scholarly journals Convalescent Plasma Reduces Mortality and Decreases Hospitalization Stay in Patients with Moderate COVID-19 Pneumonia

Metabolites ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 761
Author(s):  
Maamoun Basheer ◽  
Elias Saad ◽  
Dorin Shlezinger ◽  
Nimer Assy
Keyword(s):  
Clinical Laboratory ◽  
Wide Spectrum ◽  
Clinical Severity ◽  
Upper Respiratory Tract ◽  
Elderly Age ◽  
Plasma Therapy ◽  
Risk Of Death ◽  
Respiratory Tract Illnesses ◽  
Study Population ◽  
Discriminant Analyses

Humans infected with SARS-CoV-2 may develop COVID-19, which manifests across a wide spectrum of clinical severity ranging from mild upper respiratory tract illnesses to diffuse viral pneumonia, causing acute respiratory failure. Many therapies have been tested for their efficacy in treating COVID-19. Controversy surrounds convalescent plasma transfusions as an effective treatment for COVID-19. This study discusses the efficacy of this treatment on COVID-19 patients. Electronic medical record data were collected from patients diagnosed with COVID-19, from November 2020 to August 2021, in the Galilee Medical Center’s COVID-19 departments. Epidemiological, clinical, laboratory and imaging variables were analyzed. Multivariate stepwise regression and discriminant analyses were used to identify and validate the correlation between convalescent treatment and either death or time to negative PCR and hospitalization length. The study population included 270 patients, 100 of them treated with convalescent plasma. The results show that convalescent plasma therapy significantly prevented mortality in moderate patients, reduced hospitalization length and time to negative PCR. Additionally, high BMI, elderly age, high CRP and 4C-scores correlated with the severity and mortality of COVID-19 patients. Convalescent plasma also significantly reduced inflammatory markers, especially in moderate COVID-19 patients. In non-critical hospitalized patients, convalescent plasma therapy reduces morbidity and mortality in moderate COVID-19 patients and hospitalization length. Identifying patients who could benefit from this treatment could reduce the risk of death and shorten their hospitalization stay.

scholarly journals Clinical Predictors of Mortality and Critical Illness in Patients with COVID-19 Pneumonia

Metabolites ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 679
Author(s):  
Maamoun Basheer ◽  
Elias Saad ◽  
Rechnitzer Hagai ◽  
Nimer Assy
Keyword(s):  
Predictive Factors ◽  
Clinical Laboratory ◽  
Medical Center ◽  
Clinical Predictors ◽  
Radiographic Findings ◽  
Risk Of Death ◽  
High Flow Oxygen ◽  
Cytokine Levels ◽  
Study Population ◽  
Discriminant Analyses

Background/Aim: Early identification of patients with COVID-19 who will develop severe or critical disease symptoms is important for delivering proper and early treatment. We analyzed demographic, clinical, immunological, hematological, biochemical and radiographic findings that may be of utility to clinicians in predicting COVID-19 severity and mortality. Methods: Electronic medical record data from patients diagnosed with COVID-19 from November 2020 to June 2021 in the COVID-19 Department in the Galilee Medical Center, Nahariya, Israel, were collected. Epidemiologic, clinical, laboratory and imaging variables were analyzed. Multivariate stepwise regression analyses and discriminant analyses were used to identify and validate powerful predictors. The main outcome measure was invasive ventilation, or death. Results: The study population included 390 patients, with a mean age of 61 ± 18, and 51% were male. The non-survivors were mostly male, elderly and overweight and significantly suffered from hypertension, diabetes mellitus type 2, lung disease, hemodialysis and past use of aspirin. Four predictive factors were found that associated with increased disease severity and/or mortality: age, NLR, BUN, and use of high flow oxygen therapy (HFNC). The AUC or diagnostic accuracy was 87%, with a sensitivity of 97%, specificity of 60%, PPV of 87% and NPP of 91%. The cytokine levels of CXCL-10, GCSF, IL-2 and IL-6 were significantly reduced upon the discharge of severely ill COVID-19 patients. Conclusions: The predictive factors associated with increased mortality include age, NLR, BUN, and use of HFNC upon admission. Identifying those with higher risks of mortality could help in early interventions to reduce the risk of death.

scholarly journals Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247422
Author(s):  
Jesús Díez-Manglano ◽  
Marta Nataya Solís-Marquínez ◽  
Andrea Álvarez García ◽  
Nicolás Alcalá-Rivera ◽  
Irene Maderuelo Riesco ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Healthcare Workers ◽  
Clinical Laboratory ◽  
Population Data ◽  
Clinical Severity ◽  
Multivariate Logistic Regression Model ◽  
Risk Of Death ◽  
Professional Exposure ◽  
Treatment Data ◽  
Observational Cohort

