Hospitalized COVID-19 Patients Research Articles

Could Anemia Impact the Severity of Infections? COVID-19 as an Example

Background The association between anemia and severity of infection as well as mortality rates among patients infected with COVID-19 has scarcely been studied. This is the first study UAE aimed to assess the influence of anemia on COVID-19 severity, ICU admission, and mortality rate. Methods A retro-prospective chart review of hospitalized COVID-19 patients was conducted in a large COVID-19 referral hospital in UAE. The study included adult patients with confirmed COVID-19. Clinical and laboratory data, severity of the disease, ICU admissions, and mortality rates were analyzed and correlated to the presence of anemia among the patients. Results A total of 3092 patients were included. 362 patients (11.7%) were anemic and most of the cases were between asymptomatic and mild COVID-19 (77.4%, n=2393). Among patients with anemia, 30.1% (n=109) had moderate to severe COVID-19. Statistically, anemia was associated significantly with a higher risk for severe COVID-19 outcome compared to nonanemic patients (AOR:1.59, 95% CI:1.24-2.04, p<0.001). Intensive care unit (ICU) admission was almost 3 times higher among anemic patients compared to nonanemic (AOR:2.83,95% CI:1.89-4.25, p<0.001). In addition, the overall mortality rate of 2.8% (n=87) was 2.5-fold higher in anemic than nonanemic patients (OR:2.56, CI: 1.49-4.06, p<0.001). Moreover, older age (≥48-year-old) and male gender were independent predictors for severe illness (Age: OR=1.26, CI:1.07-1.51, p=0.006; Gender: OR:1.43,CI:1.15-1.78, p<0.001)) and ICU admission (Age: OR:2.08, CI:1.47-2.94, p<0.001; Gender: OR: 1.83, CI:1.12-3.00, p=0.008) whereas only age ≥48 years old contributed to higher mortality rate (OR:1.60, CI:1.04-2.46, p=0.034). Conclusion Anemia was a major risk factor for severe COVID-19, ICU admission and mortality among hospitalized COVID-19 patients. Thus, healthcare providers should be aware of monitoring the hematological parameters among hospitalized patients with COVID-19 and anemia to reduce the risk of disease complications and mortality. This association should also be considered in other infectious diseases.

A retrospective cohort study of Paxlovid efficacy depending on treatment time in hospitalized COVID-19 patients.

Paxlovid, a SARS-CoV-2 antiviral, not only prevents severe illness but also curtails viral shedding, lowering transmission risks from treated patients. By fitting a mathematical model of within-host Omicron viral dynamics to electronic health records data from 208 hospitalized patients in Hong Kong, we estimate that Paxlovid can inhibit over 90% of viral replication. However, its effectiveness critically depends on the timing of treatment. If treatment is initiated three days after symptoms first appear, we estimate a 17% chance of a post-treatment viral rebound and a 12% (95% CI: 0-16%) reduction in overall infectiousness for non-rebound cases. Earlier treatment significantly elevates the risk of rebound without further reducing infectiousness, whereas starting beyond five days reduces its efficacy in curbing peak viral shedding. Among the 104 patients who received Paxlovid, 62% began treatment within an optimal three-to-five-day day window after symptoms appeared. Our findings indicate that broader global access to Paxlovid, coupled with appropriately timed treatment, can mitigate the severity and transmission of SARS-Cov-2.

Neurological diagnoses in hospitalized COVID-19 patients associated with adverse outcomes: A multinational cohort study.

