scholarly journals Prognosis of patients hospitalized with a diagnosis of COVID-19 pneumonia in a tertiary hospital in Turkey

2021 ◽  
Vol 41 (6) ◽  
pp. 327-335
Author(s):  
Tayfun Birtay ◽  
Suzan Bahadir ◽  
Ebru Kabacaoglu ◽  
Ozgur Yetiz ◽  
Mehmet Fatih Demirci ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Pneumonia Severity Index ◽  
Severity Index ◽  
Disease Index ◽  
Morbidity And Mortality ◽  
Smoking History ◽  
Pneumonia Severity ◽  
Laboratory Parameters ◽  
The Relationship ◽  
D Dimer

BACKGROUND: SARS-CoV2/COVID-19 emerged in China and caused a global pandemic in 2020. The mortality rate has been reported to be between 0% and 14.6% in all patients. In this study, we determined the clinical and laboratory parameters of COVID-19 related morbidity and mortality in our hospital. OBJECTIVES: Investigate the relationship between demographic, clinical, and laboratory parameters on COVID-19-related morbidity and mortality. DESIGN: Retrospective observational study. SETTINGS: Tertiary care hospital. PATIENTS AND METHODS: Patients diagnosed with COVID-19 pneumonia from March until the end of December were included in the study. MAIN OUTCOME MEASURES: The relationship between demographic, clinical, and laboratory parameters and the morbidity and mortality rates of patients diagnosed with COVID-19. SAMPLE SIZE: 124 patients RESULTS: The mortality rate was 9.6% (12/124). Coronary artery disease ( P <.0001) diabetes mellitus ( P =.04) fever (>38.3°C) at presentation ( P =.04) hypertension ( P <.0001), and positive smoking history ( P <.0001) were significantly associated with mortality. Patients who died were older, had a higher comorbid disease index, pneumonia severity index, fasting blood glucose, baseline serum creatinine, D-dimer, and had lower baseline haemoglobin, SaO 2 , percentage of lymphocyte counts and diastolic blood pressure. Patients admitted to the ICU were older, had a higher comorbidity disease index, pneumonia severity index, C-reactive protein, WBC, D-dimer, creatinine, number of antibiotics used, longer O 2 support duration, lower hemoglobin, lymphocyte (%), and baseline SaO 2 (%). CONCLUSIONS: Our results were consistent with much of the reported data. We suggest that the frequency, dosage, and duration of steroid treatment should be limited. LIMITATIONS: Low patient number, uncertain reason of mortality, no standard treatment regimen, limited treatment options, like ECMO. CONFLICT OF INTEREST: None.

A COMPARATIVE STUDY OF CLINICAL AND BIOCHEMICAL PROFILE AMONG SURVIVORS AND NON SURVIVORS OF PATIENTS WITH COVID-19 INFECTION - A RETROSPECTIVE STUDY.

2021 ◽  
pp. 4-6
Author(s):  
Tilak. N ◽  
Abhijna Vithal Yergolkar ◽  
Ashwin Kulkarni ◽  
T. Anil Kumar ◽  
Sujatha. K.J ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Comparative Study ◽  
Biochemical Parameters ◽  
Clinical Course ◽  
Pneumonia Severity Index ◽  
Severity Index ◽  
Age And Gender ◽  
Pneumonia Severity ◽  
And Gender ◽  
D Dimer

