Survival Analysis of Symptomatic COVID-19 in Phuentsholing Municipality, Bhutan

COVID-19 is a disease that is caused by a highly transmissible and pathogenic novel coronavirus: severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). All of the COVID-19 positive cases in Bhutanese travellers returning via the Phuentsholing point of entry, the local population, and Indian nationals were isolated in the Phuentsholing COVID-19 isolation ward, Bhutan. This study aimed to identify the risk factors for developing symptoms among COVID-19 positive patients in this ward. A retrospective cohort study was conducted using the data regarding COVID-19 positive cases in the Phuentsholing COVID-19 isolation ward from 28 May 2020 to 31 May 2021. The Cox proportional hazards regression model was used to identify the risk factors of developing COVID-19 symptoms. There were 521 patients in the study; 368 (70.6%) were males and 153 (29.4%) were females. The mean age was 32 years (with a range of 1–78 years), and 290 (56.0%) reported at least one symptom. The median length of isolation was eight days (with a range of 3–48 days). The common symptoms were: cough (162, 31.0%), fever (135, 26.0%), and headache (101, 19.0%). In the multivariable Cox regression, vaccinated patients were 77.0% (p = 0.047) less likely to develop symptoms compared to those who were not vaccinated. The front line workers and the mini-dry port (MDP) workers were 15 (p = 0.031) and 41 (p < 0.001) times more likely to be symptomatic compared to returning travellers. The young and economically active population group was most commonly affected by COVID-19. The presence of risk factors, such as being front line workers, MDP workers, or not being vaccinated against COVID-19, meant that patients had a higher probability of developing symptoms of COVID-19.

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Clinical Characteristics and Risk Factors for Mortality of COVID-19 Patients With Diabetes in Wuhan, China: A Two-Center, Retrospective Study

10.2337/figshare.12210008.v1 ◽

2020 ◽

Cited By ~ 2

Author(s):

Qiao Shi ◽

Xiaoyi Zhang ◽

Fang Jiang ◽

Xuanzhe Zhang ◽

Chibu Bimu ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Retrospective Study ◽

Proportional Hazards ◽

Cox Regression ◽

Laboratory Data ◽

Cox Proportional Hazards ◽

Hospital Death ◽

Regression Analyses ◽

Patients With Diabetes

<div><b>OBJECTIVE: </b>Diabetes is common in COVID-19 patients and associated with unfavorable outcomes. We aimed to describe the characteristics, outcomes and analyze the risk factors for in-hospital mortality of COVID-19 patients with diabetes.</div><div><b><br></b></div><div><b>RESEARCH DESIGN AND METHODS: </b>This two-center, retrospective study was performed at two tertiary hospitals in Wuhan, China. Confirmed COVID-19 patients with diabetes (N=153) who were discharged or died from January 1, 2020, to March 8, 2020, were identified. One sex- and age-matched COVID-19 patient without diabetes was randomly selected for each patient with diabetes. Demographic, clinical, and laboratory data were abstracted. Cox proportional hazards regression analyses were performed to identify the risk factors associated with the mortality in these patients.</div><div><br></div><div><b>RESULTS:</b> Of 1561 COVID-19 patients, 153 (9.8%) had diabetes, with a median age of 64.0 (IQR, 56.0-72.0) years. A higher proportion of ICU admission (17.6% vs 7.8%, P=0.01) and more fatal cases (20.3% vs 10.5%, P=0.017) were identified in COVID-19 patients with diabetes than in the matched patients. Multivariable Cox regression analyses of these 306 patients showed that hypertension (hazards ratio [HR] 2.50, 95% CI 1.30-4.78), cardiovascular disease (HR 2.24, 95% CI 1.19-4.23) and chronic pulmonary disease (HR 2.51, 95% CI 1.07-5.90) were independently associated with in-hospital death. Diabetes (HR 1.58, 95% CI 0.84-2.99) was not statistically significantly associated with in-hospital death after adjustment. Among patients with diabetes, nonsurvivors were older (76.0 vs 63.0 years), most were male (71.0% vs 29.0%), and were more likely to have underlying hypertension (83.9% vs 50.0%) and cardiovascular disease (45.2% vs 14.8%) (all P-values<0.05). Age ≥70 years (HR 2.39, 95% CI 1.03-5.56) and hypertension (HR 3.10, 95% CI 1.14-8.44) were independent risk factors for in-hospital death of patients with diabetes.</div><div><br></div><div><b>CONCLUSIONS: </b>COVID-19 patients with diabetes had worse outcomes compared with the sex- and age-matched patients without diabetes. Older age and comorbid hypertension independently contributed to in-hospital death of patients with diabetes.</div>

