120 research outputs found
Services just for men? Insights from a national study of the well men services pilots.
- Author
- A Broom
- A Gregory
- A Petersen
- A Scott-Samuel
- A White
- Anne Ludbrook
- C Burgess
- D Ridge
- Edwin van Teijlingen
- European Commission Eurostat
- F Douglas
- FAM Douglas
- Flora CG Douglas
- G McCartney
- I Banks
- I Sanden
- J Bonhomme
- J Leishman
- JA Smith
- JA Smith
- JA Smith
- JJ Macdonald
- Joe Greener
- JP Mackenbach
- JR Mahalik
- K Hunt
- K Judge
- KF Keenan
- M Lohan
- Organisation of Economic Cooperation and Development OECD
- P Branney
- P Crawshaw
- P de Souza
- PM Galdas
- PM Galdas
- R O'Brien
- R Williams
- RS Sadovsky
- RW Connell
- RW Connell
- S Kraemer
- S MacIntyre
- S Macintyre
- S Robertson
- S Robertson
- S Sharpe
- T Lloyd
- W Courtney
- WH Courtenay
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2013
- Field of study
Men continue to have a lower life expectancy in most countries compared to women. Explanations of this gendered health inequality tend to focus on male risk taking, unhealthy lifestyle choices and resistance to seeking help from health services. In the period 2005-2008 the Scottish Government funded a nationwide community health promotion programme aimed at improving men's health, called Well Men Service Pilots (henceforth WMS)
Forest biodiversity, ecosystem functioning and the provision of ecosystem services
- Author
- A Anzures-Dadda
- A Campos-Arceiz
- A Chhatre
- A Hector
- A Nikula
- A Oxbrough
- A Oxbrough
- A Paquette
- A Schuldt
- A Traveset
- A Veres
- A Wolf
- AAV Soares
- AD Barnes
- AE Richards
- AI Milcu
- AM Klein
- AM Liebhold
- AM Osuri
- Anne Oxbrough
- AR Styring
- AS Mori
- AS Mori
- B Castagneyrol
- B Castagneyrol
- B Castagneyrol
- B Finegan
- B Gardiner
- B Gardiner
- Barry Gardiner
- Bastien Castagneyrol
- BE Penaluna
- BR Sturtevant
- CC Phifer
- CD Michener
- CE Lovelock
- CJ O’Callaghan
- CM Kennedy
- CP Quine
- CT Graham
- D Beaune
- D Binkley
- D Binkley
- D Binkley
- D Edwards
- D Garcia
- D Lindenmayer
- D Rubene
- D Schröter
- D Thom
- DA Lutz
- DA Wardle
- David I. Forrester
- DB Lindenmayer
- DB Lindenmayer
- DB Lindenmayer
- DD Shirima
- DG Brockway
- DI Forrester
- DI Forrester
- DI Forrester
- DI Forrester
- DU Hooper
- E Ansink
- Eckehard G. Brockerhoff
- EG Brockerhoff
- EG Brockerhoff
- EG Brockerhoff
- EL Zvereva
- EM Everham III
- EV Wehncke
- EW Muiruri
- F Isbell
- F Isbell
- F Lebourgeois
- F Plas van der
- F Plas van der
- F Plas van der
- F Santaniello
- FM Jesus
- Fons van der Plas
- FT Vries de
- G Conti
- G Decocq
- G Mace
- GF Smith
- GM Mace
- H Jactel
- H Jactel
- H Jactel
- H Jactel
- H Jactel
- H Pretzsch
- H Taki
- H Taki
- H Taki
- Hervé Jactel
- Hisatomo Taki
- Ian D. Thompson
- ID Thompson
- ID Thompson
- IL Boyd
- J Barlow
- J Cortes-Flores
- J Fründ
- J Ollerton
- J Ruffell
- J Terborgh
- J Zhao
- JA Stanturf
- JA White
- JF Brodie
- JJ Monge
- JL Neumann
- JL Stape
- JM Burgar
- JM Tylianakis
- José Ramón González-Olabarria
- JP Gonzalez-Varo
- JR González
- JR González
- JS Lefcheck
- JS Markl
- K Jung
- KC Cavanaugh
- KE Barton
- KK Sangha
- KL Cockle
- KMA Chan
- KR Kirby
- L Barbaro
- L Berndt
- L Coote
- L Fahrig
- L Fahrig
- L Gamfeldt
- L Gibson
- LA Garibaldi
- Luc Barbaro
- M Damien
- M Deconchat
- M Hanewinkel
- M Lange
- M Plath
- M Proctor
- M Staab
- M Zandersen
- MA Aizen
- MA Linnell
- MB Dickinson
- MD Ulyshen
- ME Harmon
- MG Ryan
- MGE Mitchell
- Millennium Ecosystem Assessment (MEA)
- MJ Aspinwall
- MJ Kelty
- MT Jönsson
- MV Kozlov
- MW Wilson
- N Fagerholm
- N Farwig
- NG Ulanova
- Nicolas Meurisse
- O Rickenbach
- OD Sholes
- P Balvanera
- P Corona
- P Fernandes
- P Fernandez-Conradi
- P Gonzalez
- P Vangansbeke
- PA Hambäck
- PH Freer-Smith
- Phil O’B. Lyver
- PJ Verkerk
- PL Pert
- PO’B Lyver
- PO’B Lyver
- R Costanza
- R Winfree
- RB Root
- RD Gregory
- RG Ribe
- RJ Keenan
- RK Gould
- RK Turner
- RS Bueno
- RS Gonzales
- S Cooper-Ellis
- S Côté
- S Dupont
- S Irwin
- S Martín-Alcón
- S Ratcliffe
- S Seibold
- SB Unsicker
- SG Potts
- T Bourdier
- T Häyhä
- T Newbold
- T Payn
- T Plieninger
- TA Verschut
- TC Daniel
- TC Luu
- TG Seidler
- TJ Aslam
