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Georgakopoulou VE, Gkoufa A, Makrodimitri S, Tsakanikas A, Basoulis D, Voutsinas PM, Karamanakos G, Eliadi I, Samara S, Triantafyllou M, Eleftheriadou I, Kampouropoulou O, Papageorgiou CV, Anastasopoulou A, Papalexis P, Trakas I, Trakas N, Spandidos DA, Steiropoulos P, Sipsas NV. Risk factors for the in‑hospital and 1‑year mortality of elderly patients hospitalized due to COVID‑19‑related pneumonia. Exp Ther Med 2024; 27:22. [PMID: 38125348 PMCID: PMC10728907 DOI: 10.3892/etm.2023.12310] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/09/2023] [Indexed: 12/23/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is characterized by poor outcomes and a high mortality rate, particularly among elderly patients. Since the beginning of the pandemic, an older age has been recognized as a critical risk factor for disease severity, with increasing mortality rates in each decade of life. This phenomenon may be a consequence of a poor previous health status, with a higher prevalence of pre-existing comorbidities and a higher degree of frailty. The majority of studies on the outcomes and risk factors of elderly patients refer to the first waves of the pandemic and the predictors of in-hospital mortality in these patients. The aim of the present study was to provide a detailed description of the clinical characteristics and management of a cohort of elderly patients (≥65 years of age) who were hospitalized with COVID-19-related pneumonia in all phases of the pandemic, presenting their outcomes, and investigating predictors of in-hospital and out-of-hospital mortality over a period of 1 year in this particularly vulnerable population. A total of 1,124 elderly patients (603 males, 53.7%) with a mean age of 78.51±7.42 years and a median Charlson comorbidity index (CCI) of 5 were included in the study. Of these patients, 104 (9.3%) were hospitalized during the period of prevalence of the original strain Wuhan, 385 (34.3%) were hospitalized during the period of prevalence of the Alpha variant, 221 (19.7%) were hospitalized during the period of prevalence of the Delta variant, and 414 (36.8%) were hospitalized during the period of prevalence of the Omicron variant. Overall, the in-hospital mortality rate was 33.4% (375 patients), and the 1-year mortality rate was 44.7% (502 patients). The majority of patients had not been vaccinated or had not completed full vaccination against severe acute respiratory syndrome coronavirus-2 (843 patients, 75%), given the period of infection. Age, immature granulocytes, lactate dehydrogenase (LDH) levels, ferritin levels, chest X-ray score, as well as the absence of full vaccination, cough and fatigue, were statistically significantly and independently associated with in-hospital mortality, while age, LDH levels, ferritin levels, alanine aminotransferase levels, CCI, chest X-ray score, the absence of cough and fatigue, and a history of dementia were statistically significantly and independently associated with 1-year mortality. On the whole, the present study demonstrates that both the in-hospital mortality and 1-year mortality rates of elderly patients hospitalized due to COVID-19-related pneumonia are high.
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Affiliation(s)
- Vasiliki Epameinondas Georgakopoulou
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Department of Pathophysiology, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Aikaterini Gkoufa
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Sotiria Makrodimitri
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Aristeidis Tsakanikas
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Dimitrios Basoulis
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Department of Pathophysiology, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Pantazis M. Voutsinas
- Department of Pathophysiology, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Georgios Karamanakos
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Irene Eliadi
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Stamatia Samara
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Maria Triantafyllou
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Ioanna Eleftheriadou
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Olga Kampouropoulou
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Chrysovalantis V. Papageorgiou
- Pulmonology Department, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Amalia Anastasopoulou
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Petros Papalexis
- Unit of Endocrinology, First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Department of Biomedical Sciences, University of West Attica, 12243 Athens, Greece
| | - Ilias Trakas
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Nikolaos Trakas
- Department of Biochemistry, Sismanogleio Hospital, 15126 Athens, Greece
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Paschalis Steiropoulos
- Department of Pulmonology, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Nikolaos V. Sipsas
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Department of Pathophysiology, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Georgakopoulou VE, Gkoufa A, Tsakanikas A, Makrodimitri S, Karamanakos G, Basoulis D, Voutsinas PM, Eliadi I, Bougea A, Spandidos DA, Angelopoulou E, Steiropoulos P, Sipsas NV. Predictors of COVID‑19‑associated mortality among hospitalized elderly patients with dementia. Exp Ther Med 2023; 26:395. [PMID: 37456163 PMCID: PMC10347294 DOI: 10.3892/etm.2023.12094] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 06/23/2023] [Indexed: 07/18/2023] Open
Abstract
