Clinical characteristics and outcomes of patients with Corona Virus Disease 2019 (COVID-19) at Mercy Health Hospitals, Toledo, Ohio

Importance The ongoing pandemic of the novel Corona Virus Disease 2019 (COVID-19) is an unprecedented challenge to global health, never experienced before. Objective This study aims to describe the clinical characteristics and outcomes of patients with COVID-19 admitted to Mercy Hospitals. Design and methods Retrospective, observational cohort study designed to include every COVID-19 subject aged 18 years or older admitted to Mercy Saint (St) Vincent, Mercy St Charles, and Mercy St Anne’s hospital in Toledo, Ohio from January 1, 2020 through June 15th, 2020. Primary Outcome Measure was mortality in the emergency department or as an in-patient. Results 470 subjects including 224 males and 246 females met the inclusion criteria for the study. Subjects with the following characteristics had higher odds (OR) of death: Older age [OR 8.3 (95% CI 1.1–63.1, p = 0.04)] for subjects age 70 or more compared to subjects age 18–29); Hypertension [OR 3.6 (95% CI 1.6–7.8, p = 0.001)]; Diabetes [OR 3.1 (95% CI 1.7–5.6, p<0.001)]; COPD [OR 3.4 (95% CI 1.8–6.3, p<0.001)] and CKD stage 2 or greater [OR 2.5 (95% CI 1.3–4.9, p = 0.006)]. Combining all age groups, subjects with hypertension had significantly greater odds of the following adverse outcomes: requiring hospital admission (OR 2.2, 95% CI 1.4–3.4, p<0.001); needing respiratory support in 24 hours (OR 2.5, 95% CI: 1.7–3.7, p<0.001); ICU admission (OR 2.7, 95% CI 1.7–4.4, p<0.001); and death (OR 3.6, 95% CI 1.6–7.8, p = 0.001). Hypertension was not associated with needing vent in 24 hours (p = 0.07). Conclusion Age and hypertension were associated with significant comorbidity and mortality in Covid-19 Positive patients. Furthermore, people who were older than 70, and had hypertension, diabetes, COPD, or CKD had higher odds of dying from the disease as compared to patients who hadn’t. Subjects with hypertension also had significantly greater odds of other adverse outcomes.

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Multisystem inflammatory syndrome-neonate: youngest COVID survivor

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20213330 ◽

2021 ◽

Vol 8 (9) ◽

pp. 1615

Author(s):

Sushil Singla ◽

Mohitesh Kumar ◽

Yaswanth C. Raavi

Keyword(s):

Virus Disease ◽

Age Groups ◽

Severe Infection ◽

Health Concern ◽

The Novel ◽

Global Public Health ◽

Limited Data ◽

Corona Virus ◽

Inflammatory Syndrome ◽

Respiratory Droplets

The novel corona virus disease (COVID-19) caused by the severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) is a global public health concern, primarily transmitted through respiratory droplets; though other routes of transmission are documented but not been fully demonstrated. At risk included all age groups, somehow for reasons unknown infants and children appears to be at a lower risk of severe infection, but recently children with hyper inflammatory syndrome and multi-organ dysfunction associated with COVID-19 have been increasingly reported. We report a case of 31-week neonate of 1.292 kg confirmed with SARS-CoV-2 infection, at birth, born to a COVID positive mother, initially developed respiratory distress at birth and abrupt progression to severe distress and later developed pneumothorax and hyper-inflammation (MIS-N). Respiratory support, corticosteroids, enoxaparin, antimicrobials, and other preterm care were given, and finally recovered and discharged after 30 days (1.812 kg). This case highlights the severe presentation of COVID-19 in a pre-term neonate. To the best of our knowledge this is apparently the youngest covid survivor till date reported in world. Clinical data on COVID-19 in new-born is extremely limited, so it is important to understand that these conclusions are based on limited data and our understanding will continue to evolve.

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Clinical cases of eculizumab use as a part of complex therapy in patients with severe COVID-19.

