51
|
Abratenko P, An R, Anthony J, Arellano L, Asaadi J, Ashkenazi A, Balasubramanian S, Baller B, Barnes C, Barr G, Basque V, Bathe-Peters L, Benevides Rodrigues O, Berkman S, Bhanderi A, Bhat A, Bishai M, Blake A, Bolton T, Book JY, Camilleri L, Caratelli D, Caro Terrazas I, Cavanna F, Cerati G, Chen Y, Cianci D, Collin GH, Conrad JM, Convery M, Cooper-Troendle L, Crespo-Anadón JI, Del Tutto M, Dennis SR, Detje P, Devitt A, Diurba R, Dorrill R, Duffy K, Dytman S, Eberly B, Ereditato A, Escudero Sanchez L, Evans JJ, Fine R, Fiorentini Aguirre GA, Fitzpatrick RS, Fleming BT, Foppiani N, Franco D, Furmanski AP, Garcia-Gamez D, Gardiner S, Ge G, Genty V, Gollapinni S, Goodwin O, Gramellini E, Green P, Greenlee H, Gu W, Guenette R, Guzowski P, Hagaman L, Hen O, Hilgenberg C, Horton-Smith GA, Hourlier A, Itay R, James C, Ji X, Jiang L, Jo JH, Johnson RA, Jwa YJ, Kaleko D, Kalra D, Kamp N, Kaneshige N, Karagiorgi G, Ketchum W, Kirby M, Kobilarcik T, Kreslo I, LaZur R, Lepetic I, Li K, Li Y, Lin K, Lister A, Littlejohn BR, Louis WC, Luo X, Manivannan K, Mariani C, Marsden D, Marshall J, Martinez Caicedo DA, Mason K, Mastbaum A, McConkey N, Meddage V, Mettler T, Miller K, Mills J, Mistry K, Mogan A, Mohayai T, Moon J, Mooney M, Moor AF, Moore CD, Mora Lepin L, Mousseau J, Murphy M, Naples D, Navrer-Agasson A, Nebot-Guinot M, Neely RK, Newmark DA, Nowak J, Nunes M, Palamara O, Paolone V, Papadopoulou A, Papavassiliou V, Pate SF, Patel N, Paudel A, Pavlovic Z, Piasetzky E, Ponce-Pinto ID, Prince S, Qian X, Raaf JL, Radeka V, Rafique A, Reggiani-Guzzo M, Ren L, Rice LCJ, Rochester L, Rodriguez Rondon J, Rosenberg M, Ross-Lonergan M, Russell B, Scanavini G, Schmitz DW, Schukraft A, Seligman W, Shaevitz MH, Sharankova R, Shi J, Sinclair J, Smith A, Snider EL, Soderberg M, Söldner-Rembold S, Soleti SR, Spentzouris P, Spitz J, Stancari M, John JS, Strauss T, Sutton K, Sword-Fehlberg S, Szelc AM, Tang W, Terao K, Thomson M, Thorpe C, Totani D, Toups M, Tsai YT, Uchida MA, Usher T, Van De Pontseele W, Viren B, Weber M, Wei H, Williams Z, Wolbers S, Wongjirad T, Wospakrik M, Wresilo K, Wright N, Wu W, Yandel E, Yang T, Yarbrough G, Yates LE, Yu HW, Zeller GP, Zennamo J, Zhang C. Search for an Excess of Electron Neutrino Interactions in MicroBooNE Using Multiple Final-State Topologies. PHYSICAL REVIEW LETTERS 2022; 128:241801. [PMID: 35776450 DOI: 10.1103/physrevlett.128.241801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 04/13/2022] [Indexed: 06/15/2023]
Abstract
We present a measurement of ν_{e} interactions from the Fermilab Booster Neutrino Beam using the MicroBooNE liquid argon time projection chamber to address the nature of the excess of low energy interactions observed by the MiniBooNE Collaboration. Three independent ν_{e} searches are performed across multiple single electron final states, including an exclusive search for two-body scattering events with a single proton, a semi-inclusive search for pionless events, and a fully inclusive search for events containing all hadronic final states. With differing signal topologies, statistics, backgrounds, reconstruction algorithms, and analysis approaches, the results are found to be either consistent with or modestly lower than the nominal ν_{e} rate expectations from the Booster Neutrino Beam and no excess of ν_{e} events is observed.
Collapse
|
52
|
Patel N, Teh W, Omoniyi O, Martin W, Weir-McCall J, D’Errico L, O’Sullivan M, Davies W, Costopoulos C, Costanzo P. 1069 ESSENTIAL FRAILTY TOOLSET AS A PREDICTOR OF PROLONGED LENGTH OF STAY AND DISCHARGE DESTINATION AFTER TRANSCATHETER AORTIC VALVE IMPLANTATION. Age Ageing 2022. [DOI: 10.1093/ageing/afac125.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Frailty is associated with poor outcomes following transcatheter aortic valve implantation (TAVI). Rockwood is the widely used score for this population. In a recent trial, a more objective score, the Essential Frailty Toolset (EFT) outperformed Rockwood’s in predicting mortality and disability 1-year post-TAVI. Whether it predicts in-hospital length of stay (LOS) and discharge destination post-TAVI remains unclear.
Method
A cohort of patients undergoing TAVI for aortic stenosis was recruited, demographic characteristics collected, and frailty assessed with EFT and Rockwood scores. Primary outcomes were LOS post-TAVI, categorised as ‘not prolonged’ (≤2 days) or ‘prolonged’ (>2 days) and discharge destination, characterised as ‘home’ or ‘non-home’.
Results
86 patients were recruited, with median age 82 years (IQR 78–86). 54% were male. EFT identified 35% and Rockwood 11% as frail. 19% were cognitively impaired. 5 chair rises were completed by 70%, with 30% managing under 15 seconds. Median haemoglobin was 121 g/L (IQR 109.5–136). Median albumin was 36 g/L (IQR 33–39). 84% of procedures were transfemoral. 20% had moderate–severe left ventricular systolic dysfunction. Median LOS post-TAVI was 2 days (IQR 2–5). 94% were discharged home, 6% to referring local hospital or rehabilitation centre. 46% were NYHA class III-IV. A model for prolonged LOS including comorbidities, showed frailty determined by EFT (OR 4.80, CI 95% 1.52–15.2, p = 0.008) but not Rockwood (OR 5.00, CI 95% 0.865–29.0, p = 0.072) was the only significant independent predictor for prolonged LOS. A model adjusting for comorbidities also showed EFT to be an independent predictor for non-home discharge destination of borderline significance (OR 2.57 CI 95% 0.994–6.66, p = 0.051) but Rockwood was not (OR 1.38 CI95% 0.485–3.91, p = 0.548).
Conclusion
In a real-world elderly population, EFT score was a stronger, more independent predictor of prolonged LOS and non-home discharge post-TAVI, than Rockwood’s. EFT would be an effective pre-operative assessment tool for LOS and discharge destination for TAVI.
