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Yazar EE, Gunluoglu G, Arpinar Yigitbas B, Calikoglu M, Gulbas G, Yılmaz Demirci N, Sarioglu N, Bozkus F, Hoca NT, Ogan N, Tural Onur S, Turan MO, Kosar F, Akpinar EE, Mete B, Ozturk C. Can the ADO Index Be Used as a Predictor of Mortality from COVID-19 in Patients with COPD? Int J Chron Obstruct Pulmon Dis 2024; 19:851-858. [PMID: 38596202 PMCID: PMC11001538 DOI: 10.2147/copd.s440099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/20/2024] [Indexed: 04/11/2024] Open
Abstract
Background Several studies have shown that the risk of mortality due to COVID-19 is high in patients with COPD. However, evidence on factors predicting mortality is limited. Research Question Are there any useful markers to predict mortality in COVID-19 patients with COPD?. Study Design and Methods A total of 689 patients were included in this study from the COPET study, a national multicenter observational study investigating COPD phenotypes consisting of patients who were followed up with a spirometry-confirmed COPD diagnosis. Patients were also retrospectively examined in terms of COVID-19 and their outcomes. Results Among the study patients, 105 were diagnosed with PCR-positive COVID-19, and 19 of them died. Body mass index (p= 0.01) and ADO (age, dyspnoea, airflow obstruction) index (p= 0.01) were higher, whereas predicted FEV1 (p< 0.001) and eosinophil count (p= 0.003) were lower in patients who died of COVID-19. Each 0.755 unit increase in the ADO index increased the risk of death by 2.12 times, and each 0.007 unit increase in the eosinophil count decreased the risk of death by 1.007 times. The optimum cut-off ADO score of 3.5 was diagnostic with 94% sensitivity and 40% specificity in predicting mortality. Interpretation Our study suggested that the ADO index recorded in the stable period in patients with COPD makes a modest contribution to the prediction of mortality due to COVID-19. Further studies are needed to validate the use of the ADO index in estimating mortality in both COVID-19 and other viral respiratory infections in patients with COPD.
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Affiliation(s)
- Esra Ertan Yazar
- Department of Chest Diseases, Istanbul Medeniyet University, Medical Faculty, Istanbul, Turkey
| | - Gulsah Gunluoglu
- Department of Chest Diseases, Yedikule Chest Disease and Chest Surgery Research and Training Hospital, Istanbul, Turkey
| | - Burcu Arpinar Yigitbas
- Department of Chest Diseases, Istanbul Medeniyet University, Medical Faculty, Istanbul, Turkey
| | - Mukadder Calikoglu
- Department of Chest Diseases, Mersin University, Medical Faculty, Mersin, Turkey
| | - Gazi Gulbas
- Department of Chest Diseases, Inonu University, Medical Faculty, Malatya, Turkey
| | | | - Nurhan Sarioglu
- Department of Chest Diseases, Balikesir University, Medical Faculty, Balikesir, Turkey
| | - Fulsen Bozkus
- Department of Chest Diseases, Kahramanmaras Sutcu Imam University, Medical Faculty, Kahramanmaras, Turkey
| | - Nevin Taci Hoca
- Department of Chest Diseases, Gazi University, Medical Faculty, Ankara, Turkey
| | - Nalan Ogan
- Department of Chest Diseases, Ufuk University, Medical Faculty, Ankara, Turkey
| | - Seda Tural Onur
- Department of Chest Diseases, Yedikule Chest Disease and Chest Surgery Research and Training Hospital, Istanbul, Turkey
| | - Muzaffer Onur Turan
- Department of Chest Diseases, Prof Dr, Izmir Katip Celebi University, Atatürk Research and Training Hospital, Izmir, Turkey
| | - Filiz Kosar
- Department of Chest Diseases, Yedikule Chest Disease and Chest Surgery Research and Training Hospital, Istanbul, Turkey
| | - Evrim Eylem Akpinar
- Department of Chest Diseases, Ufuk University, Medical Faculty, Ankara, Turkey
| | - Burak Mete
- Department of Public Health Çukurova University, Medical Faculty, Adana, Turkey
| | - Can Ozturk
- Department of Chest Diseases, Gazi University, Medical Faculty, Ankara, Turkey
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Liu L, Silva Almodóvar A, Nahata MC. Medication adherence in Medicare-enrolled older adults with asthma and chronic obstructive pulmonary disease before and during COVID-19 pandemic. Ther Adv Chronic Dis 2023; 14:20406223231205796. [PMID: 37822769 PMCID: PMC10563468 DOI: 10.1177/20406223231205796] [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: 12/22/2022] [Accepted: 09/19/2023] [Indexed: 10/13/2023] Open
Abstract
