1
|
Mutch H, Young JJ, Sadiq F, Rose AM, Evans JM. Enhanced surveillance of hospitalised COVID-19 patients in Europe: I-MOVE-COVID-19 surveillance network, February 2020 to December 2021. Euro Surveill 2023; 28:2200669. [PMID: 37382887 PMCID: PMC10311949 DOI: 10.2807/1560-7917.es.2023.28.26.2200669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 03/29/2023] [Indexed: 06/30/2023] Open
Abstract
BackgroundIn early 2020, the I-MOVE-COVID-19 hospital surveillance system was adapted from an existing influenza surveillance system to include hospitalised COVID-19 cases.AimTo describe trends in the demographic and clinical characteristics of hospitalised COVID-19 cases across Europe during the first 2 years of the pandemic, and to identify associations between sex, age and chronic conditions with admission to intensive care or high dependency units (ICU/HDU) and in-hospital mortality.MethodsWe pooled pseudonymised data from all hospitalised COVID-19 cases in 11 surveillance sites in nine European countries, collected between 1 February 2020 and 31 December 2021. Associations between sex, age and chronic conditions, with ICU/HDU admission and in-hospital mortality were examined using Pearson's chi-squared test, and crude odds ratio (OR) estimates with respective 95% confidence intervals (CI).ResultsOf 25,971 hospitalised COVID-19 cases, 55% were male, 35% were 75 years or older and 90% had a chronic underlying condition. Patients with two or more chronic underlying conditions were significantly more likely to die in-hospital from COVID-19 (OR: 10.84; 95% CI: 8.30-14.16) than those without a chronic condition.ConclusionThe surveillance demonstrated that males, those 75 years or older and those with chronic conditions were at greater risk of in-hospital death. Over the surveillance period, outcomes tended to improve, likely because of vaccinations. This surveillance has laid the groundwork for further research studies investigating the risk factors of hospitalised COVID-19 cases and vaccine effectiveness.
Collapse
Affiliation(s)
- Heather Mutch
- Public Health Scotland, Glasgow, Scotland, United Kingdom
| | | | - Fatima Sadiq
- Public Health Scotland, Glasgow, Scotland, United Kingdom
| | | | - Josie Mm Evans
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, United Kingdom
- Public Health Scotland, Glasgow, Scotland, United Kingdom
| |
Collapse
|
2
|
Marti C, Gaudet-Blavignac C, Martin J, Lovis C, Stirnemann J, Grosgurin O, Novotny F, Iten A, Mendes A, Prendki V, Serratrice C, Farhoumand PD, Abidi N, Vetter P, Carballo S, Reny JL, Berner A, Gayet-Ageron A. Trends in management and outcomes of COVID patients admitted to a Swiss tertiary care hospital. Sci Rep 2023; 13:6013. [PMID: 37045983 PMCID: PMC10096110 DOI: 10.1038/s41598-023-32954-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 04/05/2023] [Indexed: 04/14/2023] Open
Abstract
Two successive COVID-19 flares occurred in Switzerland in spring and autumn 2020. During these periods, therapeutic strategies have been constantly adapted based on emerging evidence. We aimed to describe these adaptations and evaluate their association with patient outcomes in a cohort of COVID-19 patients admitted to the hospital. Consecutive patients admitted to the Geneva Hospitals during two successive COVID-19 flares were included. Characteristics of patients admitted during these two periods were compared as well as therapeutic management including medications, respiratory support strategies and admission to the ICU and intermediate care unit (IMCU). A mutivariable model was computed to compare outcomes across the two successive waves adjusted for demographic characteristics, co-morbidities and severity at baseline. The main outcome was in-hospital mortality. Secondary outcomes included ICU admission, Intermediate care (IMCU) admission, and length of hospital stay. A total of 2'983 patients were included. Of these, 165 patients (16.3%, n = 1014) died during the first wave and 314 (16.0%, n = 1969) during the second (p = 0.819). The proportion of patients admitted to the ICU was lower in second wave compared to first (7.4 vs. 13.9%, p < 0.001) but their mortality was increased (33.6% vs. 25.5%, p < 0.001). Conversely, a greater proportion of patients was admitted to the IMCU in second wave compared to first (26.6% vs. 22.3%, p = 0.011). A third of patients received lopinavir (30.7%) or hydroxychloroquine (33.1%) during the first wave and none during second wave, while corticosteroids were mainly prescribed during second wave (58.1% vs. 9.1%, p < 0.001). In the multivariable analysis, a 25% reduction of mortality was observed during the second wave (HR 0.75; 95% confidence interval 0.59 to 0.96). Among deceased patients, 82.3% (78.2% during first wave and 84.4% during second wave) died without beeing admitted to the ICU. The proportion of patients with therapeutic limitations regarding ICU admission increased during the second wave (48.6% vs. 38.7%, p < 0.001). Adaptation of therapeutic strategies including corticosteroids therapy and higher admission to the IMCU to receive non-invasive respiratory support was associated with a reduction of hospital mortality in multivariable analysis, ICU admission and LOS during the second wave of COVID-19 despite an increased number of admitted patients. More patients had medical decisions restraining ICU admission during the second wave which may reflect better patient selection or implicit triaging.
