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Objective. To assess the impact of obesity and overweight on the course of COVID-19. Patients and methods. This prospective study included 218 patients with SARS-CoV-2 infection aged 18 to 94 years hospitalized between June 2020 and March 2021. We evaluated their clinical and laboratory parameters and their association with body weight. All patients were divided into 3 groups depending on their body mass index (BMI). Group 1 included 81 patients with grade 1-3 obesity (BMI >=30);group 2 comprised 71 overweight patients (BMI >=25 and <30);group 3 included 66 patients with normal body weight (BMI >=18.5 and <25). We analyzed clinical symptoms (including shortness of breath, fever, myalgia, headache, fatigue, changes in the oropharynx, cough, rhinorrhea, sore throat, anosmia, and diarrhea), prevalence of concomitant disorders and complications, findings of computed tomography and pulse oximetry, and findings of instrumental and laboratory examinations (complete blood count, urine test, electrocardiography, echo cardiography, biochemical assays, including C-reactive protein, procalcitonin, alanine aminotransferase, aspartate aminotransferase, lactate, lactate dehydrogenase, activated partial thromboplastin time, prothrombin index, D-dimer, ferritin). Data analysis was performed using the Statistica 6.0 software. Results. We found that overweight and obese patients were more likely to have the main COVID-19 symptoms and comorbidities than those with normal weight. Overweight and obese patients also required respiratory support more frequently than patients with normal weight. Obese and overweight patients had more severe systemic inflammation (CRP, procalcitonin), cytolysis (ALT, AST), and thrombosis (D-dimer). Conclusion. Our findings suggest that obesity and overweight are the factors associated with a more severe SARS-CoV-2 infection, which should be considered when planning their treatment and developing resource strategies.Copyright © 2022, Dynasty Publishing House. All rights reserved.
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Post-COVID syndrome develops after COVID-19 (COronaVIrus Disease 2019) and leads to cumulative effects in the form of shortness of breath and impaired lung function. Notably, patients with airway inflammation and COVID-19 were found to have increased concentrations of hyaluronic acid (HA). Since bovhyaluronidase azoximer (Longidase) catalyzes the hydrolysis of HA, this drug has the potential to reduce HA levels and improve lung function in patients with post-COVID syndrome. The aim of the DISSOLVE trial, which was conducted early in the pandemic, was to investigate the efficacy and safety of bovhyaluronidase azoximer in patients with symptoms associated with post-COVID syndrome. Methods. An open, prospective, controlled, comparative, multicenter clinical trial (NCT04645368) included adult patients (n = 160) who had post-COVID syndrome. Patients in the treatment group (n = 81) received bovhyaluronidase azoximer, and individuals in the control group (n = 79) were followed up without intervention. The study included physical examination, evaluation of forced vital capacity (FVC), assessment of dyspnea with the Modified Medical Research Council Dyspnea Scale (mMRC), 6-minute walking test, and pulse oximetry. These indicators were measured on 3 visits, at days 1 (baseline), 75, and 180. In addition, the number of patients who experienced adverse events and serious adverse events were recorded. Results. Baseline patient characteristics in the treatment group and the control group were similar. In the treatment group, there was a statistically significant reduction in residual pulmonary abnormalities after visit 2 (day 75) and visit 3 (day 180). In addition, FVC, pulse oximetry values, and functional exercise tolerance increased statistically significantly at days 75 and 180 compared to baseline. The mMRC scores for dyspnea decreased statistically significantly in the treatment group over 75 days. The safety profile of the drug was reported to be favorable throughout the study. Conclusion. Treatment with bovhyaluronidase azoximer in patients with post-COVID syndrome showed improvement in FVC, pulse oximetry, functional exercise tolerance, and mMRC dyspnea.Copyright © Chuchalin A.G. et al., 2023.
