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  1. Article ; Online: Risk factors on admission associated with hospital length of stay in patients with COVID-19: a retrospective cohort study.

    Guo, Anping / Lu, Jin / Tan, Haizhu / Kuang, Zejian / Luo, Ying / Yang, Tian / Xu, Junlan / Yu, Jishuang / Wen, Canhong / Shen, Aizong

    Scientific reports

    2021  Volume 11, Issue 1, Page(s) 7310

    Abstract: ... To address this, we conduct a retrospective study, which involved patients with laboratory-confirmed COVID-19 ... Treating patients with COVID-19 is expensive, thus it is essential to identify factors on admission ... associated with hospital length of stay (LOS) and provide a risk assessment for clinical treatment ...

    Abstract Treating patients with COVID-19 is expensive, thus it is essential to identify factors on admission associated with hospital length of stay (LOS) and provide a risk assessment for clinical treatment. To address this, we conduct a retrospective study, which involved patients with laboratory-confirmed COVID-19 infection in Hefei, China and being discharged between January 20 2020 and March 16 2020. Demographic information, clinical treatment, and laboratory data for the participants were extracted from medical records. A prolonged LOS was defined as equal to or greater than the median length of hospitable stay. The median LOS for the 75 patients was 17 days (IQR 13-22). We used univariable and multivariable logistic regressions to explore the risk factors associated with a prolonged hospital LOS. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated. The median age of the 75 patients was 47 years. Approximately 75% of the patients had mild or general disease. The univariate logistic regression model showed that female sex and having a fever on admission were significantly associated with longer duration of hospitalization. The multivariate logistic regression model enhances these associations. Odds of a prolonged LOS were associated with male sex (aOR 0.19, 95% CI 0.05-0.63, p = 0.01), having fever on admission (aOR 8.27, 95% CI 1.47-72.16, p = 0.028) and pre-existing chronic kidney or liver disease (aOR 13.73 95% CI 1.95-145.4, p = 0.015) as well as each 1-unit increase in creatinine level (aOR 0.94, 95% CI 0.9-0.98, p = 0.007). We also found that a prolonged LOS was associated with increased creatinine levels in patients with chronic kidney or liver disease (p < 0.001). In conclusion, female sex, fever, chronic kidney or liver disease before admission and increasing creatinine levels were associated with prolonged LOS in patients with COVID-19.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; COVID-19/epidemiology ; COVID-19/etiology ; Child ; Child, Preschool ; China ; Comorbidity ; Creatinine/blood ; Female ; Fever/virology ; Hospitalization ; Humans ; Length of Stay/statistics & numerical data ; Male ; Middle Aged ; Multivariate Analysis ; Renal Insufficiency, Chronic/epidemiology ; Retrospective Studies ; Young Adult
    Chemical Substances Creatinine (AYI8EX34EU)
    Language English
    Publishing date 2021-03-31
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-021-86853-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Incidence and risk factors of COVID-19 associated pneumothorax.

    Taha, Muhanad / Elahi, Morvarid / Wahby, Krista / Samavati, Lobelia

    PloS one

    2022  Volume 17, Issue 8, Page(s) e0271964

    Abstract: ... of pneumothorax in critically ill adults with COVID-19.: Method: This retrospective cohort study included adult ... associated with prolonged duration of mechanical ventilation and length of hospital stay. Strikingly, receipt ... 2019 (COVID-19) pneumonia, specifically in those patients who develop acute respiratory distress ...