Collapse
Affiliation(s)
- Christophe Marti
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.
- Division of General Internal Medicine, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 4, 1211, Geneva 14, Switzerland.
| | - Christophe Gaudet-Blavignac
- Division of Medical Information Science, Geneva University Hospitals, Geneva, Switzerland
- Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Jeremy Martin
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Christian Lovis
- Division of Medical Information Science, Geneva University Hospitals, Geneva, Switzerland
- Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Jérôme Stirnemann
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of General Internal Medicine, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 4, 1211, Geneva 14, Switzerland
| | - Olivier Grosgurin
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of General Internal Medicine, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 4, 1211, Geneva 14, Switzerland
| | - Fiona Novotny
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of General Internal Medicine, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 4, 1211, Geneva 14, Switzerland
| | - Anne Iten
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Infection Control Program, Geneva University Hospitals, Geneva, Switzerland
| | - Aline Mendes
- Division of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Virginie Prendki
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Internal Medicine of the Elderly, Geneva University Hospitals, Geneva, Switzerland
| | - Christine Serratrice
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Acute Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Pauline Darbellay Farhoumand
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of General Internal Medicine, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 4, 1211, Geneva 14, Switzerland
| | - Nour Abidi
- Department of Acute Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Pauline Vetter
- Geneva Center for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Sebastian Carballo
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of General Internal Medicine, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 4, 1211, Geneva 14, Switzerland
| | - Jean-Luc Reny
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of General Internal Medicine, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 4, 1211, Geneva 14, Switzerland
| | - Amandine Berner
- Division of General Internal Medicine, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 4, 1211, Geneva 14, Switzerland
| | - Angèle Gayet-Ageron
- Division of Clinical Epidemiology, Geneva University Hospitals, Geneva, Switzerland
| |
Collapse
|
3
|
Banazadeh M, Olangian-Tehrani S, Sharifi M, Malek-Ahmadi M, Nikzad F, Doozandeh-Nargesi N, Mohammadi A, Stephens GJ, Shabani M. Mechanisms of COVID-19-induced cerebellitis. Curr Med Res Opin 2022; 38:2109-2118. [PMID: 36305796 DOI: 10.1080/03007995.2022.2141963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The COVID-19 pandemic caused by SARS-CoV2 has raised several important health concerns, not least increased mortality and morbidity. SARS-CoV2 can infect the central nervous system via hematogenous or transneuronal routes, acting through different receptors including ACE2, DPP4, and neuropilin 1 and cause several issues, including the focus here, cerebellitis. The cerebellum is an essential part of the CNS located adjacent to the brainstem with a complex micro and macroscopic structure. The cerebellum plays several physiological roles, such as coordination, cognition, and executive functioning. Damage to the cerebellum can lead to incoordination and ataxia. In our narrative review, we searched different databases from 2021 to 2022 with the keywords cerebellum and COVID-19; 247 studies were identified and reviewed, focusing on clinical studies and excluding non-clinical studies; 56 studies were finally included for analysis. SARS-CoV2 infection of the cerebellum can be seen to be assessed through many methods such as MRI, PET, CT, postmortem studies, and histological findings. These methodological studies have demonstrated that cerebellar infection with COVID-19 can bring about several sequelae: thrombosis, microbleed, hemorrhage, stroke, autoantibody production, ataxia, and widespread inflammation in the cerebellum. Such central effects are likely to exacerbate the known multiorgan effects of SARS-CoV2 and should also be considered as part of disease prognosis.
Collapse
Affiliation(s)
- Mohammad Banazadeh
- Pharmaceutical Sciences and Cosmetic Products Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Sepehr Olangian-Tehrani
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Avicennet, Tehran, Iran
| | - Melika Sharifi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Farhad Nikzad
- Avicennet, Tehran, Iran
- Student Research Committee, International Campus, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Alireza Mohammadi
- School of Pharmacy, Guilan University of Medical Science, Rasht, Iran
| | - Gary J Stephens
- School of Pharmacy, University of Reading, Whiteknights, Reading, UK
| | - Mohammad Shabani
- Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
| |
Collapse
|
4
|
König S, Hohenstein S, Pellissier V, Leiner J, Hindricks G, Nachtigall I, Kuhlen R, Bollmann A. Changing trends of patient characteristics and treatment pathways during the COVID-19 pandemic: A cross-sectional analysis of 72,459 inpatient cases from the German Helios database. Front Public Health 2022; 10:1028062. [PMID: 36420010 PMCID: PMC9678052 DOI: 10.3389/fpubh.2022.1028062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 10/12/2022] [Indexed: 11/09/2022] Open
Abstract
Background This study compared patient profiles and clinical courses of SARS-CoV-2 infected inpatients over different pandemic periods. Methods In a retrospective cross-sectional analysis, we examined administrative data of German Helios hospitals using ICD-10-codes at discharge. Inpatient cases with SARS-CoV-2 infection admitted between 03/04/2020 and 07/19/2022 were included irrespective of the reason for hospitalization. All endpoints were timely assigned to admission date for trend analysis. The first pandemic wave was defined by change points in time-series of incident daily infections and compared with different later pandemic phases according to virus type predominance. Results We included 72,459 inpatient cases. Patients hospitalized during the first pandemic wave (03/04/2020-05/05/2020; n = 1,803) were older (68.5 ± 17.2 vs. 64.4 ± 22.6 years, p < 0.01) and severe acute respiratory infections were more prevalent (85.2 vs. 53.3%, p < 0.01). No differences were observed with respect to distribution of sex, but comorbidity burden was higher in the first pandemic wave. The risk of receiving intensive care therapy was reduced in all later pandemic phases as was in-hospital mortality when compared to the first pandemic wave. Trend analysis revealed declines of mean age and Elixhauser comorbidity index over time as well as a decline of the utilization of intensive care therapy, mechanical ventilation and in-hospital mortality. Conclusion Characteristics and outcomes of inpatients with SARS-CoV-2 infection changed throughout the observational period. An ongoing evaluation of trends and care pathways will allow for the assessment of future demands.
