LIVIVO - Search results -

Search results

Result 1 - 10 of total 17

Search options

Article ; Online: Predictors of clinical deterioration in non-severe patients with COVID-19: a retrospective cohort study.

Yitao, Zhang / Mu, Chen / Ling, Zhou / Shiyao, Cheng / Jiaojie, Xue / Zhichong, Chen / Huajing, Peng / Maode, Ou / Kanglin, Cheng / Mao, Ou Yang / Xiaoneng, Mo / Weijie, Zeng

Current medical research and opinion

2021 Volume 37, Issue 3, Page(s) 385–391

Abstract: ... The aim of this study was to identify the predictors for clinical deterioration in patients with COVID-19 ... the risk factors associated with clinical deterioration.: Results: A total of 49 (19%) patients showed clinical ... comorbidities and treatments were all collected. The study endpoint was clinical deterioration within 20 days ...

Abstract	Objective: Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains pandemic with considerable morbidity and mortality around the world. The aim of this study was to identify the predictors for clinical deterioration in patients with COVID-19 who did not show clinical deterioration upon hospital admission. Methods: Two hundred fifty-seven patients with confirmed COVID-19 pneumonia admitted to Guangzhou Eighth People's Hospital between 23 January and 21 March 2020 were retrospectively enrolled. Demographic data, symptoms, laboratory values, comorbidities and treatments were all collected. The study endpoint was clinical deterioration within 20 days from hospital admission. Univariate and multivariable logistic regression methods were used to explore the risk factors associated with clinical deterioration. Results: A total of 49 (19%) patients showed clinical deterioration after admission. Compared with patients that did not experience clinical deterioration, clinically deteriorated patients had more dyspnea, cough and myalgia (65.3% versus 29.3%) symptoms and more had comorbidities (89.8% versus 36.1%). Clinical and laboratory characteristics at admission that were associated with clinical deterioration included senior age, diabetes, hypertension, myalgia, higher temperature, systolic blood pressure, C-reactive protein (CRP), procalcitonin, activated partial thromboplastin time, aspartate aminotransferase, alanine transaminase, direct bilirubin, plasma creatinine, lymphocytopenia, thrombocytopenia, decreased albumin and bicarbonate concentration. Medical history of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, calcium channel blockers and metformin were also risk factors. Conclusion: The four best predictors for clinical deterioration were CRP, procalcitonin, age and albumin. A "best" multivariable prediction model, resulting from using a variable selection procedure, included senior age, presentation with myalgia, and higher level of CRP and serum creatinine (bias-corrected
MeSH term(s)	Age Factors ; C-Reactive Protein/analysis ; COVID-19/blood ; COVID-19/epidemiology ; COVID-19/physiopathology ; COVID-19/therapy ; China/epidemiology ; Clinical Deterioration ; Female ; Hospitalization/statistics & numerical data ; Humans ; Male ; Middle Aged ; Noncommunicable Diseases/epidemiology ; Noncommunicable Diseases/therapy ; Procalcitonin/analysis ; Retrospective Studies ; Risk Assessment/methods ; Risk Factors ; SARS-CoV-2/isolation & purification ; Sensitivity and Specificity ; Serum Albumin/analysis
Chemical Substances	Procalcitonin ; Serum Albumin ; C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2021-02-04
Publishing country	England
Document type	Journal Article
ZDB-ID	80296-7
ISSN	1473-4877 ; 0300-7995
ISSN (online)	1473-4877
ISSN	0300-7995
DOI	10.1080/03007995.2021.1876005
Database	MEDical Literature Analysis and Retrieval System OnLINE

Full text online

Accessible to users with ZB MED library card

In stock of ZB MED Cologne/Königswinter

Zs.A 955: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
Jg. 1995 - 2021: Lesesall (1.OG)
ab Jg. 2022: Lesesaal (EG)

Order via subito

This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

Details ▾

Article: Predictors of Mortality in Tocilizumab-Treated Severe COVID-19.

