Corpus overview


MeSH Disease

Human Phenotype


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    Mortality rate among critically ill patients with COVID-19 in a medical system with adequate hospital resources: a prospective observational study

    Authors: Christina Routsi; Eleni Magira; Stelios Kokkoris; Ilias Siembos; Charikleia Vrettou; Dimitris Zervakis; Eleni Ischaki; Sotiris Malahias; Ioanna Sigala; Andreas Asimakos; Theodora Daidou; Panagiotis Kaltsas; Evangelia Douka; Adamandia Sotiriou; Vassiliki Markaki; Prodromos Temberikidis; Apostolos Koroneos; Panagiotis Politis; Zafiria Mastora; Efrosini Dima; Theodoros Tsoutsouras; Ioannis Papahatzakis; Panagiota Gioni; Athina Strilakou; Aikaterini Maraguti; Eleftheria Mizi; Ageliki Kanavou; Aikaterini Sarri; Evdokia Gavrielatou; Spyros Mentzelopoulos; Ioannis Kalomenidis; Vassilios Papastamopoulos; Anastasia Kotanidou; Spyros G Zakynthinos

    doi:10.21203/ Date: 2020-08-01 Source: ResearchSquare

    Background: For critically ill patients with coronavirus disease MESHD 2019 (COVID-19) who require intensive care unit (ICU) admission, mortality rates vary widely depending on many factors, among which hospital resources and clinical setting seem important. We sought to determine the outcome of critically ill patients admitted in the usual multidisciplinary ICUs of a big referral for COVID-19 tertiary-care hospital with adequate resources.Methods: We performed a prospective observational study of all adult TRANS patients with COVID-19 consecutively admitted to four COVID-designated ICUs at Evangelismos Hospital, Athens, Greece, from March 11 to April 27, 2020.Results: Among 50 critically ill patients, ICU and hospital mortality for the entire cohort was 32% (16/50), whereas 66% (33/50) of patients were discharged alive from the ICU and 2% (1/50) were still treated in the ICU until June 16, 2020. ICU and hospital mortality for those who received invasive mechanical ventilation was 39% (16/41). Patients who eventually died had already increased risk of death MESHD on ICU admission, as suggested by the high values of the Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores, the presence of current malignancy and occurrence of cardiac arrest HP in 44% (7/16) of patients, and the general need for circulatory support by noradrenaline. Median PaO2/FiO2 on ICU admission for the entire cohort was 121 mmHg [interquartile range (IQR), 86-171 mmHg] and most patients had moderate and severe acute respiratory distress HP syndrome MESHD (ARDS) according to the Berlin Definition. The primary cause of death MESHD of all patients was multi-organ failure, most commonly due to sepsis MESHD sepsis HP, whereas none died from refractory hypoxemia HP, neurologic dysfunction or withdrawal of life support. Hospital stay was long in patients who survived [median 24 days (IQR, 15-35 days)] and was frequently complicated by bacteremias MESHD bacteremias HP [36% (12/33)].Conclusion: Severely ill COVID-19 patients with moderate and severe ARDS may have equal or even lower mortality rates compared to ARDS due to other causes, when they are admitted in general ICUs with experienced and adequate staff without limitations in hospital resources, where established ARDS therapies are used. 

    Spinal Epidural Abscess MESHD Abscess HP in COVID-19 patients

    Authors: Giuseppe Talamonti; Davide Colistra; Francesco Crisà; Marco Cenzato; Pietro Giorgi; Giuseppe D'Aliberti