Few studies examining the patient outcomes of concurrent neurological manifestations during acute COVID-19 leveraged multinational cohorts of adults and children or distinguished between central and peripheral nervous system (CNS vs. PNS) involvement. Using a federated multinational network in which local clinicians and informatics experts curated the electronic health records data, we evaluated the risk of prolonged hospitalization and mortality in hospitalized COVID-19 patients from 21 healthcare systems across 7 countries. For adults, we used a federated learning approach whereby we ran Cox proportional hazard models locally at each healthcare system and performed a meta-analysis on the aggregated results to estimate the overall risk of adverse outcomes across our geographically diverse populations. For children, we reported descriptive statistics separately due to their low frequency of neurological involvement and poor outcomes. Among the 106,229 hospitalized COVID-19 patients (104,031 patients ≥18 years; 2,198 patients <18 years, January 2020-October 2021), 15,101 (14%) had at least one CNS diagnosis, while 2,788 (3%) had at least one PNS diagnosis. After controlling for demographics and pre-existing conditions, adults with CNS involvement had longer hospital stay (11 versus 6 days) and greater risk of (Hazard Ratio = 1.78) and faster time to death (12 versus 24 days) than patients with no neurological condition (NNC) during acute COVID-19 hospitalization. Adults with PNS involvement also had longer hospital stay but lower risk of mortality than the NNC group. Although children had a low frequency of neurological involvement during COVID-19 hospitalization, a substantially higher proportion of children with CNS involvement died compared to those with NNC (6% vs 1%). Overall, patients with concurrent CNS manifestation during acute COVID-19 hospitalization faced greater risks for adverse clinical outcomes than patients without any neurological diagnosis. Our global informatics framework using a federated approach (versus a centralized data collection approach) has utility for clinical discovery beyond COVID-19.

Evaluating treatment efficacy in hospitalized COVID-19 patients, with applications to Adaptive COVID-19 Treatment Trials.

The current endpoints for therapeutic trials of hospitalized COVID-19 patients capture only part of the clinical course of a patient and have limited statistical power and robustness. We specify proportional odds models for repeated measures of clinical status, with a common odds ratio of lower severity over time. We also specify the proportional hazards model for time to each level of improvement or deterioration of clinical status, with a common hazard ratio for overall treatment benefit. We apply these methods to Adaptive COVID-19 Treatment Trials. For remdesivir versus placebo, the common odds ratio was 1.48 (95% confidence interval (CI) = 1.23-1.79; p < 0.001), and the common hazard ratio was 1.27 (95% CI = 1.09-1.47; p = 0.002). For baricitinib plus remdesivir versus remdesivir alone, the common odds ratio was 1.32 (95% CI = 1.10-1.57; p = 0.002), and the common hazard ratio was 1.30 (95% CI = 1.13-1.49; p < 0.001). For interferon beta-1a plus remdesivir versus remdesivir alone, the common odds ratio was 0.95 (95% CI = 0.79-1.14; p = 0.56), and the common hazard ratio was 0.98 (95% CI = 0.85-1.12; p = 0.74). The proposed methods comprehensively characterize the treatment effects on the entire clinical course of a hospitalized COVID-19 patient.

Physical and Mental Health Characteristics of Hospitalized COVID-19 Patients with and without Type 2 Diabetes Mellitus in Turkey.

The aim of this study was to assess the rates of depression, anxiety, and stress and quality of sleeping among COVID-19 patients with and without type 2 diabetes mellitus (T2DM). A case and control design has been employed, involving patients affected by COVID-19 infection (884 with T2DM vs. 884 controls without T2DM) and hospitalized in Istanbul (Turkey) from January to December 2021. A multivariate stepwise regression approach was used to test the associations between sociodemographic, metabolic, serum markers, mental health scores, and T2DM/COVID-19 patients' clinical presentation. A statistically significant difference between T2DM and non-T2DM was found with respect to age, gender, BMI (body mass index), smoking, physical exercise, and physical comorbidities as well as levels of depression, anxiety, stress, and sleeping disorders (0.0003 ≤ all p = 0.025). With regard to serum biomarkers, vitamin D and ferritin were identified as useful parameters of reduction of glycated hemoglobin as well as COVID-19 infection among T2DM patients. This study detected that 25% of patients with COVID-19 and T2DM experienced mental distress, with sleeping disturbances and lifestyle changes markedly impacting their clinical outcome alongside metabolic and serum parameters.

