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Mahjoub M, Gallas M, Chelly S, Mezgar Z, Khrouf M. Facteurs de risque de la sévérité de la COVID-19 chez des patients
tunisiens aux Urgences de Sousse, Tunisie. LA TUNISIE MEDICALE 2023; 101:426-432. [PMID: 38372540 PMCID: PMC11217966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 07/18/2023] [Indexed: 07/05/2024]
Abstract
INTRODUCTION Despite the spread of COVID-19 in Tunisia and its impact on people, health and economy, few studies have investigated the profile of COVID-19 Tunisian patients. AIM Determine the epidemiological, clinical, para-clinical and therapeutic characteristics patients and identify the associated factors of severity. METHODS This is a retrospective study, conducted among confirmed COVID-19 patients consulting the hospital emergency department. We collected Data using from the patients' computerized files. We performed Data entry and analysis using SPSS 22. RESULTS We included 375 patients. The average age was 66.7±11.43 years with a sex ratio of 1.6. The most frequent comorbidities were diabetes (100%), hypertension (64.5%), and chronic heart disease (25.9%). The most frequent clinical signs were dyspnea (75.2%), asthenia (66.9%), cough (66.7%) and fever (60.3%). The most frequent biological abnormalities were biological inflammatory syndrome (96%) and elevation of troponin (69.3%). CT scans revealed lung damage in 34.1% of patients. As for treatments, 91.7% received antibiotics, 89% received corticosteroids, 89.3% received anticoagulants, and 85.1% received ventilation (42.6% non-invasive ventilation and 1.9% were intubated). Risk factors of severity were age, chronic heart disease and hypertension. CONCLUSION Knowing the particularities of Tunisian patients will help to install recommendations to improve the process of care and prevention.
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Affiliation(s)
- Mohamed Mahjoub
- Care Quality and Safety Department- Farhat Hached Hospital- Sousse- Tunisia/ University of Sousse- Tunisia
| | - Meriem Gallas
- School of Health Sciences and Technology, Department of Master of Research in Health Sciences, Sousse, Tunisia/ University of Sousse- Tunisia
| | - Souhir Chelly
- Care Quality and Safety Department- Farhat Hached Hospital- Sousse- Tunisia/ University of Sousse- Tunisia
| | - Zied Mezgar
- Emergency and Intensive Care Department-Farhat Hached Hospital Sousse, Tunisia/ University of Sousse- Tunisia
| | - Meriem Khrouf
- Emergency and Intensive Care Department-Farhat Hached Hospital Sousse, Tunisia/ University of Sousse- Tunisia
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Chandel A, Leazer S, Alcover KC, Farley J, Berk J, Jayne C, Mcnutt R, Olsen M, Allard R, Yang J, Johnson C, Tripathi A, Rechtin M, Leon M, Williams M, Sheth P, Messer K, Chung KK, Collen J. Intensive Care and Organ Support Related Mortality in Patients With COVID-19: A Systematic Review and Meta-Analysis. Crit Care Explor 2023; 5:e0876. [PMID: 36890875 PMCID: PMC9988289 DOI: 10.1097/cce.0000000000000876] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023] Open
Abstract
To perform a systematic review and meta-analysis to generate estimates of mortality in patients with COVID-19 that required hospitalization, ICU admission, and organ support. DATA SOURCES A systematic search of PubMed, Embase, and the Cochrane databases was conducted up to December 31, 2021. STUDY SELECTION Previously peer-reviewed observational studies that reported ICU, mechanical ventilation (MV), renal replacement therapy (RRT) or extracorporeal membrane oxygenation (ECMO)-related mortality among greater than or equal to 100 individual patients. DATA EXTRACTION Random-effects meta-analysis was used to generate pooled estimates of case fatality rates (CFRs) for in-hospital, ICU, MV, RRT, and ECMO-related mortality. ICU-related mortality was additionally analyzed by the study country of origin. Sensitivity analyses of CFR were assessed based on completeness of follow-up data, by year, and when only studies judged to be of high quality were included. DATA SYNTHESIS One hundred fifty-seven studies evaluating 948,309 patients were included. The CFR for in-hospital mortality, ICU mortality, MV, RRT, and ECMO were 25.9% (95% CI: 24.0-27.8%), 37.3% (95% CI: 34.6-40.1%), 51.6% (95% CI: 46.1-57.0%), 66.1% (95% CI: 59.7-72.2%), and 58.0% (95% CI: 46.9-68.9%), respectively. MV (52.7%, 95% CI: 47.5-58.0% vs 31.3%, 95% CI: 16.1-48.9%; p = 0.023) and RRT-related mortality (66.7%, 95% CI: 60.1-73.0% vs 50.3%, 95% CI: 42.4-58.2%; p = 0.003) decreased from 2020 to 2021. CONCLUSIONS We present updated estimates of CFR for patients hospitalized and requiring intensive care for the management of COVID-19. Although mortality remain high and varies considerably worldwide, we found the CFR in patients supported with MV significantly improved since 2020.
