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Madaras L, Anvari R, Schuchardt-Peet C, Hoskote A, Kashyap R. Co-Infection with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) and Human Coronavirus HKU1 (HCoV-HKU1). Eur J Case Rep Intern Med 2025; 12:005068. [PMID: 39926579 PMCID: PMC11801512 DOI: 10.12890/2025_005068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2024] [Accepted: 12/30/2024] [Indexed: 02/11/2025] Open
Abstract
Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and human coronavirus HKU1 (HCoV-HKU1) are two forms of human coronaviruses known to cause respiratory tract symptoms. A co-infection with both viruses is rare, particularly in the United States. Case description An 85-year-old male presented to the Emergency Department with recurrent falls, diarrhoea and cough, and whose viral panel was positive for both SARS-COV-2 and HCoV-HKU1. The patient developed bacterial pneumonia and was treated with antibacterial agents and glucocorticoids. His past medical history of atrial fibrillation required careful monitoring and subsequent discontinuation of remdesivir, a medication known to cause adverse cardiovascular effects in COVID-19 patients. The length of stay was also prolonged due to delirium and deconditioning. Ultimately, the patient required an urgent ablation followed by the placement of a permanent pacemaker, and anticoagulation therapy was initiated before discharge. The patient had a favourable outcome given the rarity of this case. Discussion COVID-19 patients co-infected with other human coronaviruses should be monitored for disease progression and superimposed bacterial infections. Providers should be cautious with the use of remdesivir in cases of co-infection and in severely ill COVID-19 patients who have a history of atrial fibrillation. LEARNING POINTS This is a rare clinical case of a patient co-infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and human coronavirus HKU1 (HCoV-HKU1), two forms of coronaviruses; the report presents an epidemiological anomaly and a treatment framework.The importance of close monitoring of bacterial infections in coronavirus co-infections is reinforced.The cautious use of remdesivir in patients with a history of atrial fibrillation in severe or unique COVID-19 disease is recommended.
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Affiliation(s)
- Laszlo Madaras
- Hospital Medicine, WellSpan Health Summit Health, Chambersburg, USA
| | - Radean Anvari
- College of Medicine, Drexel University, Philadelphia, USA
| | | | | | - Rahul Kashyap
- College of Medicine, Drexel University, Philadelphia, USA
- Internal Medicine, WellSpan York Hospital, York, USA
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Kashyap R, Yenokyan G, Joyner R, Gerstenhaber M, Alderfer M, Siegrist E, Moore J, Paller CJ, Aboumatar H, Potter JJ, Watkins S, Niederhuber JE, Ford DE, Dobs A. Clinical Research Network: JHCRN Infrastructure and Lessons Learned. Clin Transl Sci 2025; 18:e70123. [PMID: 39844357 PMCID: PMC11754071 DOI: 10.1111/cts.70123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Revised: 12/10/2024] [Accepted: 12/12/2024] [Indexed: 01/24/2025] Open
Abstract
Clinical research studies are becoming increasingly complex resulting in compounded work burden and longer study cycle times, each fueling runaway costs. The impact of protocol complexity often results in inadequate recruitment and insufficient sample sizes, which challenges validity and generalizability. Understanding the need to provide an alternative model to engage researchers and sponsors and bringing clinical research opportunities to the broader community, clinical research networks (CRN) have been proposed and initiated in the United States and other parts of the world. We report on the Johns Hopkins Clinical Research Network (JHCRN), established in 2009 as a multi-disease research collaboration between the academic medical centers and community hospitals/health systems. We have discussed vision, governance, infrastructure, participating hospitals' characteristics, and lessons learned in creating this partnership. Designed to leverage organized patient communities, community-based investigators, and academic researchers, the JHCRN provides expedited research across nine health systems in the mid-Atlantic region. With one IRB of record, a centralized contracting office, and a pool of dedicated network coordinators, it facilitates research partnerships to expand research collaborations among the differing sizes and types of hospitals/health systems in a region. As of August 2024, total 81 studies-clinical trials, cohort studies, and comparative effectiveness research have been conducted, with funding from the NIH, private foundations, and industry. The JHCRN experience has enhanced understanding of the complexity of participating sites and associated ambulatory practices. In conclusion, the CRN, as an academic-community partnership, provides an infrastructure for multiple disease studies, shared risk, and increased investigator and volunteer engagement.
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Affiliation(s)
- Rahul Kashyap
- Johns Hopkins Clinical Research NetworkBaltimoreMarylandUSA
- WellSpan HealthYorkPennsylvaniaUSA
| | - Gayane Yenokyan
- Johns Hopkins Clinical Research NetworkBaltimoreMarylandUSA
- Johns Hopkins UniversityBaltimoreMarylandUSA
| | - Robert Joyner
- Johns Hopkins Clinical Research NetworkBaltimoreMarylandUSA
- TidalHealth Richard A. Henson Research InstituteSalisburyMarylandUSA
| | - Melissa Gerstenhaber
- Johns Hopkins Clinical Research NetworkBaltimoreMarylandUSA
- Johns Hopkins UniversityBaltimoreMarylandUSA
| | - Mary Alderfer
- Johns Hopkins Clinical Research NetworkBaltimoreMarylandUSA
- Tower HealthReadingPennsylvaniaUSA
| | - Erika Siegrist
- Johns Hopkins Clinical Research NetworkBaltimoreMarylandUSA
- Luminis Health Research InstituteAnnapolisMarylandUSA
| | - Joan Moore
- Johns Hopkins Clinical Research NetworkBaltimoreMarylandUSA
- WellSpan HealthYorkPennsylvaniaUSA
| | - Channing J. Paller
- Johns Hopkins Clinical Research NetworkBaltimoreMarylandUSA
- Johns Hopkins UniversityBaltimoreMarylandUSA
| | - Hanan Aboumatar
- Johns Hopkins Clinical Research NetworkBaltimoreMarylandUSA
- Johns Hopkins UniversityBaltimoreMarylandUSA
| | - James J. Potter
- Johns Hopkins Clinical Research NetworkBaltimoreMarylandUSA
- Johns Hopkins UniversityBaltimoreMarylandUSA
| | - Stanley Watkins
- Johns Hopkins Clinical Research NetworkBaltimoreMarylandUSA
- Luminis Health Research InstituteAnnapolisMarylandUSA
| | - John E. Niederhuber
- Johns Hopkins Clinical Research NetworkBaltimoreMarylandUSA
- Johns Hopkins UniversityBaltimoreMarylandUSA
| | - Daniel E. Ford
- Johns Hopkins Clinical Research NetworkBaltimoreMarylandUSA
- Johns Hopkins UniversityBaltimoreMarylandUSA
| | - Adrian Dobs
- Johns Hopkins Clinical Research NetworkBaltimoreMarylandUSA
- Johns Hopkins UniversityBaltimoreMarylandUSA
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Wilson R, Ko C, Kashyap R. COVID-19 in the Setting of HIV and Severe Hemophilia A: A Case Report. HCA HEALTHCARE JOURNAL OF MEDICINE 2024; 5:145-150. [PMID: 38984227 PMCID: PMC11229595 DOI: 10.36518/2689-0216.1615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
Introduction A hyperactive immune response is the driving force behind severe Coronavirus disease 2019 (COVID-19). Complications of severe COVID-19 include acute respiratory distress syndrome, acute respiratory failure, and increased risk of venous thromboembolism (VTE). The management of patients with COVID-19 includes respiratory support, decreasing immune response to the virus to prevent the progression of disease, and anticoagulation to prevent VTE. Case Presentation We present the case of a patient with a history of human immunodeficiency virus (HIV) and hemophilia A admitted with COVID-19. This case demonstrates the difficulties present when managing COVID-19 in patients with specific comorbidities. Anticoagulation is a recommended component of COVID-19 treatment but is contraindicated in patients with severe hemophilia due to increased risk for bleeding. Research has also shown that dexamethasone decreases mortality in patients with COVID-19, but doctors should use dexamethasone cautiously in patients with HIV since it is an immunosuppressant. Taking certain antiretroviral therapies, such as rilpivirine, also contraindicates the use of dexamethasone. Conclusion In this case, it is important to monitor for the risk and presence of superimposed bacterial or opportunistic infections. Treating a patient with these comorbidities who is infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) highlights the importance of balancing the risks and benefits.
