scholarly journals Prospective Analysis Between Neutrophil-to-Lymphocyte Ratio on Admission and Development of Delirium Among Older Hospitalized Patients With COVID-19

2021 ◽  
Vol 13 ◽  
Author(s):  
Eduardo Fernández-Jiménez ◽  
Ainoa Muñoz-Sanjose ◽  
Roberto Mediavilla ◽  
Gonzalo Martínez-Alés ◽  
Iker I. Louzao ◽  
...  
Keyword(s):  
Age Groups ◽  
Binary Logistic Regression ◽  
Illness Severity ◽  
Hospitalized Patients ◽  
Neutrophil To Lymphocyte Ratio ◽  
Medical Comorbidity ◽  
Logistic Regression Models ◽  
Lymphocyte Ratio ◽  
Increased Risk ◽  
Prospective Association

Objective: To examine any prospective association between neutrophil-to-lymphocyte ratio (NLR) at hospital admission and subsequent delirium in older COVID-19 hospitalized patients comparing by sex and age groups.Methods: The sample consisted of 1,785 COVID-19 adult inpatients (minimum sample size required of 635 participants) admitted to a public general hospital in Madrid (Spain) between March 16th and April 15th, 2020. Variables were obtained from electronic health records. Binary logistic regression models were performed between baseline NLR and delirium adjusting for age, sex, medical comorbidity, current illness severity, serious mental illness history and use of chloroquine and dexamethasone. An NLR cut-off was identified, and stratified analyses were performed by age and sex. Also, another biomarker was tested as an exposure (the systemic immune-inflammation index –SII).Results: 55.3% of the patients were men, with a mean age of 66.8 years. Roughly 13% of the patients had delirium during hospitalization. NLR on admission predicted subsequent delirium development (adjusted OR = 1.02, 95 percent CI: 1.00–1.04, p = 0.024). Patients between 69 and 80 years with NLR values > 6.3 presented a twofold increased risk for delirium (p = 0.004). There were no sex differences in the association between baseline NLR and delirium (p > 0.05) nor SII predicted delirium development (p = 0.341).Conclusion: NLR is a good predictor of delirium during hospitalization, especially among older adults, independently of medical comorbidity, illness severity, and other covariates. Routine blood tests on admission might provide valuable information to guide the decision-making process to be followed with these especially vulnerable patients.

Seroprevalence of anti-SARS-CoV-2 IgG antibodies in hospitalized patients at a tertiary referral center in North India (Preprint)

2020 ◽  
Author(s):  
Dr. Animesh Ray ◽  
Dr. Komal Singh ◽  
Souvick Chattopadhyay ◽  
Farha Mehdi ◽  
Dr. Gaurav Batra ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Age Groups ◽  
Hospitalized Patients ◽  
North India ◽  
P Value ◽  
Care Hospital ◽  
Igg Antibodies ◽  
Igg Antibody ◽  
Increased Risk ◽  
Significant Difference

BACKGROUND Seroprevalence of IgG antibodies against SARS-CoV-2 is an important tool to estimate the true extent of infection in a population. However, seroprevalence studies have been scarce in South East Asia including India, which, as of now, carries the third largest burden of confirmed cases in the world. The present study aimed to estimate the seroprevalence of anti-SARS-CoV-2 IgG antibody among hospitalized patients at one of the largest government hospital in India OBJECTIVE The primary objective of this study is to estimate the seroprevalence of SARS-CoV-2 antibody among patients admitted to the Medicine ward and ICU METHODS This cross-sectional study, conducted at a tertiary care hospital in North India, recruited consecutive patients who were negative for SARS-CoV-2 by RT-PCR or CB-NAAT. Anti-SARS-CoV-2 IgG antibody levels targeting recombinant spike receptor-binding domain (RBD) protein of SARS CoV-2 were estimated in serum sample by the ELISA method RESULTS A total of 212 hospitalized patients were recruited in the study with mean age (±SD) of 41.2 (±15.4) years and 55% male population. Positive serology against SARS CoV-2 was detected in 19.8%patients(95% CI 14.7-25.8). Residency in Delhi conferred a higher frequency of seropositivity 26.5% (95% CI 19.3-34.7) as compared to that of other states 8% (95% CI 3.0-16.4) with p-value 0.001. No particular age groups or socio-economic strata showed a higher proportion of seropositivity CONCLUSIONS Around, one-fifth of hospitalized patients, who were not diagnosed with COVID-19 before, demonstrated seropositivity against SARS-CoV-2. While there was no significant difference in the different age groups and socio-economic classes; residence in Delhi was associated with increased risk (relative risk of 3.62, 95% CI 1.59-8.21)

