ABSTRACT
BackgroundMutations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may reduce the efficacy of neutralizing monoclonal antibody therapy against coronavirus disease 2019 (COVID-19). We here evaluated the efficacy of casirivimab-imdevimab in patients with mild-to-moderate COVID-19 during the Delta variant surge in Fukushima Prefecture, Japan. MethodsWe enrolled 949 patients with mild-to-moderate COVID-19 who were admitted to hospital between July 24, 2021 and September 30, 2021. Clinical deterioration after admission was compared between casirivimab-imdevimab users (n = 314) and non-users (n = 635). ResultsThe casirivimab-imdevimab users were older (P < 0.0001), had higher body temperature ([≥] 38{degrees}C) (P < 0.0001) and greater rates of history of cigarette smoking (P = 0.0068), hypertension (P = 0.0004), obesity (P < 0.0001), and dyslipidemia (P < 0.0001) than the non-users. Multivariate logistic regression analysis demonstrated that receiving casirivimab-imdevimab was an independent factor for preventing deterioration (odds ratio 0.448; 95% confidence interval 0.263-0.763; P = 0.0023). Furthermore, in 222 patients who were selected from each group after matching on the propensity score, deterioration was significantly lower among those receiving casirivimab-imdevimab compared to those not receiving casirivimab-imdevimab (7.66% vs 14.0%; p = 0.021). ConclusionThis real-world study demonstrates that casirivimab-imdevimab contributes to the prevention of deterioration in COVID-19 patients after hospitalization during a Delta variant surge. SummaryThis real-world retrospective study demonstrates the contribution of treatment with casirivimab-imdevimab to the prevention of deterioration in patients with mild-to-moderate coronavirus disease 2019 (COVID-19) even during the Delta variant pandemic.
ABSTRACT
BACKGROUNDDue to the dissemination of vaccination against severe acute respiratory syndrome coronavirus 2 in the elderly, the virus-susceptible subjects have shifted to unvaccinated non-elderlies. The risk factors of COVID-19 deterioration in non-elderly patients without respiratory failure have not yet been determined. This study was aimed to create simple predicting method to identify such patients who have high risk for exacerbation. METHODSWe analyzed the data of 1,675 patients aged under 65 years who were admitted to hospitals with mild-to-moderate COVID-19. For validation, 324 similar patients were enrolled. Disease progression was defined as administration of medication, oxygen inhalation and mechanical ventilator starting one day or longer after admission. RESULTSThe patients who exacerbated tended to be older, male, had histories of smoking, and had high body temperatures, lower oxygen saturation, and comorbidities such as diabetes/obesity and hypertension. Stepwise logistic regression analyses revealed that comorbidities of diabetes/obesity, age [≥] 40 years, body temperature [≥] 38{degrees}C, and oxygen saturation < 96% (DOATS) were independent risk factors of worsening COVID-19. As a result two predictive scores were created: DOATS score, which includes all the above risk factors; and DOAT score, which includes all factors except for oxygen saturation. In the original cohort, the areas under the receiver operating characteristic curve of the DOATS and DOAT scores were 0.789 and 0.771, respectively. In the validation, the areas were 0.702 and 0.722, respectively. CONCLUSIONWe established two simple prediction scores that can quickly evaluate the risk of progression of COVID-19 in non-elderly, mild/moderate patients. SummaryThe risk stratification models using independent risks, namely comorbidity of diabetes or obesity, age [≥] 40 years, high body temperature [≥] 38{square}, and oxygen saturation < 96%, DOATS and DOAT scores, predicted worsening COVID-19 in patients with mild-to-moderate cases.
ABSTRACT
Orthostatic Disregulation (OD, a kind of dysautonomia) is a syndrome which indicates disfunction of vessel contraction reflex during static standing. OD patients often show some symptoms of fainting, dizziness, headache and the like or syncope when they are holding orthostatic posture. OD is more recognized especially in preadolescence and adolescence periods (9-15 yrs.) . Brück & Oltmann (1957), Okuni (1958) etc, have reported details about OD.<BR>The purpose of this study was to obtain and discuss details relating to recent appearance of OD, physique, growth characteristics, cardio-vascular functions and physical fitness on OD children by the questionnaire method and some experiments.<BR>2, 227 children in elementary and junior high school in Yokohama and Kamakura cities as sub jectswere first screened by the questionnaire. And 165 subjects out of 2, 227 were at random selected for data on Schellong standing test, passive head-up tilt and distance running.<BR>The value of 9-29%, which was the ratio of false OD (+) appearance by the questionnaire method in this study, was recognized higher than the value of 5-20% by previous studies'. Physique on false OD (+) children was somewhat lean in comparison with the normal. And they had more height increase than the normal.<BR>In physical fitness, distance running, 50 m dash, broad jump, ball throw, chinning exercise and back pull-over tests, OD children were inferior than the normal.<BR>A concrete datum in syncope for standing was got in this study. When an OD child exhibited syncope, systolic blood pressure became 78 mmHg (rest 120-130 mmHg) and heart rate became 76 beats per minute (standing before syncope 100-110 beats per minute) . T wave in II, <SUB>a</SUB>V<SUB>F</SUB> and P wave in II, III (depression, negative waves etc.) of ECG varied from resting ECG. Judging from these data about ECG and blood pressure on standing test, passive head-up tilt, it was indicated that a reflex system of vessel contraction on OD child didn't work well, and that the heart of OD child was much stressed by gravity in orthostatic posture and changing posture than the normal.<BR>In addition, a fact was proven that false OD (+) children (39.1% boys and 48.2% girls) didn't like sports and physical activities comparing with the normal (16.4% boys and 23.5% girls), It was statistically significant. Therefore, it is estimated that there is a relationship between appearance of OD and physical activities in daily life.
ABSTRACT
In the studies of physical motion analysis the multiple photographic method with a stroboscope or the fast motion picture which has been used, are not sufficient to pursue a motion of some kinds of sports and of some hidden physical spot only from one direction and difficult to synchronize picture obtaind from three direction.<BR>To make use of electrical engineering from the points of Physiology and Kinesiology, it is worthy of pursuing a physical motion on three dimensions, up & down, right & left and before & behind at once, and furthermore, physiological phenomena in electrocardiogram and electromyogram with connection to the above analyzer.<BR>For that purpose a physical locomotion pursuit analyzer (SN-type, refered to PLPA later on) was devised.<BR>The present devised analyzer is composed of a three dimensions-accelerometor in a gyroscope, a preamplifier, a integration amplifier and a pen-writing recorder.<BR>As already known in the principle of physics, velocity can be obtained by single integration of acceleration rate and displacement by double integration of a acceleration rate.<BR>In above the PLPA, therefore, acceleration rate, velocity and displacement, each of three dimensions can be determined. Capacity of the present analyzer was as follows; Frequency rate : 1.5-20.0 HZ (Static accelerated component under 1.5 HZ was cut by differentiation circuit of DC-cut), time constant of electrical integration circuit : about 0.2sec.<BR>In the present report the outline of PLPA and some data of our experiments obtained by use of it were dealt.<BR>The problems of the telemetering system of this analyzer and digital exhibition by connection to computer require further study.
