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Proportion and prognosis of ICU-admitted coronavirus disease 2019-infected patients in relation to all hospitalized cases in Abbasia Chest Hospital, Cairo 开罗阿巴西亚胸科医院2019年冠状病毒感染重症监护病房患者与所有住院病例的比例及预后
IF 0.1 Pub Date : 2023-07-01 DOI: 10.4103/ecdt.ecdt_89_22
H. Mahmoud, M. Tageldin, Yehia R. Yousef
Background Because of the outbreak of coronavirus disease 2019 (COVID-19), there has been an increase in the demand for intensive care services all over the world. Severe cases fulfill one of the following criteria: respiratory rate more than 30/min, oxygen saturation less than or equal to 93%, and PaO2/FiO2 less than or equal to 300 mmHg. ICU admission is required for seriously ill patients who require high-flow nasal cannula, intubation, or more oxygen to treat hypoxemia or multiple organ dysfunctions. However, it is unclear whether patients with COVID-19 who are admitted to the ICU will survive. Aim To estimate the proportion and prognosis of ICU-admitted COVID cases in relation to whole COVID cases admitted at Abbassia Chest Hospital and estimation of risk factors responsible for mortality. Patients and methods This retrospective observational study was conducted on all cases of COVID-19-infected patients admitted at respiratory ICU of Abbassia Chest Hospital in relation to all hospitalized cases during the period between January 2021 and June 2021. All of the cases were subjected to full history taking, laboratory investigations, and radiological assessment with chest radiograph and computed tomography. The reported outcomes included weaning from mechanical ventilation, discharge, mortality, and cause of death. Results The study included 76 patients with COVID-19. Overall, 43 (56.6%) were males and 33 (43.4%) were females, with a mean age of 57.17 ± 12.54 years. The incidence of mortality was 32.9%. The acute respiratory distress syndrome (ARDS) was the most common cause for ICU admission and encountered in 57.4% of the cases. All of the dead cases had severe ARDS. The use of invasive mechanical ventilation was reported in 76.5% of the included died cases, and this was statistically significantly higher as compared with the survived group. On the contrary, the length of ICU stay was statistically significantly higher in the survived group. Conclusion COVID-19 infection is associated with a high percentage of ICU admission with a high mortality rate. Many factors are associated with the high risk of mortality among the ICU admitted COVID-19-infected patients including severe ARDS, deterioration of the systemic organ functions, and the utilization of invasive mechanical ventilation.
由于2019冠状病毒病(COVID-19)的爆发,世界各地对重症监护服务的需求有所增加。严重者满足以下条件之一:呼吸频率≥30/min,血氧饱和度≤93%,PaO2/FiO2≤300mmhg。重症患者需要高流量鼻插管、插管或更多的氧气来治疗低氧血症或多器官功能障碍,则需要进入ICU。但是,目前尚不清楚入住ICU的新冠肺炎患者能否存活。目的了解阿巴西亚胸科医院重症监护病房收治的新冠肺炎病例占全部新冠肺炎病例的比例和预后,并评估导致死亡的危险因素。患者与方法本研究对2021年1月至2021年6月阿巴西亚胸科医院呼吸ICU收治的所有covid -19感染患者进行回顾性观察研究。所有病例均接受了完整的病史记录、实验室调查以及胸片和计算机断层扫描的放射学评估。报告的结果包括机械通气、出院、死亡率和死亡原因。结果纳入76例新冠肺炎患者。男性43例(56.6%),女性33例(43.4%),平均年龄57.17±12.54岁。死亡率为32.9%。急性呼吸窘迫综合征(ARDS)是ICU住院最常见的原因,占57.4%。死亡病例均为严重急性呼吸窘迫综合征。有创机械通气在纳入的死亡病例中占76.5%,与存活组相比,这一比例有统计学意义。与此相反,存活组的ICU住院时间明显高于存活组。结论COVID-19感染与ICU住院率高、病死率高相关。重症急性呼吸窘迫综合征(ARDS)、全身器官功能恶化、有创机械通气的使用等因素与ICU收治的covid -19感染患者死亡风险高相关。
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引用次数: 0
Association of inflammatory biomarkers with coronavirus disease 2019 severity: a retrospective study in the UAE 炎症生物标志物与2019冠状病毒病严重程度的关联:阿联酋的一项回顾性研究
IF 0.1 Pub Date : 2023-07-01 DOI: 10.4103/ecdt.ecdt_104_22
H. Said, A. Almansoury, S. Fekry, Wael Abdelfattah
Background The inflammatory process involved in severe acute respiratory syndrome coronavirus 2 infection is one of great interest in understanding the pathophysiology and severity of coronavirus disease 2019 (COVID-19). This study aimed to evaluate the association of inflammatory markers with severe COVID-19. Patients and methods The data were collected from patient files admitted to two tertiary hospitals in UAE during the COVID-19 pandemic from April to July 2020. During first COVID-19 wave that hits UAE, general symptoms as well as radiographic, blood, and immunological findings were also recorded. Results The study included 320 patients. Men (84.1%) outnumbered women (15.9%). Most (73.8%) patients had no comorbidities. The patients were from several nationalities, with Indians being the majority (51.9%). Most patients (65.6%) had mild, whereas 26.6% had severe manifestations. Only 25 patients were asymptomatic. C-reactive protein level had a significant relation to COVID-19 severity. Some parameters such as lactate dehydrogenase, ferritin, D-dimer, neutrophil/lymphocyte ratio, ICU admission, and death rates as well as radiological findings in the severe group had significant differences compared with the mild and asymptomatic groups. Conclusions These data are valuable contributions to the monitoring, severity assessment, and prognosis of patients with COVID-19.
