Case Recovery Rate Research Articles

Spatio-temporal Analysis of COVID-19: A Global Study

Background: COVID-19 is an international public health emergency in the world. Objectives: The aim of the present study is to determine the geographic pattern and temporal trend of Coronavirus disease 2019 incidence, fatality, and recovery rates worldwide. Methods: The present ecological study is a mixed exploratory study. The study population included Patients with COVID-19, recovered individuals, and deaths from COVID-19 from October 1, 2019, until June 30, 2021, worldwide. Descriptive analysis included the calculation cumulative incidence rate (CIR), case fatality rate (CFR), and case recovery rate (CRR) of COVID-19. Global Moran's I and Anselin Local Moran's I tests were used for spatial analysis. The joinpoint regression analysis was used to examine the time trend by ArcGIS, Joinpoint, and SPSS software. Results: The average cumulative incidence rate was 1077 in 106 individuals; also, the average case recovery rate and average case fatality rate were %72.81 and %3.21, respectively. Global Moran's I index measured for CIR was 0.159. The results of Anselin's local Moran's I, high-high cluster, consists of some countries in South America and in southern and Western Europe and central and western Asia. The temporal trend of changes in the incidence rate and CRR of COVID-19 were incremental, and the average annual percentage change from October 2019 to June 2021 increased by 44.4% and 3.2%, respectively (P < 0.001), but CFR decreased by -0.3% and was not significant (P > 0.05). Conclusions: As regards the specific spatial pattern of fatality and recovery rate of COVID-19, it seems essential to consider spatial conditions and environmental factors which are related to the incidence and fatality of COVID-19 in different regions, as well as the necessity of upgrading the care system in high-risk areas, in order to have better management and control of the pandemic and optimal function in early diagnosis, proper treatment, and high vaccination coverage.

Analysis and forecasting of confirmed, death, and recovered cases of COVID-19 infections in Nigeria: Implications for university administrators.

The coronavirus (COVID-19) disease outbreak was a public health emergency of international concern which eventually evolved into a pandemic. Nigeria was locked down in March, 2020 as the country battled to contain the spread of the disease. By August 2020, phase-by-phase easing of the lockdown was commenced and university students will soon return for academic activities. This study undertakes some epidemiological analysis of the Nigerian COVID-19 data to help the government and university administrators make informed decisions on the safety of personnel and students.The COVID-19 data on confirmed cases, deaths, and recovered were obtained from the website of the Nigerian Centre for Disease Control (NCDC) from April 2, 2020 to August 24, 2020. The infection rate, prevalence, ratio, cause-specific death rate, and case recovery rate were used to evaluate the epidemiological characteristics of the pandemic in Nigeria. Exponential smoothing was adopted in modeling the time series data and forecasting the pandemic in Nigeria up to January 31, 2021.The results indicated that the pandemic had infection rate of at most 3 infections per 1 million per day from April to August 2020. The death rate was 5 persons per 1 million during the period of study while recovery rate was 747 persons per 1000 infections. Analysis of forecast data showed steady but gradual decrease in the daily infection rate and death rate and substantial increase in the recovery rate, 975 recoveries per 1000 infections.In general, the epidemiological attributes of the pandemic from the original data and the forecast data indicated optimism in the decrease in the rate of infection and death in the future. Moreover, the infection rate, prevalence and death rate in January 2021 coincided with the predictions based on the analysis. Therefore, the Nigerian government is encouraged to allow universities in the country to reopen while university administrators set up the necessary protocols for strict adherence to safety measures.

Case fatality and recovery rate of COVID 19: What are we missing?

Case fatality and recovery rate of COVID 19: What are we missing?

Analysis of Covid-19 in densely populated States/Union Territories of India

Covid-19 is one of the biggest challenges that the world has faced ever especially for countries like India which is having the second-highest population in the world. The Larger population plays the role of a catalyst for the expansion of the Covid-19 virus as maintaining necessary physical distance becomes quite difficult in these areas. In this Paper, the spread of Covid-19 has been analyzed in densely populated five states and one union territory of India i.e. Uttar-Pradesh, Maharashtra, Bihar, West Bengal, Tamilnadu, and Delhi. Along with symptoms of serious and mild Covid-19 patients, the general precautions that need to be taken by patients during quarantine days have been also discussed. The spread of Covid-19 has been analyzed based on per day change in three parameters i.e. Active Case Rate (ACR), Recovery Rate (RR), and Death Rate (DR). All these parameters have been calculated from the data available at https://www.pib.gov.in/newsite/bulletinn.aspxand the analysis has been performed on approximately six-month data taken from June to November 2020. Based on the above calculation, the peak of Covid-19, as well as variation in the Active Case Rate, Recovery Rate, and Death Rate in the respective states/union territory, has been summarized in this study.

