Correlation between Previous Antibiotic Exposure and COVID-19 Severity. A Population-Based Cohort Study

We examined the correlation between previous antibiotic exposure and COVID-19 severity using a population-based observational matched cohort study with patient level data obtained for more than 5.8 million people registered in SIDIAP in Catalonia, Spain. We included all patients newly diagnosed with COVID-19 from March to June 2020 and identified all their antibiotic prescriptions in the previous two years. We used a composite severity endpoint, including pneumonia, hospital admission and death due to COVID-19. We examined the influence of high antibiotic exposure (>4 regimens), exposure to highest priority critically important antimicrobials (HPCIA) and recent exposure. Potential confounders were adjusted by logistic regression. A total of 280,679 patients were diagnosed with COVID-19, 146,656 of whom were exposed to at least one antibiotic course (52.3%) during the preceding two years. A total of 25,222 presented severe COVID-19 infection (9%), and the risk of severity was highest among those exposed to antibiotics (OR 1.12; 95% CI: 1.04–1.21). Among all individuals exposed to antibiotics, high, recent and exposure to HPCIAs were correlated with increased COVID severity (OR 1.19; 95% CI: 1.14–1.26; 1.41; 95% CI: 1.36–1.46; and 1.35; 95% CI: 1.30–1.40, respectively). Our findings confirm a significant correlation between previous antibiotic exposure and increased severity of COVID-19 disease.

Download Full-text

PCV120 A STATISTICAL COMPARISON OF LOGISTIC REGRESSION VERSUS MACHINE LEARNING TREE-BASED CLASSIFICATION METHODS IN PREDICTING CORONARY HEART DISEASE USING REAL-WORLD PATIENT-LEVEL DATA

Value in Health ◽

10.1016/j.jval.2019.09.844 ◽

2019 ◽

Vol 22 ◽

pp. S563-S564

Author(s):

H. Smolen

Keyword(s):

Machine Learning ◽

Coronary Heart Disease ◽

Logistic Regression ◽

Heart Disease ◽

Real World ◽

Classification Methods ◽

Patient Level Data ◽

Statistical Comparison ◽

Patient Level ◽

Level Data

Download Full-text

Incidence, Factors, and Patient-Level Data for Spontaneous HBsAg Seroclearance: A Cohort Study of 11,264 Patients

Clinical and Translational Gastroenterology ◽

10.14309/ctg.0000000000000196 ◽

2020 ◽

Vol 11 (9) ◽

pp. e00196

Author(s):

Yee Hui Yeo ◽

Tai-Chung Tseng ◽

Tetsuya Hosaka ◽

Chris Cunningham ◽

James Yan Yue Fung ◽

...

Keyword(s):

Cohort Study ◽

Patient Level Data ◽

Patient Level ◽

Level Data ◽

Hbsag Seroclearance

Download Full-text

Age and Stage Effects on The Initial Costs of Cancer- Analysis from Population-based and Patient-Level Data

British Journal of Cancer Research ◽

10.31488/bjcr.146 ◽

2020 ◽

Vol 3 (2) ◽

Keyword(s):

Population Based ◽

Patient Level Data ◽

Patient Level ◽

Level Data

Download Full-text

Lenalidomide Maintenance After Autologous Stem-Cell Transplantation in Newly Diagnosed Multiple Myeloma: A Meta-Analysis

Journal of Clinical Oncology ◽

10.1200/jco.2017.72.6679 ◽

2017 ◽

Vol 35 (29) ◽

pp. 3279-3289 ◽

Cited By ~ 240

Author(s):

Philip L. McCarthy ◽

Sarah A. Holstein ◽

Maria Teresa Petrucci ◽

Paul G. Richardson ◽

Cyrille Hulin ◽

...