    doi:10.21203/ Date: 2020-06-27 Source: ResearchSquare

    Objective: To report the peculiarities of spinal epidural abscess MESHD abscess HP in COVID-19 patients, because we observed an unusually high number of these patients following the outbreak of SARS-Corona Virus-2.Methods: We reviewed the clinical documentation of six consecutive COVID-19 patients with primary spinal epidural abscess MESHD abscess HP that we had to surgically manage during a two-month period. These cases were analyzed for what concerns both the viral infection MESHD and the spinal abscess MESHD abscess HP.Results: Abscess was primary in all cases TRANS meaning that no evident infective source was found. Primary abscess MESHD abscess HP represents the rarest form of spinal epidural abscess MESHD abscess HP, which is usually secondary to invasive procedures or spreading from adjacent infective sites, such as spondylodiscitis and generally occurs in patients with diabetes, obesity MESHD obesity HP, cancer, or other chronic disease MESHD. In all cases, there was mild lymphopenia MESHD lymphopenia HP but the spinal abscess MESHD abscess HP occurred regardless the severity of the viral disease MESHD, the immunologic state, and the presence of bacteremia MESHD bacteremia HP. Obesity MESHD Obesity HP was the only risk factor and was reported just in two patients. All patients but one were hypertensive. The preferred localizations were cervical and thoracic, whereas the classic abscess MESHD abscess HP generally occurs at lumbar level. No patient had history of pyogenic infection MESHD, even though previous asymptomatic TRANS bacterial contaminations were reported in three cases.Conclusion: We wonder about the concentration of this uncommon disease MESHD in a so short period. To our knowledge, cases of epidural spinal abscess MESHD abscess HP in COVID-19 patients have been not yet reported. Accordingly, we ignore if the SARS-Corona Virus-2 may really predispose to spinal epidural abscesses MESHD abscesses HP. However, we hypothesize that, in our patients, the spinal infection MESHD could have depended on the coexistence of an initially asymptomatic TRANS bacterial contamination. The well-known COVID-19-related endotheliitis might have created the conditions for retrograde bacterial invasion of the correspondent spinal epidural space. Anyway, the spinal epidural abscess MESHD abscess HP carries significantly high morbidity and mortality. It is difficult to diagnose, especially in compromised COVID-19 patients but it should be kept in mind because early diagnosis and treatment are crucial.

    Bacteremia MESHD Bacteremia HP and Blood SERO Culture Utilization During COVID-19 Surge in New York City

    Authors: Jorge Sepulveda; Lars F Westblade; Susan Whittier; Michael Joseph Satlin; William Greendyke; Justin G Aaron; Jason E. Zucker; Donald Dietz; Magdalena E Sobieszczyk; Justin J Choi; Dakai Liu; Kelvin Espinal; Sarah Russell; Dennis Camp; Charles Connelly; Daniel A. Green

    doi:10.1101/2020.05.05.20080044 Date: 2020-05-06 Source: medRxiv

    A surge of patients with coronavirus disease MESHD 2019 (COVID-19) presenting to New York City hospitals in March 2020 led to a sharp increase in the utilization of blood SERO cultures, which overwhelmed the capacity of automated blood SERO culture instruments. We sought to evaluate the utilization and diagnostic yield of blood SERO cultures during the COVID-19 pandemic to determine prevalence SERO and common etiologies of bacteremia MESHD bacteremia HP, and to inform a diagnostic approach to relieve blood SERO culture overutilization. We performed a retrospective cohort analysis of 88,201 blood SERO cultures from 28,011 patients at a multicenter network of hospitals within New York City to evaluate order volume, positivity rate, time to positivity, and etiologies of positive cultures in COVID-19. Ordering volume increased by 34.8% in the second half of March 2020 compared to the first half of the month. The rate of bacteremia MESHD bacteremia HP was significantly lower among COVID-19 patients (3.8%) than COVID-19 negative patients (8.0%) and those not tested (7.1%), p < 0.001. COVID-19 patients had a high proportion of organisms reflective of commensal skin microbiota, reducing the bacteremia MESHD bacteremia HP rate to 1.6% when excluded. More than 98% of all positive cultures were detected within 4 days of incubation. Bloodstream infections MESHD are very rare for COVID-19 patients, which supports the judicious use of blood SERO cultures in the absence of compelling evidence for bacterial co- infection MESHD. Clear communication with ordering providers is necessary to prevent overutilization of blood SERO cultures during COVID-19 surges, and laboratories should consider shortening the incubation period TRANS from 5 days to 4 days to free additional capacity.

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MeSH Disease
Human Phenotype

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