严重急性呼吸综合征冠状病毒2感染的炎症过程是了解冠状病毒病2019 (COVID-19)病理生理和严重程度的重要兴趣之一。本研究旨在评估炎症标志物与严重COVID-19的相关性。患者和方法数据收集自2020年4月至7月2019冠状病毒病大流行期间阿联酋两家三级医院的患者档案。在第一波COVID-19袭击阿联酋期间,还记录了一般症状以及放射学、血液和免疫学检查结果。结果纳入320例患者。男性(84.1%)多于女性(15.9%)。大多数(73.8%)患者无合并症。患者来自多个国家,其中印度人占多数(51.9%)。大多数患者(65.6%)表现为轻度,而26.6%表现为重度。只有25例患者无症状。c反应蛋白水平与COVID-19严重程度有显著相关性。重症组乳酸脱氢酶、铁蛋白、d -二聚体、中性粒细胞/淋巴细胞比值、ICU入院率、死亡率及影像学表现等指标与轻症、无症状组比较差异有统计学意义。结论这些数据对COVID-19患者的监测、严重程度评估和预后有重要贡献。
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引用次数: 0
Prevalence of obstructive sleep apnea in patients with lone atrial fibrillation 单发房颤患者阻塞性睡眠呼吸暂停的患病率
IF 0.1 Pub Date : 2023-07-01 DOI: 10.4103/ecdt.ecdt_108_22
Aida M. Yousef, M. Abdelsalam, Mohamed El Dosky Aboshehata, Heba El Dosky, S. Arafa
Purpose The aim of this study is to detect the prevalence of obstructive sleep apnea syndrome (OSAS) in patients having lone atrial fibrillation (AF). Patients and methods Fifty patients with lone AF were referred to our sleep unit from the Department of Cardiology at the University Hospital. Lone AF was defined as AF in patients without cardiac structural abnormality and less than 60 years of age. All patients were subjected to a detailed history with stress on the number and date of documented episodes of AF and how it was terminated, OSA symptoms (excessive daytime sleepiness, witnessed apnea, loud habitual snoring, and nocturnal choking), and OSA screening questionnaires. ENT and cardiac examination by a specialist was done. Full-night attended polysomnography was performed on full night. Results The median apnea–hypopnea index in the studied group was 10.8 (range, 0.4–69.4). There were 21 (42.0%) non-OSA patients, while there were 29 (58%) OSA patients. There were eight (27.6%) mild OSA patients. Moderate OSA patients were 10 (34.5%). Severe OSA patients were 11 (37.9%). Median of the frequency of AF episodes in the last 1 year was significantly higher in the OSA group than in the normal group (P=0.01). No significant difference was present between both groups as regards the number of nocturnal arrhythmias not related to respiratory events. The frequency of paroxysmal AF episodes during the last year shows a significant positive correlation with severity of OSA, desaturation index, and total arousal index. Conclusion The results of our study support our hypothesis that OSA is a risk factor for AF. We should investigate patients with lone AF for the possibility of OSA.
{"title":"Prevalence of obstructive sleep apnea in patients with lone atrial fibrillation","authors":"Aida M. Yousef, M. Abdelsalam, Mohamed El Dosky Aboshehata, Heba El Dosky, S. Arafa","doi":"10.4103/ecdt.ecdt_108_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_108_22","url":null,"abstract":"Purpose The aim of this study is to detect the prevalence of obstructive sleep apnea syndrome (OSAS) in patients having lone atrial fibrillation (AF). Patients and methods Fifty patients with lone AF were referred to our sleep unit from the Department of Cardiology at the University Hospital. Lone AF was defined as AF in patients without cardiac structural abnormality and less than 60 years of age. All patients were subjected to a detailed history with stress on the number and date of documented episodes of AF and how it was terminated, OSA symptoms (excessive daytime sleepiness, witnessed apnea, loud habitual snoring, and nocturnal choking), and OSA screening questionnaires. ENT and cardiac examination by a specialist was done. Full-night attended polysomnography was performed on full night. Results The median apnea–hypopnea index in the studied group was 10.8 (range, 0.4–69.4). There were 21 (42.0%) non-OSA patients, while there were 29 (58%) OSA patients. There were eight (27.6%) mild OSA patients. Moderate OSA patients were 10 (34.5%). Severe OSA patients were 11 (37.9%). Median of the frequency of AF episodes in the last 1 year was significantly higher in the OSA group than in the normal group (P=0.01). No significant difference was present between both groups as regards the number of nocturnal arrhythmias not related to respiratory events. The frequency of paroxysmal AF episodes during the last year shows a significant positive correlation with severity of OSA, desaturation index, and total arousal index. Conclusion The results of our study support our hypothesis that OSA is a risk factor for AF. We should investigate patients with lone AF for the possibility of OSA.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84495036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bronchoalveolar lavage in lung cancer: does it increase the positive yield of bronchoscopy? 肺癌的支气管肺泡灌洗:是否增加了支气管镜检查的阳性率?