Estimating Case Fatality and Case Recovery Rates of COVID-19: is this the right thing to do?

Introduction:Case fatality rates (CFRs) and case recovery rates (CRRs) are frequently used to define health consequences related to specific disease epidemics, including the COVID-19 pandemic. This study aimed to compare various methods and models for calculating CFR and CRR related to COVID-19 based on the global and national data available as of April 2020.Methods:This analytical epidemiologic study was conducted based on detailed data from 210 countries and territories worldwide in April 2020. We used three different formulas to measure CFR and CRR, considering all possible scenarios.Results:We included information for 72 countries with more than 1,000 cases of COVID-19. Overall, using first, second, and third estimation models, the CFR were 6.22%, 21.20%, and 8.67%, respectively; similarly, the CRR was estimated as 23.21%, 78.86%, 32.23%, respectively. We have shown that CFRs vary so much spatially and depend on the estimation method and timing of case reports, likely resulting in overestimation.Conclusions:Even with the more precise method of CFRs estimation, the value is overestimated. Case fatality and recovery rates should not be the only measures used to evaluate disease severity, and the better assessment measures need to be developed as indicators of countries’ performance during COVID-19 pandemic.

Asia's largest urban slum-Dharavi: A global model for management of COVID-19

The Dharavi sector of Mumbai, India is constituted as one of the biggest slums of Asia and the world's most populated areas. The COVID-19 outburst is at its peak in May and curve gets flattened within next two months. This article focuses on factors responsible for transmission, prevention and in controlling the COVID-19 spread in Dharavi. The COVID-19 data was interpreted in terms of Case Recovery Rate (CRR) and Case Fatality Rate (CFR) for total and closed both. The CFR per closed reached 10.12% nearly to per total 9.82% in Dharavi on 31st July 2020. The CRR per total cases in Dharavi and Mumbai is 87.16 & 76.18% and per closed cases is 89.87 & 93.20% respectively in comparison to the CFR. The calculated CFR and CRR for both Dharavi and Mumbai suggest that the COVID-19 recovery rate is more than the fatality rate. The Dharavi people serve as an important role in controlling the pandemic by adopting 4-T model tracing, tracking, testing, and treating strategy. This article is beneficial for government policy makers and private agencies in controlling the COVID-19 pandemic in densely populated areas and also for nations with high fatality rate.

Epidemic Trend and Effect of COVID-19 Transmission in India during Lockdown Phase

To evaluate the present situation concerning the epidemic trend associated with the COVID-19 in Indian demography, the dynamics of the case rise has been analyzed from the perspective of the different index. The index for the analysis has been chosen in terms of the Case Recovery Rate (CRR), CASE Fatality Rate (CFR), as well as Mortality rate (MR). The study includes the rise of the case related to the pandemic in the different demographic regions of India as well as deep analysis and calculation of the indexes considered for the study. The analysis of the rising cases has also been investigated to relax the imposed rule so that economy of the country will not get affected adversely. Several preventive and control initiative has been taken by the central and state government in collaboration. The result of this paper can be taken as an input to decide further policy in the fight against the COVID- 19.