Pagkratis, Konstantinos / Chrysikos, Serafeim / Antonakis, Emmanouil / Pandi, Aggeliki / Kosti, Chrysavgi Nikolaou / Markatis, Eleftherios / Hillas, Georgios / Digalaki, Antonia / Koukidou, Sofia / Chaini, Eleftheria / Afthinos, Andreas / Dimakou, Katerina / Papanikolaou, Ilias C

Vaccines

2022 Volume 10, Issue 6

Abstract: ... Older age and high serum LDH levels are predictors of mortality in tocilizumab-treated severe COVID-19 ... the characteristics of nonresponders to treatment. Methods: This was a retrospective multicenter study in two ... Purpose: Tocilizumab is associated with positive outcomes in severe COVID-19. We wanted to describe ...

Abstract	Purpose: Tocilizumab is associated with positive outcomes in severe COVID-19. We wanted to describe the characteristics of nonresponders to treatment. Methods: This was a retrospective multicenter study in two respiratory departments investigating adverse outcomes at 90 days from diagnosis in subjects treated with tocilizumab (8 mg/kg intravenously single dose) for severe progressive COVID-19. Results: Of 121 subjects, 62% were males, and 9% were fully vaccinated. Ninety-six (79.4%) survived, and 25 died (20.6%). Compared to survivors (S), nonsurvivors (NS) were older (median 57 versus 75 years of age), had more comorbidities (Charlson comorbidity index 2 versus 5) and had higher rates of intubation/mechanical ventilation (p < 0.05). On admission, NS had a lower PO2/FiO2 ratio, higher blood ferritin, and higher troponin, and on clinical progression (day of tocilizumab treatment), NS had a lower PO2/FiO2 ratio, decreased lymphocytes, increased neutrophil to lymphocyte ratio, increased ferritin and lactate dehydrogenase (LDH), disease located centrally on computed tomography scan, and increased late c-reactive protein. Cox proportional hazards regression analysis identified age and LDH on deterioration as predictors of death; admission PO2/FiO2 ratio and LDH as predictors of intubation; PO2/FiO2 ratios, LDH, and central lung disease on radiology as predictors of noninvasive ventilation (NIV) (a < 0.05). The log-rank test of mortality yielded the same results (p < 0.001). ROC analysis of the above predictors in a separate validation cohort yielded significant results. Conclusions: Older age and high serum LDH levels are predictors of mortality in tocilizumab-treated severe COVID-19 patients. Hypoxia levels, LDH, and central pulmonary involvement radiologically are associated with intubation and NIV.
Language	English
Publishing date	2022-06-20
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2703319-3
ISSN	2076-393X
ISSN	2076-393X
DOI	10.3390/vaccines10060978
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: Predictors of Mortality in Tocilizumab-Treated Severe COVID-19

Konstantinos Pagkratis / Serafeim Chrysikos / Emmanouil Antonakis / Aggeliki Pandi / Chrysavgi Nikolaou Kosti / Eleftherios Markatis / Georgios Hillas / Antonia Digalaki / Sofia Koukidou / Eleftheria Chaini / Andreas Afthinos / Katerina Dimakou / Ilias C. Papanikolaou

Vaccines, Vol 10, Iss 978, p

2022 Volume 978

Abstract: ... in tocilizumab-treated severe COVID-19 patients. Hypoxia levels, LDH, and central pulmonary involvement ... the characteristics of nonresponders to treatment. Methods: This was a retrospective multicenter study in two ... Purpose: Tocilizumab is associated with positive outcomes in severe COVID-19. We wanted to describe ...

