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Duong-Quy S, Huynh-Truong-Anh D, Nguyen-Thi-Kim T, Nguyen-Quang T, Tran-Ngoc-Anh T, Nguyen-Van-Hoai N, Do-Thi-Thu M, Nguyen-Chi T, Nguyen-Van T, Tang-Thi-Thao T, Nguyen-Tuan A, Nguyen-Hoang Q, Hoang-Phi-Tuyet P, Vu-Van G, Nguyen-Lan H, Nguyen-Hong C, Dinh-Ngoc S, Truong-Viet D, Nguyen-Nhu V, Nguyen-Duy T. Predictive Factors of Mortality in Patients with Severe COVID-19 Treated in the Intensive Care Unit: A Single-Center Study in Vietnam. Pulm Ther 2023; 9:377-394. [PMID: 37415031 PMCID: PMC10447826 DOI: 10.1007/s41030-023-00231-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/12/2023] [Indexed: 07/08/2023] Open
Abstract
INTRODUCTION The fourth outbreak of COVID-19 with the delta variant in Vietnam was very fierce due to the limited availability of vaccines and the lack of healthcare resources. During that period, the high mortality of patients with severe and critical COVID-19 caused many concerns for the health system, especially the intensive care units. This study aimed to analyze the predictive factors of death and survival in patients with severe and critical COVID-19. METHODS We conducted a cross-sectional and descriptive study on 151 patients with severe and critical COVID-19 hospitalized in the Intensive Care Unit of Binh Duong General Hospital. RESULTS Common clinical symptoms of severe and critical COVID-19 included shortness of breath (97.4%), fatigue (89.4%), cough (76.8%), chest pain (47.7%), loss of smell (48.3%), loss of taste (39.1%), and headache (21.2%). The abnormal biochemical features were leukopenia (2.1%), anemia, thrombocytopenia (18%), hypoxia with low PaO2 (34.6%), hypocapnia with reduced PaCO2 (29.6%), and blood acidosis (18.4%). Common complications during hospitalization were septic shock (15.2%), cardiogenic shock (5.3%), and embolism (2.6%). The predictive factors of death were being female, age > 65 years, cardiovascular comorbidity, thrombocytopenia (< 137.109/l), and hypoxia at inclusion or after the first week or blood acidosis (pH < 7.28). The use of a high dose of corticosteroids reduced the mortality during the first 3 weeks of hospitalization but significantly increased risk of death after 3 and 4 weeks. CONCLUSIONS Common clinical symptoms, laboratory features, and death-related complications of critical and severe COVID-19 patients were found in Vietnamese patients during the fourth wave of the COVID-19 pandemic. The results of this study provide new insight into the predictive factors of mortality for patients with severe and critical COVID-19.
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Affiliation(s)
- Sy Duong-Quy
- Biomedical Research Center, Lam Dong Medical College, Dalat City, Vietnam
- Hershey Medical Center, Penn State Medical College, State College, PA, USA
- Phu Chanh Covid-19 Hospital, Binh Duong General Hospital, Thu Dau Mot, Binh Duong Province, Vietnam
| | - Duc Huynh-Truong-Anh
- Phu Chanh Covid-19 Hospital, Binh Duong General Hospital, Thu Dau Mot, Binh Duong Province, Vietnam
| | - Thanh Nguyen-Thi-Kim
- Phu Chanh Covid-19 Hospital, Binh Duong General Hospital, Thu Dau Mot, Binh Duong Province, Vietnam
| | - Tien Nguyen-Quang
- Phu Chanh Covid-19 Hospital, Binh Duong General Hospital, Thu Dau Mot, Binh Duong Province, Vietnam
| | - Thuy Tran-Ngoc-Anh
- Phu Chanh Covid-19 Hospital, Binh Duong General Hospital, Thu Dau Mot, Binh Duong Province, Vietnam
| | - Nam Nguyen-Van-Hoai
- Phu Chanh Covid-19 Hospital, Binh Duong General Hospital, Thu Dau Mot, Binh Duong Province, Vietnam
| | - Mai Do-Thi-Thu
- Phu Chanh Covid-19 Hospital, Binh Duong General Hospital, Thu Dau Mot, Binh Duong Province, Vietnam
| | - Thanh Nguyen-Chi
- Phu Chanh Covid-19 Hospital, Binh Duong General Hospital, Thu Dau Mot, Binh Duong Province, Vietnam
| | - Toi Nguyen-Van
- Biomedical Research Center, Lam Dong Medical College, Dalat City, Vietnam
| | - Tram Tang-Thi-Thao
- Biomedical Research Center, Lam Dong Medical College, Dalat City, Vietnam
| | - Anh Nguyen-Tuan
- Biomedical Research Center, Lam Dong Medical College, Dalat City, Vietnam
| | - Quan Nguyen-Hoang
- Biomedical Research Center, Lam Dong Medical College, Dalat City, Vietnam
| | | | - Giap Vu-Van
- Respiratory Center, Bach Mai Hospital, Hanoi City, Vietnam
| | - Hieu Nguyen-Lan
- Phu Chanh Covid-19 Hospital, Binh Duong General Hospital, Thu Dau Mot, Binh Duong Province, Vietnam
| | | | - Sy Dinh-Ngoc
- Respiratory Department, National Hospital of Lung Diseases, Hanoi City, Vietnam
| | - Dung Truong-Viet
- Department of Public Health, Thang Long University, Ha Noi City, Vietnam
| | - Vinh Nguyen-Nhu
- Department of Respiratory Functional Exploration. University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
| | - Thai Nguyen-Duy
- National Institute for Control of Vaccines and Biologicals, Ministry of Health, Hanoi City, Vietnam.
