scholarly journals Sex difference in hospitalized patients with COVID-19 infection

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Heba Wagih Abdelwahab ◽  
Shaker Wagih Shaltout ◽  
Ahmed Mohamed Fouda ◽  
Raed Elmetwally Ali ◽  
Nesrein M. Shalaby ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Mortality Rate ◽  
Sex Difference ◽  
Statistical Significance ◽  
Severe Disease ◽  
Cross Sectional Study ◽  
Female Group ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Inflammatory Stimuli

The pandemic of COVID-19 infection is rapidly progressing to one of the most severe threats to human health. The different responses of the immune system in females and males to a range of infectious and inflammatory stimuli were investigated. We aimed to explore the association of sex with the course of infection among the hospitalized COVID-19 patients. This Comparative cross-sectional study was conducted on RT- PCR positive COVID-19 patients. Severe and critical patients who required hospital or ICU admission were included in the study. The total number of patients was 150 (75 males and 75 females) with mean age of 57Y±14.7. There was a statistical significance in age between both groups [mean ± SD: males 60.5 (12.2), females 54 (15.3) (p=0:0.007)]. The prevalence of diabetes mellitus, hypertension, chronic kidney disease and ischemic heart disease was higher among males but without statistical significance. Consolidation was significantly more prevalent in female group (85.3% vs 61.3% in male group). The need of mechanical ventilation was higher in men, but with no statistical significance (44% Vs 32%, p=0.302). Also, mortality rate was higher (48%) in males than in females (37.3%), but with no statistical significance (p=0.262). During the COVID-19 infection, the risk factors of severe disease and progression to the need of mechanical ventilation support in addition to mortality rate are more prevalent among males. However, radiological patterns apart from consolidation, distribution of radiological abnormalities and CT severity score in both groups did not show significant sex difference.

scholarly journals Factors associated with caring behaviors of family caregivers for patients receiving home mechanical ventilation with tracheostomy: A cross-sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254987
Author(s):  
Hyang Sook Kim ◽  
Chung Eun Lee ◽  
Yong Sook Yang
Keyword(s):  
Mechanical Ventilation ◽  
Family Caregivers ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Home Mechanical Ventilation ◽  
Cross Sectional ◽  
Caring Behaviors ◽  
Factors Associated ◽  
Caring Behavior ◽  
Number Of Patients

Background The number of patients on home mechanical ventilation (HMV) worldwide has been steadily rising as medical technological advanced. To ensure the safety and quality care of the patients receiving HMV with tracheostomy, caring behavior of family caregivers is critical. However, studies on caring behavior of family caregivers and its associated factors were remained unexplored. This study aimed to describe the caring behaviors of family caregivers for patients receiving home mechanical ventilation with tracheostomy and to identify factors associated with their caring behaviors. Methods This was a cross-sectional study for 95 family caregivers for patients with invasive home mechanical ventilation in South Korea. Caring behaviors were assessed by the Caring Behavior Scale with 74 items with 5-point Likert scale. Data were analyzed using multiple regression analysis. Results Caring behaviors score of caregivers was 304.68±31.05 out of 370. They were significantly associated with knowledge on emergency care (β = 0.22, p = .011), number of required instruments for care (β = 0.21, p = .010), frequency of home visit care (β = 0.19, p = .017), experience of emergency situation for the last six months (β = 0.19, p = .009) and activities of daily living of patient (β = 0.27, p = .002). Conclusion Development of standardized multidisciplinary discharge education for improving the caring capacity of caregivers is required for successful and healthy application of home mechanical ventilation.

scholarly journals The relationship between serum 25-hydroxyvitamin D levels and the severity of COVID-19 disease and its mortality

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Maryam Vasheghani ◽  
Nasrin Jannati ◽  
Parvaneh Baghaei ◽  
Mitra Rezaei ◽  
Roqayeh Aliyari ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Severe Disease ◽  
Multivariate Logistic Regression Analysis ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Hydroxyvitamin D ◽  
Severity Of Disease ◽  
25 Hydroxyvitamin D ◽  
General Wards ◽  
The Relationship