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Affiliation(s)
- Ryan Wilson
- TriStar Southern Hills Medical Center, Nashville, TN
| | - Chae Ko
- TriStar Southern Hills Medical Center, Nashville, TN
| | - Rahul Kashyap
- TriStar Southern Hills Medical Center, Nashville, TN
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Padte S, Samala Venkata V, Mehta P, Tawfeeq S, Kashyap R, Surani S. 21st century critical care medicine: An overview. World J Crit Care Med 2024; 13:90176. [PMID: 38633477 PMCID: PMC11019625 DOI: 10.5492/wjccm.v13.i1.90176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 12/28/2023] [Accepted: 01/24/2024] [Indexed: 03/05/2024] Open
Abstract
Critical care medicine in the 21st century has witnessed remarkable advancements that have significantly improved patient outcomes in intensive care units (ICUs). This abstract provides a concise summary of the latest developments in critical care, highlighting key areas of innovation. Recent advancements in critical care include Precision Medicine: Tailoring treatments based on individual patient characteristics, genomics, and biomarkers to enhance the effectiveness of therapies. The objective is to describe the recent advancements in Critical Care Medicine. Telemedicine: The integration of telehealth technologies for remote patient monitoring and consultation, facilitating timely interventions. Artificial intelligence (AI): AI-driven tools for early disease detection, predictive analytics, and treatment optimization, enhancing clinical decision-making. Organ Support: Advanced life support systems, such as Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy provide better organ support. Infection Control: Innovative infection control measures to combat emerging pathogens and reduce healthcare-associated infections. Ventilation Strategies: Precision ventilation modes and lung-protective strategies to minimize ventilator-induced lung injury. Sepsis Management: Early recognition and aggressive management of sepsis with tailored interventions. Patient-Centered Care: A shift towards patient-centered care focusing on psychological and emotional well-being in addition to medical needs. We conducted a thorough literature search on PubMed, EMBASE, and Scopus using our tailored strategy, incorporating keywords such as critical care, telemedicine, and sepsis management. A total of 125 articles meeting our criteria were included for qualitative synthesis. To ensure reliability, we focused only on articles published in the English language within the last two decades, excluding animal studies, in vitro/molecular studies, and non-original data like editorials, letters, protocols, and conference abstracts. These advancements reflect a dynamic landscape in critical care medicine, where technology, research, and patient-centered approaches converge to improve the quality of care and save lives in ICUs. The future of critical care promises even more innovative solutions to meet the evolving challenges of modern medicine.
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Affiliation(s)
- Smitesh Padte
- Department of Research, Global Remote Research Scholars Program, St. Paul, MN 55104, United States
| | | | - Priyal Mehta
- Department of Research, Global Remote Research Scholars Program, St. Paul, MN 55104, United States
| | - Sawsan Tawfeeq
- Department of Research, Global Remote Research Scholars Program, St. Paul, MN 55104, United States
| | - Rahul Kashyap
- Department of Research, Global Remote Research Scholars Program, St. Paul, MN 55104, United States
- Department of Research, WellSpan Health, York, PA 17403, United States
- Department of Pulmonary & Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, United States
| | - Salim Surani
- Department of Pulmonary & Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, United States
- Department of Medicine & Pharmacology, Texas A&M University, College Station, TX 77843, United States
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Talaei F, Banga A, Pursell A, Gage A, Pallipamu N, Seri AR, Adhikari R, Kashyap R, Surani S. New-onset atrial fibrillation among COVID-19 patients: A narrative review. World J Crit Care Med 2023; 12:236-247. [PMID: 38188450 PMCID: PMC10768419 DOI: 10.5492/wjccm.v12.i5.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/20/2023] [Accepted: 09/11/2023] [Indexed: 12/07/2023] Open
Abstract
Over the last three years, research has focused on examining cardiac issues arising from coronavirus disease 2019 (COVID-19) infection, including the emergence of new-onset atrial fibrillation (NOAF). Still, no clinical study was conducted on the persistence of this arrhythmia after COVID-19 recovery. Our objective was to compose a narrative review that investigates COVID-19-associated NOAF, emphasizing the evolving pathophysiological mechanisms akin to those suggested for sustaining AF. Given the distinct strategies involved in the persistence of atrial AF and the crucial burden of persistent AF, we aim to underscore the importance of extended follow-up for COVID-19-associated NOAF. A comprehensive search was conducted for articles published between December 2019 and February 11, 2023, focusing on similarities in the pathophysiology of NOAF after COVID-19 and those persisting AF. Also, the latest data on incidence, morbidity-mortality, and management of NOAF in COVID-19 were investigated. Considerable overlaps between the mechanisms of emerging NOAF after COVID-19 infection and persistent AF were observed, mostly involving reactive oxygen pathways. With potential atrial remodeling associated with NOAF in COVID-19 patients, this group of patients might benefit from long-term follow-up and different management. Future cohort studies could help determine long-term outcomes of NOAF after COVID-19.
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Affiliation(s)
- Fahimeh Talaei
- Department of Critical Care Medicine, Mayo Clinic, Phoenix, AZ 85054, United States
| | - Akshat Banga
- Department of Internal Medicine, Sawai Man Singh Medical College, Jaipur 302004, India
| | - Amanda Pursell
- Internal Medicine, Tristar Centennial Medical Center, TriStar Division, HCA Healthcare, Nashville, TN 37203, United States
| | - Ann Gage
- Cardiology, TriStar Centennial Medical Center, TriStar Division, HCA Healthcare, Nashville, TN 37203, United States
| | - Namratha Pallipamu
- Department of Medicine, Siddharta Medical College, Vijayawada 520008, Andhra Pradesh, India
| | - Amith Reddy Seri
- Department of Internal Medicine, Mclaren Regional Medical Center, Flint, MI 48532, United States
| | - Ramesh Adhikari
- Department of Internal Medicine, Franciscan Health, Lafayette, IN 46237, United States
| | - Rahul Kashyap
- Department of Anaesthesiology & Critical Care Medicine, Mayo Clinic, Rochester, MN 55902, United States
- Department of Research, WellSpan Health, York, PA 17401, United States
| | - Salim Surani
- Department of Anaesthesiology & Critical Care Medicine, Mayo Clinic, Rochester, MN 55902, United States
- Department of Medicine & Pharmacology, Texas A&M University, College Station, TX 77843, United States
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ElSaban M, Bhatt G, Lee J, Koshiya H, Mansoor T, Amal T, Kashyap R. A historical delve into neurotrauma-focused critical care. Wien Med Wochenschr 2023; 173:368-373. [PMID: 36729341 PMCID: PMC9892675 DOI: 10.1007/s10354-022-01002-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 12/27/2022] [Indexed: 02/03/2023]
Abstract
Neurocritical care is a multidisciplinary field managing patients with a wide range of aliments. Specifically, neurotrauma is a rapidly growing field with increasing demands. The history of how neurotrauma management came to its current form has not been extensively explored before. Our review delves into the history, timeline, and noteworthy pioneers of neurotrauma-focused neurocritical care. We explore the historical development during early times, the 18th-20th centuries, and modern times, as well as warfare- and sports-related concussions. Research is ever growing in this budding field, with several promising innovations on the horizon.
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Affiliation(s)
- Mariam ElSaban
- Department of Anesthesiology, Mayo Clinic, Rochester, MN USA
| | - Gaurang Bhatt
- All India Institute of Medical Sciences, Rishikesh, India
| | - Joanna Lee
- David Tvildiani Medical University, Tbilisi, Georgia
| | - Hiren Koshiya
- Department of Hematology & Oncology, Mayo Clinic, Jacksonville, USA Florida
| | | | - Tanya Amal
- Maulana Azad Medical College, New Delhi, India
| | - Rahul Kashyap
- Department of Critical Care Medicine, Mayo Clinic, Rochester, MN USA
- Medical director research, WellSpan Health, New York, PA USA
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7
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Tekin A, Qamar S, Sharma M, Singh R, Malinchoc M, Bansal V, Deo N, Bogojevic M, Valencia-Morales DJ, Zec S, Zorko-Garbajs N, Sharma N, Lal A, Sanghavi DK, Cartin-Ceba R, Khan SA, La Nou AT, Cherian A, Zabolotskikh IB, Kumar VK, Kashyap R, Walkey AJ, Domecq JP, Yadav H, Gajic O, Odeyemi YE. Development and Validation of an Acute Respiratory Distress Syndrome Prediction Model in Coronavirus Disease 2019: Updated Lung Injury Prediction Score. Mayo Clin Proc 2023; 98:736-747. [PMID: 37028977 PMCID: PMC9800809 DOI: 10.1016/j.mayocp.2022.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/05/2022] [Accepted: 11/22/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To develop and validate an updated lung injury prediction score for coronavirus disease 2019 (COVID-19) (c-LIPS) tailored for predicting acute respiratory distress syndrome (ARDS) in COVID-19. PATIENTS AND METHODS This was a registry-based cohort study using the Viral Infection and Respiratory Illness Universal Study. Hospitalized adult patients between January 2020 and January 2022 were screened. Patients who qualified for ARDS within the first day of admission were excluded. Development cohort consisted of patients enrolled from participating Mayo Clinic sites. The validation analyses were performed on remaining patients enrolled from more than 120 hospitals in 15 countries. The original lung injury prediction score (LIPS) was calculated and enhanced using reported COVID-19-specific laboratory risk factors, constituting c-LIPS. The main outcome was ARDS development and secondary outcomes included hospital mortality, invasive mechanical ventilation, and progression in WHO ordinal scale. RESULTS The derivation cohort consisted of 3710 patients, of whom 1041 (28.1%) developed ARDS. The c-LIPS discriminated COVID-19 patients who developed ARDS with an area under the curve (AUC) of 0.79 compared with original LIPS (AUC, 0.74; P<.001) with good calibration accuracy (Hosmer-Lemeshow P=.50). Despite different characteristics of the two cohorts, the c-LIPS's performance was comparable in the validation cohort of 5426 patients (15.9% ARDS), with an AUC of 0.74; and its discriminatory performance was significantly higher than the LIPS (AUC, 0.68; P<.001). The c-LIPS's performance in predicting the requirement for invasive mechanical ventilation in derivation and validation cohorts had an AUC of 0.74 and 0.72, respectively. CONCLUSION In this large patient sample c-LIPS was successfully tailored to predict ARDS in COVID-19 patients.