The mortality of elderly patients with dementia hospitalized with coronavirus disease 2019 (COVID-19)-associated pneumonia is high. The mortality rate of these patients continues to be high following their discharge. However, data on the outcomes of these patients in all phases of the pandemic are limited. The aim of the present study was to examine the clinical characteristics and the in-hospital and 90-day mortality rates of elderly patients with dementia hospitalized due to COVID-19-associated pneumonia during all phases of the pandemic. During the time period between February 15, 2021 to July 15, 2022, 105 elderly patients (≥65 years old) with dementia of various etiologies were hospitalized due to COVID-19-associated pneumonia. The patient characteristics and in-hospital outcomes within 90 days of admission were recorded. The mean age of the patients was 84.03±7.61 years and 60 (57.1%) patients were females. A total of 52 (49.5%) patients were hospitalized during the omicron variant period, 27 (25.7%) were fully vaccinated (three doses) and 38 (36.2%) patients succumbed during their hospitalization. In total, 52 (49.5%) patients succumbed within the first 90 days of admission. According to the univariate regression analysis, the omicron variant [hazard ratio (HR), 2.126; 95% confidence interval (CI), 1.073-4.213; P=0.031] and the absence of full vaccination (HR, 6.231; 95% CI, 1.500-25.87; P=0.012) were associated with a higher in-hospital mortality. In the multivariate regression analysis, only the absence of complete vaccination was an independent predictor of mortality (HR, 5.182; 95% CI, 1.205-22.28; P=0.027). According to the univariate regression analysis, age (HR, 1.045; 95% CI, 1.006-1.085; P=0.023) and the lack of complete vaccination (HR, 3.254; 95% CI, 1.294-8.181; P=0.012) were associated with 90-day mortality; in addition, by multivariate regression analysis, age (HR, 1.047; 95% CI, 1.007-1.048; P=0.021) and the absence of full vaccination (HR, 3.286; 95% CI, 1.307-8.265; P=0.011) exhibited an independent association with the 90-day mortality rate. Based on the findings presented herein, the in-hospital and 90-day mortality rates of elderly patients with dementia and COVID-19-associated pneumonia is high. An older age and the lack of complete vaccination are independently associated with poor outcomes.
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Affiliation(s)
- Vasiliki Epameinondas Georgakopoulou
- Department of Infectious Diseases and COVID-19 Unit, Laiko General Hospital, Medical School, 11527 Athens, Greece
- Department of Pathophysiology, Laiko General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Aikaterini Gkoufa
- Department of Infectious Diseases and COVID-19 Unit, Laiko General Hospital, Medical School, 11527 Athens, Greece
| | - Aristeidis Tsakanikas
- Department of Infectious Diseases and COVID-19 Unit, Laiko General Hospital, Medical School, 11527 Athens, Greece
| | - Sotiria Makrodimitri
- Department of Infectious Diseases and COVID-19 Unit, Laiko General Hospital, Medical School, 11527 Athens, Greece
| | - Georgios Karamanakos
- Department of Infectious Diseases and COVID-19 Unit, Laiko General Hospital, Medical School, 11527 Athens, Greece
| | - Dimitrios Basoulis
- Department of Infectious Diseases and COVID-19 Unit, Laiko General Hospital, Medical School, 11527 Athens, Greece
- Department of Pathophysiology, Laiko General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Pantazis M. Voutsinas
- Department of Pathophysiology, Laiko General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Irene Eliadi
- Department of Infectious Diseases and COVID-19 Unit, Laiko General Hospital, Medical School, 11527 Athens, Greece
| | - Anastasia Bougea
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Efthalia Angelopoulou
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Paschalis Steiropoulos
- Department of Pulmonology, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Nikolaos V. Sipsas
- Department of Infectious Diseases and COVID-19 Unit, Laiko General Hospital, Medical School, 11527 Athens, Greece
- Department of Pathophysiology, Laiko General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Georgakopoulou V, Basoulis D, Voutsinas P, Makrodimitri S, Samara S, Triantafyllou M, Eliadi I, Karamanakos G, Papageorgiou C, Anastasopoulou A, Bitsani A, Kampouropoulou O, Eleftheriadou I, Gkoufa A, Spandidos D, Papalexis P, Sipsas N. Factors predicting poor outcomes of patients treated with tocilizumab for COVID‑19‑associated pneumonia: A retrospective study. Exp Ther Med 2022; 24:724. [DOI: 10.3892/etm.2022.11660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 10/10/2022] [Indexed: 11/05/2022] Open
Affiliation(s)
- Vasiliki Georgakopoulou
- Infectious Diseases and COVID‑19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Dimitrios Basoulis
- Infectious Diseases and COVID‑19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Pantazis Voutsinas
- Infectious Diseases and COVID‑19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Sotiria Makrodimitri
- Infectious Diseases and COVID‑19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Stamatia Samara
- Infectious Diseases and COVID‑19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Maria Triantafyllou
- Infectious Diseases and COVID‑19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Irene Eliadi
- Infectious Diseases and COVID‑19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Georgios Karamanakos
- Infectious Diseases and COVID‑19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Chrysovalantis Papageorgiou
- Pulmonology Department, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Amalia Anastasopoulou
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Aikaterini Bitsani
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Olga Kampouropoulou
- Infectious Diseases and COVID‑19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Ioanna Eleftheriadou
- Infectious Diseases and COVID‑19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Aikaterini Gkoufa
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Demetrios Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Petros Papalexis
- Unit of Endocrinology, First Department of Internal Medicine, Laiko General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Nikolaos Sipsas
- Infectious Diseases and COVID‑19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
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4
