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Naderi M, Soltani SA, Rad AT, Mehrbakhsh Z, Sodagar S, Tahamtan A, Hosseini SS. Recurrent viral RNA positivity and candidiasis findings in hospitalized patients with COVID-19. Future Microbiol 2022; 17:673-682. [PMID: 35465729 DOI: 10.2217/fmb-2022-0041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: The aim of this study was to evaluate reinfection and fungal infections among 785 patients with COVID-19 disease admitted to Baqiyatallah Hospital in Northeastern Iran after the onset of the COVID-19 epidemic. Materials & Methods: In this descriptive-analytic study (20 February-21 July 2020), reinfection and fungal infections among 785 patients were investigated using epidemiological questionnaire, clinical trials, Real-time PCR and CT scan (chest computed tomography) from the hospital HIS (hospital's information system) and collected samples. Results: Reinfection and one oral candidiasis were diagnosed in one 68-year-old man and one 47-year-old man 63 and 42 days after the initial infection, respectively. Conclusion: The research results showed that exposure to COVID-19 may not establish long-term protective immunity to all patients.
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Affiliation(s)
- Malihe Naderi
- Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, 4934174515, Iran.,PhD candidate in Microbiology, Department of Microbiology & Microbial Biotechnology, Faculty of Life Sciences & Biotechnology, Shahid Beheshti University, Tehran, Iran
| | - Seyed Amir Soltani
- Master of Health Services Management, Golestan University of Medical Sciences, Gorgan, 4934174515, Iran
| | - Akram Taheri Rad
- Master of Microbiology, Department of Microbiology, Golestan University of Medical Sciences, Gorgan, 4934174515, Iran
| | - Zahra Mehrbakhsh
- PhD candidate in Biostatics, Department of Biostatistics, School of Health, Hamedan University of Medical sciences, Hamadan, Iran.,PhD candidate, Department of Biostatistics, School of Health, Golestan University of Medical sciences, Gorgan, 4934174515, Iran
| | - Sina Sodagar
- Basic Sciences, Laboratory Sciences Research Center, Golestan University of Medical Sciences, Gorgan, 4934174515, Iran
| | - Alireza Tahamtan
- Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, 4934174515, Iran
| | - Seyedeh Sedigheh Hosseini
- Basic Sciences, Laboratory Sciences Research Center, Golestan University of Medical Sciences, Gorgan, 4934174515, Iran.,Asistant professor, Department of Labratory Sciences, Faculty of Paramedicine, Golestan University of Medical Sciences, Gorgan, 4934174515, Iran
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Balut MD, Wyte-Lake T, Steers WN, Chu K, Dobalian A, Ziaeian B, Heyworth L, Der-Martirosian C. Expansion of telemedicine during COVID-19 at a VA specialty clinic. HEALTHCARE (AMSTERDAM, NETHERLANDS) 2021; 10:100599. [PMID: 34999492 PMCID: PMC8616735 DOI: 10.1016/j.hjdsi.2021.100599] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 11/16/2021] [Accepted: 11/22/2021] [Indexed: 11/30/2022]
Abstract
Background COVID-19 rapidly accelerated the implementation of telemedicine in U.S. Department of Veterans Affairs (VA) specialty care clinics. This mixed-methods study was conducted at a VA medical center to understand the use of telemedicine, and the barriers and facilitators to its implementation, in cardiology outpatient clinics. Methods Quantitative analyses modeled monthly trends of telemedicine use over 24-months (March 2019–March 2021) with segmented logistic regression and adjusted for socio-demographic predictors of patient-level telemedicine use. Qualitative interviews were conducted (July–October 2020) with eight cardiology clinicians. Results At the onset of COVID-19, likelihood of telemedicine use was ∼12 times higher than it was pre-COVID-19 (p < 0.001). White (OR = 1.38, 95% CI:1.23–1.54), married (OR = 1.25, 95% CI:1.11–1.40), Veterans with other health insurance (OR = 1.19, 95% CI:1.06–1.35), were more likely to use telemedicine. Veterans with higher health risk factors were less likely (OR = 0.95, 95% CI:0.93–0.97). Facilitators to rapid expansion of telemedicine included prior telemedicine experience; provider trainings; and staff champions. In contrast, lack of technical support and scheduling grids for virtual visits and patient ability/preference served as barriers. Conclusions Findings suggest that once mutable barriers were addressed, the medical center was able to expand its telemedicine efforts during COVID-19. Beyond the pandemic, a hybrid of virtual and face-to-face care might be feasible and likely beneficial for healthcare providers and patients in specialty care. Implications The ability to rapidly transition from in-person to virtual visits can potentially assist with the continuity of care and management of chronic disease during infectious outbreaks and other major disasters that obstruct traditional care models.