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Affiliation(s)
- Aysun Tekin
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Shahraz Qamar
- Post-baccalaureate Research Education Program, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN, USA
| | - Mayank Sharma
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Romil Singh
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | | | - Vikas Bansal
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Neha Deo
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Marija Bogojevic
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | | | - Simon Zec
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Nika Zorko-Garbajs
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA; Department of Vascular Neurology and Intensive Therapy, University Medical Centre Ljubljana, Slovenia
| | - Nikhil Sharma
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Amos Lal
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Devang K Sanghavi
- Department of Critical Care Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Rodrigo Cartin-Ceba
- Division of Pulmonary, Department of Medicine and Department of Critical Care Medicine, Mayo Clinic, Scottsdale, AZ, USA
| | - Syed A Khan
- Division of Critical Care Medicine, Mayo Clinic Health System, Mankato, MN, USA
| | - Abigail T La Nou
- Division of Critical Care Medicine, Mayo Clinic Health System, Eau Claire, WI, USA
| | - Anusha Cherian
- Department of Anesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Igor B Zabolotskikh
- Department of Anesthesiology, Intensive Care Medicine and Transfusiology, Kuban State Medical University with affiliation Territorial Hospital #2, Krasnodar, Russia
| | | | - Rahul Kashyap
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Allan J Walkey
- Pulmonary Center, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Evans Center of Implementation and Improvement Sciences, Boston University School of Medicine, Boston, MA, USA
| | - Juan P Domecq
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Hemang Yadav
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Ognjen Gajic
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Yewande E Odeyemi
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA; Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.
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Yim HK, Min JH. Response to the coronavirus disease 2019 pandemic of dental hygienists in South Korea-Part II: Fear and anxiety. Int J Dent Hyg 2022; 21:466-474. [PMID: 36524317 DOI: 10.1111/idh.12650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 09/27/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES The purpose of this cross-sectional study was to evaluate the mental fear and anxiety about coronavirus disease 2019 (COVID-19) among Korean clinical dental hygienists and to investigate factors influencing the anxiety felt after the outbreak of COVID-19. METHODS A questionnaire on mental fear (Fear-C) and anxiety for COVID-19 was conducted among 500 clinical dental hygienists in South Korea. Fear-C was identified with eight questions. The General Anxiety Disorder-7 (GAD-7) questionnaire was scored for the pre-COVID-19 situation (GADBefore ) and the current situation going through the pandemic (GADAfter ). The scores for the responses to the questionnaire were 0 points for strong negative and 3 points for strong positive. Higher scores indicate higher levels of fear and anxiety. All data were analysed using IBM SPSS Statistics, and the statistical significance was set at α = 0.05. RESULTS The average Fear-C was 16.11 ± 3.89 out of 24.00. There were significant differences in Fear-C when the type of work organization and symptoms related to COVID-19 (Sx-C) differed. Significant differences were confirmed in GADBefore according to age range, systemic diseases, and Sx-C (p < 0.05). There was no difference in GADAfter for all general characteristics, except Sx-C (p > 0.05). In the regression model of GADAfter , Sx-C (β = 0.526), Fear-C (β = 0.358), and GADBefore (β = 0.515) were positively related to GADAfter (p < 0.001), respectively. CONCLUSIONS Most dental hygienists complained of Fear-C. GADAfter was significantly higher than GADBefore . The factor that had the greatest impact on GADAfter was Sx-C.
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Affiliation(s)
- Hyun-Kyung Yim
- Department of Dental Hygiene, College of Medical and Health Sciences, Cheongju University, Cheongju, South Korea
| | - Ji-Hyun Min
- Department of Dental Hygiene, College of Medical and Health Sciences, Cheongju University, Cheongju, South Korea
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Vekaria PH, Syed A, Anderson J, Cornett B, Bourbia A, Flynn MG, Kashyap R, Shah AR. Association of dementia and patient outcomes among COVID-19 patients: A multi-center retrospective case-control study. Front Med (Lausanne) 2022; 9:1050747. [PMID: 36419792 PMCID: PMC9676493 DOI: 10.3389/fmed.2022.1050747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 10/20/2022] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND We conducted a retrospective cohort study on COVID-19 patients with and without dementia by extracting data from the HCA Healthcare Enterprise Data Warehouse between January-September 2020. AIMS To describe the role of patients' baseline characteristics specifically dementia in determining overall health outcomes in COVID-19 patients. METHODS We grouped in-patients who had ICD-10 codes for dementia (DM) with age and gender-matched (1:2) patients without dementia (ND). Our primary outcome variables were in-hospital mortality, length of stay, Intensive Care Unit (ICU) admission, ICU-free days, mechanical ventilation (MV) use, MV-free days and 90-day re-admission. RESULTS Matching provided similar age and sex in DM and ND groups. BMI (median, 25.8 vs. 27.6) and proportion of patients who had smoked (23.3 vs. 31.3%) were lower in DM than in ND patients. The median (IQR) Elixhauser Comorbidity Index was higher in dementia patients 7 (5-10) vs. 5 (3-7, p < 0.01). Higher mortality was observed in DM group (30.8%) vs. ND group (26.4%, p < 0.01) as an unadjusted univariate analysis. The 90-day readmission was not different (32.1 vs. 31.8%, p = 0.8). In logistic regression analysis, the odds of dying were not different between patients in DM and ND groups (OR = 1.0; 95% CI 0.86-1.17), but the odds of ICU admissions were significantly lower for dementia patients (OR = 0.58, 95% CI 0.51-0.66). CONCLUSIONS Our data showed that COVID-19 patients with dementia did not fare substantially worse, but in fact, fared better when certain metrics were considered.
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Affiliation(s)
- Pratikkumar H. Vekaria
- Prisma Health-Upstate, Greenville, SC, United States
- Redmond Regional Medical Center, Advent Health, Rome, GA, United States
| | - Areej Syed
- Redmond Regional Medical Center, Advent Health, Rome, GA, United States
| | | | | | - Amine Bourbia
- Redmond Regional Medical Center, Advent Health, Rome, GA, United States
| | | | - Rahul Kashyap
- HCA Healthcare, Nashville, TN, United States
- Mayo Clinic, Rochester, MN, United States
| | - Asif R. Shah
- Redmond Regional Medical Center, Advent Health, Rome, GA, United States
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Tekin A, Qamar S, Bansal V, Surani S, Singh R, Sharma M, LeMahieu AM, Hanson AC, Schulte PJ, Bogojevic M, Deo N, Sanghavi DK, Cartin-Ceba R, Jain NK, Christie AB, Sili U, Anderson HL, Denson JL, Khanna AK, Zabolotskikh IB, La Nou AT, Akhter M, Mohan SK, Dodd KW, Retford L, Boman K, Kumar VK, Walkey AJ, Gajic O, Domecq JP, Kashyap R. The Association of Latitude and Altitude with COVID-19 Symptoms: A VIRUS: COVID-19 Registry Analysis. Open Respir Med J 2022. [PMID: 37273949 DOI: 10.2174/18743064-v16-e2207130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Better delineation of COVID-19 presentations in different climatological conditions might assist with prompt diagnosis and isolation of patients.
Objectives:
To study the association of latitude and altitude with COVID-19 symptomatology.
Methods:
This observational cohort study included 12267 adult COVID-19 patients hospitalized between 03/2020 and 01/2021 at 181 hospitals in 24 countries within the SCCM Discovery VIRUS: COVID-19 Registry. The outcome was symptoms at admission, categorized as respiratory, gastrointestinal, neurological, mucocutaneous, cardiovascular, and constitutional. Other symptoms were grouped as atypical. Multivariable regression modeling was performed, adjusting for baseline characteristics. Models were fitted using generalized estimating equations to account for the clustering.
Results:
The median age was 62 years, with 57% males. The median age and percentage of patients with comorbidities increased with higher latitude. Conversely, patients with comorbidities decreased with elevated altitudes. The most common symptoms were respiratory (80%), followed by constitutional (75%). Presentation with respiratory symptoms was not associated with the location. After adjustment, at lower latitudes (<30º), patients presented less commonly with gastrointestinal symptoms (p<.001, odds ratios for 15º, 25º, and 30º: 0.32, 0.81, and 0.98, respectively). Atypical symptoms were present in 21% of the patients and showed an association with altitude (p=.026, odds ratios for 75, 125, 400, and 600 meters above sea level: 0.44, 0.60, 0.84, and 0.77, respectively).