Collapse
|
53
|
Patel N, Chandrashekhar R. Expression of MMP2, MMP9 and PGP 9.5 in human aorta in patients with coronary artery disease. Cardiovasc Res 2022. [DOI: 10.1093/cvr/cvac066.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Atherosclerosis has been recognised as inflammatory conditions which involves activation of MMPs of which increased MMP2 & MMP9 expression has been correlated with the development of human aortic plaques.The Sympathetic Nervous System exerts complex control over inflammation in atherosclerosis both: on systemic scale and at the regional level.Protein gene product9.5 (PGP9.5) is a cytoplasmic neuron & is a reliable marker for visualisation of the cardiovascular system innervation.There have been no studies in the existing literature on the expression of PGP 9.5 and MMP2, MMP9 on human aorta.Aim:To study the expression of MMP2, MMP9 and PGP9.5 in the human aorta & gain insights into atherosclerosis & neural modulation in the aorta.Materials &
Methods
This is a single centre, prospective cohort, pilot study with a sample size of 87 patients,done over 2 years at AIMS,Kochi.During CABG, punch biopsy of the aorta taken & processed.One paraffin embedded section used for routine H&E staining & others used for IHC.IHC detection kits use 3, 3’-DABChromogen as a substrate of HRP for visualisation of antigenic structures in the tissues.Positive & negative control tissue were run for all 3 Antibodies.Interpretation done as Diffuse/Focal & Intense/Moderate/ Weak classification based on intensity signals observed on IHC by an experienced Cardiac Pathologist.Results:7 Controls with well matched baseline characteristics: Controls-Aorta samples taken from patients who were undergoing Aortic Valve Surgery for Aortic Valve disease with normal coronaries documented on a coronary angiogram.65.9% of patients with Positive MMP2 & 28.6 % of patients in the Control group was found to have significant difference when compared to positive & negative outcomes amongst the 2 groups.89.3% of patients with positive MMP2 had significant co-relation with PGP9.5 levels expressed in the same specimen analysed.MMP9 also had a p value of 0.002 suggesting a significant co-relation between MMP9 & PGP9.5.Statistically significant Co-relation seen between the Age, CRP & the levels of MMP 9 expressed in the Aorta observed.MMP2 & MMP9 expression have a definite & significant co-expression with PGP9.5 expression in human aorta,suggesting a novel marker of neuromodulation in atherosclerotic process in human aorta.
Expression of MMP2, MMP9 and PGP 9.5 in human aorta in patients with coronary artery disease
Collapse
|
54
|
Patel SK, Patel RN, Patel AK, Patel N, Choquesillo-Lazarte D. Copper hydrazone complexes with different nuclearties and geometries: Synthesis, characterization, single crystal structures, Hirshfeld analysis and superoxide dismutase mimetic activities. J Mol Struct 2022. [DOI: 10.1016/j.molstruc.2022.132545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
55
|
DI Iorio M, Cook C, Vanni K, Patel N, D’silva K, Fu X, Wang J, Prisco L, Kowalski E, Zaccardelli A, Martin L, Qian G, Hsu T, Wallace Z, Sparks J. POS1234 DMARD DISRUPTION, INCREASED DISEASE ACTIVITY, AND PROLONGED SYMPTOM DURATION AFTER ACUTE COVID-19 AMONG PATIENTS WITH RHEUMATIC DISEASE: A PROSPECTIVE STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundSystemic autoimmune rheumatic disease (SARD) patients may be at risk for disease flare and prolonged symptom duration after COVID-19, perhaps related to DMARD disruption and immune activation.ObjectivesTo describe DMARD disruption and identify differences in SARD activity among patients with and without prolonged COVID-19 symptom duration.MethodsWe identified all SARD patients with confirmed COVID-19 at the Mass General Brigham healthcare system in Boston, USA; prospective recruitment is ongoing. Surveys were used to collect demographics, clinical characteristics, DMARD disruption, COVID-19 course, and SARD disease activity before and after COVID-19. The survey included validated instruments measuring disease activity, pain, fatigue, functional status, and respiratory quality of life. Prolonged symptom duration was defined as COVID-19 symptoms lasting ≥28 days. We compared differences in patient-reported measures between those with and without prolonged symptoms.ResultsWe analyzed survey responses from 174 COVID-19 survivors with SARDs (mean age 52±16 years, 81% female, 80% White). The most common SARDs were RA (40%) and SLE (14%). Fifty-one percent of the 127 respondents on any DMARD reported a disruption to their regimen at COVID-19 onset (Figure 1). Among individual DMARDs, 56-77% were reported to have any change, except for hydroxychloroquine (23%) and rituximab (46%). SARD flare after COVID-19 was reported by 41% of respondents (Table 1). Patient global assessment of SARD activity was worse after COVID-19 (mean 7.6±2.3 before vs. 6.6±2.9 after COVID-19, p<0.001). Prolonged symptom duration was reported by 45% of participants. Those with prolonged symptoms had a higher initial COVID-19 symptom count (median 7 vs. 4, p<0.001) and were more likely to be hospitalized for COVID-19 (28% vs. 17%, p=0.001). Respondents experiencing prolonged symptom duration had higher disease activity on RAPID3 (p=0.007) as well as more pain (p<0.001) and fatigue (p=0.03) compared to those without prolonged symptoms.Table 1.Acute COVID-19 course, SARD flare/activity, and patient-reported outcomes among COVID-19 survivors with SARDs.All COVID-19 survivors with SARDs (n=174)Prolonged symptom duration ≥28 days (n=78)No prolonged symptom duration/(n=96)p-value (prolonged vs. not)Acute COVID-19 courseCOVID-19 symptom duration, days, median [IQR]14 [9, 29]46 [30, 65]11 [7, 14]<0.0001Initial symptom count, median [IQR]6 [3, 8]7 [6, 9]4 [2, 7]<0.001Hospitalized, n (%)38 (22)22 (28)16 (17)0.001SARD flare/activitySelf-reported SARD flare after COVID-19, n (%)71 (41)38 (49)33 (34)0.15Disease activity by RAPID3, median [IQR]9 [4, 14]11.2 [6, 16]7 [3, 13]0.0067RAPID3 categorical score, n (%)0.13Remission (0)11 (7)4 (5)7 (7)Near remission (0.3-1.0)23 (14)5 (7)18 (19)Low severity (1.3-2.0)26 (15)10 (14)16 (17)Moderate severity (2.3-4.0)55 (33)27 (36)28 (29)High severity (4.3-10.0)54 (32)28 (38)26 (27)Patient-reported outcomesPain by SF-MPQ, median [IQR]2 [1, 2]2 [1, 2]1 [0, 2]0.0008Fatigue by FSI, median [IQR]53 [27, 84]66 [31, 91.5]43 [26, 76]0.031mHAQ, median [IQR]0.125 [0, 0.38]0.25 [0, 0.75]0.125 [0, 0.38]0.11Respiratory quality of life by SGRQ, global [IQR]15 [4, 29]16 [4, 36]10 [4, 26]0.49RAPID3, Routine Assessment of Patient Index Data 3; SF-MPQ, Short-form McGill Pain Questionnaire; FSI, Fatigue Symptom Inventory; mHAQ, modified Health Assessment Questionnaire; SGRQ, Saint George’s Respiratory Questionnaire.Figure 1.Frequency of baseline DMARD use and proportion with any disruption at COVID-19 onset.ConclusionDMARD disruption, SARD flare, and prolonged symptoms were common in this prospective study of COVID-19 survivors with SARDs. Those with prolonged COVID-19 symptom duration, defined as ≥28 days, had higher SARD activity, more pain, and more fatigue compared to those without prolonged symptoms. These findings suggest that post-acute sequelae of COVID-19 may have a large impact on underlying SARD activity and quality of life.Disclosure of InterestsMichael Di Iorio: None declared, Claire Cook: None declared, Kathleen Vanni: None declared, Naomi Patel Consultant of: Receives consulting fees from FVC Health unrelated to this work., Kristin D’Silva: None declared, Xiaoqing Fu: None declared, Jiaqi Wang: None declared, Lauren Prisco: None declared, Emily Kowalski: None declared, Alessandra Zaccardelli: None declared, Lily Martin: None declared, Grace Qian: None declared, Tiffany Hsu: None declared, Zachary Wallace Consultant of: Receives consulting fees from Viela Bio, Zenas BioPharma, and MedPace unrelated to this work., Grant/research support from: Receives research support from Bristol-Myers Squibb and Principia/Sanofi., Jeffrey Sparks Consultant of: Receives consultant fees from AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Gilead, Inova Diagnostics, Janssen, Optum, and Pfizer unrelated to this work., Grant/research support from: Receives research support from Bristol Myers Squibb.
