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Horvath VJ, Békeffy M, Németh Z, Szelke E, Fazekas-Pongor V, Hajdu N, Svébis MM, Pintér J, Domján BA, Mészáros S, Körei AE, Kézdi Á, Kocsis I, Kristóf K, Kempler P, Rozgonyi F, Takács I, Tabák AG. The effect of COVID-19 vaccination status on all-cause mortality in patients hospitalised with COVID-19 in Hungary during the delta wave of the pandemic. GeroScience 2024; 46:1881-1894. [PMID: 37755581 PMCID: PMC10828407 DOI: 10.1007/s11357-023-00931-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/04/2023] [Indexed: 09/28/2023] Open
Abstract
The high mortality of patients with coronavirus disease 2019 (COVID-19) is effectively reduced by vaccination. However, the effect of vaccination on mortality among hospitalised patients is under-researched. Thus, we investigated the effect of a full primary or an additional booster vaccination on in-hospital mortality among patients hospitalised with COVID-19 during the delta wave of the pandemic. This retrospective cohort included all patients (n = 430) admitted with COVID-19 at Semmelweis University Department of Medicine and Oncology in 01/OCT/2021-15/DEC/2021. Logistic regression models were built with COVID-19-associated in-hospital/30 day-mortality as outcome with hierarchical entry of predictors of vaccination, vaccination status, measures of disease severity, and chronic comorbidities. Deceased COVID-19 patients were older and presented more frequently with cardiac complications, chronic kidney disease, and active malignancy, as well as higher levels of inflammatory markers, serum creatinine, and lower albumin compared to surviving patients (all p < 0.05). However, the rates of vaccination were similar (52-55%) in both groups. Based on the fully adjusted model, there was a linear decrease of mortality from no/incomplete vaccination (ref) through full primary (OR 0.69, 95% CI: 0.39-1.23) to booster vaccination (OR 0.31, 95% CI 0.13-0.72, p = 0.006). Although unadjusted mortality was similar among vaccinated and unvaccinated patients, this was explained by differences in comorbidities and disease severity. In adjusted models, a full primary and especially a booster vaccination improved survival of patients hospitalised with COVID-19 during the delta wave of the pandemic. Our findings may improve the quality of patient provider discussions at the time of admission.
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Affiliation(s)
- Viktor J Horvath
- Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, 2/a Korányi S. Str, 1083, Budapest, Hungary.
| | - Magdolna Békeffy
- Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, 2/a Korányi S. Str, 1083, Budapest, Hungary
| | - Zsuzsanna Németh
- Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, 2/a Korányi S. Str, 1083, Budapest, Hungary
| | - Emese Szelke
- Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, 2/a Korányi S. Str, 1083, Budapest, Hungary
| | - Vince Fazekas-Pongor
- Department of Public Health, Semmelweis University Faculty of Medicine, Budapest, Hungary
| | - Noémi Hajdu
- Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, 2/a Korányi S. Str, 1083, Budapest, Hungary
| | - Márk M Svébis
- Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, 2/a Korányi S. Str, 1083, Budapest, Hungary
| | - József Pintér
- Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, 2/a Korányi S. Str, 1083, Budapest, Hungary
| | - Beatrix A Domján
- Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, 2/a Korányi S. Str, 1083, Budapest, Hungary
| | - Szilvia Mészáros
- Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, 2/a Korányi S. Str, 1083, Budapest, Hungary
| | - Anna E Körei
- Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, 2/a Korányi S. Str, 1083, Budapest, Hungary
| | - Árpád Kézdi
- Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, 2/a Korányi S. Str, 1083, Budapest, Hungary
| | - Ibolya Kocsis
- Department of Laboratory Medicine, Semmelweis University Faculty of Medicine, Budapest, Hungary
| | - Katalin Kristóf
- Department of Laboratory Medicine, Semmelweis University Faculty of Medicine, Budapest, Hungary
| | - Péter Kempler
- Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, 2/a Korányi S. Str, 1083, Budapest, Hungary
| | - Ferenc Rozgonyi
- Department of Laboratory Medicine, Semmelweis University Faculty of Medicine, Budapest, Hungary
| | - István Takács
- Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, 2/a Korányi S. Str, 1083, Budapest, Hungary
| | - Adam G Tabák
- Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, 2/a Korányi S. Str, 1083, Budapest, Hungary
- Department of Public Health, Semmelweis University Faculty of Medicine, Budapest, Hungary
- UCL Brain Sciences, University College London, London, UK
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Alhusseinawi H, Sander L, Handberg A, Rasmussen RW, Kingo PS, Jensen JB, Rasmussen S. Impact of low pneumoperitoneum on renal function and acute kidney injury biomarkers during robot-assisted radical prostatectomy (RARP): a randomised clinical trial. J Robot Surg 2024; 18:31. [PMID: 38231282 PMCID: PMC10794424 DOI: 10.1007/s11701-023-01744-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 10/14/2023] [Indexed: 01/18/2024]
