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Background: With the COVID-19 pandemic since December 2019, many people around the world have been infected and affected, one of them is Indonesia. The increasing number of deaths due to COVID-19 infection that occurs in the adult to geriatric age group, especially in geriatrics who often have comorbidities. This study aims to describe the analysis of risk factors for mortality in geriatric patients infected with COVID-19 in the intensive care unit. Method(s): This study is a retrospective observational analytic Single Center study, the study was conducted by taking medical record data from geriatric patients with COVID-19 who were treated in the ICU during the period from February 1 to May 31, 2021. Result(s): Of the 52 patient medical record data, 27 patients died. In this study the mean age, weight, height, BMI and SOFA score;66 years, 70 kg, 160 cm2, 26 kg/m2, and 6. From the results of medical record data, the highest mortality was found in the group with risk factors, namely SOFA score, PaO2/FiO2 ratio, ventilator use, inotropic use, and vasopressor use. Conclusion(s): Mortality in our study was 51.9%. Risk factors that affect mortality in geriatric patients infected with COVID-19 are high SOFA scores, low PaO2/FiO2 ratios, use of ventilators, inotropes, and vasopressors. Copyright © 2022, Anka Publishers. All rights reserved.
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BACKGROUND: Coronavirus disease 2019 (COVID-19) may lead to myocardial damage and arrhythmia. Patients with ECG changes have shown an increased risk of mortality. OBJECTIVE(S): We aimed to study the changes in the electrocardiogram, which may be of great significance for risk stratification of COVID-19-positive patients. METHOD(S): A retrospective study was conducted to compare electrocardiogram changes and disease severity markers in COVID-19-positive patients admitted to a referral hospital between February 20 and March 20, 2020. RESULT(S): Our study consisted of 201 cases, including 123 males and 78 females. Ages ranged between 16 and 97 years old. Fifty-two (25.9%) cases had a history of ICU admission. Multivariate logistic regression analysis showed that a low O2 saturation level (OR = 0.920, 95% CI 0.868-0.976, p=0.005), several lab tests, ECG changes (OR = 46.84, 95% CI 3.876- 566.287, p =.002) and Age (OR = 1.03, 95% CI 1.000- 1.065, p =.048) were the independent risk factors for predicting mortality rate. In addition, we utilized multivariate logistic regression analysis, demonstrating that LBBB (OR = 4.601, 95% CI: 1.357-15.600, p=0.014) is the only ECG risk factor associated with morbidity in elderly patients with ECG changes. CONCLUSION(S): ECG changes are strong indicators of high mortality rates in elderly COVID-19 patients. ECG interpretations should therefore be used for risk stratification and predicting the need for ICU admission. Copyright © 2022, Isfahan University of Medical Sciences(IUMS). All rights reserved.
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INTRODUCTION: Since the beginning of COVID-19 pandemic in early 2020, we continue to gather more data on various aspects of COVID-19. While many pediatric studies have concentrated on cardio-vascular effects of Multisystem Inflammatory Syndrome of Childhood (MIS-C), very few studies have evaluated the effect on cardiac physiology during the COVID-19 infection. METHOD(S): It is retrospective chart analysis of patients admitted to Pediatric ICU in a tertiary care center of a children's hospital in South Alabama between January 2020 and June 2022. Patients were identified based on International Classification of Disease (ICD-10) code for COVID-19 (U07.1). During the admission the first echocardiogram (Echo) obtained was evaluated. Patients who did not receive the echocardiogram were excluded. Echo findings were read by board certified pediatric cardiologists. The data was analyzed using SPSS software (V25.0) RESULTS: Among 203 children who were hospitalized with COVID-19 infection, 56 (27.5%) patients had an echocardiogram done during the admission. Those who had echocardiogram done were older than those who did not, with Median age [Inter-Quartile Range (IQR)] of 9.83 (2.45 - 14.08) years vs 4.16 (0.68 - 11.7) years, p = 0.003. Patients who had an Echo had a higher median Length of Stay (LOS) 7.03 (4.85 - 11.78) days vs 3.89 (2.20 - 6.03) days, p< 0.001. Race, ethnicity and gender, were not associated with probability of obtaining Echo, adjusted odds ratio (AOR) [95% CI];0.84 (0.21-3.83), p=0.81;1.2 (0.23- 6.28), p = 0.83;1.31 (0.69-2.45), p =0.4, respectively. Median LV ejection fraction (LVEF) and Tricuspid Valve Regurgitation maximum velocity (TR Vmax) were 68 (62-73) % and 1.81 (0 - 2.27) m/s, respectively. The LOS had a positive correlation with TR Vmax but not with LVEF, coefficient of correlation(R) being 0.33, p = 0.01, and 0.49, p = 0.72, respectively. CONCLUSION(S): Echocardiogram on admission in COVID-19 pediatric patients is more likely to be obtained in older children and is associated with longer length of stay. Also, higher the TR Vmax on the initial Echo, longer is the length of stay of these patients. Although further studies including multi-center trials are needed to get better understanding of findings of Echo is COVID-19 pediatric patients and their role in predicting severity of illness.