Тромбоз, гемостаз и реология ◽

10.25555/thr.2021.3.0987 ◽

2021 ◽

Author(s):

Р.А. Майер ◽

Б.А. Бакиров ◽

А.А. Набиева ◽

Д.А. Кудлай

Keyword(s):

Virus Disease ◽

Membrane Attack Complex ◽

Lung Ventilation ◽

Blood Analysis ◽

The Novel ◽

Reactive Protein ◽

Corona Virus ◽

Complex Therapy ◽

Novel Coronavirus ◽

Clinical Cases

Введение. В последние 2 года серьезной проблемой для всего мирового сообщества стало распространение новой коронавирусной (CoV) инфекции COVID-19 (COrona VIrus Disease-2019). Ввиду сложившихся событий в лечении COVID-19 активно стали применяться новые молекулы и уже зарегистрированные лекарственные препараты, доказавшие свою эффективность при других заболеваниях. Цель исследования: оценить эффективность применения препарата экулизумаб у пациентов с тяжелой формой течения COVID-19. Материалы и методы. Проанализированы 3 клинических случая применения препарата экулизумаб в составе комплексной терапии у пациентов с тяжелой формой течения COVID-19. Для оценки эффективности лечения проводился мониторинг основных клинико-лабораторных показателей, а также показателей, характеризующих воспалительный процесс при коронавирусной инфекции: общий анализ крови, биохимический анализ крови, проанализированы уровни таких показателей как ферритин, С-реактивный белок, интерлейкин-6, лактатдегидрогеназа и мембраноатакующий комплекс. Результаты. На фоне проводимой терапии выявлено снижение концентрации основных маркеров воспаления относительно исходных значений. Заключение. Комплексная терапия, включающая экулизумаб, облегчает течение заболевания, позволяет сократить длительность пребывания пациентов в отделении реанимации и интенсивной терапии, укорачивает срок их пребывания на искусственной вентиляции легких, тем самым снижая процент летальности. Background. In the past two years, the incidence of the novel coronavirus (CoV) infection COVID-19 (COrona Virus Disease-2019) has been a serious problem for the global community. Considering these circumstances, new molecules and already registered drugs that have proven their effectiveness in other diseases, began to be actively used in COVID-19 treatment. Objectives: to assess the effi cacy of eculizumab in patients with severe COVID-19. Patients/Methods. Three clinical cases of eculizumab use as a part of complex therapy in patients with severe COVID-19 have been analyzed. To assess the treatment efficacy, the main clinical and laboratory parameters and indicators of inflammatory process in coronavirus infection were monitored (clinical blood analysis, biochemical blood test, levels of ferritin, C-reactive protein, interleukin-6, lactate dehydrogenase and membrane attack complex). Results. Under the therapy we found the reduction of concentration of the main inflammation markers relative to the initial values. Conclusions. Complex therapy with eculizumab facilitates the course of the disease, reduces the stay duration of patients in the intensive care unit, shortens the period of artificial lung ventilation, thereby reducing the mortality rate.

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Death in delirious palliative-care patients occurs irrespective of age: A prospective, observational cohort study of 229 delirious palliative-care patients

Palliative & Supportive Care ◽

10.1017/s1478951520000887 ◽

2020 ◽

pp. 1-9

Author(s):

Annina Seiler ◽

David Blum ◽

Caroline Hertler ◽

Markus Schettle ◽

Carl Moritz Zipser ◽

...

Keyword(s):

Palliative Care ◽

Cohort Study ◽

Care Center ◽

Tertiary Care ◽

Age Groups ◽

Observational Cohort Study ◽

Adverse Outcomes ◽

Prospective Observational Cohort Study ◽

Precipitating Factors ◽

Observational Cohort

Abstract Objectives Patients with terminal illness are at high risk of developing delirium, in particular, those with multiple predisposing and precipitating risk factors. Delirium in palliative care is largely under-researched, and few studies have systematically assessed key aspects of delirium in elderly, palliative-care patients. Methods In this prospective, observational cohort study at a tertiary care center, 229 delirious palliative-care patients stratified by age: <65 (N = 105) and ≥65 years (N = 124), were analyzed with logistic regression models to identify associations with respect to predisposing and precipitating factors. Results In 88% of the patients, the underlying diagnosis was cancer. Mortality rate and median time to death did not differ significantly between the two age groups. No inter-group differences were detected with respect to gender, care requirements, length of hospital stay, or medical costs. In patients ≥65 years, exclusively predisposing factors were relevant for delirium, including hearing impairment [odds ratio (OR) 3.64; confidence interval (CI) 1.90–6.99; P < 0.001], hypertonia (OR 3.57; CI 1.84–6.92; P < 0.001), and chronic kidney disease (OR 4.84; CI 1.19–19.72; P = 0.028). In contrast, in patients <65 years, only precipitating factors were relevant for delirium, including cerebral edema (OR 0.02; CI 0.01–0.43; P = 0.012). Significance of results The results of this study demonstrate that death in delirious palliative-care patients occurs irrespective of age. The multifactorial nature and adverse outcomes of delirium across all age in these patients require clinical recognition. Potentially reversible factors should be detected early to prevent or mitigate delirium and its poor survival outcomes.