Collapse
|
56
|
Patel N, Zhang Y, Jayne D, Merkel PA, Yue H, Bekker P, Stone JH. POS0833 DIFFERENCES BETWEEN AVACOPAN AND PREDNISONE FOR THE TREATMENT OF ANCA-ASSOCIATED VASCULITIS AT DIFFERENT THRESHOLDS OF GLUCOCORTICOID TOXICITY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundTreatment with glucocorticoids (GCs) for ANCA-associated vasculitis (AAV) is associated with substantial toxicity. The Glucocorticoid Toxicity Index (GTI) was developed to measure change in GC toxicity over time.1 Data from the composite GTI domains provide both an Aggregate Improvement Score (AIS) and a Cumulative Worsening Score (CWS) of GC toxicity, permitting the instrument to compare both improvement and worsening of GC toxicity across treatment groups. The GTI was a pre-specified secondary outcome in ADVOCATE, a randomized, double-blind, placebo-controlled trial in patients with AAV that aimed to replace a GC taper with avacopan, a complement C5a receptor inhibitor. Patients were randomized to either avacopan or a prednisone taper on a background of either cyclophosphamide or rituximab.2 In ADVOCATE, the median GC exposure was 400 mg vs. 2939 mg in the avacopan and prednisone groups, respectively, which is an 86% median reduction in GC exposure from all sources. Remission rates were comparable in the two groups at 26 weeks (72.3% vs. 70.1%, respectively), and avacopan was superior at 52 weeks (sustained remission in 65.7% vs. 54.9%).2ObjectivesTo compare GC toxicity between the treatment groups at three different thresholds of GC toxicity, beginning with the minimum detectable difference (MDD) of the GTI.MethodsThe MDD for the GTI (10 points) was calculated in the initial validation phase of the instrument. Thus, any GTI score > 10 points may be considered to represent a true change in GC toxicity. We compared the two groups at GTI thresholds of 10, 20, and 30 points for both the CWS and AIS. The CWS comprises a total of all GC-related toxicities that have occurred in the GTI between baseline and 26 weeks (time of primary outcome). The AIS, in contrast, allows toxicities to be added if they are new or subtracted if they improve. Higher CWS and AIS values indicate greater severity of GC toxicity. The two scores together capture the nuances of longitudinal GC toxicity across multiple domains. We compared the percentages of those in the two treatment groups who exceeded GTI threshold values of 10, 20, and 30 points in the CWS or AIS.ResultsThe percentages of patients exceeding the specified AIS thresholds differentiated the avacopan group from the prednisone group (48.2% vs. 60.4%, respectively, at the 10-point threshold, p=0.02; 29.5% vs. 45.1% at the 20-point threshold, p=0.003; and 18.1% vs. 33.5% at the 30-point threshold, p=0.001) (Table 1). The CWS differentiated avacopan from prednisone at the 20- and 30-point thresholds (57.8% vs 73.2%, respectively, at 20 points, p=0.002; 41.0% vs 55.5% at 30 points, p=0.007).Table 1.Percentages of Patients in ADVOCATE Exceeding Selected GTI Thresholds at Week 26GTI threshold/study groupn (%) exceeding CWS thresholdp-valuen (%) exceeding AIS thresholdp-valueGTI worsening > 10 points Avacopan (N = 164)138 (83.1%)0.14780 (48.2%)0.022 Prednisone (N = 166)144 (87.8%)99 (60.4%)GTI worsening > 20 points Avacopan (N = 164)96 (57.8%)0.00249 (29.5%)0.003 Prednisone (N = 166)120 (73.2%)74 (45.1%)GTI worsening > 30 points Avacopan (N = 164)68 (41.0%)0.00730 (18.1%)0.001 Prednisone (N = 166)91 (55.5%)55 (33.5%)AIS, Aggregate Improvement Score; CWS, Cumulative Worsening Score; GTI, Glucocorticoid Toxicity IndexConclusionAmong patients with AAV, treatment with avacopan was associated with lower GC toxicity across multiple GTI thresholds compared to treatment with prednisone, consistent with the substantial reduction in total GC exposure associated with avacopan. The GTI scores differentiated the two treatment groups effectively through a composite of GC toxicity domains.References[1]McDowell PJ, Stone JH, Zhang Y, et al. Quantification of Glucocorticoid-Associated Morbidity in Severe Asthma Using the Glucocorticoid Toxicity Index. J Allergy Clin Immunol Pract. 2021; 9:365-72.[2]Jayne DRW, Merkel PA, Schall TJ, et al. Avacopan for the Treatment of ANCA-Associated Vasculitis. N Engl J Med. 2021;384:599-609.Disclosure of InterestsNaomi Patel: None declared, Yuqing Zhang: None declared, David Jayne Speakers bureau: Amgen, Vifor, Consultant of: Astra-Zeneca, BMS, Boehringer-Ingelheim, Chemocentryx, GSK, Novartis, Otsuka, Roche/Genentech, Takeda, UCB & Vifor, Grant/research support from: GSK, Roche/Genentech, Peter A Merkel Consultant of: AbbVie, AstraZeneca, Boeringher-Ingelheim, Bristol-Myers Squibb, ChemoCentryx, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, Immagene, InflaRx, Jannsen, Kiniksa, Kyverna, Magenta, MiroBio, Novartis, Pfizer, Regeneron, Sparrow, Takeda, Talaris, Grant/research support from: AbbVie, AstraZeneca, Boeringher-Ingelheim, Bristol-Myers Squibb, ChemoCentryx, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, InflaRx, Sanofi, Takeda, Huibin Yue Shareholder of: ChemoCentryx, Employee of: ChemoCentryx, Pirow Bekker Shareholder of: ChemoCentryx, Consultant of: ChemoCentryx, Employee of: ChemoCentryx, John H. Stone Shareholder of: Steritas, Consultant of: ChemoCentryx, Roche/Genentech, Sanofi, Bristol-Myers Squib, AbbVie, InflaRx, Kyverna, Novartis, Q32Bio, Zenas, Horizon, Grant/research support from: Roche/Genentech, Horizon, Sanofi, Bristol-Myers Squib
Collapse
|
57
|