Data based Analysis, Modeling and Forecasting of Novel Coronavirus in infected regions using Extreme Learning Machine algorithm

In current development in science and technology, Machine learning algorithms play an essential role for prediction, classification, data analysis and data visualization. With this efficient algorithm, we can solve many real-world problems in all domains like education, healthcare, banking, geographical analysis, etc., in the current scenario; much research work is going on with the new virus's infection called the corona. This Corona virus is a comprehensive unit of virus this cause illness in humans or animals, now in East Asian countries, this virus affected more people. In India, the first case was found in January month, originated from China. The entire world is focusing on the disease, and day by day, the infection and death rate is increasing. In this, we intended to focus on the spread of this deadly disease and to demonstrate which countries are the most affected by doing statistical analysis. On December 2019, As of 10 February 2020, China reported overall of 40,235 cases 909 deaths, evoking local and foreign terror. Here we provide estimates of the major epidemiological parameters, Based on the epidemiological data available to the public for Hubei, China, 11 January to 10 February 2020. In particular, we give an estimate Fatality and case recovery rates, along with their 90 per cent confidence levels as the epidemic progresses. For this work implementation, Extreme Learning Machine algorithm used. ELM is a feed-forward network and its learning rate also fast when compare to normal neural network. No need to provide any weights and bias values. This algorithm will give a promising result with the best accuracy.

Lifestyle Acquired Immunity, Decentralized Intelligent Infrastructures, and Revised Healthcare Expenditures May Limit Pandemic Catastrophe: A Lesson From COVID-19.

Throughout history, the human race has often faced pandemics with substantial numbers of fatalities. As the COVID-19 pandemic has now affected the whole planet, even countries with moderate to strong healthcare support and expenditure have struggled to contain disease transmission and casualties. Countries affected by COVID-19 have different demographics, socioeconomic, and lifestyle health indicators. In this context, it is important to find out to what extent these parametric variations are modulating disease outcomes. To answer this, this study selected demographic, socioeconomic, and health indicators e.g., population density, percentage of the urban population, median age, health expenditure per capita, obesity, diabetes prevalence, alcohol intake, tobacco use, case fatality of non-communicable diseases (NCDs) as independent variables. Countries were grouped according to these variables and influence on dependent variables e.g., COVID-19 positive tests, case fatality, and case recovery rates were statistically analyzed. The results suggested that countries with variable median age had a significantly different outcome on positive test rate (P < 0.01). Both the median age (P = 0.0397) and health expenditure per capita (P = 0.0041) showed a positive relation with case recovery. An increasing number of tests per 100 K of the population showed a positive and negative relationship with the number of positives per 100 K population (P = 0.0001) and the percentage of positive tests (P < 0.0001), respectively. Alcohol intake per capita in liter (P = 0.0046), diabetes prevalence (P = 0.0389), and NCDs mortalities (P = 0.0477) also showed a statistical relation to the case fatality rate. Further analysis revealed that countries with high healthcare expenditure along with high median age and increased urban population showed more case fatality but also had a better recovery rate. Investment in the health sector alone is insufficient in controlling the severity of the pandemic. Intelligent and sustainable healthcare both in urban and rural settings and healthy lifestyle acquired immunity may reduce disease transmission and comorbidity induced fatalities, respectively.

COVID-19 early pandemic scenario in India compared to China and rest of the world: a data driven and model analysis

The coronavirus disease 2019 (COVID-19) global pandemic is ongoing, and this is devastating. This study aimed to explore the early COVID-19 pandemic situation in Indian context compared to that of China (the primary epicenter of the ongoing COVID-19 pandemic) as well as in countries outside China. Various epidemiologic parameters, by data driven analysis: basic reproduction number (R0), average reproduction number (R), effective reproduction number (Re), daily growth rate (DGR), case fatality rate (CFR) and case recovery rate (CRR), as well as model analysis: R0, R, Re, serial interval (SI), transmission rate (β) and recovery rate (γ), of COVID-19 early pandemic in India were determined, and were compared with China and rest of the world. The DGR, CRR, CFR, and SI of COVID-19 in India were 17%, 8.25%, 1.87%, and 5.76 days, respectively. The data driven estimates of R0, R and Re were 1.03, 1.73, and 1.35, respectively. The exponential and SIR model had higher estimates of R0, R and Re. The data driven as well as estimated COVID-19 cases reflected the growing nature of the epidemic in India and world excluding China, whereas the same in China revealed the involved population became infected with the disease and moved into the recovered stage. The Re values in India before and after lockdown were 1.62 and 1.37 respectively, with SI 5.52 days and 5.98 days, respectively. The current findings reflected the effectiveness of lockdowns, and therefore, for an early end of the COVID-19 pandemic, strong social distancing is important.

Epidemic Trend of COVID-19 Transmission in India During Lockdown-1 Phase.