    Abstract Background: Pneumothorax has been increasingly observed among patients with coronavirus disease-2019 (COVID-19) pneumonia, specifically in those patients who develop acute respiratory distress syndrome (ARDS). In this study, we sought to determine the incidence and potential risk factors of pneumothorax in critically ill adults with COVID-19.
    Method: This retrospective cohort study included adult patients with laboratory-confirmed SARS-CoV-2 infection admitted to one of the adult intensive care units of a tertiary, academic teaching hospital from May 2020 through May 2021.
    Results: Among 334 COVID-19 cases requiring ICU admission, the incidence of pneumothorax was 10% (33 patients). Patients who experienced pneumothorax more frequently required vasopressor support (28/33 [84%] vs. 191/301 [63%] P = 0.04), were more likely to be proned (25/33 [75%] vs. 111/301 [36%], P<0.001), and the presence of pneumothorax was associated with prolonged duration of mechanical ventilation; 21 (1-97) versus 7 (1-79) days, p<0.001 as well as prolonged hospital length of stay (29 [9-133] vs. 15 [1-90] days, P<0.001), but mortality was not significantly different between groups. Importantly, when we performed a Cox proportional hazard ratio (HR) model of multivariate parameters, we found that administration of tocilizumab significantly increased the risk of developing pneumothorax (HR = 10.7; CI [3.6-32], P<0.001).
    Conclusion: Among 334 critically ill patients with COVID-19, the incidence of pneumothorax was 10%. Presence of pneumothorax was associated with prolonged duration of mechanical ventilation and length of hospital stay. Strikingly, receipt of tocilizumab was associated with an increased risk of developing pneumothorax.
    MeSH term(s) Adult ; COVID-19/complications ; Critical Illness ; Humans ; Incidence ; Intensive Care Units ; Pneumothorax/epidemiology ; Pneumothorax/etiology ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; SARS-CoV-2
    Language English
    Publishing date 2022-08-05
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0271964
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Risk factors associated with in-hospital mortality patients with COVID-19 in Saudi Arabia.

    Aljuaid, Mohammed / Alotair, Hadil / Alnajjar, Farrah / Alonazi, Wadi / Sharaf, Hanaa / Sheshah, Eman / Alashgar, Lolwah / Alshaikh, Mashael

    PloS one

    2022  Volume 17, Issue 6, Page(s) e0270062

    Abstract: ... This is a retrospective observational cohort study of hospitalized adult COVID-19 patients at two ... Risk factors for in-hospital mortality of COVID-19 patients in Saudi Arabia have not been well ... A total of 564 hospitalized patients with COVID-19 were included in the study. The overall ...

    Abstract Risk factors for in-hospital mortality of COVID-19 patients in Saudi Arabia have not been well studied. Previous reports from other countries have highlighted the effect of age, gender, clinical presentation and health conditions on the outcome of COVID-19 patients. Saudi Arabia has a different epidemiological structure with a predominance of young population, which calls for separate study. The objective of this study is to assess the predictors of mortality among hospitalized patients with COVID-19 in Saudi Arabia. This is a retrospective observational cohort study of hospitalized adult COVID-19 patients at two tertiary hospitals in Saudi Arabia between May to July 2020. Electronic charts were retrospectively reviewed comparing survivors and non-survivors in terms of demographic and clinical variables and comorbid conditions. A total of 564 hospitalized patients with COVID-19 were included in the study. The overall in-hospital mortality rate was 20%. The non-survivors were significantly older than survivors (59.4 ± 13.7 years and 50.5 ± 13.9 years respectively P< 0.001). Diabetes mellitus, hypertension, heart failure and ischemic heart disease were more prevalent among non-survivors (P< 0.001). The mean values of glycosylated hemoglobin HgA1C, D-dimer, ferritin, lactate dehydrogenase LDH, Alanin aminotransferase ALT and creatinine were significantly higher among non-survivors (P < 0.05). Multivariate logistic regression analysis revealed that age (aOR = 1.04; 95% CI 1.02-1.08; P < 0.01), chronic kidney disease (aOR = 4.04; 95% CI 1.11-14.77; P < 0.05), acute respiratory distress syndrome ARDS (aOR = 14.53; 95% CI 5.42-38.69; P < 0.01), Mechanical Ventilation (aOR = 10.57; 95% CI 5.74-23.59; P < 0.01), Shock (aOR = 3.85; 95% CI 1.02-14.57; P < 0.05), admission to intensive care unit (ICU) (aOR = 0.12; 95% CI 0.04-0.33; P < 0.01) and length of stay (aOR = 0.96; 95% CI 0.93-0.99; P < 0.05) were significant contributors towards mortality. The in-hospital mortality rate of COVID-19 patients admitted to tertiary hospitals in Saudi Arabia is high. Older age, chronic kidney disease and ARDS were the most important predictors of mortality.
    MeSH term(s) Adult ; COVID-19 ; Cohort Studies ; Hospital Mortality ; Humans ; Renal Insufficiency, Chronic ; Respiratory Distress Syndrome ; Retrospective Studies ; Risk Factors ; Saudi Arabia/epidemiology
    Language English
    Publishing date 2022-06-24
    Publishing country United States
    Document type Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0270062
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: The risk of death or unplanned readmission after discharge from a COVID-19 hospitalization in Alberta and Ontario.

