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IntroductionThe novel coronavirus disease 2019 (COVID-19) has rapidly spread across the globe, overwhelming healthcare systems and depleting resources. The infection has a wide spectrum of presentations, and pre-existing comorbidities have been found to have a dramatic effect on the disease course and prognosis. We sought to analyze the effect of asthma on the disease progression and outcomes of COVID-19 patients. MethodsWe conducted a multi-center retrospective study of positively confirmed COVID-19 patients from multiple hospitals in Louisiana. Demographics, medical history, comorbidities, clinical presentation, daily laboratory values, complications, and outcomes data were collected and analyzed. The primary outcome of interest was in-hospital mortality. Secondary outcomes were Intensive Care Unit (ICU) admission, risk of intubation, duration of mechanical ventilation, and length of hospital stay. ResultsA total of 502 COVID-19 patients (72 asthma and 430 non-asthma cohorts) were included in the study. The frequency of asthma in hospitalized cohorts was 14.3%, higher than the national prevalence of asthma (7.7%). Univariate analysis revealed that asthma patients were more likely to be obese (75% vs 54.2%, p=0.001), with higher frequency of intubation (40.3% vs 27.8%, p = 0.036), and required longer duration of hospitalization (15.1{+/-}12.5 vs 11.5{+/-}10.6, p=0.015). After adjustment, multivariable analysis showed that asthmatic patients were not associated with higher risk of ICU admission (OR=1.81, 95%CI=0.98-3.09, p=0.06), endotracheal intubation (OR=1.77, 95%CI=0.99-3.04, p=0.06) or complications (OR=1.37, 95%CI=0.82-2.31, p=0.23). Asthmatic patients were not associated with higher odds of prolonged hospital length of stay (OR=1.48, 95%CI=0.82-2.66, p=0.20) or with the duration of ICU stay (OR=0.76, 95%CI=0.28-2.02, p=0.58). Kaplan-Meier curve showed no significant difference in overall survival of the two groups (p=0.65). ConclusionDespite the increased prevalence of hospitalization in asthmatic COVID-19 patients compared to the general population, after adjustment for other variables, it was neither associated with increased severity nor worse outcomes.
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To investigate the relationship between BCG vaccination and SARS-CoV-2 by bioinformatic approach. Two datasets for Sars-CoV-2 infection group and BCG-vaccinated group were downloaded. Differentially Expressed Genes were identified. Gene ontology and pathways were functionally enriched, and networking was constructed in NetworkAnalyst. Lastly, correlation between post-BCG vaccination and COVID-19 transcriptome signatures were established. A total of 161 DEGs (113 upregulated DEGs and 48 downregulated genes) were identified in the Sars-CoV-2 group. In the pathway enrichment analysis, cross-reference of upregulated KEGG pathways in Sars-CoV-2 with downregulated counterparts in the BCG-vaccinated group, resulted in the intersection of 45 common pathways, accounting for 86.5% of SARS-CoV-2 upregulated pathways. Of these intersecting pathways, a vast majority were immune and inflammatory pathways with top significance in IL-17, TNF, NOD-like receptors, and NF-{kappa}B signaling pathways. Our data suggests BCG-vaccination may incur a protective role in COVID-19 patients until a targeted vaccine is developed. Supplementary Materials(https://drive.google.com/open?id=15Na738L282XNaQAJUh0cZf1WoG9jJfzJ)
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OBJECTIVES: To evaluate the safety and efficacy of holmium laser enucleation of the prostate in patients with small to moderate size prostate. METHODS: We retrospectively reviewed the data of 224 patients with a preoperative prostate size =60 cm(3), who had undergone holmium laser enucleation of the prostate at our institution from March 1998 to February 2005. The patient characteristics, indications for surgery, preoperative and postoperative International Prostate Symptom Score, including quality-of-life score, peak urinary flow rate, postvoid residual urine volume, enucleation time, morcellation time, total energy used, enucleated tissue weight, catheterization time, hospital stay, pathologic examination findings, and complications were recorded. RESULTS: The mean prostate size was 43 +/- 11.1 cm(3), the mean operative time was 80 minutes, and the enucleated tissue weight was 24 g. The mean catheterization time and hospital stay was 1.2 and 1.4 days, respectively. No major intraoperative complications were encountered. Only 2 patients (0.9%), who were receiving anticoagulation therapy, required a postoperative blood transfusion. At 1 year postoperatively, the International Prostate Symptom Score had improved from 17.6 +/- 6.7 to 4.9 +/- 4.4 (72%), the quality-of-life score had improved from 3.5 +/- 1.3 to 1.2 +/- 1.3 (66%), the peak urinary flow rate had increased from 7.5 +/- 3.1 to 21.2 +/- 9.5 mL/s (183%), and the postvoid residual urine volume had decreased from 155 +/- 170 to 27 +/- 48 mL (83%). CONCLUSIONS: Holmium laser enucleation of the prostate is safe and effective treatment in patients with small to moderate size prostate as well as those with larger prostates, with low morbidity and a short catheterization time and hospital stay.