1
|
Ghosh P, Niesen MJ, Pawlowski C, Bandi H, Yoo U, Lenehan PJ, M. PK, Nadig M, Ross J, Ardhanari S, O’Horo JC, Venkatakrishnan AJ, Rosen CJ, Telenti A, Hurt RT, Soundararajan V. Severe acute infection and chronic pulmonary disease are risk factors for developing post-COVID-19 conditions. medRxiv 2022:2022.11.30.22282831. [PMID: 36523407 PMCID: PMC9753786 DOI: 10.1101/2022.11.30.22282831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Post-COVID-19 conditions, also known as "long COVID", has significantly impacted the lives of many individuals, but the risk factors for this condition are poorly understood. In this study, we performed a retrospective EHR analysis of 89,843 individuals at a multi-state health system in the United States with PCR-confirmed COVID-19, including 1,086 patients diagnosed with long COVID and 1,086 matched controls not diagnosed with long COVID. For these two cohorts, we evaluated a wide range of clinical covariates, including laboratory tests, medication orders, phenotypes recorded in the clinical notes, and outcomes. We found that chronic pulmonary disease (CPD) was significantly more common as a pre-existing condition for the long COVID cohort than the control cohort (odds ratio: 1.9, 95% CI: [1.5, 2.6]). Additionally, long-COVID patients were more likely to have a history of migraine (odds ratio: 2.2, 95% CI: [1.6, 3.1]) and fibromyalgia (odds ratio: 2.3, 95% CI: [1.3, 3.8]). During the acute infection phase, the following lab measurements were abnormal in the long COVID cohort: high triglycerides (meanlongCOVID: 278.5 mg/dL vs. meancontrol: 141.4 mg/dL), low HDL cholesterol levels (meanlongCOVID: 38.4 mg/dL vs. meancontrol: 52.5 mg/dL), and high neutrophil-lymphocyte ratio (meanlongCOVID: 10.7 vs. meancontrol: 7.2). The hospitalization rate during the acute infection phase was also higher in the long COVID cohort compared to the control cohort (ratelongCOVID: 5% vs. ratecontrol: 1%). Overall, this study suggests that the severity of acute infection and a history of CPD, migraine, CFS, or fibromyalgia may be risk factors for long COVID symptoms. Our findings motivate clinical studies to evaluate whether suppressing acute disease severity proactively, especially in patients at high risk, can reduce incidence of long COVID.
Collapse
Affiliation(s)
| | | | | | - Hari Bandi
- nference, inc., Cambridge, Massachusetts 02139, USA
| | - Unice Yoo
- nference, inc., Cambridge, Massachusetts 02139, USA
| | | | | | - Mihika Nadig
- nference, inc., Cambridge, Massachusetts 02139, USA
| | - Jason Ross
- nference, inc., 18 3rd St. S.W., Rochester MN 55902, USA
| | | | | | | | - Clifford J. Rosen
- Maine Medical Center, Portland, ME 04102, USA
- NIH RECOVER Initiative, USA
| | | | | | - Venky Soundararajan
- nference Labs, Bengaluru, India
- nference, inc., Cambridge, Massachusetts 02139, USA
- nference, inc., 18 3rd St. S.W., Rochester MN 55902, USA
- nference, inc. 2424 Erwin Road, Durham, NC 27705, USA
- Anumana, inc., Cambridge, Massachusetts 02139, USA
| |
Collapse
|
2
|
Abstract
Patients with differentiated thyroid cancer may have asymptomatic involvement of renal and/or adrenal gland, particularly if they are elderly and have associated metastases to other organs, which may remain undetected if these patients are not subjected to radioiodine treatment. Our experience also emphasises the role of routine post-radioiodine therapy whole body scan with high degree of clinical suspicion, which may reveal lesions otherwise not discernable in low dose whole body scan. All suspicious lesions should be subjected to structural imaging like ultrasound, CT or MRI for confirmation. In this setting, the role of radioiodine therapy is primarily aimed at palliation that might prolong their survival, probably reduce further spread and thus overall improve the quality of life.
Collapse
Affiliation(s)
- A Kumar
- Department of Nuclear Medicine, at All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | | | | |
Collapse
|
8
|
Abstract
A 10-year-old child with neurofibromatosis-1 was evaluated for progressive lumbar scoliosis, back pain, and foot numbness. Magnetic resonance imaging showed several lumbar intraspinal and extraspinal masses consistent with neurofibromas. The mass at L3-L5 compressed the thecal sac and was thought to be the source of the symptoms. On operative exploration, a lumbar epidural arteriovenous malformation was found, which was removed in its entirety. The child's back pain and foot numbness resolved. Epidural arteriovenous malformations in patients with neurofibromatosis-1 are rare and have been reported only in the cervical spine. Our finding of a lumbar epidural arteriovenous malformation in a child with neurofibromatosis-1 demonstrates that vascular anomalies can be present throughout the spine of patients with neurofibromatosis-1 and should be considered in the differential diagnosis of any neurofibromatosis-1-related epidural mass.
Collapse
Affiliation(s)
- M Nadig
- Pritzker School of Medicine, University of Chicago Children's Hospital, Illinois 60637, USA
| | | | | | | | | | | |
Collapse
|
11
|
Nadig M. [The divided female--motherhood and public culture]. Psyche (Stuttg) 1990; 44:53-70. [PMID: 2305104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The author compares "individual" motherhood, common in countries like Switzerland and the Federal Republic, with the "social" motherhood characteristic of a Mayan peasant culture in Yucatan. She discusses various psychoanalytic conceptions of motherhood, for instance, Freud's and Winnicott's. She argues that the ideological concept of the missing penis actually expresses the very real cultural deficiency of women. The retention of such ideological concepts prevents the actual conditions from being acknowledged in psychoanalytic theory. This, in turn, blocks the change in paradigm necessary for an adequate metatheoretical handling of gender differences.
Collapse
|