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Artikel ; Online: Timing and causes of death in severe COVID-19 patients.

de Roquetaillade, Charles / Bredin, Swann / Lascarrou, Jean-Baptiste / Soumagne, Thibaud / Cojocaru, Mariana / Chousterman, Benjamin Glenn / Leclerc, Maxime / Gouhier, Albin / Piton, Gaël / Pène, Frédéric / Stoclin, Annabelle / Llitjos, Jean-François

Critical care (London, England)

2021 Band 25, Heft 1, Seite(n) 224

Abstract: Background: Previous studies reporting the causes of death in patients with severe COVID-19 have ... of death, among severe COVID-19 patients admitted to the ICU. ... in patients with severe COVID-19 admitted to the intensive care unit (ICU).: Methods: We performed ...

Abstract	Background: Previous studies reporting the causes of death in patients with severe COVID-19 have provided conflicting results. The objective of this study was to describe the causes and timing of death in patients with severe COVID-19 admitted to the intensive care unit (ICU). Methods: We performed a retrospective study in eight ICUs across seven French hospitals. All consecutive adult patients (aged ≥ 18 years) admitted to the ICU with PCR-confirmed SARS-CoV-2 infection and acute respiratory failure were included in the analysis. The causes and timing of ICU deaths were reported based on medical records. Results: From March 1, 2020, to April 28, 287 patients were admitted to the ICU for SARS-CoV-2 related acute respiratory failure. Among them, 93 patients died in the ICU (32%). COVID-19-related multiple organ dysfunction syndrome (MODS) was the leading cause of death (37%). Secondary infection-related MODS accounted for 26% of ICU deaths, with a majority of ventilator-associated pneumonia. Refractory hypoxemia/pulmonary fibrosis was responsible for death in 19% of the cases. Fatal ischemic events (venous or arterial) occurred in 13% of the cases. The median time from ICU admission to death was 15 days (25th-75th IQR, 7-27 days). COVID-19-related MODS had a median time from ICU admission to death of 14 days (25th-75th IQR: 7-19 days), while only one death had occurred during the first 3 days since ICU admission. Conclusions: In our multicenter observational study, COVID-19-related MODS and secondary infections were the two leading causes of death, among severe COVID-19 patients admitted to the ICU.
Sprache	Englisch
Erscheinungsdatum	2021-06-30
Erscheinungsland	England
Dokumenttyp	Journal Article
ZDB-ID	2041406-7
ISSN	1466-609X ; 1364-8535
ISSN (online)	1466-609X
ISSN	1364-8535
DOI	10.1186/s13054-021-03639-w
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Timing and Outcomes of Noninvasive Ventilation in 307 ARDS COVID-19 Patients

Nardi Tetaj / Pierluca Piselli / Sara Zito / Giada De Angelis / Maria Cristina Marini / Dorotea Rubino / Ilaria Gaviano / Maria Vittoria Antonica / Elisabetta Agostini / Candido Porcelli / Giulia Valeria Stazi / Gabriele Garotto / Donatella Busso / Silvana Scarcia / Assunta Navarra / Claudia Cimaglia / Simone Topino / Fabio Iacomi / Alessandra D’Abramo /

Carmela Pinnetti / Gina Gualano / Alessandro Capone / Alberta Villanacci / Andrea Antinori / Fabrizio Palmieri / Gianpiero D’Offizi / Stefania Ianniello / Fabrizio Taglietti / Paolo Campioni / Francesco Vaia / Emanuele Nicastri / Enrico Girardi / Luisa Marchioni / on behalf of the ReCOVeRI Study Group

Medicina, Vol 58, Iss 8, p

An Observational Study in an Italian Third Level COVID-19 Hospital

2022 Band 1104

Abstract: ... the efficacy of NIV in patients with COVID-19 ARDS. Materials and Methods : We conducted an observational ... cohort study including adult ARDS COVID-19 patients admitted in a third level COVID-center in Rome, Italy ... period, a total of 942 COVID-19 patients were admitted to our hospital, of which 307 (32.5%) presented ...