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Analysis of clinical characteristics, nucleic acid detection and prognosis of 72 cases of common type Corona Virus Disease 2019(COVID-19) pneumonia in Hubei Province,China

10.21203/rs.3.rs-29841/v1 ◽

2020 ◽

Author(s):

Jiangrong Liao ◽

Yueyan Lou ◽

Shuoyan Lu ◽

Xueyun Xian ◽

Xiulin Wu ◽

...

Keyword(s):

Nucleic Acid ◽

Neutrophil Count ◽

Clinical Characteristics ◽

Treatment Time ◽

Leukocyte Count ◽

Virus Disease ◽

Common Type ◽

Nucleic Acid Test ◽

Corona Virus ◽

Acid Test

Abstract Background: To describe the clinical characteristics and the time of nucleic acid turning negative in patients with common type Corona Virus Disease 2019(COVID-19) pneumonia and analyze the treatment time and prognostic factors.Methods: It’s a retrospective analysis of 72 cases of common type COVID-19 pneumonia diagnosed by nucleic acid test and Computed tomography (CT).Results: The average time of nucleic acid test turning negative is 17.37±9.29 days, and the average treatment time was 23.74±8.06 days. There was no influence of Blood leukocyte count, Neutrophil count, lymphocyte count, C-reactive protein (CRP), glutamic-pyruvic transaminase (ALT), glutamic oxalacetic transaminase (AST), creatinine, D-dimer on the prognosis of the patients, whether univariate or multivariate logistic regression analysis. By χ2 test of the drugs and prognosis, we found that oseltamivir may have an impact on the prognosis of patients (P<0.05), while other drugs have no significant impact on the prognosis of patients. Through the correlation analysis, we found that age, the admission temperature, leukocyte count, neutrophil count, CRP were positively correlated with the treatment time of the patients (both P<0.05). Leukocyte count and neutrophil count were positively correlated with the time of nucleic acid test turning negative (both P<0.05).Conclusions: Age, the admission temperature, leukocyte count, neutrophil count, CRP were positively correlated with the treatment time of the patients. Leukocyte count and neutrophil count were positively correlated with the time of nucleic acid test turning negative. Oseltamivir may have an impact on the prognosis of patients, but the detailed role needs further study.

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A Review on Automatic Covid-19 Lung Infection Detection from Different Imaging Techniques

International Journal for Research in Applied Science and Engineering Technology ◽

10.22214/ijraset.2021.37211 ◽

2021 ◽

Vol 9 (VII) ◽

pp. 3850-3856

Author(s):

Sangeeta Singh

Keyword(s):

World Health Organization ◽

Virus Disease ◽

Imaging Techniques ◽

World Health ◽

The Novel ◽

Corona Virus ◽

The World ◽

Health Organization ◽

High Level ◽

Precision Rate

Corona Virus Disease-2019 commonly known as COVID-19 which has been defined by the Novel Corona Virus. It is a family of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) and was first detected during respiratory outbreak. It was first reported to the World Health Organization on December 31, 2019. On January 30, 2020, the World Health Organization declared the COVID-19 eruption a global health emergency. As of 27-May-2021 169,095,283 confirmed cases have been reported in the world and 2, 73, 67, 935 cases in India. It is required to identify the infection with high precision rate but there are lots of deficiency in the diagnosing system that may resulted false alarm rate. Initially it could be detected through throat saliva but now it can also be identified thought the impairment in lungs from computerized tomographical imaging technique. This paper reviewed various researches over COVID-19 diagnosis approach as well as the syndrome in respiratory organs. There are so many imaging techniques through which lungs impairments can be detected that may diagnose COVID-19 with high level of accuracy. CT scan image is the best alternative for diagnosing COVID-19.

