Alireza Sedaghat; Amene Raouf-Rahmati; Katayoun Samadi; Farida Daneshvar Mozaffari; Ahmad Nemati; Benyamin Fazli
Abstract
Introduction: Currently, humankind is facing a COVID-19 pandemic that has spread worldwide. This is the first study conducted during the first phase of the COVID-19 outbreak in Mashhad, Iran, to describe the clinical, therapeutic, and laboratory findings of survivor and non-survivor patients with COVID-19.Methods: ...
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Introduction: Currently, humankind is facing a COVID-19 pandemic that has spread worldwide. This is the first study conducted during the first phase of the COVID-19 outbreak in Mashhad, Iran, to describe the clinical, therapeutic, and laboratory findings of survivor and non-survivor patients with COVID-19.Methods: This retrospective study included a total of 191 confirmed COVID-19 patients aged ≥18 who were admitted to an intensive care unit in the northeast of Iran in 2020. Clinical, therapeutic, and laboratory findings were recruited. The data were analyzed using SPSS software (version 23) through the Mann-Whitney U test, Chi-Square test, independent sample t-test, as well as a single variable and multivariable logistic regression.Results: Out of a total of 191 hospitalized patients, 137 (71.7%) survived and 54 (28.2%) expired. The mean age of non-survived patients was 17 years higher than that of survived patients (P<0.0001). Hypertension, diabetes, and coronary and pulmonary diseases were significantly related to mortality (OR: 3, 2.8, 21.4, and 5.4, respectively; P<0.05). Respiratory rate >24/min, heart rate>125/min, platelet count <100*109/L, creatinine >133 μmol/L, LDH >245 U/L, WBC count >10*109/L, lymphocyte count <0.8*109/L and D-dimer >1 μg/mL were frequently observed in non-survivor patients (P<0.05). Most of the patients had an abnormality on chest radiographs, and bilateral pulmonary infiltration was the dominant chest radiograph abnormality in these patients. Moreover, consolidation and ground-glass opacification were observed more frequently in non-survived patients (P<0.05). More than 57% of severe cases required non-invasive and invasive mechanical ventilation before they died, while it was 1% in survived cases (P<0.05).Conclusion: Older age, previous comorbidities such as diabetes, hypertension, coronary and pulmonary diseases, lymphopenia, leukocytosis, increased respiratory rate, creatinine, LDH, and D-dimer levels were related to a poor prognosis and mortality in patients with SARS-CoV-2 infection.
Alireza Sedaghat; Benyamin Fazli; arash peivandi; Farzaneh Fazeli; Bita Mirzaie Feyzabadi
Abstract
Background and Aim: This study was aimed to evaluate the prognosis of patients with severe burns by measuring the plasma base excess and serum lactate levels and comparing it with the ABSI scoring system as an important indicator in the resuscitation of burn patients.Methods: This prospective cohort ...
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Background and Aim: This study was aimed to evaluate the prognosis of patients with severe burns by measuring the plasma base excess and serum lactate levels and comparing it with the ABSI scoring system as an important indicator in the resuscitation of burn patients.Methods: This prospective cohort study was performed on all patients hospitalized in the burn ward of the hospital. The demographic data and ABSI scoring of all patients were recorded. Patients' clinical information and routine tests, gasometry (for measuring plasma base excess) and serum lactate levels were measured at the time of admission, 12 hours, and 24 hours after admission.Results: A total of 311 burning patients were evaluated in this study. Mann-Whitney test showed a significant difference in the mean plasma BE1 (at the time of admission) and BE2 (24 hours after admission) between the patients who were discharged and the patients who died (P <0.001). The results indicated a difference in the process of lactate changes between two groups of patients in terms of intensity of ABSI(P <0.001). The multivariate logistic regression with the entry of BE and lactate at the time of admission and ABSI as predictive variables indicated a significant BE and ABSI.Conclusion: The results of this study confirmed that the plasma base excess can be used as a valuable tool in the monitoring of burn patients' resuscitation along with clinical criteria. On the other hand, the ABSI scoring system is still a valuable tool to predict the deaths of burn patients.
Alireza Sedaghat; Ali Ahmadabadi; Seyed Hassan Tavousi; Benyamin Fazli; Mahmood Khorsand; Bita Mirzaie Feyzabadi
Abstract
Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare, but potentially life-threatening reactions to medications. Both conditions have significant morbidity and mortality. This study aimed to document the epidemiological features, aetiologies, treatment and clinical ...
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Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare, but potentially life-threatening reactions to medications. Both conditions have significant morbidity and mortality. This study aimed to document the epidemiological features, aetiologies, treatment and clinical outcomes of such patients.Method: In this retrospective cross-sectional study the records of all patients with TEN treated for5 years in central Hospital, Mashhad, Iran were reviewed. Results: Thirty-four patients were studied with a mean age of 26.5 years. Mean age in the mortality and survivors groups was 33.6 and 25.3 years, respectively. Drugs accounted for all 34 cases were including Anti-convulsants (52.9%) other the most common implicated drug followed by antibiotics (26.5%), allopurinol (5.9%) and multiple drugs (anticonvulsants plus antibiotics) (14.7%). Antibiotics had the shortest interval between ingestion time and onset of symptoms. The mean ICU length of stay was 12.7 days, with a range of 1 to 30 days. The mean of SCORTEN was 2.3; it was 3.3 and 2.1 in the mortality and survivors group, respectively (P=0.001).All 34 TEN cases were given intravenous immunoglobulins (IVIG). Six patients with TEN died (17.6%). The highest mortality was found in the allopurinol group with 50%, whereas anticonvulsants and antibiotics had a mortality rate of 16.6% and 15.3%, respectively.Conclusion: Anti-convulsants especially Lamotrigine were the most frequently implicated drug, followed by antibiotics and allopurinol. IVIG was shown beneficial effects in TEN syndrome.