ABSTRACT
Introduction: It is known that patients with COVID-19 infection have a significant incidence of arrhythmias. According to a study from Wuhan, China in 2020, approximately 17% of hospitalized COVID-19 patients suffered from arrhythmia, including Atrial Fibrillation (AF). Here we present a study of the outcomes of AF in COVID admissions at the national cohort registry. Method(s): Utilizing the NIS of the year 2020, we identified patients with diagnosis of COVID-19 and subsequently classified COVID-admission into with and without AF. Multilogistic regression analysis (OR) was done to compare in hospital outcomes. Result(s): Of 1,060,976 patients with diagnosis of COVID, 57,011 (5.37%) had AF. On adjusted analysis, COVID-AF patients had significantly higher odds of heart failure (aOR 1.25, 95% CI 1.19-1.31, P=0.001). On the contrary, there was no statistically significant difference in the odds of MACCE (aOR 0.97, 95% CI 0.91-1.01, P=0.19), in hospital mortality (aOR 0.93, 95% CI 0.88-0.09, P=0.07), AMI (aOR 1.12, 95% CI 1.03-1.22, P=0.08), MCS (aOR 0.86, 95% CI 2.08 - 2.60, P= 0.789), cardiogenic shock (aOR 1.15, 95% CI 0.90-1.45, P=0.257), major bleeding (aOR 1.12, 95% CI 0.96-1.30, P=0.136), PCA (aOR 0.30, 95% CI 0.87-1.93, P=0.205), PCI (aOR 0.10, 95% CI 0.49-2.40, P= 0.82), stroke (aOR 1.02, 95% CI 0.84-1.23, P=0.871) between the two cohorts. The presence of AF in COVID-19 hospitalizations was associated with higher length of stay (9.25 +/-9.05 vs 7.35 +/- 8) and higher adjusted total charge(97,321 155,117+/- vs 77,372+/- 149,354) compared to COVID without AF association. Conclusion(s): COVID-19 patients with AF can have higher odds of heart failure compared to COVID-19 patients without AF. The odds of in hospital mortality, MACCE, MCS, AMI, major bleeding, PCI, PCA and stroke were similar. Large prospective trials are needed to validate these findings. [Formula presented]Copyright © 2023
ABSTRACT
Introduction: Congestive heart failure (CHF) is the most common cardiac admission diagnosis worldwide with high risk of morbidity and mortality. The data on the clinical impact of CHF on COVID-19 hospitalizations is limited. Here we present a study of the cardiovascular outcomes of baseline CHF on COVID-19 admissions at a national level. Method(s): The National Inpatient Sample database from 2020 was queried to identify patients with a primary diagnosis of COVID-19 and stratified based on the presence of congestive heart failure. Multivariate regressions analysis was done to compare inpatient outcomes among COVID patients with and without CHF. The primary outcome measure was in-hospital mortality. Secondary outcomes were in hospital cardiovascular outcomes. The adjusted odds ratios (aOR) of in-hospital outcomes were calculated using chi-square statistics in software STATA v.17. Result(s): 1,060,885 weighted COVID-19 hospitalizations were identified, of which 115,685(10.9%) were associated with CHF. On adjusted analysis, patients with COVID-CHF had significantly higher odds of MACCE (aOR 1.23, 95% CI 1.182-1.28, P<0.001), MCS ( aOR 3.22, 95% CI 2.26-3.26, P<0.001), cardiogenic shock ( aOR 2.72, 95% CI 2.26-3.26, P<0.001), AMI (aOR 2.72, 95% C. On the contrary, patients with COVID and baseline CHF had a lower incidence of inpatient AKI (aOR 0.64, 95% CI 0.49-0.84, P<0.001). The odds of in-hospital mortality, major bleeding and cardiac arrest between the two cohorts were similar. Additionally, presence of CHF in COVID hospitalization was associated with higher length of stay (8.81+/- 8.91 vs 7.28 +/-7.9) and adjusted total charge ($96,640 +/- 177,439 vs $76,214 +/-145,830) compared to COVID without CHF Conclusion(s): COVID 19 patients with CHF have increased odds of MACCE, MCS, cardiogenic shock, AMI, PCA and PCI. Out of hospital outcomes need further studies. [Formula presented]Copyright © 2023
ABSTRACT