Background Medication adherence in Medicare-enrolled older adults with asthma and chronic obstructive pulmonary disease (COPD) before and during the coronavirus disease 2019 (COVID-19) pandemic is unknown. Objectives To evaluate medication adherence and determinants of high adherence before and during the COVID-19 pandemic in this population. Design Retrospective cohort study. Methods The proportion of days covered (PDC) reflected medication adherence from January to July 2019 and from January to July 2020. Patients <65 years of age, with COPD or asthma alone, or with cystic fibrosis were excluded. Paired t tests were used to assess adherence changes. Logistic regression explored association of age, sex, diagnosis of depression, number of medications, medication-related problems, prescribers, pharmacies, controller medication classes, albuterol rescue inhaler fills, oral corticosteroid fills, and having a 90-day supply with high adherence (PDC ⩾ 80%). Results This analysis included 989 patients. In this cohort, 61.2% of patients received oral corticosteroids. Over 60% of patients had ⩾3 rescue fills in both 2019 and 2020. Medication adherence to controller medications significantly decreased for all controller medications (p < 0.001) in 2020. In 2019 and 2020, number of controller medication classes and having a 90-day supply were associated with high adherence (p < 0.001). In 2019, variables associated with high adherence also included number of medication-related problems and having ⩾3 albuterol rescue inhalers (p < 0.001). Conclusion Medication adherence to controllers significantly decreased during the pandemic among older adults with asthma and COPD. Patients with multiple controller classes and a 90-day supply were more likely to be highly adherent. A 90-day supply of medications should be used to facilitate access to medication during the pandemic. Healthcare professionals should assess medication adherence, resolve the barriers of adherence and medication-related problems to achieve desired clinical outcomes among older adults with both asthma and COPD.
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Affiliation(s)
- Ligang Liu
- Institute of Therapeutic Innovations and Outcomes (ITIO), College of Pharmacy, The Ohio State University, Columbus, Ohio, USA
| | - Armando Silva Almodóvar
- Institute of Therapeutic Innovations and Outcomes (ITIO), College of Pharmacy, The Ohio State University, Columbus, Ohio, USA
| | - Milap C. Nahata
- Institute of Therapeutic Innovations and Outcomes (ITIO), College of Pharmacy, The Ohio State University, 500 West 12th Ave, Columbus, OH 43210, USA
- College of Medicine, The Ohio State University, Columbus, Ohio, US
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Wiegand HF, Fehr M, Glock M, Rueb M, Roth-Sackenheim C, Köhler S, Pogarell O, Horster S, Geschke K, Tüscher O, Lieb K, Falkai P, Hölzel LP, Adorjan K. [COVID-19 vaccination for people with severe mental diseases : Results of the COVID Ψ outpatient survey and recommendations for psychiatry]. DER NERVENARZT 2023:10.1007/s00115-023-01477-5. [PMID: 37138091 PMCID: PMC10155662 DOI: 10.1007/s00115-023-01477-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND Severe mental illnesses are risk factors for SARS-CoV-2-related morbidity and mortality. Vaccination is an effective protection; therefore, high vaccination rates should be a major priority for people with mental illnesses. OBJECTIVES (1) Identification of at-risk groups for non-vaccination and structures and interventions needed for widespread vaccination among people with mental illnesses from the perspective of outpatient psychiatrists and neurologists, (2) discussion of the results in the context of the international literature and (3) recommendations derived from them. MATERIAL AND METHODS Qualitative content analysis of COVID-19 vaccination-related questions from the COVID Ψ online survey of n = 85 psychiatrists and neurologists in Germany. RESULTS In the survey, people with schizophrenia, severe lack of drive, low socioeconomic status and homelessness were seen as risk groups for non-vaccination. Increased and targeted information, education, addressing and motivation and easily accessible vaccination offers by general practitioners, psychiatrists, and neurologists as well as complementary institutions were considered as important interventions. DISCUSSION COVID-19 vaccinations as well as information, motivation and access support should be systematically offered by as many institutions of the psychiatric, psychotherapeutic and complementary care systems in Germany as possible.
