ICU admission of COVID-19 patients: Identification of risk factors

ICU admission of COVID-19 patients: Identification of risk factors

Shaimaa H Fouad (1), Mohamed Farouk Allam (2), Sara Ibrahim (3), Ahmed Ashraf Okba (4), Sylvia W Roman (1), Amr Hosny (5) & Mayada Moneer (1)

 

1. Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

2. Department of Family Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

3. Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

4. Department of Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

5. Department of Anesthesia and Intensive Care, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

 

Egyptian Journal of Anaesthesia 2021;37(1):202-207.

 

DOI: 10.1080/11101849.2021.191943

 

ABSTRACT

 

Background. The WHO has declared COVID-19 as a global pandemic with a rapidly increasing number of patients at a rate exceeding the limits of health-care resources. Some people seem to be at higher risk of worse prognosis and increased mortality. Identifying these vulnerable groups is a necessity.

 

Aim of study. To identify the risk factors associated with ICU admission in COVID-19 patients.

 

Methodology. We present a retrospective study where the clinical data of patients with laboratory-confirmed COVID-19 infection were collected from Ain-Shams University Isolation-Hospital records on admission from 10 April 2020 to 30 July 2020 to identify risk factors in patients requiring ICU admission during hospital stay.

 

Results. Of 323 subjects diagnosed by the RT-PCR as positive COVID-19, 62 (19.2%) of which were admitted at the ICU. The mean age of the subjects was 46.6 ± 16 years. Significant morbidities were associated with higher age groups (p value 0.000), smokers (p value 0.004), Cairo-residents (p value 0.009), being a health-care provider (p value 0.001) and hypertensive patients (p value 0.000).

 

Conclusions. Elderly, smokers, diabetic and hypertensive need further attention during disease course. Our results call for further investigations of risk factors for COVID-19 severity; preferably on large prospective cohorts, to increase their validity.

 

KEYWORDS: COVID-19; patient stratification; prognosis; hospital; ICU; severity; risk factors; COVID-19 vaccinations.

 

Egyptian Journal of Anaesthesia, 2021;37(1):202-207.

 

DOI: 10.1080/11101849.2021.191943

 

https://www.tandfonline.com/doi/pdf/10.1080/11101849.2021.1919433?needAccess=true

Screening and early detection of chronic kidney disease at primary healthcare

Screening and early detection of chronic kidney disease at primary healthcare

Silvana Nader Nagib (1), Saeed Abdelwahab (2), Ghada Essam El-Din Amin (3), Mohamed Farouk Allam (1)

1. Department of Family Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

2. Department of Internal Medicine and Nephrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

3. Department of Community, Environment and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Clinical and Experimental Hypertension 2021 Mar 17;1-3. Online ahead of print. 

DOI: 10.1080/10641963.2021.1896726

 

ABSTRACT 

Chronic kidney disease (CKD) represents a global public health concern and results in poor health outcomes. While the burden of CKD is accurately well defined in developed countries, increasing evidence indicates that the CKD burden may be even greater in developing countries. Primary care has an essential role in the early identification of CKD and the prompt integrated management between primary and secondary CKD care, with participation of the patient, should be done in high quality. Systematic screening for CKD in at-risk individuals is strongly indicated for timely intervention when needed and to perceive the impact of such policies on CKD incidence. Furthermore, failure to recognize a patient in stages 1–3 of CKD may result in high incidence of CKD complications and kidney failure, often leaving the patient unsuitable for different renal replacement therapies, such as dialysis and transplantation. Therefore, primary care early referral and consultation with a nephrologist can give a better chance for different dialysis procedures and minimize the rate of hospitalization and mortality.

 

Keywords: Screening, Health Programmes, Chronic Kidney Disease, Primary Healthcare Centers. 

Clinical and Experimental Hypertension 2021 Mar 17;1-3. 

https://www.tandfonline.com/doi/full/10.1080/10641963.2021.1896726

Awareness and attitude of healthcare workers towards Telehealth in Cairo, Egypt

Awareness and attitude of healthcare workers towards Telehealth in Cairo, Egypt

 

Sara Shouman (1), Tamer Emara (2), Heba Gamal Saber (3), Mohamed Farouk Allam (1)

 

1. Faculty of Medicine, Family Medicine, Ain Shams University, Cairo, Egypt.

2. Faculty of Medicine, Neurology, Ain Shams University, Cairo, Egypt.

3. Faculty of Medicine, Geriatrics and Gerontology, Ain Shams University, Cairo, Egypt.

 

International Journal of Clinical Practice 2021 Mar 2;e14128. Online ahead of print.

First published: 02 March 2021

 

DOI: https://doi.org/10.1111/ijcp.14128

 

Abstract

Background: Telehealth is delivering health care services remote from health-care facilities using telecommunications. Egypt is aiming for Universal Health Coverage; this increases the demand for telehealth in routine health services.

Objective: To measure the awareness of telehealth health care workers of primary health care units and to evaluate the effect of an orientation programme on primary health care workers' awareness and acceptance of the application of telehealth.

