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    Outcomes of COVID-19 MESHD among Patients with End Stage Renal Disease MESHD on Remdesivir

    Authors: Vijairam Selvaraj; Muhammad Baig; Kwame Dapaah-Afriyie; Arkadiy Finn; Atin Jindal; George Bayliss

    doi:10.1101/2021.02.10.21251527 Date: 2021-02-15 Source: medRxiv

    BACKGROUNDSince the beginning of the COVID-19 pandemic MESHD, there has been widespread use of remdesivir in adults and children. There is little known information about its outcomes in patients with severe renal dysfunction MESHD or end-stage renal disease MESHD who are on hemodialysis. METHODSA retrospective, multicenter study was conducted on patients with end-stage renal disease MESHD on hemodialysis that were discharged after treatment for COVID-19 MESHD between April 1st and December 31st, 2020. Primary endpoints were the length of stay, mortality, maximum oxygen requirements along with the escalation of care needing mechanical ventilation. Secondary endpoints included change in C reactive protein HGNC, d dimer levels, and disposition. RESULTSA total of 52 charts were reviewed, of which 28 met the inclusion criteria. 14 patients received remdesivir, and 14 patients did not receive remdesivir. The majority of patients were caucasian, female, with diabetes mellitus MESHD and hypertension MESHD. The mean age was 65.33 +14.14 years. All the patients in the remdesivir group received dexamethasone as compared to only 30% of patients in the non-remdesivir group. There was no significant difference in C reactive protein HGNC, d dimer levels, and disposition between the two groups. Approximately 35% of the patients died, 18% required intensive ventilation, and the mean length of stay was 12.21 days. DISCUSSIONThe study demonstrated no clinically significant difference in length of stay, maximum oxygen requirements, or mortality in COVID-19 MESHD patients with end-stage renal disease MESHD in the remdesivir group as compared to the non-remdesivir group. Further studies are needed to study the effects of remdesivir on the renal function and disease course in patients with chronic kidney disease MESHD stage 4 or 5 that are not on dialysis.

    Clinical Presentation, Management and Outcome of Staffs with COVID-19 Disease MESHD: a large tertiary Oil and Refinery Grand Hospital Study

    Authors: Bahram Dehghan; Ahmad abeshtan; Abdullah Sarami; Saied Saeidimehr; Elham Maraghi; Fakher Rahim

    doi:10.21203/rs.3.rs-218397/v1 Date: 2021-02-07 Source: ResearchSquare

    Objective The aim of the present study was to assess clinical characteristics, managing and controlling, and in-hospital outcome of COVID-19 MESHD among oil refinery workers in a single referral center.Methods This cross-sectional study was conducted in a non-COVID single referral center from March to August 2020. At the Naft grand Hospital, the COVID-19 MESHD specimen collection and molecular detection unit was established with staff trained to collect suitable samples (sufficiently deep swabs), storage, packaging, and transportation. The diagnosis of COVID-19 infection MESHD (SARS-CoV-2) was confirmed by real-time reverse transcription polymerase chain reaction (RT-PCR) assay.Results Overall, 500 patients with confirmed COVID-19 MESHD infection were included, of which the most common comorbidities were hypertension MESHD (52.2%) and diabetes MESHD (45.6%). Moreover, 298 patients (59.6%) had one to three comorbidities, 148 patients (29.6%) had four to six cases, and two patients (0.4%) had seven and more comorbidities. Finally, 23 people (4.6%) have cancer MESHD and 206 people (41.2%) have other diseases. 390 (78.8%) received Kaletra, and 387 (78.02%) receive Azithromycin. Overall, PCR test result was positive in 377 (75.4%) patients, computed tomography scan (CT-scan) test was positive in 413 (82.6%) patients, and CRP HGNC test had positive result in 335 patients (67%) patients.Conclusion Most referred cases were survivors with mild to moderate symptoms, and a few of them were unfortunately non-survivor. This could be due to those people with mild COVID-19 MESHD symptoms may respond well to the treatment and institutional isolation. Thus, good and evidence-based clinical care combined with strong public health interventions will save the lives of thousands, if not millions, worldwide.