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P6229Potato consumption is associated with total and cause-specific mortality: a population-based cohort study and pooling of prospective studies with 73,717 participants

European Heart Journal ◽

10.1093/eurheartj/ehz746.0831 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

M Mazidi ◽

D P Mikhailidis ◽

N Katsiki ◽

D Pella ◽

M Banach

Keyword(s):

Risk Factors ◽

Prospective Studies ◽

Cardiometabolic Risk ◽

Proportional Hazards ◽

Cox Regression ◽

Cox Proportional Hazards ◽

Cardiometabolic Risk Factors ◽

Cox Models ◽

Potato Consumption

Abstract Background The long-term effect of potato consumption on mortality and cardiometabolic risk factors is still largely unknown. Purpose Using the National Health and Nutrition Examination Surveys (NHANES) 1999–2010, we evaluated the long-term impact of potato intake on total and cause-specific (cardiovascular disease [CVD],cerebrovascular disease and cancer] mortality, and the results were next validated in the systematic review and meta-analysis of cohort studies investigating pooled associations of potato consumption with all-cause and cause-specific death. Methods Vital status through December 31, 2011 was ascertained. Cox proportional hazards were applied to determine the hazard ratios (HRs) and 95% confidence intervals (95% CIs) of mortality for each quartile of the potato intake, with the lowest quartile (Q1 – with the lowest intake) used as reference. We used adjusted Cox regression to determine the risk ratio (RR) and 95% CI, as well as random effects models and generic inverse variance methods to synthesize quantitative and pooled data, followed by a leave-one-out method for sensitivity analysis. Results Among the 24,856 participants included, 3433 deaths occurred during the mean follow-up of 6.4 years. In multivariate adjusted Cox models, total (42%), CVD (65%), cerebrovascular (26%) and cancer (52%) mortality risk was greater in individuals with higher potato consumption than those with the lowest intake (p<0.001 for all comparisons). However this link disappeared after adjustment for confounding factors (see Table below). Results from pooling current prospective studies with 73,717 participants revealed a non-significant association between total (RR: 1.25, 0.98–1.60, p=0.066), CVD (RR: 0.99, 0.90–1.08, p=0.845) and stroke mortality (RR: 0.94, 0.85–1.03, p=0.214) with potato consumption. Individuals with a higher potato intake had a less favorable profile of cardiometabolic factors, including greater WC (97.2 vs. 99.5 cm, p<0.001) and a less favorable profile of systolic and diastolic blood pressure, levels of triglycerides (TGs), high-density lipoprotein-cholesterol (HDL-C) and TG/HDL-C ratio (p<0.001 for all comparisons). HRs for mortality across potato intake. Conclusions Our results highlighted the neutral effect of potato intake on long-term mortalities; whereas potato consumption was adversely related to cardiometabolic risk factors. These findings should be taken into consideration for public health strategies, establishing the position for potatoes in the food pyramid. Acknowledgement/Funding None

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Incidence and maternal-fetal risk factors of stillbirth: A population-based historical cohort and a nested case-control study

10.21203/rs.2.18523/v1 ◽

2019 ◽

Author(s):

Zahra Maleki ◽

Haleh Ghaem ◽

Mozhgan Seif ◽

Sedigheh Foruhari

Keyword(s):

