scholarly journals Pre-Existing Diabetes and COVID-Associated Hyperglycaemia in Patients with COVID-19 Pneumonia

Biology ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 754
Author(s):  
Andrea Laurenzi ◽  
Amelia Caretto ◽  
Chiara Molinari ◽  
Elena Bazzigaluppi ◽  
Cristina Brigatti ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Patient Management ◽  
Humoral Response ◽  
Negative Association ◽  
Organ Injury ◽  
Acid Decarboxylase ◽  
Close Monitoring ◽  
Adverse Clinical Outcome ◽  
Laboratory Findings ◽  
Progression Of Disease

Aim. The aim of the current study was to compare clinical characteristics, laboratory findings, and major outcomes of patients hospitalized for COVID-19 pneumonia with COVID-associated hyperglycaemia or pre-existing diabetes. Methods. A cohort of 176 adult patients with a diagnosis of pre-existing diabetes (n = 112) or COVID-associated hyperglycaemia (n = 55) was studied. Results. Patients with COVID-associated hyperglycaemia had lower BMI, significantly less comorbidities, and higher levels of inflammatory markers and indicators of multi-organ injury than those with pre-existing diabetes. No differences between pre-existing diabetes and COVID-associated hyperglycaemia were evident for symptoms at admission, the humoral response against SARS-CoV-2, or autoantibodies to glutamic acid decarboxylase or interferon alpha-4. COVID-associated hyperglycaemia was independently associated with the risk of adverse clinical outcome, which was defined as ICU admission or death (HR 2.11, 95% CI 1.34–3.31; p = 0.001), even after adjustment for age, sex, and other selected variables associated with COVID-19 severity. Furthermore, at the same time, we documented a negative association (HR 0.661, 95% CI 0.43–1.02; p = 0.063) between COVID-associated hyperglycaemia to swab negativization. Conclusions. Recognizing hyperglycaemia as a specific clinical entity associated with COVID-19 pneumonia is relevant for early and appropriate patient management and close monitoring for the progression of disease severity.

scholarly journals Preexisting and new-onset diabetes in patients with COVID-19 pneumonia

2021 ◽  
Author(s):  
Andrea Laurenzi ◽  
Amelia Caretto ◽  
Chiara Molinari ◽  
Elena Bazzigaluppi ◽  
Cristina Brigatti ◽  
...  
Keyword(s):  
Humoral Response ◽  
Organ Injury ◽  
Acid Decarboxylase ◽  
Close Monitoring ◽  
Adverse Clinical Outcome ◽  
Laboratory Findings ◽  
Onset Diabetes ◽  
Progression Of Disease ◽  
New Onset

AbstractObjectiveThe aim of the current study was to compare clinical characteristics, laboratory findings and major outcomes of patients hospitalized for COVID 19 pneumonia with new-onset or preexisting diabetes.DesignA cohort of 176 adult patients with a diagnosis of pre-existing (n=112) or new-onset diabetes (n=55) and confirmed COVID-19 pneumonia was studied. Clinical outcomes and laboratory findings were analysed according to the presence of preexisting or new-onset diabetes. The time to viral clearance and the persistence of hyperglycemia were assessed during the follow-up after hospital discharge.ResultsPatients with new-onset diabetes had lower BMI, significantly less comorbidities and higher levels of inflammatory markers and indicators of multi-organ injury than those with preexisting diabetes. No differences between preexisting and new onset diabetes were evident for symptoms at admission, humoral response against SARS-CoV-2 or autoantibodies to glutamic acid decarboxylase or interferon alpha-4. New-onset diabetes was independently associated with the risk of adverse clinical outcome defined as ICU admission or death (HR 2.11, 95% CI 1.34-3.31; p=0.001), even after adjustment for age, sex and other selected variables associated with COVID-19 severity. Furthermore, we documented a negative association (HR 0.661, 95% CI 0.43-1.02; p=0.063) between new-onset diabetes and the time to swab negativization. During follow-up we observed that in 30% of the patients with new-onset diabetes hyperglycemia reversed when the viral infection resolved.ConclusionsThe recognition of new-onset diabetes as a specific clinical entity associated with COVID-19 pneumonia is relevant for early and appropriate patient management and close monitoring for the progression of disease severity.

scholarly journals Changes in liver function in patients with covid-19 and the demographics of the disease in a mid-sized city of Turkey: A retrospective analysis

2020 ◽  
Vol 7 (12) ◽  
pp. 739-744
Author(s):  
Huseyin Avni Demir
Keyword(s):  
Liver Function ◽  
Clinical Characteristics ◽  
Severe Disease ◽  
Close Monitoring ◽  
Test Results ◽  
Laboratory Findings ◽  
Icu Patients ◽  
Mortality And Morbidity ◽  
The Mean ◽  
Significant Mortality

