An instance of COVID19 vaccinationassociated forme fruste purpura fulminans

Chronic obstructive pulmonary disease (COPD) is still a constant threat to people's health. We aimed to identify the relationship between increased red cell distribution width (RDW) on admission and length of hospitalization in acute exacerbation of chronic obstructive pulmonary disease patients (AECOPD).Patients with AECOPD were recruited and divided into 3 groups based on RDW tertiles.Two hundred eighty six patients with AECOPD admitted to our department during January 1, 2017 and June 30, 2019 were enrolled in the study. According to the RDW tertiles (≤12.8%, 12.9% to 13.6%, >13.6%), the patients were divided into 3 groups. DAPT inhibitor Length of stay was significantly related to RDW (P < .001) in AECOPD patients. Correlation analysis indicated that RDW was negatively associated with FEV1% predicted (r = -0.142, P = .016). However, RDW was positively associated with prolonged of stay (r = 0.298, P < .001) in AECOPD patients. Multivariate regression analysis discovered that RDW was independently associated wi hospitalization (P = .001). Receiver operating characteristic (ROC) curve showed that RDW was a good predictor of prolonged hospital stay in AECOPD patients, and the area under the curve (AUC) was 0.818 (95% CI 0.769-0.868). The highest sensitivity to predict prolonged hospital stay was 83.8% and the specificity was 71.6% with the cut-off 13.35%.In conclusion, prolonged hospital stay in AECOPD patients was closely associated with increased RDW. Elevated RDW may be an independent predictor for prolonged hospitalization in AECOPD patients.
The role of thoracic CT (computerized tomography) in monitoring disease course of COVID-19 is controversial. The purpose of this study is to investigate the risk factors and predictive value of deterioration on repeatedly performed CT scan during hospitalization.All COVID-19 patients treated in our isolation ward, from January 22, 2020 to February 7, 2020, were reviewed. Patients included were categorized into RD (Radiological Deterioration) group or NRD (No Radiological Deterioration) group according to the manifestation on the CT routinely performed during the hospitalization. All clinical data and CT images were analyzed.Forty three patients were included in our study. All are moderate cases with at least 4 CT scans each. Eighteen (42.9%) patients had radiological deteriorations which were all identified in CT2 (the first CT after admission). Patients in RD group had lower leukocyte count (P = .003), lymphocyte count (P = .030), and higher prevalence (P = .012) of elevated C-reactive protein (CRP) at admetween symptom onset and the time of CT2 (P  less then  .01). There was no significant difference in hospital stay or fibrotic change on CT4 (follow-up CT scan performed 4 weeks after discharge) between 2 groups. Shorter duration between symptom onset and CT2 time (odds ratio [OR], 0.436; 95% confidence interval 0.233-0.816; P  less then  .01) and lower leukocyte count in baseline evaluation (OR, 0.316; 95% CI 0.116-0.859; P  less then  .05) were associated with increased odds of radiological deterioration on CT image during hospitalization.For moderate COVID-19 patients, the value of routinely performed CT during the treatment is limited. We recommend avoiding using CT as a routine monitor in moderate COVID-19 patients.
Acute ischemic stroke (AIS) is an important factor leading to adult death and disability globally. For AIS patients who meet certain conditions, recombinant tissue plasminogen activator (rt-PA) intravenous thrombolysis is an important method recommended by national guidelines to achieve vascular recanalization. However, complications such as hemorrhagic transformation and vascular reocclusion after thrombolysis are still unsolved problems in clinical. Several systematic reviews of clinical randomized controlled trials (RCTs) in the past have shown that Chinese herbal injections (CHIs) can improve the neurological function of patients, increase the tolerance of ischemic tissues to hypoxia, and inhibit platelet aggregation. Therefore, this study conducted a meta-analysis of AIS treatment with intravenous thrombolysis alone and compared it with the combined application of CHIs. To evaluate whether CHIs have a synergistic effect on thrombolytic therapy and provide a basis for clinical application.
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CRD42020215546.
CRD42020215546.
The efficacy and safety of bivalirudin in percutaneous coronary intervention (PCI) has always been a hot topic in perioperative antithrombotic therapy, but there are still some controversies. So studies are needed to provide more evidence, especially the real world study which includes patients excluded from previous RCT studys. Our study aimed to investigate these information and analyze the independent predictors of postoperative adverse events.A retrospective study enrolled 1416 patients underwent PCI in Tianjin Chest Hospital from May 2016 to October 2017. The incidence of stent-thrombosis and net clinical adverse events, including all-cause death, myocardial infarction, stroke, urgent target-vessel revascularization and bleeding, were followed up for 30 days and 1 year. Logistic regression and COX regression were respectively used to analyze independent predictors of bleeding events within 30-days, and independent predictors of Major adverse cardiovascular and cerebrovascular events (MACCE) in patientsays, BMI >25 kg/m2, anemia, KILLIP ≥2, EF <45%, eGFR <60 ml/minutes were independent risk factors and Statins, PPI were independent protective factors of MACCE within 1-year.
25 kg/m2, anemia, KILLIP ≥2, EF less then 45%, eGFR less then 60 ml/minutes were independent risk factors and Statins, PPI were independent protective factors of MACCE within 1-year.
Procalcitonin (PCT) was used for predicting the development of acute kidney injury (AKI) in several studies recently. We aimed to investigate the accuracy of PCT for predicting AKI in this study.
Studies that assessed the predictive performance of PCT for the development of AKI in adult patients were searched from Medline, Embase, and the Cochrane Library from inception to June 2020. We calculated the pooled sensitivities and specificities and the area under the summary receiver-operating characteristic (SROC) curves. I2 was used to test the heterogeneity and the potential heterogeneity was investigated by meta-regression.
In total, 9 of 119 studies with 4852 patients were included, 1272 were diagnosed with AKI. In the overall analysis, the area under the SROC curve was 0.82 (95% CI, 0.79-0.85) and the pooled sensitivity and specificity were 0.76 (95% confidence interval [CI], 0.64-0.85) and 0.75 (95% CI, 0.61-0.86), respectively. In the subgroup analysis among septic patients, the pooled sensitivity and specificity were 0.