Risk Factors ◽

Regression Model ◽

Proportional Hazards ◽

Cox Regression ◽

Gestational Hypertension ◽

Population Based ◽

Cox Proportional Hazards ◽

Historical Cohort ◽

Significance Level ◽

Fetal Risk

Abstract Background: For parents, stillbirth is a disappointing phenomenon; thus, identifying the associated risk factors can be beneficial in order to prevent this event. This study aimed to investigate the incidence and risk factors associated with stillbirth.Methods: In this historical cohort study, a total of 18129 birth records were investigated. For each case of stillbirth, three live birth infants on the same day and same hospital were selected as the controls, which were matched for gestational age. The data was collected using a researcher-made checklist. Finally, data were analyzed using STATA, 13.0 with Cox proportional hazards regression model at the significance level of 0.05.Results: The cumulative incidence of still birth was 9.48 per 1000 live births. Based on multivariate Cox regression model, five risk factors for stillbirth were identified, including male gender, fetal diseases, gestational hypertension, gestational diabetes, and hypothyroidism, (all hazard ratios > 1 and p<0.05).Conclusion: For the first time, maternal hypothyroidism, oligohydramnios and polyhydramnios were shown as risk factors for stillbirth, which were not evaluated in any previous study. The findings of this study suggest that some maternal and fetal risk factors can be recognized as predictors of stillbirth, which might help to prevent and detect high-risk parents at early stages in order to avoid adverse health consequences in the mother and her neonate.

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Genetic and nongenetic factors for contralateral progression of unilateral moyamoya disease: the first report from the SUPRA Japan Study Group

Journal of Neurosurgery ◽

10.3171/2021.3.jns203913 ◽

2021 ◽

pp. 1-10

Author(s):

Yohei Mineharu ◽

Yasushi Takagi ◽

Akio Koizumi ◽

Takaaki Morimoto ◽

Takeshi Funaki ◽

...

Keyword(s):

Risk Factors ◽

Moyamoya Disease ◽

Proportional Hazards ◽

Proportional Hazards Model ◽

Cox Regression ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Multicenter Cohort Study ◽

Cox Regression Analysis ◽

Unilateral Moyamoya Disease

OBJECTIVE Although many studies have analyzed risk factors for contralateral progression in unilateral moyamoya disease, they have not been fully elucidated. The aim of this study was to examine whether genetic factors as well as nongenetic factors are involved in the contralateral progression. METHODS The authors performed a multicenter cohort study in which 93 cases with unilateral moyamoya disease were retrospectively reviewed. The demographic features, RNF213 R4810K mutation, lifestyle factors such as smoking and drinking, past medical history, and angiographic findings were analyzed. A Cox proportional hazards model was used to find risk factors for contralateral progression. RESULTS Contralateral progression was observed in 24.7% of cases during a mean follow-up period of 72.2 months. Clinical characteristics were not significantly different between 63 patients with the R4810K mutation and those without it. Cox regression analysis showed that the R4810K mutation (hazard ratio [HR] 4.64, p = 0.044), childhood onset (HR 7.21, p < 0.001), male sex (HR 2.85, p = 0.023), and daily alcohol drinking (HR 4.25, p = 0.034) were independent risk factors for contralateral progression. CONCLUSIONS These results indicate that both genetic and nongenetic factors are associated with contralateral progression of unilateral moyamoya disease. The findings would serve to help us better understand the pathophysiology of moyamoya disease and to manage patients more appropriately.

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Targeted metabolomic profiling and prediction of cardiovascular events: a prospective study of patients with psoriatic arthritis and psoriasis

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-220168 ◽

2021 ◽

pp. annrheumdis-2021-220168

Author(s):

Keith Colaco ◽

Ker-Ai Lee ◽

Shadi Akhtari ◽

Raz Winer ◽

Paul Welsh ◽

...