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Affiliation(s)
- Michelle D Balut
- Veterans Emergency Management Evaluation Center (VEMEC), U.S. Department of Veterans Affairs, 16111 Plummer St. North Hills, CA, USA.
| | - Tamar Wyte-Lake
- Veterans Emergency Management Evaluation Center (VEMEC), U.S. Department of Veterans Affairs, 16111 Plummer St. North Hills, CA, USA
| | - William Neil Steers
- Veterans Emergency Management Evaluation Center (VEMEC), U.S. Department of Veterans Affairs, 16111 Plummer St. North Hills, CA, USA
| | - Karen Chu
- Veterans Emergency Management Evaluation Center (VEMEC), U.S. Department of Veterans Affairs, 16111 Plummer St. North Hills, CA, USA
| | - Aram Dobalian
- Veterans Emergency Management Evaluation Center (VEMEC), U.S. Department of Veterans Affairs, 16111 Plummer St. North Hills, CA, USA; Division of Health Systems Management and Policy, University of Memphis School of Public Health, 3825 DeSoto Ave. Memphis, TN, USA
| | - Boback Ziaeian
- Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), U.S. Department of Veterans Affairs, 16111 Plummer St. North Hills, CA, USA; Division of Cardiology, UCLA David Geffen School of Medicine, 10833 Le Conte Ave, Los Angeles, CA, USA
| | - Leonie Heyworth
- Office of Connected Care, Veterans Health Administration (VHA), US Department of Veterans Affairs, 50 Irving St. NW, Washington, DC, USA; Department of Medicine, University of California, San Diego. 9500 Gilman Dr, San Diego, CA, USA
| | - Claudia Der-Martirosian
- Veterans Emergency Management Evaluation Center (VEMEC), U.S. Department of Veterans Affairs, 16111 Plummer St. North Hills, CA, USA
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Ngiam JN, Chew NWS, Tham SM, Lim ZY, Li TYW, Cen S, Tambyah PA, Santosa A, Sia CH, Cross GB. Utility of conventional clinical risk scores in a low-risk COVID-19 cohort. BMC Infect Dis 2021; 21:1094. [PMID: 34689760 PMCID: PMC8542362 DOI: 10.1186/s12879-021-06768-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 10/05/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Several specific risk scores for Coronavirus disease 2019 (COVID-19) involving clinical and biochemical parameters have been developed from higher-risk patients, in addition to validating well-established pneumonia risk scores. We compared multiple risk scores in predicting more severe disease in a cohort of young patients with few comorbid illnesses. Accurately predicting the progression of COVID-19 may guide triage and therapy. METHODS We retrospectively examined 554 hospitalised COVID-19 patients in Singapore. The CURB-65 score, Pneumonia Severity Index (PSI), ISARIC 4C prognostic score (4C), CHA2DS2-VASc score, COVID-GRAM Critical Illness risk score (COVID-GRAM), Veterans Health Administration COVID-19 index for COVID-19 Mortality (VACO), and the "rule-of-6" score were compared for three performance characteristics: the need for supplemental oxygen, intensive care admission and mechanical ventilation. RESULTS A majority of patients were young (≤ 40 years, n = 372, 67.1%). 57 (10.3%) developed pneumonia, with 16 (2.9% of study population) requiring supplemental oxygen. 19 patients (3.4%) required intensive care and 2 patients (0.5%) died. The clinical risk scores predicted patients who required supplemental oxygenation and intensive care well. Adding the presence of fever to the CHA2DS2-VASc score and 4C score improved the ability to predict patients who required supplemental oxygen (c-statistic 0.81, 95% CI 0.68-0.94; and 0.84, 95% CI 0.75-0.94 respectively). CONCLUSION Simple scores including well established pneumonia risk scores can help predict progression of COVID-19. Adding the presence of fever as a parameter to the CHA2DS2-VASc or the 4C score improved the performance of these scores in a young population with few comorbidities.