Collapse
Affiliation(s)
- Sebastian König
- Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany,Real World Evidence and Health Technology Assessment, Helios Health Institute, Berlin, Germany,*Correspondence: Sebastian König
| | - Sven Hohenstein
- Real World Evidence and Health Technology Assessment, Helios Health Institute, Berlin, Germany
| | - Vincent Pellissier
- Real World Evidence and Health Technology Assessment, Helios Health Institute, Berlin, Germany
| | - Johannes Leiner
- Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany,Real World Evidence and Health Technology Assessment, Helios Health Institute, Berlin, Germany
| | - Gerhard Hindricks
- Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany,Real World Evidence and Health Technology Assessment, Helios Health Institute, Berlin, Germany
| | - Irit Nachtigall
- Department of Preventive Medicine and Hygiene, Helios Hospital Bad Saarow, Bad Saarow, Germany,Department of Anaesthesiology and Operative Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | - Andreas Bollmann
- Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany,Real World Evidence and Health Technology Assessment, Helios Health Institute, Berlin, Germany
| |
Collapse
|
5
|
Izzo R, Trimarco V, Mone P, Aloè T, Capra Marzani M, Diana A, Fazio G, Mallardo M, Maniscalco M, Marazzi G, Messina N, Mininni S, Mussi C, Pelaia G, Pennisi A, Santus P, Scarpelli F, Tursi F, Zanforlin A, Santulli G, Trimarco B. Combining L-Arginine with vitamin C improves long-COVID symptoms: The LINCOLN Survey. Pharmacol Res 2022; 183:106360. [PMID: 35868478 PMCID: PMC9295384 DOI: 10.1016/j.phrs.2022.106360] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/17/2022] [Accepted: 07/18/2022] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Recent evidence suggests that oxidative stress and endothelial dysfunction play critical roles in the pathophysiology of COVID-19 and Long-COVID. We hypothesized that a supplementation combining L-Arginine (to improve endothelial function) and Vitamin C (to reduce oxidation) could have favorable effects on Long-COVID symptoms. METHODS We designed a survey (LINCOLN: L-Arginine and Vitamin C improves Long-COVID), assessing several symptoms that have been associated with Long-COVID to be administered nationwide to COVID-19 survivors; the survey also included effort perception, measured using the Borg scale. Patients receiving the survey were divided in two groups, with a 2:1 ratio: the first group included patients that received L-Arginine + Vitamin C, whereas the second group received a multivitamin combination (alternative treatment). RESULTS 1390 patients successfully completed the survey. Following a 30-day treatment in both groups, the survey revealed that patients in the L-Arginine + Vitamin C treatment arm had significantly lower scores compared to patients who had received the multivitamin combination. There were no other significant differences between the two groups. When examining effort perception, we observed a significantly lower value (p < 0.0001) in patients receiving L-Arginine + Vitamin C compared to the alternative-treatment arm. CONCLUSIONS Our survey indicates that the supplementation with L-Arginine + Vitamin C has beneficial effects in Long-COVID, in terms of attenuating its typical symptoms and improving effort perception.
Collapse
Affiliation(s)
- Raffaele Izzo
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - Valentina Trimarco
- Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University, Naples, Italy
| | - Pasquale Mone
- Department of Medicine, Albert Einstein College of Medicine, New York, NY, USA
| | | | | | | | | | | | | | | | | | - Simone Mininni
- Associazione Scientifica Interdisciplinare Aggiornamento Medico (ASIAM), Florence, Italy
| | - Chiara Mussi
- Department of Biomedical and Metabolic Sciences and Neuroscience, University of Modena and Reggio Emilia, Modena, Italy
| | - Girolamo Pelaia
- Department of Health Science, Magna Graecia University, Catanzaro, Italy
| | | | | | | | | | | | - Gaetano Santulli
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy; Department of Medicine, Albert Einstein College of Medicine, New York, NY, USA.
| | - Bruno Trimarco
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| |
Collapse
|