Clinical Characteristics and prognostic factors for Intensive Care Unit Admission of Patients With COVID-19. Retrospective Study Using Machine Learning and Natural Language Processing.

13 p.Background: Many factors involved in the onset and clinical course of the ongoing COVID-19 pandemic are still unknown. Although big data analytics and artificial intelligence are widely used in the realms of health and medicine, researchers are only beginning to use these tools to explore the clinical characteristics and predictive factors of patients with COVID-19. Objective: Our primary objectives are to describe the clinical characteristics and determine the factors that predict intensive care unit (ICU) admission of patients with COVID-19. Determining these factors using a well-defined population can increase our understanding of the real-world epidemiology of the disease. Methods: We used a combination of classic epidemiological methods, natural language processing (NLP), and machine learning (for predictive modeling) to analyze the electronic health records (EHRs) of patients with COVID-19. We explored the unstructured free text in the EHRs within the Servicio de Salud de Castilla-La Mancha (SESCAM) Health Care Network (Castilla-La Mancha, Spain) from the entire population with available EHRs (1,364,924 patients) from January 1 to March 29, 2020. We extracted related clinical information regarding diagnosis, progression, and outcome for all COVID-19 cases. Results: A total of 10,504 patients with a clinical or polymerase chain reaction?confirmed diagnosis of COVID-19 were identified; 5519 (52.5%) were male, with a mean age of 58.2 years (SD 19.7). Upon admission, the most common symptoms were cough, fever, and dyspnea; however, all three symptoms occurred in fewer than half of the cases. Overall, 6.1% (83/1353) of hospitalized patients required ICU admission. Using a machine-learning, data-driven algorithm, we identified that a combination of age, fever, and tachypnea was the most parsimonious predictor of ICU admission; patients younger than 56 years, without tachypnea, and temperature 39 ºC without respiratory crackles) were not admitted to the ICU. In contrast, patients with COVID-19 aged 40 to 79 years were likely to be admitted to the ICU if they had tachypnea and delayed their visit to the emergency department after being seen in primary care. Conclusions: Our results show that a combination of easily obtainable clinical variables (age, fever, and tachypnea with or without respiratory crackles) predicts whether patients with COVID-19 will require ICU admissio

Impact of the COVID-19 pandemic in mortality due to respiratory diseases: A comparative analysis of 2021 and 2020 vs 2019 in Spain.

Introduction: We previously reported an increase in respiratory mortality in 2020 in Spain after COVID-19. It is unclear if this rise is sustained in the longer-term. We aimed to determine whether respiratory mortality in 2021 in Spain returned to pre-pandemic levels. Material and methods: In an observational, large study using official National Institute of Statistics data, we explored deaths due to respiratory diseases, that is, all causes of death by the standard WHO list of diseases of the respiratory system plus COVID-19, tuberculosis and lung cancer. Using the latest available official data of Spain, we analyzed changes in the mortality pattern in Spain from January 2019 to December 2021. We endorsed STROBE guidance for observational research. Results: There were 98,714 deaths due to respiratory diseases in 2021 in Spain, corresponding to 21.9% of all deaths, becoming second in the ranking of causes of death. Respiratory diseases mortality in Spain has not returned to pre-pandemic levels in 2021, still with an increase of 30.3% (95% CI 30.2-30.4) compared to rates in 2019. All respiratory-specific causes of death decreased in 2021, except for lung cancer, that increased in women and decreased in men compared to 2019 (both p<0.05). In a multivariate analysis some established risk factors for respiratory diseases mortality were confirmed, such as male gender and older age; further, an association with reduced mortality in rural Spain was observed, still with a large geographical variability. Conclusions: The COVID-19 pandemic has had a lasting impact on deaths due to respiratory diseases and certain specific causes of death in 2021, and it has disproportionately affected certain regions

Face Mask Exemptions, Respiratory Patients, and COVID-19 in Spain. Data From the 2021 ITC EUREST-PLUS Spain Survey

Dear Editor, During the initial waves of the COVID-19 pandemic, respiratory patients received confusing messages by several patient associations and the World Health Organization1, 2 to be exempted from wearing face masks. Allegedly, many assumed that difficult breathing through face masks might exacerbate their respiratory condition, producing asthma attacks or chronic obstructive pulmonary disease (COPD) exacerbations. In its December 2020 Interim Guidance on Mask use in the context of COVID-19, WHO cited studies suggesting that masks might have an adverse impact on respiratory disease patients, but they did not provide any guidance about whether respiratory disease patients should or should not wear masks; explicitly, it reads in page 10 of 22 the following paragraph and references

Space-Dependent Probabilities for K0−K0ˉK^0-\bar{K^0} Oscillations

We analyze $K^0-\bar{K^0}$ oscillations in space in terms of propagating wave packets with coherent $K_S$ and $K_L$ components. The oscillation probabilities $P_{K^0 \to K^0} (x)$ and $P_{K^0 \to \bar{K^0}} (x)$ depending only on the distance $x$, are defined through the time integration of a current density $j(x,t)$ . The definition is such that it coincides with the experimental setting, thus avoiding some ambiguities and clarifying some controversies that have been discussed recently.Comment: 11 pages, late