AbstractSupplemental vitamin D can reduce the risk and mortality of viral pneumonia. The relationship between 25 hydroxyvitamin D [25(OH)D] levels and the severity and mortality of Coronavirus disease 2019 (COVID-19) was evaluated. In this cross-sectional study, the admitted patients with COVID-19 were categorized as mild, moderate, severe, and critical based on clinical and radiologic characteristics. Calcium, phosphorus, albumin, creatinine, and serum 25(OH)D were measured and their correlation with the severity of disease and mortality were analyzed. During 2 months, 508 patients (442 patients in general wards and 66 patients in the intensive care unit (ICU)) were included. The participants were 56 ± 17 years old (52% male, 37% with comorbidity). Concerning severity, 13%, 42%, 36%, and 9% had mild, moderate, severe, and critical diseases, respectively. The mortality rate was 10.8%. Admission to ICU, severity of disease and mortality decreased significantly across quartiles of 25(OH)D. According to multivariate logistic regression analysis, disease mortality had a positive correlation with age and had a negative correlation with the serum level of 25(OH)D, calcium, and albumin. In hospitalized patients with COVID-19, low 25(OH)D was associated with severe disease and increased ICU admission and mortality rate.

scholarly journals A capacity assessment of healthcare workers to provide second-line antiretroviral therapy in Malawi: 2016

2021 ◽  
Author(s):  
Wingston Ng'ambi ◽  
Yusuf Babaye ◽  
Paul Nyasulu ◽  
Andreas Jahn ◽  
Abiba Longwe-Ngwira ◽  
...  
Keyword(s):  
Health Workers ◽  
Statistical Significance ◽  
World Health Organisation ◽  
Cross Sectional Study ◽  
World Health ◽  
Second Line ◽  
First Line ◽  
Chi Square ◽  
Cross Sectional ◽  
Number Of Patients

INTRODUCTION: According to the estimates by the World Health Organisation, Malawi is lagging behind for the number of patients that should have been on second-line ART. In settings like Malawi the low switching is attributable to low knowledge of clinical assessment for first-line antiretroviral treatment (ART) failure. We analyzed the knowledge level of different cadres of health workers on the management of second-line ART. METHODS: This cross-sectional study assessed readiness of first-line ART providers to provide second-line ART in the 26 districts of Malawi. Descriptive statistics were conducted using STATA v15.0. The passing score was 80%. Associations were assessed using Chi-Square tests. Statistical significance was placed at P<0.05. RESULTS: Of the 754 ART providers assessed, 290 (38%) were eligible to prescribe second-line ARVs. We observed significant differences for eligibility by cadre and district (P<0.001). Furthermore, 69% of the ART providers correctly identified second-line ARVs while 9% of the providers correctly chose second-line ARVs for management of different side-effects. Both competencies varied by cadre and district (P<0.001). Of the ART providers, 9% correctly interpreted the VL results which we found to significantly vary by cadre (P<0.001) and not districts. However, 78% of ART providers were able to prescribe correct dose of second-line ART which did not significantly vary by cadre (P=0.27). Spatial analysis showed Thyolo and Chiradzulu as high performing districts. CONCLUSIONS: This assessment found that registered nurses had comparable knowledge to medical doctors and clinical officers in most areas but not in correctly selecting second line ARVs. To strengthen task shifting approaches, capacity building should focus on how to correctly select second line regimen and interpret viral load results. Training activities should also consider regional and district-level variability in capacity.

scholarly journals High Frequency of SARS-CoV-2 RNAemia and Association With Severe Disease

2020 ◽  
Author(s):  
Catherine A Hogan ◽  
Bryan A Stevens ◽  
Malaya K Sahoo ◽  
ChunHong Huang ◽  
Natasha Garamani ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Severe Disease ◽  
Invasive Mechanical Ventilation ◽  
Tertiary Care ◽  
Prognostic Indicator ◽  
Cross Sectional Study ◽  
Clinical Severity ◽  
Plasma Samples ◽  
Cross Sectional ◽  
Icu Admission

Abstract Background Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in blood, also known as RNAemia, has been reported, but its prognostic implications are poorly understood. This study aimed to determine the frequency of SARS-CoV-2 RNA in plasma and its association with coronavirus disease 2019 (COVID-19) clinical severity. Methods An analytical cross-sectional study was performed in a single-center tertiary care institution and included consecutive inpatients and outpatients with confirmed COVID-19. The prevalence of SARS CoV-2 RNAemia and the strength of its association with clinical severity variables were examined and included intensive care unit (ICU) admission, invasive mechanical ventilation, and 30-day all-cause mortality. Results Paired nasopharyngeal and plasma samples were included from 85 patients. The median age was 55 years, and individuals with RNAemia were older than those with undetectable SARS-CoV-2 RNA in plasma (63 vs 50 years; P = .04). Comorbidities were frequent including obesity (37.6%), hypertension (30.6%), and diabetes mellitus (22.4%). RNAemia was detected in 28/85 (32.9%) of patients, including 22/28 (78.6%) who required hospitalization. In models adjusted for age, RNAemia was detected more frequently in individuals who developed severe disease including ICU admission (32.1 vs 14.0%; P = .04) and invasive mechanical ventilation (21.4% vs 3.5%; P = .02). All 4 deaths occurred in individuals with detectable RNAemia. An additional 121 plasma samples from 28 individuals with RNAemia were assessed longitudinally, and RNA was detected for a maximum duration of 10 days. Conclusions This study demonstrated a high proportion of SARS-CoV-2 RNAemia, and an association between RNAemia and clinical severity suggesting the potential utility of plasma viral testing as a prognostic indicator for COVID-19.

