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Individual and Environmental Risk Factors for covid-19 mortality in Elderly in 7 European University Hospitals

Journal of Environmental Protection 2022年第7期13卷 508-526页

作者： Thomas Bourdrel Leo Zabrocki Nathalie Compte Bert Bravenboer Romain Decours Hélène Pelerin Laure De Decker Laurence Le Jumeau de Kergaradec Matthieu Lilamand Claire Roubaud Baudron Bertrand Fougère Rachid Mahmoudi Benoit Schorr Georges Kaltenbach Thomas Vogel Vincent-Henri Puech Fréderic Blanc Marie-Abèle Bind ICube Laboratory UMR 7357 and CNRS University of Strasbourg Strasbourg France Paris School of Economics EHESS Paris France Geriatric Department Universitair Ziekenhuis Brussel Bruxelles Belgium Service de Gé riatrie Centre hospitalier d&eacute partemental de Vendé e La Roche Sur Yon France Unité de recherche clinique Centre hospitalier d&eacute partemental de Vendé e La Roche Sur Yon France Service de Mé decine aigü e gé riatrique Centre hospitalier universitaires de Nantes Nantes France Service de Gé rontologie Centre hospitalier universitaires de Nantes Nantes France Service de Gé riatrie Assistance publique Hô pitaux de Paris (APHP) Nord Paris France Unité Post Urgences Gé riatriques Centre hospitalier universitaire de Bordeaux H&ocirc pital Pellegrin Bordeaux France Department of Geriatric Medicine Centre hospitalier universitaire de Tours Tours France Mé decine Interne Gé riatrie et Biologie du Vieillissement Centre hopitalier universitaire de Reims Reims France Pô le de Gé riatrie La Robertsau Geriatric Hospital University Hospital of Strasbourg Strasbourg France European Centre for Medium-Range Weather Forecasts Copernicus Atmosphere Monitoring Service London UK Biostatistics Center Massachusetts General Hospital Boston MA USA

Because the elderly account for 80% of deaths from covid-19 and they may be more vulnerable to air pollution, in this retrospective study we aimed to explore individual and environmental risk factors for covid-19 mortality in the geriatric departments of seven European University hospitals, between February and May 2020. Long-term exposure to air pollution was estimated through annual pollutant concentrations at the residential address over the last two years. Short-term variations in air pollutants and weather parameters were also examined through a 20-day period before the confirmed PCR diagnostic of covid-19. We found positive associations for diabetes and covid-19 mortality (OR 2.2 CI 95%: 1.1, 4.4). Regarding environmental factors, we found no association between covid-19 mortality and air pollutants and weather parameters;however, our study suffers from strong disparities—such as patient characteristics—between fairly polluted and less polluted cities. In order to overcome those disparities between cities, we aimed to explore the relationship between air pollution and covid-19 mortality within each city, but even with the high-efficiency modelisation systems, differences in air pollutants were too small to estimate the effect of air pollution at the city level. Thus, this study highlights the need to improve the estimation of individual exposure to air pollution. To address this issue, solutions exist such as the increase of the number of fixed air monitors, or even better, through the use of individual markers of air pollution exposure such as urinary black carbon or passive individual samplers. Furthermore, we underline that outdoor air pollutant concentrations may not be representative of individual exposure, especially in the elderly, thus, we suggest that further studies focus on indoor air pollution. Regarding meteorological conditions, we found no association between UV, temperature, wind speed and covid-19 mortality. We found a positive association bet

关键词： covid-19 mortality Air Pollution Particulate Matter Ultraviolet Radiation Temperature

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Bayesian Rule Modeling for Interpretable mortality Classification of covid-19 Patients

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Computers, Materials & Continua 2021年第12期69卷 2827-2843页

作者： Jiyoung Yun Mainak Basak Myung-Mook Han Software Department Gachon UniversitySeongnam13120Korea