    COVID-19 MESHD anosmia MESHD and gustatory symptoms as a prognosis factor: a subanalysis of the HOPE COVID-19 MESHD (Health Outcome Predictive Evaluation for COVID-19 MESHD) Registry

    Authors: Jesús Porta-Etessam; Iván Núñez-Gil; Nuria González García; Cristina Fernández; María Viana-LLamas; Charbel Maroun Eid; Rodolfo Romero; Marta Molina; Aitor Uribarri; Victor Becerra; Marcos García Aguado; Jia Huang; Elisa Rondano; Enrico Cerrato; Emilio Alfonso; Alex Castro; francisco Marín; Sergio Raposeiras; Martino Pepe; Gisela Feites; Paloma Mate; Bernardo Cortese; Luís Buzón; Jorge Javita; Vicente Estrada

    doi:10.21203/rs.3.rs-158894/v1 Date: 2021-01-27 Source: ResearchSquare

    Olfactory and gustatory dysfunctions MESHD ( OGD MESHD) are a frequent symptom of Coronavirus disease 2019 MESHD ( COVID-19 MESHD). It has been proposed that the neuroinvasive potential of the novel SARS-CoV-2 could be due to olfactory bulb invasion, conversely studies suggest it could be a good prognostic factor. The aim of the current study was to investigate the prognosis value of OGD in COVID-19 MESHD.These symptoms were recorded on admission from a cohort study of 5868 patients with confirmed or highly suspected COVID-19 MESHD infection included in the multicenter international HOPE Registry (NCT04334291).There was statistical relation in multivariate analysis for OGD in gender, more frequent in female 12.41% vs 8.67% in male, related to age, more frequent under 65 years, presence of hypertension MESHD, dyslipidemia MESHD, diabetes MESHD, smoke, renal insufficiency MESHD, lung, heart, cancer MESHD and neurological disease MESHD. We did not find statistical differences in pregnant (p=0.505), patient suffering cognitive (p=0.484), liver (p=0.1) or immune disease (p=0.32). There was inverse relation (protective) between OGD MESHD and prone positioning (0.005) and death MESHD (<0.0001), but no with ICU (0.165) or mechanical ventilation (0.292). On univariable logistic regression OGD was found to be inversely related to death in COVID-19 MESHD patients. The Odds Ratio was 0.26 (0.15-0.44) (p<0.001) and Z was -5.05.The presence of anosmia MESHD is fundamental in the diagnosis of SARS.CoV-2 infection MESHD, but also could be important when classifying patients and in therapeutic decisions. Even more knowing that it is an early symptom of the disease. Knowing that other situations as being Afro-American or Latino-American, Hypertension MESHD, renal insufficiency MESHD, or increase of C-reactive protein HGNC ( CRP HGNC) imply a worse prognosis we can make a clinical score to estimate the vital prognosis of the patient.The exact pathogenesis of SARS-CoV-2 that causes olfactory and gustative disorders remains unknown but seems related to the prognosis. This point is fundamental, insomuch as could be a plausible way to find a treatment. 

