scholarly journals Oral Bacteriotherapy in Patients With COVID-19: A Retrospective Cohort Study

2021 ◽  
Vol 7 ◽  
Author(s):  
Giancarlo Ceccarelli ◽  
Cristian Borrazzo ◽  
Claudia Pinacchio ◽  
Letizia Santinelli ◽  
Giuseppe Pietro Innocenti ◽  
...  
Keyword(s):  
Cohort Study ◽  
Intestinal Epithelial ◽  
Risk Of Mortality ◽  
Crude Mortality ◽  
Increased Risk ◽  
Observational Cohort ◽  
Prospective Trials ◽  
Independent Variable ◽  
Retrospective Observational Cohort Study ◽  
Length Of Hospitalization

Background: Mounting evidence suggests SARS-CoV-2 may impact on host microbiota and gut inflammation, infecting intestinal epithelial cells. This possible link and its implications can be investigated by observing the effects of modulation of the microbial flora in patients with COVID-19. The aim of this study was to compare the rate of mortality, the need of ICU hospitalization and the length of hospitalization in patients with severe COVID-19 pneumonia who received the best available therapy (BAT) vs. patients treated with BAT and supplemented with oral bacteriotherapy.Methods: This retrospective, observational cohort study included 200 adults with severe COVID-19 pneumonia. All patients received therapeutic regimens including low molecular weight heparin plus one or more between hydroxychloroquine, azithromycin, antivirals, and Tocilizumab. Oral bacteriotherapy was used as complementary treatment.Results: Out of the 200 patients, 112 received BAT without oral bacteriotherapy, and 88 BAT with oral bacteriotherapy. Crude mortality was 22%. Eleven percent died in the group of patients treated with BAT plus oral bacteriotherapy vs. 30% subjects in the group of patients managed only with BAT (p < 0.001). By multivariate analysis, the age >65 years, CRP >41.8 mg/L, Platelets <150.000 mmc, and cardiovascular events were associated with the increased risk of mortality. Oral bacteriotherapy was an independent variable associated with a reduced risk for death. Despite large prospective trials are needed, this study highlights a possible role for oral bacteriotherapy in the management of patients hospitalized for COVID-19 pneumonia.

scholarly journals Incidence, Risk Factors and Impact on Clinical Outcomes of Bloodstream Infections in Patients Hospitalised with COVID-19: A Prospective Cohort Study

Antibiotics ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1031
Author(s):  
Andrea Cona ◽  
Alessandro Tavelli ◽  
Andrea Renzelli ◽  
Benedetta Varisco ◽  
Francesca Bai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Bloodstream Infections ◽  
Corticosteroid Treatment ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Incidence Risk ◽  
Observational Cohort ◽  
Healthcare Associated ◽  
Hospital Acquired

With the aim of describing the burden and epidemiology of community-acquired/healthcare-associated and hospital-acquired bloodstream infections (CA/HCA-BSIs and HA-BSIs) in patients hospitalised with COVID-19, and evaluating the risk factors for BSIs and their relative impact on mortality, an observational cohort study was performed on patients hospitalised with COVID-19 at San Paolo Hospital in Milan, Italy from 24 February to 30 November 2020. Among 1351 consecutive patients hospitalised with COVID-19, 18 (1.3%) had CA/HCA-BSI and 51 (3.8%) HA-BSI for a total of 82 episodes of BSI. The overall incidence of HA-BSI was 3.3/1000 patient-days (95% CI 2.4–4.2). Patients with HA-BSI had a longer hospital stay compared to CA/HCA-BSI and no-BSI groups (27 (IQR 21–35) vs. 12 (7–29) vs. 9 (5–17) median-days, p < 0.001) but a similar in-hospital mortality (31% vs. 33% vs. 25%, p = 0.421). BSI was not associated with an increased risk of mortality (CA/HCA-BSI vs. non-BSI aOR 1.27 95% CI 0.41–3.90, p = 0.681; HA-BSI vs. non-BSI aOR 1.29 95% CI 0.65–2.54, p = 0.463). Upon multivariate analysis, NIMV/CPAP (aOR 2.09, 95% CI 1.06–4.12, p = 0.034), IMV (aOR 5.13, 95% CI 2.08–12.65, p < 0.001) and corticosteroid treatment (aOR 2.11, 95% CI 1.06–4.19, p = 0.032) were confirmed as independent factors associated with HA-BSI. Development of HA-BSI did not significantly affect mortality. Patients treated with corticosteroid therapy had double the risk of developing BSI.

scholarly journals The association of serum gamma-glutamyltransferase and the incidence of type 2 diabetes mellitus based on propensity score matching: a retrospective observational cohort study

2020 ◽  
Author(s):  
Buyuan Dong ◽  
Ziwei Ji ◽  
Leye He ◽  
Hao Chen ◽  
Mengxia Chen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Japanese Population ◽  
Observational Cohort Study ◽  
Gamma Glutamyltransferase ◽  
Increased Risk ◽  
Gender And Age ◽  
Observational Cohort ◽  
And Gender ◽  
Retrospective Observational Cohort Study