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Georgakopoulou V, Bali T, Adamantou M, Asimakopoulou S, Makrodimitri S, Samara S, Triantafyllou M, Voutsinas P, Eliadi I, Karamanakos G, Basoulis D, Chatzipanagiotou O, Adamopoulou E, Alevizou A, Athanasiadis M, Spandidos D, Papalexis P, Tarantinos K, Sipsas N, Samarkos M, Cholongitas E. Acute hepatitis and liver injury in hospitalized patients with COVID‑19 infection. Exp Ther Med 2022; 24:691. [PMID: 36277149 PMCID: PMC9535623 DOI: 10.3892/etm.2022.11627] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a systemic illness with an increased host inflammatory response that affects multiple extra-pulmonary organs, including the gastrointestinal tract. Abnormalities in liver biochemistry have been observed in a significant proportion of patients with COVID-19 upon admission, and this proportion increases with hospitalization. These abnormalities are typically manifested as elevations in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels, with less frequently detected elevations in the levels of cholestatic enzymes. Elevated aminotransaminase levels have been linked to an increased risk of mortality and complications, indicating the severity of COVID-19 infection. The present study evaluated the prevalence and the baseline factors associated with the development of acute hepatitis (ΑΗ), liver injury (LI) and associated patterns, as well as the presence of abnormalities in the levels of aminotransferases at discharge in the same cohort. For this purpose, 1,304 patients with confirmed COVID-19 infection were enrolled in the study. According to the results obtained, AST levels at baseline were the only independent factor for AH during hospital stay, while AST, alkaline phosphatase and ferritin levels were independent baseline factors for the development of LI. The patients with hepatocellular, compared to those with cholestatic LI, exhibited similar survival rates, as well as similarities in the development of acute kidney injury and the need for oxygen via high-flow nasal cannula and/or mechanical ventilation. In addition, age and ALT were independent risk factors for persistent abnormal values of AST and ALT at discharge.
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Affiliation(s)
- Vasiliki Georgakopoulou
- Infectious Diseases and COVID‑19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Triada Bali
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Magdalini Adamantou
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Stavroula Asimakopoulou
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Sotiria Makrodimitri
- Infectious Diseases and COVID‑19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Stamatia Samara
- Infectious Diseases and COVID‑19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Maria Triantafyllou
- Infectious Diseases and COVID‑19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Pantazis Voutsinas
- Infectious Diseases and COVID‑19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Irene Eliadi
- Infectious Diseases and COVID‑19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Georgios Karamanakos
- Infectious Diseases and COVID‑19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Dimitrios Basoulis
- Infectious Diseases and COVID‑19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Odysseas Chatzipanagiotou
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Eleni Adamopoulou
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Antonia Alevizou
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Menelaos Athanasiadis
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Demetrios Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Petros Papalexis
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | | | - Nikolaos Sipsas
- Infectious Diseases and COVID‑19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Michael Samarkos
- Infectious Diseases and COVID‑19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Evangelos Cholongitas
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Anastasopoulou A, Gkoufa A, Diamantopoulos P, Kazanas S, Eliadi I, Samarkos M, Gogas H. Clinical course of COVID-19 infection in a melanoma patient treated with nivolumab and bempegaldesleukin: a case report. Immunotherapy 2022; 14:1015-1020. [PMID: 35852114 PMCID: PMC9295713 DOI: 10.2217/imt-2021-0331] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
The exact impact of immune checkpoint inhibitors in the course and outcome of COVID-19 in cancer patients is currently unclear. Herein, we present the first description of an elderly melanoma patient who developed COVID-19 pneumonia while under treatment with nivolumab and bempegaldesleukin in combination with an investigational PEGylated interleukin (IL-2). We present the clinical characteristics and the laboratory and imaging findings of our patient during the course of COVID-19 pneumonia. Moreover, we discuss the currently available data regarding the mechanism of action of immune checkpoint inhibitors and IL-2 analogs in the treatment of COVID-19. The administration of these agents did not have a negative effect on the outcome of COVID-19 pneumonia in an elderly melanoma patient. Immune checkpoint inhibitors represent a major advance in the treatment of several solid malignancies, including melanoma. Bempegaldesleukin is an investigational PEGylated IL-2 that is being evaluated, in combination with nivolumab, in the management of a variety of cancers. The immunomodulation caused by these agents may also modify the immune response in COVID-19. Currently available data regarding the impact of immune checkpoint inhibitors in reducing the severity of COVID-19 in patients with cancer are mixed, whereas no clinical data are available for bempegaldesleukin. Herein, we report the case of an elderly female melanoma patient who developed COVID-19 pneumonia while under treatment with nivolumab and bempegaldesleukin. The administration of these agents did not have a negative effect on the outcome of COVID-19 pneumonia in our patient.
