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.
Ahmad Nemati; Farkhonde Nikkhah; Mohammad Moshiri; Hanie Salmani Izadi; Leila Etemad
Abstract
SV (sodium valproate) is an antiepileptic drug that is often prescribed for epilepsy, bipolar disorders, and migraine. We reported an SV intoxicated case that cardiac and neurologic abnormalities were promptly responded to hemodialysis (HD). She ingested a large amount of SV (150 pills of SV 200mg) for ...
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SV (sodium valproate) is an antiepileptic drug that is often prescribed for epilepsy, bipolar disorders, and migraine. We reported an SV intoxicated case that cardiac and neurologic abnormalities were promptly responded to hemodialysis (HD). She ingested a large amount of SV (150 pills of SV 200mg) for a suicide attempt. She was initially alert but her Glasco coma scale (GCS) decreased to 6 thought 11 hours. However, valproate (>150mg/l) and ammonia serum (164µg/dL) levels were not excessively elevated. The serial electrocardiography (ECG) showed QT prolongation and a signs of sodium channel block such as dominant R wave in AVR lead and T-wave inversion in the precordial leads. She had low level of calcium and potassium serum levels. Supportive treatment, charcoal, and L-carnitine, were not effective and HD was started due to the resistant cardiac and neurologic symptoms. After a 3-hour HD session, decreased GCS, pathological ECG findings, and laboratory abnormalities dramatically disappeared. In conclusion, HD is an effective and rapid response treatment for Valproate-induced loss of consciousness and life-threatening cardiac abnormality.