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Affiliation(s)
| | - Nicholas W S Chew
- Department of Cardiology, National University Heart Centre Singapore, Singapore, Singapore
| | - Sai Meng Tham
- Department of Infectious Diseases, National University Health System, 1E Kent Ridge Rd, NUHS Tower Block, Level 10, Singapore, 119228, Singapore
| | - Zhen Yu Lim
- Department of Medicine, National University Health System, Singapore, Singapore
| | - Tony Y W Li
- Department of Medicine, National University Health System, Singapore, Singapore
| | - Shuyun Cen
- Department of Medicine, National University Health System, Singapore, Singapore
| | - Paul Anantharajah Tambyah
- Department of Infectious Diseases, National University Health System, 1E Kent Ridge Rd, NUHS Tower Block, Level 10, Singapore, 119228, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Infectious Diseases Translational Research Programme, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Amelia Santosa
- Department of Rheumatology, National University Health System, Singapore, Singapore
| | - Ching-Hui Sia
- Department of Cardiology, National University Heart Centre Singapore, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Gail Brenda Cross
- Department of Infectious Diseases, National University Health System, 1E Kent Ridge Rd, NUHS Tower Block, Level 10, Singapore, 119228, Singapore.
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
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KURYATA O, SIRENKO O, GAVVA O, CHVORA D. Unexpected phenomenon of hyperthyroidism as a probable cause of cardiovascular complications in elderly post-COVID-19 patients without prior thyroid pathology. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2021. [DOI: 10.23736/s0393-3660.21.04613-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Driggs D, Selby I, Roberts M, Gkrania-Klotsas E, Rudd JHF, Yang G, Babar J, Sala E, Schönlieb CB. Machine Learning for COVID-19 Diagnosis and Prognostication: Lessons for Amplifying the Signal While Reducing the Noise. Radiol Artif Intell 2021; 3:e210011. [PMID: 34240059 PMCID: PMC7995449 DOI: 10.1148/ryai.2021210011] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/01/2021] [Accepted: 03/03/2021] [Indexed: 12/19/2022]
Affiliation(s)
| | | | - Michael Roberts
- From the Department of Applied Mathematics and Theoretical Physics
(D.D., M.R., C.B.S.) and Division of Cardiovascular Medicine (J.H.F.R.),
University of Cambridge, Cambridge, England; Department of Radiology, School of
Clinical Medicine, University of Cambridge and CRUK Cambridge Centre, Cambridge
Biomedical Campus, Cambridge CB2 0QQ, England (I.S., J.B., E.S.);
Oncology R&D, AstraZeneca, Cambridge, England (M.R.); Department of
Infectious Diseases, University of Cambridge Hospitals, Cambridge, England
(E.G.K.); and National Heart and Lung Institute, Imperial College London,
London, England (G.Y.)
| | - Effrossyni Gkrania-Klotsas
- From the Department of Applied Mathematics and Theoretical Physics
(D.D., M.R., C.B.S.) and Division of Cardiovascular Medicine (J.H.F.R.),
University of Cambridge, Cambridge, England; Department of Radiology, School of
Clinical Medicine, University of Cambridge and CRUK Cambridge Centre, Cambridge
Biomedical Campus, Cambridge CB2 0QQ, England (I.S., J.B., E.S.);
Oncology R&D, AstraZeneca, Cambridge, England (M.R.); Department of
Infectious Diseases, University of Cambridge Hospitals, Cambridge, England
(E.G.K.); and National Heart and Lung Institute, Imperial College London,
London, England (G.Y.)