    McAlister, Finlay A / Dong, Yuan / Chu, Anna / Wang, Xuesong / Youngson, Erik / Quinn, Kieran L / Verma, Amol / Udell, Jacob A / Yu, Amy Y X / Razak, Fahad / Ho, Chester / de Mestral, Charles / Ross, Heather J / van Walraven, Carl / Lee, Douglas S

    CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne

    2022  Volume 194, Issue 19, Page(s) E666–E673

    Abstract: ... unplanned readmission after a COVID-19 hospital discharge.: Methods: We conducted a retrospective ... whether current readmission prediction equations are useful for discharge risk stratification of COVID-19 ... hospital admission for COVID-19 should include sex, discharge locale and socioeconomic measures ...

    Abstract Background: The frequency of readmissions after COVID-19 hospitalizations is uncertain, as is whether current readmission prediction equations are useful for discharge risk stratification of COVID-19 survivors or for comparing among hospitals. We sought to determine the frequency and predictors of death or unplanned readmission after a COVID-19 hospital discharge.
    Methods: We conducted a retrospective cohort study of all adults (≥ 18 yr) who were discharged alive from hospital after a nonpsychiatric, nonobstetric, acute care admission for COVID-19 between Jan. 1, 2020, and Sept. 30, 2021, in Alberta and Ontario.
    Results: Of 843 737 individuals who tested positive for SARS-CoV-2 by reverse transcription polymerase chain reaction during the study period, 46 412 (5.5%) were adults admitted to hospital within 14 days of their positive test. Of these, 8496 died in hospital and 34 846 were discharged alive (30 336 discharged after an index admission of ≤ 30 d and 4510 discharged after an admission > 30 d). One in 9 discharged patients died or were readmitted within 30 days after discharge (3173 [10.5%] of those with stay ≤ 30 d and 579 [12.8%] of those with stay > 30 d). The LACE score (length of stay, acuity, Charlson Comorbidity Index and number of emergency visits in previous 6 months) for predicting urgent readmission or death within 30 days had a c-statistic of 0.60 in Alberta and 0.61 in Ontario; inclusion of sex, discharge locale, deprivation index and teaching hospital status in the model improved the c-statistic to 0.73.
    Interpretation: Death or readmission after discharge from a COVID-19 hospitalization is common and had a similar frequency in Alberta and Ontario. Risk stratification and interinstitutional comparisons of outcomes after hospital admission for COVID-19 should include sex, discharge locale and socioeconomic measures, in addition to the LACE variables.
    MeSH term(s) Adult ; Alberta/epidemiology ; COVID-19/epidemiology ; COVID-19/therapy ; Comorbidity ; Emergency Service, Hospital ; Hospitalization ; Humans ; Length of Stay ; Ontario/epidemiology ; Patient Discharge ; Patient Readmission ; Retrospective Studies ; Risk Factors ; SARS-CoV-2
    Language English
    Publishing date 2022-05-13
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 215506-0
    ISSN 1488-2329 ; 0008-4409 ; 0820-3946
    ISSN (online) 1488-2329
    ISSN 0008-4409 ; 0820-3946
    DOI 10.1503/cmaj.220272
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Risk factors for delirium among SARS-CoV-2 positive veterans.

