scholarly journals The Risk Factors, Clinical Characteristics, and Outcome of Air Leak Syndrome in COVID-19: A Systematic Review

2021 ◽  
Vol 25 (12) ◽  
pp. 1434-1445
Author(s):  
Anjan Trikha ◽  
Abhishek Singh ◽  
Puneet Khanna ◽  
Yudhyavir Singh ◽  
Neha Pangasa
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Clinical Characteristics ◽  
Air Leak ◽  
Air Leak Syndrome

COVID-19 in Healthcare Workers: A Systematic Review and Meta-Analysis of Prevalence, Risk Factors, Clinical Characteristics, and Outcomes

2020 ◽  
Author(s):  
Sergio Alejandro Gómez-Ochoa ◽  
Oscar H. Franco ◽  
Lyda Z. Rojas ◽  
Sandra Lucrecia Romero Guevara ◽  
Luis Eduardo Echeverría ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Healthcare Workers ◽  
Clinical Characteristics ◽  
Meta Analysis

scholarly journals Clinical Analysis of Air-Leak Syndrome Following Allogeneic Hematopoietic Stem Cell Transplantation in Pediatric Patients

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4870-4870
Author(s):  
Wei Zhao ◽  
Man Chen ◽  
Yanli Zhao ◽  
Hui Wang ◽  
Peihua Lu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Stem Cell ◽  
Survival Rate ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Pediatric Patients ◽  
Air Leak ◽  
Hematopoietic Stem ◽  
Air Leak Syndrome

Abstract Background: Air-leak syndrome (ALS) occurs when there is leakage of gas from the alveoli, which results in clinical symptoms including cough and sputum, dyspnea, and hypoxemia. ALS is rare but potentially life-threatening in patients who have received an allogeneic hematopoietic stem cell transplantation (allo-HSCT) and is an independent prognosis factor of patients undergoing HSCT. However, the clinical features and risk factors for post-transplant ALS among pediatric patients have rarely been explored. Aims: This study analyzed the clinical characteristics, risk factors, clinical treatment options and prognosis to provide a scientific basis for ALS prevention and treatment for pediatric patients. Methods: We retrospectively reviewed patients who were diagnosed with ALS following allo-HSCT between January 2013 and December 2019 at the Hebei Yanda Lu Daopei Hospital, and analyzed the role of ALS in the prognosis of the HSCT. Results: A total of 2026 pediatric patients received an HSCT between January 2013 and December 2019. The ALS incidence rate was 1.4% (28 of 2,206 patients) with a survival rate of 64.3% (10 of 28 patients). The median overall survival (OS) time was 429 days (range: 55-1614 days). Sixteen patients were males and 12 were female. The median patients age was 12 years old (range: 1-16 years), and the median follow-up time was 871 days (range: 55-2973 days).We divided ALS into two categories: 15 cases of bronchiolitis obliterans syndrome (BOS) and 13 cases of idiopathic pneumonia syndrome (IPS). There was a significant difference in OS between the twogroups (80% among BOS patients versus 46% among IPS patients; P=0.037). Logical regression analysis showed that gender, an unmatched transplant donor and recipients (P=0.049), time to first occurrence of graft-versus-host disease after transplantation (P=0.021), and dosage of methylprednisolone >0.5mg/kg at the onset of ALS (P=0.049), were independent risk factors for poor prognosis in ALS. In addition, we found fluticasone, azithromycin, and montelukast (FAM) could significantly improve the prognosis following ALS (P=0.005). Compared with IPS, our results showed that some patients with BOS may benefit from imatinib (P=0.055), ruxolitinib (P=0.009), or pirfenidone (P=0.044). Conclusion: ALS is a rare manifestation of pulmonary complications following HSCT among pediatric patients. Our analysis demonstrates that early diagnosis and FAM treatment may improve the survival rate of ALS following HSCT among pediatric patients. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

scholarly journals Risk Factors for Mortality in Patients with Covid-19: A Systematic Review

2020 ◽  
Author(s):  
Ratna Yustinawati ◽  
◽  
Anhari Achadi ◽  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Systematic Review ◽  
Organ Failure ◽  
Sofa Score ◽  
Clinical Characteristics ◽  
Research Question ◽  
Master Of Public Health ◽  
Epidemiological Characteristics ◽  
D Dimer

