CLINICAL CHARACTERISTICS OF 28 PATIENTS WITH DIABETES AND COVID-19 IN WUHAN, CHINA

Objective: Previous studies on coronavirus disease 2019 (COVID-19) were based on information from the general population. We aimed to further clarify the clinical characteristics of diabetes with COVID-19. Methods: Twenty-eight patients with diabetes and COVID-19 were enrolled from January 29, 2020, to February 10, 2020, with a final follow-up on February 22, 2020. Epidemiologic, demographic, clinical, laboratory, treatment, and outcome data were analyzed. Results: The average age of the 28 patients was 68.6 ± 9.0 years. Most (75%) patients were male. Only 39.3% of the patients had a clear exposure of COVID-19. Fever (92.9%), dry cough (82.1%), and fatigue (64.3%) were the most common symptoms, followed by dyspnea (57.1%), anorexia (57.1%), diarrhea (42.9%), expectoration (25.0%), and nausea (21.4%). Fourteen patients were admitted to the intensive care unit (ICU). The hemoglobin A1c level was similar between ICU and non-ICU patients. ICU patients had a higher respiratory rate, higher levels of random blood glucose, aspartate transaminase, bilirubin, creatine, N-terminal prohormone of brain natriuretic peptide, troponin I, D-dimers, procalcitonin, C-reactive protein, ferritin, interleukin (IL)-2R, IL-6, and IL-8 than non-ICU patients. Eleven of 14 ICU patients received noninvasive ventilation and 7 patients received invasive mechanical ventilation. Twelve patients died in the ICU group and no patients died in the non-ICU group. Conclusion: ICU cases showed higher rates of organ failure and mortality than non-ICU cases. The poor outcomes of patients with diabetes and COVID-19 indicated that more supervision is required in these patients. Abbreviations: COVID-19 = coronavirus disease 2019; ICU = intensive care unit; MERS-CoV = middle East respiratory syndrome-related coronavirus; 2019- nCoV = 2019 novel coronavirus; NT-proBNP = N-terminal prohormone of brain natriuretic peptide; SARS-CoV = severe acute respiratory syndrome-related coronavirus

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Association of opioid exposure during intensive care unit stays with post-discharge opioid use: A retrospective study and literature review

Journal of Opioid Management ◽

10.5055/jom.2021.0685 ◽

2021 ◽

Vol 17 (6) ◽

pp. 511-516

Author(s):

Yoonsun Mo, MS, PharmD, BCPS, BCCCP ◽

John Zeibeq, MD ◽

Nabil Mesiha, MD ◽

Abou Bakar, PharmD ◽

Maram Sarsour, PharmD ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Retrospective Study ◽

Hospital Discharge ◽

Invasive Mechanical Ventilation ◽

High Dose ◽

Opioid Use ◽

Electronic Health Record Data ◽

Icu Patients ◽

Mechanically Ventilated

Objective: To evaluate whether pain management strategies within intensive care unit (ICU) settings contribute to chronic opioid use upon hospital discharge in opioid-naive patients requiring invasive mechanical ventilation. Design: A retrospective, observational study.Setting: An 18-bed mixed ICU at a community teaching hospital located in Brooklyn, New York.Participants: This study included mechanically ventilated patients requiring continuous opioid infusion from April 25, 2017 to May 16, 2019. Patients were excluded if they received chronic opioid therapy at home or expired during this hospital admission. Eligible patients were identified using an electronic health record data query.Main outcome measure(s): The proportion of ICU patients who continued to require opioids upon ICU and hospital discharge. Results: A total of 196 ICU patients were included in this study. Of these, 22 patients were transferred to a regular floor while receiving a fentanyl transdermal patch. However, the fentanyl patch treatment was continued only for three patients (2 percent) at hospital discharge.Conclusions: This retrospective study suggested that high-dose use of opioids in mechanically ventilated, opioid-naive ICU patients was not associated with continued opioid use upon hospital discharge.