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Background and Objectives: Photoplethysmography (PPG) sensors have been increasingly used for remote patient monitoring, especially during the COVID-19 pandemic, for the management of chronic diseases and neurological disorders. There is an urgent need to evaluate the accuracy of these devices. This scoping review considers the latest applications of wearable PPG sensors with a focus on studies that used wearable PPG sensors to monitor various health parameters. The primary objective is to report the accuracy of the PPG sensors in both real-world and clinical settings. Methods: This scoping review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). Studies were identified by querying the Medline, Embase, IEEE, and CINAHL databases. The goal was to capture eligible studies that used PPG sensors to monitor various health parameters for populations with a minimum of 30 participants, with at least some of the population having relevant health issues. A total of 2,996 articles were screened and 28 are included in this review. Results: The health parameters and disorders identified and investigated in this study include heart rate and heart rate variability, atrial fibrillation, blood pressure (BP), obstructive sleep apnea, blood glucose, heart failure, and respiratory rate. An overview of the algorithms used, and their limitations is provided. Conclusion: Some of the barriers identified in evaluating the accuracy of multiple types of wearable devices include the absence of reporting standard accuracy metrics and a general paucity of studies with large subject size in real-world settings, especially for parameters such as BP.
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Objective. To assess the impact of obesity and overweight on the course of COVID-19. Patients and methods. This prospective study included 218 patients with SARS-CoV-2 infection aged 18 to 94 years hospitalized between June 2020 and March 2021. We evaluated their clinical and laboratory parameters and their association with body weight. All patients were divided into 3 groups depending on their body mass index (BMI). Group 1 included 81 patients with grade 1-3 obesity (BMI >=30);group 2 comprised 71 overweight patients (BMI >=25 and <30);group 3 included 66 patients with normal body weight (BMI >=18.5 and <25). We analyzed clinical symptoms (including shortness of breath, fever, myalgia, headache, fatigue, changes in the oropharynx, cough, rhinorrhea, sore throat, anosmia, and diarrhea), prevalence of concomitant disorders and complications, findings of computed tomography and pulse oximetry, and findings of instrumental and laboratory examinations (complete blood count, urine test, electrocardiography, echo cardiography, biochemical assays, including C-reactive protein, procalcitonin, alanine aminotransferase, aspartate aminotransferase, lactate, lactate dehydrogenase, activated partial thromboplastin time, prothrombin index, D-dimer, ferritin). Data analysis was performed using the Statistica 6.0 software. Results. We found that overweight and obese patients were more likely to have the main COVID-19 symptoms and comorbidities than those with normal weight. Overweight and obese patients also required respiratory support more frequently than patients with normal weight. Obese and overweight patients had more severe systemic inflammation (CRP, procalcitonin), cytolysis (ALT, AST), and thrombosis (D-dimer). Conclusion. Our findings suggest that obesity and overweight are the factors associated with a more severe SARS-CoV-2 infection, which should be considered when planning their treatment and developing resource strategies.Copyright © 2022, Dynasty Publishing House. All rights reserved.
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Background: Physical activity has been shown to have a positive impact on cystic fibrosis (CF) symptoms and slows decline in lung function. Additionally, moderate-intensity activities have been shown to improve sputum expectoration and oxygen saturation in children with CF, improving symptoms [1]. This study assessed whether using fitness trackers and providing a daily step goal would increase physical activity in hospitalized children with CF. Method(s): This pre-post pilot study included participants aged 6 to 21 who were admitted to the hospital for a pulmonary exacerbation of CF between October 2020 and November 2021. Garmin vivosmart 4 wrist-based activity trackers were issued, and baseline datawere tracked and analyzed for the first 2 study days. Pre-goal number of steps was defined as average number of steps taken on those 2 days. On study day 3, a step goal and menu of activities designed to increase physical activity were shared with the participants. Steps after goal settingwere defined as average number of steps taken on study day 3 and beyond while hospitalized, excluding day of discharge. Data collected from the medical record and the activity tracker web-based profile included daily oxygen requirement, daily step count, sleep duration, overnight pulse oximetry levels, resting heart rate, calories expended, and intensity minutes. The primary outcome of change in daily steps and attainment of step goals was analyzed using descriptive statistical testing, means, and standard deviations. Outpatient data were collected for 3 months to observe adherence to goals after discharge. Result(s): Eight participants aged 6 to 18 completed the study. Hospital length of stay ranged from 4 to 14 days. Participants took an average of 1508 +/- 1078 steps before goal setting, which increased to an average of 3704 +/- 1555 steps after the intervention. Step goals were met 56% of the time, although these data were highly variable. During the first week after hospital discharge, participants took an average of 6303 +/- 1786 steps per day (Figure 1).