No abstract
Systemic inflammation-related sinus bradycardia in COVID-19 infection has not been well described yet. This six-patient case series excludes common causes of bradycardia. As bradycardia may be a sequela of COVID-19 infection, we recommend closely monitoring hemodynamics and stopping medications that can exacerbate bradycardia in these patients.
BackgroundOver the past three years, COVID-19 has been a major source of mortality in intensive care units around the world. Many scoring systems have been developed to estimate mortality in critically ill patients. Our intent with this study was to compare the efficacy of these systems when applied to COVID-19. MethodsThe was a multicenter, retrospective cohort study of critically ill patients with COVID-19 admitted to 16 hospitals in Texas from February 2020 to March 2022. The Simplified Acute Physiology Score (SAPS) II, Acute Physiology and Chronic Health Evaluation (APACHE) II, Sequential Organ Failure Assessment (SOFA) score, and 4C Mortality scores were calculated on the initial day of ICU admission. Primary endpoints were all-cause mortality, ICU length of stay, and hospital length of stay. ResultsInitially, 62,881 patient encounters were assessed, and the cohort of 292 was selected based on the inclusion of the requisite values for each of the scoring systems. The median age was 56 +/-14.93 years and 61% of patients were male. Mortality was defined as patients who expired or were discharged to hospice and was 78%. The different scoring systems were compared using logistic regression, receiver operating characteristic (ROC) curve, and area under the ROC curve (AUC) analysis to compare the accuracy of prediction of the mortality and length of stay. The multivariate analysis showed that SOFA, APACHE II, SAPS II, and 4C scores were all significant predictors of mortality. The SOFA score had the highest AUC, though the confidence intervals for all of the models overlap therefore one model could not be considered superior to any of the others. Linear regression was performed to evaluate the models' ability to predict ICU and hospital length of stay, and none of the tested systems were found to be significant predictors of length of stay. ConclusionThe SOFA, APACHE II, ISARIC 4-C, and SAPS II scores all accurately predicted mortality in critically ill patients with COVID-19. The SOFA score trended to perform the best.
Anemia is a diagnostic challenge in patients with coronavirus disease 2019 . This is due to the broad differential of etiologies for anemia, which includes bleeding, bone marrow suppression secondary to sepsis, and hemolytic anemia. Here, we present a first-ever case of otherwise unexplained anemia in a patient receiving treatment for COVID-19 secondary to parvovirus B19 reactivation. While parvovirus infections often present as acute states of anemia, this patient developed a case of reactivation secondary to immunosuppression from COVID-19 treatment. This case indicates the importance of assessing for parvovirus infections in COVID-19 patients with otherwise unexplained anemia.
Introduction: Patients suffering from diabetes mellitus are known to have increased susceptibility to certain infections. It has significant impact on tissues throughout the body including the oral cavity. Aim: To assess the dentition status and treatment needs among type II Diabetic and Non-Diabetic individuals in Chennai city. Materials and Methods: A Hospital based Cross-sectional comparative study was conducted among diabetics and non-diabetic population attending the Govt. Stanley hospital in Chennai City. WHO Oral Health Assessment Form (1997) was used to assess the dentition status and treatment needs. The final sample size of the study was 1000 which included 500 diabetics and 500 non-diabetics. Results: The present study revealed not much difference in oral hygiene practices among diabetic and non-diabetics. In the present study, there was no statistical difference in the caries experience among the study subjects. The mean number of teeth missing due to other reasons was 1.40+2.80 among diabetics and 0.65+1.70 among non-diabetics (p<0.0001). Conclusion: There was no significant difference in the prevalence of dental caries among the study subjects. The mean decayed, missing, filled and DMFT scores were similar among diabetics and non-diabetics.
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