Conclusions:
We observed geographic variability in symptoms of COVID-19 patients. Respiratory symptoms were most common but were not associated with the location. Gastrointestinal symptoms were less frequent in lower latitudes. Atypical symptoms were associated with higher altitude.
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11
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Qamar S, Tekin A, Singh R, Surani S, Adhikari R, Bansal V, Sharma M, Bogojevic M, Deo N, Zec S, Valencia Morales DJ, Taji J, Kumar VK, Boman K, Khan SA, Domecq JP, Kashyap R. How do frontline healthcare workers learn from COVID-19 webinars during a pandemic? An online survey study. Hosp Pract (1995) 2022; 50:326-330. [PMID: 35982643 DOI: 10.1080/21548331.2022.2114741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
OBJECTIVES The COVID-19 pandemic severely restricted in-person learning. As a result, many educational institutions switched to online platforms to continue teaching. COVID-19 webinars have been useful for rapidly disseminating information to frontline healthcare workers. While conducting COVID-19 webinars through online platforms is a popular method to train medical professionals, their effectiveness has never been investigated. Our aim was to ascertain the usefulness of COVID-19 webinars during the pandemic. METHODS We conducted an online survey of about 400 frontline healthcare workers. 112 people responded to the survey (response rate = 28%). In it, we asked several questions to determine whether webinars had been a useful resource to help deal with COVID-19 patients. RESULTS We found that a majority of healthcare worker respondents had favourable opinions of online education during the pandemic as around 78% of respondents either agreed or highly agreed that webinars are a useful source of knowledge. A significant proportion (34%) did not participate in webinars and gave time constraints as their main reason for not participating. CONCLUSION Our results indicated that while online education is a great way to disseminate information quickly to a large amount of people, it also comes with its disadvantages. As we transition into a post-pandemic world, we need to make sure that online teaching is designed with the best interests of the healthcare workers in mind to ensure that we get the most out of it.
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Affiliation(s)
- Shahraz Qamar
- Post-baccalaureate Research Education Program, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Aysun Tekin
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Romil Singh
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Salim Surani
- Department of Medicine, Texas A&M University, Corpus Christi, TX 78404, United States
| | - Ramesh Adhikari
- Department of Hospital Medicine, Franciscan Health, Lafayette, USA
| | - Vikas Bansal
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Mayank Sharma
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Marija Bogojevic
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Neha Deo
- Medical Student, Mayo Clinic Alix School of Medicine, Rochester, MN, USA
| | - Simon Zec
- Department of Critical Care Medicine, Mayo Clinic, Rochester, USA
| | - Diana J Valencia Morales
- Departments of Anesthesiology and Perioperative Medicine, and Health Sciences Research, Rochester, MN, USA
| | - Jamil Taji
- Department of Intensive Care, Mayo Clinic Health System, Mankato, MN
| | | | - Karen Boman
- Society of Critical Care Medicine, Mount Prospect, IL
| | - Syed Anjum Khan
- Department of Intensive Care, Mayo Clinic Health System, Mankato, MN
| | - Juan Pablo Domecq
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN
| | - Rahul Kashyap
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
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12
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Sprenger S, Bare JP, Kashyap R, Cardella L. Acute mania following COVID-19 in a woman with no past psychiatric history case report. BMC Psychiatry 2022; 22:486. [PMID: 35858846 PMCID: PMC9296893 DOI: 10.1186/s12888-022-04110-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 07/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic that began in late 2019 is caused by infection with the severe acute respiratory syndrome coronavirus-2. Since that time, many neuropsychiatric sequelae including psychosis, neurocognitive disorders, and mood disorders have been observed. The mechanism underlying these effects are currently unknown, however several mechanisms have been proposed. CASE PRESENTATION A 47-year-old woman with past medical history including hypertension and premenstrual syndrome but no psychiatric history presented to the psychiatric hospital with new onset mania. She had developed symptoms of COVID-19 and was later diagnosed with COVID pneumonia. During quarantine, she reported high levels of stress, grief, and anxiety. Seventeen days into her illness, she developed altered mental status, sleeplessness, elevated mood, talkativeness, and preoccupations. Her spouse was concerned for her safety and contacted emergency medical services who brought her to the psychiatric hospital. She had not slept for five days prior to her arrival and exhibited flight of ideas, talkativeness, and grandiose ideas. She reported a family history of bipolar disorder but no past manic or depressive episodes. She was diagnosed with acute mania and stabilized using antipsychotics, a mood stabilizer, and a short course of a benzodiazepine. Many of her symptoms improved, including her elevated mood, increased activity level, and flight of ideas though she continued to have decreased need for sleep as her benzodiazepine was tapered. She and her partner were agreeable to transitioning to outpatient care after her mood stabilized. CONCLUSIONS This report emphasizes the link between COVID-19 and neuropsychiatric symptoms. Acute mania has no recognized association with COVID-19, but similar presentations have been reported. The patient's age and time to onset of psychiatric symptoms is consistent with previous reports. Given the growing body of evidence, this association warrants further investigation. Severe acute respiratory syndrome coronavirus-2 causes systemic inflammation and has been shown to be neurotropic. In addition, patients undergoing quarantine experience anxiety related to the disease in addition to social isolation. Psychiatric practitioners should be aware of these effects and advocate for psychiatric evaluation following COVID-19 infection. Understanding the sequelae of infectious disease is crucial for responding to future pandemics.
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Affiliation(s)
- Steven Sprenger
- Department of Psychiatry, Tristar Centennial Medical Center, HCA Healthcare, 2300 Patterson St, 37203, Nashville, TN, USA.
| | - J. Pilar Bare
- grid.414420.70000 0001 0158 6152Department of Psychiatry, Tristar Centennial Medical Center, HCA Healthcare, 2300 Patterson St, 37203 Nashville, TN USA
| | - Rahul Kashyap
- grid.414420.70000 0001 0158 6152Department of Psychiatry, Tristar Centennial Medical Center, HCA Healthcare, 2300 Patterson St, 37203 Nashville, TN USA
| | - Luigi Cardella
- grid.414420.70000 0001 0158 6152Department of Psychiatry, Tristar Centennial Medical Center, HCA Healthcare, 2300 Patterson St, 37203 Nashville, TN USA
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13
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Kone A, Horter L, Rose C, Rao CY, Orquiola D, Thomas I, Byrkit R, Bryant-Genevier J, Lopes-Cardozo B. The impact of traumatic experiences, coping mechanisms, and workplace benefits on the mental health of U.S. public health workers during the COVID-19 pandemic. Ann Epidemiol 2022; 74:66-74. [PMID: 35850418 PMCID: PMC9287576 DOI: 10.1016/j.annepidem.2022.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 06/30/2022] [Accepted: 07/08/2022] [Indexed: 12/01/2022]
Abstract
Purpose To evaluate the association between risk factors, mitigating factors, and adverse mental health outcomes among United States public health workers. Methods Cross-sectional online survey data were collected March to April 2021. The survey was distributed to public health workers who worked in a state, tribal, local, or territorial public health department since March 2020. Results In total, 26,174 United States state and local public health workers completed the survey. Feeling isolated was a risk factor for anxiety (PR, 1.84; 95% CI, 1.74–1.95), depression (PR, 1.84; 95% CI, 1.75–1.94), post-traumatic stress disorder (PR, 1.50; 95% CI, 1.43–1.57), and suicidal ideation (PR, 3.23; 95% CI, 2.82–3.69). The ability to take time off was linked to fewer reported symptoms of anxiety (PR, 0.87; 95% CI, 0.83–0.90), depression (PR, 0.86; 95% CI, 0.83–0.89), post-traumatic stress disorder (PR, 0.84; 95% CI, 0.81–0.88), and suicidal ideation (PR, 0.84; 95% CI, 0.77–0.92). Conclusions Since COVID-19 was declared a pandemic, respondents who felt isolated and alone were at an increased risk for adverse mental health outcomes. Findings from this study call for public health organizations to provide their workforce with services and resources to mitigate adverse mental health outcomes.