Abstract	Purpose: Tocilizumab is associated with positive outcomes in severe COVID-19. We wanted to describe the characteristics of nonresponders to treatment. Methods: This was a retrospective multicenter study in two respiratory departments investigating adverse outcomes at 90 days from diagnosis in subjects treated with tocilizumab (8 mg/kg intravenously single dose) for severe progressive COVID-19. Results: Of 121 subjects, 62% were males, and 9% were fully vaccinated. Ninety-six (79.4%) survived, and 25 died (20.6%). Compared to survivors (S), nonsurvivors (NS) were older (median 57 versus 75 years of age), had more comorbidities (Charlson comorbidity index 2 versus 5) and had higher rates of intubation/mechanical ventilation ( p < 0.05). On admission, NS had a lower PO 2 /FiO 2 ratio, higher blood ferritin, and higher troponin, and on clinical progression (day of tocilizumab treatment), NS had a lower PO 2 /FiO 2 ratio, decreased lymphocytes, increased neutrophil to lymphocyte ratio, increased ferritin and lactate dehydrogenase (LDH), disease located centrally on computed tomography scan, and increased late c-reactive protein. Cox proportional hazards regression analysis identified age and LDH on deterioration as predictors of death; admission PO 2 /FiO 2 ratio and LDH as predictors of intubation; PO 2 /FiO 2 ratios, LDH, and central lung disease on radiology as predictors of noninvasive ventilation (NIV) (a < 0.05). The log-rank test of mortality yielded the same results ( p < 0.001). ROC analysis of the above predictors in a separate validation cohort yielded significant results. Conclusions: Older age and high serum LDH levels are predictors of mortality in tocilizumab-treated severe COVID-19 patients. Hypoxia levels, LDH, and central pulmonary involvement radiologically are associated with intubation and NIV.
Keywords	COVID-19 ; tocilizumab ; mortality ; outcomes ; severity ; Medicine ; R
Subject code	310
Language	English
Publishing date	2022-06-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

Full text online

Full text

Inter-library loan at ZB MED

Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

Article ; Online: Outcome predictors and patient progress following delivery in pregnant and postpartum patients with severe COVID-19 pneumonitis in intensive care units in Israel (OB-COVICU): a nationwide cohort study.

Fatnic, Elena / Blanco, Nikole Lee / Cobiletchi, Roman / Goldberger, Esty / Tevet, Aharon / Galante, Ori / Sviri, Sigal / Bdolah-Abram, Tali / Batzofin, Baruch M / Pizov, Reuven / Einav, Sharon / Sprung, Charles L / van Heerden, P Vernon / Ginosar, Yehuda

The Lancet. Respiratory medicine

2023 Volume 11, Issue 6, Page(s) 520–529

Abstract: ... week postpartum. We excluded pregnant patients in which the ICU admission was unrelated to severe COVID ... In this multicentre, nationwide, prospective and retrospective cohort study, we evaluated all pregnant women who were ... Background: A key unresolved controversy in severe COVID-19 pneumonitis in pregnancy is ...

Abstract	Background: A key unresolved controversy in severe COVID-19 pneumonitis in pregnancy is the optimum timing of delivery and whether delivery improves or worsens maternal outcomes. We aimed to assess clinical data on every intensive care unit (ICU) day for pregnant and postpartum women admitted to the ICU with COVID-19, with a particular focus on the days preceding and following delivery. Methods: In this multicentre, nationwide, prospective and retrospective cohort study, we evaluated all pregnant women who were admitted to an ICU in Israel with severe COVID-19 pneumonitis from the 13th week of gestation to the 1st week postpartum. We excluded pregnant patients in which the ICU admission was unrelated to severe COVID-19 pneumonitis. We assessed maternal and neonatal outcomes and longitudinal clinical and laboratory ICU data. The primary overall outcome was maternal outcome (worst of the following: no invasive positive pressure ventilation [IPPV], use of IPPV, use of extracorporeal membrane oxygenation [ECMO], or death). The primary longitudinal outcome was Sequential Organ Failure Assessment (SOFA) score, and the secondary longitudinal outcome was the novel PORCH (positive end-expiratory pressure [PEEP], oxygenation, respiratory support, chest x-ray, haemodynamic support) score. Patients were classified into four groups: no-delivery (pregnant at admission and no delivery during the ICU stay), postpartum (ICU admission ≥1 day after delivery), delivery-critical (pregnant at admission and receiving or at high risk of requiring IPPV at the time of delivery), or delivery-non-critical (pregnant at admission and not critically ill at the time of delivery). Findings: From Feb 1, 2020, to Jan 31, 2022, 84 patients were analysed: 34 patients in the no-delivery group, four in postpartum, 32 in delivery-critical, and 14 in delivery-non-critical. The delivery-critical and postpartum groups had worse outcomes than the other groups: 26 (81%) of 32 patients in the delivery-critical group and four (100%) of four patients in the postpartum group required IPPV; 12 (38%) and three (75%) patients required ECMO, and one (3%) and two (50%) patients died, respectively. The delivery-non-critical and no-delivery groups had far better outcomes than other groups: six (18%) of 34 patients and two (14%) of 14 patients required IPPV, respectively; no patients required ECMO or died. Oxygen saturation (SpO Interpretation: In patients who underwent delivery during their ICU stay, maternal outcome deteriorated following delivery among those defined as critical compared with non-critical patients, who improved following delivery. Interventional delivery should be considered for maternal indications before patients deteriorate and require mechanical ventilation. Funding: None.
MeSH term(s)	Infant, Newborn ; Female ; Humans ; Pregnancy ; COVID-19/therapy ; Cohort Studies ; Retrospective Studies ; Israel/epidemiology ; Prospective Studies ; Intensive Care Units ; Postpartum Period ; Oxygen
Chemical Substances	Oxygen (S88TT14065)
Language	English
Publishing date	2023-02-03
Publishing country	England
Document type	Multicenter Study ; Journal Article
ZDB-ID	2686754-0
ISSN	2213-2619 ; 2213-2600
ISSN (online)	2213-2619
ISSN	2213-2600
DOI	10.1016/S2213-2600(22)00491-X
Database	MEDical Literature Analysis and Retrieval System OnLINE