    Santos, Charles J / Nuradin, Nebil / Joplin, Christopher / Leigh, Alexandra E / Burke, Rebecca V / Rome, Robin / McCall, Jonathan / Raines, Amanda M

    Psychiatry research

    2021  Volume 309, Page(s) 114375

    Abstract: ... been proposed to account for the association between COVID-19 and delirium, few studies have examined ... of continued investigation into factors that may account for neuropsychiatric dysfunction among COVID-19 ... of cardiovascular illness, length of stay, intensive care unit admission, initiation of new dialysis, and ...

    Abstract There have been increasing reports of atypical neuropsychological symptoms among patients hospitalized with Coronavirus Disease 2019 (COVID-19). Although numerous pathophysiological mechanisms have been proposed to account for the association between COVID-19 and delirium, few studies have examined factors associated with its development and none have done so in the context of a veteran sample. The current study exploratorily examined demographic and medical variables that might be associated with delirium among a cohort of SARS-CoV-2 positive veterans. Demographic and medical data were extracted from the computerized patient records of 162 veterans who were admitted to a large southeastern Veterans Affairs hospital for COVID-19 complications between March 1, 2020 and April 20, 2020. At the zero-order level, age, a history of cardiovascular illness, length of stay, intensive care unit admission, initiation of new dialysis, and the development of new thromboembolic or cardiac findings were associated with delirium. However, when simultaneously examining the impact of these predictor variables in a logistic regression, only length of stay and new cardiac findings increased the odds of delirium. Findings highlight the importance of continued investigation into factors that may account for neuropsychiatric dysfunction among COVID-19 patients.
    MeSH term(s) COVID-19 ; Delirium/epidemiology ; Humans ; Retrospective Studies ; Risk Factors ; SARS-CoV-2 ; Veterans
    Language English
    Publishing date 2021-12-30
    Publishing country Ireland
    Document type Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 445361-x
    ISSN 1872-7123 ; 1872-7506 ; 0925-4927 ; 0165-1781
    ISSN (online) 1872-7123 ; 1872-7506
    ISSN 0925-4927 ; 0165-1781
    DOI 10.1016/j.psychres.2021.114375
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Incidence and risk factors of COVID-19 associated pneumothorax.

    Muhanad Taha / Morvarid Elahi / Krista Wahby / Lobelia Samavati

    PLoS ONE, Vol 17, Iss 8, p e

    2022  Volume 0271964

    Abstract: ... in critically ill adults with COVID-19. Method This retrospective cohort study included adult patients ... COVID-19) pneumonia, specifically in those patients who develop acute respiratory distress syndrome ... with COVID-19, the incidence of pneumothorax was 10%. Presence of pneumothorax was associated with prolonged ...

