Medical Specialties Commons^™

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, …

Covid-19 Breakthrough Infections In Type 1 Diabetes Mellitus: A Cross-Sectional Study By The Covid-19 Vaccination In Autoimmune Diseases (Covad) Group, Suhrud Panchawagh, Naveen Ravichandran, Bhupen Barman, Arvind Nune, Mahnoor Javaid, Abraham Edgar Gracia-Ramos, Jessica Day, Mrudula Joshi, Masataka Kuwana, Sreoshy Saha

Medical College Documents

To investigate the frequency, profile, and severity of COVID-19 breakthrough infections (BI) in patients with type I diabetes mellitus (T1DM) compared to healthy controls (HC) after vaccination. The second COVID-19 Vaccination in Autoimmune Diseases (COVAD-2) survey is a multinational cross-sectional electronic survey which has collected data on patients suffering from various autoimmune diseases including T1DM. We performed a subgroup analysis on this cohort to investigate COVID-19 BI characteristics in patients with T1DM. Logistic regression with propensity score matching analysis was performed. A total of 9595 individuals were included in the analysis, with 100 patients having T1DM. Among the fully vaccinated …

Frequency Of Dysnatremia In Patients Admitted With Covid-19 Infection And Its Prognostic Implication, Farah Gul Khan, Saadia Sattar, Muhammad M. Yaqoob, Nida Vallani, Maryam Asad

Section of Nephrology

Objective: We aimed to investigate the frequency of dysnatremia among patients admitted with COVID-19 infection and its association with inpatient mortality.
Methods: This retrospective longitudinal study was conducted for 12 weeks. Serum sodium levels were recorded at admission, during the hospital stay, and within 48 hours of discharge or death. Logistic regression was used to determine the predictors of mortality.
Results: This study included 574 patients (69.7% men, age 55.6 ± 14.4 years). On admission, mean sodium was 135.9 ± 6.4 mEq/L; 39% had hyponatremia and 4.7% had hypernatremia. During admission, hypernatremia increased to 18.8%; maximum sodium in patients who …

Building Up A Genomic Surveillance Platform For Sars-Cov-2 In The Middle Of A Pandemic: A True North-South Collaboration, Waqasuddin Khan, Furqan Kabir, Samiah Kanwar, Fatima Aziz, Sahrish Muneer, Adil Kalam, Mehdia Ali, Nadia Ansari, Fyezah Jehan, Muhammad Imran Nisar

Department of Paediatrics and Child Health

Next-generation sequencing technology has revolutionised pathogen surveillance over the last two decades. However, the benefits are not equitably distributed, with developing countries lagging far behind in acquiring the required technology and analytical capacity. Recent declines in the cost associated with sequencing-equipment and running consumables have created an opportunity for broader adoption. During the COVID-19 pandemic, rapid diagnostics development and DNA sequencing revolutionised the ability to diagnose and sequence SARS-CoV-2 rapidly. Socioeconomic inequalities substantially impact the ability to sequence SARS-CoV-2 strains and undermine a developing country's pandemic preparedness. Low- and middle-income countries face additional challenges in establishing, maintaining and expanding genomic …

Clinical Characteristics And Risk Factors For Mortality During The 'First Wave' Of Covid-19 In Reynosa, Tamaulipas, Luis G. Vargas Garcia, Francisco E. Díaz Cisneros, Antonio Gutiérrez Sierra, Juan Rosales Martínez, Manlio F. Lara Duck, Netzahualcoyotl Mayek Pérez

Research Symposium

Background: The COVID-19 pandemic has impacted public health in Mexico. As of February 2020, there have been at least four "waves" of contagion that resulted in 5.82 million positive cases and more than 325 thousand deaths. At the beginning of the COVID-19 pandemic, hospital and population-based information was available, frequently with non-specific symptoms. Little was known about the risk factors for mortality in specific conditions. We described the clinical characteristics of patients with COVID-19 in Reynosa, Tamaulipas during 2020 and identified the risk factors for mortality.