scholarly journals High frequency of SARS-CoV-2 RNAemia and association with severe disease

2020 ◽  
Author(s):  
Catherine A. Hogan ◽  
Bryan Stevens ◽  
Malaya K. Sahoo ◽  
ChunHong Huang ◽  
Natasha Garamani ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Severe Disease ◽  
Tertiary Care ◽  
Prognostic Indicator ◽  
Cross Sectional Study ◽  
Clinical Severity ◽  
Nasopharyngeal Swab ◽  
Plasma Samples ◽  
Cross Sectional ◽  
All Cause Mortality

AbstractBackgroundDetection of SARS-CoV-2 RNA in the blood, also known as RNAemia, has been reported, but its prognostic implications are not well understood. This study aimed to determine the frequency of SARS-CoV-2 RNA in plasma and its association with the clinical severity of COVID-19.MethodsAn analytical cross-sectional study was performed in a single-center tertiary care institution in northern California and included consecutive inpatients and outpatients with COVID-19 confirmed by detection of SARS-CoV-2 RNA in nasopharyngeal swab specimens. The prevalence of SARS CoV-2 RNAemia and the strength of its association with clinical severity variables were examined and included the need for transfer to an intensive care unit (ICU), mechanical ventilation and 30-day all-cause mortality.ResultsPaired nasopharyngeal and plasma samples were included from 85 patients. The overall median age was 55 years, and individuals with RNAemia were older than those with undetectable SARS-CoV-2 RNA in plasma (63 vs 50 years; p=0.001). Comorbidities were frequent including obesity (37.7%), hypertension (30.6%) and diabetes mellitus (22.4%). RNAemia was detected in a total of 28/85 (32.9%) individual patients, including 22/28 (78.6%) who required hospital admission. RNAemia was detected more frequently in individuals who developed severe disease including the need for ICU transfer (32.1% vs 14.0%; p=0.05), mechanical ventilation (21.4% vs 3.5%; p=0.01) and 30-day all-cause mortality (14.3% vs 0%; p=0.01). No association was detected between RNAemia and estimated levels of viral RNA in the nasopharynx. An additional 121 plasma samples from 28 individuals with RNAemia were assessed longitudinally, and RNA was detected for a maximum duration of 10 days.ConclusionThis study demonstrated a high proportion of SARS-CoV-2 RNAemia, and an association between RNAemia and clinical severity suggesting the potential utility of plasma viral testing as a prognostic indicator for COVID-19.

scholarly journals Sirtuin 1 Levels in Recurrent Implantation Failure

2017 ◽  
Vol 39 (10) ◽  
pp. 541-544 ◽  
Author(s):  
Yaprak Engin-Ustun ◽  
A. Ozgu-Erdinc ◽  
Emel Kiyak Caglayan ◽  
Cavidan Gulerman ◽  
Esma Sarikaya ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Statistical Significance ◽  
Cross Sectional Study ◽  
Sirtuin 1 ◽  
Implantation Failure ◽  
Recurrent Implantation Failure ◽  
Cross Sectional ◽  
Vitro Fertilization ◽  
Number Of Patients

AbstractSirtuin 1 has an important role in cellular processes, including apoptosis and cellular stress. The purpose of this study was to assess serum sirtuin 1 levels in women with recurrent implantation failure (RIF). In this cross-sectional study, we included 28 women with RIF, 29 healthy women who had conceived by in vitro fertilization (IVF), and 30 women with a 1-cycle failure of IVF as controls. Human serum nicotinamide adenine dinucleotide (NAD)-dependent deacetylase sirtuin-1 (SIRT1/SIRT2L1) levels were detected using a commercial colorimetric kit. Recurrent implantation failure patients have higher sirtuin 1 levels than non-pregnant women and healthy pregnant women, but this difference did not reach statistical significance due to the low number of patients in our study. These higher sirtuin 1 levels may result from the inflammation imbalance of RIF patients. The only statistically significant correlation found was between age and sirtuin (r = 0.277, p = 0.009).