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Affiliation(s)
- Ahoua Kone
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Libby Horter
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Charles Rose
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Carol Y Rao
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Diana Orquiola
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Isabel Thomas
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ramona Byrkit
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Barbara Lopes-Cardozo
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
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14
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Singh R, Rathore SS, Khan H, Karale S, Chawla Y, Iqbal K, Bhurwal A, Tekin A, Jain N, Mehra I, Anand S, Reddy S, Sharma N, Sidhu GS, Panagopoulos A, Pattan V, Kashyap R, Bansal V. Association of Obesity With COVID-19 Severity and Mortality: An Updated Systemic Review, Meta-Analysis, and Meta-Regression. Front Endocrinol (Lausanne) 2022; 13:780872. [PMID: 35721716 PMCID: PMC9205425 DOI: 10.3389/fendo.2022.780872] [Citation(s) in RCA: 89] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 01/10/2022] [Indexed: 12/11/2022] Open
Abstract
Background Obesity affects the course of critical illnesses. We aimed to estimate the association of obesity with the severity and mortality in coronavirus disease 2019 (COVID-19) patients. Data Sources A systematic search was conducted from the inception of the COVID-19 pandemic through to 13 October 2021, on databases including Medline (PubMed), Embase, Science Web, and Cochrane Central Controlled Trials Registry. Preprint servers such as BioRxiv, MedRxiv, ChemRxiv, and SSRN were also scanned. Study Selection and Data Extraction Full-length articles focusing on the association of obesity and outcome in COVID-19 patients were included. Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were used for study selection and data extraction. Our Population of interest were COVID-19 positive patients, obesity is our Intervention/Exposure point, Comparators are Non-obese vs obese patients The chief outcome of the study was the severity of the confirmed COVID-19 positive hospitalized patients in terms of admission to the intensive care unit (ICU) or the requirement of invasive mechanical ventilation/intubation with obesity. All-cause mortality in COVID-19 positive hospitalized patients with obesity was the secondary outcome of the study. Results In total, 3,140,413 patients from 167 studies were included in the study. Obesity was associated with an increased risk of severe disease (RR=1.52, 95% CI 1.41-1.63, p<0.001, I2 = 97%). Similarly, high mortality was observed in obese patients (RR=1.09, 95% CI 1.02-1.16, p=0.006, I2 = 97%). In multivariate meta-regression on severity, the covariate of the female gender, pulmonary disease, diabetes, older age, cardiovascular diseases, and hypertension was found to be significant and explained R2 = 40% of the between-study heterogeneity for severity. The aforementioned covariates were found to be significant for mortality as well, and these covariates collectively explained R2 = 50% of the between-study variability for mortality. Conclusions Our findings suggest that obesity is significantly associated with increased severity and higher mortality among COVID-19 patients. Therefore, the inclusion of obesity or its surrogate body mass index in prognostic scores and improvement of guidelines for patient care management is recommended.
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Affiliation(s)
- Romil Singh
- Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA, United States
| | - Sawai Singh Rathore
- Department of Internal Medicine, Dr. Sampurnanand Medical College, Jodhpur, India
| | - Hira Khan
- Department of Neurology, Allegheny General Hospital, Pittsburgh, PA, United States
| | - Smruti Karale
- Department of Internal Medicine, Government Medical College-Kolhapur, Kolhapur, India
| | - Yogesh Chawla
- Department of Immunology, Mayo Clinic, Rochester, MN, United States
| | - Kinza Iqbal
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Abhishek Bhurwal
- Department of Gastroenterology and Hepatology, Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ, United States
| | - Aysun Tekin
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Rochester, MN, United States
| | - Nirpeksh Jain
- Department of Emergency Medicine, Marshfield Clinic, Marshfield, WI, United States
| | - Ishita Mehra
- Department of Internal Medicine, North Alabama Medical Center, Florence, AL, United States
| | - Sohini Anand
- Department of Internal Medicine, Patliputra Medical College and Hospital, Dhanbad, India
| | - Sanjana Reddy
- Department of Internal Medicine, Gandhi Medical College, Secunderabad, India
| | - Nikhil Sharma
- Department of Nephrology, Mayo Clinic, Rochester, MI, United States
| | - Guneet Singh Sidhu
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MI, United States
| | | | - Vishwanath Pattan
- Department of Medicine, Division of Endocrinology and Metabolism, State University of New York (SUNY) Upstate Medical University, Syracuse, NY, United States
| | - Rahul Kashyap
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Rochester, MN, United States
| | - Vikas Bansal
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MI, United States
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15
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Nawaz FA, Deo N, Surani S, Maynard W, Gibbs ML, Kashyap R. Critical care practices in the world: Results of the global intensive care unit need assessment survey 2020. World J Crit Care Med 2022; 11:169-177. [PMID: 36331973 PMCID: PMC9136725 DOI: 10.5492/wjccm.v11.i3.169] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 12/11/2021] [Accepted: 03/06/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND There is variability in intensive care unit (ICU) resources and staffing worldwide. This may reflect variation in practice and outcomes across all health systems. AIM To improve research and quality improvement measures administrative leaders can create long-term strategies by understanding the nature of ICU practices on a global scale. METHODS The Global ICU Needs Assessment Research Group was formed on the basis of diversified skill sets. We aimed to survey sites regarding ICU type, availability of staffing, and adherence to critical care protocols. An international survey 'Global ICU Needs Assessment' was created using Google Forms, and this was distributed from February 17th, 2020 till September 23rd, 2020. The survey was shared with ICU providers in 34 countries. Various approaches to motivating healthcare providers were implemented in securing submissions, including use of emails, phone calls, social media applications, and WhatsApp™. By completing this survey, providers gave their consent for research purposes. This study was deemed eligible for category-2 Institutional Review Board exempt status. RESULTS There were a total 121 adult/adult-pediatrics ICU responses from 34 countries in 76 cities. A majority of the ICUs were mixed medical-surgical [92 (76%)]. 108 (89%) were adult-only ICUs. Total 36 respondents (29.8%) were 31-40 years of age, with 79 (65%) male and 41 (35%) female participants. 89 were consultants (74%). A total of 71 (59%) respondents reported having a 24-h in-house intensivist. A total of 87 (72%) ICUs were reported to have either a 2:1 or ≥ 2:1 patient/nurse ratio. About 44% of the ICUs were open and 76% were mixed type (medical-surgical). Protocols followed regularly by the ICUs included sepsis care (82%), ventilator-associated pneumonia (79%); nutrition (76%), deep vein thrombosis prophylaxis (84%), stress ulcer prophylaxis (84%), and glycemic control (89%). CONCLUSION Based on the findings of this international, multi-dimensional, needs-assessment survey, there is a need for increased recruitment and staffing in critical care facilities, along with improved patient-to-nurse ratios. Future research is warranted in this field with focus on implementing appropriate health standards, protocols and resources for optimal efficiency in critical care worldwide.
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Affiliation(s)
- Faisal A Nawaz
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 505055, United Arab Emirates
| | - Neha Deo
- Department of Medicine, Mayo Clinic Alix School of Medicine, Rochester, MN 55905, United States
| | - Salim Surani
- Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, United States
- Texas A&M University, College Station, TX 77843, United States
| | - William Maynard
- Internal Medicine, TriStar Centennial Medical Center, HCA Healthcare, Nashville, TN 37203, United States
| | - Martin L Gibbs
- Pulmonary and Critical Care, Tulane University School of Medicine, New Orleans, LA 70112, United States
| | - Rahul Kashyap
- Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, United States
- Internal Medicine, TriStar Centennial Medical Center, HCA Healthcare, Nashville, TN 37203, United States
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16
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Mushtaq H, Singh S, Mir M, Tekin A, Singh R, Lundeen J, VanDevender K, Dutt T, Khan SA, Surani S, Kashyap R. The Well-Being of Healthcare Workers During the COVID-19 Pandemic: A Narrative Review. Cureus 2022; 14:e25065. [PMID: 35719833 PMCID: PMC9201991 DOI: 10.7759/cureus.25065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 05/17/2022] [Indexed: 12/21/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has turned into a global healthcare challenge, causing significant morbidity and mortality.Healthcare workers (HCWs) who are on the frontline of the COVID-19 outbreak response face an increased risk of contracting the disease. Some common challenges encountered by HCWs include exposure to the pathogen, psychological distress, and long working hours. In addition, HCWs may be more prone to develop mental health issues such as anxiety, depression, suicidal thoughts, post-traumatic stress disorder (PTSD), sleep disorders, and drug addictions compared to the general population. These issues arise from increased job stress, fear of spreading the disease to loved ones, and potential discrimination or stigma associated with the disease. This study aims to review the current literature to explore the effects of COVID-19 on healthcare providers' physical and mental well-being and suggest interventional strategies to combat these issues. To that end, we performed a literature search on Google Scholar and PubMed databases using combinations of the following keywords and synonyms: "SARS-CoV-2", "Healthcare-worker", "COVID-19", "Well-being", "Wellness", "Depression", "Anxiety", and "PTSD."