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Background. Comparing outcomes of both symptomatic and asymptomatic hospitalized pregnant women with COVID-19 can inform both the prognosis during hospitalization for pregnant women with COVID-19 and the relationship of COVID-19 to pregnancy outcomes. Methods. Using population-based surveillance data from COVID-19 Associated Hospitalization Surveillance Network (COVID-NET), chart reviews were conducted for SARS-CoV-2 positive pregnant patients, age 15 to 49 years, residing in Alameda, Contra Costa, and San Francisco Counties in California who delivered in a hospital between March 1st 2020 and February 28th 2021. Cases were defined as SARS-CoV-2 positive if they had a positive test during hospitalization or within 14 days prior to admission. Multivariate analysis was used to describe demographic characteristics, underlying medical conditions, vaccination status, and pregnancy outcomes by presence or absence of symptoms upon hospitalization. Chi-square tests assessed significance with p-values < 0.05 considered statistically significant. Results. Among the 330 SARS-CoV-2 positive women that delivered in a hospital, 60.3% were Hispanic or Latino, 4.9% were White (Non-Hispanic), 6.4% were Black (Non-Hispanic), 6.7% were Asian or Pacific Islander, 0.9% were multiracial, and 20.9% were unknown race or ethnicity. Symptomatic cases spent a median of 3 days in the hospital while asymptomatic cases spent a median of 2 days in the hospital. Symptomatic women were more likely to have a Caesarian-section (OR 2.49, 95% CI: 1.45, 4.28), have preeclampsia (OR 2.19, 95% CI: 1.17, 4.10), and be admitted to the ICU (OR 3.78, 95% CI: 1.08, 13.29) than asymptomatic women. Invasive mechanical ventilation was required for 3 of the 109 symptomatic women and none of the 221 asymptomatic women (P=0.03). Conclusion. Among hospitalized SARS-CoV-2 positive patients in three California countries from March 1st 2020 to February 28th 2021, symptomatic pregnant women were more likely to have a Caesarian-section, have preeclampsia, and be admitted to the ICU compared to asymptomatic pregnant women. As COVID-19 continues to be prevalent, future studies should examine the associations and potential confounders between COVID-19 symptoms and pregnancy outcomes.
