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INTRODUCTION: Dengue fever (DF) arises from the dengue virus (DENV), a common viral illness transmitted by arthropods. This medical condition has the potential to result in severe complications, including but not limited to liver failure, disseminated intravascular coagulation, dengue encephalopathy, myocarditis, acute renal failure, and hemolytic uremic syndrome. Evaluating cardiac manifestations in dengue is crucial for timely intervention and intensive care to save patients' lives. MATERIALS AND METHODS: A longitudinal study involved 104 dengue fever patients admitted to the Department of Medicine at New Civil Hospital, Surat, between May 2021 and October 2021, to identify potential cardiac involvement. RESULTS: The study found that out of the 104 patients, 28 (26.92%) showed cardiac involvement based on clinical manifestations. Among these patients, 28 (26.92%) exhibited abnormal ECG results, and 39 (37.50%) showed elevated creatine kinase-MB (CK-MB) levels. Of the 28 patients who showed ECG changes, 14 (50%) displayed abnormal 2D-echocardiography (ECHO) results. The most common electrocardiographic anomaly was a T-wave inversion in V1-V4. The predominant 2D-ECHO finding was mild pericardial effusion. CONCLUSION: Cardiac involvement in dengue presents atypically and can lead to conditions like myocarditis, arrhythmias, cardiac failure, or shock. Assessing cardiac manifestations in dengue patients is pivotal for appropriate management.
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BACKGROUND: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has significant health implications. Anemia is usually an unseen comorbidity, which could significantly affect outcomes in AECOPD patients, and there is limited data to support this. We conducted this study to assess the effect of anemia on this patient population. METHODS: We performed a retrospective cohort study using the National (Nationwide) Inpatient Sample (NIS) data from 2008 to 2014. Patients with AECOPD and anemia with age >40 years were identified using appropriate International Classification of Diseases, Ninth Revision (ICD-9) codes, excluding transfer out to other hospitals. We calculated the Charlson Comorbidity Index as a measure of associated comorbidities. We analyzed bivariate group comparisons in patients with and without anemia. Odds ratios were calculated using multivariate logistic and linear regression analysis using SAS version 9.4 (2013; SAS Institute Inc. Cary, North Carolina, United States). RESULTS: Among 3,331,305 patients hospitalized with AECOPD, 567,982 (17.0%) had anemia as a comorbidity. The majority of patients were elderly, women, and white. After adjusting for potential confounders in regression, mortality (adjusted OR (aOR) 1.25, 95%CI: 1.18-1.32), length of hospital stay (ß 0.79, 95%Cl 0.76-0.82), and hospitalization cost (ß 6873, 95%Cl 6437-7308) were significantly higher in patients with anemia. In addition, patients with anemia required significantly higher blood transfusion (aOR 16.9, 95%CI 16.1-17.8), invasive ventilator support (aOR 1.72, 95%CI 1.64-1.79), and non-invasive ventilator support (aOR 1.21, 95%CI 1.17-1.26). CONCLUSION: In this first retrospective largest cohort study on this topic, we find anemia is a significant comorbidity associated with adverse outcomes and healthcare burden in hospitalized AECOPD patients. We should focus on close monitoring and management of anemia to improve the outcomes in this population.