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Affiliation(s)
- Hisham Mushtaq
- Critical Care Medicine, Mayo Clinic Health System, Mankato, USA
| | | | - Mikael Mir
- Internal Medicine, University of Minnesota School of Medicine, Minneapolis, USA
| | - Aysun Tekin
- Critical Care Medicine, Mayo Clinic, Rochester, USA
| | - Romil Singh
- Critical Care Medicine, Allegheny Health Network, Pittsburgh, USA
| | - John Lundeen
- Psychiatry, TriStar Centennial Medical Center, TriStar Division, HCA Healthcare, Nashville, USA
| | - Karl VanDevender
- Internal Medicine, Frist Clinic, TriStar Centennial Medical Center, HCA Healthcare, Nashville, USA
| | - Taru Dutt
- Psychiatry, Hennepin County Medical Center, Minneapolis, USA
| | - Syed Anjum Khan
- Critical Care Medicine, Mayo Clinic Health System, Mankato, USA
| | - Salim Surani
- Anesthesiology, Mayo Clinic, Rochester, USA
- Medicine, Texas A&M University, College Station, USA
| | - Rahul Kashyap
- Critical Care Medicine, TriStar Centennial Medical Center, TriStar Division, HCA Healthcare, Nashville, USA
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17
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AlBloushi AF. Contribution of Saudi Arabia to Regional and Global Publications on COVID-19–Related Research: A Bibliometric and Visualization Analysis. J Infect Public Health 2022; 15:709-719. [PMID: 35667303 PMCID: PMC9473701 DOI: 10.1016/j.jiph.2022.05.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 05/21/2022] [Accepted: 05/23/2022] [Indexed: 11/16/2022] Open
Abstract
Background At the global level and in Saudi Arabia, COVID-19 remains a major public health problem. The COVID-19 pandemic contributed substantially to a surge in publications on the novel coronavirus responsible for this pandemic. This research is intended to assess the increasing contribution of Saudi Arabia to the global research on COVID-19. Methods A bibliometric analysis of all Saudi-affiliated publications on COVID-19 documented between December 2019 and October 2021 was conducted in October 2021 using the Web of Science advanced search builder. Results A total of 175,615 global publications on COVID-19 were retrieved in the search. Among these, 9118 (5.2%) publications were from Arab nations. Among the Arab nations, Saudi Arabia (n = 3615) had the highest number of COVID-19 publications, followed by Egypt (n = 2053) and the United Arab Emirates (n = 1057), respectively. Globally, Saudi Arabia ranked 15th among the countries with the highest publication productivity, and the rank was 11th after standardization based on the population size and the gross domestic product. International collaborations were mainly with the researchers from Egypt, followed by the United States, India, Pakistan, and the United Kingdom. King Saud University was the most productive among all institutes in terms of COVID-19-related publications at both local and regional levels. Conclusion Saudi Arabia is the leading Arabian nation and one of the top fifteen nations worldwide in terms of COVID-19 research output. Further efforts are warranted from the researchers based in Saudi Arabia in the direction of increasing the quality and the number of publications at the global level. This can be achieved by timely response, proper planning, understating the global research progress, and enhancing the knowledge exchange and collaboration with the other local and international institutes.
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18
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Huang W, Jiang B, Luo J, Luo M, Ding X, Yang Q, Zhao LH, Sun QG, Tong XL. Treatment of COVID-19 in Hemodialysis Patients Using Traditional Chinese Medicine: A Single-Center, Retrospective Study. Front Pharmacol 2022; 13:764305. [PMID: 35401217 PMCID: PMC8987001 DOI: 10.3389/fphar.2022.764305] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 03/11/2022] [Indexed: 01/08/2023] Open
Abstract
Background: To explore the effect of combining traditional Chinese medicine (TCM) and Western medicine in hemodialysis patients with coronavirus disease 2019 (COVID-19). Methods: This study was conducted from 27 January 2020 to 17 March 2020 in Wuhan Third Hospital Guanggu Branch, Wuhan, China. Fifty-three patients were included and divided into a control group (CG), which received Western medicine and a combined treatment group, which received TCM and Western medicine (TG). Clinical and laboratory data, TCM symptom scores, and chest computed tomography results were extracted and compared between the two groups. Results: The TG included 21 (67.7%) men and 10 (32.3%) women with a mean age of 61.02 (standard deviation [SD] 15.07, range 26–89) years. The mean dialysis duration in the TG was 49 (SD 31) months. Of all patients in the TG, 27 (87.1%) had fatigue, 18 (58.1%) had dry cough, 16 (51.6%) had anorexia, 11 (35.5%) had dyspnea, and 11 (35.5%) had fever. The CG included 14 (63.6%) men and 8 (36.4%) women with a mean age of 61.45 (SD 13.78, range 36–84) years. The mean dialysis duration in the CG was 63 (SD 46) months. Of all patients in the CG, 21 (95.5%) had fatigue, 12 (54.5%) had dry cough, 17 (77.3%) had anorexia, 12 (54.5%) had dyspnea, and 7 (31.8%) had fever. After treatment, the TCM symptom scores of the two groups decreased; the anorexia scores were lower in the TG than in the CG (p < 0.05). After treatment, albumin increased and D-dimer, C-reactive protein, and lactate dehydrogenase levels decreased in the TG. The d-dimer levels were lower and the albumin level was higher in the TG than in the CG after treatment (p < 0.05). The cure rate was higher, and the mortality rate was lower in the TG than in the CG (p < 0.05). Conclusion: A combination of TCM and Western medicine in hemodialysis patients with COVID-19 could relieve symptoms and help recovery. Further evidence from larger randomized controlled trials is needed to confirm our results.
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Affiliation(s)
- Wei Huang
- Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan, China
| | - Bo Jiang
- Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan, China
| | - Jinli Luo
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Meng Luo
- Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan, China
| | - Xiaoming Ding
- Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan, China
| | - Qian Yang
- Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan, China
| | - Lin-Hua Zhao
- Guang’anmen Hospital, China Academy of Chinese Medical Science, Beijing, China
- *Correspondence: Lin-Hua Zhao, ; Qin-Guo Sun, ; Xiao-Lin Tong,
| | - Qin-Guo Sun
- Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan, China
- *Correspondence: Lin-Hua Zhao, ; Qin-Guo Sun, ; Xiao-Lin Tong,
| | - Xiao-Lin Tong
- Guang’anmen Hospital, China Academy of Chinese Medical Science, Beijing, China
- *Correspondence: Lin-Hua Zhao, ; Qin-Guo Sun, ; Xiao-Lin Tong,
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19
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Koritala T, Hussain A, Pleshkova Y, Dondapati L, Tirupathi R, Rabaan AA, Al Mutair A, Alhumaid S, Al-Tawfiq JA, Kashyap R. A narrative review of emergency use authorization versus full FDA approval and its effect on COVID-19 vaccination hesitancy. LE INFEZIONI IN MEDICINA 2022; 29:339-344. [PMID: 35146338 DOI: 10.53854/liim-2903-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 08/04/2021] [Indexed: 01/17/2023]
Abstract
COVID-19 pandemic affected the lives of many with its devastating mortality and morbidity. Acquisition of herd immunity is one way to mitigate the spread of infection. Many factors influence the acceptance of vaccination including the regulatory process of the vaccines. This review article will briefly summarize the Emergency Use Authorization, Full FDA Approval process and highlight how the key factors affecting the vaccination hesitancy, are being influenced by the lack of Full FDA Approval.
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Affiliation(s)
- Thoyaja Koritala
- Department of Internal Medicine, Mayo Clinic Health System, Mankato, MN, USA
| | - Akbar Hussain
- Department of Internal Medicine, Keystone Health, Chambersburg, PA, USA
| | - Yelena Pleshkova
- Department of Clinical Sciences, University of Houston College of Medicine, Houston, TX, USA
| | - Lavanya Dondapati
- Department of Internal Medicine, Baylor St. Luke's Medical Center, Houston, TX, USA
| | - Raghavendra Tirupathi
- Department of Medicine, Keystone Health, Penn state College of Medicine, Chambersburg, PA, USA
| | - Ali A Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia.,Department of Public Health and Nutrition, University of Haripur, Haripur, Pakistan
| | - Abbas Al Mutair
- Research center, Almoosa Specialist Hospital, Al-Ahsa, Saudi Arabia.,College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh, Saudi Arabia.,School of Nursing, Wollongong University, Wollongong NSW, Australia
| | - Saad Alhumaid
- Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa, Saudi Arabia
| | - Jaffar A Al-Tawfiq
- Infectious Disease Unit, Specialty Internal Medicine and Infection Control Unit, Quality and Patient Safety, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia.,Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.,Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Rahul Kashyap
- Department of Anesthesiology and Peri-operative Medicine, Mayo Clinic, Rochester, MN, USA
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20
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Singh R, Rathore SS, Khan H, Bhurwal A, Sheraton M, Ghosh P, Anand S, Makadia J, Ayesha F, Mahapure KS, Mehra I, Tekin A, Kashyap R, Bansal V. Mortality and Severity in COVID-19 Patients on ACEIs and ARBs-A Systematic Review, Meta-Analysis, and Meta-Regression Analysis. Front Med (Lausanne) 2022; 8:703661. [PMID: 35083229 PMCID: PMC8784609 DOI: 10.3389/fmed.2021.703661] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 12/08/2021] [Indexed: 12/20/2022] Open
Abstract
Purpose: The primary objective of this systematic review is to assess association of mortality in COVID-19 patients on Angiotensin-converting-enzyme inhibitors (ACEIs) and Angiotensin-II receptor blockers (ARBs). A secondary objective is to assess associations with higher severity of the disease in COVID-19 patients. Materials and Methods: We searched multiple COVID-19 databases (WHO, CDC, LIT-COVID) for longitudinal studies globally reporting mortality and severity published before January 18th, 2021. Meta-analyses were performed using 53 studies for mortality outcome and 43 for the severity outcome. Mantel-Haenszel odds ratios were generated to describe overall effect size using random effect models. To account for between study results variations, multivariate meta-regression was performed with preselected covariates using maximum likelihood method for both the mortality and severity models. Result: Our findings showed that the use of ACEIs/ARBs did not significantly influence either mortality (OR = 1.16 95% CI 0.94-1.44, p = 0.15, I 2 = 93.2%) or severity (OR = 1.18, 95% CI 0.94-1.48, p = 0.15, I 2 = 91.1%) in comparison to not being on ACEIs/ARBs in COVID-19 positive patients. Multivariate meta-regression for the mortality model demonstrated that 36% of between study variations could be explained by differences in age, gender, and proportion of heart diseases in the study samples. Multivariate meta-regression for the severity model demonstrated that 8% of between study variations could be explained by differences in age, proportion of diabetes, heart disease and study country in the study samples. Conclusion: We found no association of mortality or severity in COVID-19 patients taking ACEIs/ARBs.