Methods: The COVID-19 cases registered from March to November 2020 in Reynosa were divided …

The Impact Of The Covid-19 Pandemic On Respiratory Syncytial Virus, Amrit Kahlon, Ravina Ramnani, Kartik Rajpal, Yusra Irshad, Sudeep Chapagain, Arushee Bhatnagar, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Timing Of Invasive Mechanical Ventilation And Death In Critically Ill Adults With Covid-19: A Multicenter Cohort Study., Adam Green, Jean-Sebastien Rachoin, Christa Schorr, Phil Dellinger, Jonathan D Casey, Isabel Park, Shruti Gupta, Rebecca M Baron, Shahzad Shaefi, Krystal Hunter, David E Leaf

Cooper Medical School of Rowan University Faculty Scholarship

PURPOSE: To investigate if the timing of initiation of invasive mechanical ventilation (IMV) for critically ill patients with COVID-19 is associated with mortality.

MATERIALS AND METHODS: The data for this study were derived from a multicenter cohort study of critically ill adults with COVID-19 admitted to ICUs at 68 hospitals across the US from March 1 to July 1, 2020. We examined the association between early (ICU days 1-2) versus late (ICU days 3-7) initiation of IMV and time-to-death. Patients were followed until the first of hospital discharge, death, or 90 days. We adjusted for confounding using a multivariable Cox …

Implementation Of A Virtual Interprofessional Icu Learning Collaborative: Successes, Challenges, And Initial Reactions From The Structured Team- Based Optimal Patient-Centered Care For Virus Covid-19 Collaborators, Simon Zec, Nika Zorko Garbajs, Yue Dong, Ognjen Gajic, Christina Kordik, Lori Harmon, Marija Bogojevic, Romil Singh, Yuqiang Sun, Vikas Bansal, Linh Vu, Kelly Cawcutt, John M. Litell, Sarah Redmond, Elly Fitzpatrick, Kirstin J. Kooda, Michelle Biehl, Neha S. Dangayach, Viren Kaul, June M. Chae, Aaron Leppin, Mathew Siuba, Rahul Kashyap, Allan J. Walkey, Alexander S. Niven

Jefferson Hospital Staff Papers and Presentations

IMPORTANCE: Initial Society of Critical Care Medicine Discovery Viral Infection and Respiratory illness Universal Study (VIRUS) Registry analysis suggested that improvements in critical care processes offered the greatest modifiable opportunity to improve critically ill COVID-19 patient outcomes. OBJECTIVES: The Structured Team-based Optimal Patient-Centered Care for Virus COVID-19 ICU Collaborative was created to identify and speed implementation of best evidence based COVID-19 practices. DESIGN, SETTING, AND PARTICIPANTS: This 6-month project included volunteer interprofessional teams from VIRUS Registry sites, who received online training on the Checklist for Early Recognition and Treatment of Acute Illness and iNjury approach, a structured and systematic method …

Case Report And Brief Review: Co-Infection Covid-19 Virus And Influenza A Virus, James Espinosa, Umar Sannoh, Alan Lucerna

Rowan-Virtua Research Day

We report the case of a 45 year old male who presented to the an emergency department with a complaint of myalgias, chills and sore throat of a two day duration. The patient tested positive for COVID-19 virus as well as Influenza A virus. The purpose of this brief review is to discuss what is known about co-infection of COVID-19 and influenza A.

The Impact Of Covid-19 On Post-Recovery Memory, Chelsea Mcnamara, Alison Mancuso

Rowan-Virtua Research Day

The SARS-CoV-2 virus, responsible for the covid-19 pandemic, has had profound effects on countries worldwide. As the pandemic progressed, clinical and patient data continued to mount. A subset of symptoms named “Long Covid Syndrome” persisted in patients after recovering from infection. One commonly reported but understudied symptom was a deficit in memory function. Although commonly reported, prevalence of ‘brain fog’ has yet to be characterized using patient data. Using Rowan Medicine electronic patient data, we were able to collect information on patients before and after the emergence of the coronavirus. Data was collected on reported memory-related symptoms as well as …

Development Of Schizophrenia In A Genetically Predisposed Individual Following Covid-19, Sung Kang, Jonathan Yuh, Timothy Wong

