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1.
JACCP Journal of the American College of Clinical Pharmacy ; 5(12):1352-1353, 2022.
Article in English | EMBASE | ID: covidwho-2173025

ABSTRACT

Introduction: Nirmatrelvir-ritonovir (NIM-RTV) for COVID-19 increases tacrolimus (XR-Tac;IR-Tac) concentrations. Increased availability of NIM-RTV and ongoing COVID-19 infections, poses a significant risk to solid organ transplant (SOT) recipients. Case: Case 1 describes a 66-year-old (yo) male 1.5 years post-liver transplant on XR-Tac (goal 4-8 ng/mL). After 4 doses of NIM-RTV, XR-Tac was held and NIM-RTV continued. His tacrolimus level was 23.9 ng/mL and SCr 2.4 mg/dL (baseline 1.4 mg/dL) 3 days after holding XR-Tac. Case 2 was a 60 yo male 7 months post-lung transplant that received 2 doses of NIM-RTV + IR-Tac (goal 8-10 ng/mL). He experienced AKI (SCr 1.3 mg/dL, baseline 1.0 mg/dL) with a tacrolimus level >60 ng/mL. Tacrolimus and NIM-RTV were held and phenytoin initiated. The patient's SCr returned to baseline 5 days later. Case 3 includes a 53 yo male 2.5 years post-kidney transplant on XRTac (goal 4-6 ng/mL). Following 2 doses of NIM-RTV, he was hospitalized with a tacrolimus level >60 ng/mL, AKI (SCr 2.2 mg/dL, baseline 1.7 mg/dL) and nausea/vomiting. Both medications were held and phenytoin initiated. Tacrolimus and SCr returned to baseline 6 days later. Case 4 was a 75 yo female 19 years post-heart transplant on IRTac (goal 4-6 ng/mL). After 4 doses of NIM-RTV, she required hospital admission for AKI and vision changes. Tacrolimus level was >60 ng/mL. Phenytoin was started as IR-Tac and NIM-RTV were stopped. Tacrolimus, SCr, and vision returned to normal 4 days later. Discussion(s): Limited data and knowledge regarding severity of concomitant NIM-RTV/tacrolimus exists. Furthermore, there is no data describing the use of the CYP3A4 inducer phenytoin to reverse tacrolimus toxicity. Conclusion(s): Even after only a few doses of concomitant NIM-RTV and tacrolimus, there is a significant risk of tacrolimus toxicity. Phenytoin induction may serve to minimize the toxicities associated with supratherapeutic troughs above the upper limit of detection.

2.
Chinese Journal of Nosocomiology ; 32(20):3197-3200, 2022.
Article in English, Chinese | GIM | ID: covidwho-2170162

ABSTRACT

OBJECTIVE: To monitor the virus residues in the ward environment of the patients infected with the new coronavirus Omicron BA.2 after discharge from the hotel-renovated Fangcang shelter hospital, and to provide basis and guidance for the clinical prevention and control and disinfection work. METHODS: Thirty Omicron BA.2-infected patients admitted to the Dapengshan hotel Fangcang shelter hospital in Cixi city of Ningbo from Apr. 5 to 27, 2022 were selected as the research subjects. The general features of 30 patients with Omicron variant infection on admission were collected, and the samples of the ward environment such as door handle, bedside table, pillow, wooden floor, toilet, wall, and power switch were taken after discharge, and nucleic acid detection and analysis were conducted. RESULTS: The median age of the 30 Omicron BA.2-infected patients was 36.00 years, there were 40%(12/30) cases having fever, the average hospitalization time was(13.33+or-2.10) days, and there were 93.33%(28/30) cases receiving two and three doses of vaccination. The mean value of the cycle threshold of nucleic acid detection of the N gene was 23.71, and the average Ct of ORF1 ab gene was 24.82. From 1 d before discharge to 6 d after discharge, the nucleic acid positive detection rate of the bedside table in the ward was 80.00%-21.44%, and the positive detected rate of the wooden floor was 83.33%-42.86%, and the positive detection rate of the door handle was 15.03%-12.50%, and the positive detection rate of the pillow was 46.70%-14.33%.and the positive detection rate of the toilet is 26.76%-14.33%, and the positive detection rate of the power switch is 27.56%-14.33%, whereas the positive detection rate of the wall is 0. CONCLUSION: The positive detection rate of Omicron BA.2 in the hotel Fangcang hospital ward was the highest with wooden floor and bedside table, followed by pillow, power switch, toilet, door handle and wall, which had high application value and reference significance for the prevention and control of nosocomial infection and environmental disinfection in the hotel Fangcang shelter hospital.