- V Chavez
- V Guyot
- V Guyot
- V Lehouck
- WA Kurz
- WJ Bond
- WJ Bond
- X Moreira
- Y Charbonnier
- YA Boafo
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2017
- Field of study
Forests are critical habitats for biodiversity and they are also essential for the provision of a wide range of ecosystem services that are important to human well-being. There is increasing evidence that biodiversity contributes to forest ecosystem functioning and the provision of ecosystem services. Here we provide a review of forest ecosystem services including biomass production, habitat provisioning services, pollination, seed dispersal, resistance to wind storms, fire regulation and mitigation, pest regulation of native and invading insects, carbon sequestration, and cultural ecosystem services, in relation to forest type, structure and diversity. We also consider relationships between forest biodiversity and multifunctionality, and trade-offs among ecosystem services. We compare the concepts of ecosystem processes, functions and services to clarify their definitions. Our review of published studies indicates a lack of empirical studies that establish quantitative and causal relationships between forest biodiversity and many important ecosystem services. The literature is highly skewed; studies on provisioning of nutrition and energy, and on cultural services, delivered by mixed-species forests are under-represented. Planted forests offer ample opportunity for optimising their composition and diversity because replanting after harvesting is a recurring process. Planting mixed-species forests should be given more consideration as they are likely to provide a wider range of ecosystem services within the forest and for adjacent land uses. This review also serves as the introduction to this special issue of Biodiversity and Conservation on various aspects of forest biodiversity and ecosystem services
Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.
- Author
- Ab Majid MA
- Ab Rahman AS
- Ab Rahman R
- Abayasinghe C
- Abbott T
- Abdullah NH
- Abdur-Rahman L
- Abeloos J
- Abernethy C
- Abidin UN
- Abrunhosa A
- Absar M
- Adam S
- Adams D
- Adams G
- Adamson M
- Adekola O
- Adelaja Y
- Ademola A
- Adenekan A
- Adenike O
- Adeolu AA
- Adetoye A
- Adewale B
- Adigun T
- Adolfsson A
- Aflori L
- Africander C
- Afshari A
- Agarwal V
- Agodirin O
- Aguero Vera M
- Aguzzoli C
- Ahmad A
- Ahmad N
- Ahmad T
- Ahmad T
- Ahmad Y
- Ahmed A
- Ahmed J
- Ai Y
- Aignatoaie M
- Aimoniotou-Georgiou E
- Akanmu O
- Akerman N
- Akinwale M
- Akring I
- Al 'Amri K
- Al Anizi M
- Al hussaini S
- Al-Soudaine Y
- Aladin H
- Alagbe-Briggs O
- Alaman Laguarda G
- Albaj S
- Alcock D
- Alcock L
- Aldecoa C
- Aldecoa C
- Aleixo FB
- Alexander H
- Alexander M
- Alexander-Sefre F
- Alherz F
- Ali H
- Ali M
- Ali S
- Alias A
- Alias AH
- Alias RLR
- Alit MA
- Allen S
- Allen SJ
- Allison J
- Alloj C
- Allorto NL
- Allsop J
- Almeida W
- Alonso E
- Alphonsus C
- Alvares D
- Alves MJ
- Amador JCB
- Ameer Y
- Amendola CP
- Ami N
- Amstrup-Hansen L
- Anagnou A
- Andersen C
- Anderson C
- Anderson C
- Anderson F
- Anderson P
- Andreadaki E
- Andreou A
- Andreou P
- Andrew A
- Andrews E
- Angermair S
- Angus K
- Anillo V
- Antal O
- Antill P
- Antoniadou E
- Antonina W
- Apagaki E
- Apostolou K
- Applewhaite C
- Aquino LPG
- Ar P
- Arawwawala D
- Ardern D
- Argue R
- Arkalaki E
- Armaganidis A
- Armstrong J
- Armstrong R
- Arnaoutoglou C
- Arnaoutoglou E
- Arnold G
- Arrandale L
- Arrich J
- Arrigo M
- Arshad H
- Arshad MA
- Arumugam S
- Arustei M
- Arvaniti K
- Arya A
- Arya S
- Asimakos A
- Asudo F
- Athanasakis E
- Atiku M
- Attrill E
- Attwood C
- Auer P
- Avidan M
- Avila Sanchez FJ
- Avila EJD
- Avis J
- Awad H
- Axioti E
- Ayyaz H
- Azam UAA
- Azambuja P
- Azevedo C
- Aziz FZ
- Baas P
- Baghirzada L
- Bai H-P
- Bai Y
- Baillie S
- Baines D
- Baio TH
- Bairaktari A
- Baker G
- Baker K-A
- Baker P
- Balain B
- Balaji P
- Balajonda N
- Balanescu A
- Balasubramaniam M
- Baldisserotto S
- Baldwin J
- Baldwin M
- Balfoussia D
- Bali C
- Bandeira ME
- Banerjee R
- Bankewitz C
- Banner-Goodspeed V
- Bao Q
- Barcraft-Barnes H
- Barneto L
- Barnett A
- Baroselli A
