Background
Renal involvement in COVID-19 leads to severe disease and higher mortality. We study renal parameters in COVID-19 patients and their association with mortality and length of stay in hospital.
Methods
A retrospective study (n=340) of confirmed COVID-19 patients with renal involvement determined by the presence of acute kidney injury. Multivariate analyses of logistic regression for mortality and linear regression for length of stay (LOS) adjusted for relevant demographic, comorbidity, disease severity, and treatment covariates.
Results
Mortality was 54.4% and mean LOS was 12.9 days. For mortality, creatinine peak (OR:35.27, 95% CI:2.81, 442.06, p<0.01) and persistent renal involvement at discharge (OR:4.47, 95% CI:1.99,10.06, p<0.001) were each significantly associated with increased odds for mortality. Increased blood urea nitrogen peak (OR:0.98, 95%CI:0.97,0.996, p<0.05) was significantly associated with decreased odds for mortality. For LOS, increased blood urea nitrogen peak (B:0.001, SE:<0.001, p<0.01), renal replacement therapy (B:0.19, SE:0.06, p<0.01), and increased days to acute kidney injury (B:0.19, SE:0.05, p<0.001) were each significantly associated with increased length of stay.
Conclusion
Our study emphasizes the importance in identifying renal involvement parameters in COVID-19 patients. These parameters are associated with LOS and mortality, and may assist clinicians to prognosticate COVID-19 patients with renal involvement.
Epidermal inclusion cysts (EIC) are common benign lesions of the skin, ovaries, and testicles. However, their occurrence in thyroid gland is rare. We reported a case in which a 57-year-old male patient with history of nontoxic uninodular goiter presented with dysphonia and dysphagia. The cytology of ultrasound guided fine needle aspiration of the thyroid nodule revealed epidermal cyst. Despite the benign presentation. The patient underwent lobectomy to relieve his clinical symptoms and the surgical pathology exam confirmed the diagnosis of benign thyroid cyst, consistent with EIC of the thyroid.
Introduction. COVID-19 affects the hematologic system. We evaluate the impact of hematologic involvement of different blood cell line parameters of white blood cells including absolute neutrophil count (ANC), hemoglobin, and platelets in COVID-19 patients and their association with hospital mortality and length of stay (LOS).
Methods. This is a retrospective study of 475 patients with confirmed positive COVID-19 infection and hematologic abnormalities in the metropolitan New York City area.
Results. Increased (ANC) (OR:1.20; 95% CI:1.02-1.42, p<0.05) increased days to hematologic involvement (OR:4.44, 95% CI:1.42-13.90; p<0.05), and persistence of hematologic involvement at discharge (OR:2.87, 95% CI:1.20, 6.90, p<0.05) were associated with higher mortality. Higher hemoglobin at admission (OR:0.77, 95% CI:0.60-0.98, p<0.001) and platelets peak (OR:0.995, 95% CI 95%:0.992-0.997, p<0.001) were associated with decreased mortality. Patients with higher white blood cell peak (B=0.46, SE=0.07, p<0.001) and higher hemoglobin at admission (B=0.05, SE=0.01, p<0.001) were associated with higher LOS. Those with higher hemoglobin nadir (B=-0.06, SE=0.01, p<0.001), higher platelets nadir (B=-0.001, SE=<0.001, p<0.001), and hematologic involvement at discharge/death (B=-0.06, SE=0.03, p<0.05) were associated with lower LOS.
Conclusions. These findings can be used by clinicians to better risk-stratify patients with hematologic involvement in COVID-19 and tailor therapies to potentially improve patient outcomes.
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