IF 0.1 Pub Date : 2023-07-01 DOI: 10.4103/ecdt.ecdt_88_22
K. Salama, Manal R. Hafez, A. Farag, Doaa Salim
Background Cells obtained from bronchoalveolar space can give a definite diagnosis in malignancies. The present study aimed to assess the diagnostic yield of bronchoalveolar lavage (BAL) in lung cancer and to assess the relationship of its yield with radiology, endoscopy, and pathological subtypes. Patients and methods A retrospective study with re-revision of saved bronchoscopic video, computed tomography (CT) films, and pathology slides was conducted on 101 patients with definite bronchogenic carcinoma diagnosed over 4 years. Results BAL positive yield was found in 42.4% of cases, and its yield coincided with other bronchoscopic sampling methods in 43.6% of cases. Regarding CT findings, the BAL positive yield was significantly higher in peripheral lesions (79.1%), mass size more than or equal to 3 cm (62.8%), CT bronchus sign (46.5%), hilar and/or mediastinal adenopathy (86.0%), and consolidation (51.2%). The most common bronchoscopic abnormality in patients with BAL positive yield was submucosal lesions (83.3%). The adenocarcinoma (48.8%) and bronchoalveolar carcinoma (11.6%) were the histopathological types having significant BAL positive yield. The most significant predictive factors for BAL positive yield were mediastinal adenopathy, endobronchial lesions, nonvisible lesions, adenocarcinoma type, submucosal lesions, CT bronchus sign, mass size more than or equal to 3 cm, peripheral lesions, and concomitant use of bronchial brushing. BAL had 40.3% sensitivity, 51.7% specificity, 67.4% positive predictive value, 25.9% negative predictive value, and 43.6% diagnostic accuracy in bronchogenic carcinoma. Conclusion BAL increases the positive yield of bronchoscopy by 13.9% with fair diagnostic performance, especially in peripherally locating nonvisible lesions. Although tissue biopsy remains the gold standard sampling, clinicians might rely on BAL cytology for diagnosis of lung cancer in some patients.
背景:从支气管肺泡间隙获得的细胞可以明确诊断恶性肿瘤。本研究旨在评估支气管肺泡灌洗(BAL)对肺癌的诊断率,并评估其与放射学、内窥镜检查和病理亚型的关系。患者和方法对101例确诊为支气管源性癌的患者进行回顾性研究,并对保存的支气管镜影像、CT片和病理切片进行重新修订。结果BAL阳性检出率为42.4%,与其他支气管镜取样方法检出率一致的占43.6%。CT表现方面,外周病变(79.1%)、肿块大小大于或等于3cm(62.8%)、CT支气管征象(46.5%)、肺门和/或纵隔腺病(86.0%)和实变(51.2%)的BAL阳性率明显较高。BAL阳性患者中最常见的支气管镜异常是粘膜下病变(83.3%)。腺癌(48.8%)和支气管肺泡癌(11.6%)是BAL阳性的组织病理学类型。BAL阳性产率最显著的预测因素是纵隔腺病、支气管内病变、不可见病变、腺癌类型、粘膜下病变、CT支气管征象、肿块大小大于或等于3cm、周围病变以及同时使用支气管刷牙。BAL对支气管源性癌的敏感性为40.3%,特异性为51.7%,阳性预测值为67.4%,阴性预测值为25.9%,诊断准确率为43.6%。结论BAL可使支气管镜检查阳性检出率提高13.9%,诊断效果较好,尤其是对周围不可见病变的定位。虽然组织活检仍然是金标准取样,但临床医生可能依赖BAL细胞学来诊断某些患者的肺癌。
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引用次数: 0
Coexistence of tubercular constrictive pericarditis with tubercular pleural effusion 结核性缩窄性心包炎与结核性胸腔积液共存
IF 0.1 Pub Date : 2023-04-01 DOI: 10.4103/ecdt.ecdt_51_20
Amol G Andhale, S. Acharya, S. Shukla, Akhilesh Annadatha, Vidyashree Hulkoti
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引用次数: 0
Laboratory markers and radiological signs of mild versus severe COVID-19 patients 轻、重度COVID-19患者的实验室标志物和放射学征象
IF 0.1 Pub Date : 2023-04-01 DOI: 10.4103/ecdt.ecdt_84_22
Hisham Abdel-Aaty, Mahmoud M. El-Habashy, I. Shedeed, A. Mahrous
Background Coronavirus disease 2019 (COVID-19), a global pandemic that has spread worldwide in a dramatic manner since its first emergence in December 2019 from Wuhan, China. To date, there is still lack of an appropriate protocol that predicts cases who are impending to develop severe COVID-19. Hence, this work was an attempt to determine the potential association of the clinical, laboratory, and radiological parameters with the severity of COVID-19 and the ability of these parameters to predict the severe cases. Patients and methods This is a retrospective study that was based on recruiting the data from the files of patients who attended the chest outpatient clinic, or admitted to the chest department or the ICU of our institution. The study included adult patients who were diagnosed with COVID-19. Patients were categorized into two groups: severe/critical cases and mild/moderate disease cases. Data concerning the patient history, clinical picture, and radiological data were obtained and analyzed. Results Eighty adult patients with COVID-19 were included