    Evaluation of Patients With Covid-19 MESHD Diagnosis for Chronic Diseases MESHD

    Authors: Murat Altuntas; Habip Yilmaz; Emre Güner

    doi:10.21203/rs.3.rs-135761/v1 Date: 2020-12-24 Source: ResearchSquare

    Aim: Covid-19 MESHD is one of the most important pandemics in the world history. Chronic diseases MESHD, which are risk factors that increase the case fatality rates, have been the leading cause of death MESHD all over the world. In this study, it was aimed to detect coexisting diseases in patients hospitalized with the diagnosis of Covid-19 MESHD.           Material and Method: It was carried out with the data of 229 inpatients in an intensive care unit between 01.06.2020 - 30.06.2020. Among the inclusion criteria of the study; it is necessary to have a diagnosis confirmed by PCR test, to be hospitalized in the relevant intensive care unit on the date of the study and to have data accessible through the hospital automation system. According to literature; chronic diseases of the patients and their effects on the covid-19 MESHD process were evaluated. Statistical analyzes were performed using the Statistical Package for Social Sciences (SPSS) version 24.0 (IBM Corp .; Armonk, NY, USA).Results: It was seen that the average age of the patients were 61.4±15.9 years old. While the average symptom duration was 8.2±5.3 days; total hospitalization period was 13.1±5.9 days. The length of stay of 75 patients who were sent to intensive care unit was determined as 10.1±7.1. The most common chronic disease MESHD among patients was hypertension MESHD with 47.2%. This was followed by diabetes mellitus MESHD (32.8%) and heart disease MESHD (27.5%), respectively. In the presented study, cough MESHD (59.4%), fever MESHD (58.5%) and shortness of breath MESHD (45.9%) were found to be the most common symptoms. Leukopenia MESHD, impairments in liver and muscle enzymes, abnormal C-reactive protein HGNC, ferritin and d-dimer levels were the important laboratory findings.Conclusion: Particular attention should be paid to the elderly Covid-19 MESHD patients with chronic diseases MESHD, especially DM MESHD, HT MESHD and cancer MESHD.

    Intubation prognosis in COVID-19 MESHD patients and associated factors: a cross-sectional study

    Authors: Mostafa Mohammadi; Hesam Aldin Varpaei; Majid Amini

    doi:10.21203/rs.3.rs-115894/v1 Date: 2020-11-25 Source: ResearchSquare

    Background: In December 2019, a new pathogen, HCoV, or New Corona Virus 2019 (2019-nCoV), was recognized in Wuhan, China, causing a pandemic. COVID-19 MESHD has a wide range of clinical severity. Approximately 3.2% of patients within some periods of the disease require intubation and invasive ventilation. Methods: This study was descriptive-analytical and was conducted in the Imam Khomeini Hospital. Patients with Covid-19 MESHD who required endotracheal intubation were identified and their clinical signs and laboratory parameters were recorded. SPSS23 software was used for statistical analysis. Results: 120 patients with coronavirus with different conditions were evaluated. The mean age was 55±14. 30 patients had cardiovascular disease MESHD ( hypertension MESHD) and 20 endocrine disease MESHD( diabetes MESHD). Respiratory acidosis MESHD, decreased oxygen saturation, lymphopenia MESHD, and increased CRP HGNC were the most common finding before intubation. 31 patients had no comorbidity conditions. However, 27 patients had more than one comorbidity condition, and 23 experienced acute respiratory distress syndrome MESHD. The mortality rate was 49.2%. Discussion: Although all laboratory parameters and patients symptoms can affect the treatment outcome, it was found that WBC and absolute lymphocyte count, BUN, SOFA and APACHE scores, inflammatory index ratio CRP HGNC / LDH % CRP HGNC / ESR% and ESR / LDH%, arterial blood gas indices, pulse rate, and patient temperature before intubation are among the parameters that can affect the patient's 14-day prognosis. Conclusion: Except for the mentioned items, CRP HGNC / LDH% ratio seems to be a good indicator for checking the prognosis of discharge or death MESHD of patients within 14 days, However, CRP HGNC / ESR% and ESR / LDH% are appropriate criteria for determining the prognosis for discharge or stay in the ICU for more than 14 days.

    Development of a predictive risk model for severe COVID-19 MESHD disease using population-based administrative data