To assess the current epidemic trend of COVID-19/SARS-CoV-2 in India, the epidemic dynamics of COVID-19 cases in India in terms of Case Fatality Rate (CFR), Case Recovery Rate (CRR) and Mortality rate (MR) COVID-19 have been evaluated during Lockdown-1. The analysis includes (i) epidemic curve of Covid-19 cases (ii) demographic analysis (iii) calculation of the CFR and CRR by different methods (iv) calculation of MR (v) Geo-temporal analysis (vi) epidemiological transmission factor (vii) evaluation of the effects and impact of infection, prevention and control in India. A total of 10,815 COVID-19 confirmed cases have been reported in 31 states/union territories as of April 14, 2020 with 9272 active cases (85.73%), 1190 cured/discharged (11%), and 353 deaths (3.23%). Among confirmed cases, most cases (59%) are aged 20–49 which is working age in India and 76% cases are reported for men. The median age of Indian COVID-19 patients found to be 39. As of April 14, the CFR per total cases in India is 3.32% and per closed cases is 23.27%. The CRR per total cases in India is 11.00% and per closed cases is 76.72%, which indicates that the recovery rate of COVID-19 is more than the fatality rate in India. The prevention and control measures taken by the state and central governments at all levels and measure of maintenance of social distancing by people have resulted in effective curbing in the COVID-19 transmission in India.

Increase in COVID-19 cases and case-fatality and case-recovery rates in Europe: A cross-temporal meta-analysis.

The new coronavirus (COVID‐19) infection reported in China in December 2019 has become a pandemic in a few weeks, affecting the entire world. In this respect, it is crucial to determine the case‐increase, case‐fatality, and case‐recovery rates to control COVID‐19. In this study, the case‐increase, case‐fatality, and case‐recovery rates of COVID‐19 in 36 European countries were analyzed with the meta‐analysis method using data released by the health organizations and WHO. The data were obtained from the website of health organizations of 36 European countries and the website of WHO until 11 May 2020. The analyses were carried out on 1 744 704 COVID‐19‐diagnosed cases in 36 European countries. The case‐increase, case‐fatality and case‐recovery rates of COVID‐19 were calculated using 95% confidence intervals (95% CI), single‐arm meta‐analysis, cross‐temporal meta‐analysis, and meta‐regression random‐effects model. The standardized case‐increase rate of COVID‐19 is 5% (95% CI [0.040, 0.063]) and the average case‐increase rate in European countries has started to decline by around 3% (95% CI [0.047, 0.083]) weekly. The countries with the highest rate of case increase are Belgium, Sweden, Russia, the Netherlands and the United Kingdom. Although the case‐fatality rate of COVID‐19 patients was 4.5% as of May 11 (95% CI [0.037‐0.055]), this rate is 6.3% (95% CI [0.047, 0.083]) in standardized time (6th week). The case‐recovery rates of patients are 46% (95% CI [0.376‐0.547]). This study presents important results regarding the COVID‐19 pandemic in Europe. Although the rate of increase in new COVID‐19 cases has dropped, there is not much decline in the case‐fatality rates and no increase in case‐recovery rates. The case‐fatality rate of COVID‐19 in Europe was estimated to be in the range of 4% to 4.5% and a minimum of 4 weeks (as of 11 May) is expected to have the figure below 1% in a country with an average case‐increase rate. Monitoring case fatalities in Belgium, the Netherlands and Sweden, and treatment successes in Germany and Austria play a role of utmost importance.

