Journal of investigative medicine : the official publication of the American Federation for Clinical Research
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Multicenter Study
EXPRESS: Risk Factors for Post-acute Sequelae of COVID-19: Survey Results From a Tertiary Care Hospital.
Identifying risk factors for post-acute sequelae of COVID-19 (PASC) is important. We conducted a multicenter cross-sectional survey study to define and characterize risk factors for severe COVID-19 in adults (≥18 years) treated at our virtual COVID-19 clinic from March 1, 2020, through March 31, 2021. We assessed patient demographics, symptom types, and persistence, incidence of PASC, and COVID-19-caused hospitalizations. ⋯ A significantly greater proportion of respondents with PASC were women (68.4% vs 56.7%, p < 0.001), had been hospitalized (12.2% vs 4.4%, p < 0.001), reported having negative psychological COVID-19-related repercussions (39.9% vs 15.3%, p < 0.001), and required more than 1 month to resume normal activities (38.8% vs 12.9%, p < 0.001) than did those without PASC. These findings may improve our understanding of PASC and provide a framework for early recognition of and intervention for patients at higher risk for PASC. Further research is needed to understand the predictors of persistent symptoms after acute SARS-CoV-2 infection and the risk of PASC.
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In the midst of the coronavirus disease 2019 (COVID-19) pandemic, intensive care units (ICUs) around the world have been pushed to their limits as they grapple with the effects of the severe acute respiratory syndrome coronavirus 2 virus. Identifying prognostic factors that influence mortality in COVID-19 patients admitted to the ICU could offer valuable insights for clinicians seeking to prevent disease progression. A retrospective analysis was conducted on COVID-19 patients admitted to the ICU between January and September 2020. ⋯ In addition, elevated D-dimer and aspartate aminotransferase (AST) levels, as well as lymphopenia, were more commonly observed in deceased patients. The study concluded that those who died in the ICU tended to be older, white, and burdened with more comorbidities and impaired consciousness. With the intriguing link between specific symptoms and survival, further research is essential to uncover the underlying pathophysiological mechanisms that influence ICU patient outcomes in the context of COVID-19.
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American Academy of Pediatrics approves pacifier use for soothing and calming; it recommends delaying its use until breastfeeding is well established. Though pacifiers have protective effects against sudden infant death syndrome, prolonged use of a pacifier can lead to complications. American Academy of Family Physicians discourages the use by 6 months to 1 year of age. ⋯ Eleven (8.3%) caregivers reported that information about pacifiers was provided by medical and day-care providers. Pacifier use was not significantly related to the feeding method during the first 2 months of life. This study identifies impressions and common misconceptions of pacifier use which may assist in the development of comprehensive guidelines.
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Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is extremely rare in children. Renal involvement is a common and severe complication of AAV as it can cause end stage kidney disease (ESKD). ANCA renal risk score (ARRS) is helpful in predicting long-term ESKD in patients with ANCA-associated glomerulonephritis (AAGN). ⋯ Delong test result showed that ARRS exhibited better predictive value for ESKD than the Berden classification (p < 0.001) and rapidly progressive glomerulonephritis (p < 0.001). This is the first study to investigate the value of the ARRS for predicting renal prognosis among Chinese children. The ARRS is a preferred index that can predict ESKD in Chinese children with AAGN.
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Observational Study
EXPRESS: Potential Reduction of Post-Acute Sequelae of SARS-COV2 Symptoms Via Vaccination.
The objective of this observational study is to determine whether vaccination for SARS-CoV-2 alters the clinical presentation of post-COVID conditions (PCC). Self-reported data provided by patients requesting care for PCC at the Mayo Clinic were analyzed to assess for a relationship between vaccination status prior to COVID infection and PCC symptoms. In all, 477 subjects were included in this study. ⋯ After applying Bonferroni correction for multiple comparisons, decreased abdominal pain remained significant. We conclude that vaccination against SARS-CoV-2 may reduce the symptoms of PCC, leading to improved morbidity and function. Further studies on the impact of vaccination on PCC and recovery are needed.