(Figure Presented) Figure 1. During the intervention, patients met their step goal 56% of the time, although this was highly variable. Two patients met their goal 100% of the time (9- year-old boy, 7-year-old girl), two met it 0% of the time (18-year-old boy, 17-year-old girl), one met it 44% of the time (6-year-old boy), and the remaining three met it 67% of the time (10-year-old girl, 17-year-old girl, 14-year-old boy). Conclusion(s): This intervention shows promise, with daily number of steps doubling from baseline during the intervention period. There was great variability among participants, suggesting that the approach helps some more than others. Enrollment was initially planned for 20 patients, but the SARS-CoV-2 pandemic and changes to CF therapy reduced hospitalizations during the study period. Outpatient data were analyzed for only the first week after discharge because of poor adherence to wearing the device. Although our results showa positive impact, further research is needed to determine the effect such an intervention would have on a larger scale. Future directions of research include determining potential clinical benefit from increased activity during hospitalization and prolonged follow-up to assess long-term benefits of intervention.Copyright © 2022, European Cystic Fibrosis Society. All rights reserved
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Post-COVID syndrome develops after COVID-19 (COronaVIrus Disease 2019) and leads to cumulative effects in the form of shortness of breath and impaired lung function. Notably, patients with airway inflammation and COVID-19 were found to have increased concentrations of hyaluronic acid (HA). Since bovhyaluronidase azoximer (Longidase) catalyzes the hydrolysis of HA, this drug has the potential to reduce HA levels and improve lung function in patients with post-COVID syndrome. The aim of the DISSOLVE trial, which was conducted early in the pandemic, was to investigate the efficacy and safety of bovhyaluronidase azoximer in patients with symptoms associated with post-COVID syndrome. Methods. An open, prospective, controlled, comparative, multicenter clinical trial (NCT04645368) included adult patients (n = 160) who had post-COVID syndrome. Patients in the treatment group (n = 81) received bovhyaluronidase azoximer, and individuals in the control group (n = 79) were followed up without intervention. The study included physical examination, evaluation of forced vital capacity (FVC), assessment of dyspnea with the Modified Medical Research Council Dyspnea Scale (mMRC), 6-minute walking test, and pulse oximetry. These indicators were measured on 3 visits, at days 1 (baseline), 75, and 180. In addition, the number of patients who experienced adverse events and serious adverse events were recorded. Results. Baseline patient characteristics in the treatment group and the control group were similar. In the treatment group, there was a statistically significant reduction in residual pulmonary abnormalities after visit 2 (day 75) and visit 3 (day 180). In addition, FVC, pulse oximetry values, and functional exercise tolerance increased statistically significantly at days 75 and 180 compared to baseline. The mMRC scores for dyspnea decreased statistically significantly in the treatment group over 75 days. The safety profile of the drug was reported to be favorable throughout the study. Conclusion. Treatment with bovhyaluronidase azoximer in patients with post-COVID syndrome showed improvement in FVC, pulse oximetry, functional exercise tolerance, and mMRC dyspnea.Copyright © Chuchalin A.G. et al., 2023.
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Objective. Pulse oximetry is a non-invasive optical technique used to measure arterial oxygen saturation (SpO2) in a variety of clinical settings and scenarios. Despite being one the most significant technological advances in health monitoring over the last few decades, there have been reports on its various limitations. Recently due to the Covid-19 pandemic, questions about pulse oximeter technology and its accuracy when used in people with different skin pigmentation have resurfaced, and are to be addressed.Approach. This review presents an introduction to the technique of pulse oximetry including its basic principle of operation, technology, and limitations, with a more in depth focus on skin pigmentation. Relevant literature relating to the performance and accuracy of pulse oximeters in populations with different skin pigmentation are evaluated.Main Results. The majority of the evidence suggests that the accuracy of pulse oximetry differs in subjects of different skin pigmentations to a level that requires particular attention, with decreased accuracy in patients with dark skin.Significance. Some recommendations, both from the literature and contributions from the authors, suggest how future work could address these inaccuracies to potentially improve clinical outcomes. These include the objective quantification of skin pigmentation to replace currently used qualitative methods, and computational modelling for predicting calibration algorithms based on skin colour.