- Barraclough J
- Barras J-P
- Barrett S
- Barrett WJ
- Basanth S
- Batchelor N
- Bateman B
- Bates A
- Bates S
- Batista HD
- Bauchmuller K
- Bauer M
- Baumgarten G
- Baxter L
- Beaton C
- Beattie S
- Beavis V
- Bechan S
- Bejia T
- Belciu I
- Belda MT
- Bell G
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- Bellandi M
- Bello J
- Beloeil H
- Belskiy V
- Ben-Menachem E
- Benavent P
- Benevento A
- Bengeri S
- Bennett C
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- Bentley C
- Beretta L
- Berg A
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- Berntsen E
- Bertram W
- Bester D
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- Bettega F
- Bettinelli A
- Bhardwaj N
- Bhatia K
- Bhula C
- Bi Y
- Biais M
- Biccard BM
- Bidd H
- Bidgoli J
- Biffen A
- Bignami E
- Bilolikar A
- Bin Mustapha MT
- Birch J
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- Bodansky D
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- Bouwman A
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- Brennan A
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- Briscoe R
- Bristogiannis S
- Brooke J
- Brookes J
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- Broomby R
- Brotto AF
- Brown A
- Brown CW
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- Browning J
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- Brunete T
- Brunswicker A
- Bryant H
- Bua E
- Buccimazza I
- Buckley S
- Buerkle C
- Buhre W
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- Buhrer T
- Builu PM
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- Chatzimichali CA
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- Chazova E
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- Chicken D-W
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- Chin II
- Chirkut S
- Chisbert Cuenca V
- Chlorou D
- Choi H-MD
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- Christiansen IC
- Christmas N
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- Christodoulopoulou T
- Christofaki M
- Christoforidis D
- Chronis C
- Chu HM
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- Chua P
- Chukkambotla S
- Chung CKE
- Cifra E
- Ciobanu C
- Ciobotaru OR
- Cirstea E
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- Clarkson A
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- Cloro LM
- Clyde A
- Cobzaru I
- Codita A
- Colangelo A
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- Colling K
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- Colvin C
- Commey T
- Comptaer N
- Conde C
- Conradie A
- Constantin K
- Cook T
- Cooper L
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- Cooper M
- Cooper R
- Cooper S
- Copaciu E
- Cope J
- Copetti E
- Copley E
- Copotoiu SM
- Coppens M
- Corneci D
- Cornell J
- Cornish J
- Correia da Silva RFM
- Corti D
- Costanzo E
- Costelloe H
- Cotter R
- Cotterell S
- Cotterill D
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- Coutinho F
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- Cripps H
- Critchley R
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- Cueva A
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- Curley G
- Currow H
- Czepanski C
- Czeslick E
- D'Andrea R
- da Costa Fischer BF
- Dafnios N
- Dai H
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- Dalamagka M
- Dalampini E
- Dali-Kemmery L
- Dalton E
- Damant R
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- Datson A
- Daubeny T
- Daugaard M
- Davari M
- Dave T
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- Daya B
- De Andres Ibanez JA
- de Araujo DM
- De Baerdemaeker L
- de Beer J
- de Boer HD
- De Bruyne A
- de Campos Ferreira MF
- de Fretes J
- de Gasperi J
- De Hert S
- De Jongh K
- De Kegel D
- De Meyer JN
- De Oliveira MC
- de Rudnicki S
- de Swardt M
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- de Wet J
- Deacon M
- Deblaere I
- Dedemadi G
- Deen T
- Deepak S
- Deighton K
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- Delgado Garcia DR
- Delgado Navarro C
- Della Rocca G
- Dempsey G
- Dempster A
- den Hoedt M
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- Dent K
- Dermitzaki D
- Desbordes J
- Despotidis V