3.
New Zealand Medical Journal ; 133(1520):153-156, 2020.
Article in English | EMBASE | ID: covidwho-2170139
4.
Revista Cubana de Pediatria ; 94(4) (no pagination), 2022.
Article in Spanish | EMBASE | ID: covidwho-2168197

ABSTRACT

Introduction: Acute respiratory infections represent a health problem in children, with high morbidity and high mortality rates. Objective(s): To determine the circulation of respiratory viruses in children admitted with a diagnosis of acute respiratory infection, negative to COVID-19. Method(s): Descriptive observational study in 119 children with acute respiratory infection, in the ages from 0 to 6, and with hospital admission in the period from October 2021 to April 2022. Nasopharyngeal exudate samples were taken for virological study (real-time polymerase chain reaction). The variables studied were: age, sex, clinical diagnosis, period of occurrence and isolation of respiratory viruses. Result(s): The female sex predominated with 51% and the age corresponding to the neonatal period with 50 %, followed by infants between 1 and 11 months (40%), and only 10% in the ages from 1 to 6 years. 42 % of the samples with a predominance of CoV229E (78%) were positive;other viruses such as influenza A (6 %), respiratory syncytial (6 %), CoVOC43 (2%) and rhinovirus (2%) were isolated. CoV229E was common in patients with high acute respiratory infection (48.7%), followed by severe acute respiratory infection (20.5%) and bronchiolitis (28.2%). Viral co-infection was detected only in severe acute respiratory infection, specifically by IFA/CoV229E (4%) and CoV229E/bocavirus (2%). Conclusion(s): The importance of molecular biology for viral isolation is highlighted. The Coronavirus CoV229E has relevance in cases of acute high and severe respiratory infection mainly in children under 1 year old. Copyright © 2022, Editorial Ciencias Medicas. All rights reserved.

5.
Gastroenterologie a Hepatologie ; 76(6):512-513, 2022.
Article in Czech | EMBASE | ID: covidwho-2206916
6.
Gaceta Medica de Mexico ; 158(6):425-431, 2022.
Article in Spanish | EMBASE | ID: covidwho-2205315

ABSTRACT

Introduction: SARS-CoV-2 infection has in, most cases, a mild course, although acute respiratory distress syndrome is associated with higher mortality. Objective(s): To determine overall mortality in hospitalized or intensive care unit (ICU)-admitted COVID-19 patients. Method(s): Inferential analysis from a database of the General Directorate of Epidemiology of Mexico. SARS-CoV-2-positive patients, hospitalized within the January 2020-December 2021 period, were included. General characteristics were described and a binary regression model was created to determine associations with mortality. Result(s): 116,446 patients who required hospital admission were identified. Overall mortality was 44%;in-hospital mortality, 33%;and ICU mortality, 33%. Mortality of patients with mechanical ventilation and hospital admission was 87%, and with ICU admission, 75%. In the public sector, hospital admissions at the Mexican Institute of Social Security and the Ministry of Health predominated, with OR = 2.24 (p = 0.004) and OR = 2.55 (p = 0.001), respectively, for mortality. Conclusion(s): Mortality was higher in the public sector, and this could be due to the overcrowding of services, which determined a scarcity of resources. Copyright © 2022, Academia Nacional de Medicina. All rights reserved.