Full text online

Accessible to users with ZB MED library card

In stock of ZB MED Cologne/Königswinter

Zs.A 7041: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
ab Jg. 2022: Lesesaal (EG)

Order via subito

Details ▾

Article ; Online: Predictors of mortality in COVID-19 patients at Kinshasa Medical Center and a survival analysis: a retrospective cohort study.

Nlandu, Yannick / Mafuta, Danny / Sakaji, Junior / Brecknell, Melinda / Engole, Yannick / Abatha, Jessy / Nkumu, Jean-Robert / Nkodila, Aliocha / Mboliassa, Marie-France / Tuyinama, Olivier / Bena, Dauphin / Mboloko, Yves / Kobo, Patrick / Boloko, Patrick / Tshangu, Joseph / Azika, Philippe / Kanku, Jean-Pierre / Mafuta, Pally / Atantama, Magloire /

Mavungu, Jean-Michel / Kitenge, Rosita / Sehli, Asma / Van Eckout, Karel / Mukuku, Cathy / Bergeret, Léo / Benchetritt, David / Kalifa, Golan / Rodolphe, Ahmed / Bukabau, Justine

BMC infectious diseases

2021 Volume 21, Issue 1, Page(s) 1272

Abstract: ... features of severe COVID-19 in sub-Saharan Africa. This study aims to identify predictors of mortality ... in COVID-19 patients at Kinshasa Medical Center (KMC).: Methods: In this retrospective, observational ... at 0.05.: Results: 432 patients with confirmed COVID-19 were identified and only 106 (24.5 ...

Abstract	Background: Despite it being a global pandemic, there is little research examining the clinical features of severe COVID-19 in sub-Saharan Africa. This study aims to identify predictors of mortality in COVID-19 patients at Kinshasa Medical Center (KMC). Methods: In this retrospective, observational, cohort study carried out at the Kinshasa Medical Center (KMC) between March 10, 2020 and July 10, 2020, we included all adult inpatients (≥ 18 years old) with a positive COVID-19 PCR result. The end point of the study was survival. The study population was dichotomized into survivors and non-survivors group. Kaplan-Meier plot was used for survival analyses. The Log-Rank test was employed to compare the survival curves. Predictors of mortality were identified by Cox regression models. The significance level of p value was set at 0.05. Results: 432 patients with confirmed COVID-19 were identified and only 106 (24.5%) patients with moderate, severe or critical illness (mean age 55.6 ± 13.2 years old, 80.2% were male) were included in this study, of whom 34 (32%) died during their hospitalisation. The main complications of the patients included ARDS in 59/66 (89.4%) patients, coagulopathy in 35/93 (37.6%) patients, acute cardiac injury in 24/98 (24.5%) patients, AKI in 15/74 (20.3%) patients and secondary infection in 12/81 (14.8%) patients. The independent predictors of mortality were found to be age [aHR 1.38; 95% CI 1.10-1.82], AKI stage 3 [aHR 2.51; 95% CI 1.33-6.80], proteinuria [aHR 2.60; 95% CI 1.40-6.42], respiratory rate [aHR 1.42; 95% CI 1.09-1.92] and procalcitonin [aHR 1.08; 95% CI 1.03-1.14]. The median survival time of the entire group was 12 days. The cumulative survival rate of COVID-19 patients was 86.9%, 65.0% and 19.9% respectively at 5, 10 and 20 days. Levels of creatinine (p = 0.012), were clearly elevated in non-survivors compared with survivors throughout the clinical course and increased deterioration. Conclusion: Mortality rate of COVID-19 patients is high, particularly in intubated patients and is associated with age, respiratory rate, proteinuria, procalcitonin and acute kidney injury.
MeSH term(s)	Adolescent ; Adult ; Aged ; COVID-19 ; Cohort Studies ; Democratic Republic of the Congo/epidemiology ; Humans ; Male ; Middle Aged ; Retrospective Studies ; SARS-CoV-2
Language	English
Publishing date	2021-12-20
Publishing country	England
Document type	Journal Article ; Observational Study
ISSN	1471-2334
ISSN (online)	1471-2334
DOI	10.1186/s12879-021-06984-x
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Inter-library loan at ZB MED

Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

Article ; Online: Clinical Characteristics and Predictors of Disease Progression in Severe Patients with COVID-19 Infection in Jiangsu Province, China: A Descriptive Study.

Huang, Mao / Yang, Yi / Shang, Futai / Zheng, Yishan / Zhao, Wenjing / Luo, Liang / Han, Xudong / Lin, Aihua / Zhao, Hongsheng / Gu, Qing / Shi, Yi / Li, Jun / Xu, Xingxiang / Liu, Kexi / Deng, YiJun / Cao, Quan / Wang, Weiwei

The American journal of the medical sciences

2020 Volume 360, Issue 2, Page(s) 120–128

Abstract: Background: We studied patients with coronavirus disease 2019 (COVID-19) infected ... Province.: Methods: A multicenter retrospective cohort study was conducted to analyze clinical ... predictors of disease progression.: Results: A total of 653 infected cases with COVID-19 were reported ...

Abstract	Background: We studied patients with coronavirus disease 2019 (COVID-19) infected by severe acute respiratory syndrome coronavirus 2, a virus that originated in Wuhan, China, and is spreading over the country including Jiangsu Province. We studied the clinical characteristics and therapies of severe cases in Jiangsu Province. Methods: A multicenter retrospective cohort study was conducted to analyze clinical, laboratory data and treatment of 60 severe cases with COVID-19 infection in Jiangsu Province between January 24, 2020 and April 20, 2020. The improvement and deterioration subgroups were compared to identify predictors of disease progression. Results: A total of 653 infected cases with COVID-19 were reported in Jiangsu Province, of which 60 severe cases were included in this study. Up until April 20, 2020, the mortality of severe patients was 0%. The median age was 57 years. The average body mass index of these patients was 25 kg/m². White blood cell counts decreased in 45.0% of patients, lymphopenia in 63.3%, thrombocytopenia in 13.3% and procalcitonin levels in 88.3% of the patients were less than 0.5 ng/mL. There were no statistically significant differences in immunoglobulin therapy and GCs therapy between the improvement and deterioration subgroups. Logistic regression analysis identified higher levels of troponin T (odds ratio [OR]: 1.04; 95% confidence interval [CI]: 1.00-1.08; P = 0.04), antiviral therapy with aerosol inhalation of interferon (OR: 6.33; 95% CI: 1.18-33.98; P = 0.03), and the application of non-invasive mechanical ventilation (OR: 1.99; 95%CI: 1.17-3.41; P = 0.01) as predictors of disease progression, whereas higher lymphocyte count (OR: 0.11; 95% CI: 0.02-0.57; P = 0.01) and early prone ventilation were associated with improvement (OR: 0.11; 95% CI: 0.01-0.98; P = 0.04). Conclusions: COVID-19 infection had a low mortality rate in Jiangsu Province, China. The higher levels of troponin T and lower lymphocyte count were predictors of disease progression. Early prone ventilation may be an effective treatment for severe cases.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Betacoronavirus ; COVID-19 ; China ; Coronavirus Infections/blood ; Coronavirus Infections/mortality ; Coronavirus Infections/therapy ; Female ; Humans ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral/blood ; Pneumonia, Viral/mortality ; Pneumonia, Viral/therapy ; Respiratory Distress Syndrome/blood ; Respiratory Distress Syndrome/mortality ; Respiratory Distress Syndrome/therapy ; Retrospective Studies ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-06-01
Publishing country	United States
Document type	Clinical Trial ; Journal Article
ZDB-ID	82078-7
ISSN	1538-2990 ; 0002-9629
ISSN (online)	1538-2990
ISSN	0002-9629
DOI	10.1016/j.amjms.2020.05.038
Database	MEDical Literature Analysis and Retrieval System OnLINE