- Diaconescu C
- Dias F
- Dias S
- Dickson J
- Ditai J
- Divatia J
- Dixon L
- do Nascimento Junior P
- Dobson G
- Docherty P
- Dodiyi-Manuel A
- Dodsworth K
- Dolan R
- Dong B
- Donohue R
- Donovan A
- Douglas J
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- Downes C
- Doyle D
- Dragnea D
- Dragoescu NA
- Drake M
- Drimala M
- Drinkwater Z
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- Du X
- Duarte C
- Dube NZ
- Duca A
- Dudgeon L
- Dudson R
- Duenser M
- Dumitrascu CO
- Dumitrescu A
- Dunay A
- Dunk N
- Durant E
- Durodola A
- Dursin AN
- Durst A
- Duttchen K
- Dutu M
- Dwyer H
- Dylst D
- Dzhamullaev P
- Dzulkipli N
- Echem R
- Edmond H
- Edwards J
- Edwards M
- Edwards M
- Efthymiadi A
- Egan T
- Eggleston C
- Eichwalder A
- Eikman J
- Ekelund K
- el Manser D
- El-Sayed A
- Elabib A
- Elena G
- Elferink-Vonk R
- Elgasim M
- Ellis J
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- Endersby S
- Eneje P
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- Epodoi J
- Eskildsen KZ
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- Evans A
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- Ezekiel E
- Ezike H
- Fagerlund MJ
- Faina L
- Falk E
- Fan H
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- Fanfani LC
- Faponle F
- Faria e Maia D
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- Farid N
- Farina Z
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- Fasina O
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- Gradwohl-Matis I
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- Zoulamoglou M
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- Publication venue
- 'Oxford University Press (OUP)'
- Publication date
- 01/01/2016
- Field of study
BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700
Effect of sitagliptin on cardiovascular outcomes in type 2 diabetes
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- Ziegler O
- Zimanova J
- Zimmerman R
- Zinman B
- Śmiałowski A
- Publication venue
- 'Massachusetts Medical Society'
- Publication date
- 01/01/2015
- Field of study
BACKGROUND: Data are lacking on the long-term effect on cardiovascular events of adding sitagliptin, a dipeptidyl peptidase 4 inhibitor, to usual care in patients with type 2 diabetes and cardiovascular disease. METHODS: In this randomized, double-blind study, we assigned 14,671 patients to add either sitagliptin or placebo to their existing therapy. Open-label use of antihyperglycemic therapy was encouraged as required, aimed at reaching individually appropriate glycemic targets in all patients. To determine whether sitagliptin was noninferior to placebo, we used a relative risk of 1.3 as the marginal upper boundary. The primary cardiovascular outcome was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. RESULTS: During a median follow-up of 3.0 years, there was a small difference in glycated hemoglobin levels (least-squares mean difference for sitagliptin vs. placebo, -0.29 percentage points; 95% confidence interval [CI], -0.32 to -0.27). Overall, the primary outcome occurred in 839 patients in the sitagliptin group (11.4%; 4.06 per 100 person-years) and 851 patients in the placebo group (11.6%; 4.17 per 100 person-years). Sitagliptin was noninferior to placebo for the primary composite cardiovascular outcome (hazard ratio, 0.98; 95% CI, 0.88 to 1.09; P<0.001). Rates of hospitalization for heart failure did not differ between the two groups (hazard ratio, 1.00; 95% CI, 0.83 to 1.20; P = 0.98). There were no significant between-group differences in rates of acute pancreatitis (P = 0.07) or pancreatic cancer (P = 0.32). CONCLUSIONS: Among patients with type 2 diabetes and established cardiovascular disease, adding sitagliptin to usual care did not appear to increase the risk of major adverse cardiovascular events, hospitalization for heart failure, or other adverse events
Whole-genome sequencing reveals host factors underlying critical COVID-19
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- Abd Elghafar M. S.
- Abdel-Aziz M.
- Abdelrazik M.
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- Zongo O.
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- Zyndorf M.