Coronavirus disease 2019(covid-19)has been termed a“Pandemic Disease”that has infected many people and caused many deaths on a nearly unprecedented *** more people are infected each day,it continues to pose a serious threat to humanity *** a result,healthcare systems around the world are facing a shortage of medical space such as wards and *** most cases,healthy people experience tolerable symptoms if they are ***,in other cases,patients may suffer severe symptoms and require treatment in an intensive care ***,hospitals should select patients who have a high risk of death and treat them *** solve this problem,a number of models have been developed for mortality ***,they lack interpretability and *** prepare a model that addresses these issues,we proposed a covid-19 mortality prediction model that could provide new *** identified blood factors that could affect the prediction of covid-19 *** particular,we focused on dependency reduction using partial correlation and mutual ***,we used the Class-Attribute Interdependency Maximization(CAIM)algorithm to bin continuous ***,we used Jensen Shannon Divergence(JSD)and Bayesian posterior probability to create less redundant and more accurate *** provided a ruleset with its own posterior probability as a *** extracted rules are in the form of“if antecedent then results,posterior probability(θ)”.If the sample matches the extracted rules,then the result is *** average AUC Score was 96.77%for the validation dataset and the F1-score was 92.8%for the test *** to the results of previous studies,it shows good performance in terms of classification performance,generalization,and interpretability.

关键词： covid-19 mortality explainable AI bayesian probability feature selection

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The Effect of Dexamethasone versus Methylprednisolone in the Treatment of covid-19 Patients in Jordan

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Advances in Infectious Diseases 2023年第3期13卷 508-520页

作者： Jamal Wadi Al Ramahi Nour Hasan Amal Matar Ma’en Maher Al-Ali Lara Abdulhadi Dania Abu Kaf Waseem Saadeh Nour Hamdan Hassan Abu Khalaf Mohamed Gharaibeh Hanadi Hamadallah Ala’a Bader Mohammad Atout Sae’ed Moh. Mar’I Tamer Alhamed Department of Medicine School of Medicine The University of Jordan Amman Jordan Clinical Pharmacy Al Khalidi Hospital Amman Jordan Department of General Medicine Al Khalidi Hospital Amman Jordan Department of Clinical Medical Sciences Faculty of Medicine Yarmouk University Irbid Jordan Department of Medicine The Specialty Hospital Amman Jordan Department of Anesthesia The Specialty Hospital Amman Jordan Department of Pharmacy Jordan Hospital Amman Jordan Department of Pharmacy The Specialty Hospital Amman Jordan

Background: Previous studies focused on the treatment effect of steroids versus no steroids in treating severe covid-19 patients, a few studies evaluated outcomes for treating those patients with either dexamethasone or methylprednisolone. Currently, we evaluate the difference in mortality associated with treating covid-19 patients with dexamethasone versus methylprednisolone. Methods: With a retrospective multicenter study, records were reviewed for the admitted patients with severe covid-19 during the peak of the severe covid-19 pandemic. All admitted patients on dexamethasone or methylprednisolone were included. Patients were analyzed as all populations and propensity scores matched patients. Propensity scores were calculated for several confounders by the generalized linear model, and a “greedy” near-neighbor matching algorithm was used. Continuous variables with nonnormal distribution were analyzed by Wilcoxon signed rank test. Chi-squared and Fischer exact test analyzed categorical variables. P-values were adjusted by the Bonferroni method for both data cohorts. Body mass index was in categories. Radiological findings were divided into five categories. The outcomes: mortality, the need for home oxygen therapy, recovery, and residual symptoms on discharge were analyzed by an independent two-sample test for equality of proportions (with Yates correction), and logistic regression analysis. Results: Among the 1128 reviewed records, patients on dexamethasone or methylprednisolone were 1071, and the propensity score-matched patients were 784: dexamethasone 393 and methylprednisolone 391. There was no significant difference in the characteristics of patients between the two steroids (p-value and adjusted p-value > 0.05) for most variables. PSM adjusted a few discrepant variables before analysis. The outcome of the unmatched patients demonstrated dexamethasone benefit in the need for home oxygen therapy ( 0.05). However, matched patients demonstrated significantly low

关键词： Dexamethasone Methylprednisolone covid-19 mortality Home Oxygen covid-19 Recovery

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