Background

This pilot study included 68 cases with post-COVID-19 persistent cough (> 8 weeks), randomly allocated into two groups; intervention group (32 patients) received standard cough therapy, and montelukast 10 mg/day for 14 days and control group (36 patients) received only cough sedatives.

Results

We found a significant improvement in the number of cough paroxysms/day, cough severity visual analog scale, cough severity index and cough quality of life, shorter duration improvement, and minimal side effects in the interventional group.

Conclusions

We suggest that montelukast may be effective to reduce the duration and severity of the persistent post-COVID-19 cough and further improve quality of life.

Background

The worldwide use of prone position (PP) for invasively ventilated patients with COVID-19 is progressively increasing from the first pandemic wave in everyday clinical practice. Among the suggested treatments for the management of ARDS patients, PP was recommended in the Surviving Sepsis Campaign COVID-19 guidelines as an adjuvant therapy for improving ventilation. In patients with severe classical ARDS, some authors reported that early application of prolonged PP sessions significantly decreases 28-day and 90-day mortality.

Methods and analysis

Since January 2021, the COVID19 Veneto ICU Network research group has developed and implemented nationally and internationally the “PROVENT-C19 Registry”, endorsed by the Italian Society of Anesthesia Analgesia Resuscitation and Intensive Care…’(SIAARTI). The PROVENT-C19 Registry wishes to describe 1. The real clinical practice on the use of PP in COVID-19 patients during the pandemic at a National and International level; and 2. Potential baseline and clinical characteristics that identify subpopulations of invasively ventilated patients with COVID-19 that may improve daily from PP therapy. This web-based registry will provide relevant information on how the database research tools may improve our daily clinical practice.

Conclusions

This multicenter, prospective registry is the first to identify and characterize the role of PP on clinical outcome in COVID-19 patients. In recent years, data emerging from large registries have been increasingly used to provide real-world evidence on the effectiveness, quality, and safety of a clinical intervention. Indeed …

Background

Adherence to preventive control measures is influenced by perception, attitudes, and practices toward the disease prevention.

Aim

To assess the perceptions, attitude, and practices of university students in three health sector faculties (Medicine, Nursing, and Pharmacy) from six Egyptian universities towards COVID-19 pandemic prevention.

Methods

An electronic online survey was distributed to students of 3 faculties (Medicine, Pharmacy, and Nursing) in six Egyptian universities from March to July 2021. The questionnaire consists of the following parts: socio-demographic data of participants, student perception and attitude towards the COVID-19 pandemic and its consequences, as well as practices of preventive measures in the community.

Results

The study included 1990 participants. Most respondents perceived the seriousness of the COVID-19 pandemic (88.2%). The rates of practicing precautionary 

Introduction

Bronchiectasis was considered as an uncommon radiological feature of corona virus disease 2019 (COVID-19) infection. The clinical course and outcome of COVID-19 bronchiectasis overlap is still a point for research. The aim of this study was to evaluate the prevalence, course, and outcome of bronchiectasis as an atypical presentation of COVID-19 infection.

Methods

A cross-sectional study has been conducted from July 2021 to February 2022 and included 425 COVID-19 swab-positive patients who were examined by high resolution computed tomography of the chest during acute phase (4 weeks) of the infection.

Results

Fourteen (3.3%) patients newly developed bronchiectasis-de novo. Patients with de novo bronchiectasis had significantly higher cough score, frequency of colored sputum and mMRC score, respiratory distress (p < 0.001) and respiratory failure (p = 0.02) than patients with no bronchiectasis. They also had the higher frequency of ICU’s admission (p = 0.02), need to non-invasive (p = 0.01), and invasive mechanical ventilation (p = < 0.001), duration of mechanical ventilation, ICU’s stay and overall hospital stay (p < 0.001). As for the outcome, death rate was also statistically significantly higher among those with De novo bronchiectasis than those without bronchiectasis (p = 0.04).

Conclusion

Bronchiectasis is an uncommon presentation among COVID-19 patients. However, bronchiectasis increases disease burden in COVID-19 patients. It may have a negative impact on the outcome.

Frailty is a clinical syndrome characterized by decreased reserve and resilience [1]. Identifying frailty in critically ill patients can help to guide management, including the selection of appropriate interventions and the development of care plans such as time-limited trials in patients with an unclear benefit from critical care. The Clinical Frailty Scale (CFS) and the FRAIL checklist (1) are both tools proposed to assess frailty in older adults, but they have some key differences. The CFS is a simple, ordinal scale that assigns a score of 1 to 9 based on an assessment of the patient’s level of frailty. It takes into account various physical and functional characteristics. It is quick and easy to use, and it has been validated in multiple settings [2–4]. The FRAIL checklist assesses five domains of frailty: functional impairment, recurrent hospitalizations, advanced malignancy and chronic diseases, irreversible organ failure, and long …

We would like to express our sincere gratitude for the thoughtful comments made by Cheung et al. in their response to our letter [1]. We evaluated the distribution and prognostic relevance of previously proposed surrogate parameters for frailty, Clinical Frailty Scale (CFS)[2–4] and the FRAIL checklist [5], in our database and found that in the univariate analysis, both were associated with 90-day mortality. However, after multivariable adjustment for age, gender, SOFA score, and the presence of therapy goal limitations, only the CFS, but not the FRAIL checklist, was still associated with mortality. We concluded that the CFS has added value compared to the FRAIL checklist. Cheung et al. pointed out that the rate of patients with CFS> 4 was higher than those with

FRAIL> 0. We agree with Cheung et al.’s assessment that the items of the FRAIL checklist are less concrete than the pictograms of the CFS, and this could be a …

Background

Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.

Methods

This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.

Results

In phase 1, 43 interventions were identified …

Background and objective

The most important presentation of COVID-19 is hyper inflammatory condition and cytokine storm that occurs due to excessive increase of the inflammatory mediators specially, pro-inflammatory interleukins such as IL-1β, IL-6 and tumor necrosis factor-α which have an important role in the cytokine storm pathway. Up till now there is not a definitive treatment for COVID-19 disease, but according to the pathophysiology of the disease, Anakinra (Interleukin- 1 inhibitor) is an adjuvant treatment option in patients with severe COVID-19 by blocking the effect of IL-1. So, we aimed to summarize the studies that evaluated the safety and efficacy of Anakinra in patients diagnosed with COVID-19.

Methods

We performed a search in PubMed, Cochrane Library, Scopus, and Web of Science (WOS) databases from inception till 7 Jan 2022. Additionally, we searched randomized and non-randomized 

Background

Several studies have found an association between diabetes mellitus, disease severity and outcome in COVID-19 patients. Old critically ill patients are particularly at risk. This study aimed to investigate the impact of diabetes mellitus on 90-day mortality in a high-risk cohort of critically ill patients over 70 years of age.

Methods

This multicentre international prospective cohort study was performed in 151 ICUs across 26 countries. We included patients ≥ 70 years of age with a confirmed SARS-CoV-2 infection admitted to the intensive care unit from 19th March 2020 through 15th July 2021. Patients were categorized into two groups according to the presence of diabetes mellitus. Primary outcome was 90-day mortality. Kaplan–Meier overall survival curves until day 90 were analysed and compared using the log-rank test. Mixed-effect Weibull regression models were computed to investigate the influence of

Background

Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave.

Methods

This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs.

Results

Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of