in this study. They were classified into severe/critical (40 patients) or mild/moderate disease (40 patients). Patients with severe/critical COVID-19 disease were significantly older in age and had higher comorbidities, prevalence, higher incidence of cough, dyspnea, gastrointestinal tract symptoms and fatigue, elevated total leukocyte count, lower relative lymphocytes, lower absolute lymphocytes and higher neutrophils, higher blood glucose levels, higher alanine transaminase, higher aspartate aminotransferase and lower serum albumin, reduced Ca levels, elevated lactate dehydrogenase, serum ferritin, D-dimer, and C-reactive protein levels. They had significantly higher computed tomographic (CT) scores and CT chest with greater than 50% lesions or progressive lesions. The mortality rate was 10%, all of which were from the severe disease group. Conclusion The current study is confirming an overall substantial association between severe COVID-19 and older age, chronic diseases, CT imaging pattern, and severity score, leukocyte count, lymphopenia, blood glucose, serum albumin, alanine transaminase, aspartate aminotransferase, calcium levels, C-reactive protein, D-dimer, lactate dehydrogenase, and ferritin. These results highlighted the importance of using clinical, laboratory, and radiological features for monitoring of COVID-19 patients.
2019冠状病毒病(COVID-19)是一种全球大流行病,自2019年12月在中国武汉首次出现以来,已在全球范围内以惊人的方式传播。迄今为止,仍然缺乏一种适当的方案来预测即将发展为严重COVID-19的病例。因此,本工作旨在确定临床、实验室和放射学参数与COVID-19严重程度的潜在关联,以及这些参数预测严重病例的能力。患者和方法本研究是一项回顾性研究,数据来源于我院胸科门诊、胸科或ICU就诊的患者档案。该研究包括被诊断患有COVID-19的成年患者。患者分为重/危重症和轻/中度疾病两组。收集和分析患者病史、临床表现和放射学资料。结果本研究共纳入80例成人COVID-19患者。患者分为重/危重症(40例)和轻/中度疾病(40例)。COVID-19重症/危重型患者年龄明显偏大,合并症、患病率、咳嗽、呼吸困难、胃肠道症状和疲劳发生率均较高,白细胞总数升高、相对淋巴细胞降低、绝对淋巴细胞降低、中性粒细胞升高、血糖升高、谷丙转氨酶升高、天冬氨酸转氨酶升高、血清白蛋白降低、钙水平降低、乳酸脱氢酶升高、血清铁蛋白升高。d -二聚体和c反应蛋白水平。他们的计算机断层扫描(CT)评分明显较高,CT胸部病变大于50%或进展性病变。死亡率为10%,均为重症组。目前的研究证实,重症COVID-19与年龄、慢性疾病、CT成像模式、严重程度评分、白细胞计数、淋巴细胞减少、血糖、血清白蛋白、丙氨酸转氨酶、天冬氨酸转氨酶、钙水平、c反应蛋白、d -二聚体、乳酸脱氢酶和铁蛋白之间存在全面的实质性关联。这些结果突出了利用临床、实验室和放射学特征监测COVID-19患者的重要性。
{"title":"Laboratory markers and radiological signs of mild versus severe COVID-19 patients","authors":"Hisham Abdel-Aaty, Mahmoud M. El-Habashy, I. Shedeed, A. Mahrous","doi":"10.4103/ecdt.ecdt_84_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_84_22","url":null,"abstract":"Background Coronavirus disease 2019 (COVID-19), a global pandemic that has spread worldwide in a dramatic manner since its first emergence in December 2019 from Wuhan, China. To date, there is still lack of an appropriate protocol that predicts cases who are impending to develop severe COVID-19. Hence, this work was an attempt to determine the potential association of the clinical, laboratory, and radiological parameters with the severity of COVID-19 and the ability of these parameters to predict the severe cases. Patients and methods This is a retrospective study that was based on recruiting the data from the files of patients who attended the chest outpatient clinic, or admitted to the chest department or the ICU of our institution. The study included adult patients who were diagnosed with COVID-19. Patients were categorized into two groups: severe/critical cases and mild/moderate disease cases. Data concerning the patient history, clinical picture, and radiological data were obtained and analyzed. Results Eighty adult patients with COVID-19 were included in this study. They were classified into severe/critical (40 patients) or mild/moderate disease (40 patients). Patients with severe/critical COVID-19 disease were significantly older in age and had higher comorbidities, prevalence, higher incidence of cough, dyspnea, gastrointestinal tract symptoms and fatigue, elevated total leukocyte count, lower relative lymphocytes, lower absolute lymphocytes and higher neutrophils, higher blood glucose levels, higher alanine transaminase, higher aspartate aminotransferase and lower serum albumin, reduced Ca levels, elevated lactate dehydrogenase, serum ferritin, D-dimer, and C-reactive protein levels. They had significantly higher computed tomographic (CT) scores and CT chest with greater than 50% lesions or progressive lesions. The mortality rate was 10%, all of which were from the severe disease group. Conclusion The current study is confirming an overall substantial association between severe COVID-19 and older age, chronic diseases, CT imaging pattern, and severity score, leukocyte count, lymphopenia, blood glucose, serum albumin, alanine transaminase, aspartate aminotransferase, calcium levels, C-reactive protein, D-dimer, lactate dehydrogenase, and ferritin. These results highlighted the importance of using clinical, laboratory, and radiological features for monitoring of COVID-19 patients.