Keyword(s):

Multiple Myeloma ◽

Stem Cell ◽

Stem Cell Transplantation ◽

Cumulative Incidence ◽

Meta Analysis ◽

Observation Group ◽

Newly Diagnosed ◽

Patient Level Data ◽

Patient Level ◽

Level Data

Purpose Lenalidomide maintenance therapy after autologous stem-cell transplantation (ASCT) demonstrated prolonged progression-free survival (PFS) versus placebo or observation in several randomized controlled trials (RCTs) of patients with newly diagnosed multiple myeloma (NDMM). All studies had PFS as the primary end point, and none were powered for overall survival (OS) as a primary end point. Thus, a meta-analysis was conducted to better understand the impact of lenalidomide maintenance in this setting. Patients and Methods The meta-analysis was conducted using primary-source patient-level data and documentation from three RCTs (Cancer and Leukemia Group B 100104, Gruppo Italiano Malattie Ematologiche dell'Adulto RV-MM-PI-209, and Intergroupe Francophone du Myélome 2005-02) that met the following prespecified inclusion criteria: an RCT in patients with NDMM receiving ASCT followed by lenalidomide maintenance versus placebo or observation with patient-level data available and achieved database lock for primary efficacy analysis. Results Overall, 1,208 patients were included in the meta-analysis (605 patients in the lenalidomide maintenance group and 603 in the placebo or observation group). The median PFS was 52.8 months for the lenalidomide group and 23.5 months for the placebo or observation group (hazard ratio, 0.48; 95% CI, 0.41 to 0.55). At a median follow-up time of 79.5 months for all surviving patients, the median OS had not been reached for the lenalidomide maintenance group, whereas it was 86.0 months for the placebo or observation group (hazard ratio, 0.75; 95% CI, 0.63 to 0.90; P = .001). The cumulative incidence rate of a second primary malignancy before disease progression was higher with lenalidomide maintenance versus placebo or observation, whereas the cumulative incidence rates of progression, death, or death as a result of myeloma were all higher with placebo or observation versus lenalidomide maintenance. Conclusion This meta-analysis demonstrates a significant OS benefit and confirms the PFS benefit with lenalidomide maintenance after ASCT in patients with NDMM when compared with placebo or observation.

Download Full-text

Antibiotic Exposure in the First Year of Life and the Risk of Attention-Deficit/Hyperactivity Disorder: A Population-Based Cohort Study

American Journal of Epidemiology ◽

10.1093/aje/kwz178 ◽

2019 ◽

Vol 188 (11) ◽

pp. 1923-1931 ◽

Cited By ~ 1

Author(s):

Amani F Hamad ◽

Silvia Alessi-Severini ◽

Salaheddin M Mahmud ◽

Marni Brownell ◽

I fan Kuo

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Cohort Study ◽

Confidence Interval ◽

Attention Deficit ◽

Population Based ◽

First Year ◽

Antibiotic Exposure ◽

Matched Cohort ◽

Hyperactivity Disorder ◽

First Year Of Life

Abstract Early childhood antibiotic exposure induces changes in gut microbiota reportedly associated with the development of attention-deficit/hyperactivity disorder (ADHD). We conducted a population-based cohort study to examine the association between antibiotic use in the first year of life and ADHD risk. We included children born in Manitoba, Canada, between 1998 and 2017. Exposure was defined as having filled 1 or more antibiotic prescriptions during the first year of life. ADHD diagnosis was identified in hospital abstracts, physician visits, or drug dispensations. Risk of developing ADHD was estimated using Cox proportional hazards regression in a high-dimensional propensity score–matched cohort (n = 69,738) and a sibling cohort (n = 67,671). ADHD risk was not associated with antibiotic exposure in the matched-cohort (hazard ratio = 1.02, 95% confidence interval: 0.97, 1.08) or in the sibling cohort (hazard ratio = 0.96, 95% confidence interval: 0.89, 1.03). In secondary analyses of the matched cohort, ADHD risk increase was observed in those exposed to 4 or more antibiotic courses or a duration longer than 3 weeks. These associations were not observed in the sibling cohort. We concluded that antibiotic exposure in the first year of life does not pose an ADHD risk on a population level.

Download Full-text