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Elevated admission N-terminal pro-brain natriuretic peptide level predicts the development of atrial fibrillation in general surgical intensive care unit patients

Journal of Trauma and Acute Care Surgery ◽

10.1097/ta.0000000000001552 ◽

2017 ◽

Vol 83 (3) ◽

pp. 485-490 ◽

Cited By ~ 3

Author(s):

Nalin Chokengarmwong ◽

Daniel Dante Yeh ◽

Yuchiao Chang ◽

Luis Alfonso Ortiz ◽

Haytham M.A. Kaafarani ◽

...

Keyword(s):

Atrial Fibrillation ◽

Intensive Care Unit ◽

Intensive Care ◽

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Brain Natriuretic Peptide Level ◽

Surgical Intensive Care Unit ◽

Surgical Intensive Care ◽

Natriuretic Peptide Level ◽

Peptide Level

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Clinical characteristics and outcomes of patients under invasive mechanical ventilation at Ayder comprehensive specialized hospital adult intensive care unit, Mekelle, Ethiopia.

10.1183/13993003.congress-2018.pa333 ◽

2018 ◽

Author(s):

Ephrem Berhe ◽

Kibrom G/Slassie ◽

Tesfay G/Zeabher

Keyword(s):

Intensive Care Unit ◽

Mechanical Ventilation ◽

Intensive Care ◽

Clinical Characteristics ◽

Invasive Mechanical Ventilation ◽

Adult Intensive Care Unit ◽

Specialized Hospital

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N-terminal pro-brain natriuretic peptide and cardiac troponin I for the prognostic utility in elderly patients with severe sepsis or septic shock in intensive care unit: A retrospective study

Journal of Critical Care ◽

10.1016/j.jcrc.2014.12.008 ◽

2015 ◽

Vol 30 (3) ◽

pp. 654.e9-654.e14 ◽

Cited By ~ 20

Author(s):

Hui Cheng ◽

Wei-Ze Fan ◽

Sheng-Chi Wang ◽

Zhao-Hui Liu ◽

Hui-Ling Zang ◽

...

Keyword(s):

Intensive Care Unit ◽

Septic Shock ◽

Severe Sepsis ◽

Intensive Care ◽

Retrospective Study ◽

Elderly Patients ◽

Brain Natriuretic Peptide ◽

Cardiac Troponin ◽

Troponin I ◽

Prognostic Utility

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Assessment of Postresuscitation Volume Status by Bioimpedance Analysis in Patients with Sepsis in the Intensive Care Unit: A Pilot Observational Study

Canadian Respiratory Journal ◽

10.1155/2016/8671742 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 6

Author(s):

Bram Rochwerg ◽

Jason H. Cheung ◽

Christine M. Ribic ◽

Faraz Lalji ◽

France J. Clarke ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Venous Pressure ◽

Invasive Mechanical Ventilation ◽

Kidney Injury ◽

Volume Status ◽

Bioimpedance Analysis ◽

Consent Rate ◽

Icu Patients ◽

Unit Increase

Background. Bioimpedance analysis (BIA) is a novel method of assessing a patient’s volume status.Objective. We sought to determine the feasibility of using vector length (VL), derived from bioimpedance analysis (BIA), in the assessment of postresuscitation volume status in intensive care unit (ICU) patients with sepsis.Method. This was a prospective observational single-center study. Our primary outcome was feasibility. Secondary clinical outcomes included ventilator status and acute kidney injury. Proof of concept was sought by correlating baseline VL measurements with other known measures of volume status.Results. BIA was feasible to perform in the ICU. We screened 655 patients, identified 78 eligible patients, and approached 64 for consent. We enrolled 60 patients (consent rate of 93.8%) over 12 months. For each 50-unit increase in VL, there was an associated 22% increase in the probability of not requiring invasive mechanical ventilation (IMV) (p=0.13). Baseline VL correlated with other measures of volume expansion including serum pro-BNP levels, peripheral edema, and central venous pressure (CVP).Conclusion. It is feasible to use BIA to predict postresuscitation volume status and patient-important outcomes in septic ICU patients.Trial Registration. This trial is registered with clinicaltrials.govNCT01379404registered on June 7, 2011.

