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Introduction: The coronavirus disease 2019 (COVID-19) pandemic has rapidly spread worldwide and claimed millions of lives. Several studies have attempted to understand the relationship between COVID-19 infection and health disparities. The aim of the current work was to evaluate the pre-admission health characteristics, symptomatology, diagnostic abnormalities, treatment measures and clinical outcomes of the community served by our institution, with a sub-analysis of our Hispanic community. Methods: This is a single-center, cross-sectional cohort study of patients with COVID-19 admitted from 15 March 2020 to 30 April 2020 to MacNeal Hospital. A retrospective chart review was performed including patients >18 years and a positive nasopharyngeal SARS-CoV-2 PCR. Demographical data, comorbidities, clinical data, treatment regimen, and patient outcomes were collected. Results: A total of 257 patients were included in the study of which 60.4% were identified as Hispanic. The median age at admission of Hispanic patients was significantly lower compared to non-Hispanic patients (56.6 vs. 65.7 years, p<0.01). Non-Hispanic patients had lower prevalence of hypertension, coronary artery disease, and chronic lung disease. Most common at presentation were shortness of breath (69.6%), cough (69.2%), and fever (64%). Hypertension was the most common comorbidity (53.6%). Approximately 89% of the patients received antibiotics, 40.4% hydroxy-chloroquine, 13.2% steroids, and 6% tocilizumab. Twenty six percent required mechanical ventilation (MV), and over half of them (56.7%) were Hispanic. The strongest factors associated with MV were smoking (OR 2.97, 95%CI 1.01-8.69), CRP >10 mg/dL (OR 4.53, 95%CI 1.49-13.38) and D-dimer >1.5 mcg/mL (OR 3.63, 95%CI 1.31-10.05). An oxygen saturation of >90% on room air on presentation was a protective factor when predicting intubation (OR 0.11, 95%CI 0.03-0.33). The overall 30-day mortality rate was 17.1% (n=44); 11.9% in the Hispanic group vs 26.3% in the non-Hispanic group (p<0.003). Conclusions: Our review of consecutive patients admitted with COVID-19 demonstrated that over half of patients were of Hispanic descent. Interestingly enough, despite being significantly younger and healthier, the need for mechanical ventilation in the Hispanic group was not significantly different compared to the non-Hispanic group. However, the Hispanic group had a lower mortality rate.
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Introduction Acute diverticulitis is defined as a macroscopic inflammation of a diverticulum or diverticula. Approximately, 4.0% of patients with diverticulosis present with an acute diverticulitis event: with the incidence increasing in the younger patient population. According to the American Gastrointestinal Association, a colonoscopy should be performed six to eight weeks after resolution of acute diverticulitis. The purpose of this study is to determine if there is malignancy after an acute diverticulitis event in adults less than 50 years old. Methods A retrospective chart review study was performed at Loyola MacNeal Hospital in Berwyn, Illinois. Patients between the ages of 18 and49 years with acute diverticulitis were identified. Of the identified patients, those who underwent colonoscopy after a computed tomography (CT)-verified acute diverticulitis event were recorded. Colonoscopy findings, as well as pathology results, were recorded. Results A total of 295 patient presented with diverticulitis. Of these 295 patients, 111 patients underwent colonoscopy post diverticulitis event. Of the 111 patients, 86 were after uncomplicated event and 25 were after a complicated diverticulitis event. Pre-malignant tubular adenomas were found in 12.8% (11/86) of patients with acute uncomplicated diverticulitis and 24.0% (6/25) of the patients with complicated diverticulitis. No cases of neoplasm were found. Conclusion Of the 111 patients who underwent colonoscopy after an acute diverticulitis event, no malignancy was found in patients less than 50 years of age.
