HighlightsAcute adrenal insufficiency, although rare, is the most frequently reported endocrine manifestation of the APS.Major surgery has been identified as a precipitating factor for this potentially fatal condition.Effective treatment requires timely diagnosis and intervention at the acute phase. Therefore, a high index of suspicion is crucial. The APLS patients who overcome the acute phase bear a favorable prognosis regarding restoration of their adrenal function.
assessed using the MedDietScore (range 0-55). During 2011-2012, 2583 out of the 3042 baseline participants attended the 10-year follow-up of the Attica study (15% lost-to-follow-up). The individual CVD risk was estimated with the use of HellenicSCORE, the dietary assessment through the MedDietScore. The observed risk was used in order to investigate the risk estimation of the nested models. Results: The МedDietScore and the HellenicSCORE were significant predictors of the 10-year CVD risk, even after adjusting for several confounders (p<0.05). The misclassification bias of the HellenicSCORE was 13.8%. The MedDietScore was associated with reduced misclassification rates (p<0.001), by explaining 6.1% of the bias. Conclusions: Inclusion of dietary assessment, as well as other lifestyle parameters, could increase the correct classification rates and thus reduce the CVD burden.
Background
Due to COVID-19 gastrointestinal microbiome alterations, COVID-19 can be complicated by Clostridioides difficile infection (CDI). This retrospective cohort study aimed to evaluate the prevalence of Clostridium difficile infection in patients with COVID-19pneumonia
Methods
A retrospective cohort study was conducted on PCR Covid-19 positive patients admitted in the ICU from September,2020 to 30th April 2021. All patients in the cohort study were on mechanical ventilation, or at some point during their ICU admission required mechanical ventilation. Hospital-onset (HO-CDI), defined as a positive C. difficile test over 3 days after admission.
Results
Overall, during the study period, a total of 240 PCR Covid-19 patients were admitted to the ICU; of these, 11 (4.5%) were COVID-19 CDI positive. Nine were males (81%). The mean hospital stay for these COVID-19 patients was 12 days (range 1–59 days). HO-CDI median day of identification was 12 days. All patients received ≥2 antibiotics and dexamethasone at admission. Compared to historical controls, COVID-19 patients did not have a higher overall CDI positive rate. However, mortality among COVID-19 HO-CDI patients was increased 7/11 (63%).
Conclusion
Whether COVID-19 itself increases an individual’s risk for CDI remains unclear. Multiple contributing factors drive CDI incidence, severity, and recurrence. Although protective measures such as gowns and gloves during COVID-19 increased, CDI cases in the hospital setting should continue to emphasize the importance of antimicrobial stewardship.
Disclosures
All Authors: No reported disclosures
Background
The aim of this work were to investigate the rate and aetiology of bloodstream infection collected from COVID and non-COVID patients admitted in the ICU
Methods
A retrospective cohort study was conducted on PCR Covid-19 positive patients admitted in the ICU from 20th March to 30th April 2020. Corresponding data from the same period in 2019 collected of all consecutive patients admitted in the same ICU were retrospectively reviewed for the presence of microbiologically documented bloodstream infections at least 8 hours after admission. All patients in the cohort study were on mechanical ventilation, or at some point during their ICU admission required mechanical ventilation.
Results
We identified a total of 19 (38%) BSIs in the COVID-19 group and 10 (12%) BSI in the non-COVID-19 group (p=0,8). COVID-19 patients had an increased probability to develop ICU-BSI, at a median of 8 days of ICU admission as opposed to 6 in the non-COVID-19 group. Patients were comparable in terms of age, and APACHE II score. Out of 19 BSI CoVID-19 patients, 14 (73%) were male vs 5 (50%) in the non-CoVID-19 BSI patients (p=0.0007). Of all BSI-CoVID-19 patients, 7 cases (37%), 3 (16%), and 3(16%) had underlying diseases such as hypertension, diabetes, and obesity vs 1(9%), 0(0%), and 0 (0%) in the BSI-non CoVID-19 patients statistically significant at p=0.004, p=0.05, and p=0.05, respectively. ICU-acquired BSIs were mostly due to multi-drug-resistant pathogens. Clinical outcomes were statistically significantly different between patients with CoVid-19 BSI 7(37% ) and 2(20%)in BSI- non-CoVID-19 pneumonia (p=0.02).
Conclusion
Our findings emphasize that although the incidence of BSI in CoVID-19 positive ICU admitted patients slightly increased their impact on overall outcome was significantly worse. Consequently, it is important to pay attention to bacterial superinfections in critical patients positive for COVID-19.
Disclosures
All Authors: No reported disclosures
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