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2022
- Field of study
Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care1 or hospitalization2–4 after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genes—including reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)—in critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease
Impact of clinical phenotypes on management and outcomes in European atrial fibrillation patients: a report from the ESC-EHRA EURObservational Research Programme in AF (EORP-AF) General Long-Term Registry
- Author
- ?liwi?ski A.
- ?zin B.
- Aalborg University
- Aalborg University Hospital
- Aarup A.
- Abalea J.
- Abela E.
- Acimovic T.
- Adamczewski J.
- Adams C.
- Adams L.
- Adams M.
- Adrag?o P.
- Ahadi N.
- Ahmad S.
- Ahyt B.
- Akin Serdar Serdar O.
- Alam I.
- Alcalde O.
- Alin D.
- Alina-Ramona N.
- Allison J.
- Almeida S.
- Alves M.
- Andersen K.
- Andersen M.
- Andrews N.
- Andric A.
- Anguita M.
- Anneken L.
- Antoniades L.
- Antovski A.
- Arandjelovic A.
- Arend C.
- Arhipova T.
- Ari H.
- Aring J.
- Arnaud D.
- Arnault I.
- Arnold M.
- Asanin M.
- Asanovic D.
- Ashton A.
- Atar D.
- Atar D.
- Atmaca Y.
- Austin R.
- Axthelm C.
- Ayarra M.
- Azhari A.
- B?aszczyk H.
- Badenco N.
- Bader H.
- Badila E.
- Bahadur S.
- Bairamukova A.
- Bajraktarova Proseva Proseva T.
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- Balachandran K.
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- Bartholome S.
- Bartos D.
- Baumer A.
- Baytok G.
- Beacock D.
- Beckendorf C.
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- Beerachee Y.
- Beitar T.
- Belcher G.
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- Benham L.
- Berger M.
- Bernardo R.
- Bernucci D.
- Bertomeu Gonzalez Gonzalez V.
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- Burg M.R.
- Burkhardt D.
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- Buzea A.
- Cachia M.
- Canpolat U.
- Carmo P.
- Carol Davila University of Medicine and Pharmacy
- Carpintero M.
- Casta?o S.
- Catanescu G.
- Celentano C.
- Celic V.
- Chastre T.
- Cheggour S.
- Chlebu? M.
- Chua Y.
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- Cimaglia P.
- Cinteza M.
- Ciobanu A.
- Ciudad M.
- Ciurus T.
- Ciutea M.
- Clinical Center of Serbia
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- Costa F.
- Cottam V.
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- Deljanin Ilic Ilic M.
- Demir M.
- Demirtas B.
- Denart M.
- Department of Anaesthesiology and Intensive Care
- Department of Cardiology
- Department of Clinical Medicine
- Department of Gastroenterology and Hepatology
- Desai H.
- Desteghe L.
- Di Chiara Chiara A.
- Dickinson C.
- Diemberger I.
- Dietz D.
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- Garc?a-Bolao I.
- Garg S.
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- Gelev V.
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- Georgiana C.
- Gerardy A.
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- Getty A.
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- Gherghinescu C.
- Giannini I.
- Gibbs C.
- Gibson E.
- Gil Ortega Ortega M.
- Giry L.
- Gjergo H.
- Gl?ggler S.
- Goanta E.
- Goda A.
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- Goddard W.
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- Gorczyca-Michta I.
- Gorka H.
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- Gvenetadze R.
- H?tz H.
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- Haeussler-Schuchardt M.
- Hagens V.
- Haim M.
- Haissaguerre M.
- Hansen S.
- Harc-Dyl E.
- Hardman C.
- Harman E.
- Harrison Stephanie L.
- Hassler N.
- Haushan P.
- Hawksworth C.
- Haynes R.
- Hegya D.
- Heidbuchel H.
- Heitmann K.
- Herzet J.
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- Hoffer E.
- Hoffmann B.
- Hohensee H.
- Holbrook B.
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- Holst Hansen Hansen C.
- Hordy?ski G.
- Hoskamp J.
- Hospital Virgen de la Arrixaca
- Hostiuc M.
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- Hudson K.
- Hughes D.
- Hunt A.
- Hunt J.
- Hurford F.
- Hussain S.
- Hvilsted Rasmussen Rasmussen L.
- Hôpital Trousseau CHU de Tours
- Ilic S.
- Ilic V.
- Ille M.
- Ingram T.
- Investigators on behalf of the ESC-EHRA EORP-AF Long-Term General Registry
- Ionac A.
- Ionescu G.
- Iqbal R.
- IRCCS Istituti Clinici Scientifici Maugeri S.p.A. SB - Pavia
- Iric-Cupic V.
- Isakova N.
- Jacob P.
- Jakubowski P.
- James K.
- Jan A.
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- Jedrzejczyk-Patej E.
- Jeewooth A.
- Jefferey P.