    Abstract Background Pneumothorax has been increasingly observed among patients with coronavirus disease-2019 (COVID-19) pneumonia, specifically in those patients who develop acute respiratory distress syndrome (ARDS). In this study, we sought to determine the incidence and potential risk factors of pneumothorax in critically ill adults with COVID-19. Method This retrospective cohort study included adult patients with laboratory-confirmed SARS-CoV-2 infection admitted to one of the adult intensive care units of a tertiary, academic teaching hospital from May 2020 through May 2021. Results Among 334 COVID-19 cases requiring ICU admission, the incidence of pneumothorax was 10% (33 patients). Patients who experienced pneumothorax more frequently required vasopressor support (28/33 [84%] vs. 191/301 [63%] P = 0.04), were more likely to be proned (25/33 [75%] vs. 111/301 [36%], P<0.001), and the presence of pneumothorax was associated with prolonged duration of mechanical ventilation; 21 (1-97) versus 7 (1-79) days, p<0.001 as well as prolonged hospital length of stay (29 [9-133] vs. 15 [1-90] days, P<0.001), but mortality was not significantly different between groups. Importantly, when we performed a Cox proportional hazard ratio (HR) model of multivariate parameters, we found that administration of tocilizumab significantly increased the risk of developing pneumothorax (HR = 10.7; CI [3.6-32], P<0.001). Conclusion Among 334 critically ill patients with COVID-19, the incidence of pneumothorax was 10%. Presence of pneumothorax was associated with prolonged duration of mechanical ventilation and length of hospital stay. Strikingly, receipt of tocilizumab was associated with an increased risk of developing pneumothorax.
    Keywords Medicine ; R ; Science ; Q
    Subject code 610
    Language English
    Publishing date 2022-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Functional, Clinical, and Sociodemographic Variables Associated with Risk of In-Hospital Mortality by COVID-19 in People over 80 Years Old.

    Rodríguez-Sánchez, I / Redondo-Martín, M / Furones-Fernández, L / Méndez-Hinojosa, M / Chen-Chim, Á / Saavedra-Palacios, R / Gil-Gregorio, P

    The journal of nutrition, health & aging

    2021  Volume 25, Issue 8, Page(s) 964–970

    Abstract: ... in predicting mortality in older patients hospitalized due to COVID-19.: Design: Cohort study with a mean ... length of stay was recorded. Clinical symptoms, laboratory and X-ray findings were collected at time ... of admission. For multivariant analysis, logistic regressions were performed to identify risk factors for death ...

    Abstract Objectives: The objective is to assess the role of functional, clinical, and analytic parameters in predicting mortality in older patients hospitalized due to COVID-19.
    Design: Cohort study with a mean follow-up of 12.8 days.
    Setting: Public university hospital (Madrid, Spain).
    Participants: 499 patients 80 and above consecutively admitted to a Spanish public university hospital between 4 March 2020 and 16 May 2020.
    Measurements: Mortality was the main outcome. Data of sociodemographic variables (age, sex, living), comorbidities, polypharmacy, functional status, date of hospital admission and length of stay was recorded. Clinical symptoms, laboratory and X-ray findings were collected at time of admission. For multivariant analysis, logistic regressions were performed to identify risk factors for death.
    Results: Mean age was 86.7±4.4 with 37% of death. Mortality was associated with male gender [odds ratio (OR) 1.50; 95% confidence interval (CI) 1.01-2.24], with a 5-points increase on Barthel Index [OR 1.01 (95%CI 1.00-1.02)], higher Charlson Index score [OR 1.13 (95%CI 1.02-1.26)] and comorbidities [OR 1.28 (95%CI 1.06-1.53)], hyperpolipharmacy [OR 2.00 (95%CI 1.04-3.82)], unilateral pneumonia [OR 1.83 (95%CI 1.01-3.30)], higher levels of C-reactive protein [OR 1.09 (95%CI 1.06-1.12)] and creatine [OR 1.48 (95%CI 1.15-1.89)]. Higher oxygen levels were a protective factor [OR 0.92 (95%CI 0.89-0.95)].
    Conclusions: Functional status, being male, a higher burden of comorbidities, hyperpolipharmacy, unilateral pneumonia and some laboratory parameters predict in-hospital mortality in this older population. The knowledge of these mortality risk factors should be used to improve the survival of older hospitalized patients.
    MeSH term(s) Activities of Daily Living ; Aged ; Aged, 80 and over ; COVID-19/diagnosis ; COVID-19/mortality ; COVID-19/therapy ; Cohort Studies ; Female ; Functional Status ; Hospital Mortality ; Hospitalization/statistics & numerical data ; Humans ; Male ; Retrospective Studies ; Risk Factors ; SARS-CoV-2 ; Spain/epidemiology
    Language English
    Publishing date 2021-09-18
    Publishing country France
    Document type Journal Article
    ZDB-ID 2081921-3
    ISSN 1760-4788 ; 1279-7707
    ISSN (online) 1760-4788
    ISSN 1279-7707
    DOI 10.1007/s12603-021-1664-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Risk Factors Associated With In-Hospital Mortality in a US National Sample of Patients With COVID-19.