Aim To determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW). Methods Observational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20–65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality. Results As of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p = 0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.211, 95%CI 0.067–0.667, p = 0.008). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001). Conclusions Hospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality.

scholarly journals Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry

2020 ◽  
Author(s):  
Jesús Díez-Manglano ◽  
Marta Nataya Solís Marquínez ◽  
Andrea Álvarez García ◽  
Nicolás Alcalá-Rivera ◽  
Irene Maderuelo Riesco ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Healthcare Workers ◽  
Clinical Laboratory ◽  
Population Data ◽  
Clinical Severity ◽  
Multivariate Logistic Regression Model ◽  
Risk Of Death ◽  
Professional Exposure ◽  
Treatment Data ◽  
Observational Cohort

ABSTRACTAimTo determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW).MethodsObservational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20-65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality.ResultsAs of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p=0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.219, 95%CI 0.069-0.693, p=0.01). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001).ConclusionsHospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality.

scholarly journals Diagnostic and severity scores for Cockayne syndrome

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
M. A. Spitz ◽  
F. Severac ◽  
C. Obringer ◽  
S. Baer ◽  
N. Le May ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Severity Score ◽  
Wide Spectrum ◽  
Genetic Disorder ◽  
Continuous Distribution ◽  
Cockayne Syndrome ◽  
Clinical Severity ◽  
Diagnostic Score ◽  
Clinical Diagnostic ◽  
Severity Scores

Abstract Background Cockayne syndrome is a progressive multisystem genetic disorder linked to defective DNA repair and transcription. This rare condition encompasses a very wide spectrum of clinical severity levels ranging from severe prenatal onset to mild adult-onset subtypes. The rarity, complexity and variability of the disease make early diagnosis and severity assessment difficult. Based on similar approaches in other neurodegenerative disorders, we propose to validate diagnostic and severity scores for Cockayne syndrome. Methods Clinical, imaging and genetic data were retrospectively collected from 69 molecularly confirmed CS patients. A clinical diagnostic score and a clinical-radiological diagnostic score for CS were built using a multivariable logistic regression model with a stepwise variable selection procedure. A severity score for CS was designed on five items (head circumference, growth failure, neurosensorial signs, motor autonomy, communication skills) and validated by comparison with classical predefined severity subtypes of CS. Results Short stature, enophtalmos, hearing loss, cataracts, cutaneous photosensitivity, frequent dental caries, enamel hypoplasia, morphological abnormalities of the teeth, areflexia and spasticity were included in the clinical diagnostic score as being the most statistically relevant criteria. Appropriate weights and thresholds were assigned to obtain optimal sensitivity and specificity (95.7% and 86.4% respectively). The severity score was shown to be able to quantitatively differentiate classical predefined subtypes of CS and confirmed the continuous distribution of the clinical presentations in CS. Longitudinal follow-up of the severity score was able to reflect the natural course of the disease. Conclusion The diagnostic and severity scores for CS will facilitate early diagnosis and longitudinal evaluation of future therapeutic interventions. Prospective studies will be needed to confirm these findings.

scholarly journals Clinical Features of Maintenance Hemodialysis Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China

2020 ◽  
Vol 15 (8) ◽  
pp. 1139-1145 ◽  
Author(s):  
Jun Wu ◽  
Jushuang Li ◽  
Geli Zhu ◽  
Yanxia Zhang ◽  
Zhimin Bi ◽  
...  
Keyword(s):  
Clinical Features ◽  
Troponin I ◽  
Clinical Laboratory ◽  
Cardiac Injury ◽  
Hemodialysis Patients ◽  
Hospitalized Patients ◽  
Maintenance Hemodialysis ◽  
Computed Tomographic ◽  
Risk Of Death ◽  
Novel Coronavirus

