1
|
López-Sampalo A, Hernández-Negrín H, Bernal-López MR, Rubio-Rivas M, Martín-Escalante MD, Wikman-Jogersen P, García-Reyne A, Fernández-Madera Martínez R, Gómez-Antúnez M, Beato-Pérez JL, Torres-Peña JD, Martín-Oterino JA, Loureiro-Amigo J, Vicente de la Sota J, Gil-Sánchez R, Lorenzo-López Reboiro M, Bernal-Román B, Fernández-Sola J, Amorós-Martínez F, Vicente-López N, Valle-Bernard R, López-Ruiz A, Ramos-Rincón JM, Gómez-Huelgas R. The impact of frailty on intra-hospital survival in older patients with COVID-19 infection: the importance of early identification. SEMI-COVID National Registry. Rev Clin Esp 2023; 223:461-469. [PMID: 37454971 DOI: 10.1016/j.rceng.2023.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 05/24/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Emerging evidence suggests that frailty may be a significant predictor of poor outcomes in older individuals hospitalized due to COVID-19. This study aims to determine the prognostic value of frailty on intrahospital patient survival. METHODS This observational, multicenter, nationwide study included patients aged 70 years and older who were hospitalized due to COVID-19 in Spain between March 1 and December 31, 2020. Patient data were obtained from the SEMI-COVID-19 Registry of the Spanish Society of Internal Medicine. Frailty was assessed using the Clinical Frailty Scale. The primary outcome was hospital survival. Cox proportional hazards models were used to assess predictors of survival. RESULTS A total of 1,878 participants (52% men and 48% women) were included, with 1,351 (71.9%) survivors and 527 (28.1%) non-survivors. The non-survivor group had higher mean age (83.5 vs. 81 years), comorbidities (6.3 vs. 5.3 points on the Charlson index), degree of dependency (26.8% vs. 12.4% severely dependent patients), and frailty (34.5% vs. 14.7% severely frail patients) compared to survivors. However, there were no differences in terms of sex. Our results demonstrate that a moderate-severe degree of frailty is the primary factor independently associated with shorter survival [HR 2.344 (1.437-3.823; p<0.001) for CFS 5-6 and 3.694 (2.155-6.330; p<0.001) for CFS 7-9]. CONCLUSION Frailty is the main predictor of adverse outcomes in older patients with COVID-19. The utilization of tools such as the Clinical Frailty Scale is crucial for early detection in this population.
Collapse
Affiliation(s)
- A López-Sampalo
- Internal Medicine Department, Regional University Hospital of Málaga, Instituto de Investigación Biomedica de Málaga (IBIMA- Plataforma BIONAND), University of Málaga (UMA), Málaga, Spain
| | - H Hernández-Negrín
- Internal Medicine Department, Regional University Hospital of Málaga, Instituto de Investigación Biomedica de Málaga (IBIMA- Plataforma BIONAND), University of Málaga (UMA), Málaga, Spain
| | - M-R Bernal-López
- Internal Medicine Department, Regional University Hospital of Málaga, Instituto de Investigación Biomedica de Málaga (IBIMA- Plataforma BIONAND), University of Málaga (UMA), Málaga, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.