Gilbert E, Figueroa-Parra G, Valenzuela-Almada M, Vallejo S, Neville MR, Patel N, Cook C, Fu X, Hagi R, McDermott G, Di Iorio M, Masto L, Vanni K, Kowalski E, Qian G, Wallace Z, Duarte-Garcia A, Sparks J. OP0251 IMPACT OF INTERSTITIAL LUNG DISEASE ON SEVERE COVID-19 OUTCOMES FOR PATIENTS WITH RHEUMATOID ARTHRITIS: A MULTICENTER STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundRA has been associated with poor COVID-19 outcomes, but few studies have investigated outcomes in RA features such as interstitial lung disease.ObjectivesTo assess COVID-19 outcomes in patients with RA overall, and those with and without ILD, compared to general population comparators.MethodsA multicenter, retrospective cohort study was conducted at Mayo Clinic (19 hospitals and affiliated outpatient centers in 4 states) and Mass General Brigham (14 hospitals and affiliated outpatient centers in New England). Consecutive patients with RA meeting ACR/EULAR criteria and a positive COVID-19 test from March 1, 2020 through June 6, 2021 were matched 1:5 on age, sex, race, and COVID-19 test date with general population comparators without RA. RA features assessed included: RA-ILD per Bongartz criteria [1], duration, rheumatoid factor (RF), cyclic citrullinated peptide antibody (CCP), bone erosions, and treatments. The primary outcome was a composite of hospitalization or death following COVID-19 diagnosis. We used multivariable Cox regression to investigate the association of RA, and features such as ILD, with COVID-19 outcomes compared to matched comparators.ResultsWe analyzed 582 patients with RA and 2892 comparators without RA, all with COVID-19. Mean age was 62 years, 51% were female, and 79% were White. Mean RA duration was 11 years, 67% were seropositive (52% RF+ and 54% CCP+), 27% had bone erosions, 28% were on steroids, and 79% were on DMARDs. 50/582 (9%) patients with RA had ILD.The COVID-19 hospitalization or death rate for RA patients was higher than comparators (3.0 per 1,000 days [95% CI 2.5-3.6] vs. 1.9 per 1,000 days [95% CI 1.7-2.1], respectively). Overall, RA patients had a 53% higher risk of hospitalization or death than comparators after adjustment (95% CI 1.20-1.94).Among those with RA-ILD, the hospitalization or death rate was significantly higher than comparators (10.9 [95% CI 6.7-15.2] vs. 2.5 per 1,000 days [1.8-3.2], respectively). RA-ILD was associated with nearly 3-fold higher risk for hospitalization or death than comparators (multivariable HR 2.84 [95% CI 1.64-4.91], Table 1). There was a significant interaction between RA/comparator status and presence/absence of ILD for risk of severe COVID-19 (p<0.001, Figure 1). The elevated risk for severe COVID-19 was similar for RA subgroups defined by serostatus or bone erosions.Table 1.Frequencies, proportions, and hazard ratios for COVID-19 outcomes, comparing all RA patients, and subgroups with or without RA-ILD, to matched comparators.COVID-19 OutcomesAll RA Patients (n=582)RA-ILD (n=50)RA Patients without ILD (n=532)Comparators (n=2,892)Hospitalization, n (%)121 (21)24 (48)97 (18)402 (14)Unadjusted HR (95% CI)1.58 (1.27, 1.96)2.65 (1.71, 4.09)1.43 (1.12, 1.82)Ref.Adjusted* HR (95% CI)1.45 (1.14, 1.83)2.35 (1.38, 4.00)1.31 (1.00, 1.70)Ref.Death, n (%)26 (4)9 (18)17 (3)63 (2)Unadjusted HR (95% CI)1.72 (0.98, 3.01)5.88 (2.07, 16.71)1.13 (0.56, 2.29)Ref.Adjusted* HR (95% CI)1.24 (0.66, 2.32)13.94 (4.30, 45.18)0.75 (0.35, 1.63)Ref.Hospitalization or death, n (%)126 (22)25 (50)101 (19)419 (14)Unadjusted HR (95% CI)1.66 (1.33, 2.07)3.01 (1.93, 4.70)1.47 (1.14, 1.89)Ref.Adjusted* HR (95% CI)1.53 (1.20, 1.94)2.84 (1.64, 4.91)1.34 (1.02, 1.77)Ref.*Adjusted for age, sex, race, and smokingFigure 1.Multivariable hazard ratios for the composite outcome of hospitalization or death from COVID-19, comparing all RA and subgroups by serostatus, bone erosions, and ILD to matched comparators without RA.ConclusionWe confirmed that RA was associated with severe COVID-19 outcomes compared to the general population. We found evidence that ILD may be an effect modifier for the relationship between RA and severe COVID-19 outcomes, but RA subgroups defined by serostatus and bone erosions had similarly elevated risk. These findings suggest that ILD or its treatment may be a major contributor to severe COVID-19 outcomes in RA.References[1]Bongartz, T, et al, Arthritis Rheum. 2010 Jun;62(6):1583-91.Disclosure of InterestsNone declared
Collapse
|
58
|
Ralli GP, Carter RD, McGowan DR, Cheng WC, Liu D, Teoh EJ, Patel N, Gleeson F, Harris AL, Lord SR, Buffa FM, Fenwick JD. Radiogenomic analysis of primary breast cancer reveals [18F]-fluorodeoxglucose dynamic flux-constants are positively associated with immune pathways and outperform static uptake measures in associating with glucose metabolism. Breast Cancer Res 2022; 24:34. [PMID: 35581637 PMCID: PMC9115966 DOI: 10.1186/s13058-022-01529-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 05/11/2022] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND PET imaging of 18F-fluorodeoxygucose (FDG) is used widely for tumour staging and assessment of treatment response, but the biology associated with FDG uptake is still not fully elucidated. We therefore carried out gene set enrichment analyses (GSEA) of RNA sequencing data to find KEGG pathways associated with FDG uptake in primary breast cancers. METHODS Pre-treatment data were analysed from a window-of-opportunity study in which 30 patients underwent static and dynamic FDG-PET and tumour biopsy. Kinetic models were fitted to dynamic images, and GSEA was performed for enrichment scores reflecting Pearson and Spearman coefficients of correlations between gene expression and imaging. RESULTS A total of 38 pathways were associated with kinetic model flux-constants or static measures of FDG uptake, all positively. The associated pathways included glycolysis/gluconeogenesis ('GLYC-GLUC') which mediates FDG uptake and was associated with model flux-constants but not with static uptake measures, and 28 pathways related to immune-response or inflammation. More pathways, 32, were associated with the flux-constant K of the simple Patlak model than with any other imaging index. Numbers of pathways categorised as being associated with individual micro-parameters of the kinetic models were substantially fewer than numbers associated with flux-constants, and lay around levels expected by chance. CONCLUSIONS In pre-treatment images GLYC-GLUC was associated with FDG kinetic flux-constants including Patlak K, but not with static uptake measures. Immune-related pathways were associated with flux-constants and static uptake. Patlak K was associated with more pathways than were the flux-constants of more complex kinetic models. On the basis of these results Patlak analysis of dynamic FDG-PET scans is advantageous, compared to other kinetic analyses or static imaging, in studies seeking to infer tumour-to-tumour differences in biology from differences in imaging. Trial registration NCT01266486, December 24th 2010.