Keyword(s):

Risk Factors ◽

Regression Models ◽

Proportional Hazards ◽

Cox Regression ◽

Characteristic Curve ◽

Density Lipoprotein ◽

Receiver Operator Characteristic Curve ◽

Cox Proportional Hazards ◽

A Prospective Study ◽

Age And Sex

ObjectiveIn patients with psoriatic disease (PsD), we sought serum metabolites associated with cardiovascular (CV) events and investigated whether they could improve CV risk prediction beyond traditional risk factors and the Framingham Risk Score (FRS).MethodsNuclear magnetic resonance metabolomics identified biomarkers for incident CV events in patients with PsD. The association of each metabolite with incident CV events was analysed using Cox proportional hazards regression models first adjusted for age and sex, and subsequently for traditional CV risk factors. Variable selection was performed using penalisation with boosting after adjusting for age and sex, and the FRS.ResultsAmong 977 patients with PsD, 70 patients had incident CV events. In Cox regression models adjusted for CV risk factors, alanine, tyrosine, degree of unsaturation of fatty acids and high-density lipoprotein particles were associated with decreased CV risk. Glycoprotein acetyls, apolipoprotein B and cholesterol remnants were associated with increased CV risk. The age-adjusted and sex-adjusted expanded model with 13 metabolites significantly improved prediction of CV events beyond the model with age and sex alone, with an area under the receiver operator characteristic curve (AUC) of 79.9 versus 72.6, respectively (p=0.02). Compared with the FRS alone (AUC=73.9), the FRS-adjusted expanded model with 11 metabolites (AUC=75.0, p=0.72) did not improve CV risk discrimination.ConclusionsWe identify novel metabolites associated with the development of CV events in patients with PsD. Further study of their underlying causal role may clarify important pathways leading to CV events in this population.

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Clinical Characteristics and Risk Factors for Mortality of COVID-19 Patients With Diabetes in Wuhan, China: A Two-Center, Retrospective Study

10.2337/figshare.12210008 ◽

2020 ◽

Cited By ~ 1

Author(s):

Qiao Shi ◽

Xiaoyi Zhang ◽

Fang Jiang ◽

Xuanzhe Zhang ◽

Chibu Bimu ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Retrospective Study ◽

Proportional Hazards ◽

Cox Regression ◽

Laboratory Data ◽

Cox Proportional Hazards ◽

Hospital Death ◽

Regression Analyses ◽

Patients With Diabetes

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Systemic Inflammatory Cytokines Associate With SARS-COV-2 Viral Shedding Time in Covid-19 Inpatients

10.21203/rs.3.rs-31556/v1 ◽

2020 ◽

Author(s):

Jing Shi ◽

Chongsheng Cheng ◽

Muqing Yu ◽

Xiaochen Li ◽

Ke Wang ◽

...

Keyword(s):

Risk Factors ◽

Regression Analysis ◽

Proportional Hazards ◽

Cox Regression ◽

Interleukin 2 ◽

Cox Proportional Hazards ◽

Cox Regression Analysis ◽

Global Challenge ◽

Viral Shedding ◽

Virus Clearance

Abstract Background: Since December 2019, coronavirus disease 2019 (COVID-19), as an infectious disease with cytokine storm, has become an emerging global challenge. To assess the duration of SARS-COV-2 viral shedding and associated risk factors in COVID-19 patients.Methods: COVID-19 patients with interleukin (IL)-1b, soluble interleukin-2 receptor (sIL-2R), IL-6, IL-8, IL-10 and tumor necrosis factor (TNF)-α cytokines data consecutively admitted to Tongji Hospital from January 27, 2020 through February 5, 2020 were enrolled and been followed up until March 24, 2020. We utilized Kaplan-Meier method and Cox proportional hazards regression analysis to assess the duration of viral shedding and risk factors affecting virus clearance.Results: 246 inpatients with laboratory confirmed COVID-19 were enrolled. The median duration of viral shedding was 24 days, ranging from 6 to 63 days. Age, severity of COVID-19, albumin, lactate dehydrogenase (LDH), D-dimer, ferritin and sIL-2R were associated with duration of viral shedding. Administration of lopinavir-ritonavir, arbidol, oseltamivir and intravenous immunoglobulin did not shorten viral shedding time. Multivariate cox regression analysis revealed that sIL-2R, LDH and severity of COVID-19 were independent factors associated with duration of viral shedding. At stratified analysis, the viral shedding time was positively correlated with age, sIL-2R and LDH in non-corticosteroid subgroup, while negatively correlated with lymphocyte count in corticosteroid group. Conclusions: The present study demonstrated that elevated sIL-2R, increased LDH and severe status were related to prolongation of viral shedding in COVID-19 inpatients. Further research is urgent to investigate the mechanism of immune reaction involved in the virus clearance process and aim to the optimal antiviral therapy.

