Predicting Mortality for COVID-19 Patients Admitted to an Emergency Department Using Early Warning Scores in Poland.

COVID-19 disease is characterised by a wide range of symptoms that in most cases resemble flu or cold. Early detection of infections, monitoring of patients' conditions, and identification of patients with worsening symptoms became crucial during the peak of pandemic. The aim of this study was to assess and compare the performance of common early warning scores at the time of admission to an emergency department in predicting in-hospital mortality in patients with COVID-19. The study was based on a retrospective analysis of patients with SARS-CoV-2 infection admitted to an emergency department between March 2020 and April 2022. The prognostic value of early warning scores in predicting in-hospital mortality was assessed using the receiver operating characteristic (ROC) curve. Patients' median age was 59 years, and 52.33% were male. Among all the EWS we assessed, REMS had the highest overall accuracy (AUC 0.84 (0.83-0.85)) and the highest NPV (97.4%). REMS was the most accurate scoring system, characterised by the highest discriminative power and negative predictive value compared to the other analysed scoring systems. Incorporating these tools into clinical practice in a hospital emergency department could provide more effective assessment of mortality and, consequently, avoid delayed medical assistance.

Clinical Course of 53 Previously Vaccinated Patients Admitted to the National Hospital in Warsaw, Poland with COVID-19 Between November 2021 and March 2022.

BACKGROUND Current vaccines against SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) and vaccine booster programs aim to reduce hospitalizations due to severe COVID-19 (coronavirus disease 2019). It is now accepted that vaccination does not completely prevent infection and that breakthrough COVID-19 does occur. This study included 53 vaccinated patients who were hospitalized at a single center in Poland with breakthrough COVID-19 and aimed to evaluate the factors associated with their clinical course. MATERIAL AND METHODS This study covered the period 26 November 2021 to 11 March 2022. All patients had been vaccinated against COVID-19 with one of the following 4 vaccines: the mRNA-1273 (Moderna) mRNA vaccine (Spikevax); the BNT162b2 (Pfizer-BioNTech) mRNA vaccine (nucleoside-modified) (Comirnaty); the Ad26.COV2.S (Janssen/J0ohnson & Johnson) recombinant vaccine (Jcovden); and the AZD1222 (ChAdOx1) (Oxford/AstraZeneca) recombinant vaccine (Vaxzevria). RESULTS The course of COVID-19 in vaccinated patients was relatively similar. The patients vaccinated more than 24 weeks earlier rarely needed a stay in the Intensive Care Unit (ICU) (P=0.021), and the occurrence of deaths was significantly lower in this group (P=0.046). Women remained in hospital considerably longer than men (P=0.011). Age and comorbidities did not affect the course of this infection. CONCLUSIONS Despite the many advantages of the COVID-19 vaccination, our observations indicate a potential risk of infection after vaccination. The assessment of the course of COVID-19 in vaccinated patients gives the possibility to compare different vaccines and indicate factors that can reduce immunity.

The Course of COVID-19 among Unvaccinated Patients-Data from the National Hospital in Warsaw, Poland.

INTRODUCTION: Studies to date indicate the relatively high effectiveness of vaccinations in preventing severe COVID-19 symptoms. However, in Poland, 40% of the population remains unvaccinated. OBJECTIVE: The objective of this study was to describe the natural history of COVID-19 in unvaccinated hospital patients in Warsaw, Poland. MATERIAL AND METHODS: This study evaluated data from 50 adult patients from the National Hospital in Warsaw, Poland, in the period 26 November 2021 to 11 March 2022. None of these patients had been vaccinated against COVID-19. RESULTS: Analysis showed that the average hospitalisation time for these unvaccinated COVID-19 patients was 13 days. Clinical deterioration was observed in 70% of these patients, 40% required the intensive care unit, and 34% subsequently died prior to the end of the study. CONCLUSIONS: There was a significant deterioration and high mortality rate in the unvaccinated patients. For this reason, it seems prudent to take measures to increase the vaccination coverage level of the population against COVID-19.

Retrospective Study to Identify Risk Factors for Severe Disease and Mortality Using the Modified Early Warning Score in 5127 Patients with COVID-19 Admitted to an Emergency Department in Poland Between March 2020 and April 2021.