Abstract	Background and Objectives : Background: Coronavirus disease 2019 (COVID-19) is a novel cause of Acute Respiratory Distress Syndrome (ARDS). Noninvasive ventilation (NIV) is widely used in patients with ARDS across several etiologies. Indeed, with the increase of ARDS cases due to the COVID-19 pandemic, its use has grown significantly in hospital wards. However, there is a lack of evidence to support the efficacy of NIV in patients with COVID-19 ARDS. Materials and Methods : We conducted an observational cohort study including adult ARDS COVID-19 patients admitted in a third level COVID-center in Rome, Italy. The study analyzed the rate of NIV failure defined by the occurrence of orotracheal intubation and/or death within 28 days from starting NIV, its effectiveness, and the associated relative risk of death. The factors associated with the outcomes were identified through logistic regression analysis. Results : During the study period, a total of 942 COVID-19 patients were admitted to our hospital, of which 307 (32.5%) presented with ARDS at hospitalization. During hospitalization 224 (23.8%) were treated with NIV. NIV failure occurred in 84 (37.5%) patients. At 28 days from starting NIV, moderate and severe ARDS had five-fold and twenty-fold independent increased risk of NIV failure (adjusted odds ratio, aOR = 5.01, 95% CI 2.08–12.09, and 19.95, 95% CI 5.31–74.94), respectively, compared to patients with mild ARDS. A total of 128 patients (13.5%) were admitted to the Intensive Care Unit (ICU). At 28-day from ICU admission, intubated COVID-19 patients treated with early NIV had 40% lower mortality (aOR 0.60, 95% CI 0.25–1.46, p = 0.010) compared with patients that underwent orotracheal intubation without prior NIV. Conclusions : These findings show that NIV failure was independently correlated with the severity category of COVID-19 ARDS. The start of NIV in COVID-19 patients with mild ARDS (P/F > 200 mmHg) appears to increase NIV effectiveness and reduce the risk of orotracheal intubation and/or death. ...
Schlagwörter	COVID-19 ; noninvasive ventilation ; intensive care unit ; acute respiratory distress syndrome ; ARDS ; NIV failure ; Medicine (General) ; R5-920
Thema/Rubrik (Code)	610
Sprache	Englisch
Erscheinungsdatum	2022-08-01T00:00:00Z
Verlag	MDPI AG
Dokumenttyp	Artikel ; Online
Datenquelle	BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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Artikel: The Importance of the Timing of Tocilizumab Administration in Moderate to Severely Ill COVID-19: Single Centered Experience Case series.

Tenda, Eric Daniel / Andrian, Setiabakti / Albert, Sedjahtera / Asaf, Moses M / Pitoyo, Ceva W / Setiati, Siti / Subekti, Imam

Acta medica Indonesiana

2021 Band 53, Heft 3, Seite(n) 319–325

Abstract: ... is recommended for severe COVID-19 patients in the latest therapeutic guideline published ... three patients with moderate to severe COVID-19 infections that receive tocilizumab as an adjunct ... as signified by plasma IL-6 levels in moderate to severe COVID-19 patients could potentially improve overall ...

Abstract	One of the main causes of death in COVID-19 is the dysregulation of the host's immune system which leads to cytokine storm, a potentially fatal systemic inflammatory syndrome. Interleukin 6 (IL-6) is a pro-inflammatory cytokine that is produced in response to infections and tissue injuries and is believed to play a pivotal role in the event of a cytokine storm, as signified by its increase in the process. Considering the role of IL-6 as a pro-inflammatory cytokine in the process of cytokine storm in COVID-19, perceiving IL-6 as a therapeutic target could prove to be promising. Tocilizumab is a monoclonal antibody that competitively inhibits the binding of IL-6 to its receptor (IL-6R). The use of IL-6R blocker is recommended for severe COVID-19 patients in the latest therapeutic guideline published by the World Health Organization (WHO), but the timing of the administration has not been specified. While previous studies about the use of tocilizumab in COVID-19 patients have shown various results, these studies do not emphasize on plasma IL-6 levels when deciding the time of tocilizumab administration. In this case series, we present three patients with moderate to severe COVID-19 infections that receive tocilizumab as an adjunct to the standard of care therapy. This case series introduces the novel idea that the timely use of tocilizumab as signified by plasma IL-6 levels in moderate to severe COVID-19 patients could potentially improve overall clinical condition and increase survival rate.
Mesh-Begriff(e)	Adult ; Aged ; Antibodies, Monoclonal/administration & dosage ; Antibodies, Monoclonal/adverse effects ; Antibodies, Monoclonal, Humanized/administration & dosage ; Antibodies, Monoclonal, Humanized/adverse effects ; COVID-19/diagnosis ; COVID-19/drug therapy ; COVID-19/immunology ; COVID-19/physiopathology ; Cytokine Release Syndrome/etiology ; Cytokine Release Syndrome/immunology ; Cytokine Release Syndrome/prevention & control ; Drug Monitoring/methods ; Humans ; Interleukin-6/antagonists & inhibitors ; Interleukin-6/blood ; Male ; Middle Aged ; Receptors, Interleukin-6/immunology ; SARS-CoV-2/isolation & purification ; Severity of Illness Index ; Time-to-Treatment ; Treatment Outcome
Chemische Substanzen	Antibodies, Monoclonal ; Antibodies, Monoclonal, Humanized ; IL6R protein, human ; Interleukin-6 ; Receptors, Interleukin-6 ; tocilizumab (I031V2H011)
Sprache	Englisch
Erscheinungsdatum	2021-09-30
Erscheinungsland	Indonesia
Dokumenttyp	Case Reports ; Journal Article
ZDB-ID	2474707-5
ISSN	2338-2732 ; 0125-9326
ISSN (online)	2338-2732
ISSN	0125-9326
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Timing and Outcomes of Noninvasive Ventilation in 307 ARDS COVID-19 Patients: An Observational Study in an Italian Third Level COVID-19 Hospital.

