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European Heart Journal ; 42(SUPPL 1):1147, 2021.
Article in English | EMBASE | ID: covidwho-1553893


Background: The COVID-19 pandemic is an ongoing global pandemic. Jerusalem with its 919,400 inhabitants has a wide variety of populations, of which 62% are Jews (36% ultra-orthodox;64% non-ultraorthodox) and 38% Arabs which were largely affected by the pandemic. Objectives: The aim of our study was to understand the different presentations, course and clinical outcomes in these different ethnical and cultural groups in Jerusalem in the COVID-19 pandemic. Methods: We performed a cohort study of all COVID-19 patients admitted between March 9 - July 16, 2020 to the two university medical centers in Jerusalem. Demographic data, presenting symptoms, comorbid conditions, medications, physical examination, laboratory and imaging data as well as outcome at 30-day were systematically recorded. Patients were divided according to their religion and ethnicity into 3 main groups: 1) Ultra- Orthodox Jews;2) other (non-Ultra-Orthodox) Jews and 3) Arabs. Results: Six hundred and two patients comprised the study population. Of them the 361 (60%) were Ultra-Orthodox Jews;166 (27.5%) non-Ultra- Orthodox Jews and 75 (12.5%) Arabs. The Arab patients were younger than the Ultra-Orthodox Jews and the non-Ultra-Orthodox Jews (51±18 year-old vs. 57±21 and 59±19, respectively, p<0.01), but suffered from significantly more co-morbidities. Fever, cough, dyspnea and fatigue, were more prominent, as presenting symptoms, in the Jewish patients as compared with the Arab patients. Moreover, hemodynamic shock, ischemic ECG changes and pathological chest x-ray were all more frequent in the Ultra-Orthodox patients as compared the other groups of patients. Being an Ultra-Orthodox was independently associated with significantly higher rate of Major Adverse Cardiovascular Events (MACE) [OR=1.96;95% CI (1.03-3.71), p<0.05]. Age was the only independent risk factor associated with increased mortality rate [OR=1.10;95% CI (1.07-1.13), p<0.001]. Conclusions: The COVID-19 first phase in Jerusalem, affected different ethnical and cultural groups differently, with the Ultra-Orthodox Jews mostly affected by admission rates, presenting symptoms clinical course and MACE (Acute coronary syndrome, shock, cerebrovascular event or venous thromboembolism). It is conceivable that vulnerable populations need special attention and health planning in time of pandemic, to prevent rapid distribution and severe morbidity.

Journal of the American Geriatrics Society ; 69(SUPPL 1):S74, 2021.
Article in English | EMBASE | ID: covidwho-1214838


Background: Coronavirus 2019 (COVID-19), also known as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), infection is a pandemic that causes acute respiratory injury, hospital admission and death. Older adults are at a higher risk of serious illness and death from this pandemic. Many COVID-19 patients have a pre-existing cardiovascular disease (CVD). We aim to develop a risk factor stratification tool, using Artificial Intelligence (AI) method, to predict mortality, ICU admission, and length of hospital stay, in patients with CVD during this pandemic. Methods: This is a retrospective cohort study. An IRB approval was obtained. Patients with confirmed (SARS-Cov-2) test, age more than 60 and older, who were admitted to the Sparrow hospital between March 2020 and October 2020 were included. CV risk factors including Hypertension (HTN), Chronic Ischemic Heart Disease (CHD), Heart Failure (HF), and Cardiac Arrhythmia (CA) were used. Results: Of the 426 patients with COVID-19(mean age:74.5 years), at least 1 CVD was identified in most patients. HTN being the most common (55%), followed by CHD (22%), HF (20%) and CA (3%). Multivariable logistic regression has been conducted to identify risk factors for adverse outcomes and competing risk survival analysis for mortality. Outcomes measures included hospital stay > 7 days, ICU admission, and death. Discussion: Our data suggests patients with HTN required longer hospital stay, had higher ICU admissions and death rate. Conclusion: CV risk factors are common in older adults. HTN is the commonest CVD in this population. Several CV risk factors may contribute to the severity of COVID19 and its impact on older adults. Our study suggests that CV risk factors including HTN, HF, CHD, and CA have major impact on COVID-19 infection in hospitalized geriatric populations - see graph 1. Patients with HTN, had longer hospital stay, ICU admission, and mortality. Based on this work, we suggest that a large data sample might be required to develop an AI software that can help predict outcomes and the need for certain resources for older patients.

Journal of the American Geriatrics Society ; 69:S148-S148, 2021.
Article in English | Web of Science | ID: covidwho-1195029