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Affiliation(s)
- Amalia Anastasopoulou
- First Department of Internal Medicine, Laikon General Hospital, Medical School of National & Kapodistrian University of Athens, Athens, 11527, Greece
| | - Aikaterini Gkoufa
- First Department of Internal Medicine, Laikon General Hospital, Medical School of National & Kapodistrian University of Athens, Athens, 11527, Greece
| | - Panagiotis Diamantopoulos
- First Department of Internal Medicine, Laikon General Hospital, Medical School of National & Kapodistrian University of Athens, Athens, 11527, Greece
| | - Spyridon Kazanas
- First Department of Internal Medicine, Laikon General Hospital, Medical School of National & Kapodistrian University of Athens, Athens, 11527, Greece
| | - Irene Eliadi
- First Department of Internal Medicine, Laikon General Hospital, Medical School of National & Kapodistrian University of Athens, Athens, 11527, Greece
| | - Michael Samarkos
- First Department of Internal Medicine, Laikon General Hospital, Medical School of National & Kapodistrian University of Athens, Athens, 11527, Greece
| | - Helen Gogas
- First Department of Internal Medicine, Laikon General Hospital, Medical School of National & Kapodistrian University of Athens, Athens, 11527, Greece
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Siafarikas C, Stafylidis C, Tentolouris A, Samara S, Eliadi I, Makrodimitri S, Spandidos D, Mathioudakis N, Karamichalos P, Papalexis P, Chlapoutakis S, Sklapani P, Trakas N, Georgakopoulou V. Radiologically suspected COVID‑19‑associated organizing pneumonia responding well to corticosteroids: A report of two cases and a review of the literature. Exp Ther Med 2022; 24:453. [PMID: 35720626 PMCID: PMC9199065 DOI: 10.3892/etm.2022.11379] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 05/11/2022] [Indexed: 12/12/2022] Open
Abstract
Organizing pneumonia (OP) is a type of diffuse interstitial lung disease, which may be
induced in the context of several clinical conditions, such as drug reactions, infections,
autoimmune diseases and cancer. Coronavirus disease 2019 (COVID-19)-associated OP has been
reported as a late-stage consequence of the infection or a histological form of
COVID-19-associated pneumonia. Autopsies and postmortem lung biopsies have demonstrated
that the majority of patients with COVID-19-associated pneumonia develop secondary OP, and
COVID-19-associated pneumonia and OP have common radiological features. The diagnosis of
COVID-19-associated OP should be suspected in patients with severe acute respiratory
syndrome coronavirus 2 infection who exhibit clinical deterioration despite optimal care,
or who have aggravating symptoms following an initial recovery. The use of corticosteroids
is a typical treatment for OP. However, to date, at least to the best of our knowledge,
there are a few reports regarding the role of corticosteroids in COVID-19-associated
pneumonia; thus, the optimal time for administration, the dose and treatment duration have
not yet been determined. The present study presents two cases of patients with COVID-19,
who exhibited clinical deterioration following the initial phase of infection and with
radiological characteristics of OP who received corticosteroids and had a favorable
outcome. The early diagnosis of COVID-19-associated OP may lead to targeted treatment,
decreased requirements for ventilatory support and an improved survival rate.