Invariants of Lie Algebras with Fixed Structure of Nilradicals

An algebraic algorithm is developed for computation of invariants ('generalized Casimir operators') of general Lie algebras over the real or complex number field. Its main tools are the Cartan's method of moving frames and the knowledge of the group of inner automorphisms of each Lie algebra. Unlike the first application of the algorithm in [J. Phys. A: Math. Gen., 2006, V.39, 5749; math-ph/0602046], which deals with low-dimensional Lie algebras, here the effectiveness of the algorithm is demonstrated by its application to computation of invariants of solvable Lie algebras of general dimension $n<\infty$ restricted only by a required structure of the nilradical. Specifically, invariants are calculated here for families of real/complex solvable Lie algebras. These families contain, with only a few exceptions, all the solvable Lie algebras of specific dimensions, for whom the invariants are found in the literature.Comment: LaTeX2e, 19 page

Characteristics and prognosis of COVID-19 in patients with COPD

Patients with Chronic Obstructive Pulmonary Disease (COPD) have a higher prevalence of coronary ischemia and other factors that put them at risk for COVID-19-related complications. We aimed to explore the impact of COVID-19 in a large population-based sample of patients with COPD in Castilla-La Mancha, Spain. We analyzed clinical data in electronic health records from 1 January to 10 May 2020 by using Natural Language Processing through the SAVANA Manager® clinical platform. Out of 31,633 COPD patients, 793 had a diagnosis of COVID-19. The proportion of patients with COVID-19 in the COPD population (2.51%; 95% CI 2.33–2.68) was significantly higher than in the general population aged >40 years (1.16%; 95% CI 1.14–1.18); p < 0.001. Compared with COPD-free individuals, COPD patients with COVID-19 showed significantly poorer disease prognosis, as evaluated by hospitalizations (31.1% vs. 39.8%: OR 1.57; 95% CI 1.14–1.18) and mortality (3.4% vs. 9.3%: OR 2.93; 95% CI 2.27–3.79). Patients with COPD and COVID-19 were significantly older (75 vs. 66 years), predominantly male (83% vs. 17%), smoked more frequently, and had more comorbidities than their non-COPD counterparts. Pneumonia was the most common diagnosis among COPD patients hospitalized due to COVID-19 (59%); 19% of patients showed pulmonary infiltrates suggestive of pneumonia and heart failure. Mortality in COPD patients with COVID-19 was associated with older age and prevalence of heart failure (p < 0.05). COPD patients with COVID-19 showed higher rates of hospitalization and mortality, mainly associated with pneumonia. This clinical profile is different from exacerbations caused by other respiratory viruses in the winter seasonGrant COVID-19 UAH 2019/00003/016/001/005 from Alcalá Universit

All solvable extensions of a class of nilpotent Lie algebras of dimension n and degree of nilpotency n-1

We construct all solvable Lie algebras with a specific n-dimensional nilradical n_(n,2) (of degree of nilpotency (n-1) and with an (n-2)-dimensional maximal Abelian ideal). We find that for given n such a solvable algebra is unique up to isomorphisms. Using the method of moving frames we construct a basis for the Casimir invariants of the nilradical n_(n,2). We also construct a basis for the generalized Casimir invariants of its solvable extension s_(n+1) consisting entirely of rational functions of the chosen invariants of the nilradical.Comment: 19 pages; added references, changes mainly in introduction and conclusions, typos corrected; submitted to J. Phys. A, version to be publishe

Bell-inequalities for K0K0ˉK^0 \bar{K^0} Pairs from Φ\Phi-Resonance Decays

We analyze the premises of recent propositions to test local realism via Bell-inequalities using neutral kaons from $\Phi$-resonance decays as entangled EPR-pairs. We pay special attention to the derivation of Bell-inequalities, or related expressions, for unstable and oscillating kaon `quasi-spin' states and to the possibility of the actual identification of these states through their associated decay modes. We discuss an indirect method to extract probabilities to find these states by combining experimental information with theoretical input. However, we still find inconsistencies in previous derivations of Bell-inequalities. We show that the identification of the quasi-spin states via their associated decay mode does not allow the free choice to perform different tests on them, a property which is crucial to establish the validity of any Bell-inequality in the context of local realism. In view of this we propose a different kind of Bell-inequality in which the free choice or adjustability of the experimental set-up is guaranteed. We also show that the proposed inequalities are violated by quantum mechanics.Comment: 22 pages. Late

Three-party entanglement from positronium

The decay of ortho-positronium into three photons produces a physical realization of a pure state with three-party entanglement. Its quantum correlations are analyzed using recent results on quantum information theory, looking for the final state which has the maximal amount of GHZ-like correlations. This state allows for a statistical dismissal of local realism stronger than the one obtained using any entangled state of two spin one-half particles.Comment: REVTEX, 13 pages, 3 figure

Neutrino oscillations from relativistic flavor currents

By resorting to recent results on the relativistic currents for mixed (flavor) fields, we calculate a space-time dependent neutrino oscillation formula in Quantum Field Theory. Our formulation provides an alternative to existing approaches for the derivation of space dependent oscillation formulas and it also accounts for the corrections due to the non-trivial nature of the flavor vacuum. By exploring different limits of our formula, we recover already known results. We study in detail the case of one-dimensional propagation with gaussian wavepackets both in the relativistic and in the non-relativistic regions: in the last case, numerical evaluations of our result show significant deviations from the standard formula.Comment: 16 pages, 4 figures, RevTe