PRESS-NEWS.org - Press Release Distribution
FREE PRESS RELEASES DISTRIBUTION

New tools find COVID patients at highest risk of mechanical ventilation and death

A pair of novel calculators could help hospitals predict patient outcomes and better allocate scarce resources such as ICU beds and ventilators.

2021-02-26
(Press-News.org) BOSTON - Two novel calculators for predicting which patients admitted to the hospital with COVID-19 are at greatest risk of requiring mechanical ventilation or of in-hospital death have been developed and validated by Massachusetts General Hospital (MGH). In a study published in The Lancet's EClinicalMedicine, researchers describe how these models could enable clinicians to better stratify risk in COVID-infected patients to optimize care and resource utilization in hospitals faced with ICU capacity constraints.

"Information that can accurately predict severity of the clinical course at the time of hospital admission has been limited," says senior author Rajeev Malhotra, MD, a cardiologist at MGH and investigator in the MGH Cardiovascular Research Center. "Using a combination of past medical history, vital signs, and laboratory results at the time of patient admission, we developed models that can differentiate between risk for mechanical ventilation and risk for in-hospital mortality. While other studies have focused on 30-day hospital outcomes, we followed all COVID-19 patients to the end of their hospital course since a significant number are hospitalized well beyond 30 days."

The research team compiled this clinical information from 1,042 patients confirmed with COVID-19 who were admitted to five hospitals in the Mass General Brigham health care system during the first three months of the pandemic. Significant associations between clinical, hemodynamic, and laboratory data and the endpoints of in-hospital mortality and mechanical ventilation provided the building blocks for two separate risk stratification models known as the VICE (Ventilation in COVID Estimate) and DICE (Death in COVID Estimate) scores.

Predictive VICE factors uncovered by researchers were diabetes mellitus, oxygen saturation of the blood, and two inflammatory markers: C-reactive protein and lactate dehydrogenase. DICE factors predictive of mortality were age, male sex, coronary artery disease, diabetes mellitus, body mass index, platelet count, and a variety of inflammatory and infectious markers.

"By inputting clinical values into these online calculators, physicians can risk-stratify COVID-19 patients upon admission and determine which ones may need the most intensive care and management," says lead author Christopher Nicholson, PhD, a senior research fellow with the MGH Cardiovascular Research Center. "These risk scores allow them to predict with greater than 80% accuracy--higher than established models--patient outcomes, as well as demand for mechanical ventilators and ICU beds, which could impact end-of-life decisions involving COVID-19 patients."

Researchers were surprised to learn that age was not a significant predictor of whether a patient would require mechanical ventilation. Indeed, other than the youngest patients, the percentage of hospitalized COVID-19 patients requiring mechanical ventilation was similar in each decade of life, though there was a clear correlation between age and risk of in-hospital death, with only 15% survival in patients over 84 requiring mechanical ventilation. Nor was age a predictor of how long a patient would need ventilation. The study found that 59% of patients in the 25-to-34 age group required more than 14 days of ventilation, similar to older age groups.

"We were astonished to see the impact of this disease on young people admitted to the hospital," emphasizes Nicholson. "Our data showed they are just as likely to be put on a mechanical ventilator as older people, and to require a long duration of ventilation."

Another significant finding from the study was that regular use of statins was associated with reduced in-hospital mortality, underscoring the strong links among COVID-19, cardiovascular disease, and inflammation. In another encouraging finding, researchers did not observe any relationship between minority ethnic background of COVID-19 patients and worse clinical outcomes after adjusting for clinical risk.

"What we've generally learned from this disease is how different it is from any other we've seen in the ICU," says Malhotra, who has managed COVID patients in the cardiac intensive care unit at MGH over the past year. "For that reason, we were focused on developing a novel approach to evaluate and predict outcomes with our risk stratification calculator."

INFORMATION:

MGH has made the DICE and VICE risk calculators available to health care providers at https://covid-calculator.com/.

Co-first authors in the study included Luke Wooster, a medical student, and Haakon Sigurslid, a research assistant. The study was funded by Fast Grants, a venture established to quickly fund COVID-19 research taking place in academic institutions.

About the Massachusetts General Hospital Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The Mass General Research Institute conducts the largest hospital-based research program in the nation, with annual research operations of more than $1 billion and comprises more than 9,500 researchers working across more than 30 institutes, centers and departments. In August 2020, Mass General was named #6 in the U.S. News & World Report list of "America's Best Hospitals."



