Journal of community hospital internal medicine perspectives
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J Community Hosp Intern Med Perspect · Oct 2020
Hematological parameters predicting severity and mortality in COVID-19 patients of Pakistan: a retrospective comparative analysis.
COVID-19 is a global pandemic. In our study, we aimed to utilize the hematological parameters in predicting the prognosis and mortality in COVID-19 patients. ⋯ The inflammatory markers and hematological indices are a good guide for predicting the severity and disease outcome of coronavirus disease. NLR and PLR are elevated in severe disease while LMR and LCR are inversely correlating with disease severity.
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J Community Hosp Intern Med Perspect · Oct 2020
Clinical characteristics and outcomes of critically ill patients with COVID-19 in a tertiary community hospital in upstate New York.
Background: There are limited reports describing critically ill COVID-19 patients in the state of New York. Methods: We conducted a retrospective analysis of 32 adult critically ill patients admitted to a community hospital in upstate New York, between 14 March and 12 April 2020. We collected demographic, laboratory, ventilator and treatment data, which were analyzed and clinical outcomes tabulated. ⋯ Conclusion: Majority of patients were of older age and with medical comorbidities. With adequate resource utilization, mortality of critically ill COVID-19 patients may not be as high as previously suggested. Abbreviations: ACE-i: Angiotensin converting enzyme inhibitor; ARB: Angiotensin receptor blocker; ARDS: Acute Respiratory Distress Syndrome; BiPAP: Bilevel positive airway pressure; CABG: Coronary artery bypass graft; CFR: Case fatality rate; COVID-19: Coronavirus disease 19; CPAP: Continuous positive airway pressure; CRP: C - Reactive Protein; CT: Computed tomography; DVT: Deep vein thrombosis; ECMO: Extra Corporeal Membrane Oxygenation; ESICM: European Society of Intensive Care Medicine; FiO2: Fraction of inspired O2; HFNC: High Flow Nasal Cannula; HITF: Hypoxia-Inducible Transcription Factor; IBM: International Business Machines; ICU: Intensive Care Unit; IL: Interleukin; IMV: Invasive Mechanical Ventilation; IQR: Interquartile Range; ISTH: International Society of Thrombosis Hemostasis; NIV: Non Invasive Ventilation; NY: New York; PAI: Plasminogen activator inhibitor; PaO2: partial pressure of arterial oxygen; PCV: Pressure Control Ventilation; PEEP: Positive End Expiratory Pressure; RGH: Rochester General Hospital; RRH: Rochester Regional Health; RT-PCR: Reverse transcriptase polymerase chain reaction; RSV: Respiratory Syncytial virus; SARS-CoV-2: Severe Acute Respiratory Syndrome Coronavirus 2; SD: Standard Deviation; STEMI: ST segment elevation myocardial infarction; TNF: Tumor necrosis factor; USA: USA; VTE: Venous thromboembolism.
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J Community Hosp Intern Med Perspect · Sep 2020
Predictability of CRP and D-Dimer levels for in-hospital outcomes and mortality of COVID-19.
Systemic inflammation elicited by a cytokine storm is considered a hallmark of coronavirus disease 2019 (COVID-19). This study aims to assess the clinical utility of the C-reactive protein (CRP) and D-Dimer levels for predicting in-hospital outcomes in COVID-19. ⋯ CRP value greater than 100 mg/dL and D-dimer levels higher than 500 ng/ml during hospitalization might predict higher odds of in-hospital mortality. Higher levels at presentation might indicate impending clinical deterioration and the need for IMV.
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J Community Hosp Intern Med Perspect · Sep 2020
Case ReportsDiagnostic dilemma, an incidental diagnosis of COVID 19.
COVID 19 or SARS-CoV-2 infection was first reported in December 2019 in Wuhan City of China. Since then, it continues to spread globally and has been declared a pandemic. These patients present predominantly with respiratory complaints; however, in this article, we describe a case that was detected incidentally during workup of another suspecting diagnosis. We also elaborate on the benefits and importance of rapid testing.
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J Community Hosp Intern Med Perspect · Sep 2020
Internal medicine resident perspectives on scoring USMLE as pass/fail.
The scoring rubric on the USMLE Step 1 examination will be changing to pass/fail in January 2022. This study elicits internal medicine resident perspectives on USMLE pass/fail scoring at the national level. ⋯ Our results suggest that a majority of internal medicine residents, currently training in the USA prefer that USMLE numerical scoring is retained and not changed to pass/fail.