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Crocker-Buque T, Williams S, Brentnall AR, Gabe R, Duffy S, Prowle JR, Orkin C, Kunst H, Cutino-Moguel T, Zenner D, Bloom B, Melzer M, de Freitas S, Darmalingam M, McCafferty K, Kapil V, Pfeffer P, Martin J, Gourtsoyannis Y, Chandran S, Dhariwal A, Rachman R, Milligan I, Mabayoje D, Adobah E, Falconer J, Nugent H, Yaqoob M, Collier D, Pearse R, Caulfield M, Tiberi S. The Barts Health NHS Trust COVID-19 cohort: characteristics, outcomes and risk scoring of patients in East London. Int J Tuberc Lung Dis 2021; 25:358-366. [PMID: 33977903 DOI: 10.5588/ijtld.20.0926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Barts Health National Health Service Trust (BHNHST) serves a diverse population of 2.5 million people in London, UK. We undertook a health services assessment of factors used to evaluate the risk of severe acute respiratory coronavirus 2 (SARS-CoV-2) infection.METHODS: Patients with confirmed polymerase chain reaction (PCR) test results admitted between 1 March and 1 August 2020 were included, alongwith clinician-diagnosed suspected cases. Prognostic factors from the 4C Mortality score and 4C Deterioration scores were extracted from electronic health records and logistic regression was used to quantify the strength of association with 28-day mortality and clinical deterioration using national death registry linkage.RESULTS: Of 2783 patients, 1621 had a confirmed diagnosis, of whom 61% were male and 54% were from Black and Minority Ethnic groups; 26% died within 28 days of admission. Mortality was strongly associated with older age. The 4C mortality score had good stratification of risk with a calibration slope of 1.14 (95% CI 1.01-1.27). It may have under-estimated mortality risk in those with a high respiratory rate or requiring oxygen.CONCLUSION: Patients in this diverse patient cohort had similar mortality associated with prognostic factors to the 4C score derivation sample, but survival might be poorer in those with respiratory failure.
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Affiliation(s)
- T Crocker-Buque
- The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK
| | - S Williams
- The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK
| | - A R Brentnall
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, Mile End Road, London, UK
| | - R Gabe
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, Mile End Road, London, UK, Barts Clinical Trials Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Mile End Road, London, UK
| | - S Duffy
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, Mile End Road, London, UK
| | - J R Prowle
- The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK, The William Harvey Research Institute, Queen Mary University of London Charterhouse Square, London, UK
| | - C Orkin
- The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK
| | - H Kunst
- The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK
| | - T Cutino-Moguel
- The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK
| | - D Zenner
- Centre for Global Public Health, Queen Mary University of London, Mile End Road, London, UK
| | - B Bloom
- The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK
| | - M Melzer
- The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK, Whipps Cross University Hospital, Barts Health NHS Trust, Leytonstone, London, UK
| | - S de Freitas
- The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK
| | - M Darmalingam
- Whipps Cross University Hospital, Barts Health NHS Trust, Leytonstone, London, UK
| | - K McCafferty
- The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK
| | - V Kapil
- The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK, The William Harvey Research Institute, Queen Mary University of London Charterhouse Square, London, UK, St Bartholomew´s Hospital, Barts Health NHS Trust, West Smithfield, London, UK
| | - P Pfeffer
- The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK, The William Harvey Research Institute, Queen Mary University of London Charterhouse Square, London, UK
| | - J Martin
- Newham University Hospital, Barts Health NHS Trust, London, UK
| | - Y Gourtsoyannis
- The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK
| | - S Chandran
- The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK
| | - A Dhariwal
- The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK
| | - R Rachman
- The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK
| | - I Milligan
- The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK
| | - D Mabayoje
- The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK
| | - E Adobah
- The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK
| | - J Falconer
- The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK
| | - H Nugent
- The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK
| | - M Yaqoob
- The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK
| | - D Collier
- Barts Clinical Trials Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Mile End Road, London, UK, The William Harvey Research Institute, Queen Mary University of London Charterhouse Square, London, UK
| | - R Pearse
- The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK, The William Harvey Research Institute, Queen Mary University of London Charterhouse Square, London, UK
| | - M Caulfield
- The William Harvey Research Institute, Queen Mary University of London Charterhouse Square, London, UK
| | - S Tiberi
- The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK, Newham University Hospital, Barts Health NHS Trust, London, UK
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Nugent DB, Webster D, Mabayoje D, Chung E, El Bouzidi K, O'Sullivan A, Ainsworth J, Miller RF. Use of plasma human herpesvirus-8 viral load measurement: evaluation of practice in three UK HIV treatment centres. Int J STD AIDS 2017; 28:188-191. [PMID: 28120699 DOI: 10.1177/0956462416676031] [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] [Indexed: 11/17/2022]
Abstract
A retrospective audit of plasma human herpesvirus-8 (HHV-8) viral load testing was performed in three HIV treatment centres over 24 months. Reasons for testing (360 tests) were: symptoms of systemic inflammatory response syndrome (SIRS) (fever, lymphadenopathy and raised inflammatory markers); monitoring in known HHV-8 pathology other than Kaposi sarcoma (KS); investigation of known/suspected KS, and other/no reason. Of patients with multicentric Castleman disease (MCD), 14/16 (88%) had detectable plasma HHV-8, as did 27/45 (60%) with biopsy proven or clinically confirmed KS, and 6/19 (32%) with lymphoma. Neither of the two patients with MCD and no detectable HHV-8 had SIRS symptoms at the time of the test. There was wide variation between centres in the indications prompting HHV-8 testing, with a more conservative approach resulting in a higher proportion of positive results. Measuring plasma HHV-8 in the absence of SIRS symptoms, established HHV-8 disease monitoring, or confirmed/suspected KS is unlikely to yield detectable HHV-8 thus allowing potential cost savings.
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Affiliation(s)
- D B Nugent
- 1 Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, UK
| | - D Webster
- 2 Royal Free London NHS Foundation Trust, London, UK
| | - D Mabayoje
- 2 Royal Free London NHS Foundation Trust, London, UK
| | - E Chung
- 1 Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, UK
| | - K El Bouzidi
- 3 University College London Hospitals NHS Foundation Trust, London, UK.,4 University College London, London, UK
| | - A O'Sullivan
- 5 North Middlesex University Hospital NHS Trust, London, UK
| | - J Ainsworth
- 5 North Middlesex University Hospital NHS Trust, London, UK
| | - R F Miller
- 1 Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, UK.,3 University College London Hospitals NHS Foundation Trust, London, UK.,4 University College London, London, UK
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