Articles: covid-19.
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Randomized Controlled Trial Multicenter Study
Evaluation of point-of-care multiplex polymerase chain reaction in guiding antibiotic treatment of patients acutely admitted with suspected community-acquired pneumonia in Denmark: A multicentre randomised controlled trial.
Rapid and accurate detection of pathogens is needed in community-acquired pneumonia (CAP) to enable appropriate antibiotics and to slow the development of antibiotic resistance. We aimed to compare the effect of point-of-care (POC) polymerase chain reaction (PCR) detection of respiratory pathogens added to standard care with standard care only (SCO) on antibiotic prescriptions after acute hospital admission. ⋯ In a setting with an already restrictive use of antibiotics, adding POC-PCR to the diagnostic setup did not increase the number of patients treated with narrow-spectrum or without antibiotics. POC-PCR may result in a more targeted and adequate use of antibiotics. A significant study limitation was the concurrent Coronavirus Disease 2019 (COVID-19) pandemic resulting in an unusually low transmission of respiratory virus.
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Critical care medicine · Nov 2023
Multicenter Study Observational StudyDeclining Use of Prone Positioning After High Initial Uptake in COVID-19 Adult Respiratory Distress Syndrome.
Prone positioning for acute respiratory distress syndrome (ARDS) has historically been underused, but was widely adopted for COVID-19-associated ARDS early in the pandemic. Whether this successful implementation has been sustained over the first 3 years of the COVID-19 pandemic is unknown. In this study, we characterized proning use in patients with COVID-19 ARDS from March 2020 to December 2022. ⋯ The use of prone positioning for COVID-19 ARDS is declining. Interventions to increase and sustain appropriate use of this evidence-based therapy are warranted.
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Multicenter Study
Low dose aspirin and clinical outcomes in patients with SARS-CoV-2 pneumonia: a propensity score-matched cohort analysis from the National SIMI‑COVID‑19 Registry.
SARS- CoV-2 virus has had dramatic consequences worldwide being able to cause acute respiratory distress syndrome (ARDS), massive thrombosis and pulmonary embolism and, finally, patients' death. In COVID-19 infection, platelets have a procoagulant phenotype that can cause thrombosis in the pulmonary and systemic vascular network. Aspirin is a well-known anti-platelet drug widely used for the prevention of cardiovascular events and systematic reviews suggest a possible benefit of low-dose aspirin (LDA) use in the prevention and treatment of ARDS in patients with COVID-19 infection. However, several studies are available in the literature which do not support any benefits and no association with the patients' outcome. Therefore, currently available data are inconclusive. ⋯ 66.2% were male, median age was 77 [70-83]. 34.8% of the population died during the hospitalization. Cardiovascular diseases were not significantly different between the groups. After comparison of LDA and no-LDA subgroups, we didn't record a significant difference in mortality rate (35.7% vs 33.7%) duration of hospital stay and ICU admission. In a logistic regression model, age (OR 1.05; 95% CI 1.01-1.09), FiO2 (OR 1.024; 95% CI 1.03-1.04) and days between symptoms onset and hospitalization (OR 0.93; 95% CI 0.87-0.99) were the only variables independently associated with death.
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J. Korean Med. Sci. · Oct 2023
Multicenter Study Observational StudyEffectiveness and Adverse Events of Nirmatrelvir/Ritonavir Versus Molnupiravir for COVID-19 in Outpatient Setting: Multicenter Prospective Observational Study.
In this study, we aimed to compare the effectiveness and adverse reactions of nirmatrelvir/ritonavir and molnupiravir in high-risk outpatients with coronavirus disease 2019 (COVID-19). ⋯ The rates of hospitalization and death were low and not significantly different between high-risk patients who received either nirmatrelvir/ritonavir or molnupiravir. Although adverse events were more frequent with nirmatrelvir/ritonavir than with molnupiravir, none were severe. Nirmatrelvir/ritonavir can be safely used to treat COVID-19, while molnupiravir could be considered as an alternative treatment option for high-risk groups.
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Multicenter Study
The prevalence and risk factors of functional dyspepsia among adults in low- and middle-income countries: An international cross-sectional study.
Dyspepsia is one of the most common chronic digestive diseases, which is due to underlying organic causes that can be detected, or causes that cannot be detected called functional dyspepsia (FD). There is no epidemiological study to date that measures the prevalence and risk factors of the FD in low- and middle-income countries, so this international cross-sectional study was conducted in 15 low- and middle-income countries from data previously published its protocol NCT05340400. Participants were recruited in the period from 22/April/2022 to 14/June/2022. ⋯ Sudan obtained the highest prevalence 44.3%, then Egypt 41.4%, while the lowest prevalence was in Algeria 25.7%. Moreover, there are many risk factors, including modifiable ones, such as severe stress, chronic fatigue, smoking, abnormal BMI, insufficient or too many hours of sleep, and previous infection with Covid-19, and non-modifiable ones such as advanced age, chronic diseases, and female sex. Highlighting the prevalence and increasing risk factors of FD in low- and middle-income countries should draw the attention of those responsible for health care in these countries and reduce the risk factors.