2019 (COVID-19) and anti-melanoma differentiation-associated gene 5 (MDA5) antibody (Ab)-related dermatomyositis, implying a shared autoinflammatory aberrance. Herein, we aim to investigate whether the anti-MDA5 Ab is present in COVID-19 and correlates with the severity and adverse outcome of COVID-19 patients.Methods and FindingsWe retrospectively recruited 274 adult inpatients with COVID-19 in this study, including 48, 164, and 62 cases of deaths, severe, and non-severe patients respectively. The anti-MDA5 Ab was determined by ELISA and verified by Western Blotting, which indicated that the positive rate of anti-MDA5 Ab in COVID-19 patients was 48.2% (132/274). The clinical and laboratory features, as well as outcomes between patients with positive and negative anti-MDA5 Ab were compared and we found that the anti-MDA5 Ab positive patients tended to represent severe disease (88.6% vs 66.9%, P<0.0001). We also demonstrated that the titer of anti-MDA5 Ab was significantly elevated in the non-survivals (5.95 ± 5.16 vs 8.22 ± 6.64, P=0.030) and the positive rate was also higher than that in the survivals (23.5% vs 12.0%, P=0.012). Regarding severe COVID-19 patients, we found that high titer of anti-MDA5 Ab (≥10.0 U/mL) was more prevalent in the non-survivals (31.2% vs 14.0%, P=0.006). Moreover, a dynamic analysis of anti-MDA5 Ab was conducted at different time-points of COVID-19, which revealed that early profiling of anti-MDA5 Ab could distinguish severe patients from those with non-severe ones.ConclusionsAnti-MDA5 Ab was prevalent in the COVID-19 patients and high titer of this antibody is correlated with severe disease and unfavorable outcomes.

Implications of Hidradenitis Suppurativa Phenotypes in Cardiovascular Risk and Treatment Decisions: A Retrospective Cohort Study

Dermatology ◽  
2021 ◽  
pp. 1-6
Author(s):  
Carlos Cuenca-Barrales ◽  
Trinidad Montero-Vilchez ◽  
Luis Salvador-Rodríguez ◽  
Manuel Sánchez-Díaz ◽  
Salvador Arias-Santiago ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cardiovascular Risk ◽  
Disease Severity ◽  
Retrospective Cohort Study ◽  
Therapeutic Approach ◽  
Retrospective Cohort ◽  
Hidradenitis Suppurativa ◽  
Severe Disease ◽  
Treatment Decisions ◽  
Lesion Pattern

<b><i>Background:</i></b> New integrative hidradenitis suppurativa (HS) lesion pattern phenotypes have been proposed, an inflammatory phenotype (IP) and a follicular phenotype (FP). They are characterized by different lesion patterns, symptoms, and risks of disease progression. <b><i>Objectives:</i></b> To evaluate whether lesion pattern phenotypes (1) have a different cardiovascular risk factor profile, and (2) are associated with a different therapeutic approach in the setting of an HS clinic. <b><i>Methods:</i></b> A retrospective cohort study was conducted on 233 patients with HS. They were classified according to lesion pattern phenotype criteria. Data regarding cardiovascular risk factors and treatment decisions were gathered. <b><i>Results:</i></b> One hundred and seventeen HS patients (50.21%) were classified as FP and 112 (48.07%) as IP. IP was associated with more severe disease and greater impairment of quality of life. Regardless of disease severity, patients with IP may have a higher cardiovascular risk, assessed according to higher C-reactive protein (CRP) levels (12.75 vs. 5.89, <i>p</i> = 0.059). The lesion pattern phenotype also influenced treatment decisions regardless of disease severity. Patients with IP were more likely to be treated with systemic corticosteroids and adalimumab, showing that lesion pattern phenotypes are associated with different therapeutic approaches. <b><i>Conclusions:</i></b> IP is associated with higher CRP values, suggesting a greater cardiovascular risk in these patients and also a different therapeutic approach. This information could help guide dermatologists in the management of HS patients and help to determine future treatment recommendations.

Procalcitonin Clearance at 24, 48, 72, and 96 Hours and Mortality in Patients With Cancer and Sepsis: A Retrospective Cohort Study

2019 ◽  
Vol 35 (11) ◽  
pp. 1297-1301
Author(s):  
Antonio Paulo Nassar ◽  
Beatriz Nicolau Nassif ◽  
Daniel Vitório Veiga dos Santos ◽  
Pedro Caruso
Keyword(s):  
Cohort Study ◽  
Hospital Mortality ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Predictive Performance ◽  
Mortality Prediction ◽  
Sepsis Management ◽  
Receiver Operating Characteristic Curves ◽  
Time Points ◽  
Patients With Cancer