Subject(s)
COVID-19 , Skin Pigmentation , Humans , Pandemics , Oximetry/methods , OxygenABSTRACT
While medical technology is typically considered neutral, many devices rely upon racially biased algorithms that prioritize care for White patients over Black patients, who may require more urgent medical attention. In their accompanying article, Sudat et al. (Am J Epidemiol. 2023;XXX(XX):XXX-XXX) document striking inaccuracies in pulse oximeter readings among Black patients, with significant clinical implications. Their findings suggest that this resulted in racial differences in delivery of evidence-based care during the coronavirus disease 2019 (COVID-19) pandemic, affecting admissions and treatment protocols. Despite the medical community's growing awareness of the pulse oximeter's significant design flaw, the device is still in use. In this article, I contextualize Sudat et al.'s study results within the larger history of racial bias in medical devices by highlighting the consequences of the continued underrepresentation of diverse populations in clinical trials. I probe the implications of racially biased assessments within clinical practice and research and illustrate the disproportionate impact on patients of color by examining 2 medical tools, the pulse oximeter and pulmonary function tests. Both cases result in the undertreatment and underdiagnosis of Black patients. I also demonstrate how the social underpinnings of racial bias in medical technology contribute to poor health outcomes and reproduce health disparities, and propose several recommendations for the field to rectify the harms of racial bias in medical technology.
Subject(s)
COVID-19 , Equipment and Supplies , Racism , Humans , Black or African American , Oximetry/methods , PandemicsABSTRACT
Background: Evidence of COVID-19 respiratory sequels is restricted and predisposing factors are not well studied more than two years passing pandemic. This study followed COVID-19 patients 12 weeks after discharge from hospital for respiratory sequels. Material(s) and Method(s): This was a prospective study on discharged COVID-19 patients in 2021, in Jahrom, Iran. Exposure was COVID-19 clinical features at hospitalization, including symptoms and physical examination and laboratory findings, and primary endpoint was 12-week lung sequel, being evaluated by a chest CT scan. Demographics and previous medical history were considered covariates. SPO2and CRP 6-week changes were followed as an early tool for prediction of 12-week lung sequel. Result(s): Totally, 383 participants (17 had sequels) with mean age of 57.43 18.03 years old (50.13% male) completed 12-week study follow-ups. Ninety-one (23.8%) subjects had an ICU admission history. SPO2% in 6th week was statistically significantly associated with a higher rate of 12-week sequelae (p<0.001). Also, patients having CT scan scores between 40% to 50% (p=0.012) and higher than 50% (p=0.040) had higher chance of experiencing lung sequelae than patients with CT scan score of below 40%, as well as having ICU admission history and lower SPO2% at 6th week of discharge. There was a statistically significant increasing trend of SPO2% (P<0.001) and a statistically significant decreasing trend of CRP levels (P<0.001), overall. SPO2% increase after 6 weeks was lower in participants with lung sequels than fully improved ones (P=0.002) and as well as total 12-week change in SPO2% (P=0.001). CRP changes in none of evaluated periods were different among study groups (P>0.05). Conclusion(s): Our results were in favor of closely following SPO2levels after patient discharge, while CRP assessment seems not helpful based on our results [GMJ.2023;12:e2695].Copyright © 2023 Shiraz University of Medical Sciences. All rights reserved.
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BACKGROUND: One of the most precocious Italian COVID-19 outbreaks began in February 2020 in Medicina, a small town in the province of Bologna. We compared the characteristics of different cohorts, to identify potential predictive factors for outcome: patients of Medicina outbreak versus those of the surrounding district (Imola), and before or after the local medical intervention. METHOD(S): Between March the 3rd and April the 9th, 2020 167 adults with COVID-19 were admitted to the Emergency Department (ED) (78 from Medicina cluster, 89 from Imola district). Data at ED presentation were collected;hospitalized patients were followed until death or discharge. RESULT(S): Medicina and Imola cohorts were similar in age, main comorbidities, clinical presentation, laboratory tests, arterial blood gas analysis (ABG), death and acute respiratory distress syndrome (ARDS) rates. Age, hypertension, diabetes, chronic obstructive pulmonary disease, dyspnea, body temperature, quickSOFA Score, elevated C-reactive protein (CRP), creatinine, urea, DELTA A-a O2, respiratory rate and FiO2 were associated with death and ARDS. Elevated Glasgow Coma Scale, diastolic blood pressure, oxygen peripheral saturation, P/F and pH were associated with patient survival and protective from ARDS. After the intervention in Medicina district, patients presenting at ED were younger and with long-lasting symptoms;CRP values were significantly lower, ABG and respiratory clinical parameters were less severely impaired. These differences did not affect the outcome. CONCLUSION(S): Since the results of our study are consistent with worldwide evidences, we suggest that the early insight of a small local SARS-CoV-2 outbreak can be representative and predictive of the subsequent course of the virus in wider areas. This must be kept in mind to manage next epidemic waves.Copyright © 2022 EDIZIONI MINERVA MEDICA.