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Affiliation(s)
- Christos Siafarikas
- First Department of Propedeutic and Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Christos Stafylidis
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Anastasios Tentolouris
- First Department of Propedeutic and Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Stamatia Samara
- Department of Infectious Diseases‑COVID‑19 Unit, Laiko General Hospital, 11527 Athens, Greece
| | - Irene Eliadi
- Department of Infectious Diseases‑COVID‑19 Unit, Laiko General Hospital, 11527 Athens, Greece
| | - Sotiria Makrodimitri
- Department of Infectious Diseases‑COVID‑19 Unit, Laiko General Hospital, 11527 Athens, Greece
| | - Demetrios Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | | | | | - Petros Papalexis
- Unit of Endocrinology, First Department of Internal Medicine, Laiko General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | | | - Pagona Sklapani
- Department of Cytology, Mitera Hospital, 15123 Athens, Greece
| | - Nikolaos Trakas
- Department of Biochemistry, Sismanogleio Hospital, 15126 Athens, Greece
| | - Vasiliki Georgakopoulou
- Department of Infectious Diseases‑COVID‑19 Unit, Laiko General Hospital, 11527 Athens, Greece
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7
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Georgakopoulou VE, Vlachogiannis NI, Basoulis D, Eliadi I, Georgiopoulos G, Karamanakos G, Makrodimitri S, Samara S, Triantafyllou M, Voutsinas PM, Ntziora F, Psichogiou M, Samarkos M, Sfikakis PP, Sipsas NV. A Simple Prognostic Score for Critical COVID-19 Derived from Patients without Comorbidities Performs Well in Unselected Patients. J Clin Med 2022; 11:jcm11071810. [PMID: 35407418 PMCID: PMC8999885 DOI: 10.3390/jcm11071810] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/18/2022] [Accepted: 03/23/2022] [Indexed: 12/15/2022] Open
Abstract
We aimed to search for laboratory predictors of critical COVID-19 in consecutive adults admitted in an academic center between 16 September 2020−20 December 2021. Patients were uniformly treated with low-molecular-weight heparin, and dexamethasone plus remdesivir when SpO2 < 94%. Among consecutive unvaccinated patients without underlying medical conditions (n = 241, 49 year-old median, 71% males), 22 (9.1%) developed critical disease and 2 died (0.8%). White-blood-cell counts, neutrophils, neutrophil-to-lymphocyte ratio, CRP, fibrinogen, ferritin, LDH and γ-GT at admission were each univariably associated with critical disease. ROC-defined cutoffs revealed that CRP > 61.8 mg/L, fibrinogen > 616.5 mg/dL and LDH > 380.5 U/L were each associated with critical disease development, independently of age, sex and days from symptom-onset. A score combining higher-than-cutoff CRP (0/2), LDH (0/1) and fibrinogen (0/1) predicted critical disease (AUC: 0.873, 95% CI: 0.820−0.926). This score performed well in an unselected patient cohort (n = 1228, 100% unvaccinated) predominantly infected by the alpha variant (AUC: 0.718, 95% CI: 0.683−0.753), as well as in a mixed cohort (n = 527, 65% unvaccinated) predominantly infected by the delta variant (AUC: 0.708, 95% CI: 0.656−0.760). Therefore, we propose that a combination of standard biomarkers of acute inflammatory response, cell death and hypercoagulability reflects the severity of COVID-19 per se independently of comorbidities, age and sex, being of value for risk stratification in unselected patients.
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Affiliation(s)
- Vasiliki E. Georgakopoulou
- Infectious Diseases and COVID-19 Unit, General Hospital of Athens Laiko, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (V.E.G.); (D.B.); (I.E.); (G.K.); (S.M.); (S.S.); (M.T.); (P.M.V.); (M.P.); (M.S.)
| | - Nikolaos I. Vlachogiannis
- First Department of Propaedeutic Internal Medicine and Joint Academic Rheumatology Program, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (N.I.V.); (F.N.); (P.P.S.)
| | - Dimitrios Basoulis
- Infectious Diseases and COVID-19 Unit, General Hospital of Athens Laiko, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (V.E.G.); (D.B.); (I.E.); (G.K.); (S.M.); (S.S.); (M.T.); (P.M.V.); (M.P.); (M.S.)
| | - Irene Eliadi
- Infectious Diseases and COVID-19 Unit, General Hospital of Athens Laiko, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (V.E.G.); (D.B.); (I.E.); (G.K.); (S.M.); (S.S.); (M.T.); (P.M.V.); (M.P.); (M.S.)
| | - Georgios Georgiopoulos
- Department of Clinical Therapeutics, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - Georgios Karamanakos
- Infectious Diseases and COVID-19 Unit, General Hospital of Athens Laiko, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (V.E.G.); (D.B.); (I.E.); (G.K.); (S.M.); (S.S.); (M.T.); (P.M.V.); (M.P.); (M.S.)
| | - Sotiria Makrodimitri
- Infectious Diseases and COVID-19 Unit, General Hospital of Athens Laiko, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (V.E.G.); (D.B.); (I.E.); (G.K.); (S.M.); (S.S.); (M.T.); (P.M.V.); (M.P.); (M.S.)
| | - Stamatia Samara
- Infectious Diseases and COVID-19 Unit, General Hospital of Athens Laiko, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (V.E.G.); (D.B.); (I.E.); (G.K.); (S.M.); (S.S.); (M.T.); (P.M.V.); (M.P.); (M.S.)
| | - Maria Triantafyllou
- Infectious Diseases and COVID-19 Unit, General Hospital of Athens Laiko, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (V.E.G.); (D.B.); (I.E.); (G.K.); (S.M.); (S.S.); (M.T.); (P.M.V.); (M.P.); (M.S.)
| | - Pantazis M. Voutsinas
- Infectious Diseases and COVID-19 Unit, General Hospital of Athens Laiko, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (V.E.G.); (D.B.); (I.E.); (G.K.); (S.M.); (S.S.); (M.T.); (P.M.V.); (M.P.); (M.S.)
| | - Fotinie Ntziora
- First Department of Propaedeutic Internal Medicine and Joint Academic Rheumatology Program, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (N.I.V.); (F.N.); (P.P.S.)