BACKGROUND: The pandemic caused by SARS-Corona Virus-2 (COVID-19) is far from over. There has been ongoing new infections across the globe. The clinical course of the disease is varied among different individuals. The prediction of severity and mortality is very difcult but quite essential for timely escalation of the treatment. This is a comparative study of clinical, biochemical parameters among the survivors and non survivors of COVID-19 infection. METHODOLOGY: This is a retrospective study conducted in a tertiary care hospital in South India. This study was an audit of 39 survivors and 39 non survivors of COVID-19 infection. These patients were matched with age and gender. The clinical prole, Biochemical parameters and the clinical course among the two groups were compared and analyzed. RESULTS: 39 survivors and 39 non survivors were included in the study. The two groups were age and gender matched. The symptoms were fever, cough, breathlessness, fatigue, myalgia, body ache, diarrhea. Breathlessness was more common among patients who did not survive. Pneumonia severity index was class 1 and class 2 among patients who survived. PSI was class 4 and class 5 among the patients who did not survive. This difference was statistically signicant. It was seen that there were signicant number of comorbidities and inammatory markers like CRP, D DIMER, LDH, S. Ferritin seen among non survivors compared to the survivors. The study CONCLUSION: shows that presence of comorbidities has an adverse impact on the outcome of the patients with COVID-19 infection. The elevated inammatory markers like CRP, D Dimer and LDH predicted poor outcome. Pneumonia severity index was a useful marker to predict the outcome among patients of COVID.

scholarly journals Clinical Characteristics at Initial Presentation and Impact of Dual Therapy on the Outcome of BacteremicStreptococcus pneumoniaePneumonia in Adults

2004 ◽  
Vol 11 (8) ◽  
pp. 589-593 ◽  
Author(s):  
K Weiss ◽  
DE Low ◽  
L Cortes ◽  
A Beaupre ◽  
R Gauthier ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Leukocyte Count ◽  
Therapy Group ◽  
Pneumonia Severity Index ◽  
Dual Therapy ◽  
Severity Index ◽  
Community Acquired Pneumonia ◽  
Pneumonia Severity ◽  
The Mean ◽  
The Impact

BACKGROUND:Approximately 10% of patients hospitalized with community-acquired pneumonia (CAP) are bacteremic. BacteremicStreptococcus pneumoniaepneumonia (BSPP) is the number one cause of mortality, representing up to 70% of all CAP deaths. In fact, all CAP guidelines have identified this issue as one of the most important issues when establishing their recommendations.OBJECTIVE:To assess the impact of dual antibiotic therapy in patients with BSPP.PATIENTS AND METHODS:All cases of BSPP in patients 18 years of age and older who were hospitalized from 1995 to 2000 were retrospectively analyzed. The standard initial therapeutic regimen used was cefuroxime with or without a macrolide from 1995 to 1997, and ceftriaxone and azithromycin or clarithromycin from 1998 to 2000. During the 1995 to 1997 period, only 16% of the patients initially received a macrolide, whereas all patients in the 1998 to 2000 period received a macrolide at admission.RESULTS:Ninety-five patients (49 men, 46 women) with a mean age of 63 years (range 20 to 98 years) were included in the present study. The mean pneumonia severity index at admission was 113 for the monotherapy cohort and 114 for the dual therapy group. At admission, 30.5% of patients had a leukocyte count greater than 20´109/L, 11.5% had a systolic blood pressure less than 90 mmHg, 44.2% had a respiratory rate greater than 30 breaths/min and 33.6% had nausea/vomiting, necessitating some form of therapy or preventing the patient from eating. In addition, 16.8% had no fever at admission. Overall, 72.5% became afebrile within 48 h. Fifteen (15.8%) patients died (four within the first 72 h). The mortality rate was significantly higher in the monotherapy group (11 of 42 patients; 25.6%) than in the dual therapy cohort (four of 53 patients; 7.5%) (OR 0.23; 95% CI 0.07 to 0.74). Antibiotic resistance was not associated with increased mortality.CONCLUSION:The combination of ceftriaxone plus a macrolide significantly reduced the mortality rate compared with monotherapy (cefuroxime) in patients with CAP that have the highest mortality rate.

scholarly journals Prognostic Value of Immune-Inflammatory Index in PSI IV-V Patients with COVID-19