Abstract Background: Previous studies reported that gamma-glutamyltransferase (GGT) may play an important role in the development of diabetes. The purpose of this study is to demonstrate that GGT is an independent risk factor for diabetes and to explore whether the association between GGT and the incidence of diabetes is affected by age and gender in the general Japanese population.Methods: This study is a retrospective observational cohort study. The study included 15464 men and women with an average age of 43.71 years from the Japanese health checkup program at Murakami Memorial Hospital from 2004 to 2015. The serum gamma-glutamyltransferase was stratified by quartiles. Patients were stratified by gender and age. Results: After adjusting for potential confounders, each additional standard deviation (SD) of GGT increases the risk of diabetes by 9%. The hazard ratio (HR) is 1.09 and the confidence interval (CI) is (1.01, 1.17). Participants in the fourth quartiles (Q4,≥ 22IU/L) had a higher risk of diabetes than the first to third quartiles (Q1-Q3) of GGT (HR: 1.47, 95 % CI: 1.15-1.87). Compared with males with lower GGT activity, males aged 40 to 50 years with GGT activity in the fourth quantile had a 53% increased risk of diabetes mellitus. Conclusions: GGT was positively correlated with the incidence of diabetes in the Japanese population. Especially in males aged 40-50 y, the higher the GGT, the higher the risk of developing diabetes.

scholarly journals Retrospective cohort study of admission timing and mortality following COVID-19 infection in England

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e042712
Author(s):  
Ahmed Alaa ◽  
Zhaozhi Qian ◽  
Jem Rashbass ◽  
Jonathan Benger ◽  
Mihaela van der Schaar
Keyword(s):  
Cohort Study ◽  
Hospital Admission ◽  
Symptom Onset ◽  
Healthcare Workers ◽  
Multivariate Regression Analysis ◽  
Study Cohort ◽  
Risk Of Mortality ◽  
Observational Cohort ◽  
Minority Ethnic ◽  
Retrospective Observational Cohort Study

ObjectivesWe investigated whether the timing of hospital admission is associated with the risk of mortality for patients with COVID-19 in England, and the factors associated with a longer interval between symptom onset and hospital admission.DesignRetrospective observational cohort study of data collected by the COVID-19 Hospitalisation in England Surveillance System (CHESS). Data were analysed using multivariate regression analysis.SettingAcute hospital trusts in England that submit data to CHESS routinely.ParticipantsOf 14 150 patients included in CHESS until 13 May 2020, 401 lacked a confirmed diagnosis of COVID-19 and 7666 lacked a recorded date of symptom onset. This left 6083 individuals, of whom 15 were excluded because the time between symptom onset and hospital admission exceeded 3 months. The study cohort therefore comprised 6068 unique individuals.Main outcome measuresAll-cause mortality during the study period.ResultsTiming of hospital admission was an independent predictor of mortality following adjustment for age, sex, comorbidities, ethnicity and obesity. Each additional day between symptom onset and hospital admission was associated with a 1% increase in mortality risk (HR 1.01; p<0.005). Healthcare workers were most likely to have an increased interval between symptom onset and hospital admission, as were people from Black, Asian and minority ethnic (BAME) backgrounds, and patients with obesity.ConclusionThe timing of hospital admission is associated with mortality in patients with COVID-19. Healthcare workers and individuals from a BAME background are at greater risk of later admission, which may contribute to reports of poorer outcomes in these groups. Strategies to identify and admit patients with high-risk and those showing signs of deterioration in a timely way may reduce the consequent mortality from COVID-19, and should be explored.

scholarly journals Disorders of placental villous maturation in fetal death

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Sunil Jaiman ◽  
Roberto Romero ◽  
Percy Pacora ◽  
Eunjung Jung ◽  
Gaurav Bhatti ◽  
...  
Keyword(s):  
Cohort Study ◽  
Fetal Death ◽  
Prevalence Ratio ◽  
Normal Pregnancy ◽  
Observational Cohort Study ◽  
Maturation Arrest ◽  
Inflammatory Lesions ◽  
Multiple Gestations ◽  
Observational Cohort ◽  
Retrospective Observational Cohort Study

Abstract Objective The aims of this study were to ascertain the frequency of disorders of villous maturation in fetal death and to also delineate other placental histopathologic lesions in fetal death. Methods This was a retrospective observational cohort study of fetal deaths occurring among women between January 2004 and January 2016 at Hutzel Women’s Hospital, Detroit, MI, USA. Cases comprised fetuses with death beyond 20 weeks’ gestation. Fetal deaths with congenital anomalies and multiple gestations were excluded. Controls included pregnant women without medical/obstetrical complications and delivered singleton, term (37–42 weeks) neonate with 5-min Apgar score ≥7 and birthweight between the 10th and 90th percentiles. Results Ninety-two percent (132/143) of placentas with fetal death showed placental histologic lesions. Fetal deaths were associated with (1) higher frequency of disorders of villous maturation [44.0% (64/143) vs. 1.0% (4/405), P < 0.0001, prevalence ratio, 44.6; delayed villous maturation, 22% (31/143); accelerated villous maturation, 20% (28/143); and maturation arrest, 4% (5/143)]; (2) higher frequency of maternal vascular malperfusion lesions [75.5% (108/143) vs. 35.7% (337/944), P < 0.0001, prevalence ratio, 2.1] and fetal vascular malperfusion lesions [88.1% (126/143) vs. 19.7% (186/944), P < 0.0001, prevalence ratio, 4.5]; (3) higher frequency of placental histologic patterns suggestive of hypoxia [59.0% (85/143) vs. 9.3% (82/942), P < 0.0001, prevalence ratio, 6.8]; and (4) higher frequency of chronic inflammatory lesions [53.1% (76/143) vs. 29.9% (282/944), P < 0.001, prevalence ratio 1.8]. Conclusion This study demonstrates that placentas of womem with fetal death were 44 times more likely to present disorders of villous maturation compared to placentas of those with normal pregnancy. This suggests that the burden of placental disorders of villous maturation lesions is substantial.

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