Introduction: Previous studies have evaluated procalcitonin clearance (PCTc) as a marker of sepsis severity but at different time points and cutoffs. We aimed to assess the predictive performance of PCTc at different time points of sepsis management in patients with cancer. Methods: This retrospective cohort study included patients with cancer admitted to an intensive care unit between 2013 and 2016. We calculated PCTc at 24, 48, 72, and 96 hours after admission. Its predictive performance for hospital and 90-day mortality was analyzed with receiver operating characteristic curves and areas under the curves (AUCs). Sensitivity and specificity were calculated for different time points using different cutoffs. Results: We included 301 patients. Areas under the curves ranged from 0.62 for PCTc at 24 hours to 0.68 for PCTc at 72 and 96 hours for hospital mortality prediction, and from 0.61 for PCTc at 24 hours to 0.68 for PCTc at 72 hours for 90-day mortality prediction. For hospital mortality prediction, PCTc at 72 hours ≤80% showed the best sensitivity (96.0%; 95% confidence interval [CI]: 90.8%-98.7%), and PCTc at 96 hours ≤50% showed the best specificity (70.7%; 95% CI: 54.5%-83.9%). Conclusions: Procalcitonin clearance at 24, 48, 72, and 96 hours poorly predicted hospital and 90-day mortality. Therefore, daily PCT measurement should not be used to predict mortality for patients with cancer and sepsis.

scholarly journals Comparative outcomes of lopinavir/ritonavir and hydroxychloroquine for the treatment of coronavirus disease 2019 with mild to moderate severity.

2020 ◽  
Author(s):  
Jeong Eun Lee ◽  
Soon Ok Lee ◽  
Jeonghun Heo ◽  
Dong Wan Kim ◽  
Mi Ran Park ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Clinical Characteristics ◽  
Severe Disease ◽  
Relative Effectiveness ◽  
Initial Therapy ◽  
Clinical Failure ◽  
Moderate Severity ◽  
Moderate Disease

Abstract Background: Lopinavir/ritonavir and hydroxychloroquine are both being used to treat COVID-19, but their relative effectiveness is unknown. The purpose of this study was to compare the clinical outcomes of patients treated for COVID-19 with lopinavir/ritonavir (LPV/r) or hydroxychloroquine (HCQ).Methods: A retrospective cohort study was conducted at 2 hospitals in Busan, South Korea, that treated approximately 90% of COVID-19 patients hospitalized in Busan during the study period. All patients aged ≥15 years that were hospitalized with mild-or-moderate COVID-19 received LPV/r or HCQ as their initial treatment and were included in the analysis.Results: Among the 72 patients with mild-to-moderate disease severity on admission, 45 received LPV/r and 27 received HCQ as their initial therapy. A higher proportion of the LPV group had pneumonia on admission (LPV 49% vs. HCQ 15%), but there were no other significant differences in the demographic or clinical characteristics between groups.Switching therapy due to clinical failure was significantly more common in the HCQ group than in the LPV/r group (41% [11/27] and 2% [1/45], respectively, P=0.001). Disease progression was also significantly more common in the HCQ group than in the LPV/r group (44% [12/27] and 18% [8/45], respectively, P=0.030).Conclusions: LPV/r appears to be more effective than HCQ at preventing progression to severe disease in patients with COVID-19.

Predicting Sport-related mTBI Symptom Resolution Trajectory Using Initial Clinical Assessment Findings: A Retrospective Cohort Study

2019 ◽  
Vol 50 (6) ◽  
pp. 1191-1202 ◽  
Author(s):  
Joshua P. McGeown ◽  
Stephen Kara ◽  
Mark Fulcher ◽  
Hannah Crosswell ◽  
Robert Borotkanics ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clinical Assessment ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Symptom Resolution

scholarly journals 2789. Respiratory Syncytial Disease in Hospitalized Adults: A Retrospective Cohort Study

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S985-S986
Author(s):  
Hannah Nam ◽  
Michael G Ison
Keyword(s):  
Mechanical Ventilation ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Severe Disease ◽  
Solid Organ ◽  
Cell Transplant ◽  
Immunocompromised Patients ◽  
Transplant Patients ◽  
History Of

Abstract Background Respiratory syncytial virus (RSV) is associated with significant mortality rates amongst hematopoietic stem cell transplant (HSCT) and lung transplant recipients. Although RSV is responsible for ~177,000 hospitalizations and 14,000 deaths annually, few epidemiologic studies including all adults including those with immunocompromise have been conducted over multiple seasons. Methods A retrospective cohort study of adults admitted to a large academic medical center in Chicago, IL from 2009 to 2018 was conducted in patients with positive RSV PCR. Specific data on clinical presentation, management, and outcomes were collected by manual chart review. Descriptive statistics were calculated, and Pearson’s Chi-Squared test was utilized to assess association between severe disease status and comorbidities. Results A total of 140 patients* were admitted during part of the study period (2016–2018) with positive PCR for RSV. Most patients had otherwise underlying comorbidities prior to admission (lung 44.2%, heart 40.0%, diabetes 20.7%), history of immunocompromise (36.4%, 51) or history of smoking (39.2%, 55). Cough was the most common symptom among all hospitalized adults (90.7%, 127). However, patients with a history of transplant (both HSCT and SOT) more commonly displayed symptoms of fevers at presentation (50%, 10) when compared with non-immunocompromised patients (36.6%, 36). ICU admission occurred in one-third of the hospitalized patients, with no significant difference amongst transplant patients, immunocompromised patients, and non-immunocompromised patients. Need for mechanical ventilation was highest in patients with co-infections. None of the co-morbidities measured were independent risk factors for severe disease. Most patients (78.5%, 110) were discharged home. Among the 12 fatal cases, all were admitted to the ICU with seven (58.3%) requiring mechanical ventilation. Three (25.0%) were immunocompromised while two (16.7%) were HSCT patients, but none were solid-organ transplant patients. *Ongoing data collection. Conclusion RSV patients were diverse in their demographics, treatment, and outcomes. Large percentages of patients had underlying comorbidities such as immunocompromise due to HSCT, lung and heart disease. Disclosures All authors: No reported disclosures.

