Annals of medicine
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Multicenter Study
External Validation of a Clinical Risk Score to Predict Hospital Admission and In-Hospital Mortality in COVID-19 Patients.
Identification of patients with novel coronavirus disease 2019 (COVID-19) requiring hospital admission or at high-risk of in-hospital mortality is essential to guide patient triage and to provide timely treatment for higher risk hospitalized patients. ⋯ The COVID-19 Risk of Complications Score predicts the need for hospital admission and in-hospital mortality patients with COVID-19. Key points: Can an electronic health record generated risk score predict the risk of hospital admission and in-hospital mortality in patients diagnosed with coronavirus disease 2019 (COVID-19)? In both validation cohorts of 2,025 and 1,290 COVID-19, the cross-validated C-Statistics showed good discrimination for both hospital admission (C = 0.79 (95% CI: 0.77-0.81)) and in-hospital mortality (C = 0.75 (95% CI: 0.71-0.78)), respectively. The COVID-19 Risk of Complications Score may help predict the need for hospital admission if a patient contracts SARS-CoV-2 infection and in-hospital mortality for a hospitalized patient with COVID-19.
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Multicenter Study Observational Study
Hereditary transthyretin-related amyloidosis is frequent in polyneuropathy and cardiomyopathy of no obvious aetiology.
Hereditary Transthyretin-Related Amyloidosis, a clinically heterogeneous autosomal dominant disease caused by pathogenic variants in the TTR gene, is characterized by the deposition of insoluble misfolded protein fibrils. The diagnosis, especially in non-endemic areas, is typically delayed by 4-5 years; a misdiagnosis due to clinical heterogeneity is common. The study objective was to define the prevalence of Hereditary Transthyretin-Related Amyloidosis in patients with polyneuropathy and/or cardiomyopathy of no obvious aetiology. ⋯ Our data support the fact that Hereditary Transthyretin-Related Amyloidosis is underdiagnosed in polyneuropathy and cardiomyopathy patients. Routine implementation of genetic testing is recommended in patients with unexplained polyneuropathy and/or cardiomyopathy to accelerate the earlier diagnosis and the time-sensitive treatment initiation.KEY MESSAGESMore than 5.000 participants with CM and/or PNP of no obvious aetiology were recruited in the observational "Epidemiological analysis for the hereditary Transthyretin-Related AMyloidosis" TRAM study and screened for pathogenic TTR variants.The study demonstrated >1% of patients with CM and/or PNP of unclear aetiology are positive for a pathogenic TTR variant.Routine genetic testing is recommended in patients with unexplained CM and/or PNP to accelerate the initial diagnosis and timely treatment initiation.
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Randomized Controlled Trial Multicenter Study
A randomized, active-controlled, multicentre clinical trial to evaluate the efficacy and safety of oral sitafloxacin versus levofloxacin in Chinese adults with acute uncomplicated or complicated urinary tract infection.
To evaluate the efficacy and safety of oral sitafloxacin versus levofloxacin in Chinese adults with acute uncomplicated urinary tract infection (UTI) or complicated UTI. ⋯ Oral sitafloxacin is as effective and safe as levofloxacin in treating acute uncomplicated and complicated UTI. KEY MESSAGE: Oral sitafloxacin showed similar clinical cure rate and bacterial eradication rate as levofloxacin for treatment of complicated and uncomplicated urinary tract infections (UTIs) in a randomized, active-controlled, multicentre clinical trial. Oral sitafloxacin is safe and well-tolerated in treating acute uncomplicated and complicated UTIs in Chinese adults. Sitafloxacin is a promising alternative treatment option for UTIs in adults.
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Letter Randomized Controlled Trial Multicenter Study
Effect of a genetically engineered interferon-alpha versus traditional interferon-alpha in the treatment of moderate-to-severe COVID-19: a randomised clinical trial.
There are few effective therapies for coronavirus disease 2019 (COVID-19) upon the outbreak of the pandemic. To compare the effectiveness of a novel genetically engineered recombinant super-compound interferon (rSIFN-co) with traditional interferon-alpha added to baseline antiviral agents (lopinavir-ritonavir or umifenovir) for the treatment of moderate-to-severe COVID-19. ⋯ rSIFN-co was associated with a shorter time of clinical improvement than traditional interferon-alpha in the treatment of moderate-to-severe COVID-19 when combined with baseline antiviral agents. rSIFN-co therapy alone or combined with other antiviral therapy is worth to be further studied.Key messagesThere are few effective therapies for coronavirus disease 2019 (COVID-19) upon the outbreak of the pandemic. Interferon alphas, by inducing both innate and adaptive immune responses, have shown clinical efficacy in treating severe acute respiratory syndrome coronavirus and Middle East respiratory syndrome coronavirus.In this multicenter, head-to-head, randomized, clinical trial which included 94 participants with moderate-to-severe COVID-19, the rSIFN-co plus antiviral agents (lopinavir-ritonavir or umifenovir) was associated with a shorter time of clinical improvement than interferon-alpha plus antiviral agents.
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Multicenter Study
COVID-19: anxiety among hospital staff and associated factors.
During the COVID-19 pandemic, hospital staff have experienced a variety of mental health challenges. European research on anxiety and stress among hospital workers during the pandemic is limited. This study aimed to describe the anxiety levels of Finnish hospital workers during the COVID-19 pandemic. ⋯ Hospital staff experienced a variety of work-related stress and anxiety issues that should be visible to hospital administrators and policymakers alike. The anxiety is independent of whether the worker is directly involved in caring for or in any way coming into contact with COVID-19 patients. Key message Fifty-five percent of hospital staff have normal anxiety levels. The remaining workers may need targeted support interventions, and a smaller proportion (15%) are in danger of developing longer-term problems affecting their well-being. The anxiety experienced by hospital workers during the COVID-19 pandemic is more severe than that of the population on average. If the pandemic continues, the well-being of hospital staff may be widely threatened. Despite the different geographical locations and COVID-19 situations, hospital workers in Finland and China had similar anxiety levels. The anxiety is independent of whether staff are working in the front line of managing the COVID-19 pandemic or of the number of covid-19 patients admitted to the hospital. The hospital workers felt anxiety because they were facing a new situation which causes changes in their work and daily routine. Health care employers should engage in long-term follow-up as regards the personnel's recovery from the burden caused by the pandemic and from work in general. It is necessary to make easily attainable, flexibly delivered and cost-effective treatment interventions for anxiety available to hospital staff.