Sex Differences on Cerebrovascular Complications in Hospitalized COVID-19 Patients: A Meta-analysis (P11-5.030)

Sex Differences on Cerebrovascular Complications in Hospitalized COVID-19 Patients: A Meta-analysis (P11-5.030)

Cannabis use associated with lower mortality among hospitalized Covid-19 patients using the national inpatient sample: an epidemiological study

BackgroundPrior reports indicate that modulation of the endocannabinoid system (ECS) may have a protective benefit for Covid-19 patients. However, associations between cannabis use (CU) or CU not in remission (active cannabis use (ACU)), and Covid-19-related outcomes among hospitalized patients is unknown.MethodsIn this multicenter retrospective observational cohort analysis of adults (≥ 18 years-old) identified from 2020 National Inpatient Sample database, we utilize multivariable regression analyses and propensity score matching analysis (PSM) to analyze trends and outcomes among Covid-19-related hospitalizations with CU and without CU (N-CU) for primary outcome of interest: Covid-19-related mortality; and secondary outcomes: Covid-19-related hospitalization, mechanical ventilation (MV), and acute pulmonary embolism (PE) compared to all-cause admissions; for CU vs N-CU; and for ACU vs N-ACU.ResultsThere were 1,698,560 Covid-19-related hospitalizations which were associated with higher mortality (13.44% vs 2.53%, p ≤ 0.001) and worse secondary outcomes generally. Among all-cause hospitalizations, 1.56% of CU and 6.29% of N-CU were hospitalized with Covid-19 (p ≤ 0.001). ACU was associated with lower odds of MV, PE, and death among the Covid-19 population. On PSM, ACU(N(unweighted) = 2,382) was associated with 83.97% lower odds of death compared to others(N(unweighted) = 282,085) (2.77% vs 3.95%, respectively; aOR:0.16, [0.10–0.25], p ≤ 0.001).ConclusionsThese findings suggest that the ECS may represent a viable target for modulation of Covid-19. Additional studies are needed to further explore these findings.

A study of hospitalized COVID-19 patients with AKI in a setting of multiracial developing country

BackgroundThe commonest indication for hospitalization in COVID-19 patients is hypoxemia or severe respiratory symptoms. However, COVID-19 disease may result in extrapulmonary complications including kidney-related pathology. The reported incidence of renal involvement related to COVID infection varies based on geographical location.ObjectiveThis study aimed to assess the incidence rate of AKI in hospitalized COVID-19 patients and identify risk factors and prognostic predictors.MethodIn this retrospective study, we recruited hospitalized COVID-19 patients from January 2021 until June 2021 at the University Malaya Medical Center. The inclusion criteria were hospitalized for ≥ 48 h with confirmed COVID-19 infection and at least 18 years old. Patient demographic and clinical data were collected from electronic medical records. The staging of AKI was based on criteria as per KDIGO guidelines.ResultsOne thousand five hundred twenty-nine COVID patients fulfilled the inclusion criteria with a male-to-female ratio of 759 (49.6%) to 770 (50.3%). The median age was 55 (IQR: 36–66). 500 patients (32.7%) had diabetes, 621 (40.6%) had hypertension, and 5.6% (n = 85) had pre-existing chronic kidney disease (CKD). The incidence rate of AKI was 21.1% (n = 323). The percentage of COVID patients in different AKI stages of 1,2 and 3 were 16.3%, 2.1%, and 2.7%, respectively. Fifteen hospitalized patients (0.98%) required renal replacement therapy. 58.8% (n = 190) of AKI group had complete recovery of kidney function.Demographic factors included age (p < 0.001), diabetes (p < 0.001), hypertension (p < 0.012), CKD (p < 0.001), and vaccination status (p = 0.042) were associated with an increased risk of developing AKI. We found that the AKI cohort had statistically significant lower platelet counts and higher ferritin levels than the non-AKI cohort. AKI is a risk predictor of prolonged hospitalization (p < 0.001) and higher mortality rates (P < 0.001).ConclusionAKI is a common clinical complication among hospitalized COVID-19 patients. The etiology of AKI is multifactorial and may have an adverse impact on patient morbidity and mortality.