- Jegere S.
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- Jones R.
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- Jourdan A.
- Jovevska S.
- Jubele K.
- K?ster S.
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- Kaba R.
- Kaes S.
- Kalarus Z.
- Kalarus Z.
- Kalejs O.
- Kaminskiene S.
- Karasi?ski J.
- Karthikeyan V.
- Kasprzak J.
- Kassim H.
- Kaul N.
- Kaya H.
- Kayapinar O.
- Kaye S.
- Kazakevich E.
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- Keenan S.
- Kelsall N.
- Kemp S.
- Kepez A.
- Kerimkulova A.
- Khan M.
- Kidd S.
- Kiliszek M.
- Kisheva A.
- Klaus C.
- Kliesch A.
- Klinik Anæstesi Børn, Kredsløb og Kvinder
- Klinik Medicin og Akut
- Ko? M.
- Ko?odziej M.
- Koba E.
- Koestler A.
- Koopman P.
- Korinth A.
- Korsgaard A.
- Koshum-Bayeva K.
- Kotlar I.
- Kovacevic S.
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- Kriete M.
- Krogh Ven? Veno S.
- Krysiak W.
- Krzemien-Wolska K.
- Krzy?anowski K.
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- Kub??kov? M.
- Kubicius A.
- Kuhlmann M.
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- L?ndle V.
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- Landgraf S.
- Lane Deirdre A.
- Lange I.
- Larisa R.
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- Lazarovska K.
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- Le Moal Moal V.
- Le?o S.
- Leal M.
- Leal M.
- Lebherz C.
- Leclercq C.
- Lef?vre M.
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- Lenarczyk R.
- Lenarczyk R.
- Lengerer S.
- Leonard D.
- Leopold-Jadczyk A.
- Leparr?e S.
- Leperchois-Jacquey C.
- Lepiece C.
- Leroy J.
- Lip G.
- Lip G.Y.H.
- Lip G.Y.H.
- Lip Gregory Y. H.
- Lipski P.
- Liverpool Heart and Chest Hospital NHS Foundation Trust
- Livia M.
- Livingstone C.
- Lloyd-Jones H.
- Loachim Popescu Popescu M.
- Loayssa J.
- Loehndorf S.
- Logemann A.
- Lopez C.
- Loughlin A.
- Lozance N.
- Luchkina I.
- Luckner E.
- Ludwig Maximilian University of Munich
- Lurina B.
- Lusanova O.
- Luxton F.
- Lynggaard V.
- Madgwick P.
- Maerkl M.
- Maestre A.
- Magalh?es P.
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- Maggioni A.P.
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- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2021
- Field of study
Background: Epidemiological studies in atrial fibrillation (AF) illustrate that clinical complexity increase the risk of major adverse outcomes. We aimed to describe European AF patients\u2019 clinical phenotypes and analyse the differential clinical course. Methods: We performed a hierarchical cluster analysis based on Ward\u2019s Method and Squared Euclidean Distance using 22 clinical binary variables, identifying the optimal number of clusters. We investigated differences in clinical management, use of healthcare resources and outcomes in a cohort of European AF patients from a Europe-wide observational registry. Results: A total of 9363 were available for this analysis. We identified three clusters: Cluster 1 (n = 3634; 38.8%) characterized by older patients and prevalent non-cardiac comorbidities; Cluster 2 (n = 2774; 29.6%) characterized by younger patients with low prevalence of comorbidities; Cluster 3 (n = 2955;31.6%) characterized by patients\u2019 prevalent cardiovascular risk factors/comorbidities. Over a mean follow-up of 22.5 months, Cluster 3 had the highest rate of cardiovascular events, all-cause death, and the composite outcome (combining the previous two) compared to Cluster 1 and Cluster 2 (all P <.001). An adjusted Cox regression showed that compared to Cluster 2, Cluster 3 (hazard ratio (HR) 2.87, 95% confidence interval (CI) 2.27\u20133.62; HR 3.42, 95%CI 2.72\u20134.31; HR 2.79, 95%CI 2.32\u20133.35), and Cluster 1 (HR 1.88, 95%CI 1.48\u20132.38; HR 2.50, 95%CI 1.98\u20133.15; HR 2.09, 95%CI 1.74\u20132.51) reported a higher risk for the three outcomes respectively. Conclusions: In European AF patients, three main clusters were identified, differentiated by differential presence of comorbidities. Both non-cardiac and cardiac comorbidities clusters were found to be associated with an increased risk of major adverse outcomes
Determinants of recovery from post-COVID-19 dyspnoea: analysis of UK prospective cohorts of hospitalised COVID-19 patients and community-based controls
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- Publication venue
- 'Elsevier BV'
- Publication date
- 27/03/2023
- Field of study