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Background. Pregnancy is one of the risk factor associated with the severity of Coronavirus Disease 2019 (COVID-19). The perinatal complications also known to be increased when pregnant women become infected with COVID-19. However, there were not enough studies involving pregnant women with severe COVID-19, especially in Korea. The purpose of this study was to analyze the cases of pregnant women with COVID-19 infection with various severities, and to compare and describe the clinical course and the effects on pregnancy and perinatal prognosis according to severity. Methods. We retrospectively analyzed the medical records of adults 18 years of age or older who were PCR-confirmed COVID-19 and proved pregnancy, from February 1, 2020 to January 31, 2022. Through the epidemiological investigation report, the patient's medical history, obstetric history, date of diagnosis and variants of COVID-19, and vaccination history were collected. Clinical symptoms, oxygen demand, chest imagings, treatment, perinatal complications, fetal conditions, delivery results, and complications were collected through medical records. Results. A total of 104 pregnant women with PCR-confirmed COVID-19 were hospitalized. The age at the time of diagnosis was 33 +/-4.24 (Mean +/- SD) years, and 4 patients (3.8%) were vaccinated with the COVID-19 vaccine. During hospital stay, the most common complaints were cough (99 patients, 95.2%) and fever (85 patients, 81.7%). Oxygen was applied in 40 patients (38.5%), and in 19 patients (18.3%) in severe cases. Thirty-seven patients (35.6%) delivered during isolation treatment. Critical COVID-19 patients group has statisticaly significant higher rate of preterm delivery compared with mild COVID-19 patient group (31.6 % versus 6.3 %, p=0.009). One patient died from septic shock caused by multidrug-resistant Acinetobacter baumannii during treatment. A total of 39 babies were born, of which 4 received postnatal oxygen therapy. Conclusion. Pregnant women with COVID-19 had higher mortality rates, aggravation rates, and premature birth rates compared to non-pregnant patients of the same age. In a situation where effective and safe COVID-19 treatments for pregnant women are limited, it is necessary to increase the vaccination rate to prevent undesired outcomes in both mother and child.
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Aims: To determine the severity of deficiency and the presenting features Introduction: Vitamin D insufficiency affects almost 50% of the population worldwide. An estimated 1 billion people worldwide, across all ethnicities and age groups, have a vitamin D deficiency (VDD). This pandemic of hypovitaminosis D can mainly be attributed to lifestyle and environmental factors that reduce exposure to sunlight, which is required for ultraviolet-B (UVB)-induced vitamin D production in the skin. The high prevalence of vitamin D insufficiency is a particularly important public health issue because hypovitaminosis D is an independent risk factor for total mortality in the general population. Many health care providers have increased their recommendations for vitamin D supplementation to at least 1000 IU. Methodology: this study was done over a span of 10 months from September 2021 to July 2022 This was a retrospective descriptive study in which data were recorded for all patients aged from 6 months to 12 years of age with features suggestive of vitamin D deficiency seen in Dr DY Patil Medical College and Hospital, Pune for a period of 10 months The Health Research and ethics committee of Dr DY Patil Medical College and Hospital, Pune approved the study and waived the requirement for the informed consent. A total of 69 patients were included in this study. Result(s): 69 patients were included in the study out of which 39 were males { 56.52%} and 30 were females { 43.48%}. the main presenting feature was bowing of legs { 31.9%} followed by difficulty in walking in 15.9% Out of 69 children 53 had severe deficiency, 13 had mild to moderate deficiency and 3 had optimum levels of vitamin D. 28 children belonged to the age group of 1-5 years followed by 18 children in age group of 5-10 years and 11 children in age group less than 1 year and 10-15 years Out of the entire study group 56 children had bony deformities and 13 had neurodevelopmental presentation Conclusion(s): the above results emphasise the fact that due to covid most of the children were restricted to stay indoors for several months leading to vitamin D deficiency in them. it also emphasis the fact that regular screening of children should be done with respect to vitamin D levels and also other micronutrients and children should be encouraged to have some amount of sun exposure to get natural supplementation of vitamin D and also be supplemented at desired intervals so that they adequate amount of vitamin D levels. Copyright © 2023 Ubiquity Press. All rights reserved.
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Introduction: Acute Confusional Syndrome (ACS) is the most common neuropsychiatric complication in COVID-19 infection. Its management is still a challenge because the data and recommendations based on the evidence are limited. Objective(s): To describe the differential characteristics in the management of ACS in patients with COVID-19 pneumonia compared to ACS secondary to other causes. Method(s):We present a descriptive study that is has been carried out in 62 patients with ACS (26 of them diagnosed with COVID 19 pneumonia), who have required assessment by the liaison psychiatry service of Hospital del Mar between February and April, 2020. The sample was divided in 2 groups (with and without COVID 19 pneumonia). Chi square and Fisher's tests were used to comparisons. Result(s): Dexmetomidine (26 vs 0) and olanzapine (13 vs 3) were significantly more frequently used in COVID-19 patients (p< 0 001). A greater number of different antipsychotic drugs were used in COVID 19 patients (2.40+/- 1 323 number of drugs), (p<0.0001). Further neuroimaging tests were requested in COVID 19 patients and they received less family support (4) compared to non COVID-19 (22), (p<0.005). Conclusion(s): ACS associated with COVID-19 pneumonia in the patients in our sample is more difficult to manage than ACS associated with other pathologies, similar to which described in other series. It is associated with a longer duration of confusional symptoms and difficulties for control it.