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Affiliation(s)
- Hauke Felix Wiegand
- Klinik für Psychiatrie und Psychotherapie der Universitätsmedizin Mainz, Johannes-Gutenberg Universität Mainz, Mainz, Deutschland
| | - Mandy Fehr
- Klinik für Psychiatrie und Psychotherapie der Universitätsmedizin Mainz, Johannes-Gutenberg Universität Mainz, Mainz, Deutschland
| | - Miriam Glock
- Klinik für Psychiatrie und Psychotherapie der Universitätsmedizin Mainz, Johannes-Gutenberg Universität Mainz, Mainz, Deutschland
| | - Mike Rueb
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München (LMU), Numssbaumstr. 7, 80336, München, Deutschland
| | | | - Sabine Köhler
- Berufsverband Deutscher Nervenärzte, Berlin, Deutschland
| | - Oliver Pogarell
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München (LMU), Numssbaumstr. 7, 80336, München, Deutschland
| | - Sophia Horster
- Medizinische Klinik und Poliklinik II, Klinikum der Universität München (LMU), München, Deutschland
| | - Katharina Geschke
- Klinik für Psychiatrie und Psychotherapie der Universitätsmedizin Mainz, Johannes-Gutenberg Universität Mainz, Mainz, Deutschland
| | - Oliver Tüscher
- Klinik für Psychiatrie und Psychotherapie der Universitätsmedizin Mainz, Johannes-Gutenberg Universität Mainz, Mainz, Deutschland
| | - Klaus Lieb
- Klinik für Psychiatrie und Psychotherapie der Universitätsmedizin Mainz, Johannes-Gutenberg Universität Mainz, Mainz, Deutschland
| | - Peter Falkai
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München (LMU), Numssbaumstr. 7, 80336, München, Deutschland
| | - Lars-Peer Hölzel
- Klinik für Psychiatrie und Psychotherapie der Universitätsmedizin Mainz, Johannes-Gutenberg Universität Mainz, Mainz, Deutschland
- Oberberg Parkklinik Wiesbaden Schlangenbad, Schlangenbad, Deutschland
| | - Kristina Adorjan
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München (LMU), Numssbaumstr. 7, 80336, München, Deutschland.