Background The risk factors for recovery from COVID-19 dyspnoea are poorly understood. We investigated determinants of recovery from dyspnoea in adults with COVID-19 and compared these to determinants of recovery from non-COVID-19 dyspnoea. Methods We used data from two prospective cohort studies: PHOSP-COVID (patients hospitalised between March 2020 and April 2021 with COVID-19) and COVIDENCE UK (community cohort studied over the same time period). PHOSP-COVID data were collected during hospitalisation and at 5-month and 1-year follow-up visits. COVIDENCE UK data were obtained through baseline and monthly online questionnaires. Dyspnoea was measured in both cohorts with the Medical Research Council Dyspnoea Scale. We used multivariable logistic regression to identify determinants associated with a reduction in dyspnoea between 5-month and 1-year follow-up. Findings We included 990 PHOSP-COVID and 3309 COVIDENCE UK participants. We observed higher odds of improvement between 5-month and 1-year follow-up among PHOSP-COVID participants who were younger (odds ratio 1.02 per year, 95% CI 1.01–1.03), male (1.54, 1.16–2.04), neither obese nor severely obese (1.82, 1.06–3.13 and 4.19, 2.14–8.19, respectively), had no pre-existing anxiety or depression (1.56, 1.09–2.22) or cardiovascular disease (1.33, 1.00–1.79), and shorter hospital admission (1.01 per day, 1.00–1.02). Similar associations were found in those recovering from non-COVID-19 dyspnoea, excluding age (and length of hospital admission). Interpretation Factors associated with dyspnoea recovery at 1-year post-discharge among patients hospitalised with COVID-19 were similar to those among community controls without COVID-19. Funding PHOSP-COVID is supported by a grant from the MRC-UK Research and Innovation and the Department of Health and Social Care through the National Institute for Health Research (NIHR) rapid response panel to tackle COVID-19. The views expressed in the publication are those of the author(s) and not necessarily those of the National Health Service (NHS), the NIHR or the Department of Health and Social Care. COVIDENCE UK is supported by the UK Research and Innovation, the National Institute for Health Research, and Barts Charity. The views expressed are those of the authors and not necessarily those of the funders
Genetic mechanisms of critical illness in COVID-19.
- Author
- A A Roger Thompson
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- A Agasou
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- A Alvaro
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- R Astin-Chamberlain
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- Samreen Ijaz
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- Shen Xia
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- Stefania Mantovani
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- Stefano Rusconi
- Stella Aslibekyan
- Stephanie Roberts
- Stephen R Knight
- Summers Charlotte
- Susanna Croci
- Susanna Guerrini
- T Anderson
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- T O Jones
- T Pogreban
- T Rees
- T Samakomva
- T Smith
- T Smith
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- T Varghes
- T Williams
- T Wood
- Tammy Gilchrist
- Tenesa Albert
- Teresa Filshtein-Sonmez
- Thomas M Drake
- Thushan de Silva
- Tim Walsh
- Tom Fletcher
- Tom Solomon
- Tony Wackett
- Trevor Paterson
- Tullio Trotta
- Turtle Lance
- U Poultney
- V Amin
- V Anumakonda
- V Bastion
- V Cannons
- V Crickmore
- V Gopal
- V Irvine
- V Kasipandian
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- V Linnett
- V Martinson
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- V Parris
- V Parris
- V Pristopan
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- V Sarathy
- V Thomas
- V Thwaites
- V Tuckey
- V Turner
- V Wagstaff
- V Waugh
- Valentina Anemoli
- Vanessa Sancho-Shimizu
- Victoria Shaw
- Vitart Veronique
- W Harrison
- W Khaliq
- W Khaliq
- W McCormick
- W Woodyatt
- Walker Susan
- Walsh Timothy
- Wang Bo
- Wei Shen Lim
- Wendy S Barclay
- William A Paxton
- William Greenhalf
- Wilson James F
- Wrobel Nicola
- Wu Yang
- X Qiu
- Y Baird
- Y Choudhury
- Y Hussain
- Y Jackson
- Y Thirlwall
- Yang Jian
- Yang Zhijian
- Z Alldis
- Z Belagodu
- Z Bradshaw
- Z Coton
- Z Daly
- Z Farzad
- Z Fernandez
- Z Garland
- Z Maqsood
- Z Omar
- Z Prime
- Z Scott
- Zechner Marie
- Zhai Ranran
- Zheng Chenqing
- Publication venue
- Nature
- Publication date
- 01/01/2020
- Field of study
Host-mediated lung inflammation is present1, and drives mortality2, in the critical illness caused by coronavirus disease 2019 (COVID-19). Host genetic variants associated with critical illness may identify mechanistic targets for therapeutic development3. Here we report the results of the GenOMICC (Genetics Of Mortality In Critical Care) genome-wide association study in 2,244 critically ill patients with COVID-19 from 208 UK intensive care units. We have identified and replicated the following new genome-wide significant associations: on chromosome 12q24.13 (rs10735079, P = 1.65 × 10-8) in a gene cluster that encodes antiviral restriction enzyme activators (OAS1, OAS2 and OAS3); on chromosome 19p13.2 (rs74956615, P = 2.3 × 10-8) near the gene that encodes tyrosine kinase 2 (TYK2); on chromosome 19p13.3 (rs2109069, P = 3.98 × 10-12) within the gene that encodes dipeptidyl peptidase 9 (DPP9); and on chromosome 21q22.1 (rs2236757, P = 4.99 × 10-8) in the interferon receptor gene IFNAR2. We identified potential targets for repurposing of licensed medications: using Mendelian randomization, we found evidence that low expression of IFNAR2, or high expression of TYK2, are associated with life-threatening disease; and transcriptome-wide association in lung tissue revealed that high expression of the monocyte-macrophage chemotactic receptor CCR2 is associated with severe COVID-19. Our results identify robust genetic signals relating to key host antiviral defence mechanisms and mediators of inflammatory organ damage in COVID-19. Both mechanisms may be amenable to targeted treatment with existing drugs. However, large-scale randomized clinical trials will be essential before any change to clinical practice