scholarly journals Utilization of mechanical ventilators in low resource Faculty: a cross sectional study

2020 ◽  
Author(s):  
Tigist Bacha ◽  
Netsanet Tsegaye ◽  
Wagari Tuli
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Mortality Rate ◽  
Severity Score ◽  
Pediatric Intensive Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Multi Organ Dysfunction Syndrome

Abstract Background Few studies are available from Africa on the use of mechanical ventilation (MV) in the pediatric intensive care unit (PICU). Knowledge of the outcome of patients on MV is critical for better use of resources and clinical decision making. We aimed to see the outcome and pattern of patients treated in a pediatric intensive care unit in a teresery hospital, which is the first study to evaluate an Ethiopian PICU. Methods A cross-sectional study with retrospective data collection was employed. Data were abstracted from the patients’ medical records by trained health professionals. SPSS version 21 software was used for data entry and analysis. The reports were depicted descriptively using measures of central tendency, dispersion, and displayed through tables and graphs. Results There were 536 patients admitted during the study period. 202 (41.2%) incidence of mechanical ventilation (MV) rate 63.6% of the participants were males and 130 (59.1%) died. The most common indication for the initiation of MV was respiratory problems 46 (20.9%). we identified 30.59/1000 ventilator days developed complications.Ventilator-associated pneumonia accounted for 18.6% of the complications with 20.9/1000 ventilator days. Survival of medical cases was better than the surgical cases (including trauma); [AOR = 0.13, 95% CI(0.04–0.413)] and those who have MV for more than 3 days are 79% more likely to die than those of less than 3 days ventilated; (p = 0.003). Those who have multi-organ dysfunction syndrome die more likely than the other group of patients; [AOR = 0.181, 95% CI (0.08, 0.412)] and the patient who had high PIM II severity score had higher mortality rate; [AOR = 35, 95% CI (1.7, 11)]. Conclusions In the current study, the mortality rate of mechanically ventilated pediatric patients was high. Severity score, multi-organ dysfunction syndrome, length of stay, and being a surgical patient increased the risk of mortality. Adequate education of PICU staff on the use of mechanical ventilator and prevention of complications as well as the use of severity score is necessary.

scholarly journals Comparison of the Clinical and Laboratory Findings and Outcomes of Hospitalized COVID-19 Patients who Were Vaccinated with Coronavac or Unvaccinated: An Analytical, Cross Sectional Study

2022 ◽  
Author(s):  
Serap Şimşek-Yavuz ◽  
Gülşah Tunçer ◽  
Özlem Altuntaş Aydın ◽  
Mehtap Aydın ◽  
Filiz Pehlivanoğlu ◽  
...  
Keyword(s):  
Immune Response ◽  
Risk Factor ◽  
Mortality Rate ◽  
Independent Risk Factor ◽  
Severe Disease ◽  
Laboratory Data ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Laboratory Findings ◽  
Cross Sectional

Abstract PurposeCOVID-19 vaccines have been shown to be highly effective; however, vaccine breakthrough infections resulting from hospitalization may still occur in a small percentage of vaccinated individuals. We investigated whether the clinical and microbiological features and outcomes were different between hospitalized COVID-19 vaccinated and unvaccinated COVID-19 patients.MethodsThis multicentre, prospective, cross-sectional study was performed between April and June 2021. All hospitalized COVID-19 patients who previously had at least one dose of Coronavac were included in the study, along with some unvaccinated patients. All epidemiologic, clinical and laboratory data of the patients were recorded and compared between the vaccinated and unvaccinated individuals.ResultsThere were 69 fully Coronavac vaccinated and 175 unvaccinated patients. All breakthrough infections occurred in the first 3 months of vaccination. Fully vaccinated patients were older and had more comorbidities than unvaccinated patients (p<0.05). There were minor differences between the groups in the symptoms, physical and laboratory findings, anti-spike IgG positivity rate, mean anti-SARS-CoV-2 S antibody level, and severity of COVID-19. The mortality rate of fully vaccinated patients was higher than the mortality rate in unvaccinated patients; however, vaccination was not an independent risk factor for mortality.ConclusionsHospitalized patients with breakthrough COVID-19 after Coronavac vaccination were usually older with comorbidities. The severity and clinical outcomes of these cases were similar to those of unvaccinated patients. Our findings suggest that the immune response elicited by Coronovac could be insufficient to prevent COVID-19-related severe disease and death within 3 months of vaccination among elderly people with comorbidities.