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Female hormonal exposures and risk of rheumatoid arthritis in the French E3N-EPIC cohort study

Rheumatology ◽

10.1093/rheumatology/keab101 ◽

2021 ◽

Author(s):

Carine Salliot ◽

Yann Nguyen ◽

Gaëlle Gusto ◽

Amandine Gelot ◽

Juliette Gambaretti ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Prospective Cohort ◽

Regression Models ◽

Proportional Hazards ◽

Cox Regression ◽

Cox Proportional Hazards ◽

Smoking History ◽

Nulliparous Women ◽

Hormonal Exposures ◽

Incident Cases

Abstract Objective To assess the relationships between female hormonal exposures and risk of rheumatoid arthritis (RA), in a prospective cohort of French women. Methods E3N is an on-going French prospective cohort that included 98 995 women aged 40–65 years in 1990. Every 2–3 years, women completed mailed questionnaires on their lifestyles, reproductive factors, and health conditions. Cox proportional-hazards regression models were used to determine factors associated with risk of incident RA, with age as the time scale, adjusted for known risk factors of RA, and considering endogenous and exogenous hormonal factors. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated. Effect modification by smoking history was investigated. Results A total of 698 incident cases of RA were ascertained among 78 452 women. In multivariable-adjusted Cox regression models, risk of RA was increased with early age at first pregnancy (<22 vs ≥27 years; HR = 1.34; 95%CI 1.0–1.7) and menopause (≤45 vs ≥53 years; HR = 1.40; 95%CI 1.0–1.9). For early menopause, the association was of similar magnitude in ever and never smokers, although the association was statistically significant only in ever smokers (HR = 1.54; 95%CI 1.0–2.3). We found a decreased risk in nulliparous women never exposed to smoking (HR = 0.44; 95%CI 0.2–0.8). Risk of RA was inversely associated with exposure to progestogen only in perimenopause (>24 vs 0 months; multi-adjusted HR = 0.77; 95%CI 0.6–0.9). Conclusions These results suggest an effect of both endogenous and exogenous hormonal exposures on RA risk and phenotype that deserves further investigation.

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7 Prognostic factors for overall survival in patients with advanced melanoma treated with Anti-PD-1 therapy – the melimmune score

Journal for ImmunoTherapy of Cancer ◽

10.1136/jitc-2020-sitc2020.0007 ◽

2020 ◽

Vol 8 (Suppl 3) ◽

pp. A7-A7

Author(s):

Soraia Lobo-Martins ◽

Diogo Martins-Branco ◽

Patrícia Miguel Semedo ◽

Cecília Melo Alvim ◽

Ana Maria Monteiro ◽

...

Keyword(s):