Objective:  To define the clinical characteristics of patients hospitalized with COVID-19 in ICU and ward and to evaluate the significance of liver function test results. A new disease caused by SARS-CoV-2 has been devastating the world affecting millions of patients worldwide and leading the significant mortality and morbidity. Material and Methods: The demographic features of a cohort of 125 hospitalized patients between March 2020 and May 2020 were recorded. The clinical characteristics, laboratory findings, and mortality rates were analyzed. Results: A total of 125 patients hospitalized for COVID-19 diagnosis where 113 (90.4%) were followed-up in the ward and 12 (9.6%) were in ICU were included in the study. The mean age of the patients was 44.05±16.95 and 88 (70.4%) of the patients were male. The most common symptoms were in the following order: cough in 80 patients (64%), dyspnea in 40 (32%) and fever in 33 (26.4%). The leukocyte and neutrophil counts were significantly higher in ICU patients with COVID-19 compared to patients in the ward (p=0.002, p<0.05; respectively). The CRP and D-Dimer levels were found elevated in ICU patients with COVID-19 than in the ward (p<0.05; p<0.05, respectively). The AST level of patients with COVID-19 in ICU was significantly heightened than patients in the ward. Conclusion: The present study revealed that patients with elevated AST level were at great risk of progressing to severe disease those require close monitoring.

scholarly journals Comparison of Clinical Features and CT Temporal Changes Between Familial Clusters and Non-familial Patients With COVID-19 Pneumonia

2021 ◽  
Vol 8 ◽  
Author(s):  
Shuyi Liu ◽  
Huanchu Yuan ◽  
Bin Zhang ◽  
Wei Li ◽  
Jingjing You ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Clinical Course ◽  
Chest Ct ◽  
Close Monitoring ◽  
Laboratory Findings ◽  
Chest Computed Tomography ◽  
Familial Cluster ◽  
Viral Shedding ◽  
Ct Findings ◽  
Lung Lobes

Purpose: This study aimed to compare the clinical characteristics, laboratory findings, and chest computed tomography (CT) findings of familial cluster (FC) and non-familial (NF) patients with coronavirus disease 2019 (COVID-19) pneumonia.Methods: This retrospective study included 178 symptomatic adult patients with laboratory-confirmed COVID-19. The 178 patients were divided into FC (n = 108) and NF (n = 70) groups. Patients with at least two confirmed COVID-19 cases in their household were classified into the FC group. The clinical and laboratory features between the two groups were compared and so were the chest CT findings on-admission and end-hospitalization.Results: Compared with the NF group, the FC group had a longer period of exposure (13.1 vs. 8.9 days, p &lt; 0.001), viral shedding (21.5 vs. 15.9 days, p &lt; 0.001), and hospital stay (39.2 vs. 22.2 days, p &lt; 0.001). The FC group showed a higher number of involved lung lobes on admission (3.0 vs. 2.3, p = 0.017) and at end-hospitalization (3.6 vs. 1.7, p &lt; 0.001) as well as higher sum severity CT scores at end-hospitalization (4.6 vs. 2.7, p = 0.005) than did the NF group. Conversely, the FC group had a lower lymphocyte count level (p &lt; 0.001) and a significantly lower difference in the number of involved lung lobes (Δnumber) between admission and discharge (p &lt; 0.001). Notably, more cases of severe or critical illness were observed in the FC group than in the NF group (p = 0.036).Conclusions: Patients in the FC group had a worse clinical course and outcome than those in the NF group; thus, close monitoring during treatment and follow-ups after discharge would be beneficial for patients with familial infections.

scholarly journals COVID-19 outbreak in Jordan: Epidemiological features, clinical characteristics, and laboratory findings

2020 ◽  
Vol 57 ◽  
pp. 103-108 ◽  
Author(s):  
Shaher M. Samrah ◽  
Abdel-Hameed W. Al-Mistarehi ◽  
Ali M. Ibnian ◽  
Liqaa A. Raffee ◽  
Suleiman M. Momany ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Laboratory Findings ◽  
Epidemiological Features

scholarly journals Split ventilation with pressure regulators for patient-specific tidal volumes

2020 ◽  
Author(s):  
Lakshminarayan “Ram” Srinivasan ◽  
Chris A. Rishel ◽  
Barrett J. Larson ◽  
Juhwan Yoo ◽  
Ned M. Shelton
Keyword(s):  
Tidal Volume ◽  
Gas Flow ◽  
Patient Management ◽  
Patient Specific ◽  
Resource Constrained ◽  
Mechanical Ventilators ◽  
Pressure Regulator ◽  
Safety Testing ◽  
Progression Of Disease ◽  
Multiple Patients