7.
Journal of Health and Translational Medicine ; 25(Special Issue 1):26-33, 2022.
Article in English | EMBASE | ID: covidwho-2205123

ABSTRACT

To study the characteristics of paediatric patients admitted to two non-COVID-19 teaching hospitals before and during the implementation of the Movement Control Order (MCO) in Malaysia. The retrospective study was performed in two phases (before MCO between February to March 2020, and during MCO lockdown between March to April 2020) in two teaching hospitals on the East Coast of Peninsular Malaysia. Hospitalized children <18 years were included and those coming for elective procedures or oncology treatment were excluded. The clinical data were retrieved from both hospitals' admission records. There was a total of 496 and 191 admissions to two teaching hospitals on the East Coast of Peninsular Malaysia, respectively. A significant reduction in the number of non-COVID-19 hospital admissions was seen in both hospitals. For Hospital Universiti Sains Malaysia, the daily hospital admissions were reduced with a mean of 10 (before MCO) to 7 (during MCO) admissions/day (95% CI 1.54,7.54, p=0.001). In Sultan Ahmad Shah Medical Centre, a reduction in hospital admission was seen from 5 (before MCO) to 3 (during MCO) admissions/day (95% CI 0.61, 3.15, p=0.005). Our study observed a general drop in non-COVID-related respiratory illnesses and infectious disease cases during the MCO period. There were significant differences in neurological (p=0.029) and accident (p = 0.001) cases admissions observed between the two periods. Copyright © 2022, Faculty of Medicine, University of Malaya. All rights reserved.

8.
Asian Journal of Pharmaceutical and Clinical Research ; 15(12):118-121, 2022.
Article in English | EMBASE | ID: covidwho-2205060

ABSTRACT

Objective: The objective of the study was to find out any peculiarities in the epidemiological and clinical profiles of COVID-19 cases, admitted in the hospital;which may be useful in management of health services in future. Method(s): Retrospective analysis of hospital records of COVID-19 cases admitted from March to May 2021 in our COVID hospital. A total of 1332 hospital case records were analyzed. Result(s): Out of 1332 admitted COVID-19 cases, 50% were in age group 40-60 years. About 60% cases were male. Symptoms were fever (88.29%), sore throat (70.64%), breathlessness (58.84%), loss of smell (58.82%), pain in abdomen (53%), loss of taste (35.29%), and diarrhea (29.43%). Most cases had multiple symptoms. About 60% cases came in serious condition. About 65% cases needed intensive care unit admission. About 50% cases expired. Conclusion(s): Only peculiarity noticed in clinical profile was loss of taste and sense of smell in few cases. Preponderance of males in the age group of 40-60 years and high mortality among the admitted cases was only peculiar epidemiological feature. Copyright © 2022 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

9.
Translational Pediatrics ; 11(12):1892-1898, 2022.
Article in English | EMBASE | ID: covidwho-2204836

ABSTRACT

Background: During the coronavirus disease 2019 (COVID-19) pandemic, national measures have affected health care services. Children with asthma were a vulnerable population who were advised to avoid needless hospital visits. Telemedicine was utilized in this circumstance. However, data in Thailand is limited. This study aimed to evaluate asthma control in patients who were followed up by telemedicine compared with in-person visits at an outpatient clinic in Thailand's tertiary academic medical center. Method(s): This was a retrospective study among pediatric patients with asthma who were followed up in the pediatric pulmonary and allergy clinic of Srinagarind Hospital from 1 January to 31 May 2021. We offered telemedicine (telephone visit) and in-person visits at the hospital by their willingness during this period. All patients were asked about asthma clinical control symptoms, medication compliance, exacerbation events, and hospital admissions by pediatric pulmonologists and allergists. Then, we decided to prescribe in controller medications. In the telemedicine groups, we used the postal service to deliver controller medicine to patients. Result(s): Among 195 asthmatic children, 83 (42.56%) were followed up by telemedicine. Children who were followed up by telemedicine had more controlled symptoms than the in-person visit group [adjusted relative risk (aRR): 1.219;95% confidence interval (CI): 1.062-1.400;P value =0.005]. In the in-person visit group, children had more asthma exacerbation events than telemedicine (5 vs. 0, respectively, P value =0.073). Conclusion(s): During the COVID-19 pandemic, telemedicine follow-up in asthmatic children resulted in well-controlled symptoms and few asthma exacerbation events. Copyright © Translational Pediatrics. All rights reserved.

10.
Journal of the Japanese Association for Infectious Diseases ; 96(5):179-185, 2022.
Article in Japanese | GIM | ID: covidwho-2203546

ABSTRACT

Background: Randomized phase III clinical trials suggest that the antibody cocktail containing casirivimab and imdevimab reduces the risk of hospitalization/death in high-risk COVID-19 patients. However, the efficacy of the cocktail in daily clinical practice remains unknown.