Impact of Baseline Neutrophil-to-Lymphocyte Ratio on Long-Term Prognosis in Patients With Atrial Fibrillation

Angiology ◽  
2021 ◽  
pp. 000331972110004
Author(s):  
Shuang Wu ◽  
Yan-min Yang ◽  
Jun Zhu ◽  
Jia-meng Ren ◽  
Juan Wang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Continuous Variable ◽  
Cox Proportional Hazards ◽  
Neutrophil To Lymphocyte Ratio ◽  
Long Term Outcomes ◽  
Lymphocyte Ratio ◽  
Net Reclassification Improvement ◽  
Increased Risk ◽  
All Cause Mortality

We performed a retrospective analysis involving 1269 patients with atrial fibrillation (AF) to evaluate the predictive value of the neutrophil-to-lymphocyte ratio (NLR) on long-term outcomes. The primary outcomes were all-cause mortality and combined end point events (CEEs). Cox proportional hazards regression analysis and net reclassification improvement (NRI) analysis were performed. During a median follow-up of 3.32 years, 285 deaths and 376 CEEs occurred. With the elevation of the NLR, the incidence of all-cause mortality (2.77, 4.14, 6.12, and 12.18/100 person-years) and CEEs (4.19, 7.40, 8.03, and 15.22/100 person-years) significantly increased. Multivariate Cox analysis indicated that the highest NLR quartile was independently associated with the incidence of all-cause mortality (hazard ratio [HR] = 1.77, 95% CI: 1.19-2.65) and CEEs (HR = 1.66, 95% CI: 1.18-2.33). When the NLR was analyzed as a continuous variable, a 1-unit increment in log NLR was related to 134% increased risk of all-cause mortality and 119% increased risk of CEEs. Net reclassification improvement analysis revealed that NLR significantly improved risk stratification for all-cause death and CEEs by 15.0% and 9.6%, respectively. Neutrophil-to-lymphocyte ratio could be an independent predictor of long-term outcomes in patients with AF.

scholarly journals Traffic-Related Air Pollution and Child BMI—A Study of Prenatal Exposure to Nitrogen Oxides and Body Mass Index in Children at the Age of Four Years in Malmö, Sweden

2018 ◽  
Vol 15 (10) ◽  
pp. 2294 ◽  
Author(s):  
Kasper Frondelius ◽  
Anna Oudin ◽  
Ebba Malmqvist
Keyword(s):  
Body Mass Index ◽  
Air Pollution ◽  
Body Mass ◽  
Prenatal Exposure ◽  
Binary Logistic Regression ◽  
Childhood Overweight ◽  
Overweight And Obesity ◽  
Traffic Density ◽  
Logistic Regression Models ◽  
Increased Risk

Traffic-related air pollution could be a danger to the health of children. Earlier studies have linked prenatal exposure to an increased risk of a range of diseases and negative health outcomes, including overweight and obesity. Presently, a knowledge gap exists in investigating the risk of overweight and obesity among children exposed to lower levels of air pollution in utero. This study aimed to investigate the relationship between prenatal traffic-related air pollution (nitrogen dioxides (NOx) and traffic density) and childhood overweight and obesity in Malmö, Sweden. A cohort, based on attendance of a four-year check-up examination at Swedish Child Health Care (CHC) centers, and a parent-assessed questionnaire provided data on body-mass index adjusted for four-year-old children (ISO-BMI) as well as socioeconomic and health variables. We estimated exposure by using traffic density and levels of NOx at the maternal geocoded residential level. Analysis of 5815 children was performed using binary logistic regression models. This study showed no associations of increased risk for childhood overweight or obesity through to prenatal exposure to NOx in this low-exposure setting. We further suggest analysis of risks related to exposure levels ranging between the ones presented here and those proposed in previous literature.