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Affiliation(s)
- Abhimanyu Chandel
- Department of Pulmonary and Critical Care Medicine, Walter Reed National Medical Center, Bethesda, MD
| | - Sahar Leazer
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD
- The Metis Foundation, San Antonio, TX
| | - Karl C Alcover
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD
| | - Josiah Farley
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD
| | - Joshua Berk
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD
| | - Christopher Jayne
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD
| | - Ryan Mcnutt
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD
| | - Meredith Olsen
- Department of Pulmonary and Critical Care Medicine, Walter Reed National Medical Center, Bethesda, MD
| | - Rhonda Allard
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD
| | - Jiahong Yang
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD
| | - Caitlyn Johnson
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD
| | - Ananya Tripathi
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD
| | - Maria Rechtin
- Department of Pulmonary and Critical Care Medicine, Walter Reed National Medical Center, Bethesda, MD
| | - Mathew Leon
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD
| | - Mathias Williams
- Department of Pulmonary and Critical Care Medicine, Walter Reed National Medical Center, Bethesda, MD
| | - Phorum Sheth
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD
| | - Kyle Messer
- Department of Pulmonary and Critical Care Medicine, Walter Reed National Medical Center, Bethesda, MD
| | - Kevin K Chung
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD
| | - Jacob Collen
- Department of Pulmonary and Critical Care Medicine, Walter Reed National Medical Center, Bethesda, MD
- Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD
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Jesmani Y, Bozorgomid A, Shadmani FK, Dehbani A, Sayad B. Demographic and clinical characteristics and outcomes of COVID-19 patients admitted to a university hospital in the west of Iran: a retrospective study in the third wave. VACUNAS 2023; 24:S1576-9887(23)00007-9. [PMID: 36817340 PMCID: PMC9922569 DOI: 10.1016/j.vacun.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 01/27/2023] [Indexed: 02/15/2023]
Abstract
COVID-19 is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The characteristics of this infectious disease vary from a country to another and from one peak to the next. The aim of the present study was to describe the COVID-19 patients hospitalized in Kermanshah, a city in the west of Iran, in the third peak of the disease and to identify in-hospital mortality determinants in this disease. Methods: In this retrospective study, the clinical and demographic characteristics, laboratory findings, prescribed treatments and outcome of all COVID-19 patients (definitive, suspected, and probable) were collected from the medical records department of Farabi Hospital affiliated with Kermanshah University of Medical Sciences, Kermanshah, Iran from 22 October to 20 November 2020. Results: In total, 665 COVID-19 patients (265 females and 400 males, mean age: 58.7 years) were enrolled, including 479 confirmed, 15 probable, and 30 suspected cases. About 84% of the patients presented with low oxygen saturation levels. The most common comorbidities were hypertension (15%), diabetes (10%), and cardiovascular disease (3%). The median (IQR) length of hospital stay was 6 (Nojomi et al., 2021; Flores-Vega et al., 2022; Fattahi et al., 2021; Cusinato et al., 2022; Avatef Fazeli et al., 2021 (4., 5., 6., 7., 8.)) and 7 (Javadi Mamaghani et al., 2021; Abdolahnejad et al., 2022; Nojomi et al., 2021; Flores-Vega et al., 2022; Fattahi et al., 2021; Cusinato et al., 2022; Avatef Fazeli et al., 2021; Sayad et al., 2021; Hesni et al., 2022; Buttenschøn et al., 2022; Smits et al., 2022; Rosenberger et al., 2021; Shi et al., 2022 (2., 3., 4., 5., 6., 7., 8., 9., 10., 11., 12., 13., 14.)) day in discharged and deceased patients, respectively. Eighty-two out of 655 patients admitted to the hospital and 39of the 60 patients admitted to the ICU died. In total, in-hospital mortality rate was 12.33%. Regarding lab variables, in the adjusted model, no significant difference was observed between discharged and deceased patients.The results of multivariable logistic regression showed that each one-unit increase in oxygen saturation (SPO2) increased the odds of survival by 0.88 times (aOR 0.88, 95% CI 0.78-0.99, p = 0.043). Moreover, each one-day increase in the length of ICU stay reduced the odds of mortality by 0.49 times (aOR 0.82, 95% CI 0.26-0.95, p = 0.035). Conclusion: Hospitalized COVID-19 patients were generally more ill during the third peak so that about 85% of the patients had SPO2 ≤ 93%. The in-hospital mortality rate was also high. Demographic and paraclinical variables (except SPO2 level) were not suitable predictors of mortality.
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Affiliation(s)
- Younes Jesmani
- Infectious Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Arezoo Bozorgomid
- Infectious Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fatemeh Khosravi Shadmani
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Dehbani
- Infectious Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Babak Sayad
- Infectious Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Zhang H, Yin Y, Tao W, Liu L. Clinical Observation of MRI Scanning Combined with Clinical Nursing for Surgical Breast Cancer Patients. Int J Anal Chem 2022; 2022:6863281. [PMID: 35620047 PMCID: PMC9129973 DOI: 10.1155/2022/6863281] [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: 04/14/2022] [Revised: 04/23/2022] [Accepted: 04/25/2022] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to explore the application effect of perioperative nursing care for patients with breast cancer. In this paper, 100 breast cancer patients with lymphatic spread treated by breast surgery in September 2019 to December were selected as the evaluation objects. They were divided into two groups according to preoperative imaging examination, 50 cases in each group. Group A was examined by B-ultrasound before axillary lymphadenectomy, group B was examined by MRI before axillary lymphadenectomy, and group C was examined by B-ultrasound and MRI before axillary lymphadenectomy. The facts in the three groups of disease findings were compared. Compared with the control group, the proportion of negative emotions (such as stress and depression) in the control group decreased (P<0.05). The decrease in blood cortisol was higher than in the control group (P < 0.05). Improving the existing cancer surgery can improve the patient's heart rate and reduce blood cortisol so as to improve the patient's joint function and quality of life. The difficulty of nursing patients will also be reduced, which is medically necessary.
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Affiliation(s)
- Huan Zhang
- Breast Cancer Center, Chongqing University Cancer Hospital Department, Chongqing 400030, China
| | - Yanan Yin
- Breast Cancer Center, Chongqing University Cancer Hospital Department, Chongqing 400030, China
| | - Wenjing Tao
- Breast Cancer Center, Chongqing University Cancer Hospital Department, Chongqing 400030, China
| | - Ling Liu
- Department of Medicine, Chongqing University Cancer Hospital Department, Chongqing 400030, China
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