Collapse
|
59
|
Ardana I, Smith E, Maldonado V, Patel N, Pokharel S, Samsonraj R. Mesenchymal Stem/Stromal Cells: VALIDATION OF NOVEL GENOMIC BIOMARKER OF MESENCHYMAL STROMAL CELL SCALABILITY AND CORRELATIVE STUDIES ON SENESCENCE PHENOTYPES USEFUL FOR ALLOGENEIC CELL MANUFACTURING. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00234-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
60
|
Abratenko P, An R, Anthony J, Arellano L, Asaadi J, Ashkenazi A, Balasubramanian S, Baller B, Barnes C, Barr G, Basque V, Bathe-Peters L, Benevides Rodrigues O, Berkman S, Bhanderi A, Bhat A, Bishai M, Blake A, Bolton T, Book JY, Camilleri L, Caratelli D, Caro Terrazas I, Cavanna F, Cerati G, Chen Y, Cianci D, Conrad JM, Convery M, Cooper-Troendle L, Crespo-Anadón JI, Del Tutto M, Dennis SR, Detje P, Devitt A, Diurba R, Dorrill R, Duffy K, Dytman S, Eberly B, Ereditato A, Evans JJ, Fine R, Fiorentini Aguirre GA, Fitzpatrick RS, Fleming BT, Foppiani N, Franco D, Furmanski AP, Garcia-Gamez D, Gardiner S, Ge G, Gollapinni S, Goodwin O, Gramellini E, Green P, Greenlee H, Gu W, Guenette R, Guzowski P, Hagaman L, Hen O, Hilgenberg C, Horton-Smith GA, Hourlier A, Itay R, James C, Ji X, Jiang L, Jo JH, Johnson RA, Jwa YJ, Kalra D, Kamp N, Kaneshige N, Karagiorgi G, Ketchum W, Kirby M, Kobilarcik T, Kreslo I, Lepetic I, Li K, Li Y, Lin K, Littlejohn BR, Louis WC, Luo X, Manivannan K, Mariani C, Marsden D, Marshall J, Martinez Caicedo DA, Mason K, Mastbaum A, McConkey N, Meddage V, Mettler T, Miller K, Mills J, Mistry K, Mogan A, Mohayai T, Moon J, Mooney M, Moor AF, Moore CD, Mora Lepin L, Mousseau J, Murphy M, Naples D, Navrer-Agasson A, Nebot-Guinot M, Neely RK, Newmark DA, Nowak J, Nunes M, Palamara O, Paolone V, Papadopoulou A, Papavassiliou V, Pate SF, Patel N, Paudel A, Pavlovic Z, Piasetzky E, Ponce-Pinto ID, Prince S, Qian X, Raaf JL, Radeka V, Rafique A, Reggiani-Guzzo M, Ren L, Rice LCJ, Rochester L, Rodriguez Rondon J, Rosenberg M, Ross-Lonergan M, Scanavini G, Schmitz DW, Schukraft A, Seligman W, Shaevitz MH, Sharankova R, Shi J, Sinclair J, Smith A, Snider EL, Soderberg M, Söldner-Rembold S, Spentzouris P, Spitz J, Stancari M, John JS, Strauss T, Sutton K, Sword-Fehlberg S, Szelc AM, Tang W, Terao K, Thorpe C, Totani D, Toups M, Tsai YT, Uchida MA, Usher T, Van De Pontseele W, Viren B, Weber M, Wei H, Williams Z, Wolbers S, Wongjirad T, Wospakrik M, Wresilo K, Wright N, Wu W, Yandel E, Yang T, Yarbrough G, Yates LE, Yu HW, Zeller GP, Zennamo J, Zhang C. First Measurement of Energy-Dependent Inclusive Muon Neutrino Charged-Current Cross Sections on Argon with the MicroBooNE Detector. PHYSICAL REVIEW LETTERS 2022; 128:151801. [PMID: 35499871 DOI: 10.1103/physrevlett.128.151801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 03/09/2022] [Indexed: 06/14/2023]
Abstract
We report a measurement of the energy-dependent total charged-current cross section σ(E_{ν}) for inclusive muon neutrinos scattering on argon, as well as measurements of flux-averaged differential cross sections as a function of muon energy and hadronic energy transfer (ν). Data corresponding to 5.3×10^{19} protons on target of exposure were collected using the MicroBooNE liquid argon time projection chamber located in the Fermilab booster neutrino beam with a mean neutrino energy of approximately 0.8 GeV. The mapping between the true neutrino energy E_{ν} and reconstructed neutrino energy E_{ν}^{rec} and between the energy transfer ν and reconstructed hadronic energy E_{had}^{rec} are validated by comparing the data and Monte Carlo (MC) predictions. In particular, the modeling of the missing hadronic energy and its associated uncertainties are verified by a new method that compares the E_{had}^{rec} distributions between data and a MC prediction after constraining the reconstructed muon kinematic distributions, energy, and polar angle to those of data. The success of this validation gives confidence that the missing energy in the MicroBooNE detector is well modeled and underpins first-time measurements of both the total cross section σ(E_{ν}) and the differential cross section dσ/dν on argon.
Collapse
|
61
|
Singer-Englar T, Patel J, Kittleson M, Chang D, Patel N, Kim S, Azarbal B, Emerson D, Czer L, Kobashigawa J. Does the Degree of Diastolic Dysfunction in the First Year After Heart Transplant Affect Subsequent Outcomes? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
62
|
Kransdorf E, Patel J, Kittleson M, Singer-Englar T, Patel N, Ravellette K, Kim S, Geft D, Czer L, Esmailian F, Kobashigawa J. The Effects of Hypomagnesemia Post Heart Transplantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
63
|
Chen Q, Patel N, Emerson D, Kim S, Megna D, Catarino P, Singer-Englar T, Kittleson M, Patel J, Kobashigawa J, Esmailian F. Outcomes of Heart Re-Transplantation with Combined Kidney Transplant. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
64
|
Kittleson M, Patel J, Kransdorf E, Singer-Englar T, Patel N, Rubio M, Musto N, Hamilton M, Emerson D, Czer L, Kobashigawa J. Are Markedly Oversized Donor Hearts Associated with Poor Outcome After Heart Transplantation? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
65
|
Kittleson M, Patel J, Chang D, Patel N, Singer-Englar T, Oda M, Azarbal B, Trento A, Czer L, Kobashigawa J. Is Sacubitril/Valsartan a Risk Factor for Vasoplegia/Primary Graft Dysfunction After Heart Transplantation? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
66
|
Dhillon M, Patel J, Kittleson M, Chang D, Patel N, Singer-Englar T, Hamilton M, Czer L, Megna D, Kobashigawa J. Experience with Eculizumab in Highly Sensitized Patients Undergoing Heart Transplantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
67
|
Jamero G, Patel J, Kittleson M, Singer-Englar T, Patel N, Kim S, Nikolova A, Esmailian F, Czer L, Kobashigawa J. What is the Meaning of Culture Negative Leukocytosis Immediately After Heart Transplantation? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
68
|
Velleca A, Kittleson M, Patel J, Singer-Englar T, Patel N, Washington C, Jamero G, Czer L, Esmailian F, Zakowski P, Kobashigawa J. COVID Pandemic and Social Mitigations Decrease Hospitalizations for Heart Transplant Patients. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
69
|
Chang D, Patel J, Kittleson M, Patel N, Singer-Englar T, Kim S, Emerson D, Zabner R, Zakowski P, Kobashigawa J. Is Donor/Recipient Cytomegalovirus Mismatch Truly Associated with Increased Risk for Cardiac Allograft Vasculopathy in the Current Era? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
70
|
Allison Z, Kittleson M, Patel J, Kransdorf E, Singer-Englar T, Patel N, Geft D, Azarbal B, Czer L, Esmailian F, Kobashigawa J. Is Delayed Graft Function Worse in Simultaneous Heart-Kidney Transplant vs Kidney Transplant Alone? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
71
|
Patel J, Kittleson M, Kransdorf E, Patel N, Singer-Englar T, Hu J, Kim S, Trento A, Czer L, Kobashigawa J. Are Calcineurin Inhibitor-Free Protocols Safe and Effective in the Long-Term After Heart Transplant? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
72
|
Patel J, Kittleson M, Kransdorf E, Singer-Englar T, Patel N, Kim S, Hage A, Hamilton M, Czer L, Kobashigawa J. Treatment and Outcome of AL Amyloid After Heart Transplantation: Is It Viable? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
73
|