scholarly journals Coagulation parameters during the course of severe postpartum hemorrhage: a nationwide retrospective cohort study

2018 ◽  
Vol 2 (19) ◽  
pp. 2433-2442 ◽  
Author(s):  
Ada Gillissen ◽  
Thomas van den Akker ◽  
Camila Caram-Deelder ◽  
Dacia D. C. A. Henriquez ◽  
Kitty W. M. Bloemenkamp ◽  
...  
Keyword(s):  
Cohort Study ◽  
Platelet Count ◽  
Retrospective Cohort Study ◽  
Postpartum Hemorrhage ◽  
Retrospective Cohort ◽  
Adverse Outcome ◽  
Coagulation Parameters ◽  
Early Postpartum ◽  
Prolonged Aptt ◽  
The Moment

Abstract We describe the pattern of change in coagulation parameters during the course of severe postpartum hemorrhage in a retrospective cohort study among 1312 women experiencing severe postpartum hemorrhage necessitating blood transfusion. Levels of hemoglobin, hematocrit, platelet count, fibrinogen, activated partial thromboplastin time (aPTT) and prothrombin time (PT) per categorized volume of blood loss during severe postpartum hemorrhage were described and compared between women with and without the composite adverse outcome. Need for surgical intervention, severe acute maternal morbidity, and maternal mortality were jointly considered the composite adverse outcome. Of the 1312 women, 463 (35%) developed the composite adverse outcome. The incidence of a fibrinogen level &lt;2 g/L was 26% (342 per 1312). Low fibrinogen and prolonged aPTT during the first 2 L of hemorrhage were associated with a subsequent composite adverse outcome; median fibrinogen and aPTT among women with and without the composite end point after 1.5 to 2 L of hemorrhage were 1.5 g/L (interquartile range [IQR], 1.0-1.9) vs 2.7 g/L (IQR, 1.9-3.4) and 39 s (IQR, 30-47) vs 32 s (IQR, 28-36), respectively. PT and platelet count as assessed during the first 2 L of hemorrhage were not associated with morbidity or mortality. Our results suggest that detection of low levels of fibrinogen and elevated aPTT levels during early postpartum hemorrhage can contribute to the identification of women that may benefit from targeted hemostatic treatment. Essential in this identification process is the moment of reaching a level of fibrinogen of &lt;2 g/L during the course of postpartum hemorrhage.

scholarly journals Incidence of Bloodstream Infections in Patients with COVID-19: A Retrospective Cohort Study of Risk Factors and Outcomes

2021 ◽  
Author(s):  
Claudia Villatoro Santos ◽  
Elisa Akagi Fukushima ◽  
Wei Zhao ◽  
Mamta Sharma ◽  
Dima Youssef ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Severe Disease ◽  
Bloodstream Infections ◽  
X Ray ◽  
Abnormal Chest ◽  
Chest X Ray ◽  
Male Sex

Abstract Objective: To describe the incidence, risk factors, and outcomes of bloodstream infections (BSIs) in patients with coronavirus disease 19 (COVID-19).Methods: This was a single-center retrospective cohort study of adults admitted for COVID-19 with BSIs. Data were collected by electronic medical record review. BSIs were defined as positive blood cultures (BCs) with a known pathogen in one or more BCs or the same commensal organism in two or more BCs. Results: Of 565 eligible patients, 290 (51.3%) had BCs done, with 39 (13.4%) having a positive result. In univariable analysis, male sex, black/African American race, admission from a facility, hemiplegia, altered mental status, and a higher Charlson Comorbidity Index were positively associated with a positive BC, whereas obesity and low systolic blood pressure (SBP) were negatively associated. Patients with positive BCs were more likely to have severe disease, be admitted to the Intensive Care Unit (ICU), require mechanical ventilation, have septic shock, and higher mortality. In multivariable logistic regression, factors that were independent predictors of a positive BC were male sex (OR=2.75, p=0.03), hypoalbuminemia (OR=3.3, p=0.01), ICU admission (OR=5.3, p<0.0001), SBP < 100 (OR=3.7, p=0.03) and having a procedure (OR=10.5, p<0.0001). Patients with an abnormal chest x-ray on admission were less likely to have a positive BC (OR=0.25, p=0.007). Conclusions: We found that independent predictors of BSIs in COVID-19 patients included male sex, abnormal chest x-ray, hypoalbuminemia, admission to ICU, low SBP, and having a procedure during hospital stay.

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