| | - M Rubio-Rivas
- Internal Medicine Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, University of Barcelona, Barcelona, Spain
| | | | - P Wikman-Jogersen
- Internal Medicine Department, San Juan University Hospital, Alicante, Spain
| | - A García-Reyne
- Internal Medicine Department, 12 de Octubre University Hospital, Madrid, Spain
| | | | - M Gómez-Antúnez
- Internal Medicine Department, Gregorio Marañón University Hospital, Madrid, Spain
| | - J L Beato-Pérez
- Internal Medicine Department, Albacete University Hospital Complex, Albacete, Spain
| | - J D Torres-Peña
- Internal Medicine Department, Reina Sofia University Hospital, Córdoba, Spain
| | - J A Martín-Oterino
- Internal Medicine Department, Salamanca University Health Care Complex, Salamanca, Spain
| | - J Loureiro-Amigo
- Internal Medicine Department, Moisès Broggi Hospital, Sant Joan Despí, Barcelona, Spain
| | - J Vicente de la Sota
- Internal Medicine Department, Infanta Cristina University Hospital, Parla, Madrid, Spain
| | - R Gil-Sánchez
- Internal Medicine Department, La Fe University Hospital, Valencia, Spain
| | - M Lorenzo-López Reboiro
- Internal Medicine Department, Regional Hospital of Monforte de Lemos, Monforte de Lemos, Lugo, Spain
| | - B Bernal-Román
- Pneumology Department, Doctor José Molina Orosa University Hospital, Arrecife, Lanzarote, Spain
| | | | | | - N Vicente-López
- Internal Medicine Department, Sureste University Hospital, Arganda del Rey, Madrid, Spain
| | - R Valle-Bernard
- Internal Medicine Department, Sierrallana Hospital, Torrelavega, Cantabria, Spain
| | - A López-Ruiz
- Internal Medicine Department, Axarquía Hospital, Vélez-Málaga, Málaga, Spain
| | - J-M Ramos-Rincón
- Department of Clinical Medicine, Miguel Hernandez University of Elche, Alicante, Spain
| | - R Gómez-Huelgas
- Internal Medicine Department, Regional University Hospital of Málaga, Instituto de Investigación Biomedica de Málaga (IBIMA- Plataforma BIONAND), University of Málaga (UMA), Málaga, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| |
Collapse
|
2
|
Galindo-Oseguera E, Pinto-Almazán R, Arellano-Ramírez A, Gasca-López GA, Ocharan-Hernández ME, Calzada-Mendoza CC, Castillo-Cruz J, Martínez-Herrera E. Mortality and Survival Factors in Patients with Moderate and Severe Pneumonia Due to COVID-19. Healthcare (Basel) 2023; 11:healthcare11070932. [PMID: 37046859 PMCID: PMC10093873 DOI: 10.3390/healthcare11070932] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
During the pandemic, some mortality-related factors were age, sex, comorbidities (obesity, diabetes mellitus, and hypertension), recovery time, hospitalizations, and biochemical markers. The present work aimed to identify the mortality and survival factors in adults with moderate and severe pneumonia due to COVID-19 during the first and second waves of the pandemic in Mexico at a third-level hospital (High-Specialty Regional Hospital of Ixtapaluca (HRAEI), Ixtapaluca, Estado de Mexico, Mexico). A database was generated using information from the electronic clinical records of patients hospitalized from December 2021 to August 2022. Survival analysis was performed associating age, sex, longer recovery times, and some drugs. The risk factors found were age in the patients between 40 and 60 years (OR = 1.70), male sex (OR = 1.53), the presence of comorbidities (OR = 1.66) and hypertension (OR = 2.19), work occupation (construction workers OR = 5.22, factory workers OR = 3.13, unemployed OR = 2.93), the prehospital use of metamizole sodium (OR = 2.17), cough (OR = 1.73), and in-hospital oxygen therapy (reservoir mask OR = 6.6). The survival factors found in this study were working in the healthcare field (OR = 0.26), the prehospital use of certain medications (paracetamol OR = 0.65, dexamethasone OR = 0.55, and azithromycin OR = 0.47), presenting ageusia (OR = 0.5) and hyporexia (OR = 0.34), and the time using in-hospital oxygen therapy (device 1 OR = 0.72). Prehospital treatment needs to be reevaluated as dexamethasone and azithromycin proved to be protective factors. Likewise, providing aggressive oxygen therapy during hospital admission decreased mortality risk.
Collapse
Affiliation(s)
- Evelyn Galindo-Oseguera
- Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, Ciudad de México 11340, Mexico;
| | - Rodolfo Pinto-Almazán
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, Ciudad de México 11340, Mexico; (R.P.-A.); (M.E.O.-H.); (C.C.C.-M.)
| | - Alfredo Arellano-Ramírez
- Hospital Regional de Alta Especialidad de Ixtapaluca, Ixtapaluca 56530, Mexico; (A.A.-R.); (G.A.G.-L.)
| | | | - María Esther Ocharan-Hernández
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, Ciudad de México 11340, Mexico; (R.P.-A.); (M.E.O.-H.); (C.C.C.-M.)
| | - Claudia C. Calzada-Mendoza
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, Ciudad de México 11340, Mexico; (R.P.-A.); (M.E.O.-H.); (C.C.C.-M.)
| | - Juan Castillo-Cruz
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, Ciudad de México 11340, Mexico; (R.P.-A.); (M.E.O.-H.); (C.C.C.-M.)
