ABSTRACT
Introduction: With more people working from home after the COVID pandemic, it is of utmost importance to further understand the impact of social isolation on outcomes of patients with coronary atherosclerosis. Our preliminary studies have shown that the novel diet-inducible, fatal mouse model of coronary atherosclerosis, SR-BIDELTACT/LDLR KO, tend to die on average around 4-6 weeks after starting a high-fat Paigan diet (HFD). This mouse model can be used to further understand the effect of social isolation on cardiovascular disease. We hypothesize that social isolation will decrease survival and worsen cardiac function. Method(s): Male and female SR-BIDELTACT/LDLR KO mice were put into social isolation (n=11), in a group of 2-3 (n=13), or in a group of 4-5 (n=22). At six-weeks-old, mice were started on a HFD to induce pathology. Echocardiography was performed to assess cardiac function. Analysis was performed using one-way Analysis of Variance tests and hoc-Tukey's Honest Significant Difference tests. A log-rank test was used to calculate the difference in survival distributions. Result(s): Mice living in groups of 1, 2-3, and 4-5 lived for an average of 34.9, 35.6, and 41.5 days, respectively, after starting the HFD (Fig. 1A). The survival distribution is significantly different between the mice in isolation versus the mice in groups of 4-5 (p<;0.01). Mice in social isolation have significantly lower ejection fractions than mice living in groups of 4-5 after two weeks of being on the HFD (Fig. 1B, p=0.028). Conclusion(s): Mice in social isolation exhibited decreased survival and reduced ejection fractions compared to mice in groups of 4-5. More mice would be needed to determine whether single isolation is different from mice in groups of 2-3. Further studies should be performed to understand the mechanism underlying the effect of social isolation on heart function. Such studies may influence future prevention strategies to positively affect outcomes of patients with atherosclerosis. (Figure Presented).
ABSTRACT
Objective: Proper identification of patients at risk of developing serious disease in the context of SARS-CoV-2 infection, as well as the initiation of early treatment, is essential for COVID19 successful management. The main objective of this study was to evaluate the usefulness of serum biomarkers (i.e., neutrophils, lymphocytes, Creactive protein, lactate dehydrogenase, D-dimer, ferritin and interleukin-6) to predict the early response to immunosuppressant therapy in COVID19 patients. Material and/or methods: This is a case-control study nested in a retrospective cohort, which included hospitalized patients with COVID19 pneumonia and presented elevation of some pro-inflammatory parameters. Each of the individuals who died during the 28-day follow-up was defined as a case. For each case, four controls were selected, matched by age, sex and comorbidities. Results: Overall, 856 patients were included in the initial cohort. The incidence of therapeutic failure in the cohort was 14%, thus a total of 119 cases were identified. After applying a Cox regression model, high serum concentrations of LDH (>451 IU/L), ferritin (>1014 ng/mL) and D-Dimer (>1300 ng/mL) were identified as predictors of poor response to treatment. High-specific cut-off points could not be established for any of these biomarkers. Conclusions: Some inflammatory biomarkers, such as LDH, ferritin and D-dimer, may be helpful in identifying patients for whom an early immunomodulatory therapeutic intervention should be considered in the treatment of COVID19 patients with pneumonia.
ABSTRACT
Objective: COVID-19 has left no healthcare system untouched. Adjustments to accommodate COVID-19 pandemic needs resulted in widespread deferment of non-COVID19 scheduled healthcare activities, added to a general patient's reluctance to visit healthcare settings. This study is aimed to analyse retrospectively demographic and clinical characteristics of patients with acute poisoning attended at the Emergency Department (ED) in three different pandemic periods of time. Material and/or methods: We carried out an observational and retrospective study in which we included all the patients who visited the Emergency Department at Hospital Son Espases due to acute poisoning during three different periods of time from June to July in 2019 (pre pandemic), same period in 2020 (right after the strict confinement in Spain) and in 2021 (post-pandemic). This study was approved by the Research Ethics Committee of the Balearic Islands. Results: All cases of acute poisoning were included (n = 1182). Patients with acute poisoning presenting to the ED decreased significantly during the pandemic (2019: 1.9%, 2020: 1.5%;p < 0.01). The ratio male/female and the mean age of the patients increased during the pandemic (2 vs. 1.4, p = 0.02, and 31.4 vs. 41.3 years, p < 0.001, respectively). The roll of poisoning in suicide attempts increased substantially during the pandemic (2019: 8.71%, 2020: 21%;p < 0.01), mostly driven by the increase in poisoning due to commercially available drugs (2019: 14.20%;2020: 28.76%, p < 0.01), while recreational drug poisoning decreased (2019: 76.1%, 2020: 62%;p < 0.01), while in 2021, figures tended to return to prior patterns. Conclusions: This study found significant changes in some clinical patterns in patients attending the ED due to acute poisoning in the context of COVID19, in line with the already described impact of the pandemic in other areas of the healthcare system.