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BACKGROUND: People with intellectual disabilities (ID) are at high risk of developing respiratory health issues. The COVID-19 pandemic has compounded this, with serious consequences, and for some, death. Despite home-based oxygen saturation monitoring being recommended for people with ID, there is a stark lack of evidence in the literature on its feasibility. METHOD: We conducted 3-day baseline home-based oxygen saturation monitoring, using pulse oximeters, with eight parents of nine adults with ID in Scotland. Two eligible parents also completed a further 2 weeks of monitoring, and returned an evaluation questionnaire on its feasibility. RESULTS: Baseline mean readings for eight adults with ID were within the normal range (%Sp02 ≥ 95), and for another one 94%. Fluctuations over the 3-day assessment period were experienced by six of these individuals. However, these variations were within limits which are not dangerous (lowest reading 92%), implying that parental home-based pulse oximetry monitoring is likely to be safe for adults with ID. The two parents who completed the evaluation found home-based pulse oximetry monitoring to be easy/very easy to do, and effective/very effective. CONCLUSIONS: This is the first research study, albeit with a very small sample, to report on the potential feasibility of parental home-based pulse oximetry monitoring for adults with ID. Home-based pulse oximetry monitoring appears to be safe in adults with ID at risk of developing serious respiratory problems, and not difficult for their parents to do. There is an urgent need to replicate this work, using a larger sample, to promote home-based respiratory health monitoring more widely for people with ID.
Subject(s)
COVID-19 , Intellectual Disability , Humans , Adult , Intellectual Disability/diagnosis , Pandemics , Oximetry , OxygenABSTRACT
Aim: Data on the outpatient follow-up of COVID-19 cases is still scarce. Also, the significance of the ROX index in decision-making for hospitalization in the ambulatory COVID-19 cases remains unknown. The aim of this study is to determine the general characteristics of COVID-19 patients treated as outpatients and to investigate whether the ROX index is applicable in hospitalization decisions. Material(s) and Method(s): This retrospective cohort study was conducted in confirmed adult COVID-19 cases between 15 October 2020 and 01 March 2021. A total of 5240 confirmed COVID-19 patients were included in the present study. Factors affecting hospitalization were investigated. Result(s): The study population was divided into two groups as those who require hospitalization (n=672) and those who did not (n=4568). The number of male patients and the mean age of the patients were significantly higher in hospitalized patients group (p=0.046, p<0.001). ROX index that was calculated at the home visit on the third day of disease was found significantly lower in the group of hospitalized patients (p<0.001). There was a significant correlation between ROX index and inflammatory biomarkers in the present study (p<0.001). The ROX index was found the most accurate parameter for decision-making for hospitalization in ambulatory COVID-19 patients (AUC=0.794 CI=0.773-0.814, p<0.001). Discussion(s): The ROX index can be a useful and objective clinical tool for decision making for hospitalization in the ambulatory COVID-19 cases.Copyright © 2022, Derman Medical Publishing. All rights reserved.