    Rosenthal, Ning / Cao, Zhun / Gundrum, Jake / Sianis, Jim / Safo, Stella

    JAMA network open

    2020  Volume 3, Issue 12, Page(s) e2029058

    Abstract: ... of patients with COVID-19 infection in US acute care hospitals, COVID-19 was associated with high ICU ... to examine risk factors associated with in-hospital mortality.: Design, setting, and participants ... mortality, intensive care unit (ICU) admission, use of invasive mechanical ventilation, total hospital length of stay (LOS), ICU ...

    Abstract Importance: Coronavirus disease 2019 (COVID-19) has infected more than 8.1 million US residents and killed more than 221 000. There is a dearth of research on epidemiology and clinical outcomes in US patients with COVID-19.
    Objectives: To characterize patients with COVID-19 treated in US hospitals and to examine risk factors associated with in-hospital mortality.
    Design, setting, and participants: This cohort study was conducted using Premier Healthcare Database, a large geographically diverse all-payer hospital administrative database including 592 acute care hospitals in the United States. Inpatient and hospital-based outpatient visits with a principal or secondary discharge diagnosis of COVID-19 (International Classification of Diseases, Tenth Revision, Clinical Modification diagnosis code, U07.1) between April 1 and May 31, 2020, were included.
    Exposures: Characteristics of patients were reported by inpatient/outpatient and survival status. Risk factors associated with death examined included patient characteristics, acute complications, comorbidities, and medications.
    Main outcomes and measures: In-hospital mortality, intensive care unit (ICU) admission, use of invasive mechanical ventilation, total hospital length of stay (LOS), ICU LOS, acute complications, and treatment patterns.
    Results: Overall, 64 781 patients with COVID-19 (29 479 [45.5%] outpatients; 35 302 [54.5%] inpatients) were analyzed. The median (interquartile range [IQR]) age was 46 (33-59) years for outpatients and 65 (52-77) years for inpatients; 31 968 (49.3%) were men, 25 841 (39.9%) were White US residents, and 14 340 (22.1%) were Black US residents. In-hospital mortality was 20.3% among inpatients (7164 patients). A total of 5625 inpatients (15.9%) received invasive mechanical ventilation, and 6849 (19.4%) were admitted to the ICU. Median (IQR) inpatient LOS was 6 (3-10) days. Median (IQR) ICU LOS was 5 (2-10) days. Common acute complications among inpatients included acute respiratory failure (19 706 [55.8%]), acute kidney failure (11 971 [33.9%]), and sepsis (11 910 [33.7%]). Older age was the risk factor most strongly associated with death (eg, age ≥80 years vs 18-34 years: odds ratio [OR], 16.20; 95% CI, 11.58-22.67; P < .001). Receipt of statins (OR, 0.60; 95% CI, 0.56-0.65; P < .001), angiotensin-converting enzyme inhibitors (OR, 0.53; 95% CI, 0.46-0.60; P < .001), and calcium channel blockers (OR, 0.73; 95% CI, 0.68-0.79; P < .001) was associated with decreased odds of death. Compared with patients with no hydroxychloroquine or azithromycin, patients with both azithromycin and hydroxychloroquine had increased odds of death (OR, 1.21; 95% CI, 1.11-1.31; P < .001).
    Conclusions and relevance: In this cohort study of patients with COVID-19 infection in US acute care hospitals, COVID-19 was associated with high ICU admission and in-hospital mortality rates. Use of statins, angiotensin-converting enzyme inhibitors, and calcium channel blockers were associated with decreased odds of death. Understanding the potential benefits of unproven treatments will require future randomized trials.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; COVID-19/epidemiology ; COVID-19/mortality ; COVID-19/therapy ; Child ; Child, Preschool ; Comorbidity ; Female ; Hospitalization/statistics & numerical data ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Pandemics ; Retrospective Studies ; Risk Factors ; SARS-CoV-2 ; United States/epidemiology ; Young Adult
    Language English
    Publishing date 2020-12-01
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2020.29058
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Mortality and associated risk factors of COVID-19 infection in dialysis patients in Qatar: A nationwide cohort study.