Cole R, Moriguchi J, Kittleson M, Patel J, Chang D, Patel N, Singer-Englar T, Azarbal B, Emerson D, Czer L, Kobashigawa J. Do Temporary Mechanical Circulatory Support Devices Activate Sensitization Pathways in Patients Awaiting Heart Transplantation? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
74
|
Kittleson M, Patel J, Chang D, Singer-Englar T, Patel N, Mishalani L, Kim S, Ramzy D, Czer L, Kobashigawa J. Who is at Risk for Seizures After Heart Transplantation? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
75
|
Deen J, Patel J, Kittleson M, Chang D, Singer-Englar T, Patel N, Nikolova A, Ramzy D, Czer L, Kobashigawa J. Efficacy of Tocilizumab for Refractory Sensitized Patients Awaiting Heart Transplantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
76
|
Kittleson M, Patel J, Chang D, Patel N, Singer-Englar T, Sindha I, Truong M, Hage A, Ramzy D, Czer L, Kobashigawa J. Sex Disparities in Heart Transplant Waitlist Status After the Donor Heart Allocation Policy Change. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
77
|
Kittleson M, Patel J, Chang D, Singer-Englar T, Patel N, Velleca A, Czer L, Kobashigawa J, Zabner R, Zakowski P. The Outcome of West Nile Virus Infection After Heart Transplantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
78
|
Federico L, Courtwright A, Kamoun M, Molina M, Diamond J, Ahya V, Christie J, Clausen E, Hadjiliadis D, Patel N, Salgado J, Cevasco M, Cantu E, Crespo M, Bermudez C. Change in Panel Reactive Antibodies in Patients Bridged to Lung Transplantation with Extracorporeal Membrane Oxygenation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
79
|
Patel N, Kittleson M, Patel J, Singer-Englar T, Chang D, Hage A, Azarbal B, Czer L, Esmailian F, Kobashigawa J. Is ATG Induction with Delayed Initiation of CNI Protective of Renal Function in Patients with Mild Renal Insufficiency? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
80
|
Emerson D, Patel N, Singer-Englar T, Megna D, Catarino P, Ramzy D, Moriguchi J, Cole R, Chikwe J, Kobashigawa J, Esmailian F. Complexities of Explanting Durable LVADs (Done at Outside Facilities) at the Time of Heart Transplant Surgery. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
81
|
Anjum F, Pishko A, Diamond J, Ahya V, Christie J, Clausen E, Hadjiliadis D, Patel N, Salgado J, Cevasco M, Cantu E, Crespo M, Bermudez C, Courtwright A. Antiphospholipid Antibodies and Outcomes Following Lung Transplantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
82
|
Kobashigawa J, Patel J, Kittleson M, Cole R, Patel N, Singer-Englar T, Runyan C, Geft D, Czer L, Esmailian F. Intra-Aortic Balloon Placement without Inotropes: A Shift in Practice for Higher Urgency Status for Patients Awaiting Heart Transplant? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
83
|
Chang D, Kittleson M, Patel J, Kransdorf E, Singer-Englar T, Patel N, Truong M, Nikolova A, Trento A, Czer L, Kobashigawa J. Do Women Truly Have Less Than Optimal Outcome Post-Heart Transplantation Compared to Men. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
84
|
Kim S, Chang D, Patel J, Kittleson M, Singer-Englar T, Patel N, Welton M, Megna D, Czer L, Kobashigawa J. ACEi Use in Select Patients Awaiting Heart Transplant May Be a Risk Factor for the Development of Primary Graft Dysfunction and Vasoplegia. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
85
|
Patel J, Kittleson M, Kransdorf E, Singer-Englar T, Patel N, Yamamoto N, Kim S, Hamilton M, Emerson D, Czer L, Kobashigawa J. Sex Differences in Desensitization for Patients Awaiting Heart Transplantation: Is There a Difference? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
86
|
Abratenko P, An R, Anthony J, Arellano L, Asaadi J, Ashkenazi A, Balasubramanian S, Baller B, Barnes C, Barr G, Basque V, Bathe-Peters L, Benevides Rodrigues O, Berkman S, Bhanderi A, Bhat A, Bishai M, Blake A, Bolton T, Book JY, Camilleri L, Caratelli D, Caro Terrazas I, Castillo Fernandez R, Cavanna F, Cerati G, Chen Y, Cianci D, Conrad JM, Convery M, Cooper-Troendle L, Crespo-Anadón JI, Del Tutto M, Dennis SR, Detje P, Devitt A, Diurba R, Dorrill R, Duffy K, Dytman S, Eberly B, Ereditato A, Evans JJ, Fine R, Fiorentini Aguirre GA, Fitzpatrick RS, Fleming BT, Foppiani N, Franco D, Furmanski AP, Garcia-Gamez D, Gardiner S, Ge G, Gollapinni S, Goodwin O, Gramellini E, Green P, Greenlee H, Gu W, Guenette R, Guzowski P, Hagaman L, Hen O, Hilgenberg C, Horton-Smith GA, Hourlier A, Itay R, James C, Ji X, Jiang L, Jo JH, Johnson RA, Jwa YJ, Kalra D, Kamp N, Kaneshige N, Karagiorgi G, Ketchum W, Kirby M, Kobilarcik T, Kreslo I, LaZur R, Lepetic I, Li K, Li Y, Lin K, Littlejohn BR, Louis WC, Luo X, Manivannan K, Mariani C, Marsden D, Marshall J, Martinez Caicedo DA, Mason K, Mastbaum A, McConkey N, Meddage V, Mettler T, Miller K, Mills J, Mistry K, Mogan A, Mohayai T, Moon J, Mooney M, Moor AF, Moore CD, Mora Lepin L, Mousseau J, Murphy M, Murrells R, Naples D, Navrer-Agasson A, Nebot-Guinot M, Neely RK, Newmark DA, Nowak J, Nunes M, Palamara O, Paolone V, Papadopoulou A, Papavassiliou V, Pate SF, Patel N, Paudel A, Pavlovic Z, Piasetzky E, Ponce-Pinto ID, Prince S, Qian X, Raaf JL, Radeka V, Rafique A, Reggiani-Guzzo M, Ren L, Rice LCJ, Rochester L, Rodriguez Rondon J, Rosenberg M, Ross-Lonergan M, Scanavini G, Schmitz DW, Schukraft A, Seligman W, Shaevitz MH, Sharankova R, Shi J, Sinclair J, Smith A, Snider EL, Soderberg M, Söldner-Rembold S, Spentzouris P, Spitz J, Stancari M, John JS, Strauss T, Sutton K, Sword-Fehlberg S, Szelc AM, Tang W, Terao K, Thorpe C, Totani D, Toups M, Tsai YT, Uchida MA, Usher T, Van De Pontseele W, Viren B, Weber M, Wei H, Williams Z, Wolbers S, Wongjirad T, Wospakrik M, Wresilo K, Wright N, Wu W, Yandel E, Yang T, Yarbrough G, Yates LE, Yu HW, Zeller GP, Zennamo J, Zhang C. Search for Neutrino-Induced Neutral-Current Δ Radiative Decay in MicroBooNE and a First Test of the MiniBooNE Low Energy Excess under a Single-Photon Hypothesis. PHYSICAL REVIEW LETTERS 2022; 128:111801. [PMID: 35363017 DOI: 10.1103/physrevlett.128.111801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 02/10/2022] [Indexed: 06/14/2023]
Abstract
We report results from a search for neutrino-induced neutral current (NC) resonant Δ(1232) baryon production followed by Δ radiative decay, with a ⟨0.8⟩ GeV neutrino beam. Data corresponding to MicroBooNE's first three years of operations (6.80×10^{20} protons on target) are used to select single-photon events with one or zero protons and without charged leptons in the final state (1γ1p and 1γ0p, respectively). The background is constrained via an in situ high-purity measurement of NC π^{0} events, made possible via dedicated 2γ1p and 2γ0p selections. A total of 16 and 153 events are observed for the 1γ1p and 1γ0p selections, respectively, compared to a constrained background prediction of 20.5±3.65(syst) and 145.1±13.8(syst) events. The data lead to a bound on an anomalous enhancement of the normalization of NC Δ radiative decay of less than 2.3 times the predicted nominal rate for this process at the 90% confidence level (C.L.). The measurement disfavors a candidate photon interpretation of the MiniBooNE low-energy excess as a factor of 3.18 times the nominal NC Δ radiative decay rate at the 94.8% C.L., in favor of the nominal prediction, and represents a greater than 50-fold improvement over the world's best limit on single-photon production in NC interactions in the sub-GeV neutrino energy range.