11.
Journal of Family Medicine and Primary Care ; 11(10):6190-6196, 2022.
Article in English | GIM | ID: covidwho-2201933

ABSTRACT

Context: Coronavirus disease 2019 (COVID-19) mortality trends can help discern the pattern of outbreak evolution and systemic responses. Aim: This study aimed to explore patterns of COVID-19 deaths in Thiruvananthapuram district from 31 March 2020 to 31 December 2021. Setting and Design: Secondary data analysis of COVID-19 deaths in Thiruvananthapuram district was performed. Materials and Methods: Mortality data were obtained from the district COVID-19 control room, and deaths in the first and second waves of COVID-19 were compared. Statistical Analysis: We summarised data as proportions and medians with the inter-quartile range (IQR) and performed Chi-square tests to make comparisons wherever applicable.

12.
International Journal of Preventive Medicine ; 13(1) (no pagination), 2022.
Article in English | EMBASE | ID: covidwho-2201825

ABSTRACT

Background: The role of anti-phospholipid antibodies (aPLs) in the prognosis of COVID-19 patients is controversial. In order to prove the role of this factor, the necessary measures such as early initiation of anticoagulants should be started even in the early stages of the disease and in outpatients or the use of other drugs in addition to anticoagulants. We decided to investigate the role of these antibodies in ICU admission outcomes in critically ill COVID-19 patients. Method(s): The case-control study was carried out in Isfahan, Iran, from March to September 2021. One hundred nine patients in the case group were selected, including patients admitted to the ICU with a COVID-19 diagnosis. The 140 patients in the control group were selected from hospitalized and outpatients with COVID-19 with PCR + and pulmonary involvement, similar to the case group without the need for ICU hospitalization. The anti B2GP1 (IgM, IgG) and anti-cardiolipin (IgM, IgG)) were compared in two groups. Result(s): The frequency percentage of patients in the abnormal group of anti-phospholipid antibodies was about 10% in total. No statistically significant difference in these aPLs in continued measures was observed between the two groups of patients admitted to the ICU and those outside the ICU. Also, in the logistics regression analysis, no significant association was observed. Conclusion(s): Therefore, the cause of coagulation in patients admitted to the ICU is not related to these aPLs. This means that aPLs could not be a good predictor of patient admission to the ICU. Copyright © 2022 International Journal of Preventive Medicine.

13.
Egyptian Journal of Chest Diseases and Tuberculosis ; 71(4):452-456, 2022.
Article in English | EMBASE | ID: covidwho-2201697

ABSTRACT

Context Our study follows 34 patients during their home treatment after being diagnosed with moderate-severe coronavirus disease (COVID). The home treatment was chosen by the patients and their caregivers after being informed of the risks. Aim To evaluate the outcome of home treatment in patients with moderate to severe COVID who opted for home treatment instead of hospital admission. Patients and methods The retrospective study was conducted among patients diagnosed with SARS COV-2 with moderate to severe COVID who presented to our health care facility. We followed the patients from the initial diagnosis till the time of complete recovery. Results Overall, 87.5% of our moderate to severe COVID-infected patients were able to return to a full bill of health without the need for hospitalization. Age, BMI, or the presence of any comorbidity did not have a significant effect on the time till recovery or need for hospitalization in our sample. Majority of moderate to severe patients were not shown to need any hospitalization. Conclusion This sheds light on the fact that most moderate to severe COVID-infected patients may not require hospitalization and can be effectively managed at home under the supervision of a physician. Copyright © 2022 The Egyptian Journal of Chest Diseases and Tuberculosis.