Background and objectivesPrevious reports on the outbreak of coronavirus disease 2019 were on the basis of data from the general population. Our study aimed to investigate the clinical features of patients on maintenance hemodialysis.Design, setting, participants, & measurements In this retrospective, single-center study, we included 49 hospitalized patients on maintenance hemodialysis and 52 hospitalized patients without kidney failure (controls) with confirmed coronavirus disease 2019 at Tongren Hospital of Wuhan University from January 30, 2020 to March 10, 2020. Demographic, clinical, laboratory, and radiologic characteristics and treatment and outcomes data were analyzed. The final date of follow-up was March 19, 2020.ResultsThe median age of 101 patients was 62 years (interquartile range, 49–72). All patients were local residents of Wuhan. In terms of common symptoms, there were differences between patients on hemodialysis and controls (fatigue [59% versus 83%], dry cough [49% versus 71%], and fever [47% versus 90%]). Lymphocyte counts were decreased (0.8×109/L [patients on hemodialysis] versus 0.9×109/L [controls], P=0.02). Comparing patients on hemodialysis with controls, creatine kinase–muscle and brain type, myoglobin, hypersensitive troponin I, B-type natriuretic peptide, and procalcitonin were increased, and the percentage of abnormalities in bilateral lung was higher in computed tomographic scan (82% versus 69%, P=0.15) and unilateral lung was lower (10% versus 27%, P=0.03). Common complications including shock, acute respiratory distress syndrome, arrhythmia, and acute cardiac injury in patients on hemodialysis were significantly higher. Compared with controls, more patients on hemodialysis received noninvasive ventilation (25% versus 6%, P=0.008). As of March 19, 2020, three patients on hemodialysis (6%) were transferred to the intensive care unit and received invasive ventilation. Seven patients on hemodialysis (14%) had died.ConclusionsThe main symptoms of coronavirus disease 2019 pneumonia, including fever and cough, were less common in patients on hemodialysis. Patients on hemodialysis with coronavirus disease 2019 were at higher risk of death.

scholarly journals Prevalence of vitamin D level in the serum of patients living in Erbil city, Iraq, referred to private clinical laboratory and effect of age and sex on it

2018 ◽  
Vol 91 (1) ◽  
Author(s):  
Rabar M. Abdulrahman ◽  
Balen Muhsin Abdul Rahman
Keyword(s):  
Vitamin D ◽  
Clinical Laboratory ◽  
Mediterranean Country ◽  
Hydroxyvitamin D ◽  
Vitamin D Levels ◽  
Study Population ◽  
25 Hydroxyvitamin D ◽  
Country People ◽  
Effect Of Age ◽  
Age And Sex

This retrospective study aimed to determine the levels of 25- hydroxyvitamin D [25-(OH) D] in the individuals that have been referred to two laboratories (Bio Lab and King Lab) and to around 50 private side laboratories that use both Bio Lab and King Lab as a referral lab for their tests, in Erbil city, Iraq. Then show the range of deficiency and its relation with sunlight exposure, sex and age. Out of the total number of cases (N=10823), large percentage (nearly 78%) referred to both clinical laboratory based in Erbil city were found to have a deficiency in vitamin D levels, which means they had 25-(OH) D levels lower than 20 μg/L. This study found the percentage of vitamin D level in the serum of groups insufficient, deficient, adequate, optimal; intoxication were 52.8, 24.1, 11, 12 and 0.2% respectively. When the records have been compared according to gender, the results suggested that there was no difference between male and female within the study population (P>0.05), while there was difference in the grouped ages (P<0.05). Our results indicate that although Erbil is located in a Mediterranean country, people living there should periodically check their 25-(OH) D levels, in order to get appropriate supplements of vitamin D, which eventually prevents secondary chronic disease due to vitamin D deficiency.

scholarly journals 440. Clinical Characteristics of Early Noncritical Hospitalized Patients with Coronavirus Disease 2019 (COVID-19): A Single-Center Retrospective Study in New York City

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S287-S288
Author(s):  
Michelle Lee ◽  
Mona Fayad ◽  
Tarub Mabud ◽  
Paulino Tallon de Lara ◽  
Adiac Espinosa Hernandez ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Clinical Laboratory ◽  
Clinical Symptoms ◽  
New York State ◽  
General Medicine ◽  
Retrospective Chart Review ◽  
Clinical Severity ◽  
Study Cohort

Abstract Background COVID-19 first originated in Wuhan, China, in December 2019. As of April 9, 2020, New York State had become the single largest global epicenter of COVID-19. Methods This is a retrospective chart review of the first 33 patients with RT-PCR-confirmed COVID-19 admitted from the emergency department to a general medicine unit in a single academic hospital in New York City between March 11th to March 27th, 2020. Patient’s demographic, clinical, laboratory, radiographic investigations, treatments and clinical outcomes were retrospectively extracted from the electronic medical record and followed until April 10th, 2020. Patients were divided into severe and nonsevere sub-cohorts. Statistics were descriptive in nature. Results The study cohort (median age 68 yr, 67% male) presented with subjective fevers (82%), cough (88%), and dyspnea (76%). The median incubation period was 3 days. Most cases met SIRS criteria upon admission (76%). Patients had elevated inflammatory markers. Patients were treated with antimicrobials, corticosteroids, hydroxychloroquine, and varying levels of supplemental oxygen. Mortality was 15% and 18% of the cohort required intensive care services. Conclusion Patient age, presenting clinical symptoms, comorbidity profile, laboratory biomarkers, and radiographic features are consistent with findings published from China. Severe patients had peaks in inflammatory biomarkers later in the hospitalization, which may be useful to trend. Further studies are necessary to create guidelines to better risk-stratify COVID-19 patients based on clinical severity. Disclosures All Authors: No reported disclosures