Rowan-Virtua Research Day

We present a patient who is a 56-year-old female with a psychiatric history of anxiety disorder and a medical history of hypercholesterolemia and hyperthyroidism, who was admitted to the hospital after a witnessed seizure at an inpatient psychiatric facility. This patient’s family history is significant for her mother experiencing unspecified psychotic disorder that required psychiatric hospitalization. Our patient was first admitted to the psychiatric hospital after exhibiting worsening paranoid delusions and hallucinations that began several months prior. The patient had reportedly begun locking herself in the restroom and screaming “get out, they’re spying on me”, referring to her next-door neighbors …

Whole Body Cryotherapy As A Novel Treatment For Long Covid Syndrome Associated Brain Fog, James Mack, Brandon Goodwin, Paras Patel, Kyra Herman, Daniel Casal, Emily Levenson

Rowan-Virtua Research Day

SARS-CoV-2, which causes coronavirus disease 2019 (COVID-19), was first discovered in December 2019 in Wuhan, China when adults began presenting with severe pneumonia of an unknown cause. SARS-CoV-2 can cause a wide range of clinical manifestations. SARS-CoV-2 can penetrate the olfactory mucosa and may enter the brain through the cribriform plate along the olfactory tract, through vagal or trigeminal pathways, or pass through the blood-brain barrier. Once inside the brain, levels of inflammatory cytokines are increased and can lead to altered learning, memory, neuroplasticity, hallucinations, nightmares, cognitive and attention deficits, new-onset anxiety and depression, and psychosis. A theoretical treatment for …

Factors That Influence The Decision To Get Vaccinated Against Covid-19, Rhea Bhargava, Meghan H. Foos, Brandy M. Gotti, Alexandra L. Mulvenna, Taylor O. Smith, Danielle Cooley, Venkateswar Venkataman

Rowan-Virtua Research Day

Since the start of the COVID-19 pandemic and the launch of the vaccine, healthcare workers have been encouraging people to get vaccinated to prevent the spread of the virus. However, there is a significant number of people who are vaccine hesitant, or uncertain about receiving the COVID-19 vaccine and its booster. Vaccine hesitancy represents a state of opportunity to make positive change; therefore, it is crucial for healthcare workers to identify those who are in this population. When factors contributing to the vaccine hesitancy, including gender, age, ethnicity, education level, and income were studied, it was found that women, those …

Covid-19 Masking An Atypical Presentation Of Hairy Cell Leukemia, Kahmalia-Kalee Sada

North Texas GME Research Forum 2023

Hairy cell leukemia is a rare lymphoid neoplasm of small mature B cell lymphoid cells. Hairy cell leukemia only accounts for about 1 to 2 percent of adult leukemia cases. Early diagnosis of Hairy cell Leukemia is important, it is proven that without treatment the median survival of this cancer is four years. After numerous studies the age-adjusted risk of death with proper diagnosis and treatment has decreased by 85%. The greatest outcomes are seen in individuals who are younger with earlier diagnosis. Hairy Cell Leukemia is a rare leukemia seen with the classic triad of splenomegaly, pancytopenia, and “hairy” …

An Interesting Occurrence Of Bell’S Palsy With Atypical Presentation After Contracting Covid-19 Infection, Yen-Chung Wang, Yen-Hsiang Wang, Christian Sanchez

North Texas GME Research Forum 2023

Introduction: COVID-19 has been identified as primarily a respiratory illness, however, with its clinical manifestation of involvement with multiple organs, it is now considered a systemic illness. In particular, it also can elicit a broad spectrum of neurological symptoms. One of the proposed manifestations is Bell’s Palsy, an acute idiopathic facial nerve palsy that affects the lower motor neuron. Here we have a patient with recent COVID infection who presents with a unilateral facial droop along with unilateral weakness/tingling of extremities and was diagnosed with Bell’s Palsy.