Abstract
The objective of this study was to evaluate the effect of low pneumoperitoneum pressure (Pnp) on renal function and renal injury biomarkers during robot-assisted radical prostatectomy (RARP). A single-centre, triple-blinded, randomised clinical trial was conducted with 98 patients undergoing RARP, who were assigned to either standard Pnp of 12 mmHg or low Pnp of 7 mmHg. The primary outcome was urinary neutrophil gelatinase-associated lipocalin (u-NGAL), and several other kidney injury biomarkers were assessed as secondary outcomes. Acute kidney injury (AKI) was evaluated using the Kidney Disease Improving Global Outcomes (KDIGO) criteria, the gold standard method for defining AKI. The trial was registered on ClinicalTrials.gov (NCT04755452). Patients in the low Pnp group had significantly lower levels of u-NGAL (mean difference - 39.9, 95% CI - 73.7 to - 6.1, p = 0.02) compared to the standard Pnp group. No significant differences were observed for other urinary biomarkers. Interestingly, there was a significant difference in intraoperative urine production between the groups (low Pnp median: 200 mL, IQR: 100-325 vs. standard Pnp median: 100 mL, IQR: 50-200, p = 0.01). Similarly, total postoperative urine production also varied significantly (low Pnp median: 1325 mL, IQR: 1025-1800 vs. standard Pnp median: 1000 mL, IQR: 850-1287, p = 0.001). The occurrence of AKI, as defined by the KDIGO criteria, did not differ significantly between the groups. Low Pnp during RARP resulted in lower u-NGAL levels, suggesting a potential benefit in terms of reduced renal injury. However, the lack of a notable difference in AKI as defined by the KDIGO criteria indicates that the clinical significance of this finding may be limited. Further research is needed to validate and expand on these results, ultimately defining the optimal Pnp strategy for RARP and improving patient outcomes.
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Affiliation(s)
- Hayder Alhusseinawi
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
- Department of Urology, Aalborg University Hospital, Aalborg, Denmark.
| | - Lotte Sander
- Department of Urology, Aalborg University Hospital, Aalborg, Denmark
| | - Aase Handberg
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
| | - Rikke W Rasmussen
- Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
| | - Pernille S Kingo
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark
| | - Jørgen B Jensen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark
| | - Sten Rasmussen
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Hu CY, Cui WS, Lei Y, Tang YW, Zhang YY, Su QM, Peng F, Zeng YF, Song JL, Luo CN, Zhou Y, Li XY, Zhao ZX. Comparison of Azvudine and Nirmatrelvir/Ritonavir and Combined Use in Patients with COVID-19. Infect Drug Resist 2023; 16:7797-7808. [PMID: 38148771 PMCID: PMC10750493 DOI: 10.2147/idr.s433186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/29/2023] [Indexed: 12/28/2023] Open
Abstract
Purpose To compare the effectiveness of azvudine and nirmatrelvir/ritonavir for the treatment of coronavirus disease (COVID-19). Patients and Methods We conducted a retrospective analysis of data from 576 patients with COVID-19, comprising 195 patients without antiviral therapy, 226 patients treated with azvudine, 114 patients treated with nirmatrelvir/ritonavir, and 41 patients were treated with azvudine and nirmatrelvir/ritonavir concurrently. We compared their symptoms, mortality rates, and the length and cost of hospitalization. Results The incidence of symptoms was similar in patients treated with azvudine and in those treated with nirmatrelvir/ritonavir. However, among patients experiencing weakness, the duration of weakness was significantly shorter in the azvudine group than in the nirmatrelvir/ritonavir group (P=0.029). Mortality did not differ significantly between the azvudine group and the nirmatrelvir/ritonavir group (18.14% vs.10.53%, P=0.068). Among "severe patients", the mortality rate was markedly lower in patients treated with nirmatrelvir/ritonavir than in patients treated with azvudine (16.92% vs.32.17%, P=0.026). In patients with hepatic insufficiency, those treated with nirmatrelvir/ritonavir had substantially lower mortality than those treated with azvudine (15.09% vs.34.25%, P=0.016). In addition, patients treated with nirmatrelvir/ritonavir had longer hospital stays (P=0.002) and higher hospital costs (P<0.001) than those receiving azvudine. Compared with patients treated with nirmatrelvir/ritonavir or azvudine alone, patients taking nirmatrelvir/ritonavir and azvudine concurrently had no significant improvement in survival (P>0.05), length of stay (P>0.05), or hospital costs (P>0.05). Conclusion Azvudine is recommended for patients with non-severe COVID-19 with weakness. Nirmatrelvir/ritonavir is recommended for patients with severe COVID-19, to reduce mortality, and it could be the best choice for patients with hepatic insufficiency. The concurrent use of nirmatrelvir/ritonavir and azvudine in patients with COVID-19 could be not recommended.