In stock of ZB MED Cologne/Königswinter

Ua VI Zs.2/10: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
ab Jg. 2022: Lesesaal (EG)

Order via subito

Details ▾
- See ZB MED holdings
- Order with fees

Article: Clinical Characteristics and Predictors of Disease Progression in Severe Patients with COVID-19 Infection in Jiangsu Province, China: A Descriptive Study

Am J Med Sci

Abstract: BACKGROUND: We studied patients with coronavirus disease 2019 (COVID-19) infected ... Province. METHODS: A multicenter retrospective cohort study was conducted to analyze clinical, laboratory ... predictors of disease progression. RESULTS: A total of 653 infected cases with COVID-19 were reported ...

Abstract	BACKGROUND: We studied patients with coronavirus disease 2019 (COVID-19) infected by severe acute respiratory syndrome coronavirus 2, a virus that originated in Wuhan, China, and is spreading over the country including Jiangsu Province. We studied the clinical characteristics and therapies of severe cases in Jiangsu Province. METHODS: A multicenter retrospective cohort study was conducted to analyze clinical, laboratory data and treatment of 60 severe cases with COVID-19 infection in Jiangsu Province between January 24, 2020 and April 20, 2020. The improvement and deterioration subgroups were compared to identify predictors of disease progression. RESULTS: A total of 653 infected cases with COVID-19 were reported in Jiangsu Province, of which 60 severe cases were included in this study. Up until April 20, 2020, the mortality of severe patients was 0%. The median age was 57 years. The average body mass index of these patients was 25 kg/m². White blood cell counts decreased in 45.0% of patients, lymphopenia in 63.3%, thrombocytopenia in 13.3% and procalcitonin levels in 88.3% of the patients were less than 0.5 ng/mL. There were no statistically significant differences in immunoglobulin therapy and GCs therapy between the improvement and deterioration subgroups. Logistic regression analysis identified higher levels of troponin T (odds ratio [OR]: 1.04; 95% confidence interval [CI]: 1.00-1.08; Pâ¯=â¯0.04), antiviral therapy with aerosol inhalation of interferon (OR: 6.33; 95% CI: 1.18-33.98; Pâ¯=â¯0.03), and the application of non-invasive mechanical ventilation (OR: 1.99; 95%CI: 1.17-3.41; Pâ¯=â¯0.01) as predictors of disease progression, whereas higher lymphocyte count (OR: 0.11; 95% CI: 0.02-0.57; Pâ¯=â¯0.01) and early prone ventilation were associated with improvement (OR: 0.11; 95% CI: 0.01-0.98; Pâ¯=â¯0.04). CONCLUSIONS: COVID-19 infection had a low mortality rate in Jiangsu Province, China. The higher levels of troponin T and lower lymphocyte count were predictors of disease progression. Early prone ventilation may be an effective treatment for severe cases.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #32709280
Database	COVID19

Inter-library loan at ZB MED

Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

Details ▾

Article ; Online: Prediction of COVID-19 severity using laboratory findings on admission: informative values, thresholds, ML model performance.

Statsenko, Yauhen / Al Zahmi, Fatmah / Habuza, Tetiana / Gorkom, Klaus Neidl-Van / Zaki, Nazar

BMJ open

2021 Volume 11, Issue 2, Page(s) e044500

Abstract: ... to clinical use.: Objectives: To identify predictive biomarkers of COVID-19 severity and to justify ... of 72 patients admitted to ICU vs 488 non-severe cases). Therefore, we customised supervised ... prognosis of patients with COVID-19. The currently published prediction models are not fully applicable ...

