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AKHAVIZADEGAN HAMED, HOSAMIRUDSARI HADISEH, ALIZADEH MAHBOOBEH, ALIMOHAMADI YOUSEF, KARBAKHSH DAVARI MOJGAN, AKBARPOUR SAMANEH, NAKHOSTIN-ANSARI AMIN, FOROUGHI ALIREZA, MANSURI FARIBA, FARAJI NEDA, NASIRI ZOHREH. Can laboratory tests at the time of admission guide us to the prognosis of patients with COVID-19? JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E321-E325. [PMID: 34604572 PMCID: PMC8451338 DOI: 10.15167/2421-4248/jpmh2021.62.2.1700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 05/19/2021] [Indexed: 11/25/2022]
Abstract
Introduction To enhance the COVID-19 patients’ care and to optimize utilizing medical resources during the pandemic, relevant biomarkers are needed for prediction of the disease’s progression. The current study was aimed to determine the factors that affect the mortality of COVID-19 patients admitted in Baharloo hospital in Iran. Methods in the current retrospective study, 56 survived patients and 56 patients who were died (a total of 112 cases) because of COVID-19 infection were randomly selected from those who were admitted to Baharloo hospital. Each patient who was diagnosed with COVID-19 and had recovered from it matched with each non-survived patient in the term of age. Laboratory tests of all these patients at the time of admission were recorded and compared. All analyses performed using spss version 22 by considering α = 0.05 as a significant level. Results There was no statistical difference in the age and gender distribution between the two groups (p > 0.05). The prevalence of diabetes among survived patients was 37.5% and among non-survived patients was 26.8% and there was no statistical difference between two groups regarding this comorbidity (p = 0.22). Also, there was no statistical difference in the prevalence of hypertension and coronary heart diseases between two groups (p > 0.05). Lymphocyte percentage, blood oxygen level, and platelet (PLT) count was significantly higher in patients who had recovered (P < 0.05). Conclusions LDH level, Lymphocyte percentage, PLT count, and blood Oxygen saturation have associations with severe forms of COVID-19 infection and can be used as predictors to assess the patients who are suspected of infection with COVID-19 at the time of admission.
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Affiliation(s)
| | - HADISEH HOSAMIRUDSARI
- Infectious disease department, Tehran University of Medical Sciences, Tehran, Iran
- Correspondence: Hadiseh Hosamirudsari, Infectious Disease Department, Tehran University of Medical Sciences, Tehran, Iran - E-mail:
| | - MAHBOOBEH ALIZADEH
- Infectious disease department, Baharloo hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - YOUSEF ALIMOHAMADI
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran
| | | | - SAMANEH AKBARPOUR
- Department of Epidemiology & Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - ALIREZA FOROUGHI
- Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran
| | - FARIBA MANSURI
- Department of Pulmonology and respiratory diseases, Tehran University of Medical Sciences, Tehran, Iran
| | - NEDA FARAJI
- Department of Internal medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - ZOHREH NASIRI
- Medical physiology and nursing office, Tehran University of Medical Sciences, Tehran, Iran
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Guesneau C, Boureau AS, Bourigault C, Berrut G, Lepelletier D, de Decker L, Chapelet G. Risk Factors Associated with 30-Day Mortality in Older Patients with Influenza. J Clin Med 2021; 10:jcm10163521. [PMID: 34441817 PMCID: PMC8396973 DOI: 10.3390/jcm10163521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 07/27/2021] [Accepted: 08/02/2021] [Indexed: 12/01/2022] Open
Abstract
Background: Influenza is a common viral condition, but factors related to short-term mortality have not been fully studied in older adults. Our objective was to determine whether there is an association between geriatric factors and 30-day mortality. Methods: This was a retrospective cohort design. All patients aged 75 years and over, with a diagnosis of influenza confirmed by a positive RT-PCR, were included. The primary endpoint was death within the 30 days after diagnosis. Results: 114 patients were included; 14 (12.3%) patients died within 30 days. In multivariate analysis these patients were older (OR: 1.37 95% CI (1.05, 1.79), p = 0.021), and had a lower ADL score (OR: 0.36 95% CI (0, 17; 0.75), p = 0.006), and a higher SOFA score (OR: 2.30 95% CI (1.07, 4.94), p = 0.03). Oseltamivir treatment, initiated within the first 48 h, was independently associated with survival (OR: 0.04 95% CI (0.002, 0.78), p = 0.034). Conclusions: Identification of mortality risk factors makes it possible to consider specific secondary prevention measures such as the rapid introduction of antiviral treatment. Combined with primary prevention, these measures could help to limit the mortality associated with influenza in older patients.