14.
Pharmaceutical Journal ; 309(7966), 2022.
Article in English | EMBASE | ID: covidwho-2196679
15.
Respiration ; 2022.
Article in English | EMBASE | ID: covidwho-2194323

ABSTRACT

Background: The COVID-19 pandemic has a great impact on numberless aspects of our society. In our bronchoscopic lung volume reduction interventional program, we work with severe COPD patients on a daily basis. Objective(s): We were interested in the prevalence and outcome of COVID-19, impact of the pandemic on daily life, and the vaccination coverage in our severe COPD patients who have been treated with one-way endobronchial valves. Method(s): A questionnaire, which consisted of questions related to the infection rate, treatment, and outcome of COVID-19 infections;feelings of anxiety related to the pandemic;adherence to preventive measures;and willingness to be vaccinated;was sent to our patients in June 2021. Result(s): The questionnaire was sent to 215 patients, and the response rate was 100%. The vaccination rate was 97% in our surveyed population. The majority of patients (63%) indicated that they were quite or very anxious to get infected with COVID-19. Twenty-five (11.5%) patients were diagnosed with COVID-19, with none of these patients having been vaccinated at the time of infection. The infection rate reported in this study is comparable to that of the general Dutch population. However, the hospital admission rate and mortality rates are higher. Conclusion(s): Our results show that the SARS-CoV-2 infection rate in severe COPD patients treated with endobronchial valves was comparable with the general population;however, the hospital admission and mortality rates were worse. Copyright © 2022 Acta Cytologica

16.
Colorectal Disease ; 23(Supplement 2):131, 2021.
Article in English | EMBASE | ID: covidwho-2192484

ABSTRACT

Aim: At the end of May 2020, 37% of individuals positive for SARS-CoV2 in Italy were living in Lombardy and 49% of overall COVID-19- related deaths occurred there. Lombardy healthcare system assigned patients affected by colorectal cancer, suitable for surgery, to designated oncologic Hub hospitals. National Cancer Institute of Milan has been identified as one of those oncologic hub centers. The aim was both to treat patients in the hub waiting list as soon as possible and, simultaneously, remain a"COVID-free" center. Method(s): To manage patients from both, hub and institutional waiting list, prioritization criteria were defined and applied to each patient and internal protocol screening was carried out before treatment. All surgeons and healthcare workers were daily assessed too for symptoms. Result(s): 1 of the institutional waiting list patients and 7 of the hub list patients failed to pass the pre-hospitalization triage. Within this group, 4 patients resulted negative for SARS-CoV- 2;after a period of quarantine, they became negative and were admitted for hospitalization. 3 more patients resulted positive for SARS-CoV- 2 and despite the quarantine, one deceased for pneumonia, while other 2 patients remained asymptomatic and were admitted for hospitalization after running another triage protocol. A shorter surgical time in the hub patients was observed. Conclusion(s): Postoperative morbidity rates were similar in the two waiting list groups. In April 2020 all our staff members were tested for SARS-CoV- 2, and none resulted positive. The centralized management of colorectal cancer patients in an oncologic hub was effective during the COVID-19 outbreak.

17.
Medicine ; 101(51), 2022.
Article in English | GIM | ID: covidwho-2191116

ABSTRACT

Background: This systematic review and meta-analysis aimed to assess the association of hypernatremia with the outcomes of COVID-19 patients.

18.
Pediatric Critical Care Medicine Conference: 11th Congress of the World Federation of Pediatric Intensive and Critical Care Societies, WFPICCS ; 23(11 Supplement 1), 2022.
Article in English | EMBASE | ID: covidwho-2190765

ABSTRACT

BACKGROUND AND AIM: The purpose of this study was to describe the clinical presentation and physiologic profile of individuals with varying degrees of severity of multisystem inflammatory syndrome in children (MIS-C). METHOD(S): We performed a retrospective study of children diagnosed with MIS-C admitted to a single quaternary children's hospital from 5/2020 - 4/2021. We created an MIS-C severity score using the following parameters: hospital admission status (e.g., floor vs. intensive care unit), need for inotropic or vasoactive medications, and need for mechanical ventilation. Univariate and multivariate analyses were performed to associate risk factors corresponding to the MIS-C severity score. RESULT(S): The study included 152 children who were followed for 14 days post hospital admission. A stepwise forward selection process identified seven physiologic variables associated with 'severe' MIS-C. Specifically, a combination of elevated creatinine, international normalized ratio, white blood cell count, ferritin, respiratory rate, and decreased albumin led to an excellent discrimination between mild versus severe MIS-C (AUC = 0.915). CONCLUSION(S): This study derived an early physiologic profile enabling stratification of MIS-C severity. (Figure Presented).

