ABSTRACT
BACKGROUND: The association between asthma and COVID-19 remains controversial. Objective. To establish the prevalence of asthma in a sample of patients with COVID-19-associated pneumonia; furthermore, to describe the clinical characteristics of patients with asthma compared to patients without asthma. METHODS: Clinical data corresponding to 120 patients hospitalized for pneumonia associated with SARS-CoV-2 infection were analyzed. Patients with and without asthma were compared based on COVID-19 severity. RESULTS: The prevalence of asthma in patients with COVID-19 pneumonia was 3.5% (95% CI: 2.0% to 5.1%). When comparing the severity of COVID-19 among asthma patients with non-asthma patients, it did not differ based on symptoms, comorbidity, duration of symptoms, need for assisted mechanical ventilation, biomarkers of inflammation, and the occurrence of death. Patients with asthma and COVID-19 showed a high T2 phenotype, poor respiratory function, and no regular treatment for asthma control. CONCLUSIONS: No significant differences in the frequency of assisted mechanical ventilation or death were observed between patients hospitalized for COVID-19-associated pneumonia with and without a history of asthma.
ANTECEDENTES: La asociación el asma con la COVID-19 continúa siendo controversial. Objetivo: establecer la prevalencia de asma en una muestra de pacientes con neumonía asociada COVID-19; además, describir las características clínicas de los pacientes con asma en comparación con los pacientes sin asma. MÉTODOS: La asociación el asma con la COVID-19 continúa siendo controversial. Objetivo: establecer la prevalencia de asma en una muestra de pacientes con neumonía asociada COVID-19; además, describir las características clínicas de los pacientes con asma en comparación con los pacientes sin asma. RESULTADOS: La prevalencia de asma en los pacientes con neumonía por COVID-19 fue del 3.5% (IC 95%: 1.5% a 9.6%). Al comparar la gravedad de la COVID-19 entre los pacientes con asma con los pacientes sin asma, ésta no difirió en función de los síntomas, la comorbilidad, la duración de los síntomas, la necesidad de ventilación mecánica asistida, los biomarcadores de inflamación y la ocurrencia de muerte. Los pacientes con asma y COVID-19 mostraron un fenotipo T2 alto, con pobre función respiratoria y sin uso de tratamiento regular para el control del asma. CONCLUSIONES: No se observaron diferencias significativas en la frecuencia de la ventilación mecánica asistida o de la muerte entre los pacientes hospitalizados por neumonía asociada con COVID-19 con y sin historia de asma.
Subject(s)
Asthma , COVID-19 , Pneumonia , Humans , Asthma/complications , Asthma/epidemiology , Asthma/drug therapy , Comorbidity , COVID-19/complications , Prevalence , SARS-CoV-2 , Pneumonia/complicationsABSTRACT
Introduction: Infections caused by antimicrobial-resistant bacteria are a significant cause of death worldwide, and carbapenemase-producing bacteria are the principal agents. New Delhi metallo-beta-lactamase-1 producing Klebsiella pneumoniae (KP-NDM-1) is an extensively drug-resistant bacterium that has been previously reported in Mexico. Our aim was to conduct a case-control study to describe the risk factors associated with nosocomial infections caused by K. pneumoniae producing NDM-1 in a tertiary-care hospital in Mexico. Methods: A retrospective case-control study with patients hospitalized from January 2012 to February 2018 at the Hospital Civil de Guadalajara "Fray Antonio Alcalde" was designed. During this period, 139 patients with a culture that was positive for K. pneumoniae NDM-1 (cases) and 486 patients hospitalized in the same department and on the same date as the cases (controls) were included. Data were analyzed using SPSS v. 24, and logistic regression analysis was conducted to calculate the risk factors for KP-NDM-1 infection. Results: One hundred and thirty-nine case patients with a KP-NDM-1 isolate and 486 control patients were analyzed. In the case group, acute renal failure was a significant comorbidity, hospitalization days were extended, and significantly more deaths occurred. In a multivariate analysis of risk factors, the independent variables included the previous use of antibiotics (odds ratio, OR = 12.252), the use of a urinary catheter (OR = 5.985), the use of a central venous catheter (OR = 5.518), the use of mechanical ventilation (OR = 3.459), and the length of intensive care unit (ICU) stay (OR = 2.334) as predictors of infection with NDM-1 K. pneumoniae. Conclusion: In this study, the previous use of antibiotics, the use of a urinary catheter, the use of a central venous catheter, the use of mechanical ventilation, and ICU stay were shown to be predictors of infection with NDM-1 K. pneumoniae and were independent risk factors for infection with NDM-1 K. pneumoniae.