Neutrophil-to-Lymphocyte Ratio Associates Independently With Mortality in Hospitalized Patients With Cirrhosis

2018 ◽  
Vol 16 (11) ◽  
pp. 1786-1791.e1 ◽  
Author(s):  
Jonathan Rice ◽  
Jennifer L. Dodge ◽  
Kiran M. Bambha ◽  
Jasmohan S. Bajaj ◽  
K. Rajender Reddy ◽  
...  
Keyword(s):  
Hospitalized Patients ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lymphocyte Ratio

scholarly journals Neutrophil-to-Lymphocyte Ratio and Symptomatic Hemorrhagic Transformation in Ischemic Stroke Patients Undergoing Revascularization

2020 ◽  
Vol 10 (11) ◽  
pp. 771
Author(s):  
Milena Świtońska ◽  
Natalia Piekuś-Słomka ◽  
Artur Słomka ◽  
Paweł Sokal ◽  
Ewa Żekanowska ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Multivariable Analysis ◽  
Area Under The Curve ◽  
Intravenous Thrombolysis ◽  
Hemorrhagic Transformation ◽  
Neutrophil To Lymphocyte Ratio ◽  
Study Endpoint ◽  
Stroke Treatment ◽  
Lymphocyte Ratio ◽  
Increased Risk

Objectives: Symptomatic hemorrhagic transformation (sHT) is a life-threatening complication of acute ischemic stroke (AIS). The early identification of the patients at increased risk of sHT can have clinically relevant implications. The aim of this study was to explore the validity and accuracy of the neutrophil-to-lymphocyte ratio (NLR) in predicting sHT in patients with AIS undergoing revascularization. Methods: Consecutive patients hospitalized for AIS who underwent intravenous thrombolysis, mechanical thrombectomy or both were identified. The NLR values were estimated at admission. The study endpoint was the occurrence of sHT within 24 h from stroke treatment. Results: Fifty-one patients with AIS were included, with a median age of 67 (interquartile range, 55–78) years. sHT occurred in 10 (19.6%) patients. Patients who developed sHT had higher NLR at admission. NLR was an independent predictor of sHT and showed good discriminatory power (area under the curve 0.81). In a multivariable analysis, NLR and systolic blood pressure were independently associated with sHT. Conclusions: NLR at admission can accurately predict sHT in patients with AIS undergoing revascularization.

scholarly journals Long‐Term Particulate Matter Exposure and Incidence of Arrhythmias: A Cohort Study

2020 ◽  
Vol 9 (22) ◽  
Author(s):  
Zhenyu Zhang ◽  
Jeonggyu Kang ◽  
Yun Soo Hong ◽  
Yoosoo Chang ◽  
Seungho Ryu ◽  
...  
Keyword(s):  
Air Pollution ◽  
Cohort Study ◽  
Particulate Matter ◽  
Cardiac Arrhythmia ◽  
Logistic Regression Models ◽  
Atrial Contraction ◽  
Short Term Exposure ◽  
Increased Risk ◽  
Prospective Association

Background Studies have shown that short‐term exposure to air pollution is associated with cardiac arrhythmia hospitalization and mortality. However, the relationship between long‐term particulate matter air pollution and arrhythmias is still unclear. We evaluate the prospective association between particulate matter (PM) air pollution and the risk of incident arrhythmia and its subtypes. Methods and Results Participants were drawn from a prospective cohort study of 178 780 men and women who attended regular health screening exams in Seoul and Suwon, South Korea, from 2002 to 2016. Exposure to PM with an aerodynamic diameter of ≤10 and ≤2.5 μm (PM 10 and PM 2.5 , respectively) was estimated using a land‐use regression model. The associations between long‐term PM air pollution and arrhythmia were examined using pooled logistic regression models with time‐varying exposure and covariables. In the fully adjusted model, the odds ratios (ORs) for any arrhythmia associated with a 10 μg/m 3 increase in 12‐, 36‐, and 60‐month PM 10 exposure were 1.15 (1.09, 1.21), 1.12 (1.06, 1.18), and 1.14 (1.08, 1.20), respectively. The ORs with a 10 μg/m 3 increase in 12‐ and 36‐month PM 2.5 exposure were 1.27 (1.15, 1.40) and 1.10 (0.99, 1.23). PM 10 was associated with increased risk of incident bradycardia and premature atrial contraction. PM 2.5 was associated with increased risk of incident bradycardia and right bundle‐branch block. Conclusions In this large cohort study, long‐term exposure to outdoor PM air pollution was associated with increased risk of arrhythmia. Our findings indicate that PM air pollution may be a contributor to cardiac arrhythmia in the general population.

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