Justine J Ko, Clay Wu, Neha Mehta, Noah Wald-Dickler, Wei Yang, Renli Qiao
OBJECTIVES: This study retrospectively compares the effectiveness of methylprednisolone to dexamethasone in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or COVID-19) requiring intensive care. DESIGN: This is an institutional review board approved cohort study in patients with COVID-19 requiring intensive care unit (ICU) admission. Patients admitted and requiring oxygen supplementation were treated with no steroids, methylprednisolone, or dexamethasone...
February 25, 2021: Journal of Intensive Care Medicine
Veeral Ajmera, Wesley K Thompson, Davey M Smith, Atul Malhotra, Ravindra L Mehta, Vaishal Tolia, Jeffrey Yin, Krishna Sriram, Paul A Insel, Summer Collier, Lisa Richards, Rohit Loomba
BACKGROUND AND AIMS: Retrospective studies have shown that angiotensin-converting-enzyme (ACE) inhibitors are associated with a reduced risk of complications and mortality in persons with novel coronavirus disease 2019 (COVID-19). Thus, we aimed to examine the efficacy of ramipril, an ACE-inhibitor, in preventing ICU admission, mechanical ventilation and/or mortality while also minimizing the risk of transmission and use of personal protective equipment (PPE). METHODS: RAMIC is a multicenter, randomized, double-blind, allocation-concealed, placebo-controlled trial comparing the efficacy of treatment with ramipril 2...
February 22, 2021: Contemporary Clinical Trials
Anna Conlon, Carmel Ashur, Laraine Washer, Kim A Eagle, Marion A Hofmann Bowman
BACKGROUND: With a unique influenza season occurring in the midst of a pandemic, there is interest in assessing the role of the influenza vaccine in COVID-19 susceptibility and severity. METHODS: In this retrospective cohort study, patients receiving a laboratory test for COVID-19 were identified. The primary outcome was comparison of positive COVID-19 testing in those who received the influenza vaccine versus those who did not. Secondary end points in patients testing positive for COVID-19 included mortality, need for hospitalization, length of stay, need for intensive care, and mechanical ventilation...
February 22, 2021: American Journal of Infection Control
Michael Reaume, Shaikh M Noor Ul Husnain, Daniel Kapadia, Geneva Tatem
No abstract text is available yet for this article.
February 25, 2021: American Journal of Respiratory and Critical Care Medicine
Zhu Zhan, Xin Yang, Hu Du, Chuanlai Zhang, Yuyan Song, Xiaoyun Ran, An Zhang, Mei Yang
BACKGROUND: Since the start of the pandemic of coronavirus disease 2019 (COVID-19), over 2 million people has died globally. Acute respiratory distress syndrome (ARDS) may be the main cause of death. OBJECTIVE: This study aimed to describe the clinical features, outcomes, and acute respiratory distress syndrome (ARDS) characteristics of patients with COVID-19 admitted to the intensive care unit (ICU) in Chongqing, China. METHODS: The epidemiology of COVID-19 from January 21, 2020 to March 15, 2020 in Chongqing, China, was analyzed retrospectively, and 75 ICU patients from 2 hospitals were included in this study...
February 17, 2021: JMIR Public Health and Surveillance
A H Abdelhafiz, D Emmerton, A J Sinclair
BACKGROUND: Current literature on COVID-19 pandemic has identified diabetes as a common comorbidity in patients affected. However, the evidence that diabetes increases the risk of infection, effect of diabetes on outcomes and characteristics of patients at risk is not clear. OBJECTIVES: To explore the prevalence of diabetes in COVID-19 pandemic, effect of diabetes on clinical outcomes and to characterise the patients with diabetes affected by COVID-19. METHODS: A literature review of articles published in English language and reported outcomes on prevalence and effect of diabetes on outcomes and patients' characteristics...
February 25, 2021: International Journal of Clinical Practice
Steven L Veselsky, Marie-Veronique Poirier, Brett M Tracy, Christine A Castater, Christina Mehta, Adair K Minihan, Keneeshia N Williams, Rondi B Gelbard, Abimbola O Faloye, Randi N Smith
BACKGROUND: Suicide is a major public health issue with root causes including psychological, economical, and societal factors. METHODS: Retrospective review identified self-inflicted traumatic injuries (SITIs) at Grady Health System between 2009 and 2017. Patients were categorized by penetrating or blunt mechanism of injury (MOI). Outcomes included hospital length of stay (HLOS) and ventilator duration, mortality, and location of death. RESULTS: 678 patients in total were identified...
