The occurrence of and risk factors for developing acute critical illness during quarantine as a response to the COVID-19 pandemic

Tsai, Chin-Shiang; Huang, Tang Hsiu; Su, Po‐Lan; Chen, Chiung-Zuei; Chen, Chang Wen; Ko, Wen Chien; Lee, Nan Yao

doi:10.1016/j.jfma.2021.01.013

Cited by 2 publications

(2 citation statements)

References 14 publications

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“…While quarantine ward is important for preventing nosocomial transmission during pandemic, it may carry a potential negative effect on patient care. 30 Decrease of visiting and education may result in low rate of cultural sampling and quality of specimens. Second, low accuracy for diagnosis of LRTI based only on patients’ clinical symptoms and radiological findings.…”

Section: Discussionmentioning

confidence: 99%

Respiratory etiological surveillance among quarantined patients with suspected lower respiratory tract infection at a medical center in southern Taiwan during COVID-19 pandemic

Huang¹,

Tsai²,

Su³

et al. 2022

Journal of Microbiology, Immunology and Infection

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Background A comprehensive study of respiratory pathogens was conducted in an area with a low prevalence of COVID-19 among the adults quarantined at a tertiary hospital. Methods From March to May 2020, 201 patients suspected lower respiratory tract infection (LRTI) were surveyed for etiologies by multiplex polymerase chain reaction (PCR: FilmArray TM Respiratory Panel) test combination with cultural method, viral antigen detection and serologic surveys. Results Total 201 patients tested with FilmArray TM Respiratory Panel were enrolled, of which 68.2% had sputum bacterial culture, 86.1% had pneumococcus and Legionella urine antigen test. Their median age was 72.0 year-old with multiple comorbidities, and 11.4% were nursing home residents. Bacteria accounted for 59.7% of identified pathogens. Atypical pathogens were identified in 31.3% of total pathogens, of which viruses accounted for 23.9%. In comparison to patients with bacterial infection, patients with atypical pathogens were younger (median= 77.2 vs 67.1, years, P = 0.017) and had shorter length of hospital (8.0 vs 4.5, days, P = 0.007). Conclusions Patients with LRTI caused by atypical pathogens was indistinguishable from those with bacterial pathogens by clinical manifestations or biomarkers. Multiplex PCR providing rapid diagnosis of atypical pathogens enhance patient care and decision making when rate of sputum culture sampling was low in quarantine ward during pandemic.

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Section: Discussionmentioning

confidence: 99%

Respiratory etiological surveillance among quarantined patients with suspected lower respiratory tract infection at a medical center in southern Taiwan during COVID-19 pandemic

Huang¹,

Tsai²,

Su³

et al. 2022

Journal of Microbiology, Immunology and Infection

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“…Furthermore, we included only patients from a tertiary medical centre in Taiwan. We also did not include cases of post-COVID-19 OP, because it was not until late 2021 that SARS-CoV-2 became pandemic in Taiwan [ 29 , 30 ]. Future studies involving patients with OP of more diverse ethnicity and aetiologies would be helpful to broaden the generalisation of our findings.…”

Section: Discussionmentioning

confidence: 99%

Impact of computed tomographic patterns and extent on clinical management and outcomes of patients with organising pneumonia

et al. 2022

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BackgroundOrganizing pneumonia (OP) has variable clinical and radiographic presentations and unstandardized treatments. Most patients with OP have favourable outcomes, but some develop respiratory insufficiency, experience recurrence, or die. In this study we investigated the impact of computed tomographic (CT) patterns and extent of OP on the diagnostic and therapeutic management that patients received, and that on the therapeutic response and prognosis (particularly the risk of respiratory insufficiency and death).MethodsWe retrospectively studied 156 patients with OP followed at our hospital between 2010 and 2021. The diagnosis was confirmed histologically and verified by multidisciplinary specialists. We performed Firth's logistic regression to determine the relationship between CT features and aetiologies, management, and outcomes including the risk of severe disease (defined as the need of supplemental oxygen or mechanical ventilation). We conducted Kaplan-Meier analyses to assess survival differences.ResultsPatients exhibiting multi-lobe involvement or mixed patterns, or both, were more likely to have secondary OP and receive immunosuppressants. Higher proportions of these patients experienced recurrence. Compared to patients with single-lobe involvement and single-pattern, they also had an enhanced risk of severe disease (the adjusted odds ratio for patients who simultaneously had multi-lobe involvement and mixed patterns was 27.64; 95% confidence interval, 8.25–127.44). Besides, these patients had decreased survival probabilities.ConclusionDifferent CT features of OP impact patients’ management and prognosis. When treating patients with OP exhibiting multi-lobe involvement or mixed patterns, or both, it is important to identify the possible causative aetiology and follow closely for adverse outcomes.

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The occurrence of and risk factors for developing acute critical illness during quarantine as a response to the COVID-19 pandemic

Cited by 2 publications

References 14 publications

Respiratory etiological surveillance among quarantined patients with suspected lower respiratory tract infection at a medical center in southern Taiwan during COVID-19 pandemic

Respiratory etiological surveillance among quarantined patients with suspected lower respiratory tract infection at a medical center in southern Taiwan during COVID-19 pandemic

Impact of computed tomographic patterns and extent on clinical management and outcomes of patients with organising pneumonia

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