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Background Orthodeoxia syndrome (OS) is a rare clinical condition characterized by oxygen desaturation noted in the upright position (orthodeoxia). OS can originate in the heart, lungs, abdomen, or elsewhere due to either an intracardiac (cardiac OS) or intrapulmonary shunt, or a ventilation-perfusion mismatch. Anecdotal reports suggest that the enlargement of the aortic root could interfere with atrial septal mobility (ASM) and cause patent foramen ovale (PFO) shunt. Case A 77-year-old male patient was admitted to the ICU with pneumonia due to COVID-19. During the evaluation, the patient presented orthodeoxia detected by pulse oximetry, with oxygen saturation (SpO2) of 96% in supine and 70% in upright positions. COVID-19 was treated with remdesivir and corticosteroids without orthodeoxia improvement. Decision-making Pulmonary embolism was ruled out with CT Angiography. Transthoracic Echocardiogram was also normal. A microbubble contrast-enhanced Transesophageal echocardiography was done and confirmed an aortic root dilatation with atrial septal mobility leading to a significant patent foramen ovale (PFO) shunt. The patient was submitted to interventional closure of the patent foramen ovale with the resolution of orthodeoxia. Conclusion Increased Mobility of the Atrial Septum in Aortic Root Dilation can be a cause of PFO shunt and orthodeoxia [Formula presented]Copyright © 2023 American College of Cardiology Foundation
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Introduction: Access to in-clinic spirometry for patients with interstitial lung disease (ILD) has been restricted by the COVID19 pandemic. Remote monitoring of patient-recorded at-home spirometry & pulse oximetry offers an alternative approach to traditional hospital-based monitoring. Objective(s): To assess the feasibility of a remote monitoring programme (with spirometry & pulse oximetry) delivered within ILD clinical care settings for a 3-month period through assessment of adherence to study measurements. Method(s): In this prospective, single-arm, observational study (NCT04850521), patients were asked to record 1 spirometry and pulse oximetry measurement per day for 91 days, using a digital health application (patientMpowerTM) & Bluetooth-linked devices. Patient-recorded data could be viewed in real time by their clinical teams via a secure, password-restricted web-based portal. Health-related quality of life and patient experience were also assessed. Result(s): 51 ILD patients enrolled and provided >=1 spirometry reading. Baseline demographics: 35M/16F;29 idiopathic pulmonary fibrosis (IPF)/22 non-IPF ILD;age: 67+/-12Y;in-clinic FVC: 84+/-20% predicted;TLCO 54+/-19% predicted (mean+/-SD);median modified ILD GAP score: 3. Patients recorded spirometry on median 92% of days & pulse oximetry on median 93% of days. To date, 30 patients have completed follow-up. 26/30 patients recorded spirometry and pulse oximetry >=3 days/week & >=70% of days. Conclusion(s): In this study, daily recording of home spirometry & pulse oximetry over 3 months appeared feasible. Further research is needed to understand how remote monitoring is best used within ILD clinical services. .
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Background & Purpose: Pregnant women are at higher risk of developing severe COVID-19 compared with non-pregnant women, particularly in the third trimester1. Despite ongoing campaigns, the proportion of pregnant women vaccinated against SARS-CoV-2 is lower than in the general population2. The medium-term effects of COVID-19 during pregnancy are not well characterized. We report a cohort of pregnant women admitted to hospital with moderate-to-severe COVID-19. Method(s): Data from clinical records were retrospectively collected from all pregnant women admitted through the maternity assessment unit at St. Thomas' Hospital, between January 2021 and January 2022, due to COVID-19 requiring oxygen to maintain saturations >94%. Result(s): Fourteen women were identified (age=33.4+/-5.2 years;42.8% Caucasian;28.6% Black), requiring admission at 31+/-4.7 weeks gestation. Only two were double vaccinated (14.2%). Body mass index (BMI) was 27.2+/-6.4 kg/m2. Two women had concomitant co-morbidities (asthma and type 1 diabetes). They were managed in the obstetric high- dependency unit (level 1), barring one that required invasive ventilation for one day. The Delta variant was most commonly implicated (43%). All women requiring oxygen received steroids. Four women received Tocilizumab and three casirivimab/imdevimab;two received both. Four women were delivered by emergency Caesarean section due to maternal or fetal concerns, while the others continued their pregnancies. There was one late intrauterine death at 35 weeks. Women were followed-up for an average of six weeks. At follow-up in the obstetric medicine COVID-19 clinic, all women had complete resolution of COVID-19 on clinical examination, pulse oximetry and chest radiograph. Conclusion(s): In 14 pregnant women requiring admission to hospital for hypoxia secondary to moderate-to-severe COVID-19, concomitant co-morbidities and high BMI were not prevalent. Most were not vaccinated against SARS-CoV-2. Despite experiencing moderate-to-severe COVID-19, they had complete clinical and radiological resolution at six weeks follow-up.