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80674850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Post-COVID anxiety and its associated factors in Egyptian patients 埃及患者新冠肺炎后焦虑及其相关因素
IF 0.1 Pub Date : 2023-04-01 DOI: 10.4103/ecdt.ecdt_51_22
H. Ezzelregal, Azza Hassan, Rehab Serag, H. Eldin
Context Anxiety is one of the mood changes that occur postcoronavirus disease-2019 (post-COVID-19) and interfere with patients’ daily activity. After supposed clinical and radiological improvement to COVID-19, some still experience somatic complaints such as sensation of dyspnea. Aims Evaluating the relation between COVID-19 survivors and anxiety and to what extent this could affect their functional status. Settings and design Ain Shams University Hospital, survey study. Patients and methods The survey included 120 patients post-COVID-19 one month or more and free symptoms attending Ain Shams University Hospitals Chest Outpatient Clinic for follow-up, 45% of them were in the age group 35–55 years, 56.7% were females, 78.3% had high education, and 27.5% were smokers. All included study participants were subjected to computed tomography of chest, oxygen saturation, State Trait Anxiety Inventory (STAI) Arabic version, and Modified Medical Research Council (MMRC) Dyspnea Scale. χ2-test (or Fisher’s exact test) was used to compare data between different groups. Logistic regression analysis was used to determine the correlation between the features of individuals and their degree of anxiety. Results The most annoying COVID-19 symptoms as reported by this study participants were body pains (32.5%). About 61.7% of participants had high-state anxiety and 51.7% had high-trait anxiety. The age group 20–34 years was significantly associated with higher frequency of moderate or high-state anxiety (P<0.05), male sex was significantly associated with lower frequency of moderate or high-state anxiety compared with females (P<0.05). Conclusions Age and sex were important association factors with the prevalence of anxiety in post-COVID-19 patients. Higher grades of dyspnea were associated with higher probability of development of moderate or severe post-COVID anxiety.
焦虑是2019冠状病毒病后(后covid -19)发生的情绪变化之一,会干扰患者的日常活动。在COVID-19的临床和放射学改善后,一些人仍然会出现躯体症状,如呼吸困难的感觉。目的评估COVID-19幸存者与焦虑之间的关系,以及焦虑对其功能状态的影响程度。背景与设计:艾因沙姆斯大学医院,调查研究。患者与方法调查对象为120例新冠肺炎后1个月及以上无症状就诊于艾因沙姆斯大学附属医院胸科门诊随访的患者,其中45%年龄在35-55岁之间,56.7%为女性,78.3%为高学历,27.5%为吸烟者。所有纳入的研究参与者均接受胸部计算机断层扫描、血氧饱和度、状态-特质焦虑量表(STAI)阿拉伯文版和改良医学研究委员会(MMRC)呼吸困难量表。采用χ2检验(或Fisher精确检验)对不同组间数据进行比较。采用Logistic回归分析确定个体特征与其焦虑程度之间的相关性。结果本研究参与者报告的最恼人的COVID-19症状是身体疼痛(32.5%)。约61.7%的参与者有高状态焦虑,51.7%的参与者有高特质焦虑。20 ~ 34岁年龄段患者出现中、高状态焦虑的频率显著高于女性(P<0.05),性别与出现中、高状态焦虑的频率显著低于女性(P<0.05)。结论年龄和性别是影响新冠肺炎后患者焦虑发生率的重要因素。较高程度的呼吸困难与出现中度或重度covid后焦虑的可能性较高相关。
{"title":"Post-COVID anxiety and its associated factors in Egyptian patients","authors":"H. Ezzelregal, Azza Hassan, Rehab Serag, H. Eldin","doi":"10.4103/ecdt.ecdt_51_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_51_22","url":null,"abstract":"Context Anxiety is one of the mood changes that occur postcoronavirus disease-2019 (post-COVID-19) and interfere with patients’ daily activity. After supposed clinical and radiological improvement to COVID-19, some still experience somatic complaints such as sensation of dyspnea. Aims Evaluating the relation between COVID-19 survivors and anxiety and to what extent this could affect their functional status. Settings and design Ain Shams University Hospital, survey study. Patients and methods The survey included 120 patients post-COVID-19 one month or more and free symptoms attending Ain Shams University Hospitals Chest Outpatient Clinic for follow-up, 45% of them were in the age group 35–55 years, 56.7% were females, 78.3% had high education, and 27.5% were smokers. All