Abstract	Background: Despite the necessity, there is no reliable biomarker to predict disease severity and prognosis of patients with COVID-19. The currently published prediction models are not fully applicable to clinical use. Objectives: To identify predictive biomarkers of COVID-19 severity and to justify their threshold values for the stratification of the risk of deterioration that would require transferring to the intensive care unit (ICU). Methods: The study cohort (560 subjects) included all consecutive patients admitted to Dubai Mediclinic Parkview Hospital from February to May 2020 with COVID-19 confirmed by the PCR. The challenge of finding the cut-off thresholds was the unbalanced dataset (eg, the disproportion in the number of 72 patients admitted to ICU vs 488 non-severe cases). Therefore, we customised supervised machine learning (ML) algorithm in terms of threshold value used to predict worsening. Results: With the default thresholds returned by the ML estimator, the performance of the models was low. It was improved by setting the cut-off level to the 25th percentile for lymphocyte count and the 75th percentile for other features. The study justified the following threshold values of the laboratory tests done on admission: lymphocyte count <2.59×10 Conclusion: The performance of the neural network trained with top valuable tests (aPTT, CRP and fibrinogen) is admissible (area under the curve (AUC) 0.86; 95% CI 0.486 to 0.884; p<0.001) and comparable with the model trained with all the tests (AUC 0.90; 95% CI 0.812 to 0.902; p<0.001). Free online tool at https://med-predict.com illustrates the study results.
MeSH term(s)	Algorithms ; Biomarkers/analysis ; COVID-19/diagnosis ; COVID-19/physiopathology ; Hospitalization ; Humans ; Likelihood Functions ; Prognosis ; Retrospective Studies ; Supervised Machine Learning ; United Arab Emirates
Chemical Substances	Biomarkers
Language	English
Publishing date	2021-02-26
Publishing country	England
Document type	Journal Article
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2020-044500
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: A Tool for Early Prediction of Severe Coronavirus Disease 2019 (COVID-19): A Multicenter Study Using the Risk Nomogram in Wuhan and Guangdong, China.

Gong, Jiao / Ou, Jingyi / Qiu, Xueping / Jie, Yusheng / Chen, Yaqiong / Yuan, Lianxiong / Cao, Jing / Tan, Mingkai / Xu, Wenxiong / Zheng, Fang / Shi, Yaling / Hu, Bo

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2020 Volume 71, Issue 15, Page(s) 833–840

Abstract: ... multicenter study, 372 hospitalized patients with nonsevere COVID-19 were followed for > 15 days after admission ... Patients who deteriorated to severe or critical COVID-19 and those who maintained a nonsevere state were ... patients. Among all cases, 72 (19.4%) patients developed severe COVID-19. Older age; higher serum ...

Abstract	Background: Because there is no reliable risk stratification tool for severe coronavirus disease 2019 (COVID-19) patients at admission, we aimed to construct an effective model for early identification of cases at high risk of progression to severe COVID-19. Methods: In this retrospective multicenter study, 372 hospitalized patients with nonsevere COVID-19 were followed for > 15 days after admission. Patients who deteriorated to severe or critical COVID-19 and those who maintained a nonsevere state were assigned to the severe and nonsevere groups, respectively. Based on baseline data of the 2 groups, we constructed a risk prediction nomogram for severe COVID-19 and evaluated its performance. Results: The training cohort consisted of 189 patients, and the 2 independent validation cohorts consisted of 165 and 18 patients. Among all cases, 72 (19.4%) patients developed severe COVID-19. Older age; higher serum lactate dehydrogenase, C-reactive protein, coefficient of variation of red blood cell distribution width, blood urea nitrogen, and direct bilirubin; and lower albumin were associated with severe COVID-19. We generated the nomogram for early identifying severe COVID-19 in the training cohort (area under the curve [AUC], 0.912 [95% confidence interval {CI}, .846-.978]; sensitivity 85.7%, specificity 87.6%) and the validation cohort (AUC, 0.853 [95% CI, .790-.916]; sensitivity 77.5%, specificity 78.4%). The calibration curve for probability of severe COVID-19 showed optimal agreement between prediction by nomogram and actual observation. Decision curve and clinical impact curve analyses indicated that nomogram conferred high clinical net benefit. Conclusions: Our nomogram could help clinicians with early identification of patients who will progress to severe COVID-19, which will enable better centralized management and early treatment of severe disease.
MeSH term(s)	Adult ; Area Under Curve ; Betacoronavirus/pathogenicity ; COVID-19 ; China ; Coronavirus Infections/diagnosis ; Coronavirus Infections/pathology ; Coronavirus Infections/virology ; Disease Progression ; Female ; Humans ; Male ; Middle Aged ; Nomograms ; Pandemics ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/pathology ; Pneumonia, Viral/virology ; Prognosis ; Retrospective Studies ; Risk Assessment/methods ; Risk Factors ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-02-20
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciaa443
Database	MEDical Literature Analysis and Retrieval System OnLINE