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Affiliation(s)
- Cheng-Yi Hu
- Department of Infectious Diseases, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, People’s Republic of China
| | - Wen-Shuai Cui
- Department of Infectious Diseases, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, People’s Republic of China
| | - Yi Lei
- Department of Infectious Diseases, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, People’s Republic of China
| | - Yu-Wen Tang
- Department of Infectious Diseases, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, People’s Republic of China
| | - Yan-Yan Zhang
- Department of Infectious Diseases, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, People’s Republic of China
| | - Qi-Min Su
- Department of Infectious Diseases, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, People’s Republic of China
| | - Fang Peng
- Department of Critical Care Medicine, the Third Affiliated Hospital of Guang Zhou Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Yun-Fei Zeng
- Department of Infectious Diseases, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, People’s Republic of China
| | - Jia-Lin Song
- Department of Infectious Diseases, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, People’s Republic of China
| | - Cheng-Na Luo
- Department of Infectious Diseases, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, People’s Republic of China
| | - Yan Zhou
- Department of Infectious Diseases, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, People’s Republic of China
| | - Xin-Yan Li
- Department of Infectious Diseases, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, People’s Republic of China
| | - Zhu-Xiang Zhao
- Department of Infectious Diseases, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, People’s Republic of China
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Morello M, Amoroso D, Losacco F, Viscovo M, Pieri M, Bernardini S, Adorno G. Urine Parameters in Patients with COVID-19 Infection. Life (Basel) 2023; 13:1640. [PMID: 37629497 PMCID: PMC10455209 DOI: 10.3390/life13081640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 08/27/2023] Open
Abstract
A urine test permits the measure of several urinary markers. This is a non-invasive method for early monitoring of potential kidney damage. In COVID-19 patients, alterations of urinary markers were observed. This review aims to evaluate the utility of urinalysis in predicting the severity of COVID-19. A total of 68 articles obtained from PubMed studies reported that (i) the severity of disease was related to haematuria and proteinuria and that (ii) typical alterations of the urinary sediment were noticed in COVID-19-associated AKI patients. This review emphasizes that urinalysis and microscopic examination support clinicians in diagnosing and predicting COVID-19 severity.
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Affiliation(s)
- Maria Morello
- Clinical Biochemistry Department of Laboratory Medicine, Division of Proteins, University Hospital (PTV), 00133 Rome, Italy; (F.L.); (M.V.); (M.P.); (S.B.)
- Clinical Pathology and Clinical Biochemistry, Graduate School, Faculty of Medicine, University of Tor Vergata, 00133 Rome, Italy;
- Department of Experimental Medicine, Faculty of Medicine, University of Tor Vergata, 00133 Rome, Italy
| | - Dominga Amoroso
- Clinical Biochemistry Department of Laboratory Medicine, Division of Proteins, University Hospital (PTV), 00133 Rome, Italy; (F.L.); (M.V.); (M.P.); (S.B.)
- Clinical Pathology and Clinical Biochemistry, Graduate School, Faculty of Medicine, University of Tor Vergata, 00133 Rome, Italy;
| | - Felicia Losacco
- Clinical Biochemistry Department of Laboratory Medicine, Division of Proteins, University Hospital (PTV), 00133 Rome, Italy; (F.L.); (M.V.); (M.P.); (S.B.)
- Clinical Pathology and Clinical Biochemistry, Graduate School, Faculty of Medicine, University of Tor Vergata, 00133 Rome, Italy;
| | - Marco Viscovo
- Clinical Biochemistry Department of Laboratory Medicine, Division of Proteins, University Hospital (PTV), 00133 Rome, Italy; (F.L.); (M.V.); (M.P.); (S.B.)
- Clinical Pathology and Clinical Biochemistry, Graduate School, Faculty of Medicine, University of Tor Vergata, 00133 Rome, Italy;
| | - Massimo Pieri
- Clinical Biochemistry Department of Laboratory Medicine, Division of Proteins, University Hospital (PTV), 00133 Rome, Italy; (F.L.); (M.V.); (M.P.); (S.B.)
- Clinical Pathology and Clinical Biochemistry, Graduate School, Faculty of Medicine, University of Tor Vergata, 00133 Rome, Italy;
- Department of Experimental Medicine, Faculty of Medicine, University of Tor Vergata, 00133 Rome, Italy
| | - Sergio Bernardini
- Clinical Biochemistry Department of Laboratory Medicine, Division of Proteins, University Hospital (PTV), 00133 Rome, Italy; (F.L.); (M.V.); (M.P.); (S.B.)
- Clinical Pathology and Clinical Biochemistry, Graduate School, Faculty of Medicine, University of Tor Vergata, 00133 Rome, Italy;
- Department of Experimental Medicine, Faculty of Medicine, University of Tor Vergata, 00133 Rome, Italy
| | - Gaspare Adorno
- Clinical Pathology and Clinical Biochemistry, Graduate School, Faculty of Medicine, University of Tor Vergata, 00133 Rome, Italy;
- Department of Biomedicine and Prevention, University of Rome, 00133 Rome, Italy
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