    Authors: Jiandong Zhou; Sharen Lee; Xiansong Wang; Yi Li; William KK Wu; Tong Liu; Zhidong Cao; Daniel Dajun Zeng; Ian CK Wong; Bernard MY Cheung; Qingpeng Zhang; Gary Tse

    doi:10.1101/2020.10.21.20217380 Date: 2020-10-25 Source: medRxiv

    Background: Recent studies have reported numerous significant predictors for adverse outcomes in COVID-19 MESHD disease. However, there have been few simple clinical risk score for prompt risk stratification. The objective is to develop a simple risk score for severe COVID-19 MESHD disease using territory-wide healthcare data based on simple clinical and laboratory variables. Methods: Consecutive patients admitted to Hong Kong public hospitals between 1st January and 22nd August 2020 diagnosed with COVID-19 MESHD, as confirmed by RT-PCR, were included. The primary outcome was composite intensive care unit admission, need for intubation or death with follow-up until 8th September 2020. Results: COVID-19 MESHD testing was performed in 237493 patients and 4445 patients (median age 44.8 years old, 95% CI: [28.9, 60.8]); 50% male) were tested positive. Of these, 212 patients (4.8%) met the primary outcome. A risk score including the following components was derived from Cox regression: gender, age, hypertension MESHD, stroke MESHD, diabetes mellitus MESHD, ischemic MESHD heart disease MESHD/ heart failure MESHD, respiratory disease MESHD, renal disease MESHD, increases in neutrophil count, monocyte count, sodium, potassium, urea, alanine transaminase, alkaline phosphatase, high sensitive troponin-I, prothrombin HGNC time, activated partial thromboplastin time, D-dimer and C-reactive protein HGNC, as well as decreases in lymphocyte count, base excess and bicarbonate levels. The model based on test results taken on the day of admission demonstrated an excellent predictive value. Incorporation of test results on successive time points did not further improve risk prediction. Conclusions: A simple clinical score accurately predicted severe COVID-19 MESHD disease, even without including symptoms, blood pressure or oxygen status on presentation, or chest radiograph results.

    Patterns of Multimorbidity and Risk of Severe SARS-CoV-2 Infection MESHD: an observational study in the U.K.

    Authors: Yogini V Chudasama; Francesco Zaccardi; Clare L Gillies; Cameron Razieh; Thomas Yates; David E Kloecker; Alex V Rowlands; Melanie J Davies; Nazrul Islam; Samuel Seidu; Nita G Forouhi; Kamlesh Khunti

    doi:10.1101/2020.10.21.20216721 Date: 2020-10-23 Source: medRxiv

    Background Pre-existing comorbidities have been linked to SARS-CoV-2 infection MESHD but evidence is sparse on the importance and pattern of multimorbidity (2 or more conditions) and severity of infection indicated by hospitalisation or mortality. We aimed to use a multimorbidity index developed specifically for COVID-19 MESHD to investigate the association between multimorbidity and risk of severe SARS-CoV-2 infection MESHD. Methods We used data from the UK Biobank linked to laboratory confirmed test results for SARS-CoV-2 infection MESHD and mortality data from Public Health England between March 16 and July 26, 2020. By reviewing the current literature on COVID-19 MESHD we derived a multimorbidity index including: 1) angina MESHD; 2) asthma; 3) atrial fibrillation MESHD; 4) cancer MESHD; 5) chronic kidney disease MESHD; 6) chronic obstructive pulmonary disease MESHD; 7) diabetes mellitus MESHD; 8) heart failure MESHD; 9) hypertension MESHD; 10) myocardial infarction MESHD; 11) peripheral vascular disease MESHD; 12) stroke MESHD. Adjusted logistic regression models were used to assess the association between multimorbidity and risk of severe SARS-CoV-2 infection MESHD (hospitalisation or death MESHD). Potential effect modifiers of the association were assessed: age, sex, ethnicity, deprivation, smoking status, body mass index, air pollution, 25-hydroxyvitamin D, cardiorespiratory fitness MESHD, high sensitivity C-reactive protein HGNC. Results Among 360,283 participants, the median age was 68 [range, 48-85] years, most were White (94.5%), and 1,706 had severe SARS-CoV-2 infection MESHD. The prevalence of multimorbidity was more than double in those with severe SARS-CoV-2 infection MESHD (25%) compared to those without (11%), and clusters of several multimorbidities were more common in those with severe SARS-CoV-2 infection MESHD. The most common clusters with severe SARS-CoV-2 infection MESHD were stroke MESHD with hypertension MESHD (79% of those with stroke MESHD had hypertension MESHD); diabetes MESHD and hypertension MESHD (72%); and chronic kidney disease MESHD and hypertension MESHD (68%). Multimorbidity was independently associated with a greater risk of severe SARS-CoV-2 infection MESHD (adjusted odds ratio 1.91 [95% confidence interval 1.70, 2.15] compared to no multimorbidity). The risk remained consistent across potential effect modifiers, except for greater risk among men. Conclusion The risk of severe SARS-CoV-2 infection MESHD is higher in individuals with multimorbidity, indicating the need to target research and resources in people with SARS-CoV-2 infection MESHD and multimorbidity.

