Digestive system involvement and clinical outcomes among COVID-19 patients:A retrospective cohort study from Qatar

BACKGROUND Coronavirus disease 2019(COVID-19)caused by the severe acute respiratory syndrome coronavirus 2 virus most commonly presents with respiratory symptoms.While gastrointestinal(GI)manifestations either at presentation or during hospitalization are also common,their impact on clinical outcomes is controversial.Some studies have described worse outcomes in COVID-19 patients with GI symptoms,while others have shown either no association or a protective effect.There is a need for consistent standards to describe GI symptoms in COVID-19 patients and to assess their effect on clinical outcomes,including mortality and disease severity.AIM To investigate the prevalence of GI symptoms in hospitalized COVID-19 patients and their correlation with disease severity and clinical outcomes.METHODS We retrospectively reviewed 601 consecutive adult COVID-19 patients requiring hospitalization between May 1-15,2020.GI symptoms were recorded at admission and during hospitalization.Demographic,clinical,laboratory,and treatment data were retrieved.Clinical outcomes included all-cause mortality,disease severity at presentation,need for intensive care unit(ICU)admission,development of acute respiratory distress syndrome,and need for mechanical ventilation.Multivariate logistic regression model was used to identify independent predictors of the adverse outcomes.RESULTS The prevalence of any GI symptom at admission was 27.1%and during hospitalization was 19.8%.The most common symptoms were nausea(98 patients),diarrhea(76 patients),vomiting(73 patients),and epigastric pain or discomfort(69 patients).There was no difference in the mortality between the two groups(6.21%vs 5.5%,P=0.7).Patients with GI symptoms were more likely to have severe disease at presentation(33.13%vs 22.5%,P<0.001)and prolonged hospital stay(15 d vs 14 d,P=0.04).There was no difference in other clinical outcomes,including ICU admission,development of acute respiratory distress syndrome,or need for mechanical ventilation.Drugs associated with the development of GI symptoms during hospitalization were ribavirin(diarrhea 26.37%P<0.001,anorexia 17.58%,P=0.02),hydroxychloroquine(vomiting 28.52%,P=0.009)and lopinavir/ritonavir(nausea 32.65%P=0.049,vomiting 31.47%P=0.004,and epigastric pain 12.65%P=0.048).In the multivariate regression analysis,age>65 years was associated with increased mortality risk[odds ratio(OR)7.53,confidence interval(CI):3.09-18.29,P<0.001],ICU admission(OR:1.79,CI:1.13-2.83,P=0.012),and need for mechanical ventilation(OR:1.89,CI:1.94-2.99,P=0.007).Hypertension was an independent risk factor for ICU admission(OR:1.82,CI:1.17-2.84,P=0.008)and need for mechanical ventilation(OR:1.66,CI:1.05-2.62,P=0.028).CONCLUSION Patients with GI symptoms are more likely to have severe disease at presentation;however,mortality and disease progression is not different between the two groups.

Stochastic Modelling of Actual Black Gram Evapotranspiration

The study was undertaken to develop and evaluate evapotranspiration model for black gram (Vigna Mungo L.) crop under climatic conditions of Udaipur, India. Pan evaporation data for the duration of twenty three years (1978-2001) and measured black gram evapotranspiration data by electronic lysimeter for duration of kharif season of 2001 were used for analysis. Black gram is an important crop of Udaipur region. No sys-tematic study on modelling of black gram evapotranspiration was conducted in past under above said cli-matic conditions. Therefore, stochastic model was developed for the estimation of daily black gram evapotranspiration using 24 years data. Validation of the developed models was done by the comparison of the estimated values with the measured values. The developed stochastic model for black gram evapotran-spiration was found to predict the daily black gram evapotranspiration very accurately.

Intensive care outcome of left main stem disease surgery: A single center three years’ experience

BACKGROUND Left main coronary artery(LMCA)supplies more than 80%of the left ventricle,and significant disease of this artery carries a high mortality unless intervened surgically.However,the influence of coronary artery bypass grafting(CABG)surgery on patients with LMCA disease on morbidity intensive care unit(ICU)outcomes needs to be explored.However,the impact of CABG surgery on the morbidity of the ICU population with LMCA disease is worth exploring.AIM To determine whether LMCA disease is a definitive risk factor of prolonged ICU stay as a primary outcome and early morbidity within the ICU stay as secondary outcome.METHODS Retrospective descriptive study with purposive sampling analyzing 399 patients who underwent isolated urgent or elective CABG.Patients were divided into 2 groups;those with LMCA disease as group 1(75 patients)and those without LMCA disease as group 2(324 patients).We correlated ICU outcome parameters including ICU length of stay,post-operative atrial fibrillation,acute kidney injury,re-exploration,perioperative myocardial infarction,post-operative bleeding in both groups.RESULTS Patients with LMCA disease had a significantly higher prevalence of diabetes(43.3%vs 29%,P=0.001).However,we did not find a statistically significant difference with regards to ICU stay,or other morbidity and mortality outcome measures.CONCLUSION Post-operative performance of Patients with LMCA disease who underwent CABG were comparable to those without LMCA involvement.Diabetes was more prevalent in patients with LMCA disease.These findings may help in guiding decision making for future practice and stratifying the patients’care.