| | - Mina Psichogiou
- Infectious Diseases and COVID-19 Unit, General Hospital of Athens Laiko, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (V.E.G.); (D.B.); (I.E.); (G.K.); (S.M.); (S.S.); (M.T.); (P.M.V.); (M.P.); (M.S.)
| | - Michael Samarkos
- Infectious Diseases and COVID-19 Unit, General Hospital of Athens Laiko, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (V.E.G.); (D.B.); (I.E.); (G.K.); (S.M.); (S.S.); (M.T.); (P.M.V.); (M.P.); (M.S.)
| | - Petros P. Sfikakis
- First Department of Propaedeutic Internal Medicine and Joint Academic Rheumatology Program, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (N.I.V.); (F.N.); (P.P.S.)
| | - Nikolaos V. Sipsas
- Infectious Diseases and COVID-19 Unit, General Hospital of Athens Laiko, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (V.E.G.); (D.B.); (I.E.); (G.K.); (S.M.); (S.S.); (M.T.); (P.M.V.); (M.P.); (M.S.)
- Pathophysiology Department, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Correspondence:
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8
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Cholongitas E, Bali T, Georgakopoulou VE, Giannakodimos A, Gyftopoulos A, Georgilaki V, Gerogiannis D, Basoulis D, Eliadi I, Karamanakos G, Mimidis K, Sipsas NV, Samarkos M. Prevalence of abnormal liver biochemistry and its impact on COVID-19 patients’ outcomes: a single-center Greek study. Ann Gastroenterol 2022; 35:290-296. [PMID: 35599935 PMCID: PMC9062840 DOI: 10.20524/aog.2022.0709] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 02/14/2022] [Indexed: 12/31/2022] Open
Abstract
Background Abnormalities in aminotransferases are frequently observed in hospitalized COVID-19 patients, but their clinical impact is poorly characterized. Methods A total of 1046 patients hospitalized to the non-intensive care unit ward with documented COVID-19 were included retrospectively. Demographic, clinical and laboratory characteristics on admission and during hospital stay, including the presence of liver injury (LI), defined as aspartate aminotransferase (AST) >200 IU/L, were recorded. Results On admission, 363 (34.7%) and 269 (25.7%) patients had abnormal AST and ALT values (i.e., >40 IU/L), respectively, while during hospitalization 53 (5%) patients fulfilled the criteria for LI. In multivariate logistic regression analysis, AST (odds ratio [OR] 1.023, 95% confidence interval [CI] 1.016-1.029; P<0.001), and ferritin (OR 1.01, 95%CI 1.001-1.02; P<0.001) were the baseline factors independently associated with the development of LI during hospital stay. One hundred twenty-three (11.7%) patients died during hospitalization. The independent variables associated with mortality were: age (hazard ratio [HR] 1.043, 95%CI 1.029-1.056; P<0.001), ferritin (HR 1.1, 95%CI 1.05-1.2; P<0.001), platelets (HR 0.996, 95%CI 0.994-0.999; P=0.003), and administration of remdesivir (HR 0.50, 95%CI 0.30-0.85; P=0.009). The patients with abnormal baseline AST (i.e., >40 IU/L), compared to those with normal AST values, had worse outcomes (log rank test: 8.8, P=0.003). Conclusions Elevated aminotransferases are commonly seen in COVID-19 patients. They possibly reflect disease severity and may be associated with in-hospital mortality.