Tetaj, Nardi / Piselli, Pierluca / Zito, Sara / De Angelis, Giada / Marini, Maria Cristina / Rubino, Dorotea / Gaviano, Ilaria / Antonica, Maria Vittoria / Agostini, Elisabetta / Porcelli, Candido / Stazi, Giulia Valeria / Garotto, Gabriele / Busso, Donatella / Scarcia, Silvana / Navarra, Assunta / Cimaglia, Claudia / Topino, Simone / Iacomi, Fabio / D'Abramo, Alessandra /

Pinnetti, Carmela / Gualano, Gina / Capone, Alessandro / Villanacci, Alberta / Antinori, Andrea / Palmieri, Fabrizio / D'Offizi, Gianpiero / Ianniello, Stefania / Taglietti, Fabrizio / Campioni, Paolo / Vaia, Francesco / Nicastri, Emanuele / Girardi, Enrico / Marchioni, Luisa / On Behalf Of The ReCOVeRI Study Group

Medicina (Kaunas, Lithuania)

2022 Band 58, Heft 8

Abstract: ... the efficacy of NIV in patients with COVID-19 ARDS. Materials and Methods: We conducted an observational ... cohort study including adult ARDS COVID-19 patients admitted in a third level COVID-center in Rome, Italy ... period, a total of 942 COVID-19 patients were admitted to our hospital, of which 307 (32.5%) presented ...

Abstract	Background and Objectives: Background: Coronavirus disease 2019 (COVID-19) is a novel cause of Acute Respiratory Distress Syndrome (ARDS). Noninvasive ventilation (NIV) is widely used in patients with ARDS across several etiologies. Indeed, with the increase of ARDS cases due to the COVID-19 pandemic, its use has grown significantly in hospital wards. However, there is a lack of evidence to support the efficacy of NIV in patients with COVID-19 ARDS. Materials and Methods: We conducted an observational cohort study including adult ARDS COVID-19 patients admitted in a third level COVID-center in Rome, Italy. The study analyzed the rate of NIV failure defined by the occurrence of orotracheal intubation and/or death within 28 days from starting NIV, its effectiveness, and the associated relative risk of death. The factors associated with the outcomes were identified through logistic regression analysis. Results: During the study period, a total of 942 COVID-19 patients were admitted to our hospital, of which 307 (32.5%) presented with ARDS at hospitalization. During hospitalization 224 (23.8%) were treated with NIV. NIV failure occurred in 84 (37.5%) patients. At 28 days from starting NIV, moderate and severe ARDS had five-fold and twenty-fold independent increased risk of NIV failure (adjusted odds ratio, aOR = 5.01, 95% CI 2.08−12.09, and 19.95, 95% CI 5.31−74.94), respectively, compared to patients with mild ARDS. A total of 128 patients (13.5%) were admitted to the Intensive Care Unit (ICU). At 28-day from ICU admission, intubated COVID-19 patients treated with early NIV had 40% lower mortality (aOR 0.60, 95% CI 0.25−1.46, p = 0.010) compared with patients that underwent orotracheal intubation without prior NIV. Conclusions: These findings show that NIV failure was independently correlated with the severity category of COVID-19 ARDS. The start of NIV in COVID-19 patients with mild ARDS (P/F > 200 mmHg) appears to increase NIV effectiveness and reduce the risk of orotracheal intubation and/or death. Moreover, early NIV (P/F > 200 mmHg) treatment seems to reduce the risk of ICU mortality at 28 days from ICU admission.
Mesh-Begriff(e)	Adult ; COVID-19/complications ; Cohort Studies ; Hospitals ; Humans ; Intensive Care Units ; Noninvasive Ventilation ; Pandemics ; Respiratory Distress Syndrome/etiology ; Respiratory Distress Syndrome/therapy ; Respiratory Insufficiency/etiology
Sprache	Englisch
Erscheinungsdatum	2022-08-15
Erscheinungsland	Switzerland
Dokumenttyp	Journal Article ; Observational Study
ZDB-ID	2188113-3
ISSN	1648-9144 ; 1010-660X
ISSN (online)	1648-9144
ISSN	1010-660X
DOI	10.3390/medicina58081104
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: The Importance of the Timing of Tocilizumab Administration in Moderate to Severely Ill COVID-19