Collapse
|
87
|
Patel AK, Patel N, Jadeja RN, Patel SK, Patel RN, Kumar S, Kapavarapu R. Interaction of pseudohalides copper(II) complexes of hydrazide ligand with DNA: synthesis, spectral characterization, molecular docking simulations and superoxide dismutase activity. INORG NANO-MET CHEM 2022. [DOI: 10.1080/24701556.2022.2050755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
88
|
Ramsay I, Patel N, Peat N, Jones G. The South-East London community head and neck cancer team audit of the altered airway service. Physiotherapy 2022. [DOI: 10.1016/j.physio.2021.12.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
89
|
Patel RN, Patel SK, Patel AK, Patel N, Butcher RJ. A tetranuclear nickel(II) complex, [Ni4(L)4](ClO4)4·C2H3N·2H2O, with an asymmetric Ni4O4 open-cubane-like core. Acta Crystallogr E Crystallogr Commun 2022; 78:98-102. [PMID: 35145731 PMCID: PMC8819437 DOI: 10.1107/s2056989021012408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 11/22/2021] [Indexed: 11/17/2022]
Abstract
A tetranuclear complex with an open-cubane like structure was synthesized from 2-methoxy-6-(pyridin-2-yl-hydrazonomethyl)-phenol and characterized using micro-analytical and spectroscopic techniques, and single-crystal X-ray diffraction analysis. A tetranuclear complex with an open-cubane-like core structure was synthesized from 2-methoxy-6-(pyridin-2-yl-hydrazonomethyl)phenol (HL), namely, cyclo-tetrakis(μ-2-methoxy-6-{[2-(pyridin-2-yl)hydrazin-1-ylidene]methyl}phenolato)tetranickel(II) tetrakis(perchlorate) acetonitrile monosolvate dihydrate, [Ni4(C13H12N3O2)4](ClO4)4·C2H3N·2H2O, and characterized using micro-analytical and spectroscopic techniques. The crystal-structure determination reveals the formation of a distorted Ni4O4 cubane-like core architecture encapsulated by four hydrazone Schiff base (HL) molecules. A open-cube tetranuclear architecture is created in which nickel(II) ions of the NiN2O3 unit are connected by μ2-O anions of the phenolate moiety of HL. In this complex, each Ni centre has a slightly distorted square-pyramidal coordination environment. The supramolecular architectures are stabilized via the presence of various intermolecular hydrogen bonds and (aryl–aryl, aryl–chelate and chelate–chelate) stacking interactions.
Collapse
|
90
|
Patel AK, Jadeja RN, Patel N, Patel RN, Patel SK, Butcher R, Kumar S, Kumar G. Copper(II) hydrazone complexes derived from (Z)-N′-{(2-hydroxynapthalen-1-yl}methylene)acetohydrazide: Synthesis, spectral characterization, electrochemical behaviour, density functional study, in vitro catalytic activity and molecular docking. RESULTS IN CHEMISTRY 2022. [DOI: 10.1016/j.rechem.2021.100244] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
91
|
Patel SK, Patel RN, Patel AK, Patel N, Coloma I, Cortijo M, Herrero S, Choquesillo-Lazarte D. Synthesis, single crystal structures, DFT and in vitro anti oxidant superoxide dismutase studies of copper(II) complexes derived from the di-(2-picolyl)amine and co-ligands: Promising antioxidants. Polyhedron 2022. [DOI: 10.1016/j.poly.2021.115609] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
|
92
|
Patel N, Patel R, Wyenandt CA, Kobayashi DY. First Report of Pseudomonas cichorii Causing Bacterial Leaf Spot on Romaine Lettuce ( Lactuca sativa var . longifolia) and Escarole ( Cichorium endivia) in New Jersey. PLANT DISEASE 2021; 105:4150. [PMID: 34236210 DOI: 10.1094/pdis-05-21-0929-pdn] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
|
93
|
Baktash V, Hosack T, Rule R, Patel N, Kho J, Sekhar R, Mandal AKJ, Missouris CG. Development, evaluation and validation of machine learning algorithms to detect atypical and asymptomatic presentations of Covid-19 in hospital practice. QJM 2021; 114:496-501. [PMID: 34156436 DOI: 10.1093/qjmed/hcab172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 06/12/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Diagnostic methods for Covid-19 have improved, both in speed and availability. Because of atypical and asymptomatic carriage of the virus and nosocomial spread within institutions, timely diagnosis remains a challenge. Machine learning models trained on blood test results have shown promise in identifying cases of Covid-19. AIMS To train and validate a machine learning model capable of differentiating Covid-19 positive from negative patients using routine blood tests and assess the model's accuracy against atypical and asymptomatic presentations. DESIGN AND METHODS We conducted a retrospective analysis of medical admissions to our institution during March and April 2020. Participants were categorized into Covid-19 positive or negative groups based on clinical, radiological features or nasopharyngeal swab. A machine learning model was trained on laboratory parameters and validated for accuracy, sensitivity and specificity and externally validated at an unconnected establishment. RESULTS An Ensemble Bagged Tree model was trained on data collected from 405 patients (212 Covid-19 positive) producing an accuracy of 81.79% (95% confidence interval (CI) 77.53-85.55%), the sensitivity of 85.85% (CI 80.42-90.24%) and specificity of 76.65% (CI 69.49-82.84%). Accuracy was preserved for atypical and asymptomatic subgroups. Using an external data set for 226 patients (141 Covid-19 positive) accuracy of 76.82% (CI 70.87-82.08%), sensitivity of 78.38% (CI 70.87-84.72%) and specificity of 74.12% (CI 63.48-83.01%) was achieved. CONCLUSION A machine learning model using routine laboratory parameters can detect atypical and asymptomatic presentations of Covid-19 and might be an adjunct to existing screening measures.
Collapse
|
94
|
Patel N, Khan D. M008 MANAGEMENT OF IOHEXOL-INDUCED ANAPHYLAXIS WITH ALTERNATIVE CONTRAST AGENTS. Ann Allergy Asthma Immunol 2021. [DOI: 10.1016/j.anai.2021.08.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
95
|
Raissi G, Patel N, Casey R, Corcoran B, Sadeghi H. 152: Weekly patient-family-staff-volunteer during COVID-19. J Cyst Fibros 2021. [PMCID: PMC8518465 DOI: 10.1016/s1569-1993(21)01577-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
96
|
Stenehjem K, Patel N, Bundy V. M194 IDENTIFICATION OF T-CELL LYMPHOPENIA VIA T-CELL RECEPTOR EXCISION CIRCLE ASSAY IN TURNER SYNDROME. Ann Allergy Asthma Immunol 2021. [DOI: 10.1016/j.anai.2021.08.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
97
|
Yang K, Dinh M, Nam K, Madishetty S, Kilic S, Recinos V, Zahler S, Patel N, Elhalawani H, Scott J, Chao S, Murphy E, Suh J. Impact of Insurance Status on Radiation Treatment and Clinical Outcome in Adult Medulloblastoma. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
98
|
Patel N, Amgai B, Chakraborty S, Hajra A, Ashish K, Patel Z, Aryal B, Aronow W, Singh A. Effect of thrombocytopenia in patients with infective endocarditis: an insight from the National Inpatient Sample database. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Infective endocarditis (IE) is one of the feared diseases in septic patients, and incidences are rising due to the intravenous drug abuse epidemic. Sepsis causes an escalation of the platelet destructions leading to thrombocytopenia (1). Few independent hospital-based studies have proposed increase mortality with thrombocytopenia in patients with IE (2–5). We aim to evaluate the significance of thrombocytopenia in IE subjects from the national inpatient sample (NIS) database.