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Affiliation(s)
- Charles Guesneau
- Clinical Gerontology Department, Nantes University Hospital, 1 Place Alexis-Ricordeau, F-44000 Nantes, France
| | - Anne Sophie Boureau
- Clinical Gerontology Department, Nantes University Hospital, 1 Place Alexis-Ricordeau, F-44000 Nantes, France
| | - Céline Bourigault
- Université de Nantes, EE MiHAR (Microbiotes, Hôtes, Antibiotiques et Résistance Bacterienne), Institut de Recherche en Santé (IRS2), 22 Boulevard Bénoni-Goullin, F-44200 Nantes, France
- Bacteriology and Infection Control Department, Nantes University Hospital, 1 Place Alexis-Ricordeau, F-44000 Nantes, France
| | - Gilles Berrut
- Clinical Gerontology Department, Nantes University Hospital, 1 Place Alexis-Ricordeau, F-44000 Nantes, France
| | - Didier Lepelletier
- Université de Nantes, EE MiHAR (Microbiotes, Hôtes, Antibiotiques et Résistance Bacterienne), Institut de Recherche en Santé (IRS2), 22 Boulevard Bénoni-Goullin, F-44200 Nantes, France
- Bacteriology and Infection Control Department, Nantes University Hospital, 1 Place Alexis-Ricordeau, F-44000 Nantes, France
| | - Laure de Decker
- Clinical Gerontology Department, Nantes University Hospital, 1 Place Alexis-Ricordeau, F-44000 Nantes, France
- Université de Nantes, EE MiHAR (Microbiotes, Hôtes, Antibiotiques et Résistance Bacterienne), Institut de Recherche en Santé (IRS2), 22 Boulevard Bénoni-Goullin, F-44200 Nantes, France
| | - Guillaume Chapelet
- Clinical Gerontology Department, Nantes University Hospital, 1 Place Alexis-Ricordeau, F-44000 Nantes, France
- Université de Nantes, EE MiHAR (Microbiotes, Hôtes, Antibiotiques et Résistance Bacterienne), Institut de Recherche en Santé (IRS2), 22 Boulevard Bénoni-Goullin, F-44200 Nantes, France
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Vos LM, Oosterheert JJ, Hoepelman AIM, Bont LJ, Coenjaerts FEJ, Naaktgeboren CA. External validation and update of a prognostic model to predict mortality in hospitalized adults with RSV: A retrospective Dutch cohort study. J Med Virol 2019; 91:2117-2124. [PMID: 31410862 PMCID: PMC6851775 DOI: 10.1002/jmv.25568] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 08/03/2019] [Indexed: 01/14/2023]
Abstract
Respiratory syncytial virus (RSV) causes significant mortality in hospitalized adults. Prediction of poor outcomes improves targeted management and clinical outcomes. We externally validated and updated existing models to predict poor outcome in hospitalized RSV-infected adults. In this single center, retrospective, observational cohort study, we included hospitalized adults with respiratory tract infections (RTIs) and a positive polymerase chain reaction for RSV (A/B) on respiratory tract samples (2005-2018). We validated existing prediction models and updated the best discriminating model by revision, recalibration, and incremental value testing. We included 192 RSV-infected patients (median age 60.7 years, 57% male, 65% immunocompromised, and 43% with lower RTI). Sixteen patients (8%) died within 30 days. During hospitalization, 16 (8%) died, 30 (16%) were admitted to intensive care unit, 21 (11%) needed invasive mechanical ventilation, and 5 (3%) noninvasive positive pressure ventilation. Existing models performed moderately at external validation, with C-statistics 0.6 to 0.7 and moderate calibration. Updating to a model including lower RTI, chronic pulmonary disease, temperature, confusion and urea, increased the C-statistic to 0.76 (95% confidence interval, 0.61-0.91) to predict in-hospital mortality. In conclusion, existing models to predict poor prognosis among hospitalized RSV-infected adults perform moderately at external validation. A prognostic model may help to identify and treat RSV-infected adults at high-risk of death.