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Affiliation(s)
- Evangelos Cholongitas
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Greece (Evangelos Cholongitas, Triada Bali, Alexios Giannakodimos, Argyrios Gyftopoulos, Vasiliki Georgilaki, Dimitrios Gerogiannis, Dimitrios Basoulis, Michael Samarkos)
- Correspondence to: Evangelos Cholongitas, MD, PhD, Associate Professor, First Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Agiou Thoma 17, Athens 11527, Greece, e-mail:
| | - Triada Bali
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Greece (Evangelos Cholongitas, Triada Bali, Alexios Giannakodimos, Argyrios Gyftopoulos, Vasiliki Georgilaki, Dimitrios Gerogiannis, Dimitrios Basoulis, Michael Samarkos)
| | - Vasiliki E. Georgakopoulou
- Pulmonology Department, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Greece (Vasiliki E. Georgakopoulou)
- Infectious Diseases and COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece (Dimitrios Basoulis, Eirini Iliadi, Georgios Karamanakos, Nikolaos V. Sipsas, Michael Samarkos)
| | - Alexios Giannakodimos
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Greece (Evangelos Cholongitas, Triada Bali, Alexios Giannakodimos, Argyrios Gyftopoulos, Vasiliki Georgilaki, Dimitrios Gerogiannis, Dimitrios Basoulis, Michael Samarkos)
| | - Argyrios Gyftopoulos
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Greece (Evangelos Cholongitas, Triada Bali, Alexios Giannakodimos, Argyrios Gyftopoulos, Vasiliki Georgilaki, Dimitrios Gerogiannis, Dimitrios Basoulis, Michael Samarkos)
| | - Vasiliki Georgilaki
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Greece (Evangelos Cholongitas, Triada Bali, Alexios Giannakodimos, Argyrios Gyftopoulos, Vasiliki Georgilaki, Dimitrios Gerogiannis, Dimitrios Basoulis, Michael Samarkos)
| | - Dimitrios Gerogiannis
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Greece (Evangelos Cholongitas, Triada Bali, Alexios Giannakodimos, Argyrios Gyftopoulos, Vasiliki Georgilaki, Dimitrios Gerogiannis, Dimitrios Basoulis, Michael Samarkos)
| | - Dimitrios Basoulis
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Greece (Evangelos Cholongitas, Triada Bali, Alexios Giannakodimos, Argyrios Gyftopoulos, Vasiliki Georgilaki, Dimitrios Gerogiannis, Dimitrios Basoulis, Michael Samarkos)
- Infectious Diseases and COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece (Dimitrios Basoulis, Eirini Iliadi, Georgios Karamanakos, Nikolaos V. Sipsas, Michael Samarkos)
| | - Irene Eliadi
- Infectious Diseases and COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece (Dimitrios Basoulis, Eirini Iliadi, Georgios Karamanakos, Nikolaos V. Sipsas, Michael Samarkos)
| | - Georgios Karamanakos
- Infectious Diseases and COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece (Dimitrios Basoulis, Eirini Iliadi, Georgios Karamanakos, Nikolaos V. Sipsas, Michael Samarkos)
| | - Konstantinos Mimidis
- First Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece (Konstantinos Mimidis)
| | - Nikolaos V. Sipsas
- Pathophysiology Department, Medical School, National and Kapodistrian University of Athens, and Laiko General Hospital of Athens, Athens, Greece (Nikolaos V. Sipsas)
- Infectious Diseases and COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece (Dimitrios Basoulis, Eirini Iliadi, Georgios Karamanakos, Nikolaos V. Sipsas, Michael Samarkos)
| | - Michael Samarkos
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Greece (Evangelos Cholongitas, Triada Bali, Alexios Giannakodimos, Argyrios Gyftopoulos, Vasiliki Georgilaki, Dimitrios Gerogiannis, Dimitrios Basoulis, Michael Samarkos)
- Infectious Diseases and COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece (Dimitrios Basoulis, Eirini Iliadi, Georgios Karamanakos, Nikolaos V. Sipsas, Michael Samarkos)
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9
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Psichogiou M, Karabinis A, Poulakou G, Antoniadou A, Kotanidou A, Degiannis D, Pavlopoulou ID, Chaidaroglou A, Roussos S, Mastrogianni E, Eliadi I, Basoulis D, Petsios K, Leontis K, Kakalou E, Protopapas K, Jahaj E, Pratikaki M, Syrigos KN, Lagiou P, Gogas H, Tsiodras S, Magiorkinis G, Paraskevis D, Sypsa V, Hatzakis A. Comparative Immunogenicity of BNT162b2 mRNA Vaccine with Natural SARS-CoV-2 Infection. Vaccines (Basel) 2021; 9:1017. [PMID: 34579254 PMCID: PMC8471735 DOI: 10.3390/vaccines9091017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 08/31/2021] [Accepted: 09/07/2021] [Indexed: 12/04/2022] Open
Abstract
BNT162b2 has proven to be highly effective, but there is a paucity of data regarding immunogenicity factors and comparison between response to vaccination and natural infection. This study included 871 vaccinated healthcare workers (HCW) and 181 patients with natural infection. Immunogenicity was assessed by measuring anti-SARS-CoV-2 against the RBD domain of the spike protein (anti-RBD). Samples were collected 1-2 weeks after vaccination or 15-59 days post-onset of symptoms. Post-vaccine anti-RBD concentrations were associated with age, gender, vaccination side-effects (VSE) and prior infection (Pr-CoV). Anti-RBD median levels (95%CI) were lower by 2466 (651-5583), 6228 (3254-9203) and 7651 (4479-10,823) AU/mL in 35-44, 45-54, 55-70 yrs, respectively, compared with the 18-34 yrs group. In females, the median levels were higher by 2823 (859-4787), 5024 (3122-6926) in individuals with VSE, and 9971 (5158-14,783) AU/mL in HCWs with Pr-CoV. The ratio of anti-RBD in vaccinated individuals versus those with natural infection varied from 1.0 to 19.4. The high immunogenicity of BNT162b2 is verified, although its sustainability has yet to be elucidated. The use of comparative data from natural infection serological panels, expressing the clinical heterogeneity of natural infection, may facilitate early decisions for candidate vaccines to be evaluated in clinical trials.