Thrombosis in severely ill patients admitted in ICU due to COVID-19 pneumonia. Data from a Greek Hospital

Background: SARS-CoV-2 can lead to a prothrombotic state and the activation of the body's coagulation mechanism, resulting in thrombotic episodes, especially in critically ill patients. The rates of thromboembolic disease in patients with COVID-19 vary and range from 10-40%, while in Greece the existing epidemiological data on the incidence of thromboembolic disease in the ICU are limited. Aim This study aimed to determine the proportion of hospitalized COVID-19 patients who developed thromboembolic disease (pulmonary embolism, deep vein thrombosis, or arterial embolism). It was also crucial to investigate at the relationship between the incidence of VTE (venothrombosis-VTE) and Covid infection in ICU patients. After 28 days from ICU admission, the survival rate of patients with Covid infection admitted to ICUs within the specified time frame was also noted. Method and Material: The study included 85 patients with Covid-19 infection who were hospitalized in two ICU departments in a large adult hospital in Athens between June and September 2021. The occurrence of VTE was diagnosed by computed tomography angiography, regarding the pulmonary embolism and with triplex veins of the lower extremities. Various epidemiological factors, laboratory findings and characteristics of the patients' hospitalization in the Intensive Care Unit were recorded. Results: The incidence of VTE in patients with Covid-19 infection admitted to the Intensive Care Unit was 14% (12/85 patients). Patients who experienced VTE during their hospitalization in the Intensive Care Unit had more days on mechanical ventilation support, more days on vasoconstrictor drugs, and had been transfused more times with blood plasma. In the multivariate analysis that followed, it was found that total days of mechanical ventilation (p=0.02), total days of vasoconstrictor administration (p=0.03) and plasma transfusion (p=0.03) were still statistically significant. Conclusion: In patients with Covid-19 infection and hospitalization in the Intensive Care Unit, longer stay on mechanical respiratory support, more days of vasoconstrictor drug administration and plasma administration are independent predisposing factors for the occurrence of VTE.

Does Professional Self-Efficacy Provide a Shield in Troubling Situations? Evidence of Performance and Thriving Through Perceived Strength Use

The COVID-19 pandemic has created a more stressful and uncertain work environments, disrupting personal and organizational lives, and particularly the impact of this crises on health care professionals (i.e., doctors and nurses) is unprecedented. COVID-19 has increased the workload and job risks for frontline health care professionals, causing them significant emotional stress. In such testing times, individual’s personal effectiveness ensued by the utilization of one’s personal energy may be helpful in not only ensuring wellbeing but also providing other desired results, for example, enhanced performance. Based on this notion, we conducted a study (amidst the third wave in mid-2021) using a multi-wave design to investigate the role of professional self-efficacy of health care professionals in well-being and behavioral outcomes during crises of COVID-19. The hypothesized relationships were tested by collecting data from 361 frontline healthcare professionals dealing with COVID-19 patients in hospitals in Northern part of Pakistan. The study results verified our assumed relationships and revealed that health care workers’ professional self-efficacy was positively related to their well-being, in terms of workplace thriving, and it also showed positive association with work role performance. In addition, the results of the study also revealed that perceived strengths use mediated the relationship between professional self-efficacy and outcomes. This study discusses implications, limitations, and future directions in detail, including how the findings can be used to inform interventions and support healthcare professionals dealing with the emotional and professional stresses brought on by the pandemic.

In-Hospital Mortality by Race and Ethnicity Among Hospitalized COVID-19 Patients Using Data From the US National COVID Cohort Collaborative

BackgroundStudies examining racial and ethnic disparities in-hospital mortality for patients hospitalized with COVID-19 had mixed results. Findings from patients within academic medical centers (AMCs) are lacking, but important given the role of AMCs in improving health equity. ObjectiveThe purpose of this study is to assess whether minority patients hospitalized with COVID-19 in National COVID Cohort Collaborative (N3C) institutions, which consist predominantly of AMCs, have higher mortality rates relative to White patients. DesignA retrospective analysis of patients hospitalized with COVID-19 was performed. Logistic regression analysis was used to test the primary hypothesis. A separate analysis tested whether there were differences by race and ethnicity during the delta variant phase of the pandemic. PatientsAll hospitalized patients with COVID-19 who were above 17 years old were categorized by race and ethnicity as Black, Hispanic, Asian, White, Other, and Unknown. Main MeasuresIn-hospital mortality for patients with a known hospital outcome formed the primary outcome measure. Race and ethnicity were the primary independent variables. Key ResultsThere were 103,702 in-hospital Covid-19 admissions with 14,207 (13.7%) hospital deaths. Unadjusted in-hospital mortality for White patients was approximately 26% higher than for Black patients. After multivariable adjustment, none of the racial and ethnic groups had significantly different odds of in-hospital mortality compared to White patients. Only Hispanic patients had an odds ratio greater than one that was insignificant (OR = 1.06; 95% CI = 0.92-1.20). Findings for the delta variant phase were similar with the exception of the unknown category (OR = 1.90; 95% CI = 1.05-3.46). ConclusionsDisparities in-hospital mortality outcomes by race or ethnicity were not found in COVID-19 patients hospitalized in AMCs. AMCs are expected to lead health delivery systems in eliminating disparities associated with structural racism. The null findings are consistent with the hypothesis of no difference in hospital outcomes by race or ethnicity in academic medical centers.

Validity of inpatient electronic health record-based measures of oxygen-related therapy in the United States: Lessons applicable for studying COVID-19 endpoints.

During the COVID-19 pandemic, inpatient electronic health records (EHRs) have been used to conduct public health surveillance and assess treatments and outcomes. Invasive mechanical ventilation (MV) and supplemental oxygen (O2) use are markers of severe illness in hospitalized COVID-19 patients. In a large US system (n = 142 hospitals), we assessed documentation of MV and O2 use during COVID-19 hospitalization in administrative data versus nursing documentation. We identified 319 553 adult hospitalizations with a COVID-19 diagnosis, February 2020-October 2022, and extracted coded, administrative data for MV or O2. Separately, we developed classification rules for MV or O2 supplementation from semi-structured nursing documentation. We assessed MV and O2 supplementation in administrative data versus nursing documentation and calculated ordinal endpoints of decreasing COVID-19 disease severity. Nursing documentation was considered the gold standard in sensitivity and positive predictive value (PPV) analyses. In nursing documentation, the prevalence of MV and O2 supplementation among COVID-19 hospitalizations was 14% and 75%, respectively. The sensitivity of administrative data was 83% for MV and 41% for O2, with both PPVs above 91%. Concordance between sources was 97% for MV (κ = 0.85), and 54% for O2 (κ = 0.21). For ordinal endpoints, administrative data accurately identified intensive care and MV but underestimated hospitalizations with O2 requirements (42% vs. 18%). In comparison to nursing documentation, administrative data under-ascertained O2 supplementation but accurately estimated severe endpoints such as MV. Nursing documentation improved ascertainment of O2 among COVID-19 hospitalizations and can capture oxygen requirements in adults hospitalized with COVID-19 or other respiratory illnesses.

Profile of Interleukin-6 and Tumor Necrosis Factor-α in Hospitalized COVID-19 Patients

Abstract Background: In 2019’s December, the new COVID-19 coronavirus induced severe lower respiratory tract syndrome in Wuhan, China. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ultimately became responsible for the life-threatening pandemic. The magnitude and outcome of COVID-19 may be related to the overproduction of pro-inflammatory cytokine called “cytokine storm.” Cytokine production besides the age of patients, and comorbidities, all influence the length and severity of SARS-CoV-2. Objectives: This research was performed to investigate how these factors affect patients who have severe COVID-19 in a sample of Iraqi patients. Materials and Methods: A total of 82 participants were enrolled in this work, confirmed hospitalized COVID-19 patients (n = 60) and healthy control (n = 22) from both sexes of age range 20‐67 years. Tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) levels in the serum of COVID-19 patients and HC have been evaluated using an ELISA. Results: According to our findings, sera from COVID-19 patients had considerably higher levels of IL-6 and TNF-α than those of the control group. Furthermore, most infections were among women (63%), followed by men (37%), the higher number of patients were within 50‐59 years, while the lowest number of patients was found in the group 20‐29 years. Most COVID-19 patients appeared to be overweight and obese. Additionally, those who have diabetes mellitus are also at risk of severe COVID-19. Conclusion: Serum levels of TNF-α and IL-6 were higher in patients than in the control group, suggesting that they could be used as indicators of the severity of COVID-19 illness. Also, their combined detection provided highest specificity and sensitivity for early prediction of COVID-19 severity, which has significant clinical values.

Retrospective Chart Analysis of Psychiatry Referrals for Hospitalized COVID-19 Patients in a Dedicated COVID Hospital in a Metropolitan City in India

Abstract Background: The COVID-19 pandemic has been associated with multiple psychiatric problems in the general population as well as in those admitted with the infection. Studies done so far have mainly focused on the general population. It is important to address the needs and gaps in mental and psychological aspect of health of patients admitted with the infection to improve their overall prognosis. This study was undertaken with the aim to study the pattern of psychiatric referrals of hospitalized COVID-19 patients and to find out if there is any association between their socio-demographics, severity of COVID-19 infection, inflammatory markers, and co-morbidities. Materials and Methods: A descriptive, retrospective chart analysis of the record of 160 psychiatry referrals for COVID-19 patients seen by the on-call psychiatrist from May 2020 to October 2020 in a tertiary care hospital was undertaken. Sociodemographic data, severity of COVID-19 infection, blood investigation reports, psychiatric symptoms, diagnosis and management were recorded, tabulated, and analyzed using SPSS 20. Results: Referrals were more for individuals having moderate-to-severe COVID-19 infection, in elderly patients and in males. The most common reason for referral was disorientation (27.5%) and insomnia (27.5%), followed by the patient having a preexisting psychiatric illness (15%). The most common psychiatric diagnosis was delirium secondary to general medical condition, (28%), followed by anxiety and depressive spectrum disorders (23.75%). 32.5% of the patients referred had a past history of psychiatric illness, the most common being substance use disorder, followed by major depressive disorder and mixed anxiety depression. With the increase in the age of the individuals, the number of referrals for males was significantly more as compared to females (P = 0.00). No statistically significant association was found between age (P = 0.83), gender (P = 0.99), and psychiatric diagnosis. No significant association was found between the severity of COVID-19 and psychiatric diagnosis (P = 0.69). Conclusion: It is essential to screen for psychiatric disorders in patients admitted for COVID, as it goes a long way in reducing the overall morbidity and improves patient cooperation for various procedures which could be life-saving.

Prevalence of Antibiotic Use in Hospitalized COVID-19 Patients: An Observational Study in Secondary Healthcare Hospitals in Kosovo

