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      Call for Papers: Digital Diagnostic Techniques

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      About Pathobiology: 3.5 Impact Factor I 8.5 CiteScore I 1.088 Scimago Journal & Country Rank (SJR)

      Call for Papers: Sex and Gender in Neurodegenerative Diseases

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      A Pilot Study of Application of the Stroke Riskometer Mobile App for Assessment of the Course and Clinical Outcomes of COVID-19 among Hospitalized Patients

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          Abstract

          Introduction

          Early determination of COVID-19 severity and health outcomes could facilitate better treatment of patients. Different methods and tools have been developed for predicting outcomes of COVID-19, but they are difficult to use in routine clinical practice.

          Methods

          We conducted a prospective cohort study of inpatients aged 20–92 years, diagnosed with COVID-19 to determine whether their individual 5-year absolute risk of stroke at the time of hospital admission predicts the course of COVID-19 severity and mortality. The risk of stroke was determined by the Stroke Riskometer mobile application.

          Results

          We examined 385 patients hospitalized with COVID-19 (median age 61 years). The participants were categorized based on COVID-19 severity: 271 (70.4%) to the “not severe” and 114 (29.6%) to the “severe” groups. The median risk of stroke the next day after hospitalization was significantly higher among patients in the severe group (2.83, 95% CI: 2.35–4.68) versus the not severe group (1.11, 95% CI: 1.00–1.29). The median risk of stroke and median systolic blood pressure (SBP) were significantly higher among non-survivors (12.04, 95% CI: 2.73–21.19) and (150, 95% CI: 140–170) versus survivors (1.31, 95% CI: 1.14–1.52) and (134, 95% CI: 130–135), respectively. Those who spent more than 2.5 h a week on physical activity were 3.1 times more likely to survive from COVID-19. Those who consumed more than one standard alcohol drink a day, or suffered with atrial fibrillation, or had poor memory were 2.5, 2.3, and 2.6 times more likely not to survive from COVID-19, respectively.

          Conclusions

          High risk of stroke, physical inactivity, alcohol intake, high SBP, and atrial fibrillation are associated with severity and mortality of COVID-19. Our findings suggest that the Stroke Riskometer app could be used as a simple predictive tool of COVID-19 severity and mortality.

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          Nonparametric Estimation from Incomplete Observations

          E. Kaplan, Paul Meier (1958)
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            Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study

            Matthew Cummings, Matthew Baldwin, Darryl Abrams … (2020)
            Summary Background Over 40 000 patients with COVID-19 have been hospitalised in New York City (NY, USA) as of April 28, 2020. Data on the epidemiology, clinical course, and outcomes of critically ill patients with COVID-19 in this setting are needed. Methods This prospective observational cohort study took place at two NewYork-Presbyterian hospitals affiliated with Columbia University Irving Medical Center in northern Manhattan. We prospectively identified adult patients (aged ≥18 years) admitted to both hospitals from March 2 to April 1, 2020, who were diagnosed with laboratory-confirmed COVID-19 and were critically ill with acute hypoxaemic respiratory failure, and collected clinical, biomarker, and treatment data. The primary outcome was the rate of in-hospital death. Secondary outcomes included frequency and duration of invasive mechanical ventilation, frequency of vasopressor use and renal replacement therapy, and time to in-hospital clinical deterioration following admission. The relation between clinical risk factors, biomarkers, and in-hospital mortality was modelled using Cox proportional hazards regression. Follow-up time was right-censored on April 28, 2020 so that each patient had at least 28 days of observation. Findings Between March 2 and April 1, 2020, 1150 adults were admitted to both hospitals with laboratory-confirmed COVID-19, of which 257 (22%) were critically ill. The median age of patients was 62 years (IQR 51–72), 171 (67%) were men. 212 (82%) patients had at least one chronic illness, the most common of which were hypertension (162 [63%]) and diabetes (92 [36%]). 119 (46%) patients had obesity. As of April 28, 2020, 101 (39%) patients had died and 94 (37%) remained hospitalised. 203 (79%) patients received invasive mechanical ventilation for a median of 18 days (IQR 9–28), 170 (66%) of 257 patients received vasopressors and 79 (31%) received renal replacement therapy. The median time to in-hospital deterioration was 3 days (IQR 1–6). In the multivariable Cox model, older age (adjusted hazard ratio [aHR] 1·31 [1·09–1·57] per 10-year increase), chronic cardiac disease (aHR 1·76 [1·08–2·86]), chronic pulmonary disease (aHR 2·94 [1·48–5·84]), higher concentrations of interleukin-6 (aHR 1·11 [95%CI 1·02–1·20] per decile increase), and higher concentrations of D-dimer (aHR 1·10 [1·01–1·19] per decile increase) were independently associated with in-hospital mortality. Interpretation Critical illness among patients hospitalised with COVID-19 in New York City is common and associated with a high frequency of invasive mechanical ventilation, extrapulmonary organ dysfunction, and substantial in-hospital mortality. Funding National Institute of Allergy and Infectious Diseases and the National Center for Advancing Translational Sciences, National Institutes of Health, and the Columbia University Irving Institute for Clinical and Translational Research.
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              Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis