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Introduction: Objectives: Coeliac disease (CD) occurs in 1% of the population, but is severely underdiagnosed. Secondary prevention by early diagnosis may be achieved by case-finding. Aims & Methods: To prospectively assess whether case-finding at the Preventive Youth Health Care Centres (YHCCs) in the Netherlands is a feasible and effective strategy for early CD-diagnosis. We analyzed data from the case-finding study GLUTENSCREEN from its start at 4th February 2019 till 4th January 2022 (with interruption of 5 months due to COVID19). Parents of all symptomatic children aged 1-4 years attending the YHCC in the Kennemerland-region for a regular visit, were asked if their child has >=1 CD-related symptoms. If so, a point-of-caretest (POCT) to assess CD-specific antibodies against tissue transglutaminase (TGA), was performed onsite the YHCCs. If the POCT was positive, the child was referred to our hospital for definitive diagnosis according to the ESPGHAN guideline. Result(s): 36.9% (5706/15466) of the children had >=1 CD-related symptoms. Parents of 3104 (54.4%) children gave informed consent for a POCT (47% female;median age 2.8years). In 61 children the POCT was positive: CD was confirmed in 55 children (2.0% of the tested children) and ruled out in 5 children. Of them two children had negative HLA-DQ2/8 and TGA (ELISAtest) and in 3 children with TGA <10xULN small bowel biopsies showed Marsh 0-1 lesions. From one child who was referred to the hospital, parents refused additional investigation. Conclusion(s): Case-finding for CD using a POCT is effective and feasible and it detects a high CD prevalence of 1.8%. Before implementation of the case-finding strategy cost-effectiveness and acceptability analyses are needed. .
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Background: One of WALCE's aims is to increase the awareness of people with lung cancer and provide them educational initiatives. It has been recently investigated patients' knowledge and attitudes towards clinical trials in order to gain better insights from their experience. Material(s) and Method(s): from January to April 2022, an anonymous questionnaire with 22 multiple-choice and 4 open-ended questions was carried out by WALCE. Result(s): 109 patients from 7 Italian cancer centers have filled out the questionnaire. 58% were women and the average age was 62 years. 86% have heard about clinical trials and 90% said to be interested in knowing more about them, but only 46% acknowledged to have looked for information, using different top sources. The majority of patients prioritized their oncologists (44% of cases), over consulting websites (31%), magazines (11%), family and friends (9%) and social media (8%), they've got it during the news about COVID (7%), or by other medical specialists (6%) and patient associations (5%) and more than half of patients (83%) confirmed to have found the information they were looking for (even if 39% only "sometimes"). However, 66% believe their level of knowledge about it is still poor (i.e. 84% are not aware of the different trail phases). At the same time, 72%said to be more inclined to participate in a clinical trial after the COVID Vaccine and 88% were interested to know more about them. According to 97% of patients, clinical trials generate data about safety (47%), efficacy (40%) and prognosis (27%), only 6% answered that the objective is to evaluate the costs of clinical procedures. Only 26% participated in a trial, but 50% would have liked to and "hope" was the reason for half of them, while the remaining 50% preferred not to participate because of fear and lack of information (16% of cases). The collaboration between researchers and patients is considered beneficial by 73% of the respondents, mainly to bring out the needs of patients (41% of the cases). Finally, 85% are willing to receive more information about clinical trials by newsletters (54%) or through the oncologists (18%). Conclusion(s): the survey has highlighted the need of lung cancer patients to receive more comprehensive information about clinical trials and to cooperate with researchers to include the voice of patients.