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Clinical meaning of brain natriuretic peptide in the intensive care unit

Critical Care ◽

10.1186/cc5617 ◽

2007 ◽

Vol 11 (Suppl 2) ◽

pp. P457

Author(s):

T Principi ◽

D Elisei ◽

M Strovegli ◽

G Falzetti ◽

P Pelaia

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Clinical Meaning

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Clinical Characteristics and Outcomes of Patients With Diabetes Admitted for COVID-19 Treatment in Dubai: Single-Centre Cross-Sectional Study

JMIR Public Health and Surveillance ◽

10.2196/22471 ◽

2020 ◽

Vol 6 (4) ◽

pp. e22471

Author(s):

Rahila Bhatti ◽

Amar Hassan Khamis ◽

Samara Khatib ◽

Seemin Shiraz ◽

Glenn Matfin

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Clinical Characteristics ◽

Laboratory Data ◽

Length Of Hospital Stay ◽

C Reactive Protein ◽

Cross Sectional ◽

Reactive Protein ◽

Patients With Diabetes ◽

D Dimer

Background Recent studies have shown that diabetes is a major risk factor that contributes to the severity of COVID-19 and resulting mortality. Poor glycemic control is also associated with poor patient outcomes (eg, hospitalization and death). Objective This study aimed to describe the clinical characteristics and outcomes of patients with diabetes who were admitted to our hospital for COVID-19 treatment. Methods This cross-sectional, observational study comprised patients with diabetes admitted with COVID-19 to Mediclinic Parkview Hospital in Dubai, United Arab Emirates, from March 30 to June 7, 2020. We studied the differences among characteristics, length of hospital stay, diabetes status, comorbidities, treatments, and outcomes among these patients. Results Of the cohort patients, 25.1% (103/410) had coexistent diabetes or prediabetes. These patients represented 17 different ethnicities, with 59.2% (61/103) from Asian countries and 35% (36/103) from Arab countries. Mean patient age was 54 (SD 12.5) years, and 66.9% (69/103) of patients were male. Moreover, 85.4% (88/103) of patients were known to have diabetes prior to admission, and 14.6% (15/103) were newly diagnosed with either diabetes or prediabetes at admission. Most cohort patients had type 2 diabetes or prediabetes, and only 2.9% (3/103) of all patients had type 1 diabetes. Furthermore, 44.6% (46/103) of patients demonstrated evidence suggesting good glycemic control during the 4-12 weeks prior to admission, as defined arbitrarily by admission hemoglobin A1c level <7.5%, and 73.8% (76/103) of patients had other comorbidities, including hypertension, ischemic heart disease, and dyslipidemia. Laboratory data (mean and SD values) at admission for patients who needed ward-based care versus those who needed intensive care were as follows: fibrinogen, 462.8 (SD 125.1) mg/dL vs 660.0 (SD 187.6) mg/dL; D-dimer, 0.7 (SD 0.5) µg/mL vs 2.3 (SD 3.5) µg/mL; ferritin, 358.0 (SD 442.0) mg/dL vs 1762.4 (SD 2586.4) mg/dL; and C-reactive protein, 33.9 (SD 38.6) mg/L vs 137.0 (SD 111.7) mg/L. Laboratory data were all significantly higher for patients in the intensive care unit subcohort (P<.05). The average length of hospital stay was 14.55 days for all patients, with 28.2% (29/103) of patients requiring intensive care. In all, 4.9% (5/103) died during hospitalization—all of whom were in the intensive care unit. Conclusions Majority of patients with diabetes or prediabetes and COVID-19 had other notable comorbidities. Only 4 patients tested negative for COVID-19 RT-PCR but showed pathognomonic changes of COVID-19 radiologically. Laboratory analyses revealed distinct abnormal patterns of biomarkers that were associated with a poor prognosis: fibrinogen, D-dimer, ferritin, and C-reactive protein levels were all significantly higher at admission in patients who subsequently needed intensive care than in those who needed ward-based care. More studies with larger sample sizes are needed to compare data of COVID-19 patients admitted with and without diabetes within the UAE region.

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