19.
Critical Care Medicine ; 51(1 Supplement):547, 2023.
Article in English | EMBASE | ID: covidwho-2190664

ABSTRACT

INTRODUCTION: An impacted population of the COVID-19 pandemic is those with limited English proficiency (LEP). Due to visitor restrictions, caregivers were unable to facilitate communication with hospital staff, and those with LEP were more susceptible to poor communication with their healthcare providers. METHOD(S): Data was ed from the BIDMC site of the SCCM VIRUS Discovery Database, a de-identified, HIPAA-compliant database containing clinical information for COVID-19 patients admitted to BIDMC. Patients were placed into two groups, either requiring translator services for any language or not. Statistical analyses were performed in R Version 3.0 to calculate test statistics such as ANOVA and Chi-Square p-values. The primary outcome assessed length of stay (LOS). Secondary outcomes included complications, discharge status of alive or deceased, discharge location of either home or another care facility, and number of symptomatic days before hospital admission. The association between non-White, non-Hispanic demographics and need for translation services was also examined. RESULT(S): 1522 patients were included with 91 excluded due to unknown use of translator services. The relationship between the requirement of an interpreter and LOS, complications, and symptomatic days was not statistically significant. However, statistically significant findings include patients who required translational services were more likely discharged alive (OR 1.53, 95% CI 1.07-2.24), and discharged to their homes (OR 1.42, 95% CI 1.07-1.91). Use of translator services was strongly associated with minority status (OR 5.20, 95% CI 3.81-7.21). A limitation of this dataset is that deceased status is only recorded if the patient dies during the index visit, potentially missing those who expire from COVID-related complications post-discharge. CONCLUSION(S): The requirement of a translator was not correlated with longer hospital stays, more complications, or days symptomatic prior to admission in comparison to the patients' English-speaking counterparts. However, the use of a translator was positively correlated with survival, discharge home, and minority status. The increased odds of discharge home could be due to the cultural values of minorities providing care in a familial setting.

20.
Critical Care Medicine ; 51(1 Supplement):217, 2023.
Article in English | EMBASE | ID: covidwho-2190553

ABSTRACT

INTRODUCTION: The appropriate use of empiric antibiotics is a clinical challenge for patients with severe COVID-19. Early in the pandemic, there was concern that bacterial coinfection would influence morbidity and mortality. This concern often led to treating patients empirically with antibiotics. Fortunately, early data from the COVID-19 pandemic suggests bacterial coinfection is uncommon. However, there has been little published data on the antibiotic prescribing practices over the course of the pandemic. This study aims to investigate the inter-center variation and temporal trends of early antibiotic prescribing in patients hospitalized with COVID-19. METHOD(S): We performed a retrospective analysis using the National COVID Cohort Collaborative database. We identified patients admitted between March 2020 and December 2021 who had a positive COVID-19 PCR or antigen test 15 days prior or within 48 hours of admission. Age at time of COVID-19 diagnosis, gender, race/ethnicity, Charlson comorbidity index, the month of hospitalization, antibiotics received, labs at the time of hospital admission, and center identifier were collected. A chi-square test was used for categorical data and Wilcoxon rank-sum test for continuous data. Mixed effects logistic regression was used to evaluate predictors of early empiric antibiotic use. RESULT(S): Of 280,601 qualifying first hospitalizations, 30,469 patients received early empiric antibiotics. Antibiotic use declined across all centers over time from the first month (23%) to the last month in (8.1%) in the data collection period (p < 0.01). Antibiotic use decreased slightly by day 2 of hospitalization and was significantly reduced by day 5. Mechanical ventilation before day 2 (OR 2.25, 95% CI 2.14 - 2.36) and ECMO before day 2 (OR 1.60, 95% CI 1.25 - 2.05) but not region of residence was associated with early empiric antibiotic use. CONCLUSION(S): Although treatment of COVID-19 patients with empiric intravenous antibiotics has declined during the pandemic, the frequency of use remains higher than the reported incidence of bacterial superinfection. There is significant inter-center variation in antibiotic prescribing practices. Future research should focus on comparing outcomes and adverse events among COVID-19 patients treated with and without empiric antibiotics.

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