- Correspondence: (J.C.-C.); (E.M.-H.)
| | - Erick Martínez-Herrera
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, Ciudad de México 11340, Mexico; (R.P.-A.); (M.E.O.-H.); (C.C.C.-M.)
- Efficiency, Quality, and Costs in Health Services Research Group (EFISALUD), Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36213 Vigo, Spain
- Correspondence: (J.C.-C.); (E.M.-H.)
| |
Collapse
|
3
|
Salinas-Solis LDJ, Gaytan-Oyarzun JC, Octavio-Aguilar P. Detection of Mitogenic and Genotoxic Effects of the Turkey Tail Medicinal Mushroom (Trametes versicolor, Agaricomycetes) Extracts from Mexico on Human Lymphocyte Cultures. Int J Med Mushrooms 2023; 25:33-41. [PMID: 37947062 DOI: 10.1615/intjmedmushrooms.2023050464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Diseases caused by a compromised immune system, characterized by decreased production and diversification of T lymphocytes, such as immunodeficiencies or chronic infections, are becoming increasingly prominent. These diseases lead to increased vulnerability to infections caused by parasites, viruses, bacteria, fungi, and other microorganisms. According to various articles, Trametes versicolor has been used as immunotherapy and cancer treatment due to its polysaccharides, which have shown their value in traditional medicine. However, most of the studies have been done with Asian samples. For this reason, the aim of this study was to evaluate the effect of samples of Mexican T. versicolor on human lymphoid cells. Of various extracts, the one with the best T cell proliferative response was the extract produced by maceration in water at room temperature, but all treatments in aqueous and ethanolic extracts increased the lymphocyte count, showing that extracts of Mexican T. versicolor also have compounds that stimulate T cells. Unfortunately, genetic damage expressed as an increment in micronuclei count was identified, so using these fungus extracts in traditional medicine would require careful control of recommended doses.
Collapse
Affiliation(s)
- Letzi de Jesus Salinas-Solis
- Centro de Investigaciones Biológicas, Área Académica de Biología, Instituto de Ciencias Básicas e Ingeniería, Universidad Autónoma del Estado de Hidalgo, Mexico
| | - Juan Carlos Gaytan-Oyarzun
- Centro de Investigaciones Biológicas, Área Académica de Biología, Instituto de Ciencias Básicas e Ingeniería, Universidad Autónoma del Estado de Hidalgo, Mexico
| | - Pablo Octavio-Aguilar
- Centro de Investigaciones Biológicas, Área Académica de Biología, Instituto de Ciencias Básicas e Ingeniería, Universidad Autónoma del Estado de Hidalgo, Mexico
| |
Collapse
|
4
|
The Association between Serum Vitamin D Concentration and New Inflammatory Biomarkers-Systemic Inflammatory Index (SII) and Systemic Inflammatory Response (SIRI)-In Patients with Ischemic Heart Disease. Nutrients 2022; 14:nu14194212. [PMID: 36235864 PMCID: PMC9570511 DOI: 10.3390/nu14194212] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 10/03/2022] [Accepted: 10/07/2022] [Indexed: 11/17/2022] Open
Abstract
The incidence of ischemic heart disease (IHD) increases every year. This cardiovascular disease has an inflammatory factor in its etiology due to different immune cells that influence atherogenesis. New inflammatory biomarkers—the Systemic Inflammatory Index (SII) and the Systemic Inflammatory Response (SIRI)—attempt to describe the pro- and anti-inflammatory balance and quantify the complex impact of the immune system on atherosclerosis, while vitamin D has a multidirectional impact on the human body, including the cardiovascular and immune systems. Hence, the objective of this research was to analyze the association between SII and SIRI and serum vitamin D concentrations in patients with IHD. A significant correlation was observed between SIRI and 25(OH)D in the whole group and between both biomarkers (SII and SIRI) and 25(OH)D in the group of patients with ACS but not in the group of patients with stable IHD. The role of vitamin D in IHD complications and its association with new inflammatory biomarkers requires further well-designed, large-scale research.
Collapse
|