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COVID-19: The Pandemic Situation in the Context of India

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i58a34138 ◽

2021 ◽

pp. 456-463

Author(s):

Daksh Hardaswani

Keyword(s):

Virus Disease ◽

The Novel ◽

Physical And Mental Health ◽

Health Crisis ◽

Animal Virus ◽

Therapeutic Drugs ◽

Corona Virus ◽

Hand Wash ◽

The World ◽

Financial Impacts

The novel corona virus disease (COVID-19) is a pandemic due to the global health crisis it has created in the world and greatest challenges that it has introduced in this 21ST century. COVID-19 is the the 5th pandemic which was first reported in Wuhan, China and gradually spread into the other parts of the world. This virus is a spillover of an animal virus and then also adapted the ability of transferring human to human. The virus is highly contagious due to rapid spread and constantly evolves in the human population. COVID-19 pandemic is a lot more than just a health emergency, but it is also socio-economic because people are losing jobs and income. The COVID-19 disease affects physical and mental health due to isolation. Moreover, more and more countries are affecting the cases of COVID-19 which are rising very rapidly day by day. Therefore, every country needs to several actions which accelerates their safety health, balance between the protection of health, prevent economic and social disruption due to this pandemic. In the spirit of the solidarity, we all need to be contributing our self to protect this situation. However, every country is equally responsible for determining the measures to prevent or decrease the viral transmission. Government authorizes also trying to act for reduce disease’s trajectory and they focus on develop the vaccination and therapeutic drugs. Aim: To find causes, symptoms, awareness, Prevention, and treatment of COVID-19. Conclusion: The world is going by the critical situation and that is COVID-19 pandemic which is originated due to corona virus. Shortness of breath, fever and dry cough are most common symptoms of the novel corona virus. COVID-19 is highly contagious, so we must keep safe distance from other people and wear a mast hand wash our hands frequently. As it were together can we overcome the interwoven wellbeing and social and financial impacts of the widespread and anticipate its acceleration into an extended compassionate and nourishment security catastrophe, with the potential misfortune of as of now accomplished advancement picks up.

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The First Case of Reactive Arthritis Associated with SARS-CoV-2-Infection in A 4-Year Old Child

10.21203/rs.3.rs-106976/v1 ◽

2020 ◽

Author(s):

Stephanie Gabriele Werner ◽

Hans-Eckhard Langer

Keyword(s):

Severe Acute Respiratory Syndrome ◽

Reactive Arthritis ◽

Virus Disease ◽

The Novel ◽

Case Presentation ◽

Corona Virus ◽

First Case ◽

Novel Coronavirus ◽

The Right

Abstract Background: The novel coronavirus SARS‐CoV‐2 (severe acute respiratory syndrome coronavirus 2) and its associated disease COVID‐19 (Corona Virus Disease 19) has become a worldwide pandemic since its first cases in December 2019 in Wuhan Province in China. In Germany the pandemic started in February 2020.Case presentation: A 4 year old boy was presented and suffered from pain in the right hip. Arthrosonography demonstrated a significant effusion in the involved joint. The extended history revealed a slight but long lasting cold before. Serological findings were inconspicuous except for positive ELISA (Enzyme-linked Immuno Sorbent Assay) - test for SARS-CoV-2. Conclusion: In conclusion we believe that we can report the first case of reactive arthritis associated with SARS-CoV-2 in children.

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Clinical characteristics of 145 patients with corona virus disease 2019 (COVID-19) in Taizhou, Zhejiang, China

Infection ◽

10.1007/s15010-020-01432-5 ◽

2020 ◽

Vol 48 (4) ◽

pp. 543-551 ◽

Cited By ~ 47

Author(s):

Qingqing Chen ◽

Zhencang Zheng ◽

Chao Zhang ◽

Xijiang Zhang ◽

Huijuan Wu ◽

...