ABSTRACT Background: SARS-CoV-2, a new strain of the coronavirus, caused a global outbreak of fatal acute pneumonia. Globally, WHO has recorded 709,511 deaths from COVID-19, and the number is increasing. This study aimed to determine the risk factors for mortality in COVID-19 patients. Subjects and Method: A systematic review was conducted by searching for articles from ScienceDirect, PubMed, SpringerLink, Scopus, and Google Scholar databases. The inclusion criteria were open access, English-language, and full-text articles published in journals between 20019 and 2020. The keywords were (Coronavirus Disease 2019 AND clinical characteristics AND epidemiological characteristics AND comorbidities) OR (COVID-19 AND clinical characteristics AND epidemiological characteristics AND comorbidities). A total of eight articles was reviewed to answer the research question. The data were analyzed by PRISMA flow chart. Results: Based on the reports from China and Korea, a total of 1,314 (100%) COVID-19 patients who died was aged ≥60 years with comorbidity, in which 845 (64%) were male patients. Before the death of patients, the increase D-dimer level of ≥1 μg/ mL and Sequential Organ Failure Assessment (SOFA) score of ≥4 were reported. It indicated the occurrence of multi-organ failure and Acute Respiratory Distress Syndrome (ARDS). Most of the comorbidities were hypertension, diabetes mellitus, and cardiovascular diseases. Conclusion: Risk factors for mortality in COVID-19 patients include age at ≥60 years, male, and presence of comorbidity. The clinical features are D-dimer levels ≥1 μg / mL, high SOFA score (≥4), and ARDS. Comprehensive efforts are needed to identify risk factors early and conduct effective treatment timely to reduce the mortality of COVID-19 patients. Keywords: SARS-CoV-2, COVID-19, risk factors, mortality, comorbidity Correspondence: Ratna Yustinawati. Master of Public Health Program, Faculty of Public Health, Universitas Indonesia, Depok, West Java, Indonesia. Email: [email protected]. Mobile: +628179324304. DOI: https://doi.org/10.26911/the7thicph.01.26

scholarly journals Spontaneous Post-Transplant Air-Leak Syndrome in Adult Patients Receiving Allogeneic Hematopoietic Stem Cell Transplantation

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5780-5780
Author(s):  
Sheng-Hsuan Chien ◽  
Yao-Chung Liu ◽  
Nai-Wen Fan ◽  
Chia-Jen Liu ◽  
Tzeon-Jye Chiou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Stem Cell ◽  
Chronic Gvhd ◽  
Adult Patients ◽  
Air Leak ◽  
Hematopoietic Stem ◽  
Post Transplant ◽  
Air Leak Syndrome ◽  
Grade Iii

Abstract Introduction: Post-transplant air-leak syndrome (ALS) is a rare but potentially life-threatening complication following allogeneic hematopoietic stem cell transplantation (SCT). All forms of thoracic air leak are defined as ALS, including spontaneouspneumomediastinumorpneumopericardium, subcutaneous emphysema, interstitial emphysema and pneumothorax.The risk factors and pathogenesis of this rare complication have not been well defined, and we reviewed adult patients undergoing hematopoietic SCT in our hospital between January 2003 and December 2014 with focus on this complication. Method We reviewed 423 adult patients undergoing allogeneichematopoieticSCT from 2003 to 2014in Blood and Marrow Transplant Center of Taipei Veterans General Hospital in Taiwan. Pre-transplant and transplant-related clinical data including age, sex, pre-transplant biological data, disease diagnosis, comorbidities, type of transplant, human leukocyte antigen matching, conditioning regimens, graft-versus-host disease (GVHD) and other clinical complications were collected for analysis.We used multivariate logistic regression models adjusting for possible independent confounding factors to determine the independent risk factor of ALS. A log-rank test was used to compare survival curves for statistical significance. Results Thirteen out of 423 patients (3.07%) developed post-transplant ALS in study period. The median age at SCT was 33 years (interquartile-range: 27-46) and male were predominant (69%) among ALS patients.The median time for ALS development was at 253 days (range: 40-2680) after SCT.Multivariate analysis revealed that grade III-IVacute GVHD(odds ratio [OR] 4.36, 95% confidence interval [CI] 1.30-14.66; p = 0.017), extensive chronic GVHD (OR 4.22, 95% CI 1.26-14.12; p = 0.019) and prior history of pulmonary invasive fungal infection (OR 11.84, 95% CI 1.98-70.69; p = 0.007) were significant risk factors for ALS (Table 1) and a trend as risk factor in patients with age ≤42 years (OR 3.41, 95% CI 0.85-13.67; p = 0.083). In patients with chronic GVHD, those with ALS had significantly worse survival time than those without ALS (log-rank p = 0.04, Figure). Conclusion Currently, there are less published data analyzing and exploring post-transplant ALS in adult allogeneichematopoieticSCT. Our study showed a large patient cohort andwe confirmed the risk factors for developing post-transplant ALS, including grade III-IV acute GVHD, extensivechronic GVHD and patients with pulmonary invasive fungus infection history. Patients with young age also had a trend of risk in developing ALS. Patients with post-transplant ALS had a poor survival, especially in patients with chronic GVHD.Prospective studies are needed to determine the etiology andoptimal management of ALS after adult allogeneic hematopoietic SCT. Figure Figure. Disclosures No relevant conflicts of interest to declare.

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