    Ghonimi, Tarek Abdel Latif / Alkad, Mohamad Mahmood / Abuhelaiqa, Essa Abdulla / Othman, Muftah M / Elgaali, Musab Ahmed / Ibrahim, Rania Abdelaziz M / Joseph, Shajahan M / Al-Malki, Hassan Ali / Hamad, Abdullah Ibrahim

    PloS one

    2021  Volume 16, Issue 7, Page(s) e0254246

    Abstract: ... We studied the mortality and associated risks of COVID-19 infection in dialysis patients in the state ... the mortality of COVID-19 in dialysis patients in Qatar and risk factors associated with it. Our secondary ... among our dialysis cohort was 15%. Univariate Cox regression analysis for risk factors associated with COVID-19 ...

    Abstract Context: Patients on maintenance dialysis are more susceptible to COVID-19 and its severe form. We studied the mortality and associated risks of COVID-19 infection in dialysis patients in the state of Qatar.
    Methods: This was an observational, analytical, retrospective, nationwide study. We included all adult patients on maintenance dialysis therapy who tested positive for COVID-19 (PCR assay of the nasopharyngeal swab) during the period from February 1, 2020, to July 19, 2020. Our primary outcome was to study the mortality of COVID-19 in dialysis patients in Qatar and risk factors associated with it. Our secondary objectives were to study incidence and severity of COVID-19 in dialysis patients and comparing outcomes between hemodialysis and peritoneal dialysis patients. Patient demographics and clinical features were collected from a national electronic medical record. Univariate Cox regression analysis was performed to evaluate potential risk factors for mortality in our cohort.
    Results: 76 out of 1064 dialysis patients were diagnosed with COVID-19 (age 56±13.6, 56 hemodialysis and 20 peritoneal dialysis, 56 males). During the study period, 7.1% of all dialysis patients contracted COVID-19. Male dialysis patients had double the incidence of COVID-19 than females (9% versus 4.5% respectively; p<0.01). The most common symptoms on presentation were fever (57.9%), cough (56.6%), and shortness of breath (25%). Pneumonia was diagnosed in 72% of dialysis patients with COVID-19. High severity manifested as 25% of patients requiring admission to the intensive care unit, 18.4% had ARDS, 17.1% required mechanical ventilation, and 14.5% required inotropes. The mean length of hospital stay was 19.2 ± -12 days. Mortality due to COVID-19 among our dialysis cohort was 15%. Univariate Cox regression analysis for risk factors associated with COVID-19-related death in dialysis patients showed significant increases in risks with age (OR 1.077, CI 95%(1.018-1.139), p = 0.01), CHF and COPD (both same OR 8.974, CI 95% (1.039-77.5), p = 0.046), history of DVT (OR 5.762, CI 95% (1.227-27.057), p = 0.026), Atrial fibrillation (OR 7.285, CI 95%(2.029-26.150), p = 0.002), hypoxia (OR: 16.6; CI 95%(3.574-77.715), p = <0.001), ICU admission (HR30.8, CI 95% (3.9-241.2), p = 0.001), Mechanical ventilation (HR 50.07 CI 95% (6.4-391.2)), p<0.001) and using inotropes(HR 19.17, CI 95% (11.57-718.5), p<0.001). In a multivariate analysis, only ICU admission was found to be significantly associated with death [OR = 32.8 (3.5-305.4), p = 0.002)].
    Conclusion: This is the first study to be conducted at a national level in Qatar exploring COVID-19 in a dialysis population. Dialysis patients had a high incidence of COVID-19 infection and related mortality compared to previous reports of the general population in the state of Qatar (7.1% versus 4% and 15% versus 0.15% respectively). We also observed a strong association between death related to COVID-19 infection in dialysis patients and admission to ICU.
    MeSH term(s) Adult ; Aged ; COVID-19/epidemiology ; COVID-19/mortality ; COVID-19/therapy ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Qatar/epidemiology ; Renal Dialysis ; Respiration, Artificial ; Risk Factors
    Language English
    Publishing date 2021-07-22
    Publishing country United States
    Document type Journal Article
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0254246
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Incidence and risk factors for early readmission after hospitalization for SARS-CoV-2 infection: results from a retrospective cohort study.