included study participants were subjected to computed tomography of chest, oxygen saturation, State Trait Anxiety Inventory (STAI) Arabic version, and Modified Medical Research Council (MMRC) Dyspnea Scale. χ2-test (or Fisher’s exact test) was used to compare data between different groups. Logistic regression analysis was used to determine the correlation between the features of individuals and their degree of anxiety. Results The most annoying COVID-19 symptoms as reported by this study participants were body pains (32.5%). About 61.7% of participants had high-state anxiety and 51.7% had high-trait anxiety. The age group 20–34 years was significantly associated with higher frequency of moderate or high-state anxiety (P<0.05), male sex was significantly associated with lower frequency of moderate or high-state anxiety compared with females (P<0.05). Conclusions Age and sex were important association factors with the prevalence of anxiety in post-COVID-19 patients. Higher grades of dyspnea were associated with higher probability of development of moderate or severe post-COVID anxiety.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73296986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Role of pulmonary function tests and computed tomography volumetric quantitative analysis in assessment of idiopathic pulmonary fibrosis 肺功能检查和计算机断层体积定量分析在评估特发性肺纤维化中的作用
IF 0.1 Pub Date : 2023-04-01 DOI: 10.4103/ecdt.ecdt_71_22
Omina Zaki, R. Sharshar, R. Younes, A. Abdella
Background Idiopathic pulmonary fibrosis (IPF) is a progressive irreversible lung disease, but early assessment by pulmonary function tests (PFTs) and quantitative volumetric computed tomography (CT) analysis aid in diagnosis, disease monitoring, and prognosis in patients with IPF. Objectives The study aimed to study the role of quantitative volumetric CT indices and PFTs in assessing disease severity in patients with IPF. Patients and methods The study included 40 patients with IPF diagnosed by usual interstitial pneumonia pattern in high-resolution CT and subdivided into two groups according to the GAP staging system (sex, age, and physiology): group I included patients with IPF stage I (five patients) and stage II (15 patients), whereas group II included patients with IPF stage III (20 patients). Clinical history taking, physical examination, plain chest radiography to exclude other diagnosis, PFTs, and quantitative volumetric high-resolution CT were done for all patients. Results There was a significant difference between group I [higher normal attenuating lung volume (NL%) and lower honeycombing area volume (HA%)] versus group II (lower NL% and higher HA%), with no significant difference in whole lung volume (WL) between the two groups. There was a significant correlation between radiological parameters (NL% and HA%) and modified Medical Research Council score of dyspnea and GAP staging system. Radiological parameters (NL% and HA%) had a significant correlation with functional parameters (forced vital capacity% and diffusing capacity for carbon monoxide%). Furthermore, NL% and HA% showed a negative significant correlation with each other. Conclusions PFTs and quantitative volumetric CT parameters showed a statistically significant difference among IPF cases of various severity, and both are highly correlated with each other and with clinical modified Medical Research Council score of dyspnea score of dyspnea and GAP staging system. So, both can play a major role not only in diagnosis but also in detecting severity and predicting mortality in IPF.
特发性肺纤维化(IPF)是一种进行性不可逆的肺部疾病,但通过肺功能试验(PFTs)和定量容积计算机断层扫描(CT)分析进行早期评估有助于IPF患者的诊断、疾病监测和预后。目的探讨定量CT容积指数和pft在IPF患者疾病严重程度评估中的作用。患者和方法本研究纳入40例高分辨率CT诊断为常规间质性肺炎的IPF患者,并根据GAP分期系统(性别、年龄和生理)细分为两组:I组包括IPF I期(5例)和II期(15例)患者,II组包括IPF III期(20例)患者。所有患者均进行了临床病史、体格检查、排除其他诊断的胸部平片、pft和定量高分辨率体积CT检查。结果ⅰ组[正常衰减肺体积(NL%)升高、蜂窝状面积体积(HA%)降低]与ⅱ组(NL%降低、HA%升高)差异有统计学意义,两组间全肺体积(WL)无统计学差异。放射学参数(NL%和HA%)与改进的医学研究委员会呼吸困难评分和GAP分期系统有显著相关性。放射学参数(NL%和HA%)与功能参数(强迫肺活量%和一氧化碳扩散量%)有显著相关性。NL%与HA%呈显著负相关。结论不同严重程度IPF患者pft与定量容积CT参数差异均有统计学意义,且两者之间及与临床改良医学研究委员会呼吸困难评分及GAP分期系统高度相关。因此,两者不仅可以在诊断中发挥重要作用,而且可以在检测IPF的严重程度和预测死亡率方面发挥重要作用。