Case Description: Patient is a 47-year-old male with a past medical history of …

Opportunistic Retrospective Assessment Of Huac, Bone Density, Sft And Breast Density On Ct Images And Relationship With Severity Of Covid-19, Mahmut Subasi, Mustafa Duger, Cengiz Erol, Irmak Durur-Subasi

Journal of Mind and Medical Sciences

Aim. To evaluate mean Hounsfield unit calculation (HUAC), bone density, subcutaneous fat thickness (SFT), breast density (constitutional imaging biomarkers) and age in symptomatic patients with COVID-19, to assess their correlation with pneumonia severity. Materials and Methods. Between 11 March and 30 May 2020, 272 consecutive symptomatic female patients with COVID-19 who underwent chest CT imaging at baseline were reviewed. HUAC, bone density, SFT and breast density were evaluated retrospectively and statistically compared in cases with negative/positive PCR test results, with/without pneumonia and with mild/moderate-severe pneumonia. Univariate/multivariate logistic regression analyses were applied for estimation of moderate/severe pneumonia. Results. The parameters of …

Exploring The Possible Phenomenon Of Viral Interference Between The Novel Coronavirus And Common Respiratory Viruses, Spencer Deleveaux, Alexandria Clarke-Kregor, Xavier Fonseca-Fuentes, Essam Mekhaiel

Journal of Patient-Centered Research and Reviews

At the peak of the 2021 wave of the SARS-CoV-2 alpha variant in North America, there was concern for a superimposed wave of viral respiratory infections. There was, however, an apparent shift in the usual epidemiology of these pathogens, especially during the traditional influenza season from approximately October 2020 to March 2021. This article seeks to briefly describe the epidemiology of notable respiratory pathogens during the first wave of the COVID-19 pandemic and to focus on one possible factor for the trends observed. There are many contributory elements to the observed viral trends, but in particular, we present a synopsis …

Utilizing The System Engineering Trade Study Analysis Method To Analyze Patient Aeromedical Evacuation, Sara Shaghaghi, Jeremy M. Slagley, Michael E. Miller, Gaiven Varshney

Faculty Publications

The US Air Force has gone through many aeromedical patient isolation transport system designs. The first designs were developed in response to the Ebola outbreak in 2014 and, more recently, the COVID-19 pandemic. The trade study analysis part of the system engineering design method was used to analyze the historic and current aeromedical patient contamination control transport systems. A trade study is a process that evaluates alternatives based upon various “-ilities”, such as reconfigurability, flexibility, durability, cost, and more, and performs a systematic analysis to aid designers in producing a ‘good’ design alternative given the large set of possible solutions. …

Tocilizumab For Severe Covid-19 Infection And Multisystem Inflammatory Syndrome In Adults And Children, Amber N. Edinoff, Edward Sanders Alpaugh, Olivia Newgaard, Irza Wajid, Rachel J. Klapper, Elyse M. Cornett, Adam M. Kaye, Praneet Iyer, Alan D. Kaye

School of Medicine Faculty Publications

Coronavirus disease 2019 (COVID-19) rapidly emerged as a global pandemic, placing imminent stress and burden on healthcare resources and workers worldwide. Many patients who present with a severe COVID-19 infection are at high risk of developing severe acute respiratory distress syndrome (ARDS), leading to a vast number of patients requiring mechanical ventilation and a high mortality rate. Similar to Middle East respiratory syndrome, COVID-19 demonstrates an initial viral replication phase that manifests as a variety of symptoms typically flu-like in nature, followed by a profound inflammatory response leading to rapid production of cytokines and uncontrolled inflammation. There have also been …

Adapting International Clinical Trials During Covid-19 And Beyond, Kamala Thriemer, Kamala Thriemer, Mohammad Shafiul Alam, Bipin Adhikari, Rupam Tripura, Mohammad Sharif Hossain, Michael Christian, Najia Bano Ghanchi, Hellen Mnjala, Muhammad Asim

Department of Pathology and Laboratory Medicine

Background: The COVID-19 pandemic and resulting restrictions, particularly travel restrictions, have had significant impact on the conduct of global clinical trials. Our clinical trials programme, which relied on in-person visits for training, monitoring and capacity building across nine low- and middle-income countries, had to adapt to those unprecedented operational challenges. We report the adaptation of our working model with a focus on the operational areas of training, monitoring and cross-site collaboration.
The new working model: Adaptations include changing training strategies from in-person site visits with three or four team members to a multi-pronged virtual approach, with generic online training for …

Endogenous Mirna-Based Innate-Immunity Against Sars-Cov-2 Invasion Of The Brain, Walter J. Lukiw, Aileen I. Pogue