One-month Progress of COVID-19 Cases in East Kalimantan, Indonesia

BACKGROUND: East Kalimantan, Indonesia, will play a significant geopolitical role as the province has been selected as the location of the future capital city of Indonesia. As a buffer zone to the capital city, there is urgent attention on the preparedness of the cities and regencies in East Kalimantan to respond to emergent infectious disease events such as coronavirus disease-19 (COVID-19).&#x0D; AIM: The aim of the present study was to descriptively convey information about COVID-19 cases in East Kalimantan during the period of March 18, 2020–April 18, 2020, in terms of the isolation, testing, and tracing mechanisms used.&#x0D; METHODS: The initial distribution of COVID-19 was identified in 5 of 10 districts and is now present in almost all districts except for one very remote regency.&#x0D; RESULTS: The tracing performance of the fast response teams in East Kalimantan during this period was considered satisfactory with a mean of 0.7% of people under observation testing positive for severe acute respiratory syndrome coronavirus 2, and a mean of 14.4% patients under investigations testing positive. The use of rapid tests since March 30, 2020 has improved the detection ability, with confirmed positive cases as a percentage of confirmed negatives increasing from 20.2% to 31.8%. The use of the COVID-19 rapid test was cross-checked with a dengue rapid test to prevent false-positive identification. Confirmed clusters were announced to the public, urging people to respond and report.&#x0D; CONCLUSION: The 1-month progress of COVID-19 cases in East Kalimantan showed a total case fatality rate (CFR) of 1.85%, a closed CFR of 8.3% and a closed case recovery rate of 91.7%.

Estimating Case Fatality Rate of Symptomatic Patients with COVID-19: Is This the Right Thing to Do?

Background: Case fatality rates (CFRs) and case recovery rates (CRRs) are frequently used to define health consequences related to a certain disease epidemics, as well as for COVID-19 outbreak. Objectives: This study aimed to compare various introduced methods and models for the calculation of CFR and CRR related to COVID-19 over a present period of time based on the recent global and national data. Methods: This analytical epidemiological study was conducted on the detail data from 210 countries and territories around the world on 17 April 2020. We used three different formulas to measure CFR and CRR, considering all possible scenarios. Results: We committed to show only 72 countries with more than 1000 cases of COVID-19. Overall, using first, second and third estimation models, the CFR were 6.22%, 21.20%, and 8.67%, respectively; similarly, the CRR were estimated as 23.21%, 78.86%, 32.23%, respectively. We have shown CFR vary so much from spatially depend on the methods of estimation which have been implemented and timing of cases reports, that is a lowest CFR of 0.31 in the Singapore, and a CFR of 98.82 in UK. Overall, European region witnessing the highest CFR (9.38 to 24.88). Conclusion: Even with the more precise method of CFRs estimation, the value is overestimated. Case fatality and recovery rate is not only measure of severity of disease and the better estimation would be the more reliable indicator of country performance fighting against COVID-19.

Mortality in children with severe acute malnutrition

Malnutrition is a major contributor to the global disease burden, accounting for more than one-third of child deaths worldwide. Severe Acute Malnutrition is a disease that is an underlying condition in many under five admissions in the study area of Hiwot Fana Specialized University Hospital, Harare and in Ethiopia as a whole. The main objective of the study is to identify the prevalent cause of mortality in Severe Acute Malnutrition, among children aged 6-59 months, admitted to Hiwot Fana Specialized University Hospital, Pediatric ward, Nutrition Rehabilitation Unit from 2013 to 2015. Which will be key to help improve the management protocol so as to see better outcomes in the patients in the study area, or at the very least to be a stepping stone to and point out the need for further analytical studies on the topic. The study was a retrospective, descriptive cross-sectional study which was conducted to identify the prevalent causes of mortality in patients aged 6-59 months admitted to Hiwot Fana Specialized University Hospital, Nutrition Rehabilitation Unit over the period of 2013-2015. The study reveals that the case recovery rate of the study area is 36% with the rate of patients who have disappeared or had left against physician's advice being a whapping 61.9%. The mortality rate weez was found to be 2.1% with the mortality sex ratio of Male: Female 1.6:1. The commonest complication that appears to related with mortality in Severe Acute Malnutrition was diarrheal disease (Acute Gastroenteritis) being present in 14 of the 15 deaths in the study period. The study concludes that the Case Fatality Rate of the study area, even though very low, the high rate of disappearance and yet a comparatively low rate of recovery brings to question the general quality of care in the facility. More to this the commonest complication associated with mortality being a preventable and manageable one i.e. AGE calls for Vigilance in the management of such patients.