BACKGROUND COVID-19, a disease caused by SARS-CoV-2, has posed a threat to global public health. This retrospective study of 5127 patients with COVID-19 admitted to an Emergency Department in Poland between March 2020 and April 2021 aimed to identify risk factors for severe disease and mortality using the modified early warning score (MEWS). MATERIAL AND METHODS The study was based on a retrospective analysis of patients with SARS-CoV-2 infection admitted to the Emergency Department between March 2020 and April 2021. A total of 5127 cases were included in the final analysis. Identifying the group of high-risk patients with COVID-19 was determined based on the MEWS score. RESULTS Most of the patients studied were male (53.38%). The in-hospital mortality rate among the patients was 21.53%. The factors associated with the risk of in-hospital mortality from COVID-19 were age (>60 years, hazard ratio [HR]=2.27, P<0.001), comorbidities (cancer, HR=1.39, P=0.005; heart failure, HR=1.31, P=0.009; renal failure, HR=1.37, P=0.004), higher MEWS score (MEWS ≥5, HR=1.43, P<0.001), higher percentage of lung parenchyma affected (>50%, HR=2.10, P=0.001), and higher respiratory rate (>24 breaths per min, HR=2.10, P<0.001). CONCLUSIONS This study produced real-world data of risk factors for mortality from COVID-19 and the use of the MEWS for a faster identification of patients with COVID-19 requiring more intensive medical care.

The Level of Fear in the Polish Police Population during the COVID-19 Pandemic with the Impact of Sociodemographic Variables.

This study has a twofold objective. First, we aim to measure the levels of fear among Polish police officers using the COVID-19 Fear Scale (FCV-19S) that has a stable unidimensional structure allowing for the provision of additional data by combining variables. This structure allows the second objective to be met to measure the correlation with sociodemographic variables. The utilitarian objective of the study is to provide information for updating support policies for stress management in the service. The questionnaire was completed by 1862 people with a mean age of 38.75 years with a good Cronbach's alpha (0.89). The perceived level of fear associated with COVID-19 should be considered relatively low. Caring for the elderly does not affect the level of fear. The factors of gender, age and having children statistically significantly differentiate the perceptions of fear. Therefore, there is a necessity to focus on building support for police officers who are over 50 years old, as well as for women, where higher levels of fear in both men and women can translate into the development of psychosomatic illnesses.

Beyond GWAS-Could Genetic Differentiation within the Allograft Rejection Pathway Shape Natural Immunity to COVID-19?

COVID-19 infections pose a serious global health concern so it is crucial to identify the biomarkers for the susceptibility to and resistance against this disease that could help in a rapid risk assessment and reliable decisions being made on patients' treatment and their potential hospitalisation. Several studies investigated the factors associated with severe COVID-19 outcomes that can be either environmental, population based, or genetic. It was demonstrated that the genetics of the host plays an important role in the various immune responses and, therefore, there are different clinical presentations of COVID-19 infection. In this study, we aimed to use variant descriptive statistics from GWAS (Genome-Wide Association Study) and variant genomic annotations to identify metabolic pathways that are associated with a severe COVID-19 infection as well as pathways related to resistance to COVID-19. For this purpose, we applied a custom-designed mixed linear model implemented into custom-written software. Our analysis of more than 12.5 million SNPs did not indicate any pathway that was significant for a severe COVID-19 infection. However, the Allograft rejection pathway (hsa05330) was significant (p = 0.01087) for resistance to the infection. The majority of the 27 SNP marking genes constituting the Allograft rejection pathway were located on chromosome 6 (19 SNPs) and the remainder were mapped to chromosomes 2, 3, 10, 12, 20, and X. This pathway comprises several immune system components crucial for the self versus non-self recognition, but also the components of antiviral immunity. Our study demonstrated that not only single variants are important for resistance to COVID-19, but also the cumulative impact of several SNPs within the same pathway matters.

Analysis of Risk Factors for In-Hospital Death Due to COVID-19 in Patients Hospitalised at the Temporary Hospital Located at the National Stadium in Warsaw: A Retrospective Analysis.

The outbreak of the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pandemic has affected all aspects of social life and brought massive changes to the healthcare sector. The aim of this study was to identify the factors affecting the mortality of COVID-19 patients at a temporary hospital in Warsaw (Poland). The present study was conducted based on a retrospective analysis of the medical records of patients hospitalised at the temporary hospital located at the National Stadium in Warsaw between 1 March 2020 and 30 April 2021. The study included all cases of patients who were brought directly or transferred to the National Hospital from other hospitals for further treatment. With regard to comorbidities, the analysis found that five comorbidities­namely, diabetes (OR = 1.750, 95% CI: 1.009−2.444, p < 0.05), stroke history (OR = 2.408, 95% CI: 1.208−4.801, p < 0.05), renal failure (OR = 2.141, 95% CI: 1.052−4.356, p < 0.05), chronic obstructive pulmonary disease (OR = 2.044, 95% CI: 1.133−3.690, p < 0.05) and heart failure (OR = 1.930, 95% CI: 1.154−3.227, p < 0.05)­had a significant impact on the survival of COVID-19 patients. The analysis identified 14 factors that had a significant impact on the prognosis and mortality of the COVID-19 patients studied.