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Pulse oximetry utilises the differential absorption, by both oxy- and deoxyhaemoglobin, of a light signal passing through tissue to provide a measure of blood oxygen saturation. Although pulse oximetry devices are widely used to monitor patients in real time, and to provide an estimate of risk of deterioration, no studies exist on the association of haemoglobin levels and pulse oximetry measurement error. We examined the effect of different haemoglobin levels on pulse oximetry measurements in patients admitted to a large UK teaching hospital from 1 February 2020 to 31 December 2021 with a possible diagnosis of Covid-19 infection. Pulse oximetry and arterial blood gas oxygen saturations were compared. Two measures of blood haemoglobin levels were available;from a venous sample within 24 hours of the arterial blood gas sampling and directly from the arterial blood gas sample itself. Data were available from 1086 patients. Using the measurement of haemoglobin from the venous blood sample within 24 hours of the blood gas, there was an inverse linear association between haemoglobin and pulse oximetry measurement error of -0.06% per 1 g/L increase of haemoglobin (95% confidence intervals CI: -0.02 to -0.09). This equates to patients with a venous haemoglobin of 70g/L having a measurement error of +8.0% (95% CI: +5.9% to +10.0%) and those with a haemoglobin of 150g/L having a measurement error of +3.6% (95% CI: +2.2% to +4.9%). Similar associations were observed using arterial haemoglobin values. The association between haemoglobin and measurement error of oxygen saturation as determined by pulse oximetry is inverse and linear. It is relatively large in patients with anaemia and may affect clincial assessment.
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ABSTRACT Objective: To find the frequency of known risk factors in cases of severe transient tachypnea of the newborn (TTN) and to measure the effect of inhaled Salbutamol to bubble CPAP on required treatment duration. Study Design: Quasi-experimental study. Place and Duration of Study: Neonatal Intensive Care Unit, Combined Military Hospital, Malir Cantt, Karachi Pakistan, from Nov 2019 to Jun 2020. Methodology: A total of 60 cases of severe TTN, labelled on a predefined criterion were included in the study. The sample was randomized into two groups using an alternate sampling technique. Group-A was treated with bubble CPAP alone, while in Group-B, inhaled Salbutamol was added. The response was measured regarding the time taken to settle respiratory distress. Results: Out of 60 cases, 54(90.0%) were delivered through Caesarean section. A total of 9(15.0%) cases were born prematurely. Polycythemia was found in 10(16.6%) cases. Maternal asthma and gestational diabetes frequency were 8(13.33%) and 12(20.0%), respectively. A significant reduction was seen in the duration of respiratory distress in the study population receiving bubble CPAP with inhaled Salbutamol in the first 24 hours of illness (p-value<0.001). Conclusion: Caesarean section is the most significant risk factor for developing TTN. Adding Salbutamol nebulization to bubble CPAP resulted in an earlier settlement of respiratory distress.
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Covid-19 patients experience several symptoms such as shortness of breath, abnormal heart rate, lung function abnormalities that are similar to pneumonia symptoms. These symptom conditions indicate that the saturation of oxygen (O2) levels dissolved in the blood is not normal. To measure oxygen levels in the blood using a medical device, one of which is a Pulse Oximeter. Covid-19 patients in the Sapta Taruna Health Center were 665 patients, of which this patient was counted from January 2022 to April 2022. Based on information obtained from the Sapta Taruna Health Center, the only patients that were counted were those who did the PCR/Swab test, while the people who were suspected infected with Covid-19 there are still many who do not do PCR/Swab tests, this refusal is due to fear because Hoax information is spread in the community such as: PCR/Swab tests are painful, if the PCR/Swab test results are positive, fear of being ostracized, feel healthy and other reasons. other. Patients who have been tested positive for Covid-19 will be given drugs such as fever medicine, antibiotics, anti-virus, Vitamin C, and others according to the level of symptoms they feel, if the symptoms are felt at a moderate, mild or even asymptomatic stage, they will be advised to isolate independently (Isoma) at home, but there is no further monitoring from the Sapta Taruna Health Center, even though patients who are self-isolating at home may experience a decrease in blood oxygen levels drastically, so these patients need medical devices such as pulse oximetry so that patients who are isoma can perform independent checking, henceforth the current pulse oximetry cannot provide remote information related to the condition of oxygen saturation in the patient's blood. Judging from the problems above, the research team made a product, namely Pulse Oximetry based on IoT, this tool is to measure oxygen saturation in the patient's blood and the data from the measurements made by the patient will be automatically sent to the server and can be viewed on the Sapta Taruna Health Center website, so that the Sapta Taruna Health Center can monitoring the condition of the patient in real time without having to meet directly with the patient © 2023, International Journal of Interactive Mobile Technologies.All Rights Reserved.