School of Medicine Faculty Publications

The severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2), the causative agent of COVID-19, possesses an unusually large positive-sense, single-stranded viral RNA (ssvRNA) genome of about ~29,903 nucleotides (nt). In many respects, this ssvRNA resembles a very large, polycistronic messenger RNA (mRNA) possessing a 5′-methyl cap (m7GpppN), a 3′- and 5′-untranslated region (3′-UTR, 5′-UTR), and a poly-adenylated (poly-A+) tail. As such, the SARS-CoV-2 ssvRNA is susceptible to targeting by small non-coding RNA (sncRNA) and/or microRNA (miRNA), as well as neutralization and/or inhibition of its infectivity via the human body’s natural complement of about ~2650 miRNA species. Depending on host cell and tissue …

Implementation Of Mrsa Nasal Swabs As An Antimicrobial Stewardship Intervention To Decrease Anti-Mrsa Therapy In Covid-19 Infection, Alaina Dekerlegand, Emily Johnston, Britney Mellor, Melanie Rae Schrack, Catherine O’Neal

School of Medicine Faculty Publications

In the early stages of treating patients with SARS-CoV-2, limited information was available to guide antimicrobial stewardship interventions. The COVID-19 Task Force and Antimicrobial Stewardship Committee, at a 988-bed academic medical center, implemented the use of methicillin-resistant Staphylococcus aureus (MRSA) nasal swab polymerase chain reaction (PCR) testing to assist with the de-escalation of anti-MRSA therapy in patients with suspected superimposed bacterial pneumonia in COVID-19. A retrospective study was conducted to evaluate the impact of MRSA nasal swab PCR testing on the rate of anti-MRSA therapy between 13 April 2020 and 26 July 2020. A total of 122 patients were included …

Clinical Characteristics Of Covid-19 Waves In The Southeastern United States: A Retrospective Study, Omar Kandah, Robert Sherertz, Richard Duff, Erica Junqueira

South Atlantic Division GME Research Day 2023

No abstract provided.

Empagliflozin Induced Fanconi Syndrome In A Patient With Covid-19, Nicole Fernandez, Gilad Guez, Edgar Escasinas

Capital Division GME Research Day 2023

No abstract provided.

Clinical Presentation Of Immune-Mediated Post Sars-Cov-2 Encephalitis And Vasculitis, Trevi Mancilla, J Lee, W Hills, P Stanford

Continental, MidAmerica, & Mountain Divisions GME Research Day 2023

No abstract provided.

Factors Contributing To Ventilator Dependent Days In Covid-19, Isaac Ginsberg, Samantha Eteve, Bryan Lunt, Kenneth Krell

Continental, MidAmerica, & Mountain Divisions GME Research Day 2023

No abstract provided.

Anti-Nmda Encephalitis In A Patient With Active Covid-19 Infection, Ali Abu-Alya, Janita Sidhu, Hamza Hansoti, Tyler Voss-Hamrick, Venkatachalam Veerappan, Ruhin Sidhu

Far West Division GME Research Day 2023

No abstract provided.

Case Based Review On Headaches And Cerebral Venous Thromboembolism Post Covid-19 Infection, Aishwarya Raich, Tanvir Khosla, Vishnu Halthore, Ali Abu-Alya, Venkatachalam Veerappan

Far West Division GME Research Day 2023

No abstract provided.

A Retrospective Mortality Study Of Montelukast In Patients Hospitalized With Covid-19 Pneumonia, George Matus, Mina Bhatnagar, Mitalie Gupta, Blane Alost, Raafia Sajjad, Karen Luo, Kim Vickery, Asha Kurian

Central & West Texas GME Research Day 2023

No abstract provided.

Outcomes Of Patients With Copd During The Covid Pandemic, Jacob Hentges, Julia Fashner

East Florida Division GME Research Day 2023

A scoping review of COVID-19's impact on healthcare delivery and health outcomes found disruptions in care delivery and a shift towards telemedicine(1). Another study found no significant change in the length of stay for patients admitted to the hospital for COPD exacerbation during the pandemic period compared to the pre-pandemic period(2).

We conducted a secondary analysis of HCA Florida St. Lucie Hospital data to compare the outcomes of patients with COPD before (Jan 2018 – Feb 2020) and during the COVID-19 pandemic (March 2020 – Dec 2021). The data included patients aged over 18 years who were diagnosed with COPD …