Hand-foot-mouth disease and use of steroids, intravenous immunoglobulin, and traditional Chinese herbs in a tertiary hospital in Shantou, China

BackgroundIn contrast to the guidelines of World Health Organization (WHO) and United States-Centers for Disease Control and prevention (US-CDC), the Chinese national guidelines recommend the use of steroids, intravenous immunoglobulin (IVIG), or traditional Chinese herbs (TCHs) in hand-foot-mouth disease (HFMD) management. Their use and therapeutic efficacies are, however, unclear. We aimed to describe their use in and the clinical outcomes of hospitalized HFMD cases.MethodsA retrospective review of hospital medical records for HFMD cases during 2008–2016 was conducted in a medical school-affiliated tertiary hospital in Shantou, Guangdong, China.ResultsHospitalized children with the discharge diagnosis of HFMD (n = 3778), comprising mild (58.4%), severe (41.5%), and very severe (0.1%) cases, were enrolled in the study. Steroids, IVIG, and antiviral TCH Lan-Qin were respectively prescribed in 60.5, 37.1, and 71.0% of cases. Most cases (99.8%) recovered and six died. Recovery rate was lower with the use of IVIG and higher with Lan-Qin (alone or in combination with steroid) in the mild cases (Ps < 0.05). Longer hospital stay was observed with steroid/IVIG with or without Lan-Qin in the severe cases (Ps < 0.05).ConclusionsThis nine-year retrospective review shows 1) an increase in the incidence of HFMD as well as the use of steroids, IVIG, and TCH over time, 2) no significant advantage of using steroids and IVIG, either alone or in combination, in the management of mild HFMD cases, and 3) a higher recovery rate in mild HFMD cases with the use of antiviral TCH (Lan-Qin). Our findings need verification in a larger prospect study with cases from hospitals in other regions of China. Lan-Qin efficacy should be evaluated in randomized trials. Meanwhile, caution should be exercised in the extensive use of steroids and IVIG in HFMD management.

Compression of Morbidity and Mortality: New Perspectives

Compression of morbidity is a reduction over time in the total lifetime days of chronic disability, reflecting a balance between (1) morbidity incidence rates and (2) case-continuance rates, generated by case-fatality and case-recovery rates. Chronic disability includes limitations in activities of daily living and cognitive impairment, which can be covered by long-term-care insurance. Morbidity improvement can lead to a compression of morbidity if the reductions in age-specific prevalence rates are sufficiently large to overcome the increases in lifetime disability due to concurrent mortality improvements and progressively higher disability prevalence rates with increasing age. Compression of mortality is a reduction over time in the variance of age at death. Such reductions are generally accompanied by increases in the mean age at death; otherwise, for the variances to decrease, the death rates above the mean age at death would need to increase, and this has rarely been the case. Mortality improvement is a reduction over time in the age-specific death rates and a corresponding increase in the cumulative survival probabilities and age-specific residual life expectancies. Mortality improvement does not necessarily imply concurrent compression of mortality. This article reviews these concepts, describes how they are related, shows how they apply to changes in mortality over the past century and to changes in morbidity over the past 30 years, and discusses their implications for future changes in the United States. The major findings of the empirical analyses are the substantial slowdowns in the degree of mortality compression over the past half century and the unexpectedly large degree of morbidity compression that occurred over the morbidity/disability study period 1984–2004; evidence from other published sources suggests that morbidity compression may be continuing.

The curative effect analysis between postauricular injection and systemic application of glucocorticoids in the treatment of sudden hearing loss

Objective To investigate the therapeutic effect of topical corticosteroids injection and systemic application in the treatment of sudden hearing loss. Methods Total of 58 patients with sudden hearing loss were randomly divided into two groups.The systemic application group:dexamethasone(DEX) was applied by intravenous injection in dose of 10mg×3d,followed by 5mg×4d.And the postauricular injection group: methylprednisolone sodium succinate of 40mg was injected into cortical bone of mastoid region every three days, until hearing back to normal,or 15 days.SPSS 13.0 software was used to analyze the data. Results The total effective rate of systemic application group was 67.7%,the total effective rate of postauricular injection group was 64.7%.There was no statistical difference between the two groups(χ2= 2.58,P= 0.316).The recovery rate in cases with postauricular injection group was significantly increased in comparison with the systemic application group,but no statistical difference between the two groups(t= 2.71,P= 0.062).Patients with hearing loss in low frequencies(250Hz,500 Hz),the recovery rate in cases with postauricular injection group was significantly increased in comparison with the systemic application group(t= 3.82,P= 0.031;t= 3.26,P= 0.042). Conclusion Postauricular topical injection and systemic application of glucocorticoids in the treatment of sudden hearing loss are all have good curative effect.Systemic application is selected by conventional treatment,and topical injection has a better effect in the hearing loss of low-middle frequencies. Key words: Hearing loss; Sudden; Glucocorticoids; Drug administration routes