Cohort Profile: Post-Hospitalisation COVID-19 (PHOSP-COVID) study
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- Adamali H
- Adeloye D
- Adeyemi O
- Adrego R
- Ahmad S
- Ahmed R
- Ahwireng N
- Ainsworth M
- Al-Sheklly B
- Alamoudi A
- Ali M
- Aljaroof M
- All AM
- Allan L
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- Anderson D
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- Antoniades C
- Arbane G
- Arias A
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- Assefa-Kebede H
- Atkin C
- Atkin P
- Atkins H
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- Aul R
- Aung H
- Austin L
- Avram C
- Ayoub A
- Babores M
- Baggott R
- Bagshaw J
- Baguley D
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- Baillie JK
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- Korszun A
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- Koychev I
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- Kurupati P
- Kwan J
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- Lim L
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- Lingford-Hughes A
- Lipman M
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- Lloyd A
- Logan S
- Lomas D
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- Loosley R
- Lord JM
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- Lota H
- Lovegrove W
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- Lukaschuk E
- Lukaschuk E
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- MacGowan G
- Macharia I
- Mackie J
- Macliver L
- Madathil S
- Madzamba G
- Magee N
- Magtoto MM
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- Mallison G
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- Mansoori P
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- Marciniak S
- Marino P
- Mariveles M
- Marks M
- Marks M
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- McAllister-Williams H
- McArdle A
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- McAuley DF
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- McCall JW
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- McCann GP
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- McLeavey L
- McMahon A
- McMahon MJ
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- Menzies D
- Michael A
- Michael B
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- Monteiro W
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- Morillas MM
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- Nevado-Holgado A
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- Parekh D
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- Poinasamy K
- Poinasamy K
- Poinasamy K
- Poinasamy K
- Polgar O
- Poll L
- Porter J
- Porter J
- Porter JC
- Porter JC
- Portukhay S
- Powell N
- Prabhu A
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- Price C
- Price C
- Price D
- Price L
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- Propescu I
- Propescu J
- Prosper S
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- Quaid S
- Quigley J
- Quint J
- Quint J
- Quint JK
- Quint JK
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- Qureshi IN
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- Rahman N
- Rahman NM
- Rahman NM
- Ralser M
- Raman B
- Raman B
- Raman B
- Raman B
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- Rowe A
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- Rowland MJ
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- Rowland-Jones SL
- Rowland-Jones SL
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- Russell RJ
- Saalmink G
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- Sage EK
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- Samani N
- Samat AA
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- Wood C
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- Yip KP
- Young A
- Young B
- Young S
- Yousuf A
- Zawia A
- Zeidan L
- Zhao B
- Zheng B
- Zongo O
- Publication venue
- Oxford University Press (OUP)
- Publication date
- 18/12/2023
- Field of study
Recommended from our members
Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.
- Author
- Abbass Hakam
- Adhikari Neill
- Affleck Julia
- Agno Sathianathan Ronan
- Ahmad Norfaizan
- Ahmed Iram
- Ainscough Kate
- Al Qasim Eman
- Al Swaidan Lolowa
- Al-Bassam Wisam
- Al-Beidh Farah
- Al-Beidh Farah
- Albert Martin
- Alegria Ana
- Alexander Brian
- Alexander Peter
- Allan Angela
- Allan Elizabeth
- Allen Louise
- