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Significance Of Chronic Kidney Disease On Morbidity And Mortality In Hospitalized Patients With Covid-19, Varsha Suresh, Alexis Finer, Aarushi Varshney, Kay Thi Khine, Ishak Mansi, Abdo Asmar

HCA Healthcare Journal of Medicine

Background

Patients with comorbid illnesses are at risk for worse outcomes with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; COVID-19). Our research examined patients with chronic kidney disease (CKD) to establish whether it remains an independent risk factor for mortality and morbidity in patients with COVID-19.

Methods

We conducted a retrospective cohort study using an electronic patient database in 2020. An observational dataset from 149 hospitals comprising a United States-based health system (HCA Healthcare) was analyzed. Hospitalized patients (N=11 086), aged 18 and above, with a COVID-19 polymerase chain reaction positive result between January 1, 2020, and September 1, …

Implications Of Covid-19 On A Rapidly Growing Thymoma Case, Neeraja Narayanan, Shoaleh Motamedi, Christian Lalonde, Mikko Tauriainen

HCA Healthcare Journal of Medicine

Introduction

Thymomas are a rare form of slow-growing malignancy that originate from thymic epithelial cells presenting as an anterior mediastinal mass. Although most are asymptomatic, they can have a variety of presentations, such as local thoracic symptoms, superior vena cava syndrome, or paraneoplastic syndromes. Local compressive thoracic symptoms include shortness of breath, chest pain, and cough. Superior vena cava syndrome presents with respiratory, vascular, or neurologic symptoms. Paraneoplastic syndromes, such as myasthenia gravis, are due to abnormal T-cell maturation leading to an increased risk of autoimmune conditions.

Case Presentation

We report a case of a 71-year-old White male with multiple …

A Retrospective Cohort Study Assessing The Impact Of Statin Therapy On Hospital Length Of Stay And Inpatient Mortality In Covid-19 Patients, Huy V. Ho, Hamish Patel, Mohammed Ahmed, Ahmed Eddib, Fagunkumar Modi, Domenick Sorresso, Rahul Mhaskar, David Phrathep, Olugbenga Oyesanmi

HCA Healthcare Journal of Medicine

Background

Coronaviruses, known for their crown-like appearance, cause mild gastrointestinal and respiratory diseases. Some cause outbreaks of respiratory diseases, most recently, SARS-CoV-2, the coronavirus disease 2019 (COVID-19). Individuals with COVID-19 are reported to be in both arterial and venous prothrombotic states. In addition to a lipid-lowering effect, statin also has an anti-inflammatory effect, which addresses one of the underlying causes of thrombosis. An in-silico study revealed that statins could directly interact with the main protease enzyme of SARS-CoV-2 and prevent infectivity. Due to these pleiotropic properties, statins may positively impact the outcome of hospitalized patients with COVID-19 infections.

Methods

A …

Covid: The Sound Of Silence, Saptarshi Biswas

HCA Healthcare Journal of Medicine

COVID brought its toll of deaths. Something the human race has not experienced in recent times. Something almost unimaginable in the modern world! But having joined a new hospital and moved to a sleepy old town, COVID gave me a sense of solitude I have not experienced for eons. There are times you wonder at the endless ocean in front of you and communicate with your inner soul.

Who Left The Hospital Against Medical Advice During The Early Covid-19 Pandemic?, Bryan Werner, Se Won Lee

HCA Healthcare Journal of Medicine

Background

Patients leaving against medical advice (AMA) presents a challenge to hospitals as they try to manage costs and improve patient outcomes in an ever-increasing competitive market. Investigating AMA discharges that occurred during the early COVID-19 pandemic presents a unique opportunity to better understand this phenomenon and be better prepared for the future.

Methods

This retrospective analysis of 34 379 patients from a nationwide private healthcare system across 20 states analyzed patients during the early stages of the pandemic who chose to leave against medical advice (AMA) after being admitted with COVID-19 infection and identified several patient characteristics associated with …

Covid-19 Disease Characterization And Outcomes Comparison In Pediatrics, Rachel Rowland, Abigail Schauble, Brendon Cornett

HCA Healthcare Journal of Medicine

Background

It has been reported that children experience less severe COVID-19 symptoms than adults; however, the literature that supports this idea is evolving. The purpose of this study was to retrospectively characterize hospitalized COVID-19-positive pediatric patients with a focus on the assessment of risk factors for poorer outcomes, mortality, and evaluation of interventions utilized and associated clinical outcomes.

Methods

We conducted a multi-center retrospective chart review of patients 18 years old or younger who were COVID-19 positive and admitted to any US HCA Healthcare Pediatric service line between January 1, 2020, and November 30, 2020. We identified 6081 children across …

Ludwig’S Angina And Treatment Considerations In The Covid-19 Pandemic, Kevyn Niu, Hossein Tohidi, Hibah Khan, Paul Kitsis

HCA Healthcare Journal of Medicine

Introduction

Ludwig’s angina is a type of severe cellulitis that spreads rapidly and carries a significant risk of airway compromise. Previous complications with COVID-19 are poorly described within the literature.

Case Presentation

This case report describes the complication of COVID-19 infection with suspected Ludwig’s angina 2 days after admission, resulting in awake fibroscopic endotracheal intubation. Emergent treatment and establishing a secure airway are paramount in these cases. We discuss the role of antibiotics and adjunct treatment in these cases of potential airway compromise.

Conclusion

Limited data demonstrate simultaneous infection of COVID-19 with these types of submandibular soft tissue infections in …

The Impact Of The Covid-19 Pandemic On The Physical And Mental Health Of School-Aged Children, Syed Azlan Abbas, Sufia Athar, Nadeem Zafar Jilani

HCA Healthcare Journal of Medicine

The SARS-CoV-2 (COVID-19) pandemic caused a deleterious impact on global health. School-aged children were significantly impacted by the pandemic. These impacts may be attributed to the fact that this age group is at a vulnerable developmental stage and is susceptible to profound effects. We conducted a thorough literature review using PubMed, Medline, and Science Direct electronic database searches between 2020-2022. We retrieved 757 studies, 25 of which were included in our review. We considered the impact of the COVID-19 pandemic on the physical and mental health of school-aged children (5-18 years), and the results were analyzed and included in our …

Impact Of Inhaled Epoprostenol In Patients On Covid-19 Acute Respiratory Distress Syndrome (Ards), Stacey Nguyen, Stephen Chromi, Mark Decerbo, Surajit Dey, Joseph Mccoy, Jeffrey Murawsky

HCA Healthcare Journal of Medicine

Background

Coronavirus disease 2019 (COVID-19), a novel respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can progress to critical illness and the development of acute respiratory distress syndrome (ARDS). Variability in clinical presentation has led to 2 distinct theoretical classifications of COVID-19 ARDS based on different phenotypical presentations. The first of which follows closely to traditional ARDS presenting as severe hypoxemia with markedly reduced lung compliance, whereas the second presents as severe hypoxemia with preserved to high lung compliance. With uncertainty surrounding the specific pathological and mechanistic nature of COVID-19, we designed this study to elucidate the …

Dental Care During The Covid-19 Pandemic: Patient Perceptions Of Barriers To Dental Care, Covid-19 Safety Precautions, And Administration Of The Covid-19 Vaccine At The Dental Office, Brunilda Lugo, Sheri Denslow, Jill Fromewick, Scott Davis, Katherine Jowers, J. Amadeo Valdez

HCA Healthcare Journal of Medicine

Background

The Mountain Area Health Education Center (MAHEC) Dental Health Center sought to learn how COVID-19 affected dental care attainment and patient perceptions of appropriate safety measures, as well as their acceptance of the dental office as a site for COVID-19 vaccinations.

Methods

A cross-sectional online survey of dental patients was performed to inquire about barriers to care, safety precautions, including COVID-19 testing, and the acceptability of vaccination for COVID-19 in the dental office. All adult patients of the MAHEC Dental Health Center with an email address on file and a clinic visit in the past year were randomized for …