Risk Factors ◽

Prognostic Factors ◽

Poor Prognosis ◽

Proportional Hazards ◽

Checkpoint Inhibitors ◽

Prognostic Score ◽

Daily Practice ◽

Cox Proportional Hazards ◽

Time To Death ◽

Line Setting

BackgroundImmune checkpoint inhibitors (ICI) have changed the paradigm of advanced malignant melanoma (MM). Several prognostic factors, mostly linked to inflammation, have been under scope to better select patients for such therapies. We aimed to build and apply a prognostic score in this setting.MethodsBaseline characteristics and outcomes on 147 patients with advanced MM treated with an anti-PD1 (nivolumab or pembrolizumab) in monotherapy, between Jan-2016 and Oct-2019, in the 1st, 2nd or 3rd line setting were collected from two centres in Portugal. Data cut-off for follow-up was May-2020. Cox proportional hazards regression was used to identify independent prognostic factors for OS.ResultsWith a median FU of 28.93 months (95% CI [22.52–33.54]), mOS for the whole cohort was 14.75 months (95% CI, [10.80–18.71]). Overall, 43 and 104 patients were treated with nivolumab and pembrolizumab, respectively. We identified four adverse prognostic factors that were independent predictors of bad prognosis: number of metastatic sites >2 (p<0.001), baseline PS-ECOG =1 (p<0.001), presence of baseline lymphopenia (over lower limit of normal) (p=0.002) or very high baseline LDH (>2x upper limit of normal) (p<0.001).Patients were separated into three risk categories according to the number of risk factors present: favourable prognosis (no risk factors; n=34), intermediate prognosis (one risk factor; n=65) and poor prognosis (two or more risk factors; n=48). mOS was 43.41 (95% CI [32.13–54.69], 14.39 (95% CI [6.78–22.01]) and 6.53 months (95% CI [3.61–9.44]), for favourable, intermediate, and poor prognosis group, respectively (p<0.001; figure 1). AUC of ROC curve for OS was 0.737 (95% CI [0.654–0.819], p<0.001).Abstract 7 Figure 1Time to death - Kaplan-Meier survival plotConclusionsUsing easily accessible parameters from our daily practice, we propose the MELImmune prognostic score for advanced MM patients treated with anti-PD1 in monotherapy that could be incorporated to the daily clinical practice and clinical trials. We further aim to validate this score in an independent larger sample.Ethics ApprovalThe study was approved by both institutions’ Ethics Committee.

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Air Pollution Is Associated with Cognitive Deterioration of Alzheimer’s Disease

Gerontology ◽

10.1159/000515162 ◽

2021 ◽

pp. 1-9

Author(s):

Feng Cheng Lin ◽

Chih Yin Chen ◽

Chung Wei Lin ◽

Ming Tsang Wu ◽

Hsuan Yu Chen ◽

...

Keyword(s):

Risk Factors ◽

Air Pollution ◽

Social Engagement ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Rank Test ◽

Cognitive Deterioration ◽

Clinical Dementia Rating ◽

Severe Stage ◽

Increased Risk

<b><i>Introduction:</i></b> Dementia is one of the major causes of disability and dependency among older people worldwide. Alzheimer’s disease (AD), the most common cause of dementia among the elderly, has great impact on the health-care system of developed nations. Several risk factors are suggestive of an increased risk of AD, including APOE-ε4, male, age, diabetes mellitus, hypertension, and low social engagement. However, data on risk factors of AD progression are limited. Air pollution is revealed to be associated with increasing dementia incidence, but the relationship between air pollution and clinical AD cognitive deterioration is unclear. <b><i>Methods:</i></b> We conducted a case-control and city-to-city study to compare the progression of AD patients in different level of air-polluted cities. Clinical data of a total of 704 AD patients were retrospectively collected, 584 residences in Kaohsiung and 120 residences in Pingtung between 2002 and 2018. An annual interview was performed with each patient, and the Clinical Dementia Rating score (0 [normal] to 3 [severe stage]) was used to evaluate their cognitive deterioration. Air pollution data of Kaohsiung and Pingtung city for 2002–2018 were retrieved from Taiwan Environmental Protection Administration. Annual Pollutant Standards Index (PSI) and concentrations of particulate matter (PM<sub>10</sub>), sulfur dioxide (SO<sub>2</sub>), ozone (O<sub>3</sub>), nitrogen dioxide (NO<sub>2</sub>), and carbon monoxide (CO) were obtained. <b><i>Results:</i></b> The PSI was higher in Kaohsiung and compared with Pingtung patients, Kaohsiung patients were exposed to higher average annual concentrations of CO, NO<sub>2</sub>, PM<sub>10</sub>, and SO<sub>2</sub>. AD patients living in Kaohsiung suffered from faster cognitive deterioration in comparison with Pingtung patients (log-rank test: <i>p</i> = 0.016). When using multivariate Cox proportional hazards regression analysis, higher levels of CO, NO<sub>2</sub>, PM<sub>10</sub>, and SO<sub>2</sub> exposure were associated with increased risk of AD cognitive deterioration. Among all these air pollutants, high SO<sub>2</sub> exposure has the greatest impact while O<sub>3</sub> has a neutral effect on AD cognitive deterioration. <b><i>Conclusions:</i></b> Air pollution is an environment-related risk factor that can be controlled and is associated with cognitive deterioration of AD. This finding could contribute to the implementation of public intervention strategies of AD.

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