Introduction: It is now evident that anticoagulation plays a key role in the management of COVID-19 infection, however the significance of previous long-term oral anticoagulation in patients who later presented with COVID-19 is still unknown. Here we present an analysis of the impact of long-term oral AC on COVID-19 hospitalizations at the national cohort registry. Method(s): The NIS database from 2020 was queried to identify COVID-19 patients on long term AC use. Multivariate regression was done to compare inpatient outcomes among COVID-19 patients with and without AC. Result(s): Of 1,060,925 patients with primary diagnosis of COVID, 102, 560 (9.6%) were on AC. On adjusted analysis, patients with COVID-19 and AC use had significantly lower odds of MACCE (aOR 0.63, 95% CI 0.6-0.66, p<0.001), in-hospital mortality (aOR 0.61, 95% CI 0.58-0.64, p<0.001), cardiac arrest (aOR 0.67, 95% CI 0.6-0.75, P<0.001), acute MI (aOR 0.72, 95% CI 0.63-0.83, P<0.001), stroke (aOR 0.79, 95% CI 0.66-0.95, P=0.002), cardiogenic shock (aOR 0.58, 95% CI 0.44-0.75, P<0.001), ICU admission, (aOR 0.53, 95% CI 0.49-.57, p<0.001) mechanical ventilation,(aOR 0.54, 95% CI 0.51-.58, p<0.001) tracheostomy, (aOR 0.4, 95% CI 0.32-.5, p<0.001) and septic shock, (aOR 0.53, 95% CI 0.48-.58, p<0.001) compared to patients without AC. Additionally, lower adjusted total charge ($70,987+/-109,234 vs 79,239+/-153,418, p<0.001) in patients taking AC was observed. However, the adjusted OR of major bleeding, MCS, PCI, new HD and length of stay were similar between the two groups. Conclusion(s): Patients with COVID-19 infection who are on long term AC use have lower risk of MACCE, in-hospital mortality, cardiac arrest, acute MI, stroke cardiogenic shock and ICU admissions with no significant increased risk of major bleeding. Large prospective trials are needed to validate these findings. [Formula presented]Copyright © 2023
ABSTRACT
Purpose: The use of learning management systems (LMSs) such as Google Classroom has increased significantly in higher education institutes during the COVID-19 pandemic. However, only a few studies have investigated instructors’ continued intention to reuse LMS. The purpose of this study is to investigate the factors that influence instructors’ intention to reuse an LMS in higher education institutes. Design/methodology/approach: This study adopted a mixed-method research design. In the quantitative section, an integrated model of technology acceptance model and information system success model is proposed to explore the effects of system quality, service quality, information quality, perceived ease of use and perceived usefulness on instructors’ satisfaction and how their satisfaction will influence their intention to reuse Google Classroom in the future. In the qualitative section, to gain more understanding, instructors were asked to identify the challenges that inhibit the adoption of e-Learning technologies in public universities in Iraq and what are their recommendations to rectify them. Findings: The findings revealed that service quality had no positive influences on the satisfaction of instructors, while other factors had varying levels of influence, the findings further showed that inadequate internet service and students lack of interest are the biggest challenges instructors faced during their experience with Google Classroom. Research limitations/implications: To improve the generalizability of the results, future studies are recommended to include larger samples, in addition, further studies are also advised to take individual traits such as age and gender into consideration. Originality/value: The outcomes of this study are expected to benefit researchers, policymakers and LMS developers who are interested in factors that affect instructors’ intention to reuse LMS in higher education institutes in developing countries. © 2020, Emerald Publishing Limited.