Progression from Pneumonia to ARDS as a Predictor for Fatal COVID-19.

There is a serious concern over the variation of case fatality of COVID-19 patients that reflects the preparedness of the medical care system in response to the surge of pneumonia patients. We aimed to quantify the disease spectrum of COVID-19 on which we are based to develop a key indicator on the probability of progression from pneumonia to acute respiratory disease syndrome (ARDS) for fatal COVID-19. The retrospective cohort on 12 countries that have already experienced the epidemic of COVID-19 with available open data on the conformed cases with detailed information on mild respiratory disease (MRD), pneumonia, ARDS, and deaths were used. The pooled estimates from three countries with detailed information were 73% from MRD to pneumonia and 27% from MRD to recovery and the case-fatality rate of ARDS was 43%. The progression from pneumonia to ARDS varied from 3% to 63%. These key estimates were highly associated with the case fatality rates reported for each country with a statistically significant positive relationship (adjusted R2 = 95%). Such a quantitative model provides key messages for the optimal medical resources allocation to a spectrum of patients requiring quarantine and isolation at home, isolation wards, and intensive care unit in order to reduce deaths from COVID-19.

Meta-regression analysis of the initial bone height for predicting implant survival rates of two sinus elevation procedures.

AIM: To undertake a systematic review for the association between the initial alveolar bone height and the success of dental implants with sinus elevation procedures. MATERIALS AND METHODS: An online search was performed using the following electronic databases: PubMed, Medline, Science Direct, and Blackwell synergy. Two investigators independently assessed publications for inclusion and extracted data. Meta-regression analyses were used to test the associations between the initial alveolar bone height and implant survival with lateral window or osteotome sinus elevation procedures. RESULTS: Of 635 studies, 21 were included for analysis. A quadratic curve-fitting meta-regression showed an increasing trend of implant survival rate with greater initial bone height for the lateral window technique (p<0.0001, adjusted R(2)=0.97). The result of the meta-regression for hazard rates showed a decreasing trend (p=0.0041, adjusted R(2)=0.89). No association was found for the osteotome technique. CONCLUSIONS: For the lateral window technique, meta-regression analysis suggested a positive association between the initial alveolar bone height and implant survival rates. No relationship was found between the initial alveolar bone height and implant survival rate for the osteotome technique due to a lack of data below 4 mm of initial bone height.

Circulating viruses associated with severe complicated enterovirus infection in Taiwan: a multi-year analysis.

BACKGROUND: Few studies have investigated the viral isolation characteristics for severe complicated enterovirus infection (SCEI). This study evaluated the seasonality and contribution of circulated viruses to the chronologic trend and weekly reported SCEI epidemic. METHODS: Enterovirus infection surveillance and virology laboratory data in 2000 to 2008 obtained from the Centers for Disease Control in Taiwan were analyzed. We measured the monthly and weekly virology isolation rates by viral types. The virus-specific and the season-specific relative risks for SCEI and 95% confidence intervals (CI) associated with the isolated circulating viruses and weather status was evaluated. RESULTS: Among 1539 virology confirmed SCEI cases, the mean annual incidence rates ranged from 0.72/100,000 to 32.5/100,000 in children aged 5 years and less; rates were higher in warm months with cases peaking in June (12.6%). The untypeable nonpolio enterovirus was the most frequently isolated type among the monitored specimens (6.07%), followed by coxsackievirus A (3.99%), EV71 (1.77%), coxsackievirus B (1.56%), and echovirus (1.23%). However, these SCEI cases had very strong associations with the isolation of EV71 and coxsackievirus A and B. The corresponding relative risks were 1.14 (95% CI, 1.11-1.17), 1.03 (95% CI, 1.01-1.04), and 1.09 (95% CI, 1.07-1.12), respectively, for 1% increase in weekly isolation rate. CONCLUSIONS: Isolation rates for EV71 and coxsackieviruses A and B can predict the development of SCEI cases, particularly in warm months.