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No abstract

We compared the outcome of COVID‐19 in immunosuppressed solid organ transplant (SOT) patients to a transplant naïve population. In total, 10 356 adult hospital admissions for COVID‐19 from March 1, 2020 to April 27, 2020 were analyzed. Data were collected on demographics, baseline clinical conditions, medications, immunosuppression, and COVID‐19 course. Primary outcome was combined death or mechanical ventilation. We assessed the association between primary outcome and prognostic variables using bivariate and multivariate regression models. We also compared the primary endpoint in SOT patients to an age, gender, and comorbidity‐matched control group. Bivariate analysis found transplant status, age, gender, race/ethnicity, body mass index, diabetes, hypertension, cardiovascular disease, COPD, and GFR <60 mL/min/1.73 m2 to be significant predictors of combined death or mechanical ventilation. After multivariate logistic regression analysis, SOT status had a trend toward significance (odds ratio [OR] 1.29; 95% CI 0.99–1.69, p = .06). Compared to an age, gender, and comorbidity‐matched control group, SOT patients had a higher combined risk of death or mechanical ventilation (OR 1.34; 95% CI 1.03–1.74, p = .027).

Background: Cerebral oximetry (rSO 2) may be useful in assessing the probability of return of spontaneous circulation (ROSC). However, the potential of assessing the trend in the rSO 2 value has not been discussed when determining the probability of ROSC. Methods: This was a retrospective study of out-of-hospital cardiac arrest (OHCA) patients with continuous rSO 2 values recorded during cardiopulmonary arrest. We used logistic regression analysis at each time point to investigate the best subsets of rSO 2-related variables for ROSC, which included rSO 2 (baseline), the baseline value of rSO 2 ; amount of maximum rise, the maximum difference of rSO 2 from rSO 2 (baseline) over t minutes; DrSO 2 (t):(amount of maximum rise)/rSO 2 (baseline) over t minutes after hospital arrival. Results: Among the 90 included patients, 35 achieved ROSC. Area under the curve (AUC) analysis revealed that DrSO 2 over a 16-min measurement period was significantly higher than DrSO 2 measured over 4-, 8-, 12-, and 20-min periods. During this 16-min period, the subset showing the best AUC value was interaction of the amount of maximum rise and rSO 2 (baseline) rather than the amount of maximum rise or DrSO 2 alone (AUC = 0.91). Conclusions: The combination of rSO 2 (baseline) with the amount of maximum rise in rSO 2 value over time might be a new index for the prediction of ROSC that could be useful in guiding cardiopulmonary resuscitation. Further studies are needed to validate these findings.