In stock of ZB MED Cologne/Königswinter

Zs.A 1505: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 480: Show issues

Order via subito

Details ▾
- See ZB MED holdings
- Order with fees

Article ; Online: Time-to-Death Longitudinal Characterization of Clinical Variables and Longitudinal Prediction of Mortality in COVID-19 Patients

Anne Chen / Zirun Zhao / Wei Hou / Adam J. Singer / Haifang Li / Tim Q. Duong

Frontiers in Medicine, Vol

A Two-Center Study

2021 Volume 8

Abstract: ... Retrospective cohort study of the temporal characteristics of clinical variables with time lock to mortality ... to mortality and build a predictive model of mortality associated with COVID-19 using clinical variables.Design ... 001).Conclusion: This study identified several clinical markers that demonstrated a temporal ...

Abstract	Objectives: To characterize the temporal characteristics of clinical variables with time lock to mortality and build a predictive model of mortality associated with COVID-19 using clinical variables.Design: Retrospective cohort study of the temporal characteristics of clinical variables with time lock to mortality.Setting: Stony Brook University Hospital (New York) and Tongji Hospital.Patients: Patients with confirmed positive for severe acute respiratory syndrome coronavirus-2 using polymerase chain reaction testing. Patients from the Stony Brook University Hospital data were used for training (80%, N = 1,002) and testing (20%, N = 250), and 375 patients from the Tongji Hospital (Wuhan, China) data were used for testing.Intervention: None.Measurements and Main Results: Longitudinal clinical variables were analyzed as a function of days from outcome with time-lock-to-day of death (non-survivors) or discharge (survivors). A predictive model using the significant earliest predictors was constructed. Performance was evaluated using receiver operating characteristics area under the curve (AUC). The predictive model found lactate dehydrogenase, lymphocytes, procalcitonin, D-dimer, C-reactive protein, respiratory rate, and white-blood cells to be early predictors of mortality. The AUC for the zero to 9 days prior to outcome were: 0.99, 0.96, 0.94, 0.90, 0.82, 0.75, 0.73, 0.77, 0.79, and 0.73, respectively (Stony Brook Hospital), and 1.0, 0.86, 0.88, 0.96, 0.91, 0.62, 0.67, 0.50, 0.63, and 0.57, respectively (Tongji Hospital). In comparison, prediction performance using hospital admission data was poor (AUC = 0.59). Temporal fluctuations of most clinical variables, indicative of physiological and biochemical instability, were markedly higher in non-survivors compared to survivors (p < 0.001).Conclusion: This study identified several clinical markers that demonstrated a temporal progression associated with mortality. These variables accurately predicted death within a few days prior to outcome, which provides objective indication that closer monitoring and interventions may be needed to prevent deterioration.
Keywords	prediction ; SARS-CoV-2 ; longitudinal ; trend ; clinical variables ; Medicine (General) ; R5-920
Subject code	310 ; 610
Language	English
Publishing date	2021-04-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

Full text online

Full text

Inter-library loan at ZB MED

Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

To top

Full text online

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

Order via subito

Full text online

More links

Kategorien

Inter-library loan at ZB MED

Full text online

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

Order via subito

Inter-library loan at ZB MED

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

Kategorien

Inter-library loan at ZB MED

More links

Kategorien

Order via subito

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

Full text online

More links

Kategorien

Inter-library loan at ZB MED