{"title":"Role of pulmonary function tests and computed tomography volumetric quantitative analysis in assessment of idiopathic pulmonary fibrosis","authors":"Omina Zaki, R. Sharshar, R. Younes, A. Abdella","doi":"10.4103/ecdt.ecdt_71_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_71_22","url":null,"abstract":"Background Idiopathic pulmonary fibrosis (IPF) is a progressive irreversible lung disease, but early assessment by pulmonary function tests (PFTs) and quantitative volumetric computed tomography (CT) analysis aid in diagnosis, disease monitoring, and prognosis in patients with IPF. Objectives The study aimed to study the role of quantitative volumetric CT indices and PFTs in assessing disease severity in patients with IPF. Patients and methods The study included 40 patients with IPF diagnosed by usual interstitial pneumonia pattern in high-resolution CT and subdivided into two groups according to the GAP staging system (sex, age, and physiology): group I included patients with IPF stage I (five patients) and stage II (15 patients), whereas group II included patients with IPF stage III (20 patients). Clinical history taking, physical examination, plain chest radiography to exclude other diagnosis, PFTs, and quantitative volumetric high-resolution CT were done for all patients. Results There was a significant difference between group I [higher normal attenuating lung volume (NL%) and lower honeycombing area volume (HA%)] versus group II (lower NL% and higher HA%), with no significant difference in whole lung volume (WL) between the two groups. There was a significant correlation between radiological parameters (NL% and HA%) and modified Medical Research Council score of dyspnea and GAP staging system. Radiological parameters (NL% and HA%) had a significant correlation with functional parameters (forced vital capacity% and diffusing capacity for carbon monoxide%). Furthermore, NL% and HA% showed a negative significant correlation with each other. Conclusions PFTs and quantitative volumetric CT parameters showed a statistically significant difference among IPF cases of various severity, and both are highly correlated with each other and with clinical modified Medical Research Council score of dyspnea score of dyspnea and GAP staging system. So, both can play a major role not only in diagnosis but also in detecting severity and predicting mortality in IPF.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77137625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessment of interleukin-6 role in detecting coronavirus disease 2019 severity, mortality, and its control: A cohort study 白细胞介素-6在检测2019冠状病毒病严重程度、死亡率及其控制中的作用:一项队列研究
IF 0.1 Pub Date : 2023-04-01 DOI: 10.4103/ecdt.ecdt_75_22
H. Shalaby, Sahar Abd Elmaksoud, H. Ezzelregal, Dalia ElDine Salem
Background Elevated serum level of interleukin-6 (IL-6) in patients with coronavirus disease 2019 (COVID-19) may be a result of a cytokine storm and can be an indicator of severe and critical forms of the disease.Therefore, it is crucial to detect and control IL-6 level early in severe acute respiratory syndrome coronavirus-2-infected patients; in addition to that, IL-6 may be a target for drug development. Aim In this study, we aimed to evaluate IL-6 serum levels in severe acute respiratory syndrome coronavirus-2-infected patients with positive PCR result early after diagnosis to detect disease severity and mortality. Study design and methods This prospective study was done on 60 COVID-19-infected patients. Serum IL-6 levels were tested after diagnosis. Tocilizumab was given to 11 patients with severe COVID-19. Results High serum levels of IL-6 had been detected in 95% of patients and in all patients of the critical group. Its levels in the mild group were 1.87 times less than that in the moderate group, whereas 2.85 times less than that in the critical group. IL-6 median levels were 24, 44.85, and 68.4 ng/l for the mild, moderate, and critical groups, respectively. The IL-6 concentration was predictive of severity (with IL-6 cutoff value >56 ng/l) and was predictive of mortality (with a cutoff value >67 ng/l) for COVID-19-infected patients. Tocilizumab cure rate was 30% in critical cases. Conclusion Serum IL-6 is of paramount importance in detecting severity and mortality of COVID-19 disease, whereas therapeutic value of tocilizumab needs confirmation by detailed studies.