Clinical Utility of the Ankle-Brachial Index and Toe Brachial Index in Patients with Diabetic Foot Ulcers

2020 ◽  
Vol 16 (3) ◽  
pp. 270-277 ◽  
Author(s):  
Mutasem Ababneh ◽  
Mousab Y. Al Ayed ◽  
Asirvatham A. Robert ◽  
Mohamed A. Al Dawish
Keyword(s):  
Diabetic Foot ◽  
Statistical Significance ◽  
Ankle Brachial Index ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Arterial Disease ◽  
Cross Sectional Study ◽  
Screening Tests ◽  
Cross Sectional ◽  
Toe Brachial Index

Background: This cross sectional study investigated the clinical use of the ankle-brachial index (ABI) and toe brachial index (TBI) in 91 type 2 diabetic foot ulcer patients who visited the diabetic foot clinic, Prince Sultan Military Medical City, Saudi Arabia during July 2017 and January 2018. Materials and Methods: The ABI and TBI facilitated the detection of peripheral arterial disease (PAD) and the patients’ medical records were used to collect the clinical and demographic variables. The variables of duration (p = 0.047) and treatment (p = 0.046) of the ABI showed significant differences. Age (p = 0.034) and duration (p = 0.001) were the factors related to the diagnosis of TBI by the “χ2” test. Results: From the TBI, 26.4% of the patients were found to have PAD, while the ABI showed that 21.8% of patients had the condition. However, no statistical significance was noted. From the regression analysis, the variable duration of diabetes (≥ 20 years of age) was recognized as an independent risk factor for TBI. Conclusion: In conclusion, it is recommended both the ABI and TBI to be used as screening tests for PAD in diabetic foot ulcer patients.

scholarly journals Illness severity and risk of mental morbidities among patients recovering from COVID-19: a cross-sectional study in the Icelandic population

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e049967
Author(s):  
Karen Sól Saevarsdóttir ◽  
Hildur Ýr Hilmarsdóttir ◽  
Ingibjörg Magnúsdóttir ◽  
Arna Hauksdóttir ◽  
Edda Bjork Thordardottir ◽  
...  
Keyword(s):  
Severe Disease ◽  
Symptom Burden ◽  
Cross Sectional Study ◽  
Illness Severity ◽  
University Education ◽  
Adjusted Relative Risk ◽  
Sectional Study ◽  
Cross Sectional ◽  
Symptoms Of Depression ◽  
Increased Risk

ObjectiveTo test if patients recovering from COVID-19 are at increased risk of mental morbidities and to what extent such risk is exacerbated by illness severity.DesignPopulation-based cross-sectional study.SettingIceland.ParticipantsA total of 22 861 individuals were recruited through invitations to existing nationwide cohorts and a social media campaign from 24 April to 22 July 2020, of which 373 were patients recovering from COVID-19.Main outcome measuresSymptoms of depression (Patient Health Questionnaire), anxiety (General Anxiety Disorder Scale) and posttraumatic stress disorder (PTSD; modified Primary Care PTSD Screen for DSM-5) above screening thresholds. Adjusting for multiple covariates and comorbidities, multivariable Poisson regression was used to assess the association between COVID-19 severity and mental morbidities.ResultsCompared with individuals without a diagnosis of COVID-19, patients recovering from COVID-19 had increased risk of depression (22.1% vs 16.2%; adjusted relative risk (aRR) 1.48, 95% CI 1.20 to 1.82) and PTSD (19.5% vs 15.6%; aRR 1.38, 95% CI 1.09 to 1.75) but not anxiety (13.1% vs 11.3%; aRR 1.24, 95% CI 0.93 to 1.64). Elevated relative risks were limited to patients recovering from COVID-19 that were 40 years or older and were particularly high among individuals with university education. Among patients recovering from COVID-19, symptoms of depression were particularly common among those in the highest, compared with the lowest tertile of influenza-like symptom burden (47.1% vs 5.8%; aRR 6.42, 95% CI 2.77 to 14.87), among patients confined to bed for 7 days or longer compared with those never confined to bed (33.3% vs 10.9%; aRR 3.67, 95% CI 1.97 to 6.86) and among patients hospitalised for COVID-19 compared with those never admitted to hospital (48.1% vs 19.9%; aRR 2.72, 95% CI 1.67 to 4.44).ConclusionsSevere disease course is associated with increased risk of depression and PTSD among patients recovering from COVID-19.

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