Methodology: This was an intervention study amongst health care workers. A self-administrated valid questionnaire for health care workers was designed, the questionnaire consists of different domains of knowledge in addition to advantages, disadvantages, security and necessity perceptions. Each domain consists of Likert scale questions of 5 points. The questions were scored as the worst answer (1) and the best (5). A total of 109 questionnaires were filled by participants who spent at least 6 months in primary health care units. Then the health care workers attended an orientation programme and the questionnaire was re-filled once more. A total of 104 was recollected. Ethical issues were considered.

Results: 50.5% of the health care workers were aware of telehealth; 66.7% of health care workers with master's degree were aware of telehealth in comparison to 31.8% amongst those with a diploma, 64.3% of physicians were aware of telehealth, while 9.6% of nurses were aware. The score of knowledge and attitude increased from 130 ± 23.538 to 156.49 ± 18.456 after the educational programme.

Conclusion: Half of the health care workers were aware of telehealth; the orientation improved the Healthcare Workers' knowledge and attitude.

 

Key Words: Telehealth, Primary Health Centers, Health Care Workers.

International Journal of Clinical Practice 2021 Mar 2;e14128. Online ahead of print.

https://onlinelibrary.wiley.com/doi/full/10.1111/ijcp.14128

Chronic Kidney Disease Among Hypertensive Patients: Need for Screening Programmes

Chronic Kidney Disease Among Hypertensive Patients: Need for Screening Programmes

 

Silvana Nader Nagib (1), Saeed Abdelwahab (2), Ghada Essam El Din Amin (3) and Mohamed Farouk Allam (1)*

 

1. Department of Family Medicine, Faculty of Medicine, Ain Shams University.  

2. Department of Internal Medicine and Nephrology, Faculty of Medicine, Ain Shams University.

3. Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University.

 

American Jounral of Biomedical Science & Research 2021 - 11(4). AJBSR.MS.ID.001656.

 

DOI: 10.34297/AJBSR.2021.11.001656

 

Abstract

Chronic kidney disease (CKD) has a high morbidity and mortality rates and costs a lot of money including health care, haemodialysis costs and management of complications of CKD. Patients with more progressive stages 3 and 4 CKD experience a high incidence of cardiovascular events and death compared with stages 1 and 2 of CKD. According to the Global Burden of Disease Study conducted in 2010, CKD became the 18th place on a list of the greatest causes of deaths in the world, with an annual mortality rate of 16.3 per 100,000 people. Due to the high prevalence of diabetes, hypertension and coronary artery disease, CKD became world widespread. In alignment with the presence of metabolic and cardiovascular diseases, the prevalence of hypertensive nephropathy prevalence is 7.75%. Unfortunately, the number of patients started to develop end stage renal disease because of hypertension is exceeding. Hypertension-induced renal damage includes the systemic blood pressure load, the degree of renal microvasculature affection, and local susceptibility factors to barotrauma, all of which are affected by the degrees of hypertension. Therefore, in developing countries, screening programmes are extremely needed to detect the early stages of CKD among hypertensive diabetics and non-diabetic patients attending primary healthcare centres.

 

Keywords: Screening, Health Programmes, Chronic Kidney Disease, Hypertension, Primary healthcare centres.

 

American Jounral of Biomedical Science & Research 2021 - 11(4). AJBSR.MS.ID.001656.

 

https://biomedgrid.com/pdf/AJBSR.MS.ID.001656.pdf 

Chloroquine Phosphate is not Proved to be an Effective Treatment for Coronavirus: A Meta-analysis of Clinical Trials

Chloroquine Phosphate is not Proved to be an Effective Treatment for Coronavirus: A Meta-analysis of Clinical Trials

Mohamed Farouk Allam 

Department of Family Medicine, Faculty of Medicine, Ain Shams University. 

The Open Microbiology Journal 2020, 14: 310-311

DOI: 10.2174/1874434602014010310

Abstract:

The aim of this meta-analysis is to investigate the effectiveness of chloroquine in treating coronavirus, in general not only novel coronavirus (COVID­-19), by pooling the results of randomized controlled clinical trials (RCTs). Only 28 publications were identified; none of which was a RCT. Identified studies were published between 1987 and March 15, 2020. Of these 28 publications, 7 were published in 2020 and discussed the effectiveness of chloroquine against COVID-19. Till March 15, 2020, the final results of the clinical trials currently conducted in China were not available; only the preliminary results reported promising effectiveness of chloroquine against COVID-19. The other 21 publications not related to COVID-19 were distributed as follow; in vitro experiments (11 publications), in vivo experiments (5 publications), both in vitro and in vitro experiments (1 publication), and reviews (4 publications). Only 2 in vitro experiments were about Middle East Respiratory Syndrome coronavirus (MERS-CoV) and 5 publications (2 in vitro experiments, 2 reviews, and 1 in vivo experiment) were about Severe Acute Respiratory Syndrome coronavirus (SARS-CoV). In conclusion, this meta-analysis could not prove that chloroquine is an effective treatment against coronavirus in general or COVID-19 in particular. Expanded access trials should be encouraged especially that chloroquine is available, cheap and relatively safe drug.

Keywords: Chloroquine, coronavirus, COVID-19, Meta-analysis, Systematic Review.

The Open Microbiology Journal 2020, 14: 310-311

https://benthamopen.com/contents/pdf/TOMICROJ/TOMICROJ-14-310.pdf