AbstractAs a measure of last resort during the COVID-19 pandemic, single mechanical ventilators have been repurposed to support multiple patients. In existing split-ventilator configurations using FDA-approved tubing adaptors, each patient receives the same inspiratory pressure, requiring careful matching of patients to avoid barotrauma. Progression of disease may cause tidal volumes to diverge from desired targets, and routine interventions (eg. suctioning) in one patient may adversely affect other patients. To overcome these limitations, we demonstrate a split-ventilator configuration that enables individualized patient management by incorporating a commonly available pressure regulator used for gas appliances. We validate this method by achieving various combinations of tidal volume in each of two synthetic lungs using a standard ventilator machine in combination with two gas flow analyzers. With further safety testing and instrumentation, pressure regulators may represent a viable path to substantially augment the capacity for ventilation in resource-constrained settings.

scholarly journals Clinical Characteristics of Patients with Coronavirus Disease 2019 (COVID-19) in a Teaching Hospital in Malaysia

2021 ◽  
Vol 15 (08) ◽  
pp. 1059-1065
Author(s):  
Norfazilah Ahmad ◽  
Norzehan Fatimah Mohd Ali ◽  
Azmawati Mohammed Nawi ◽  
Mohd Rohaizat Hassan ◽  
Azimatun Noor Aizuddin ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Clinical Characteristics ◽  
Epidemiological Data ◽  
Contact Tracing ◽  
Radiological Investigation ◽  
Laboratory Findings ◽  
Normal Ranges ◽  
Asymptomatic Patients ◽  
Overseas Travel ◽  
Sporadic Cases

Introduction: Information on the clinical characteristics of local patients with confirmed COVID-19 is limited. This study aims to report the clinical characteristics of 147 patients admitted and receiving treatment at a teaching hospital. Methodology: Patients’ socio-demographic and epidemiological data, clinical features, laboratory findings and clinical outcomes were extracted using a data sheet. Results: The median patient age was 25 [interquartile range (IQR)] 20–44) years, and most of patients were male (68.7%) and of Malaysian nationality (88.4%). Almost half of the patients were from a case cluster related to a religious event (48.3%) and 12.9% had a history of overseas travel. A total of 33.3% of patients were not related to any case cluster, i.e. sporadic cases. Radiological investigation showed that 13.6% of the patients had chest X-ray changes and all laboratory parameters were within the normal ranges. Sixty-six patients (44.9%) experienced symptoms. The most common symptoms were rhinitis (66.7%), followed by fever (19.7%) and cough (15.2%). Age, gender, case cluster, comorbidity status, haemoglobin, albumin, total protein, bilirubin total and alkaline phosphatase level were associated with symptomatic status. Conclusions: In this single-centre study, COVID-19 infection led not only to case clusters, but also to sporadic infections, with patients being either symptomatic or asymptomatic. These sporadic cases and asymptomatic patients may hamper effective contact tracing, leading to rapid human-to-human transmission in our population. Future studies on the prevalence and clinical significance of asymptomatic and presymptomatic COVID-19 patients would pre-emptively address issues on further containment of the pandemic.

scholarly journals Clinical Characteristics and Outcomes of Diabetic COVID-19 patients in Kuwait

2020 ◽  
Author(s):  
Abdullah Alshukry ◽  
Mohammad Bu Abbas ◽  
Yaseen Ali ◽  
Barrak Alahmad ◽  
Abdullah A. Al-Shammari ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Clinical Laboratory ◽  
Fasting Blood Glucose ◽  
List Type ◽  
Laboratory Findings ◽  
Reactive Protein ◽  
Patients With Diabetes ◽  
Laboratory Investigations ◽  
Insight Into ◽  
Variable Clinical Presentation

AbstractBackgroundCOVID-19 has a highly variable clinical presentation, ranging from asymptomatic to severe respiratory symptoms and death. Diabetes seems to be one of the main comorbidities contributing to a worse COVID-19 outcome.ObjectiveIn here we analyze the clinical characteristics and outcomes of diabetic COVID-19 patients.MethodsIn this single-center, retrospective study of 417 consecutive COVID-19 patients, we analyze and compare disease severity, outcome, associated complications, and clinical laboratory findings between diabetic and non-diabetic COVID-19 patients.ResultsCOVID-19 patients with diabetes had more severe outcomes and higher mortality than non-diabetic COVID-19 patients. Diabetic COVID-19 patients had significantly higher prevalence of comorbidities, such as hypertension. Laboratory investigations also highlighted notably higher levels of C-reactive protein in diabetic COVID019 patients and lower estimated glomerular filtration rate. They also showed a higher incidence of complications.ConclusionDiabetes could be a major contributor to worsening outcomes in COVID-19 patients. Understanding the pathophysiology underlining these findings could provide insight into better management and improved outcome of such cases.Highlights of the StudyA significantly higher proportion of Diabetic COVID-19 patients required admission to the ICU.Higher fasting blood glucose was associated with higher risk of COVID-19 associated mortality.Diabetic COVID-19 patients had significantly higher incidence of complications including sepsis, ARDS, cardiac failure and renal failure.

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