Eric Daniel Tenda / Setiabakti Andrian / Sedjahtera Albert / Moses M Asaf / Ceva W Pitoyo / Siti Setiati / Imam Subekti

Acta Medica Indonesiana, Vol 53, Iss

Single Centered Experience Case series

2021 Band 3

Abstract	One of the main causes of death in COVID-19 is the dysregulation of the host’s immune system which leads to cytokine storm, a potentially fatal systemic inflammatory syndrome. Interleukin 6 (IL-6) is a pro-inflammatory cytokine that is produced in response to infections and tissue injuries and is believed to play a pivotal role in the event of a cytokine storm, as signified by its increase in the process. Considering the role of IL-6 as a pro-inflammatory cytokine in the process of cytokine storm in COVID-19, perceiving IL-6 as a therapeutic target could prove to be promising. Tocilizumab is a monoclonal antibody that competitively inhibits the binding of IL-6 to its receptor (IL-6R). The use of IL-6R blocker is recommended for severe COVID-19 patients in the latest therapeutic guideline published by the World Health Organization (WHO), but the timing of the administration has not been specified. While previous studies about the use of tocilizumab in COVID-19 patients have shown various results, these studies do not emphasize on plasma IL-6 levels when deciding the time of tocilizumab administration. In this case series, we present three patients with moderate to severe COVID-19 infections that receive tocilizumab as an adjunct to the standard of care therapy. This case series introduces the novel idea that the timely use of tocilizumab as signified by plasma IL-6 levels in moderate to severe COVID-19 patients could potentially improve overall clinical condition and increase survival rate.
Schlagwörter	case series ; covid-19 ; interleukin-6 ; timely ; tocilizumab ; Internal medicine ; RC31-1245
Thema/Rubrik (Code)	610
Sprache	Englisch
Erscheinungsdatum	2021-07-01T00:00:00Z
Verlag	Interna Publishing
Dokumenttyp	Artikel ; Online
Datenquelle	BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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Artikel ; Online: Effect of timing of intubation on clinical outcomes of critically ill patients with COVID-19: a systematic review and meta-analysis of non-randomized cohort studies.

Papoutsi, Eleni / Giannakoulis, Vassilis G / Xourgia, Eleni / Routsi, Christina / Kotanidou, Anastasia / Siempos, Ilias I

Critical care (London, England)

2021 Band 25, Heft 1, Seite(n) 121

Abstract: ... may have no effect on mortality and morbidity of critically ill patients with COVID-19. These results ... of patients with severe coronavirus disease 2019 (COVID-19), this issue is still controversial. We aimed ... to December 26, 2020, to identify studies which reported on mortality and/or morbidity of patients with COVID ...