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Affiliation(s)
- Laura M Vos
- Department of Infectious Diseases, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Jan Jelrik Oosterheert
- Department of Infectious Diseases, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Andy I M Hoepelman
- Department of Infectious Diseases, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Louis J Bont
- Department of Pediatric Infectious Diseases, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Frank E J Coenjaerts
- Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Christiana A Naaktgeboren
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
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Fica A, Sotomayor V, Fasce R, Dabanch J, Soto A, Charpentier P, Guerrero G, Olivares F, Triantafilo V, Omeiri NE, Gaínza-Lein M. Severe acute respiratory infections (SARI) from influenza in adult patients in Chile: the experience of a sentinel hospital. Rev Panam Salud Publica 2019; 43:e1. [PMID: 31093225 PMCID: PMC6393720 DOI: 10.26633/rpsp.2019.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 06/16/2018] [Indexed: 12/16/2022] Open
Abstract
Objective To 1) describe clinical characteristics of adult patients in Chile with severe acute respiratory infections (SARI) associated with influenza viruses, and 2) analyze virus subtypes identified in specimens collected from those patients, hospital resources used in clinical management, clinical evolution, and risk factors associated with a fatal outcome, using observational data from the SARI surveillance network (SARInet). Methods Adults hospitalized from 1 July 2011 to 31 December 2015 with influenza-associated SARI at a SARI sentinel surveillance hospital in Santiago were identified and the presence of influenza in all cases confirmed by reverse transcription polymerase chain reaction (RT-PCR), using respiratory samples. Results A total of 221 patients (mean age: 74.1 years) were hospitalized with influenza-associated SARI during the study period. Of this study cohort, 91.4% had risk factors for complications and 34.3% had been vaccinated during the most recent campaign. Pneumonia was the most frequent clinical manifestation, occurring in 57.0% of the cohort; other manifestations included influenza-like illness, exacerbated chronic bronchitis, decompensated heart failure, and asthmatic crisis. Cases occurred year-round, with an epidemic peak during autumn–winter. Both influenza A (H1N1pdm09 and H3N2) and B virus co-circulated. Critical care beds were required for 26.7% of the cohort, and 19.5% needed ventilatory assistance. Multivariate analysis identified four significant factors associated with in-hospital mortality: 1) being bedridden (adjusted odds ratio (aOR): 22.3; 95% confidence interval (CI): 3.0–164); 2) admission to critical care unit (aOR: 8.9; CI: 1.44–55); 3) Pa02/Fi02 ratio < 250 (aOR: 5.8; CI: 1.02–33); and 4) increased serum creatinine concentration (> 1 mg/dL) (aOR: 5.47; CI: 1.20–24). Seasonal influenza vaccine was identified as a significant protective factor (aOR: 0.14; CI: 0.021–0.90). Conclusions Influenza-associated SARI affected mainly elderly patients with underlying conditions. Most patients evolved to respiratory failure and more than one-quarter required critical care beds. Clinical presentation was variable. Death was associated with host characteristics and disease-associated conditions, and vaccine was protective. Virus type did not influence outcome.
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Affiliation(s)
- Alberto Fica
- Infectious Disease Service, Hospital Militar de Santiago, Santiago, Chile
| | | | - Rodrigo Fasce
- Viral Hepatitis and Emerging Diseases Section, Viral Diseases Subdepartment, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Jeannette Dabanch
- Infectious Disease Service, Hospital Militar de Santiago, Santiago, Chile
| | - Andrés Soto
- Infectious Disease Service, Hospital Militar de Santiago, Santiago, Chile
| | - Paulo Charpentier
- Infectious Disease Service, Hospital Militar de Santiago, Santiago, Chile
| | - Gonzalo Guerrero
- Infectious Disease Service, Hospital Militar de Santiago, Santiago, Chile
| | - Felipe Olivares
- Infectious Disease Service, Hospital Militar de Santiago, Santiago, Chile
| | | | - Nathalie El Omeiri
- Comprehensive Family Immunization Unit, Pan American Health Organization, Washington, D.C., United States of America
| | - Marina Gaínza-Lein
- School of Medicine, Universidad Austral de Chile-Campus Isla Teja, Valdivia, Chile
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