- Department of Biomedical Sciences, Vietnam University of Traditional Medicine, Ministry of Health, Hanoi City, Vietnam.
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Duong-Quy S, Huynh-Truong-Anh D, Nguyen-Quang T, Nguyen-Thi-Kim T, Tran-Ngoc-Anh T, Nguyen-Van-Hoai N, Do-Thi-Thu M, Nguyen-Van T, Tang-Thi-Thao T, Nguyen-Tuan A, Nguyen-Van T, Tran-Xuan Q, Vu-Tran-Thien Q, Trinh-Du T, Tran-Thai T, Nguyen-Duy T, Tran-Van H, Vo-Thi-Kim A. Guillain-Barré Syndrome due to COVID-19 Vero Cell Vaccination Associated with Concomitant COVID-19 Infection-induced ARDS and Treated Successfully by Therapeutic Plasma Exchange: A First Case Report from Vietnam. Pulm Ther 2023; 9:271-280. [PMID: 36991236 PMCID: PMC10057680 DOI: 10.1007/s41030-023-00219-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 02/27/2023] [Indexed: 03/31/2023] Open
Abstract
Post-vaccination adverse reactions have been reported with varying symptoms and severity owing to research and production time pressures during the coronavirus disease 2019 (COVID-19) pandemic. In this article, we report a rare case of Guillain-Barré syndrome (GBS) in a patient with COVID-19 with acute respiratory distress syndrome (ARDS) after receiving Sinopharm's Vero Cell vaccine (China). The patient who was initially negative for COVID-19 was diagnosed with GBS based on paralysis that developed from the lower extremities to the upper extremities, as confirmed by cytoalbuminologic dissociation in the cerebrospinal fluid. The patient's condition worsened with ARDS caused by COVID-19 infection during the hospital stay, and SpO2 decreased to 83% while receiving oxygen through a non-rebreather mask (15 l/min) on day 6. The patient was treated with standard therapy for severe COVID-19, invasive mechanical ventilation, and five cycles of therapeutic plasma exchange (TPE) with 5% albumin replacement on day 11 due to severe progression. The patient was weaned off the ventilator on day 28, discharged on day 42, and was completely healthy after 6 months without any neurological sequelae until now. Our report showed the potential of TPE for GBS treatment in critically ill patients with COVID-19 after COVID-19 vaccination.
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Affiliation(s)
- Sy Duong-Quy
- Clinical Research Unit, Lam Dong Medical College and Bio-Medical Research Centre, Dalat, Vietnam.
- Immuno-Allergology Division, Hershey Medical Center, Penn State Medical College, Hershey, PA, USA.
- Outpatient Department, Pham Ngoc Thach Medical University, Ho Chi Minh, Vietnam.
- Department of Respiratory Functional Exploration, University Medical Center, University of Medicine and Pharmacy, Ho Chi Minh, Vietnam.