    A Comparative COVID 19 Characterizations and Clinical Course Analysis between ICU and Non ICU Settings

    Authors: Amit Patel; Parloop Bhatt; Surabhi Madan; Nitesh Shah; Vipul Thakkar; Bhagyesh Shah; Rashmi Chovatia; Hardik Shah; Minesh Patel; Pradip Dabhi; Aditi Nanavati; Milan Chag; Keyur Parikh

    doi:10.1101/2020.10.07.20208389 Date: 2020-10-11 Source: medRxiv

    Objective: With COVID-19 pandemic MESHD COVID-19 pandemic MESHD severely affecting India and Ahmedabad city being one accounting for half COVID cases, objective was to determine disease course and severity of in patients at a COVID care hospital. Design: A Clinical trial registry of India registered observational study (CTRI/2020/05/025247). Setting: Certified COVID hospital located in Ahmedabad, Gujarat, India. Participants: 549 COVID positive patients hospitalized between 15 th May to 10 th August, 2020 and treated in ICU and non ICU settings. Main Outcome Measure: Comparative analysis of demographic, clinical characteristics, investigations, treatment, complications and outcome of COVID patients in ICU and non ICU settings. Results: Of the 549 hospitalized COVID positive patients, 159 were admitted in ICU during disease course while 390 had ward admissions. Overall median age was 52 (1-86) years. The ICU group was older (>65years), with associated comorbidities like hypertension MESHD and diabetes MESHD (p<0.001); higher proportion of males (79.25%); with dyspnea MESHD as a major clinical characteristic and consolidation in lungs as a major radiological finding as compared to ward patients. C - reactive protein, D-Dimer HGNC and Ferritin were higher in ICU patients. Overall 50% females depicted elevated Ferritin levels. Steriods(92.45%)and tocilizumab (69.18%) were more frequently used for ICU patients . Remdesivir was prescribed to both ICU and non ICU patients. Favirapir was also a line of treatment for 25% of ICU patients. Convalescent plasma therapy was given to 7 ICU patients. Complications like acute kidney injury MESHD (13.84%), shock (10.69 %), sepsis MESHD and encephalopathy MESHD were observed in ICU patients. Overall mortality rate was 5.47 % with higher mortality among males in comparison to females (p<0.0001). Conclusion: About 29% of overall patients required ICU admission that was commonly elderly males. Chances of ICU admission were higher with baselines comorbidities (1.5 times) and dyspnea MESHD (3.4 times) respectively. A multi-specialty COVID care team and updated treatment protocols improves outcomes.

    Clinical Course and Features of Critical Patients with COVID-19 MESHD: A Single- Center, Retrospective Study from Wuhan Huoshenshan Hospital

    Authors: Huisi He; Zhichao Jin; Yibin Ren; Junxue Wang; Shuzhen Chen; Wen Wen; Yushan Miao; Xuewei Qi; Taiyu Shang; Chenxu Zhang; Hongyang Wang; Weiqin Li; Xijing Zhang; Hao Tang