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Affiliation(s)
- Romil Singh
- Department of Anesthesiology and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States
| | | | - Hira Khan
- Department of Internal Medicine, Islamic International Medical College, Rawalpindi, Pakistan
| | - Abhishek Bhurwal
- Department of Gastroenterology and Hepatology, Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ, United States
| | - Mack Sheraton
- Department of Emergency Medicine, Trinity West Medical Center, Steubenville, OH, United States
| | - Prithwish Ghosh
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, United States
| | - Sohini Anand
- Patliputra Medical College and Hospital, Dhanbad, India
| | | | - Fnu Ayesha
- Department of Internal Medicine, Services Institute of Medical Sciences, Lahore, Pakistan
| | - Kiran S. Mahapure
- Department of Plastic Surgery, KAHER J. N. Medical College, Belgaum, India
| | - Ishita Mehra
- Department of Internal Medicine, North Alabama Medical Center, Florence, AL, United States
| | - Aysun Tekin
- Department of Anesthesiology and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States
| | - Rahul Kashyap
- Department of Anesthesiology and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States
| | - Vikas Bansal
- Department of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States
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21
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Koritala T, Pattan V, Tirupathi R, Rabaan AA, Al Mutair A, Alhumaid S, Adhikari R, Deepika K, Jain NK, Bansal V, Tekin A, Zec S, Lal A, Khan SA, Garces JPD, Abu Saleh OM, Surani SR, Kashyap R. Infection risk with the use of interleukin inhibitors in hospitalized patients with COVID-19: A narrative review. LE INFEZIONI IN MEDICINA 2021; 29:495-503. [PMID: 35146357 PMCID: PMC8805476 DOI: 10.53854/liim-2904-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/12/2021] [Indexed: 02/05/2023]
Abstract
INTRODUCTION To date, only corticosteroids and interleukin-6 (IL-6) inhibitors have been shown to reduce mortality of hospitalized patients with COVID-19. In this literature review, we aimed to summarize infection risk of IL inhibitors, with or without the use of corticosteroids, used to treat hospitalized patients with COVID-19. METHODS A literature search was conducted using the following evidence-based medicine reviews: Cochrane Central Register of Controlled Trials; Cochrane Database of Systematic Reviews; Embase; Ovid Medline; and Epub Ahead of Print, In-Process, In-Data-Review & Other Non-Indexed Citations, Daily and Versions 1946 to April 28, 2021. All relevant articles were identified using the search terms COVID-19 or SARS-coronavirus-2, infections, interleukins, inpatients, adults, and i ncidence. RESULTS We identified 36 studies of which 2 were meta-analyses, 5 were randomized controlled trials, 9 were prospective studies, and 20 were retrospective studies. When anakinra was compared with control, 2 studies reported an increased risk of infection, and 3 studies reported a similar or decreased incidence of infection. Canakinumab had a lower associated incidence of infection compared with placebo in one study. When sarilumab was compared with placebo, one study reported an increased risk of infection. Nine studies comparing tocilizumab with placebo reported decreased or no difference in infection risk (odds ratio [OR] for the studies ranged from 0.39-1.21). Fourteen studies comparing tocilizumab with placebo reported an increased risk of infection, ranging from 9.1% to 63.0% (OR for the studies ranged from 1.85-5.04). Infection most commonly presented as bacteremia. Of the 6 studies comparing tocilizumab and corticosteroid use with placebo, 4 reported a nonsignificant increase toward corticosteroids being associated with bacterial infections (OR ranged from 2.76-3.8), and 2 studies reported no increased association with a higher infection risk. CONCLUSIONS Our literature review showed mixed results with variable significance for the association of IL-6 inhibitors with risk of infections in patients with COVID-19.
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Affiliation(s)
- Thoyaja Koritala
- Division of Hospital Internal Medicine, Mayo Clinic Health System, Mankato, USA
| | | | | | - Ali A. Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
- Department of Public Health and Nutrition, University of Haripur, Haripur, Pakistan
| | - Abbas Al Mutair
- Research Center, Almoosa Specialist Hospital, Al-Ahsa, Saudi Arabia
- College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh, Saudi Arabia
- School of Nursing, Wollongong University, Wollongong, Australia
| | - Saad Alhumaid
- Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Al-Ahsa, Saudi Arabia
| | - Ramesh Adhikari
- Department of Hospital Medicine, Franciscan Health, Lafayette, USA
| | - Keerti Deepika
- Translational Health Disparities Science Research Program, Nemours Healthcare System for Children, Wilmington, USA
| | - Nitesh Kumar Jain
- Division of Community Critical Care, Mayo Clinic Health System, Mankato, USA
| | - Vikas Bansal
- Research Fellow, Mayo Clinic College of Medicine and Science, Rochester, USA
| | - Aysun Tekin
- Research Fellow, Mayo Clinic College of Medicine and Science, Rochester, USA
| | - Simon Zec
- Research Fellow, Mayo Clinic College of Medicine and Science, Rochester, USA
| | - Amos Lal
- Critical Care Internal Medicine Fellow, Mayo Clinic College of Medicine and Science, Rochester, USA
| | - Syed Anjum Khan
- Division of Community Critical Care, Mayo Clinic Health System, Mankato, USA
| | | | | | - Salim R. Surani
- Adjunct Clinical Professor of Medicine and Pharmacy, Texas A&M University, College Station, USA
- Research Collaborator (limited tenure), Mayo Clinic, Rochester, USA
| | - Rahul Kashyap
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, USA
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22
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Pattan V, Kashyap R, Bansal V, Candula N, Koritala T, Surani S. Genomics in medicine: A new era in medicine. World J Methodol 2021; 11:231-242. [PMID: 34631481 PMCID: PMC8472545 DOI: 10.5662/wjm.v11.i5.231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 06/18/2021] [Accepted: 07/19/2021] [Indexed: 02/06/2023] Open
Abstract
The sequencing of complete human genome revolutionized the genomic medicine. However, the complex interplay of gene-environment-lifestyle and influence of non-coding genomic regions on human health remain largely unexplored. Genomic medicine has great potential for diagnoses or disease prediction, disease prevention and, targeted treatment. However, many of the promising tools of genomic medicine are still in their infancy and their application may be limited because of the limited knowledge we have that precludes its use in many clinical settings. In this review article, we have reviewed the evolution of genomic methodologies/tools, their limitations, and scope, for current and future clinical application.
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Affiliation(s)
- Vishwanath Pattan
- Division of Endocrinology, Wyoming Medical Center, Casper, WY 82601, United States
| | - Rahul Kashyap
- Department of Anesthesiology and Peri-operative Medicine, Mayo Clinic, Rochester, MN 55905, United States
| | - Vikas Bansal
- Department of Anesthesiology and Peri-operative Medicine, Mayo Clinic, Rochester, MN 55905, United States
| | - Narsimha Candula
- Hospital Medicine, University Florida Health, Jacksonville, FL 32209, United States
| | - Thoyaja Koritala
- Hospital Medicine, Mayo Clinic Health System, Mankato, MN 56001, United States
| | - Salim Surani
- Department of Internal Medicine, Texas A&M University, Corpus Christi, TX 78405, United States
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23
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Sampath S, Khedr A, Qamar S, Tekin A, Singh R, Green R, Kashyap R. Pandemics Throughout the History. Cureus 2021; 13:e18136. [PMID: 34692344 PMCID: PMC8525686 DOI: 10.7759/cureus.18136] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2021] [Indexed: 12/14/2022] Open
Abstract
As we move amidst the coronavirus disease 2019 (COVID-19) pandemic, we have witnessed tremendous distress, death, and turmoil of everyday life for more than one year now. However, they are not modern phenomena; deadly pandemics have happened throughout recorded history. Pandemics such as the plague, Spanish Flu, HIV, and Ebola caused deaths, destruction of political regimes, as well as financial and psychosocial burdens. However, they sometimes resulted in scientific discoveries. Understanding the mechanism of the emergence of these pandemics is crucial to control any spreading pandemic and prevent the emergence of a potential new one. Public health agencies need to work on improving the countries' pandemic preparedness to prevent any future pandemics. The review article aims to shed light on some of the deadliest pandemics throughout history, information of critical importance for clinicians and researchers.