              Zhaohai Zheng, Fang Fang Peng, Buyun Xu … (2020)
              Background An epidemic of Coronavirus Disease 2019 (COVID-19) began in December 2019 and triggered a Public Health Emergency of International Concern (PHEIC). We aimed to find risk factors for the progression of COVID-19 to help reducing the risk of critical illness and death for clinical help. Methods The data of COVID-19 patients until March 20, 2020 were retrieved from four databases. We statistically analyzed the risk factors of critical/mortal and non-critical COVID-19 patients with meta-analysis. Results Thirteen studies were included in Meta-analysis, including a total number of 3027 patients with SARS-CoV-2 infection. Male, older than 65, and smoking were risk factors for disease progression in patients with COVID-19 (male: OR = 1.76, 95% CI (1.41, 2.18), P 40U/L, creatinine(Cr) ≥ 133mol/L, hypersensitive cardiac troponin I(hs-cTnI) > 28pg/mL, procalcitonin(PCT) > 0.5ng/mL, lactatede hydrogenase(LDH) > 245U/L, and D-dimer > 0.5mg/L predicted the deterioration of disease while white blood cells(WBC) 40U/L:OR=4.00, 95% CI (2.46, 6.52), P 28 pg/mL: OR = 43.24, 95% CI (9.92, 188.49), P 0.5 ng/mL: OR = 43.24, 95% CI (9.92, 188.49), P 245U/L: OR = 43.24, 95% CI (9.92, 188.49), P 0.5mg/L: OR = 43.24, 95% CI (9.92, 188.49), P < 0.00001; WBC < 4 × 109/L: OR = 0.30, 95% CI (0.17, 0.51), P < 0.00001]. Conclusion Male, aged over 65, smoking patients might face a greater risk of developing into the critical or mortal condition and the comorbidities such as hypertension, diabetes, cardiovascular disease, and respiratory diseases could also greatly affect the prognosis of the COVID-19. Clinical manifestation such as fever, shortness of breath or dyspnea and laboratory examination such as WBC, AST, Cr, PCT, LDH, hs-cTnI and D-dimer could imply the progression of COVID-19.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Cerebrovasc Dis Extra
                Journal ID (iso-abbrev): Cerebrovasc Dis Extra
                Journal ID (hwp): CEE
                Journal ID (publisher-id): CEE
                Title: Cerebrovascular Diseases Extra
                Publisher: S. Karger AG (Basel, Switzerland )
                ISSN (Electronic): 1664-5456
                Publication date Collection: Jan-Dec 2023
                Publication date (Electronic): 26 January 2023
                Volume: 13
                Issue: 1
                Pages: 47-55
                Affiliations
                [a ]National Institute for Stroke and Applied Neurosciences, Faculty of Health & Environmental Sciences, AUT University, Auckland, New Zealand
                [b ]iScience group, Department of Psychology, University of Konstanz, Konstanz, Germany
                [c ]National Centre for Development of Social Support and Rehabilitation, Moscow, Russia
                [d ]School of Psychology, The University of Waikato, Hamilton, New Zealand
                [e ]The City Clinical Hospital Named after A.K. Eramishantsev, Moscow, Russia
                [f ]Department of Psychology, Russian Peoples’ Friendship University, Moscow, Russia
                [g ]Academy for Postgraduate Education, Moscow, Russia
                [h ]Pirogov Russian National Research Medical University, Moscow, Russia
                [i ]I.M. Sechenov First Moscow State Medical University, Moscow, Russia
                Author notes
                Correspondence to: Alexander Merkin amerkin@ 123456aut.ac.nz
                Article
                Publisher ID: 529277
                DOI: 10.1159/000529277
                PMC ID: 10007710
                PubMed ID: 36702110
                SO-VID: 6820bfe0-6de7-4b76-9db7-f8a39f3e084d
                Copyright © © 2023 The Author(s). Published by S. Karger AG, Basel
                License:

                This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC) ( http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.

                History
                Date received : 11 July 2022
                Date accepted : 17 January 2023
                Page count
                Figures: 5, References: 26, Pages: 9
                Funding
                No external funding was received for this project.
                Categories
                Subject: Original Paper

                ScienceOpen disciplines: Cardiovascular Medicine
                Keywords: stroke riskometer mobile app,stroke,covid-19,comorbidity,prediction,severity
                Data availability:
                ScienceOpen disciplines: Cardiovascular Medicine
                Keywords: stroke riskometer mobile app, stroke, covid-19, comorbidity, prediction, severity

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