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Rui Han ◽  
Honghui Su ◽  
Gangwen Guo ◽  
Qiao Wang ◽  
Jiahui Ma ◽  
...  
Keyword(s):  
Characteristic Curve ◽  
Pneumonia Severity Index ◽  
Severity Index ◽  
Neutrophil To Lymphocyte Ratio ◽  
Pneumonia Severity ◽  
Lymphocyte Ratio ◽  
Inflammatory Index ◽  
Risk Of Mortality ◽  
The Relationship ◽  
Initial Research

Objective. Respiratory failure is the leading cause of mortality in COVID-19 patients, characterized by a generalized disbalance of inflammation. The aim of this study was to investigate the relationship between immune-inflammatory index and mortality in PSI IV-V patients with COVID-19. Methods. We retrospectively reviewed the medical records of COVID-19 patients from Feb. to Apr. 2020 in the Zhongfa Xincheng Branch of Tongji Hospital, Wuhan, China. Patients who presented high severity of COVID-19-related pneumonia were enrolled for further analysis according to the Pneumonia Severity Index (PSI) tool. Results. A total of 101 patients diagnosed with COVID-19 were identified at initial research. The survival analysis revealed that mortality of the PSI IV-V cohort was significantly higher than the PSI I-III group ( p = 0.0003 ). The overall mortality in PSI IV-V patients was 32.1% (9/28). The fatal cases of the PSI IV-V group had a higher level of procalcitonin ( p = 0.022 ) and neutrophil-to-lymphocyte ratio ( p = 0.033 ) compared with the survivors. Procalcitonin was the most sensitive predictor of mortality for the severe COVID-19 population with area under receiver operating characteristic curve of 0.78, higher than the neutrophil-to-lymphocyte ratio (0.75) and total lymphocyte (0.68) and neutrophil (0.67) counts. Conclusion. Procalcitonin and neutrophil-to-lymphocyte ratio may potentially be effective predictors for mortality in PSI IV-V patients with COVID-19. Increased procalcitonin and neutrophil-to-lymphocyte ratio were associated with greater risk of mortality.

Perbandingan Expanded Curb-65 Terhadap Curb-65 dan Psi Dalam Memprediksi Luaran Pasien Cap

2019 ◽  
Vol 4 (3) ◽  
pp. 608
Author(s):  
Suyastri Suyastri ◽  
Irvan Medison ◽  
Deddy Herman ◽  
Russilawati Russilawati
Keyword(s):  
Logistic Regression ◽  
Multivariate Analysis ◽  
Prospective Study ◽  
Pneumonia Severity Index ◽  
Severity Index ◽  
Accurate Method ◽  
P Value ◽  
Pneumonia Severity ◽  
Advantages And Disadvantages ◽  
Care Decision