    Kirkegaard, Cristina / Falcó-Roget, Anna / Sánchez-Montalvá, Adrián / Valls, Ángel / Clofent, David / Campos-Varela, Isabel / García-García, Sonia / Leguízamo, Lina María / Sellarès-Nadal, Júlia / Eremiev, Simeon / Villamarín, Miguel / Marzo, Blanca / Almirante, Benito / Len, Òscar

    Infection

    2021  Volume 50, Issue 2, Page(s) 371–380

    Abstract: ... patients with COVID-19.: Methods: We analyzed a retrospective cohort of patients with laboratory ... logistic regression to define risk factors for readmission RESULTS: A total of 629 patients were followed up during 60 ... 2.89-46.48; p = 0.001) were the risk factors statistically associated with early readmission ...

    Abstract Purpose: We aim to assess risk factors related to early readmission in previous hospitalized patients with COVID-19.
    Methods: We analyzed a retrospective cohort of patients with laboratory-confirmed COVID-19 admitted to Vall d'Hebron University Hospital, Barcelona, Spain. Early readmission was defined as the need for hospitalization within a period of 60 days after discharge. A descriptive analysis of the readmission was performed, including hospitalization outcome. We also performed a multivariate logistic regression to define risk factors for readmission RESULTS: A total of 629 patients were followed up during 60 days with a readmission cumulative incidence of 5.4% (34 out of 629) and an incidence rate of 0.034 person-years. Main reasons for readmission were respiratory worsening (13, 38.2%), decompensation of previous disease (12, 35.3%) or infectious complications (6, 17.6%). Median time to readmission was 12 days (interquartile range 7-33 days). Prior diagnosis of heart failure (OR 4.09; 95% CI 1.35-12.46; p = 0.013), length of stay during index admission greater than 13 days (OR 2.72; 95% CI 1.21-6.12; p = 0.015), treatment with corticosteroids (OR 2.39; 95% CI 1.01-5.70; p = 0.049) and developing pulmonary thromboembolism (OR 11.59; 95% CI 2.89-46.48; p = 0.001) were the risk factors statistically associated with early readmission.
    Conclusion: Readmission cumulative incidence was 5.4%. Those patients with prior diagnosis of heart failure, length of stay greater than 13 days, treated with corticosteroids or who developed pulmonary thromboembolism might benefit from close monitoring after being discharged.
    MeSH term(s) COVID-19/epidemiology ; Cohort Studies ; Hospitalization ; Humans ; Incidence ; Patient Readmission ; Retrospective Studies ; Risk Factors ; SARS-CoV-2
    Language English
    Publishing date 2021-07-30
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 185104-4
    ISSN 1439-0973 ; 0300-8126 ; 0173-2129
    ISSN (online) 1439-0973
    ISSN 0300-8126 ; 0173-2129
    DOI 10.1007/s15010-021-01662-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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