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1.
Am J Infect Control ; 49(2): 158-165, 2021 02.
Article in English | MEDLINE | ID: mdl-32652252

ABSTRACT

BACKGROUND: COVID-19 is a novel disease caused by SARS-CoV-2. METHODS: We conducted a retrospective evaluation of patients admitted with COVID-19 to one site in March 2020. Patients were stratified into 3 groups: survivors who did not receive mechanical ventilation (MV), survivors who received MV, and those who received MV and died during hospitalization. RESULTS: There were 140 hospitalizations; 22 deaths (mortality rate 15.7%), 83 (59%) survived and did not receive MV, 35 (25%) received MV and survived; 18 (12.9%) received MV and died. Thee mean age of each group was 57.8, 55.8 and 72.7 years, respectively (P = .0001). Of those who received MV and died, 61% were male (P = .01). More than half the patients (n = 90, 64%) were African American. First measured d-dimer >575.5 ng/mL, procalcitonin > 0.24 ng/mL, lactate dehydrogenase >445.6 units/L, and brain natriuretic peptide (BNP) >104.75 pg/mL had odds ratios of 10.5, 5, 4.5 and 2.9, respectively for MV (P < .05 for all). Peak BNP >167.5 pg/mL had an odds ratio of 6.7 for inpatient mortality when mechanically ventilated (P = .02). CONCLUSIONS: Age and gender may impact outcomes in COVID-19. D-dimer, procalcitonin, lactate dehydrogenase and BNP may serve as early indicators of disease trajectory.


Subject(s)
COVID-19/mortality , Hospitalization/statistics & numerical data , Respiration, Artificial/mortality , SARS-CoV-2 , Adult , Age Factors , Aged , COVID-19/blood , COVID-19/therapy , Female , Fibrin Fibrinogen Degradation Products/analysis , Humans , L-Lactate Dehydrogenase/blood , Male , Middle Aged , Natriuretic Peptide, Brain/blood , Odds Ratio , Organ Dysfunction Scores , Procalcitonin/blood , Prognosis , Retrospective Studies , Risk Factors , Sex Factors
2.
J Gen Intern Med ; 24(9): 1049-52, 2009 Sep.
Article in English | MEDLINE | ID: mdl-19603239

ABSTRACT

BACKGROUND: While inadequate treatment intensification may contribute to sub-optimal CVD risk factor control in older patients with diabetes, the relationship between patient age and treatment intensification is largely unexplored. OBJECTIVE: To examine differences in treatment intensification and control for blood pressure (BP), lipids and A1c in older vs. younger adults with diabetes. METHODS: A total of 161,697 Kaiser Permanente Northern California adult diabetes patients were stratified by age (<50, 50-64, 65-74 and 75-85) and assessed for control of A1c (<8%), LDL-c (<100 mg/dl) and SBP (<140 mmHg). Probit models assessed the marginal effects of patient age on treatment intensification and control for all three CVD risk factors. RESULTS: Patients aged 50-64 and 65-74 were significantly more likely to receive treatment intensification for elevated SBP than patients under 50 (74% and 76% vs. 71%) and significantly less likely to receive treatment intensification for elevated A1c (73% and 72% vs. 76%), with no differences noted for LDL-c treatment. Older patients had significantly worse SBP control, but better control of A1c and LDL-c. CONCLUSIONS: Both treatment intensification rates and control of BP, A1c and LDL cholesterol control varied somewhat by age, suggesting room for further improvement in treatment intensification and control.


Subject(s)
Cardiovascular Diseases/complications , Cardiovascular Diseases/therapy , Diabetes Mellitus/therapy , Patient Care/methods , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Cardiovascular Diseases/blood , Cardiovascular Diseases/physiopathology , Diabetes Mellitus/physiopathology , Female , Glycated Hemoglobin/metabolism , Humans , Male , Middle Aged , Patient Care/trends , Risk Factors , Systole , Treatment Outcome , Young Adult
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