2019冠状病毒病(COVID-19)患者血清白细胞介素-6 (IL-6)水平升高可能是细胞因子风暴的结果,可以作为该疾病严重和危急形式的指标。因此,早期检测和控制IL-6水平对严重急性呼吸综合征冠状病毒2型感染者至关重要;除此之外,IL-6可能是药物开发的靶点。目的在诊断后早期检测PCR阳性的严重急性呼吸综合征冠状病毒2型感染患者血清IL-6水平,以检测病情严重程度和死亡率。研究设计与方法本前瞻性研究对60例covid -19感染患者进行研究。诊断后检测血清IL-6水平。11例重症COVID-19患者给予托珠单抗治疗。结果95%的患者血清IL-6水平较高,危重组患者血清IL-6水平均较高。轻度组比中度组低1.87倍,重度组低2.85倍。轻度组、中度组和危重组IL-6的中位水平分别为24、44.85和68.4 ng/l。IL-6浓度可预测covid -19感染患者的严重程度(IL-6临界值>56 ng/l)和死亡率(临界值>67 ng/l)。在危重病例中,托珠单抗治愈率为30%。结论血清IL-6在检测COVID-19疾病严重程度和死亡率方面至关重要,而托珠单抗的治疗价值有待进一步研究证实。
{"title":"Assessment of interleukin-6 role in detecting coronavirus disease 2019 severity, mortality, and its control: A cohort study","authors":"H. Shalaby, Sahar Abd Elmaksoud, H. Ezzelregal, Dalia ElDine Salem","doi":"10.4103/ecdt.ecdt_75_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_75_22","url":null,"abstract":"Background Elevated serum level of interleukin-6 (IL-6) in patients with coronavirus disease 2019 (COVID-19) may be a result of a cytokine storm and can be an indicator of severe and critical forms of the disease.Therefore, it is crucial to detect and control IL-6 level early in severe acute respiratory syndrome coronavirus-2-infected patients; in addition to that, IL-6 may be a target for drug development. Aim In this study, we aimed to evaluate IL-6 serum levels in severe acute respiratory syndrome coronavirus-2-infected patients with positive PCR result early after diagnosis to detect disease severity and mortality. Study design and methods This prospective study was done on 60 COVID-19-infected patients. Serum IL-6 levels were tested after diagnosis. Tocilizumab was given to 11 patients with severe COVID-19. Results High serum levels of IL-6 had been detected in 95% of patients and in all patients of the critical group. Its levels in the mild group were 1.87 times less than that in the moderate group, whereas 2.85 times less than that in the critical group. IL-6 median levels were 24, 44.85, and 68.4 ng/l for the mild, moderate, and critical groups, respectively. The IL-6 concentration was predictive of severity (with IL-6 cutoff value >56 ng/l) and was predictive of mortality (with a cutoff value >67 ng/l) for COVID-19-infected patients. Tocilizumab cure rate was 30% in critical cases. Conclusion Serum IL-6 is of paramount importance in detecting severity and mortality of COVID-19 disease, whereas therapeutic value of tocilizumab needs confirmation by detailed studies.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90395550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Does 1-minute walk test predict results of 6-minute walk test in patients with interstitial lung diseases? 1分钟步行试验能否预测间质性肺病患者6分钟步行试验的结果?
IF 0.1 Pub Date : 2023-04-01 DOI: 10.4103/ecdt.ecdt_5_21
Engy Soliman, Ashraf Madkour, Ibrahim A Dwedar, M. Abdelkader
Background Six-minute walk test (6MWT) is well-established in assessing functional capacity and exercise-induced oxygen desaturation. For some patients, 6MWT may be very exhausting and shorter-duration test would likely be less time-consuming and easier. Aim To investigate if 1-minute walk test (1MWT) predicts the results of 6MWT test as regards the exercise capacity, exercise-induced oxygen desaturation, and symptoms in patients with interstitial lung diseases (ILDs). Patients and methods Thirty patients with ILD were recruited from a university hospital between April 2019 and June 2019. Demographics data were collected. Spirometry, 6MWT, and 1MWT were performed. Total walking distance, oxygen saturation decline, heart rate recovery, dyspnea, and leg fatigue were evaluated. Results Out of 30 cases studied, 22 (73.3%) were females and eight (26.7%) were males. The mean age was 51.9 ± 13.86, mean BMI 28.32 ± 5.55, and mean forced vital capacity 47.27 ± 14.65 l/m. The mean walking distance of 1MWT and 6MWT were 46.43 ± 9.97 and 269 ± 76.94, respectively. There was a statistically significant positive correlation between 1MWT and 6MWT regarding walking distance, heart rate recovery, dyspnea at the end of the test (Borg scale), leg fatigue at the end of the test (Borg scale), and oxygen saturation decline. No adverse events related to both walking tests were recorded. Conclusion 1MWT can predict results of 6MWT in ILD patients as regards exercise capacity, exercise-induced oxygen desaturation, and symptoms. 1MWT might serve as a practical substitute for the more cumbersome 6MWT.
背景:6分钟步行试验(6MWT)在评估功能能力和运动诱导的氧饱和度方面是公认的。对于一些患者来说,6MWT可能非常累人,短时间的测试可能会更省时、更容易。目的探讨1分钟步行试验(1MWT)能否预测6MWT试验结果对肺间质性疾病(ILDs)患者运动能力、运动性氧饱和度及症状的影响。患者和方法2019年4月至2019年6月,从一家大学医院招募了30名ILD患者。收集了人口统计数据。肺量测定,6MWT, 1MWT。评估总步行距离、血氧饱和度下降、心率恢复、呼吸困难和腿部疲劳。结果30例患者中,女性22例(73.3%),男性8例(26.7%)。平均年龄51.9±13.86,平均BMI 28.32±5.55,平均用力肺活量47.27±14.65 l/m。1MWT和6MWT的平均步行距离分别为46.43±9.97和269±76.94。1MWT与6MWT在步行距离、心率恢复、试验结束时呼吸困难(Borg量表)、试验结束时腿部疲劳(Borg量表)、血氧饱和度下降等方面有统计学意义的正相关。两项行走试验均未记录不良事件。结论1MWT可以预测ILD患者的运动能力、运动引起的氧饱和度和症状。1MWT可以作为更麻烦的6MWT的实际替代品。
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引用次数: 0
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Egyptian Journal of Chest Diseases and Tuberculosis
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