| | - Duc Huynh-Truong-Anh
- Department of Emergency and ICU, Binh Duong General Hospital, Thuan An, Binh Duong, Vietnam
| | - Tien Nguyen-Quang
- Department of Emergency and ICU, Binh Duong General Hospital, Thuan An, Binh Duong, Vietnam
| | - Thanh Nguyen-Thi-Kim
- Department of Emergency and ICU, Binh Duong General Hospital, Thuan An, Binh Duong, Vietnam
| | - Thuy Tran-Ngoc-Anh
- Department of Emergency and ICU, Binh Duong General Hospital, Thuan An, Binh Duong, Vietnam
| | - Nam Nguyen-Van-Hoai
- Department of Emergency and ICU, Binh Duong General Hospital, Thuan An, Binh Duong, Vietnam
| | - Mai Do-Thi-Thu
- Department of Emergency and ICU, Binh Duong General Hospital, Thuan An, Binh Duong, Vietnam
| | - Tinh Nguyen-Van
- Department of Emergency and ICU, Binh Duong General Hospital, Thuan An, Binh Duong, Vietnam
| | - Tram Tang-Thi-Thao
- Clinical Research Unit, Lam Dong Medical College and Bio-Medical Research Centre, Dalat, Vietnam
| | - Anh Nguyen-Tuan
- Clinical Research Unit, Lam Dong Medical College and Bio-Medical Research Centre, Dalat, Vietnam
| | - Toi Nguyen-Van
- Clinical Research Unit, Lam Dong Medical College and Bio-Medical Research Centre, Dalat, Vietnam
| | - Quynh Tran-Xuan
- Department of Internal Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | - Quan Vu-Tran-Thien
- Department of Respiratory Functional Exploration, University Medical Center, University of Medicine and Pharmacy, Ho Chi Minh, Vietnam
| | - The Trinh-Du
- Department of Intensive Care Unit, Ninh Thuan General Hospital, Phan Rang, Ninh Thuan, Vietnam
| | - Tuan Tran-Thai
- Department of Intensive Care Unit, Ninh Thuan General Hospital, Phan Rang, Ninh Thuan, Vietnam
| | - Thai Nguyen-Duy
- National Institute for Control of Vaccines and Biologicals, Ministry of Health, Hanoi, Vietnam
| | - Huong Tran-Van
- Department of Medicine, Nam Anh General Hospital, Di An, Binh Duong, Vietnam
- Department of Public Health, Thang Long University, Hanoi, Vietnam
| | - Anh Vo-Thi-Kim
- Department of Medicine, Nam Anh General Hospital, Di An, Binh Duong, Vietnam.
- Department of Public Health, Thang Long University, Hanoi, Vietnam.
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Nguyen-Van T, Hoang GD, Nguyen-Le BT, Ngo-Van T, Le DT, Dao XT, Nguyen MD. Prognostic factors for surgical outcomes among patients with multilevel cervical spondylotic myelopathy. Eur Rev Med Pharmacol Sci 2022; 26:6242-6250. [PMID: 36111925 DOI: 10.26355/eurrev_202209_29647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Many clinical and imaging characteristics can influence the prognosis of multilevel cervical spondylotic myelopathy (M-CSM). This study investigated the factors that influence surgical outcomes among patients with M-CSM. PATIENTS AND METHODS This prospective study included 30 patients who underwent surgical treatment for M-CSM from June 2019 to June 2021. RESULTS The average age was 62.29 years, and the average follow-up time was 13.13 months. Preoperative, postoperative, and follow-up Modified Japanese Orthopaedic Association (mJOA) scores were 10.17, 13.53, and 16.17, respectively. The average postoperative and follow-up recovery rates were 45.46% and 76.69%, respectively. Patients older than 60 years (p = 0.04), male patients (p = 0.023), and smokers (p = 0.027) had lower preoperative mJOA scores than other groups. Patients with symptoms duration longer than 6 months had lower recovery rates (p = 0.021) than those with shorter symptom duration. Patients with intramedullary hyperintensity in ≤ 2 vertebra (p = 0.041) or anterior surgery (p = 0.022) had better postoperative recovery rates than their counterparts. A shorter period of hyperintensity in the intramedullary region on sagittal T2-weighted magnetic resonance imaging (T2W MRI) was significantly associated with faster discharge (p = 0.044). Patients with type 3 (discrete focal) hyperintensity in the intramedullary region on axial T2W MRI had a 6.75-fold increase in experiencing less than 50% postoperative recovery compared with other groups (odds ratio: 6.75, 95% confidence interval: 2.73-16.67). CONCLUSIONS Good prognostic factors for a shorter recovery included hyperintensity in the intramedullary region for ≤ 2 levels, shorter period of hyperintensity in the intramedullary region on sagittal T2W MRI, and an anterior surgical approach. A duration of symptoms longer than 6 months and discrete hyperintensity in the intramedullary region on axial T2W MRI were poor prognostic indicators associated with a longer recovery period.
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Affiliation(s)
- T Nguyen-Van
- Department of Surgery, Hanoi Medical University, Hanoi, Vietnam.
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