Abstract	Background: Although several international guidelines recommend early over late intubation of patients with severe coronavirus disease 2019 (COVID-19), this issue is still controversial. We aimed to investigate the effect (if any) of timing of intubation on clinical outcomes of critically ill patients with COVID-19 by carrying out a systematic review and meta-analysis. Methods: PubMed and Scopus were systematically searched, while references and preprint servers were explored, for relevant articles up to December 26, 2020, to identify studies which reported on mortality and/or morbidity of patients with COVID-19 undergoing early versus late intubation. "Early" was defined as intubation within 24 h from intensive care unit (ICU) admission, while "late" as intubation at any time after 24 h of ICU admission. All-cause mortality and duration of mechanical ventilation (MV) were the primary outcomes of the meta-analysis. Pooled risk ratio (RR), pooled mean difference (MD) and 95% confidence intervals (CI) were calculated using a random effects model. The meta-analysis was registered with PROSPERO (CRD42020222147). Results: A total of 12 studies, involving 8944 critically ill patients with COVID-19, were included. There was no statistically detectable difference on all-cause mortality between patients undergoing early versus late intubation (3981 deaths; 45.4% versus 39.1%; RR 1.07, 95% CI 0.99-1.15, p = 0.08). This was also the case for duration of MV (1892 patients; MD - 0.58 days, 95% CI - 3.06 to 1.89 days, p = 0.65). In a sensitivity analysis using an alternate definition of early/late intubation, intubation without versus with a prior trial of high-flow nasal cannula or noninvasive mechanical ventilation was still not associated with a statistically detectable difference on all-cause mortality (1128 deaths; 48.9% versus 42.5%; RR 1.11, 95% CI 0.99-1.25, p = 0.08). Conclusions: The synthesized evidence suggests that timing of intubation may have no effect on mortality and morbidity of critically ill patients with COVID-19. These results might justify a wait-and-see approach, which may lead to fewer intubations. Relevant guidelines may therefore need to be updated.
Mesh-Begriff(e)	COVID-19/mortality ; COVID-19/therapy ; Cohort Studies ; Critical Illness ; Humans ; Intubation, Intratracheal/statistics & numerical data ; Time Factors ; Treatment Outcome
Sprache	Englisch
Erscheinungsdatum	2021-03-25
Erscheinungsland	England
Dokumenttyp	Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Systematic Review
ZDB-ID	2041406-7
ISSN	1466-609X ; 1364-8535
ISSN (online)	1466-609X
ISSN	1364-8535
DOI	10.1186/s13054-021-03540-6
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Study Pre-protocol for 'BronchStart - The Impact of the COVID-19 Pandemic on the Timing, Age and Severity of Respiratory Syncytial Virus (RSV) Emergency Presentations; a Multi-Centre Prospective Observational Cohort Study'

Williams, Thomas C / Lyttle, Mark D / Cunningham, Steve / Sinha, Ian / Swann, Olivia / Maxwell-Hodkinson, Abigail / Roland, Damian / Paediatric Emergency Research in the UK and Ireland (PERUKI)

medRxiv

Abstract: ... at risk is a wider age range than normal, and whether there are changes in disease severity ... This information is also needed to inform decision on the timing of passive immunisation of children at higher risk ... for presentations to an Emergency Department (ED) and frequently results in hospital admission, contributing ...

Abstract	Background Bronchiolitis (most frequently caused by Respiratory Syncytial Virus; RSV) is a common winter disease predominantly affecting children under one year of age. It is a common reason for presentations to an Emergency Department (ED) and frequently results in hospital admission, contributing to paediatric units approaching or exceeding capacity each winter. During the SARS-CoV-2 pandemic, the circulation of RSV was dramatically reduced in the United Kingdom and Ireland. Evidence from the Southern Hemisphere and other European countries suggests that as social distancing restrictions for SARS-CoV-2 are relaxed, RSV infection returns, causing delayed or even summer epidemics, with different age distributions. Study question The ability to track, anticipate and respond to a surge in RSV cases is critical for planning acute care delivery. There is an urgent need to understand the onset of RSV spread at the earliest opportunity. This will influence service planning, to inform clinicians whether the population at risk is a wider age range than normal, and whether there are changes in disease severity. This information is also needed to inform decision on the timing of passive immunisation of children at higher risk of hospitalisation, intensive care admission or death with RSV infection, which is a public health priority. Methods and likely impact This multi-centre prospective observational cohort study will use a well-established research network (Paediatric Emergency Research in the UK and Ireland, PERUKI) to report in real time cases of RSV infection in children aged under two years, through the collection of essential, but non-identifying patient information. Forty centres will gather initial data on age, index of multiple deprivation quintile, clinical features on presentation, and co-morbidities. Each case will be followed up at 7 days to identify treatment, viral diagnosis and outcome. Information be released on a weekly basis and used to support clinical decision making.
Schlagwörter	covid19
Sprache	Englisch
Erscheinungsdatum	2021-04-20
Verlag	Cold Spring Harbor Laboratory Press
Dokumenttyp	Artikel ; Online
DOI	10.1101/2021.04.18.21255700
Datenquelle	COVID19

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Artikel: Rehabilitation at the Time of Pandemic: Patient Journey Recommendations.