Titin gene mutations are common in families with both peripartum cardiomyopathy and dilated cardiomyopathy

Peripartum cardiomyopathy (PPCM) can be an initial manifestation of familial dilated cardiomyopathy (DCM). We aimed to identify mutations in families that could underlie their PPCM and DCM. We collected 18 families with PPCM and DCM cases from various countries. We studied the clinical characteristics of the PPCM patients and affected relatives, and applied a targeted next-generation sequencing (NGS) approach to detect mutations in 48 genes known to be involved in inherited cardiomyopathies. We identified 4 pathogenic mutations in 4 of 18 families (22%): 3 in TTN and 1 in BAG3. In addition, we identified 6 variants of unknown clinical significance that may be pathogenic in 6 other families (33%): 4 in TTN, 1 in TNNC1, and 1 in MYH7. Measurements of passive force in single cardiomyocytes and titin isoform composition potentially support an upgrade of one of the variants of unknown clinical significance in TTN to a pathogenic mutation. Only 2 of 20 PPCM cases in these families showed the recovery of left ventricular function. Targeted NGS shows that potentially causal mutations in cardiomyopathy-related genes are common in families with both PPCM and DCM. This supports the earlier finding that PPCM can be part of familial DCM. Our cohort is particularly characterized by a high proportion of TTN mutations and a low recovery rate in PPCM cases.

Topical injection and systemic application of glucocorticoids in the treatment of idiopathic sudden sensorineural hearing loss by type

To investigate the therapeutic effect of topical corticosteroids injection and systemic application in the treatment of typing idiopathic sudden sensorineural hearing loss (ISSNHL). Total of 438 patients with ISSNHL, including 76 with hearing loss in low-middle frequencies, 43 in middle-high frequencies, 162 in all frequencies and 157 in total deafness, were randomly divided into two groups, the systemic application group: dexamethasone (DEX) was applied by intravenous injection in dose of 10 mg×3 d followed by 5 mg×4 d, and the topical injection group: methylprednisolone sodium succinate of 40 mg was injected into cortical bone of mastoid region every three days. According to the results of pure-tone threshold audiometry, the curative effect among ISSNHL with low-middle frequencies, middle-high frequencies, all frequencies hearing loss, and total deafness were evaluated. SPSS 18.0 software was used to analyze the data. Among 220 patients with systemic application of DEX, 66 subjects (30.0%) cases were recovery, 51 (23.2%) were excellent better, 39 (17.7%) better, 64 (29.1%) were poor, and the total effective rate was 70.9% (156/220) . There was no statistical difference in total effective rate of four typing subgroups (χ(2) = 1.60, P > 0.05). And the recovery rate in total deafness subgroup was significant lower than that in low-middle and all frequencies subgroups (χ(2) = 10.63 and 15.94 respectively, both P < 0.05). In the topical injection group, the recovery rate was 30.3% (66 cases), excellent better 18.8% (41), better 15.6% (34), poor 35.3% (77), and the total effective rate was 64.7% (141/220) . There were statistical differences of total effective rate in low-middle frequencies in comparison with that in all frequencies (χ(2) = 8.38) and total deafness (χ(2) = 7.28) subgroups (both P < 0.05). Regarding recovery rate, there were significant differences between each two typing subgroups, except middle-high frequencies subgroup vs. all frequencies (χ(2) = 1.60) and total deafness (χ(2) = 2.29) subgroups (both P < 0.05). In 76 ISSNHL with hearing loss in low-middle frequencies, the recovery rate in cases with local corticosteroids injection(65.0%) was significantly increased in comparison with that with systemic application (41.7%), χ(2) = 4.15, P < 0.05. There were increasing tendencies of curative effect in other three typing groups by systemic corticosteroids application when compared with local injection, but no statistical significances (all P > 0.05). For low-middle frequencies ISSNHL, the corticosteroids administration of local injection should be the optimization. Systemic application would be applied for middle-high frequencies, all frequencies and total deafness.