scholarly journals Silent Mastoiditis Associated with Pneumococcal Meningitis

2021 ◽  
Vol 27 (2) ◽  
pp. 1-6
Author(s):  
Ashikin Mohd Nordin ◽  
Jean Jun Ong ◽  
Juriza Ismail ◽  
Norazlin Kamal Nor ◽  
Sau Wei Wong ◽  
...  
Keyword(s):  
Brain Imaging ◽  
Pneumococcal Meningitis ◽  
Wide Spectrum ◽  
Clinical Signs ◽  
Invasive Disease ◽  
Upper Respiratory Tract ◽  
Slow Recovery ◽  
Acute Mastoiditis ◽  
Focus Of Infection ◽  
Upper Respiratory

Streptococcus pneumoniae (S pneumoniae) can cause a wide spectrum of diseases which includes upper respiratory tract infection as well as more severe invasive disease such as meningitis. Meningitis may be caused by invasion of the organism through the blood brain barrier, either via haematological spread or from an adjacent focus of infection such as the ears. We describe two infants with pneumococcal meningitis and silent mastoiditis. They both presented with a classical history to suggest meningitis with no apparent focus of infection. A brain imaging was done in the first infant to look for the underlying cause of his focal seizure and in the second infant, to assess for complications of meningitis, as he had a slow recovery. While they did not have any clinical signs to point towards the diagnosis, they were both diagnosed to have acute mastoiditis from brain imaging. We would like to highlight the importance of brain imaging in excluding silent mastoiditis in infants with meningitis, particularly in those whose clinical course appears atypical.

scholarly journals A Prospective Observational Study on Rational Use of Antibiotics for Paediatric Patients with Respiratory Tract Infections in a Tertiary Care Hospital

2020 ◽  
Vol 10 (3) ◽  
pp. 36-41
Author(s):  
Syeda Zaineb Kubra Hussaini ◽  
G. Tulja Rani ◽  
Dr. Murthy ◽  
Sathish Kumar ◽  
Shravya Dyavarishetty ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Prospective Observational Study ◽  
Upper Respiratory Tract ◽  
Antibiotic Drug ◽  
Study Population ◽  
Upper Respiratory ◽  
Tract Infections ◽  
Rational Use Of Antibiotics ◽  
Selection Of

Background: Antibiotic drug overuse and inappropriate antibiotic drug selection are associated with increased drug resistance among respiratory pathogens (most notably, Streptococcus pneumoniae), possible progression to chronic disease, and increased treatment costs.[1] The selection of an antibiotic for prophylaxis should be based on known or likely target pathogens, for a short duration of time. Objective: To evaluate Rational use of antibiotics in Paediatric patients suffering from Respiratory tract    infections. Method: It was Prospective, observational study conducted by random selection of patients. Based on diagnosis, the study population was categorized into 2 groups: Upper respiratory tract infections and Lower respiratory tract infections. The study population was interviewed after obtaining written informed consent for information like demographics, diagnosis, treatment and antibiotics prescribed. Results and Discussion: In our study population, it was observed that male patient (74%) were higher than female patients (26%). Total number of antibiotics prescribed during the study period is 83. Most commonly prescribed antibiotic was Augmentin (Amoxicillin +Clavulanic acid) of dose (450mg IV BD) which is the combination drug, i.e, more effective than individual antibiotic drugs. Conclusion: In the present study it is observed that 4-different classes of antibiotics-Pencillins,Cephalosporins,Macrolides and Aminoglycosides were prescribed and used for different Respiratory diseases.The percentage of average antibiotic utilization is highest in Lower Respiratory Tract Infection with (55.22%).Mostly used Antibiotic in males for both LRTI and URTI is Augmentin with the percentage of (52%) and (80%) respectively.Where as in females it is observed that in both LRTI and URTI mostly used Antibiotic is Augmentin with percentage of (38.8%) and( 80%) respectively.Overall Second mostly used antibiotic is Ceftriaxone. Keywords: pediatrics, lower and upper respiratory tract infections, antibiotics. 

Sign in / Sign up

Export Citation Format

Share Document