February 25, 2021: American Surgeon
Y-H Wang, Z-H Xu, Y-H Zhou, S-L Sun, Z-W Xu, X Qi, W-J Zhou, H-Q Sheng, B Zhao, E-Q Mao
OBJECTIVE: Biliary and hyperlipidemic acute pancreatitis (AP) has become the second most common AP in China. Currently, AP is exclusively diagnosed as biliary or hyperlipidemic AP. However, as suggested by some reports, biliary and hyperlipidemic AP might coexist in a single patient. Moreover, acute lipotoxicity was shown to regulate the severity of biliary AP in the mouse model. Thus, whether these two etiologies coexist in AP patients and potentially worsen the clinical course remains unclear...
February 2021: European Review for Medical and Pharmacological Sciences
Areej El-Jawahri, Hacho B Bohossian, Michael K Paasche-Orlow, Joshua R Lakin, P Connor Johnson, Zara Cooper, Annemarie D Jagielo, Elise N Brannen, Matthew J Reynolds, Kathleen Coogan, Dagny Vaughn, Angelo Volandes
BACKGROUND: Outcomes of hospitalized patients with COVID-19 have been described in health systems overwhelmed with a surge of cases. However, studies examining outcomes of patients admitted to hospitals not in crisis are lacking. OBJECTIVE: To describe clinical characteristic and outcomes of all patients with COVID-19 who are admitted to hospitals not in crisis, and factors associated with mortality in this population. DESIGN: A retrospective analysis PARTICIPANTS: In total, 470 consecutive patients with COVID-19 requiring hospitalization in one health system in Boston from January 1, 2020 to April 15, 2020...
February 24, 2021: Journal of General Internal Medicine
M Hernandez-Cedeño, R Venegas-Rodriguez, R Peña-Ruiz, M Bequet-Romero, R Santana-Sanchez, E Penton-Arias, G Martinez-Donato, G Guillén-Nieto, María Del Carmen Dominguez-Horta
Hyperinflammation distinguishes COVID-19 patients who develop a slight disease or none, from those progressing to severe and critical conditions. CIGB-258 is a therapeutic option for the latter group of patients. This drug is an altered peptide ligand (APL) derived from the cellular stress protein 60 (HSP60). In preclinical models, this peptide developed anti-inflammatory effects and increased regulatory T cell (Treg) activity. Results from a phase I clinical trial with rheumatoid arthritis (RA) patients indicated that CIGB-258 was safe and reduced inflammation...
February 24, 2021: Cell Stress & Chaperones
Melania E Ebrahimi, Michelle Romijn, Roos J S Vliegenthart, Douwe H Visser, Anton H van Kaam, Wes Onland
Studies in preterm infants have shown an association between late-onset sepsis (LOS) and the development of bronchopulmonary dysplasia (BPD). It is unknown whether clinical or biochemical characteristics during sepsis modulate the risk for BPD. This single-center retrospective cohort study included all patients with a gestational age < 30 weeks, born between 2009 and 2015, in whom empiric antimicrobial treatment was initiated > 72 h after birth and continued for at least 5 days, independent on microbiological results...
February 25, 2021: European Journal of Pediatrics
Timothée Klopfenstein, Thierry Conrozier, N'dri Juliette Kadiane-Oussou, Vincent Gendrin, Souheil Zayet
In this article, we sought to summarize the available evidence of tocilizumab as a treatment for coronavirus disease 2019. Recent tocilizumab randomized trials have not shown clear evidence of efficacy, especially on mortality, in contrast to observational studies. These clinical trials focus on a heterogeneous population of patients (clinical severity and inflammatory stage), and this is possibly one of the reasons that explain heterogeneity of results. However, these same trials have shown some evidence that tocilizumab may reduce intensive care unit admissions and/or mechanical ventilation incidence, which are huge challenges in the severe acute respiratory syndrome coronavirus 2 pandemic...
February 2021: Open Forum Infectious Diseases
Steven Douedi, Shruti Kapadia, Mohammed AlAzzawi, Shuvendu Sen
Multiple myeloma is a malignancy of plasma cells which are commonly found in the bone marrow. Known for causing a wide range of symptoms and affecting various organ systems, multiple myeloma is a rare malignancy with the entire pathophysiological process yet to be elucidated. We present a case of a 51-year-old male with a history of previously treated multiple myeloma in remission, initially presenting with chest pain with an unremarkable work-up. His hospital course was complicated by hyperammonemia causing encephalopathy requiring mechanical ventilation...