    doi:10.21203/rs.3.rs-89722/v1 Date: 2020-10-08 Source: ResearchSquare

    Background: Nationally, the indicators tracking the coronavirus pandemic has remained stable. However, it’s still a public health concern and it’s worth providing more front-line data on critical illness. We aim to investigate the clinical course and features of critical patients with Corona Virus Disease MESHD 2019 ( COVID-19 MESHD).Methods: The data on 124 consecutive critical patients from 8th February through April 16th 2020, including demographic and clinical information, were obtained from the intensive care unit (ICU) of Wuhan Huoshenshan Hospital. A cross-sectional survey and comparisons of key biomarkers between survivors and nonsurvivors were performed.Results: Over the study period, 57 nonsurvivors and 67 survivors were included. The overall case-fatality rate for critical patients with COVID-19 MESHD was approximately 46%. The overall average age was 69.89±11.03 years, and the majority had underlying health problems such as hypertension MESHD (63[51%]) and diabetes MESHD (27[22%]). Compared with survivors, nonsurvivors were more likely to develop sepsis MESHD (57[100%] vs. 34[51%]), acute respiratory distress syndrome MESHD (52[91%] vs. 21[38%]) and organ dysfunction. Besides, the dynamic changes in some biomarkers (i.e. WBC, TLC, CRP, PLT) were significantly different between the two groups. The trajectories of temperature revealed that the group with a high temperature on admission that steadily declined had the highest percentage of deaths (84.21%).Conclusions: The elderly with many concomitant diseases were at the highest risk. Lymphocyte, platelet, C-reactive protein HGNC and temperature were revealed to have potential as prognostic factors, whereas some other biomarkers, such as hepatic enzymes, may not offer additional information. Moreover, patients with high temperatures on admission should receive extra care.

    Universal health care access for all residents reduce mortality in COVID-19 MESHD patients in Abu Dhabi, UAE: A retrospective multicenter cohort study

    Authors: Nawal Al kaabi; Asma Al Nuaimi; Mariam Al Harbi; Jehad Abdalla; Tehmina Khan; Huda Gasmelseed; Asad Khan; Osama Hamdoun; Stefan Weber

    doi:10.21203/rs.3.rs-87753/v1 Date: 2020-10-04 Source: ResearchSquare

    Background: SARS‐CoV‐2 was first reported in December 2019. The severity of COVID-19 MESHD infection ranges from being asymptomatic to severe infection leading to death. The aim of the study is to describe the clinical characteristics and outcomes of hospitalized COVID-19 MESHD patients within the largest government healthcare facilities in the Emirate of Abu Dhabi, the capital of UAE. Methods:  This paper is a retrospective cross-sectional study of all patients admitted to Abu Dhabi Healthcare services facilities (SEHA) between the period of March 1 HGNCst until May 31st with a laboratory-confirmed test of SARS-CoV2, known as Coronavirus disease MESHD ( COVID19 MESHD). Variation in characteristics, comorbidities, laboratory values, length of hospital stay, treatment received and outcomes were examined. Data was collected from electronic health records available at SEHA health information system.Results: There were 9390 patients included; patients were divided into severe and non-severe groups. 721 (7.68%) patients required intensive care while the remaining majority (92.32 %) were mild-moderate cases. The mean age (41.8 years) is less than the mean age reported globally. Our population had a male predominance and variable representation of different nationalities. Three major comorbidities were noted, hypertension MESHD, diabetes mellitus MESHD and chronic kidney disease MESHD. The laboratory tests that were significantly different between the severe and the non-severe groups were LDH, Ferritin, CRP HGNC, neutrophil count, IL6 HGNC and creatinine level. The major antiviral therapies the patients have received were a combination of hydroxychloroquine and favipiravir. The overall in hospital mortality was 1.63% while severe group mortality rate was 19.56 %. The Death rate in the adults younger than 30 years was noted to be higher compared to elderly patients above 60 years, 2.3% and 0.9 % respectively. Conclusion: our analysis suggests that Abu Dhabi had a relatively low morbidity and mortality rate and a high recovery rate compared to published rates in China, Italy and The United States. The demographic of the population is younger and has an international representation. The country had the highest testing rate in relation to the population volume. We believe the early identification and younger demographic had affected the favorable comparative outcome in general with early identification of cases leading to a lower mortality rate. 

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MeSH Disease
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