<p><em>Tingkat keparahan CAP adalah poin penting pengambilan keputusan perawatan pasien. Beberapa metode telah digunakan untuk menilai tingkat keparahan pneumonia seperti Pneumonia Severity Index (PSI), CURB-65, SMART-COP dan Expanded CURB-65. Metode tersebut memiliki kelebihan dan kekurangan. Expanded CURB 65 diusulkan menjadi metode yang lebih akurat untuk mengevaluasi keparahan pneumonia dan memprediksi kematian pasien CAP. Tujuan penelitian ini memprediksi keakuratan Expanded CURB  65 dibandingkan CURB 65 dan PSI. Penelitian kohort prospektif pada pasien CAP yang dirawat di RSUP Dr. M.Djamil Padang dari April sampai Oktober 2019. Tingkat keparahan CAP pada pasien dinilai menggunakan PSI, CURB 65, Expanded CURB 65, kemudian hasilnya dievaluasi berdasarkan keparahan. Data dianalisis menggunakan regresi logistik dengan CI 95% dan nilai p &lt;0,05 dianggap signifikan. Hasil penelitian pada 90 pasien sebagian besar laki-laki usia 53 tahun dengan komorbiditas terbanyak keganasan. Uji Pearson Chi aquare menunjukkan tidak ada hubungan antara tingkat keparahan berdasarkan CURB 65 dan luaran pengobatan (CI 95%, nilai p = 0,104). Sementara, PSI dan Expanded CURB 65 memiliki hubungan yang signifikan antara tingkat keparahan dan luaran (CI 95%, p=0,081 dan CI 95%, p= 0,046, masing-masing). Analisis multivariat menemukan Expanded CURB 65 lebih akurat dalam memprediksi luaran pasien CAP rawat inap (kappa =0,108 dan AUC=0,422).</em></p><p><em><br /></em></p><p><em><em>Severity of CAP is very important for site care decision inpatients. Several methods have been used to assess the severity of pneumonia such as Pneumonia Severity Index (PSI), CURB-65, SMART-COP and Expanded CURB-65. Those methods have advantages and disadvantages. Expanded CURB 65 is proposed to be more accurate method for evaluating pneumonia severity and predicting mortality in CAP. The aim of this study was to investigate the accuracy of Expanded CURB 65 compare to CURB 65 and PSI. Cohort prospective study was conducted for CAP patients who were hospitalized at RSUP Dr. M.Djamil Padang from April to October 2019. Patients was assesed for severity using PSI, CURB 65, Expanded CURB 65, then we evaluated it’s outcome. The data were analyzed by logistic regression with CI 95% and p value &lt;0,05 considered as statistically significant. We found 90 patients that predominantly males with an average age of 53 years, and the most common comorbidity is malignancy. There was no relationship between pneumonia severity by CURB 65 and outcome (CI 95%, p=0.104). PSI and Expanded CURB 65 had significant relationship between severity and outcome (CI 95%, p=0.081and CI 95%, p=0.046, respectively). Multivariate analysis showed the expanded CURB 65 was more accurate for predicting the outcome of CAP inpatients (kappa=0.108 and AUC= 0.422).</em></em></p>

Soluble form of suppression of tumorigenicity-2 predicts clinical stability of inpatients with community-acquired pneumonia

2021 ◽  
pp. 153537022110271
Author(s):  
Yifeng Zeng ◽  
Mingshan Xue ◽  
Teng Zhang ◽  
Shixue Sun ◽  
Runpei Lin ◽  
...  
Keyword(s):  
Regression Model ◽  
Predictive Value ◽  
Cox Regression ◽  
Pneumonia Severity Index ◽  
Severity Index ◽  
Community Acquired Pneumonia ◽  
Risk Classification ◽  
Soluble Form ◽  
Pneumonia Severity ◽  
Clinical Stability

The soluble form of the suppression of tumorigenicity-2 (sST2) is a biomarker for risk classification and prognosis of heart failure, and its production and secretion in the alveolar epithelium are significantly correlated with the inflammation-inducing in pulmonary diseases. However, the predictive value of sST2 in pulmonary disease had not been widely studied. This study investigated the potential value in prognosis and risk classification of sST2 in patients with community-acquired pneumonia. Clinical data of ninety-three CAP inpatients were retrieved and their sST2 and other clinical indices were studied. Cox regression models were constructed to probe the sST2’s predictive value for patients’ restoring clinical stability and its additive effect on pneumonia severity index and CURB-65 scores. Patients who did not reach clinical stability within the defined time (30 days from hospitalization) have had significantly higher levels of sST2 at admission ( P <  0.05). In univariate and multivariate Cox regression analysis, a high sST2 level (≥72.8 ng/mL) was an independent reverse predictor of clinical stability ( P < 0.05). The Cox regression model combined with sST2 and CURB-65 (AUC: 0.96) provided a more accurate risk classification than CURB-65 (AUC:0.89) alone (NRI: 1.18, IDI: 0.16, P < 0.05). The Cox regression model combined with sST2 and pneumonia severity index (AUC: 0.96) also provided a more accurate risk classification than pneumonia severity index (AUC:0.93) alone (NRI: 0.06; IDI: 0.06, P < 0.05). sST2 at admission can be used as an independent early prognostic indicator for CAP patients. Moreover, it can improve the predictive power of CURB-65 and pneumonia severity index score.

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