January 19, 2021: Curēus
Rasha El-Ahmad Polcer, Elin Jones, Karin Pettersson
In this retrospective report, we present five cases of critically ill pregnant or newly delivered women positive for Covid-19 admitted to our obstetrical departments at Karolinska University Hospital. They compose 6% of eighty-three pregnant women that tested positive for SARS-CoV-2 during the period March 25 to May 4, 2020. Three patients were at the time of admission in gestational week between 21 + 4 and 22 + 5 and treated during their antenatal period; meanwhile, the other two were admitted within 1 week postpartum...
2021: Case Reports in Obstetrics and Gynecology
Ignacio Lugones, Matías Ramos, María Fernanda Biancolini, Roberto Orofino Giambastiani
Introduction: The SARS-CoV-2 pandemic has created a sudden lack of ventilators. DuplicARⓇ is a novel device that allows simultaneous and independent ventilation of two subjects with a single ventilator. The aims of this study are (a) to determine the efficacy of DuplicARⓇ to independently regulate the peak and positive-end expiratory pressures in each subject, both under pressure-controlled ventilation and volume-controlled ventilation and (b) to determine the ventilation mode in which DuplicARⓇ presents the best performance and safety...
2021: Anesthesiology Research and Practice
Isabelle Dominique Tomacruz, Paolo Nikolai So, Renz Michael Pasilan, Jameel Kristine Camenforte, Maria Isabel Duavit
Aim: Data published on COVID-19 in the Filipino population, particularly those with end stage kidney disease (ESKD) are still lacking. Methods: We performed a retrospective, observational study of 68 ESKD patients admitted with COVID-19 infection at a tertiary hospital in Metro Manila, Philippines from April 1, 2020 to July 31, 2020. We compared the clinical features, baseline laboratory data, treatment strategies and short-term outcomes between those who survived and those who died...
2021: International Journal of Nephrology and Renovascular Disease
Johannes K Ehinger, Michael Karlsson, Fredrik Sjövall, Märta Leffler, Shana E McCormack, Sherri E Kubis, Anna Åkesson, Marni J Falk, Todd J Kilbaugh
BACKGROUND: The aim of this study was to identify factors predicting outcome in patients with mitochondrial disease admitted to pediatric intensive care units (PICU). METHODS: Retrospective study of 2434 patients (age <21 years) admitted to a PICU from 1 January 2006 through 31 March 2016 and captured in the Virtual Pediatric Systems database with ICD9 diagnosis 277.87, disorders of mitochondrial metabolism. Factors influencing mortality and prolonged length of stay (≥14 days) were analyzed using logistic regression...
February 24, 2021: Pediatric Research
Huda Alfoudri, Mohammad Shamsah, Beena Yousuf, Nasayem AlQuraini
Pediatric population have been affected by the Coronavirus disease 2019 (COVID-19) to a much smaller scale compared with the adult population. The severity of the disease is variable ranging from mild form of pneumonia to severe acute respiratory distress syndrome (ARDS) that necessitates admission to the intensive care unit (ICU) requiring a maximal level of organ support. Failure of the maximum support through mechanical ventilation can lead to the consideration of a higher level of organ support through extracorporeal membrane oxygenation (ECMO)...
March 1, 2021: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Rana W Kadry, Mir S Adil, Andrea Sikora Newsome, Payaningal R Somanath
Acute respiratory distress syndrome (ARDS) is a life-threatening form of acute lung injury (ALI) associated with hypoxemic lung damage and inflammation. Matrix metalloproteinase protein-3 (MMP3 or Stromelysin-1) is known to promote vascular injury in ALI/ARDS. Cisatracurium, a nicotinic neuromuscular blocker, is used in ARDS patients to decrease mechanical ventilator dyssynchrony, increase oxygenation, and improve mortality. However, the magnitude and the underlying mechanisms of these potential benefits of cisatracurium remains unclear...
February 23, 2021: Bioscience Trends
Wissam Shalish, Martin Keszler, Peter G Davis, Guilherme M Sant'Anna
In the modern era of neonatology, mechanical ventilation has been restricted to a smaller and more immature population of extremely preterm infants. Given the adverse outcomes associated with mechanical ventilation, every effort is made to extubate these infants as early as possible. However, the scientific basis for determining extubation readiness remains imprecise and primarily guided by clinical judgement, which is highly variable and subjective. In the absence of accurate tools to assess extubation readiness, many infants fail their extubation attempt and require reintubation, which also increases complications...
February 24, 2021: Archives of Disease in Childhood. Fetal and Neonatal Edition
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