| | - James H. F. Rudd
- From the Department of Applied Mathematics and Theoretical Physics
(D.D., M.R., C.B.S.) and Division of Cardiovascular Medicine (J.H.F.R.),
University of Cambridge, Cambridge, England; Department of Radiology, School of
Clinical Medicine, University of Cambridge and CRUK Cambridge Centre, Cambridge
Biomedical Campus, Cambridge CB2 0QQ, England (I.S., J.B., E.S.);
Oncology R&D, AstraZeneca, Cambridge, England (M.R.); Department of
Infectious Diseases, University of Cambridge Hospitals, Cambridge, England
(E.G.K.); and National Heart and Lung Institute, Imperial College London,
London, England (G.Y.)
| | - Guang Yang
- From the Department of Applied Mathematics and Theoretical Physics
(D.D., M.R., C.B.S.) and Division of Cardiovascular Medicine (J.H.F.R.),
University of Cambridge, Cambridge, England; Department of Radiology, School of
Clinical Medicine, University of Cambridge and CRUK Cambridge Centre, Cambridge
Biomedical Campus, Cambridge CB2 0QQ, England (I.S., J.B., E.S.);
Oncology R&D, AstraZeneca, Cambridge, England (M.R.); Department of
Infectious Diseases, University of Cambridge Hospitals, Cambridge, England
(E.G.K.); and National Heart and Lung Institute, Imperial College London,
London, England (G.Y.)
| | - Judith Babar
- From the Department of Applied Mathematics and Theoretical Physics
(D.D., M.R., C.B.S.) and Division of Cardiovascular Medicine (J.H.F.R.),
University of Cambridge, Cambridge, England; Department of Radiology, School of
Clinical Medicine, University of Cambridge and CRUK Cambridge Centre, Cambridge
Biomedical Campus, Cambridge CB2 0QQ, England (I.S., J.B., E.S.);
Oncology R&D, AstraZeneca, Cambridge, England (M.R.); Department of
Infectious Diseases, University of Cambridge Hospitals, Cambridge, England
(E.G.K.); and National Heart and Lung Institute, Imperial College London,
London, England (G.Y.)
| | - Evis Sala
- From the Department of Applied Mathematics and Theoretical Physics
(D.D., M.R., C.B.S.) and Division of Cardiovascular Medicine (J.H.F.R.),
University of Cambridge, Cambridge, England; Department of Radiology, School of
Clinical Medicine, University of Cambridge and CRUK Cambridge Centre, Cambridge
Biomedical Campus, Cambridge CB2 0QQ, England (I.S., J.B., E.S.);
Oncology R&D, AstraZeneca, Cambridge, England (M.R.); Department of
Infectious Diseases, University of Cambridge Hospitals, Cambridge, England
(E.G.K.); and National Heart and Lung Institute, Imperial College London,
London, England (G.Y.)
| | - Carola-Bibiane Schönlieb
- From the Department of Applied Mathematics and Theoretical Physics
(D.D., M.R., C.B.S.) and Division of Cardiovascular Medicine (J.H.F.R.),
University of Cambridge, Cambridge, England; Department of Radiology, School of
Clinical Medicine, University of Cambridge and CRUK Cambridge Centre, Cambridge
Biomedical Campus, Cambridge CB2 0QQ, England (I.S., J.B., E.S.);
Oncology R&D, AstraZeneca, Cambridge, England (M.R.); Department of
Infectious Diseases, University of Cambridge Hospitals, Cambridge, England
(E.G.K.); and National Heart and Lung Institute, Imperial College London,
London, England (G.Y.)