Negm, Ahmed M / Salopek, Adrian / Zaide, Mashal / Meng, Victoria J / Prada, Carlos / Chang, Yaping / Zanwar, Preeti / Santos, Flavia H / Philippou, Elena / Rosario, Emily R / Faieta, Julie / Pinto, Shanti M / Falvey, Jason R / Kumar, Amit / Reistetter, Timothy A / Dal Bello-Haas, Vanina / Bhandari, Mohit / Bean, Jonathan F / Heyn, Patricia C

Frontiers in aging neuroscience

2022 Band 14, Seite(n) 781226

Abstract: ... care were severely disrupted, and patients have faced several challenges during the COVID-19 outbreak ... prevention to avoid the virus spread to healthcare workers and other patients not infected with COVID-19 ... These challenges include addressing new functional impairments faced by survivors of COVID-19 and infection ...

Abstract	Purpose: The World Health Organization (WHO) declared severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) a pandemic in March 2020, causing almost 3.5 million coronavirus disease (COVID-19) related deaths worldwide. The COVID-19 pandemic has imposed a significant burden on healthcare systems, economies, and social systems in many countries around the world. The access and delivery of rehabilitation care were severely disrupted, and patients have faced several challenges during the COVID-19 outbreak. These challenges include addressing new functional impairments faced by survivors of COVID-19 and infection prevention to avoid the virus spread to healthcare workers and other patients not infected with COVID-19. In this scoping review, we aim to develop rehabilitation recommendations during the COVID-19 pandemic across the continuum of rehabilitation care. Materials and methods: Established frameworks were used to guide the scoping review methodology. Medline, Embase, Pubmed, CINAHL databases from inception to August 1, 2020, and prominent rehabilitation organizations' websites were searched. Study selection: We included articles and reports if they were focused on rehabilitation recommendations for COVID-19 survivors or the general population at the time of the COVID-19 pandemic. Data extraction: Two of our team members used the pre-tested data extraction form to extract data from included full-text articles. The strength and the quality of the extracted recommendations were evaluated by two reviewers using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach. Results: We retrieved 6,468 citations, of which 2,086 were eligible after removing duplicates. We excluded 1,980 citations based on the title and the abstract. Of the screened full-text articles, we included 106 studies. We present recommendations based on the patient journey at the time of the pandemic. We assessed the evidence to be of overall fair quality and strong for the recommendations. Conclusion: We have combined the latest research results and accumulated expert opinions on rehabilitation to develop acute and post-acute rehabilitation recommendations in response to the global COVID-19 pandemic. Further updates are warranted in order to incorporate the emerging evidence into rehabilitation guidelines.
Sprache	Englisch
Erscheinungsdatum	2022-04-12
Erscheinungsland	Switzerland
Dokumenttyp	Journal Article ; Review
ZDB-ID	2558898-9
ISSN	1663-4365
ISSN	1663-4365
DOI	10.3389/fnagi.2022.781226
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Oral Colchicine and Low-Dose Aspirin Combination Therapy for Non-elderly, Non-severe, Early Time From Onset, Adult Outpatients with Coronavirus Disease 2019 (COVID-19) during "The Fifth Pandemic Wave" in Japan.

Inokuchi, Tetsuaki / Homma, Tomoki / Kitasato, Yasuhiko / Akiyama, Mayu / Chikasue, Ayako / Nishii, Yuuya / Ban, Shigeki / Adachi, Takeki / Sonezaki, Aya / Masuda, Hiroshi / Kamei, Hideki / Takenaka, Miki / Tanaka, Maki / Okamoto, Masaki / Hoshino, Tomoaki

The Kurume medical journal

2024

Abstract: ... outpatients with COVID-19. To verify its effectiveness, we set loxoprofen as a control arm, and com parison ... rates.: Results: Thirty-eight patients (23 receiving colchicine and low-dose aspirin [CA]; 15 receiving ... outpatients with Coronavirus Disease 2019 (COVID-19) had not been established in 2021. However, some new ...