INTRODUCTION: Globally, the high use of antibiotics among hospitalized patients diagnosed with COVID-19 has been reported despite evidence that bacterial coinfections are uncommon. This issue raised our concerns, as there was a report on high frequency of antibiotic resistant bacterial infections in COVID-19 patients admitted to the intensive care unit. Thus, we conducted a study to determine the prevalence of antibiotic use for hospitalized acute COVID-19 infection in secondary healthcare hospitals in Kosovo. MATERIALS AND METHODS: A cross sectional study was conducted among patients with acute COVID-19 admitted to secondary healthcare hospitals in Kosovo. A modified Infectious Diseases International Research Initiative (ID-IRI) questionnaire was used to collect information in 460 COVID-19 PCR positive patients. RESULTS: All studied patients (100%) were treated with antibiotics. An empirical antibiotics were used to cover Methicillin-resistant Staphylococcus aureus (MRSA) infections in 136 cases (29.6%), methicillin-susceptible Staphylococcus aureus (MSSA) infections in 86 cases (18.7%), atypical pathogen in 174 cases (37.8%), and Pseudomonas infections in 48 cases (10.4%). The most frequently used antibiotics were ceftriaxone/cefotaxime plus macrolide (149 cases; 31%), ceftriaxone/cefotaxime plus quinolone (85 cases; 17.7%), and co-amoxiclav plus fluoroquinolone (78 cases; 16.3%). Imipenem was most frequently used in the ICU (64 cases; 13.3%). CONCLUSION: Despite the antibiotic guidelines clearly stated that antibiotics should only be used in confirmed case of secondary bacterial infections including the COVID-19 patients, our study revealed that the overused of antibiotics remained unchanged. As the misused and overused of antibacterial has been shown to accelerate the emergence and spread of antibacterial resistant, the inappropriate practice should be changed.

Nirmatrelvir-Ritonavir Reduced Mortality in Hospitalized Patients with COVID-19 During the Omicron Outbreak: Real-World Evidence from Beijing.

The efficacy of nirmatrelvir-ritonavir for hospitalized patients with COVID-19 has not been fully established. We conducted a retrospective analysis of hospitalized COVID-19 patients with high risk for disease progression at Beijing Chaoyang Hospital from October 15, 2022, to March 31, 2023. Patients ≥18 years old who were hospitalized with COVID-19 within 5 days of symptom onset were included. Baseline data were obtained from the routine electronic health record database of the hospital information system. Outcomes were monitored at 28 days via electronic medical record reviews or telephone interviews. We identified 1120 patients hospitalized with COVID-19 during the study period. After exclusions, 167 nirmatrelvir-ritonavir users and 132 controls were included. 28-day all-cause mortality rate was 12.0% (20/167) in the nirmatrelvir-ritonavir group, versus 22.7% (30/132) in the control group (unadjusted log-rank p = 0.010; HR = 0.49, 95% confidence interval [CI] = 0.28-0.86, IPTW-adjusted HR = 0.58, 95% CI = 0.40-0.86). The 28-day disease progression rates did not differ between the two groups (unadjusted HR = 0.59, 95% CI = 0.34-1.02, IPTW-adjusted HR = 0.73, 95% CI = 0.50-1.06). Nirmatrelvir-ritonavir significantly reduced all-cause mortality and disease progression within 28 days among patients aged ≥65 years without ≥2 vaccine doses. We found significantly reduced all-cause mortality in the nirmatrelvir-ritonavir group, particularly in elderly patients who were incompletely vaccinated. Future randomized controlled studies are needed to validate our findings.

Profile of RT-PCR for SARS-CoV-2: A Preliminary Study from COVID-19 patients in Government Medical College and Hospital, Doda, Jammu and Kashmir

Profile of RT-PCR for SARS-CoV-2: A Preliminary Study from COVID-19 patients in Government Medical College and Hospital, Doda, Jammu and Kashmir

D-Dimer As A Parameter Of Disease And Death Of Covid-19 Patients In Islamic Hospital, Surabaya