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Affiliation(s)
| | - Anwar Khedr
- Division of Critical Care Medicine, Mayo Clinic, Mankato, USA
- Internal Medicine, Tanta University Faculty of Medicine, Tanta, EGY
| | - Shahraz Qamar
- Post-Baccalaureate Research Education Program, Mayo Clinic, Rochester, USA
| | - Aysun Tekin
- Anesthesia Clinical Research Unit, Mayo Clinic, Rochester, USA
| | - Romil Singh
- Anesthesia Clinical Research Unit, Mayo Clinic, Rochester, USA
- Neurology, Allegheny Health Network, Pittsburgh, USA
| | - Ronya Green
- Family Medicine, Southern Hills Medical Center, TriStar Division, Hospital Corporation of America (HCA) Healthcare, Nashville, USA
| | - Rahul Kashyap
- Family Medicine, Southern Hills Medical Center, TriStar Division, Hospital Corporation of America (HCA) Healthcare, Nashville, USA
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24
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Characterization and Outcomes of Hospitalized Children With Coronavirus Disease 2019: A Report From a Multicenter, Viral Infection and Respiratory Illness Universal Study (Coronavirus Disease 2019) Registry. Crit Care Med 2021; 50:e40-e51. [PMID: 34387240 PMCID: PMC8670078 DOI: 10.1097/ccm.0000000000005232] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Multicenter data on the characteristics and outcomes of children hospitalized with coronavirus disease 2019 are limited. Our objective was to describe the characteristics, ICU admissions, and outcomes among children hospitalized with coronavirus disease 2019 using Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study: Coronavirus Disease 2019 registry. DESIGN Retrospective study. SETTING Society of Critical Care Medicine Viral Infection and Respiratory Illness Universal Study (Coronavirus Disease 2019) registry. PATIENTS Children (< 18 yr) hospitalized with coronavirus disease 2019 at participating hospitals from February 2020 to January 2021. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS The primary outcome was ICU admission. Secondary outcomes included hospital and ICU duration of stay and ICU, hospital, and 28-day mortality. A total of 874 children with coronavirus disease 2019 were reported to Viral Infection and Respiratory Illness Universal Study registry from 51 participating centers, majority in the United States. Median age was 8 years (interquartile range, 1.25-14 yr) with a male:female ratio of 1:2. A majority were non-Hispanic (492/874; 62.9%). Median body mass index (n = 817) was 19.4 kg/m2 (16-25.8 kg/m2), with 110 (13.4%) overweight and 300 (36.6%) obese. A majority (67%) presented with fever, and 43.2% had comorbidities. A total of 238 of 838 (28.2%) met the Centers for Disease Control and Prevention criteria for multisystem inflammatory syndrome in children, and 404 of 874 (46.2%) were admitted to the ICU. In multivariate logistic regression, age, fever, multisystem inflammatory syndrome in children, and pre-existing seizure disorder were independently associated with a greater odds of ICU admission. Hospital mortality was 16 of 874 (1.8%). Median (interquartile range) duration of ICU (n = 379) and hospital (n = 857) stay were 3.9 days (2-7.7 d) and 4 days (1.9-7.5 d), respectively. For patients with 28-day data, survival was 679 of 787, 86.3% with 13.4% lost to follow-up, and 0.3% deceased. CONCLUSIONS In this observational, multicenter registry of children with coronavirus disease 2019, ICU admission was common. Older age, fever, multisystem inflammatory syndrome in children, and seizure disorder were independently associated with ICU admission, and mortality was lower among children than mortality reported in adults.
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25
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COVID-19 Publications in Family Medicine Journals in 2020: A PubMed-Based Bibliometric Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157748. [PMID: 34360040 PMCID: PMC8345810 DOI: 10.3390/ijerph18157748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/18/2021] [Accepted: 07/19/2021] [Indexed: 01/14/2023]
Abstract
Family medicine physicians have been on the front lines of the novel coronavirus disease 2019 (COVID-19) pandemic; however, research and publications in family medicine journals are rarely discussed. In this study, a bibliometric analysis was conducted on COVID-19-related articles published in PubMed-indexed English language family medicine journals in 2020, which recorded the publication date and author’s country and collected citations from Google Scholar. Additionally, we used LitCovid (an open database of COVID-19 literature from PubMed) to determine the content categories of each article and total number of global publications. We found that 33 family medicine journals published 5107 articles in 2020, of which 409 (8.0%) were COVID-19-related articles. Among the article categories, 107 were original articles, accounting for only 26.2% of the articles. In terms of content, the main category was prevention, with 177 articles, accounting for 43.3% of the articles. At the beginning of the epidemic, 10 articles were published in family medicine journals in January 2020, accounting for 11% of all COVID-19-related articles worldwide; however, this accounted for <0.5% of all disciplinary studies in the entire year. Therefore, family medicine journals indeed play a sentinel role, and the intensities and timeliness of COVID-19 publications deserve further investigation.
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26
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Nitesh J, Kashyap R, Surani SR. What we learned in the past year in managing our COVID-19 patients in intensive care units? World J Crit Care Med 2021; 10:81-101. [PMID: 34316444 PMCID: PMC8291007 DOI: 10.5492/wjccm.v10.i4.81] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/07/2021] [Accepted: 05/17/2021] [Indexed: 02/06/2023] Open
Abstract
Coronavirus disease 2019 is a pandemic, was first recognized at Wuhan province, China in December 2019. The disease spread quickly across the globe, spreading stealthily from human to human through both symptomatic and asymptomatic individuals. A multisystem disease which appears to primarily spread via bio aerosols, it has exhibited a wide clinical spectrum involving multiple organ systems with the respiratory system pathology being the prime cause of morbidity and mortality. Initially unleashing a huge destructive trail at Wuhan China, Lombardy Italy and New York City, it has now spread to all parts of the globe and has actively thrived and mutated into new forms. Health care systems and Governments responded initially with panic, with containment measures giving way to mitigation strategies. The global medical and scientific community has come together and responded to this huge challenge. Professional medical societies quickly laid out "expert" guidelines which were conservative in their approach. Many drugs were re formulated and tested quickly with the help of national and international collaborative groups, helping carve out effective treatment strategies and help build a good scientific foundation for evidence-based medicine. Out of the darkness of chaos, we now have an orderly approach to manage this disease both from a public health preventive and therapeutic standpoint. With preventive measures such as masking and social distancing to the development of highly effective and potent vaccines, the public health success of such measures has been tempered by behavioral responses and resource mobilization. From a therapy standpoint, we now have drugs that were promising but now proven ineffective, and those that are effective when given early during viral pathogenesis or later when immune dysregulation has established, and the goal is to help reign in the destructive cascade. It has been a fascinating journey for mankind and our work here recapitulates the evolution of various aspects of critical care and other inpatient practices which continue to evolve.
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Affiliation(s)
- Jain Nitesh
- Department of Medicine, Mayo Clinic Health System, Mankato, MN 56001, United States
| | - Rahul Kashyap
- Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, United States
| | - Salim R Surani
- Department of Medicine, Texas A&M University, Corpus Christi, TX 78404, United States
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27
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Siddique N, Ahmad S, Altaf A, Mahmood K, Iqbal A, Khan MA. The emergence of scholarly literature on physical/social distancing related to Coronavirus: A bibliometric analysis. J Public Health Res 2021; 10. [PMID: 35000351 PMCID: PMC8764551 DOI: 10.4081/jphr.2021.2245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 05/04/2021] [Indexed: 12/02/2022] Open
Abstract
Background: The world is witnessing new public health crises due to the emergence of the novel coronavirus. This study aims to present a bibliometric analysis of research on coronavirus-related physical/social distancing. Design and Methods: In this study, a bibliometric analysis was applied to see the research productivity and its impact on coronavirus- related physical/social distancing. For this purpose, Scopus was used to retrieve the data for the analysis. A total of 2900 records was downloaded from the database for analysis. Results: The findings revealed that the top four authors published their research in the year 2020. The study ranked the British Medical Journal (BMJ) at the top position on publishing the research on the topic. Similarly, the USA took the lead in all countries in producing research on the topic. The researchers preferred the document type ‘Article’ for sharing their research, and a single authorship pattern was dominated on all other patterns. Conclusions: Plenty of bibliometric studies are available on coronavirus, but not a single study is found on coronavirus-related physical/social distancing. This study will be valuable in identifying different bibliometric dimensions on the topic.
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