ABSTRACT
Background: The cardiovascular complications of Coronavirus Disease 2019 (COVID-19) may be attributed to the hyperinflammatory state leading to increased mortality in patients with COVID-19. HMG-CoA Reductase Inhibitors (statins) are known to have pleiotropic and anti-inflammatory effects and may have antiviral activity along with their cholesterol-lowering activity. Thus, statin therapy is potentially a potent adjuvant therapy in COVID-19 infection. This study investigated the impact of statin use on the clinical outcome of critically ill patients with COVID-19. Methods: A multicenter, retrospective cohort study of all adult critically ill patients with confirmed COVID-19 who were admitted to Intensive Care Units (ICUs) between March 1, 2020, and March 31, 2021. Eligible patients were classified into two groups based on the statin use during ICU stay and were matched with a propensity score based on patient's age and admission APACHE II and SOFA scores. The primary endpoint was in-hospital mortality, while 30 day mortality, ventilator-free days (VFDs) at 30 days, and ICU complications were secondary endpoints. Results: A total of 1,049 patients were eligible; 502 patients were included after propensity score matching (1:1 ratio). The in-hospital mortality [hazard ratio 0.69 (95% CI 0.54, 0.89), P = 0.004] and 30-day mortality [hazard ratio 0.75 (95% CI 0.58, 0.98), P = 0.03] were significantly lower in patients who received statin therapy on multivariable cox proportional hazards regression analysis. Moreover, patients who received statin therapy had lower odds of hospital-acquired pneumonia [OR 0.48 (95% CI 0.32, 0.69), P < 0.001], lower levels of inflammatory markers on follow-up, and no increased risk of liver injury. Conclusion: The use of statin therapy during ICU stay in critically ill patients with COVID-19 may have a beneficial role and survival benefit with a good safety profile.
Subject(s)
COVID-19 , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Adult , Cohort Studies , Critical Illness , Humans , Retrospective StudiesABSTRACT
Background: Asthma is an important public health problem worldwide on account of its prevalence. Education of asthmatic patients about appropriate using of MDIs would be more effective medications. Objectives: To assess the appropriateness of using MDIs among asthmatic patients and to determine the factors significantly associated with correct use of MDI. Method: A descriptive study was conducted on 399 asthmatic patients on internet on Google from 28th October to 28th November 2015. A questionnaire was filled out and SPSS version 21 was used for data analysis. Standard method was used to obtain descriptive statistic comprising means, percentage and standard deviations in order to describe demographic variables. Analysis of variance (ANOVA) test was used to compare means of contentious and categorical variables of demographic characteristics and medical background with using MDIs and find association between them. P-value of 0.05 and less were regarded as statistically significant. Results: In the studied sample, 87% were age less than 45 years, 74% of cases were females. About 92% of cases were higher and above level of education. More than half of subjects had asthma for more than five years. There were 36% of patients using MDI. Only a few patients (12%) had the correct all skills using MDIs. There were significant association between using MDIs with age and duration of asthma (p=<0.001). Conclusions: Despite the well-known fact that a good MDI technique is of greatest importance, Majority of asthmatic patients have poor skills of MDI appropriate use. Incorrect MDIs technique is common among asthma patients. Health care professional must be focused on training on use MDI among the younger and newly diagnosis asthmatic patients. This indicating the need for regular formal training programmes on inhaler techniques so as to decipher correct practices in inhalation therapy.
ABSTRACT
Background: Asthma is an important public health problem worldwide on account of its prevalence. Education of asthmatic patients about appropriate using of MDIs would be more effective medications. Objectives: To assess the appropriateness of using MDIs among asthmatic patients and to determine the factors significantly associated with correct use of MDI. Method: A descriptive study was conducted on 399 asthmatic patients on internet on Google from 28th October to 28th November 2015. A questionnaire was filled out and SPSS version 21 was used for data analysis. Standard method was used to obtain descriptive statistic comprising means, percentage and standard deviations in order to describe demographic variables. Analysis of variance (ANOVA) test was used to compare means of contentious and categorical variables of demographic characteristics and medical background with using MDIs and find association between them. P-value of 0.05 and less were regarded as statistically significant. Results: In the studied sample, 87% were age less than 45 years, 74% of cases were females. About 92% of cases were higher and above level of education. More than half of subjects had asthma for more than five years. There were 36% of patients using MDI. Only a few patients (12%) had the correct all skills using MDIs. There were significant association between using MDIs with age and duration of asthma (p=<0.001). Conclusions: Despite the well-known fact that a good MDI technique is of greatest importance, Majority of asthmatic patients have poor skills of MDI appropriate use. Incorrect MDIs technique is common among asthma patients. Health care professional must be focused on training on use MDI among the younger and newly diagnosis asthmatic patients. This indicating the need for regular formal training programmes on inhaler techniques so as to decipher correct practices in inhalation therapy. (AU)
