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Chest ; 162(4):A432-A433, 2022.
Article in English | EMBASE | ID: covidwho-2060596


SESSION TITLE: COVID-19: Other Considerations in Management SESSION TYPE: Original Investigations PRESENTED ON: 10/18/2022 02:45 pm - 03:45 pm PURPOSE: Since its emergence in December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) has spread across the world, claiming millions of lives. With the publication of RECOVERY trial and REMAP-CAP trial, tocilizumab is recommended as additional therapy in select COVID populations by various professional societies. Although not observed initially in several randomized trials, concerns regarding serious secondary infections have been raised. Hereby, we seek to describe the epidemiology of infectious complications after tocilizumab in COVID patients admitted to a tertiary community hospital and to determine related risk factors for infections. METHODS: A retrospective cohort study was conducted among COVID patients requiring noninvasive or invasive ventilation who received tocilizumab at our hospital between June 2020 to December 2021. We define infectious complications as positive culture grown on a specimen that was also treated with antibiotics by the primary team. Baseline demographics and laboratory values are obtained through electronic medical records. Continuous outcomes are analyzed with parametric and non-parametric testing. Categorical variables are analyzed using the Chi-Square test. Risk factors are identified through Probit regression analysis and stepwise analysis. Statistics are performed using SPSS and STATA. RESULTS: 52 patients are identified with a median age of 63 and 46.2% female sex. Median hospital admission time since COVID diagnosis is 2 days and median tocilizumab administered time is 6.5 days. Common comorbidities include hypertension (63.5%), hyperlipidemia (50%) and diabetes (44.2%). Infectious complications are documented in 30 patients (57.7%), with 29 episodes of pneumonia, 7 episodes of urinary tract infection, and 4 episodes of bacteremia. Common organisms include MSSA (21%), Pseudomonas aeruginosa (19%), Klebsiella species (13%) and MRSA (5%). There are 9 cases of multidrug-resistant bacterial infection and 3 episodes of invasive fungal infection (1 Candidemia and 2 invasive aspergilloses). 22 patients (43.3%) died in the hospital before discharge with a median alive time after tocilizumab of 16.5 days. Hyperglycemia on admission (defined as a random glucose >200 mg/dl), hypertension and antibiotic use before tocilizumab are independent risk factors associated with infectious complications during regression analysis. Age >65 is the single most significant factor associated with death in the hospital. CONCLUSIONS: In real-world experience, infectious complications are not uncommon in COVID patients who receive tocilizumab. Our analyses show that potential risk factors for developing infections include a history of hypertension, hyperglycemia on admission and antibiotic use before tocilizumab. CLINICAL IMPLICATIONS: More rigorous criteria in patient selection and patient monitoring should be explored in future trials involving tocilizumab in COVID patients. DISCLOSURES: No relevant relationships by Zauraiz Anjum No relevant relationships by Ming-Yan Chow No relevant relationships by Ahmed Elkhapery No relevant relationships by Hafsa Faisal No relevant relationships by Lakshmi G Nair No relevant relationships by Charoo Iyer No relevant relationships by Hongli Liu No relevant relationships by Chengu Niu No relevant relationships by Kaiwen Zhu

Expert Syst Appl ; 212:118746, 2023.
Article in English | PMC | ID: covidwho-2007692


During the global fight against the novel coronavirus pneumonia (COVID-19) epidemic, accurate outbreak trend forecasting has become vital for outbreak prevention and control. Effective COVID-19 outbreak trend prediction remains a complex and challenging issue owing to the significant fluctuations in the COVID-19 data series. Most previous studies have limitations only using individual forecasting methods for outbreak modeling, ignoring the combination of the advantages of different prediction methods, which may lead to insufficient results. Therefore, this paper develops a novel ensemble paradigm based on multiple neural networks and a novel heuristic optimization algorithm. First, a new hybrid sine cosine algorithm-whale optimization algorithm (SCWOA) is exercised on 15 benchmark tests. Second, four neural networks are used as predictors for the COVID-19 outbreak forecasting. Each predictor is given a weight, and the proposed SCWOA is used to optimize the best matching weights of the ensemble model. The daily COVID-19 series collected from three of the most-affected countries were taken as the test cases. The experimental results demonstrate that different neural network models have different performances in various complex epidemic prediction scenarios. The SCWOA-based ensemble model can outperform all comparable models with its high accuracy and robustness.

Jiliang Xuebao/Acta Metrologica Sinica ; 42(2):259-264, 2021.
Article in Chinese | Scopus | ID: covidwho-1206381


High and low concentrations of reference material of SARS-CoV-2 genomic RNA were developed(GBW(E)091098 and GBW(E)091099)based on the inactivated RNA extraction of the novel coronavirus from infected patients as the potential material,of which the concentrations of E,ORF1ab and N gene were qualified by digital PCR. The reference values with expanded uncertainty of high concentration of reference material were(1.06±0.11)×103 copy/μL,(8.96±0.61)×102 copy/μL and(1.73±0.1)×103 copy/μL,respectively. And those for the low concentration of reference material were(1.29±0.26)×102 copy/μL,(9.5±1.8)×101 copy/μL and(2.05±0.31)×102 copy/μL,respectively. The reference material here developed had been widely applied to method establishment of nucleic acid detection for SARS-CoV-2,quality control for detection kits and testing laboratory. © 2021, Acta Metrologica Sinica Press. All right reserved.