Abstract	Background: Treatment with antiviral drugs for non-severe, early time from onset, adult outpatients with Coronavirus Disease 2019 (COVID-19) had not been established in 2021. However, some new variants of SARS-CoV-2 had caused rapid exacerbation and hospitalization among non-elderly outpatients with COVID-19, contributing to widespread crises within healthcare systems. Methods: From July to October 2021, we urgently assessed a therapeutic program using oral colchicine (1.0 mg loading dose, followed approximately half a day later by 0.5 mg twice daily for 5 days, and then 0.5 mg once daily for 4 days) and low-dose aspirin (100 mg once daily for 10 days), for non-elderly, non-severe, early time from onset, adult outpatients with COVID-19. To verify its effectiveness, we set loxoprofen as a control arm, and com parison of these two arms was performed. The primary outcomes were hospitalization, criticality, and death rates. Results: Thirty-eight patients (23 receiving colchicine and low-dose aspirin [CA]; 15 receiving loxoprofen [LO]) were evaluated. Hospitalization rate was lower in the CA group (1/23; 4.3%) than in the LO group (2/15; 13.3%); however, no significant difference was found between the two groups (p=0.34). No critical cases, deaths, or severe adverse events were found in either group. Conclusions: Our CA regimen did not show superiority over LO treatment. However, our clinical experience should be recorded as part of community health care activities carried out in Kurume City against the unprece dented COVID-19 pandemic.
Sprache	Englisch
Erscheinungsdatum	2024-03-19
Erscheinungsland	Japan
Dokumenttyp	Journal Article
ZDB-ID	603905-4
ISSN	1881-2090 ; 0023-5679
ISSN (online)	1881-2090
ISSN	0023-5679
DOI	10.2739/kurumemedj.MS7012003
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Predicting the outcome for COVID-19 patients by applying time series classification to electronic health records.

Rodrigues, Davi Silva / Nastri, Ana Catharina S / Magri, Marcello M / Oliveira, Maura Salaroli de / Sabino, Ester C / Figueiredo, Pedro H M F / Levin, Anna S / Freire, Maristela P / Harima, Leila S / Nunes, Fátima L S / Ferreira, João Eduardo

BMC medical informatics and decision making

2022 Band 22, Heft 1, Seite(n) 187

Abstract: ... of predicting a COVID-19 patient's outcome with up to 96% general accuracy and 81% accuracy considering only ... asymptomatic and cause mild symptoms, but it also can evolve into a severe disease and lead to death. It is ... Brazil) between March 2020 and October 2021 due to COVID-19. The data was then represented as univariate ...

Abstract	Background: COVID-19 caused more than 622 thousand deaths in Brazil. The infection can be asymptomatic and cause mild symptoms, but it also can evolve into a severe disease and lead to death. It is difficult to predict which patients will develop severe disease. There are, in the literature, machine learning models capable of assisting diagnose and predicting outcomes for several diseases, but usually these models require laboratory tests and/or imaging. Methods: We conducted a observational cohort study that evaluated vital signs and measurements from patients who were admitted to Hospital das Clínicas (São Paulo, Brazil) between March 2020 and October 2021 due to COVID-19. The data was then represented as univariate and multivariate time series, that were used to train and test machine learning models capable of predicting a patient's outcome. Results: Time series-based machine learning models are capable of predicting a COVID-19 patient's outcome with up to 96% general accuracy and 81% accuracy considering only the first hospitalization day. The models can reach up to 99% sensitivity (discharge prediction) and up to 91% specificity (death prediction). Conclusions: Results indicate that time series-based machine learning models combined with easily obtainable data can predict COVID-19 outcomes and support clinical decisions. With further research, these models can potentially help doctors diagnose other diseases.
Mesh-Begriff(e)	Brazil/epidemiology ; COVID-19/epidemiology ; Electronic Health Records ; Hospitalization ; Humans ; Retrospective Studies ; Time Factors
Sprache	Englisch
Erscheinungsdatum	2022-07-17
Erscheinungsland	England
Dokumenttyp	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2046490-3
ISSN	1472-6947 ; 1472-6947
ISSN (online)	1472-6947
ISSN	1472-6947
DOI	10.1186/s12911-022-01931-5
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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