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Affiliation(s)
- Mina Psichogiou
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (E.M.); (I.E.); (D.B.); (H.G.)
| | - Andreas Karabinis
- Onassis Cardiac Surgery Center, 17674 Athens, Greece; (A.K.); (D.D.); (A.C.)
| | - Garyphallia Poulakou
- 3rd Department of Internal Medicine, Sotiria General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (G.P.); (K.L.); (E.K.); (K.N.S.)
| | - Anastasia Antoniadou
- 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (A.A.); (K.P.); (S.T.)
| | - Anastasia Kotanidou
- 1st Department of Critical Care & Pulmonary Services, Medical School, National and Kapodistrian University of Athens, Evangelismos Hospital, 10676 Athens, Greece; (A.K.); (E.J.); (M.P.)
| | - Dimitrios Degiannis
- Onassis Cardiac Surgery Center, 17674 Athens, Greece; (A.K.); (D.D.); (A.C.)
| | - Ioanna D. Pavlopoulou
- Pediatric Research Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | | | - Sotirios Roussos
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (S.R.); (P.L.); (G.M.); (D.P.); (V.S.); (A.H.)
| | - Elpida Mastrogianni
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (E.M.); (I.E.); (D.B.); (H.G.)
| | - Irene Eliadi
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (E.M.); (I.E.); (D.B.); (H.G.)
| | - Dimitrios Basoulis
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (E.M.); (I.E.); (D.B.); (H.G.)
| | | | - Konstantinos Leontis
- 3rd Department of Internal Medicine, Sotiria General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (G.P.); (K.L.); (E.K.); (K.N.S.)
| | - Eleni Kakalou
- 3rd Department of Internal Medicine, Sotiria General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (G.P.); (K.L.); (E.K.); (K.N.S.)
| | - Konstantinos Protopapas
- 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (A.A.); (K.P.); (S.T.)
| | - Edison Jahaj
- 1st Department of Critical Care & Pulmonary Services, Medical School, National and Kapodistrian University of Athens, Evangelismos Hospital, 10676 Athens, Greece; (A.K.); (E.J.); (M.P.)
| | - Maria Pratikaki
- 1st Department of Critical Care & Pulmonary Services, Medical School, National and Kapodistrian University of Athens, Evangelismos Hospital, 10676 Athens, Greece; (A.K.); (E.J.); (M.P.)
| | - Konstantinos N. Syrigos
- 3rd Department of Internal Medicine, Sotiria General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (G.P.); (K.L.); (E.K.); (K.N.S.)
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (S.R.); (P.L.); (G.M.); (D.P.); (V.S.); (A.H.)
| | - Helen Gogas
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (E.M.); (I.E.); (D.B.); (H.G.)
| | - Sotirios Tsiodras
- 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (A.A.); (K.P.); (S.T.)
| | - Gkikas Magiorkinis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (S.R.); (P.L.); (G.M.); (D.P.); (V.S.); (A.H.)
| | - Dimitrios Paraskevis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (S.R.); (P.L.); (G.M.); (D.P.); (V.S.); (A.H.)
| | - Vana Sypsa
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (S.R.); (P.L.); (G.M.); (D.P.); (V.S.); (A.H.)
| | - Angelos Hatzakis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (S.R.); (P.L.); (G.M.); (D.P.); (V.S.); (A.H.)
- Hellenic Scientific Society for the Study of AIDS, Sexually Transmitted and Emerging Diseases, 11527 Athens, Greece
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Eliadi I, Tsoumi G, Kampouropoulou O, Theofanis V, Mantzourani M, Samarkos M. Characterization of the medical admissions in a tertiary Greek hospital. Eur J Intern Med 2017; 40:e15-e16. [PMID: 28119030 DOI: 10.1016/j.ejim.2017.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 01/18/2017] [Indexed: 10/20/2022]
Affiliation(s)
- Irene Eliadi
- 1st Department of Medicine, Laikon Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Georgia Tsoumi
- 1st Department of Medicine, Laikon Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Olga Kampouropoulou
- 1st Department of Medicine, Laikon Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Vasileios Theofanis
- 1st Department of Medicine, Laikon Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Marina Mantzourani
- 1st Department of Medicine, Laikon Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Michael Samarkos
- 1st Department of Medicine, Laikon Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece.
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Samarkos M, Theofanis V, Eliadi I, Vlachogiannakos J, Polyzos A. Tenofovir-associated Fanconi syndrome in a patient with chronic hepatitis B. J Gastrointestin Liver Dis 2014; 23:342. [PMID: 25267967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
| | | | - Irene Eliadi
- 1st Department of Internal Medicine, Athens, Greece
| | - John Vlachogiannakos
- Department of Gastroenterology, University of Athens Medical School, Laikon Hospital, Athens, Greece
| | - Aris Polyzos
- 1st Department of Internal Medicine, Athens, Greece
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