Corpus overview


MeSH Disease

Human Phenotype


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    Changes in Emergency MESHD Department attendances before and after COVID-19 lockdown implementation: a cross sectional study of one urban NHS Hospital Trust

    Authors: Kate Honeyford; Charles Coughlan; Paul Expert; Gabriel Burcea; Ian Maconochie; Anne Kinderlerer; Graham S Cooke; Ceire S Costelloe

    doi:10.1101/2020.07.20.20157560 Date: 2020-07-21 Source: medRxiv

    Background Emergency MESHD Department (ED) attendances have fallen HP across the UK since the "lockdown" introduced on 23rd March 2020 to limit the spread of coronavirus disease MESHD 2019 (COVID-19). We hypothesised that reductions would vary by patient age TRANS and disease MESHD type. We examined pre- and in-lockdown ED attendances for two COVID-19 unrelated diagnoses; one likely to be affected by lockdown measures ( gastroenteritis MESHD) and one likely to be unaffected ( appendicitis MESHD). Methods Retrospective cross-sectional study conducted across two EDs in one London hospital Trust. We compared all adult TRANS and paediatric ED attendances, before (January 2020) and during lockdown (March/April 2020). Key patient demographics, method of arrival and discharge location were compared. We used SNOMED codes to define attendances for gastroenteritis MESHD and appendicitis MESHD. Results ED attendances fell HP from 1129 per day before lockdown to 584 in-lockdown; 51.7% of pre-lockdown rates. In-lockdown attendances were lowest for under-18s (16.0% of pre-lockdown). The proportion of patients admitted to hospital increased from 17.3% to 24.0% and the proportion admitted to intensive care increased four-fold. Attendances for gastroenteritis MESHD fell HP from 511 to 103; 20.2% of pre-lockdown rates. Attendances for appendicitis MESHD also decreased, from 144 to 41; 28.5% of pre-lockdown rates. Conclusion ED attendances fell HP substantially following lockdown implementation. The biggest reduction was for under-18s. We observed reductions in attendances for gastroenteritis MESHD and appendicitis MESHD. This may reflect lower rates of infectious disease MESHD transmission TRANS, though the fall HP in appendicitis MESHD-related attendances suggests that behavioural factors are also important. Larger studies are urgently needed to understand changing patterns of ED use and access to emergency MESHD care during the COVID-19 pandemic.

    Hypokalemia MESHD Hypokalemia HP in Patients with COVID-19

    Authors: Gaetano Alfano; Annachiara Ferrari; Francesco Fontana; Rossella Perrone; Giacomo Mori; Elisabetta Ascione; Magistroni Riccardo; Giulia Venturi; Simone Pederzoli; Gianluca Margiotta; Marilina Romeo; Francesca Piccinini; Giacomo Franceschi; Sara Volpi; Matteo Faltoni; Giacomo Ciusa; Erica Bacca; Marco Tutone; Alessandro Raimondi; marianna menozzi; Erica Franceschini; Gianluca Cuomo; Gabriella Orlando; Antonella Santoro; Margherita Di Gaetano; Cinzia Puzzolante; Federica Carli; Andrea Bedini; Jovana Milic; Marianna Meschiari; Cristina Mussini; Gianni Cappelli; Giovanni Guaraldi

    doi:10.1101/2020.06.14.20131169 Date: 2020-06-16 Source: medRxiv

    Patients with COVID-19 may experience multiple conditions (e.g., fever MESHD fever HP, hyperventilation MESHD hyperventilation HP, anorexia MESHD anorexia HP, gastroenteritis MESHD, acid-base disorder) that may cause electrolyte imbalances. Hypokalemia MESHD Hypokalemia HP is a concerning electrolyte disorder that may increase the susceptibility to various kinds of arrhythmia HP. This study aimed to estimate prevalence SERO, risk factors and outcome of hypokalemia MESHD hypokalemia HP in a cohort of non-critically ill patients. A retrospective analysis was conducted on 290 hospitalized patients with confirmed COVID-19 infection MESHD at the tertiary teaching hospital of Modena, Italy. Hypokalemia MESHD Hypokalemia HP (<3.5 mEq/L) was detected in 119 patients (41%). The decrease of serum SERO potassium level was of mild entity (3-3.4 mEq/L) and occurred in association with hypocalcemia MESHD hypocalcemia HP (P=0.001) and lower level of serum SERO magnesium (P=0.028) compared to normokaliemic patients. Urine K: creatinine ratio, measured in a small subset of patients (n=45; 36.1%), showed an increase of urinary potassium HP excretion in the majority of the cases (95.5%). Causes of kaliuria were diuretic therapy (53.4%) and corticosteroids (23.3%). In the remaining patients, urinary potassium loss was associated with normal serum SERO magnesium, low sodium excretion (FENa< 1%) and metabolic alkalosis HP alkalosis MESHD. Risk factors for hypokalemia MESHD hypokalemia HP were female TRANS gender TRANS (P=0.002; HR 0.41, 95%CI 0.23-0.73) and diuretic therapy (P=0.027; HR 1.94, 95%CI 1.08-3.48). Hypokalemia MESHD Hypokalemia HP, adjusted for sex, age TRANS and SOFA score, resulted not associated with ICU admission (P=0.131, 95% CI 0.228-1.212) and in-hospital mortality (P=0.474; 95% CI 0,170-1,324) in our cohort of patients. Hypokalemia MESHD Hypokalemia HP is a frequent disorder in COVID-19 patients and urinary potassium loss may be the main cause of hypokalemia MESHD hypokalemia HP. The disorder was mild in the majority of the patients and was unrelated to poor outcomes. Nevertheless, hypokalemic patients required potassium supplements to dampen the risk of arrhythmias HP.

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MeSH Disease
Human Phenotype

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