| | - on behalf of the AIX-COVNET collaboration
- From the Department of Applied Mathematics and Theoretical Physics
(D.D., M.R., C.B.S.) and Division of Cardiovascular Medicine (J.H.F.R.),
University of Cambridge, Cambridge, England; Department of Radiology, School of
Clinical Medicine, University of Cambridge and CRUK Cambridge Centre, Cambridge
Biomedical Campus, Cambridge CB2 0QQ, England (I.S., J.B., E.S.);
Oncology R&D, AstraZeneca, Cambridge, England (M.R.); Department of
Infectious Diseases, University of Cambridge Hospitals, Cambridge, England
(E.G.K.); and National Heart and Lung Institute, Imperial College London,
London, England (G.Y.)
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Mirjalili H, Dastgheib SA, Shaker SH, Bahrami R, Mazaheri M, Sadr-Bafghi SMH, Sadeghizadeh-Yazdi J, Neamatzadeh H. Proportion and mortality of Iranian diabetes mellitus, chronic kidney disease, hypertension and cardiovascular disease patients with COVID-19: a meta-analysis. J Diabetes Metab Disord 2021; 20:905-917. [PMID: 33654683 PMCID: PMC7907796 DOI: 10.1007/s40200-021-00768-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/14/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Currently, the number of patients with SARS-COV-2 infection has increased rapidly in Iran, but the risk and mortality of SARS-COV-2 infection in Iranian patients with diabetes mellitus (DM), chronic kidney disease (CKD), hypertension and cardiovascular diseases (CVDs) still not clear. The aim of this meta-analysis was to estimate the proportion and mortality of SARS-COV-2 in these patients. METHODS A comprehensive literature search was carried out in PubMed, Web of Sciences, Cochrane Library, EMBASE, CNKI, SciELO, and other databases to identify all relevant studies published up to 10 January, 2020. The proportion and mortality in the patients were assessed by odd ratio (OR) and the corresponding 95 % confidence interval (95 % CI). RESULTS A total of ten case-series including 11,755 cases with SARS-COV-2 infection and 942 deaths were selected. Among them, there were total of 791 DM patients with 186 deaths, 225 CKD patients with 45 deaths, 790 hypertension cases with 86 deaths, and 471 CVDs cases with 60 deaths. Pooled data revealed that the proportion of SARS-COV-2 infection in the patients with hypertension, DM, CVDs and CKD were 21.1 %, 16.3 %, 14.0 % and 5.0 %, respectively. Moreover, the SARS-COV-2 infection were associated with an increased risk of mortality in DM (OR = 0.549, CI 95 % 0.448-0.671, p ≤ 0.001) and CKD (OR = 0.552, 95 % CI 0.367-0.829, p = 0.004) patients, but not hypertension and CVDs. There was no publication bias. CONCLUSIONS Our pooled data showed that the proportion of SARS-COV-2 infection was the highest in the Iranian patients with hypertension (21.1 %) followed by DM (16.3 %), CVDs (14.0 %) and CKD (5.0 %). Moreover, DM and CKD in patients with SARS-COV-2 infection were associated with a 0.549 and 0.552-fold increase in mortality, respectively. Clinicians in Iran should be aware of these findings, to identifying patients at higher risk and inform interventions to reduce the risk of death. Moreover, well-designed, large-scale and multicenter studies are needed to improve and validate our findings.
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Affiliation(s)
- Hamid Mirjalili
- Department of Emergency Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyed Alireza Dastgheib
- Department of Medical Genetics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Hossein Shaker
- Department of Emergency Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Bahrami
- Neonatal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahta Mazaheri
- Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Medical Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Jalal Sadeghizadeh-Yazdi
- Department of Food Science and Technology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hossein Neamatzadeh
- Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Medical Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Shaw K. The significance of hyperglycaemia and other comorbidities during the
COVID
‐19 pandemic. PRACTICAL DIABETES 2020. [PMCID: PMC7675725 DOI: 10.1002/pdi.2291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Ken Shaw
- Professor Ken Shaw, MA, MD, FRCP, Emeritus Professor of Medicine, University of Portsmouth UK
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