Subject(s)
Klebsiella Infections , Klebsiella pneumoniae , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Case-Control Studies , Humans , Klebsiella Infections/microbiology , Retrospective Studies , beta-LactamasesABSTRACT
OBJECTIVE: To determine the prevalence of blood eosinophilia in adults with chronic obstructive pulmonary disease (COPD) according to different cut-off points. METHODS: A cross-sectional study was carried out in patients with COPD. The frequency of blood eosinophilia was determined by absolute (cells/ µL) and relative (%) eosinophil count. Multivariate methods were used in order to identify the associated factors. RESULTS: 81 patients were included; the mean age was 71.9 ± 9.8 years; 46 (57%) of the patients were men. The prevalence of eosinophilia for the cut-off points of ≥ 100, ≥ 150, ≥ 200, ≥ 300, and ≥ 400 cells/µL was of 64.2%, 37.0%, 16.1%, and 9.9% respectively. Out of 81 patients, 34 (42%) had a relative eosinophil concentration of ≥ 2%; 21 (25.9%) ≥ 3%; 14 patients (17.3%) had ≥ 4%; and 10 patients (12.3%) had ≥ 5%. Eosinophilia of ≥ 100 cells/µL was associated with age of ≥ 80 years (OR = 6.04, p = 0.026), and with the exacerbation of COPD (OR = 9.40, p = 0.038); in contrast, eosinophilia of ≥ 2% was associated only with age of ≥ 80 years (OR = 3.73, p = 0.020). In addition, the eosinophil count of ≥ 100 and < 300 cells/µL was associated with the exacerbation of COPD (OR = 11.00, p = 0.026). CONCLUSIONS: Our results suggest that the frequency of eosinophilia in the context of COPD shows substantial variations according to the used definition.
Objetivo: Establecer la prevalencia de eosinofilia en sangre en adultos con enfermedad pulmonar obstructiva crónica (EPOC) según varios puntos de corte. Métodos: Se realizó un estudio transversal en pacientes con EPOC. La frecuencia de eosinofilia en sangre se determinó a partir de la concentración absoluta (células/µL) y relativa (%) de eosinófilos. Fueron realizados modelos multivariados para identificar factores asociados. Resultados: En 81 pacientes incluidos, la edad promedio fue de 71.9 ± 9.8 años; de los cuales, 46 (57 %) fueron hombres. La prevalencia de eosinofilia para los puntos de corte ≥ 100, ≥ 150, ≥ 200, ≥ 300 y ≥ 400 células/µL fue de 64.2, 43.2, 37.0, 16.1 y 9.9 %, respectivamente. De 81 pacientes, 34 (42 %) tuvieron una concentración ≥ 2 %; 21 (25.9 %) ≥ 3 %; 14 (17.3 %) ≥ 4 %; y 10 (12.3 %) ≥ 5 %. La eosinofilia ≥ 100 células/µL se asoció con la edad ≥ 80 años (RM = 6.04, p = 0.026) y con la exacerbación de la EPOC (RM = 9.40, p = 0.038); en cambio, la eosinofilia ≥ 2 %, lo hizo con solamente la edad ≥ 80 años (RM = 3.73, p = 0.020). Complementariamente, la concentración de eosinófilos ≥ 100 y < 300 células/µL se asoció con la exacerbación de la EPOC (RM = 11.00, p = 0.026). Conclusiones: Nuestros resultados sugieren que la frecuencia de eosinofilia en EPOC muestra variaciones sustanciales según la definición adoptada.