Method
We analyzed the NIS database from Jan-2016 to Dec-2018 using Stata 16.0. NIS is the largest publicly available all-payer inpatient care database in the United States, containing data on more than seven million hospital stays per year. We identified patients with IE with or without thrombocytopenia using ICD-10 codes. The primary outcome of interest was in-hospital mortality comparison. We adjusted potential confounders (age, sex, diabetes, hypertension, etc.) with multivariate logistic regression analysis. Further analysis was done after balancing the population co-morbidity using a Greedy propensity match for accuracy.
Results
A total of 174,495 subjects were included in this study with a diagnosis of IE. Among these individuals, 33,285 patients had a concurrent diagnosis of thrombocytopenia. The mean ages were 53±19.5 years for the thrombocytopenia group and 55±19.8 years for others. Females were equally represented in both cohorts. There were 4,945 (14.86%) vs 2,835 (2.01%) mortalities reported in with and without thrombocytopenia group respectively. After propensity matching, there was a pronounced increase in mortality [Odds ratio (OR): 1.93 (1.72 – 2.15), p-value: <0.001] in the group with thrombocytopenia comparing to others. Complications such as Major bleeding requiring blood transfusion [OR: 1.45 (1.35–1.57)], acute myocardial infarction [OR: 1.56 (1.35–1.70)], complete heart block [OR: 1.44 (1.16–1.53)], cardiac arrest [OR: 1.44 (1.25–1.72)], acute respiratory failure [OR: 1.51 (1.39–1.73)] and pressor support requirement [(OR: 1.73 (1.57–2.01)] were notably higher in the cohort of thrombocytopenia with statistically significant p-value (<0.001). The difference in length of stay between both cohorts after propensity match wasn't statistically significant.
Conclusion
In conclusion, IE patients with thrombocytopenia have higher incidences of in-patient mortality and poor outcomes than cohort without thrombocytopenia. Some of the adverse consequences could be temporally explained by complications related to underlying thrombocytopenia. Further investigations are needed to delineate the outcome in this group of subjects.
Funding Acknowledgement
Type of funding sources: None.
Collapse
|
99
|
Patel N, Amgai B, Chakraborty S, Hajra A, Binit A, Patel Z, Ashish K, Reddy M, Aronow W, Khalid M. Impact of atrial fibrillation in patients with colorectal cancer: a national inpatient sample database analysis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is the most common cardiac arrhythmia affecting approximately 1–2% overall population (1). Its causal relationship with colorectal cancer (CRC) is much for debate. According to one hypothesis, the presence of autoantibodies directed against ionic channels or acetylcholine receptors can predispose to the development of atrial fibrillation (2–3). Thus, AF may be regarded as an inflammatory complication in patients with colon cancer. Our study objective was to determine if AF impacts the outcome of patients with CRC.
Method
We analyzed the National Inpatient Sample (NIS) database from Oct-2015 to Dec 2018 using Stata 16.0. The NIS databases are released under the Healthcare Cost and Utilization Project, which includes inpatient admissions from the United States' participating hospitals. Total population with CRC were identified using their respective ICD-10 diagnostic codes then divided based on AF. To determine atrial fibrillation association with mortality and complications, we used multivariate logistic regression analysis using weights to generate nationally representative results. Later, a propensity-matched population analysis was done for the accuracy of the results.
Result
We found 245,305 patients admitted with CRC between Oct 2015 to Dec-2018 in the USA, out of which 28,170 (11.5%) were having AF. The mean age for the patients with AF was 77±10 compare to 65±14 years in those without AF. Patients with AF were associated with higher comorbidities and had a high population percentage with Carlson category three or above. There were 1,456 (5.2%) mortalities in the AF group compared to 5,689 (2.6%) in the other. The higher odds of mortality in patients with AF was present in multivariate logistic regression analysis in both non-propensity matched [1.71 (1.45–2.02), P-value: <0.000] and propensity-matched [1.44 (1.18–1.75), P-value: <0.001] cohorts. Patients with AF were hospitalized longer (9.20±7.8 vs. 6.85±7.0 days), leading to a high admission costs (US$ 25,875±22,875 vs. 20,087±19,314). Odds of complications such as need for blood transfusions [1.61 (1.05–1.29), P-value: 0.005], hemorrhage requiring blood transfusion [1.17 (1.05–1.29), P-value: 0.003], lower-GI bleed [1.31 (1.21–1.43), P-value: <0.001], sepsis [1.45 (1.30–1.62), P-value: <0.001], respiratory failure [1.39 (1.15–1.67), P-value: 0.001] etc. were also higher in group of patients with CRC and AF.
Conclusion
In our retrospective, propensity-matched national inpatient sample analyses of patients admitted with colorectal cancer, atrial fibrillation is associated with higher morbidity and mortality. AF was associated with a high burden of complications with prolonged hospital stay leading to increased health care expenditures.
Funding Acknowledgement
Type of funding sources: None.
Collapse
|
100
|
Lee C, Patel N, Panepinto L, Byers M, Ambrosino M, Adusumalli S, Denduluri S, Cohen J, Scherrer-Crosbie M. The role of premorbid transthoracic echocardiogram in identifying adverse clinical outcomes in patients admitted with COVID-19. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background/Introduction
The novel coronavirus disease (COVID-19) inpatient mortality rate is approximately 20% in the United States. Reports have described a wide pattern of abnormalities in echocardiograms performed in patients admitted with COVID-19. The role of premorbid transthoracic echocardiogram (TTE) in the prediction of COVID-19 severity and mortality is yet to be fully assessed.
Purpose
To assess whether a pre-COVID TTE can identify patients at high risk of adverse outcomes who are admitted with COVID-19.
Methods
All patients who underwent a TTE from one year to one month prior to an index inpatient admission for COVID-19 were retrospectively enrolled across five clinical sites. Demographic information, medical history, and laboratory data were included for analysis. Echocardiograms were analyzed by an observer blinded to clinical data. Linear and logistic regressions were performed to detect the association of variables with death, invasive mechanical ventilation, initiation of dialysis, and a composite of these endpoints during the COVID-19 admission. Outcomes were then adjusted for a risk score using inverse propensity weighting incorporating age, sex, diabetes, hypertension, obstructive sleep apnea, history of atherosclerotic cardiovascular disease, atrial fibrillation, diuretic use, and angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use.
Results
There were 104 patients (68±15 years old, 49% male, BMI 31.4±9.1kg/m2) who met inclusion criteria (baseline characteristics in Table 1). Mean time from TTE to positive SARS-CoV-2 PCR test was 139±91 days. Twenty-nine (28%) participants died during the index COVID-19 admission. There was no association of pre-COVID echocardiographic measures of systolic ventricular function with any endpoint. Diastolic function, as assessed by LV e', was associated with mortality (Table 2). There were 25 patients (24%) with a normal lateral e' (≥10cm/s); none died. There were 35 (34%) patients with LV e' lateral velocity <8 cm/s, of whom 15 (43%) died. LV e' lateral velocity <8 cm/s was associated with an unadjusted odds ratio of 7.69 (95% confidence interval [CI] 2.26–26.19) for death and 3.25 (95% CI 1.11–9.54) for the composite outcome. The odds ratio for death was 4.76 (95% CI 1.10–20.61) and 3.78 (95% CI 0.98–14.6) for the composite outcome after adjustment for clinical risk factors (Table 2).
Conclusion
In patients with an echocardiogram prior to COVID-19, impaired diastolic function as represented by an abnormal LV e' lateral velocity was associated with both inpatient COVID-19 mortality and a composite outcome of death, mechanical ventilation, and initiation of dialysis, even after adjustment for multiple co-morbidities and medication use. Knowledge of the pre-COVID TTE results may help clinicians identify patients at higher risk of adverse outcomes during an admission for COVID-19.
Funding Acknowledgement
Type of funding sources: None.
Collapse
|