ELSE PRESS RELEASES FROM THIS DATE:

Exposure to diverse career paths can help fill labor market 'skills gap'

Exposure to diverse career paths can help fill labor market skills gap
2021-02-26
COLUMBIA, Mo. -- When Patrick Rottinghaus began college, he had no idea what he wanted to do with his career. He started out as an "Open" major while he explored possibilities. Today, Rottinghaus, an associate professor in the University of Missouri College of Education, is helping young people eager to find their place in the world by identifying their strengths and connecting them with careers that match their skillset, interests and personality. As the father of three children, including a daughter soon to enter high school, he wants to ensure they are equipped ...

Engineering the boundary between 2D and 3D materials

2021-02-26
In recent years, engineers have found ways to modify the properties of some "two- dimensional" materials, which are just one or a few atoms thick, by stacking two layers together and rotating one slightly in relation to the other. This creates what are known as moiré patterns, where tiny shifts in the alignment of atoms between the two sheets create larger-scale patterns. It also changes the way electrons move through the material, in potentially useful ways. But for practical applications, such two-dimensional materials must at some point connect with the ordinary world of 3D materials. An international team led by MIT researchers has now come up with a way of imaging what goes on at these ...

Republican and Democratic voters agree on one thing--the need for generous COVID-19 relief

Republican and Democratic voters agree on one thing--the need for generous COVID-19 relief
2021-02-26
Both Democrats and Republicans overwhelmingly favor politicians who support generous COVID-19 relief spending, yet remain deeply polarized over the legitimacy of the 2020 presidential election results and former President Donald Trump's second impeachment. Meanwhile, political experts find that the former president's actions and those taken by congressional supporters in the aftermath of the election represent serious departures from American democratic norms. Those are among the most recent findings of Bright Line Watch, the political science research project cofounded by Gretchen Helmke, a professor of political science at the ...

New study highlights importance of context to physical theories

2021-02-26
A Swansea University scientist's research into the geometrical characteristics of a physical theories is highlighted in a new paper. Physicist Dr Farid Shahandeh said: "Imagine a physical theory whose explanation for the trajectory of an apple falling from a tree differs for Gala and Pink Lady. We know that the apple's variety has nothing to do with how it falls. A theory like this is overcomplicated. "Any seemingly unnecessary and nonsensical parameter like this adds context to a theory's description of a physical phenomenon. "Luckily, classical theories are not contextuality. But, we know that if we try to interpret quantum mechanics in classical terms, it becomes contextual, and consequently ...

Quantum quirk yields giant magnetic effect, where none should exist

Quantum quirk yields giant magnetic effect, where none should exist
2021-02-26
HOUSTON - (Feb. 26, 2021) - In a twist befitting the strange nature of quantum mechanics, physicists have discovered the Hall effect -- a characteristic change in the way electricity is conducted in the presence of a magnetic field -- in a nonmagnetic quantum material to which no magnetic field was applied. The discovery by researchers from Rice University, Austria's Vienna University of Technology (TU Wien), Switzerland's Paul Scherrer Institute and Canada's McMaster University is detailed in a paper in the Proceedings of the National Academy of Sciences. Of interest are both the origins of the effect, which is typically associated with magnetism, and its gigantic magnitude -- more than 1,000 times larger than one might observe in simple ...

Considering disorder and cooperative effects in photon escape rates from atomic gases

2021-02-26
Whilst a great deal of research has studied the rates of photons escaping from cold atomic gases, these studies have used a scalar description of light leaving some of its properties untested. In a new paper published in EPJ B Louis Bellando, a post-doctoral researcher at LOMA, University of Bordeaux, France, and his coauthors--Aharon Gero and Eric Akkermans, Technion-Israel Institute of Technology, Israel, and Robin Kaiser, Université Côte d'Azur, France--aim to numerically investigative the roles of cooperative effects and disorder in photon escape rates from a cold atomic gas to construct a model that considers the vectorial ...

Blood tests offer early indicator of severe COVID-19, study says

2021-02-26
When patients with COVID-19 arrive in emergency rooms, there are relatively few ways for doctors to predict which ones are more likely to become critically ill and require intensive care and which ones are more likely to enjoy a quick recovery. New Yale research could help them identify important early clues. In a recent study, researchers report that a series of biomarkers, or biological signals, associated with white blood cell activation and obesity can predict severe outcomes in COVID-19 patients. The findings appear in the Feb. 26 edition of Blood Advances. "Patients with high levels of these markers were much more like to require care in the intensive care unit, require ventilation, or die due to their COVID-19," said Dr. Hyung Chun, ...

