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  • 1
    Online Resource
    Online Resource
    Mortality risk in chronic Chagas cardiomyopathy: a systematic review and meta‐analysis
    Wiley ; 2021
    In:  ESC Heart Failure Vol. 8, No. 6 ( 2021-12), p. 5466-5481
    Details
    In: ESC Heart Failure, Wiley, Vol. 8, No. 6 ( 2021-12), p. 5466-5481
    Abstract: This study aimed to estimate the annual mortality risk and its determinants in chronic Chagas cardiomyopathy. Methods and results We conducted a systematic search in MEDLINE, Web of Science Core Collection, Embase, Cochrane Library, and LILACS. Longitudinal studies published between 1 January 1946 and 24 October 2018 were included. A random‐effects meta‐analysis using the death rate over the mean follow‐up period in years was used to obtain pooled estimated annual mortality rates. Main outcomes were defined as all‐cause mortality, including cardiovascular, non‐cardiovascular, heart failure, stroke, and sudden cardiac deaths. A total of 5005 studies were screened for eligibility. A total of 52 longitudinal studies for chronic Chagas cardiomyopathy including 9569 patients and 2250 deaths were selected. The meta‐analysis revealed an annual all‐cause mortality rate of 7.9% [95% confidence interval (CI): 6.3–10.1; I 2  = 97.74%; T 2  = 0.70] among patients with chronic Chagas cardiom yopathy. The pooled estimated annual cardiovascular death rate was 6.3% (95% CI: 4.9–8.0; I 2  = 96.32%; T 2  = 0.52). The annual mortality rates for heart failure, sudden death, and stroke were 3.5%, 2.6%, and 0.4%, respectively. Meta‐regression showed that low left ventricular ejection fraction (coefficient = −0.04; 95% CI: −0.07, −0.02; P  = 0.001) was associated with an increased mortality risk. Subgroup analysis based on American Heart Association (AHA) classification revealed pooled estimate rates of 4.8%, 8.7%, 13.9%, and 22.4% ( P   〈  0.001) for B1/B2, B2/C, C, and C/D stages of cardiomyopathy, respectively. Conclusions The annual mortality risk in chronic Chagas cardiomyopathy is substantial and primarily attributable to cardiovascular causes. This risk significantly increases in patients with low left ventricular ejection fraction and those classified as AHA stages C and C/D.
    Type of Medium: Online Resource
    ISSN: 2055-5822 , 2055-5822
    URL: Issue
    URL: Article
    DOI: 10.1002/ehf2.v8.6
    DOI: 10.1002/ehf2.13648
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2814355-3
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  • 2
    Online Resource
    Online Resource
    Cryptococcosis among hospitalised patients with COVID ‐19: A multicentre research network study
    Wiley ; 2022
    In:  Mycoses Vol. 65, No. 8 ( 2022-08), p. 815-823
    Details
    In: Mycoses, Wiley, Vol. 65, No. 8 ( 2022-08), p. 815-823
    Abstract: It is unclear if there is an association between COVID‐19 and cryptococcosis. Therefore, this study aimed to describe the clinical features, risk factors, and outcomes associated with cryptococcosis in hospitalised patients with COVID‐19. The objectives of this study were to determine the incidence of and examine factors associated with cryptococcosis after a diagnosis of COVID‐19. We used TriNetX to identify and sort patients 18 years and older hospitalised with COVID‐19 into two cohorts based on the presence or absence of a diagnosis of cryptococcosis following diagnosis of COVID‐19. Outcomes of interest included the incidence of cryptococcosis following the diagnosis of COVID‐19 as well as the proportion of patients in each group who had underlying comorbidities, received immunomodulatory therapy, required ICU admission or mechanical ventilation (MV), or died. Propensity score matching was used to adjust for confounding. Among 212,479 hospitalised patients with COVID‐19, 65 developed cryptococcosis. The incidence of cryptococcosis following COVID‐19 was 0.022%. Patients with cryptococcosis were more likely to be male and have underlying comorbidities. Among cases, 32% were people with HIV. Patients with cryptococcosis were more likely to have received tocilizumab ( p   〈  .0001) or baricitinib ( p   〈  .0001), but not dexamethasone ( p  = .0840). ICU admission (38% vs 29%), MV (23% vs 11%), and mortality (36% vs 14%) were significantly higher among patients with cryptococcosis. Mortality remained elevated after adjusted propensity score matching. Cryptococcosis occurred most often in hospitalised patients with COVID‐19 who had traditional risk factors, comparable to findings in patients without COVID‐19. Cryptococcosis was associated with increased ICU admission, MV, and mortality.
    Type of Medium: Online Resource
    ISSN: 0933-7407 , 1439-0507
    URL: Issue
    URL: Article
    DOI: 10.1111/myc.v65.8
    DOI: 10.1111/myc.13476
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2020780-3
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