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Kurtipek E, Mermer M, Yıldırım B, Yazar MA, Duran M, Duksal F. Factors Affecting Duration of Hospital Stay in Deceased COVID-19 Patients. Int J Gen Med 2023; 16:929-936. [PMID: 36938305 PMCID: PMC10022436 DOI: 10.2147/ijgm.s406021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 03/04/2023] [Indexed: 03/18/2023] Open
Abstract
Objective Extensive research has been conducted to identify the predictive criteria for COVID-19 disease. White blood cell, C-reactive protein, CRP/albumin ratio, neutrophil-to-lymphocyte ratio and ferritin are among the indicators of increased inflammatory response; hence, they could be used to determine the prognosis of COVID-19 cases. Within the scope of this study, we aimed to elucidate the predictivity of NLR, CAR and other laboratory parameters on the duration of hospital stay and mortality in patients with COVID-19. Materials and Method The data of 1516 COVID-19 patients who were hospitalized in our institution have been analyzed retrospectively. Patients were divided into two groups those who deceased within the first 10 days of hospitalization (Group I, ≤10 days) and those who deceased in the later period (Group II, >10 days). Age, gender, time to mortality after hospitalization, neutrophil count, CRP, neutrophil-to-lymphocyte ratio (NLR), CRP/albumin ratio (CAR), and d-dimer values were obtained from blood samples taken during hospitalization. Results NLR and CAR values were significantly higher in those who died in the first 10 days compared to the other group (p<0.02 and p<0.001, respectively). In addition, WBC, neutrophil, CRP and d-dimer levels were statistically significantly higher than the other group (p<0.05). Logistic regression analysis results for NLR and CAR were significant. The cut-off values were calculated (5.74 and 4.27, respectively) for both parameters. Among the most common comorbid diseases were hypertension (HT) in 41%, coronary artery disease (CAD) in 41.7%, asthma-chronic obstructive pulmonary disease (COPD) in 36.7%, diabetes mellitus (DM) in 36.1%. Conclusion NLR and CAR may have a decisive influence in determining the length of stay in hospital for patients who die in hospital due to COVID-19. In addition, it is recommended that COVID-19 cases with diabetes be followed closely.
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Affiliation(s)
- Ercan Kurtipek
- Department of Chest Diseases, University of Health Sciences, Konya City Hospital, Karatay, Konya, Turkey
- Correspondence: Ercan Kurtipek, Department of Chest Diseases, University of Health Sciences, Konya City Hospital, Karatay, Konya, Turkey, Email
| | - Mehmet Mermer
- Department of Chest Diseases, University of Health Sciences, Konya City Hospital, Karatay, Konya, Turkey
| | - Bilgenur Yıldırım
- Department of Chest Diseases, University of Health Sciences, Konya City Hospital, Karatay, Konya, Turkey
| | - Mehmet Akif Yazar
- Department of Anesthesiology and Reanimation, University of Health Sciences, Konya City Hospital, Karatay, Konya, Turkey
| | - Mustafa Duran
- Department of Cardiology, University of Health Sciences, Konya City Hospital, Karatay, Konya, Turkey
| | - Faysal Duksal
- Department of Chest Diseases, University of Health Sciences, Konya Beyhekim Training and Research Hospital, Selcuklu, Konya, Turkey
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Comorbid Asthma Increased the Risk for COVID-19 Mortality in Asia: A Meta-Analysis. Vaccines (Basel) 2022; 11:vaccines11010089. [PMID: 36679934 PMCID: PMC9862735 DOI: 10.3390/vaccines11010089] [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: 11/08/2022] [Revised: 12/22/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023] Open
Abstract
We aimed to explore the influence of comorbid asthma on the risk for mortality among patients with coronavirus disease 2019 (COVID-19) in Asia by using a meta-analysis. Electronic databases were systematically searched for eligible studies. The pooled odds ratio (OR) with 95% confidence interval (CI) was estimated by using a random-effect model. An inconsistency index (I2) was utilized to assess the statistical heterogeneity. A total of 103 eligible studies with 198,078 COVID-19 patients were enrolled in the meta-analysis; our results demonstrated that comorbid asthma was significantly related to an increased risk for COVID-19 mortality in Asia (pooled OR = 1.42, 95% CI: 1.20−1.68; I2 = 70%, p < 0.01). Subgroup analyses by the proportion of males, setting, and sample sizes generated consistent findings. Meta-regression indicated that male proportion might be the possible sources of heterogeneity. A sensitivity analysis exhibited the reliability and stability of the overall results. Both Begg’s analysis (p = 0.835) and Egger’s analysis (p = 0.847) revealed that publication bias might not exist. In conclusion, COVID-19 patients with comorbid asthma might bear a higher risk for mortality in Asia, at least among non-elderly individuals.
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Chang YS. Coronavirus disease 2019 (COVID-19) and Long COVID. Asia Pac Allergy 2022; 12:e22. [PMID: 35571554 PMCID: PMC9066082 DOI: 10.5415/apallergy.2022.12.e22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Yoon-Seok Chang
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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