New research finds exercise may help slow memory loss for people living with Alzheimer's dementia

New research finds exercise may help slow memory loss for people living with Alzheimers dementia
2021-02-26
PHOENIX, Arizona, February 26, 2021- Promising new research shows aerobic exercise may help slow memory loss for older adults living with Alzheimer's dementia. ASU Edson College of Nursing and Health Innovation Professor Fang Yu led a pilot randomized control trial that included 96 older adults living with mild to moderate Alzheimer's dementia. Participants were randomized to either a cycling (stationary bike) or stretching intervention for six months. Using the Alzheimer's Disease Assessment Scale-Cognition (ADAS-Cog) to assess cognition, the results of the trial were substantial. The six-month change in ADAS-Cog was 1.0±4.6 (cycling) and 0.1±4.1 (stretching), which were both significantly ...

Using neutron scattering to better understand milk composition

2021-02-26
Neutron scattering is a technique commonly used in physics and biology to understand the composition of complex multicomponent mixtures and is increasingly being used to study applied materials such as food. A new paper published in EPJ E by Gregory N Smith, Niels Bohr Institute, University of Copenhagen, Denmark, shows an example of neutron scattering in the area of food science. Smith uses neutron scattering to better investigate casein micelles in milk, with the aim of developing an approach for future research. Smith, also a researcher at the ISIS Neutron and Muon Source in ...

Unburdening China of cancer: Trend analysis to assist prevention measures

Unburdening China of cancer: Trend analysis to assist prevention measures
2021-02-26
The past century or so has seen unprecedented technological, scientific, and sociological evolution worldwide. These have accompanied global shifts in people's lifestyles and rapid changes in the environment, both natural and man-made. An unfavorable consequence of these alterations has been the increasing burden of cancer on human society. As the country with the largest population, China has borne this burden heavily. Despite the massive progress China has made in healthcare since the 1950s, cancer has become the leading killer in the country. ...

LAST 30 PRESS RELEASES:

Crop rotations with beans and peas offer more sustainable and nutritious food production

Five research-backed steps to a pro-vaccination social media campaign

1 in 4 parents give youth sports low rankings for enforcement of COVID-19 guidelines

Doctors still reluctant to prescribe medical cannabis: McMaster

Influence of sea surface temperature in the Indian Ocean on air quality in the Yangtze River Delta region

Frog species with 6 sex chromosomes offer new clues on evolution of complex XY systems

Study reveals the 3D structure of human uterine endometrium and adenomyosis tissue

ETRI develops a haptic film activated by LEDs

Researchers' work will help the pipeline industry limit the destructive power of bubbles

E-cigarettes with a cigarette-like level of nicotine are effective in reducing smoking

Deep Learning model developed at UHN to maximize lifespan after liver transplant 

Convenience over reputation: Study looks at how older adults pick a doctor

Ocean bacteria release carbon into the atmosphere

Spotting cows from space

Scientists watch 2D puddles of electrons emerge in a 3D superconducting material

Research suggests SEC's increasing focus on terrorism may limit financial oversight

Plastic planet: Tracking pervasive microplastics across the globe

Gut epithelium muscles up against infection

Scientists discover three liquid phases in aerosol particles

New mechanism identified behind blindness in older adults

Common approach to diversity in higher education reflects preferences of white Americans

Study reveals cancer immunotherapy patients at most risk of life-threatening side effects

Study reveals crucial details on skin-related side effects of cancer immune therapies

Researchers identify surface protein as a new osteosarcoma therapeutic target for antibody-drug conjugates

Differences in B cell responses to coronaviruses and other pathogens in children and adults

Bottom-up is the way forward for nitrogen reduction at institutions

Road salts and other human sources are threatening world's freshwater supplies

Researchers engineer probiotic yeast to produce beta-carotene

Spanking may affect the brain development of a child

UConn researchers find bubbles speed up energy transfer

[Press-News.org] New tools find COVID patients at highest risk of mechanical ventilation and death
A pair of novel calculators could help hospitals predict patient outcomes and better allocate scarce resources such as ICU beds and ventilators.