Keyword(s):

Clinical Characteristics ◽

Virus Disease ◽

Corona Virus

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COMPARATIVE STUDY OF MATERNAL AND NEONATAL OUTCOME OF COVID POSITIVE PREGNANT WOMEN IN FIRST AND SECOND WAVE

10.36106/gjra/7300373 ◽

2021 ◽

pp. 13-15

Author(s):

V. Radha Lakshmi ◽

K. Anusha Reddy

Keyword(s):

Pregnant Women ◽

Virus Disease ◽

Case Fatality ◽

Fold Increase ◽

Wave Pattern ◽

Postpartum Woman ◽

Corona Virus ◽

Global Pandemic ◽

Observational Cohort ◽

Second Wave

Introduction: Corona virus disease-19 (COVID-19), produced by severe acute respiratory syndrome Corona virus 2 (SARS-CoV2), has become a global pandemic, giving rise to a serious health threat globally. In India we have seen a two wave pattern of reported cases with peak of rst wave in September 2020 and peak of second wave in May 2021.Women undergoing pregnancy and those at the time of child birth and puerperium constitute potentially vulnerable populations for covid-19. Aims And Objectives: To evaluate differences in clinical presentation, co-morbidities, pregnancy complications and outcomes in women with covid-19 during rst wave and second wave of covid-19 pandemic. Materials And Methods: We conducted a retrospective observational cohort study of all hospitalized pregnant and postpartum woman with SARS-CoV2 infection in Government General Hospital, Kurnool. All the patients admitted from 1st May to 31st October 2020 were considered to be in the rst wave and those admitted from 1st April to 31st June were considered to be in second wave. Results: Incidence of cases has increased from 14.18 to 16.8%.There was two fold increase in the symptomatic cases from 4.2 to 8%patients in the second wave were younger in the age group of 16-25yrs.The number of pregnant women delivered by Caesarean section have increased from 57.5 %to 61.1 %.ICU admissions have signicantly increased from 2.7% to 3.1% Case fatality rate has increased from 0.4%-1.1%. As observed from the above results there is higher frequency of severe Covid 19,increased ICU ad Conclusion: missions and maternal deaths in second wave of Covid 19 pandemic as compared to the rst wave .Although the exact causes of increase in severity and mortality are unknown ,but probably due to emergence of most pathological strains of SARS-Co2.

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ANALYSIS OF THE MULTIDIMENSIONAL IMPACTS OF CORONA VIRUS DISEASE-2019 (COVID-19) PANDEMIC

Humanities & Social Sciences Reviews ◽

10.18510/hssr.2021.919 ◽

2021 ◽

Vol 9 (1) ◽

pp. 96-105

Author(s):

Imran ◽

Saima Sarir ◽

Mamoon Khan Khattak ◽

Intikhab Alam ◽

Seema Zubair

Keyword(s):

Qualitative Research ◽

Virus Disease ◽

First Century ◽

Future Research ◽

Research Approach ◽

The Novel ◽

Travel And Tourism ◽

Corona Virus ◽

Depth Interview ◽

Depth Interviews

Purpose of the study: The twenty-first century has witnessed numerous impacts of the novel Corona Virus Disease-2019 (Covid-19) pandemic in different walks of life across the globe. The present study was designed to get a societal response regarding the multifaceted impacts of the Covid-19 pandemic on the lives of the populace of the study locale. Methodology: The researchers selected a qualitative research approach for gaining in-depth insights on the issue at hand, wherein the data was collected from the potential participants through purposive sampling. The In-depth Interviews were conducted in district Swat which is one of the most affected districts from Covid-19. The In-depth Interview was used as a research instrument. The data was analyzed through thematic analysis. Main Findings: The study findings revealed that human lives are severely affected by the Covid-19 pandemic. The routine life cycle was badly affected, and people were confined to their houses. Like other parts of the world, different sectors like education, health, rituals, social interaction, travel, and tourism are desperately affected. Resultantly, it drastically raised the socio-cultural and economic (especially unemployment) unrest situation in the region. Apart from these consequences, due to the Pandemic scenario, various socio-cultural rituals, events, and activities were at a halt due to the imposition of social distancing measures. Applications of this study: The findings can be utilized/generalized in the normal course of life keeping in view the multidimensional impacts of the Covid-19 in the region. This study could be utilized for future research studies on the same issue. Novelty/Originality of this study: Besides, the study has immense significance, such studies are novel in the region with such a distinct perspective that covers various aspects of the impacts of Covid-19 using a qualitative research approach.

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