Background: Previous studies of Community Associated Pneumonia (CAP) and Chronic Obstructive Pulmonary Disease (COPD), patients have shown that D-Dimer increases higher in severe cases and can be used as a prognostic biomarker and whilst D-Dimer&gt; 1 mcg/ ml tends to be death for hospitalized adult patient with a diagnosis of Covid-19. However, D-Dimer's role in Covid-19 patients has not been fully studied. We aim to conduct research on D-Dimer as a parameter of Clinical Severity and Death of Covid-19 Patients in Islamic Hospital, in Surabaya. Methods: This type of research is an analytic observational study with a retrospective approach. The population in this study were all patient’s data retrieved from the Dahlia Room’s database from June to July 2020 which were taken through EMR (an Electrical Medical Records) from a total of 189 patients with the total sample of 82 patients. Data analysis in this study used chi-square (X2) with a significant value of p &lt;0.05. Results: Age over 60 years is associated with a higher risk of severe Covid-19 infection (P&lt;0.05). A history of hypertension significantly affects the severity of Covid-19 infection (P &lt; 0.05). The proportion of recoveries (53.7%) was higher than the number of deaths (46.3%), although the majority of patients experienced severe clinical severity (39%). Laboratory parameters, such as D-dimer values, correlated significantly with patient age (P = 0.027, &lt;0.05). Conclusion: The study highlights the importance of factors such as age and history of comorbid diseases in predicting the severity of Covid-19 infection. A better understanding of these risk factors can help in more effective management and management of Covid-19 patients.

Routine hematology description and D-dimer COVID-19 patients at Sidoarjo Regional Hospital

Background: COVID-19, caused by the SARS-COV-2 virus, is a contagious and potentially fatal disease that is commonly diagnosed using real-time reverse polymerase chain reaction (RT-PCR) assay. Studies have shown that the D-dimer level and the features of hematological exams can offer important prognostic value of the patients. This study aimed to describe data about the routine hematology features and D-Dimer levels of hospitalized COVID-19 patients in Sidoarjo Regional Hospital. Methods: This study used a retrospective, cross sectional, observational approach with descriptive analysis. Medical records of 167 COVID-19 patient were collected based on the criteria. The outcomes of the D-dimer and complete blood count of the patients were summarized. Results: According to the findings, the number of the patients with COVID-19, 53 (31.7%) were between the ages of 31 and 35, and at least 36 (21.6%) were between the ages of 17 and 30. Prominent hematology routine outcomes were the number of patients with anemia (103 or 61.7%), neutrophilia (105 or 62.9%), and lymphocytopenia (129 or 77.2%). The D-dimer value increased by 93 (55.7%) patients among 167 COVID-19 patients. Conclusion: Therefore, monitoring the patient's routine hematological presentation and D-dimer level during treatment is essential for preventing mortality and morbidity.

Antibiotic Prescription and Its Impact on COVID-19 Patient Recovery: A Cross-sectional Study

Background: COVID-19, a newly discovered infectious disease, with a wide range of intensity, has recently become the primary global health issue. Antibiotics are medications designed against microorganisms that are typically not effective in viral infections such as COVID-19. Considering that more than a third of physicians prescribe antibiotics for COVID-19 patients, it was essential to examine the efficacy of these medications. Methods: This cross-sectional study was conducted on 128 hospitalized COVID-19 patients in Iran and performed appropriate statistical tests, including the Chi-square test, and regression analyses, using SPSS 26 (IBM, USA). The missing data were managed properly. Results: The study included 128 COVID-19 patients with a mean age of 58.7 years, and 46.9% were male. Age was the only factor significantly associated with mortality and hospitalization. However, patients with abnormal potassium, prothrombin, partial thromboplastin time, urea, creatinine, and albumin levels had significantly different hospitalization periods and mortality rates. The most commonly prescribed antibiotics were ceftriaxone, hydroxychloroquine, and azithromycin. In addition, patients who took vancomycin had a significantly higher mortality rate. Conclusion: Our findings revealed that age and gender could significantly impact hospital stay duration and mortality rates. Considering that certain antibiotics were linked to prolonged hospital stays, bacterial infection during COVID-19 was not significantly related to increased mortality, which questions the necessity of antibiotics for all patients. The study identified age, gender, and certain lab parameters as associated factors with COVID-19 outcomes. Since its retrospective nature and small sample size limit the findings’ applicability, larger studies are needed to confirm the findings and explore other potential risk factors.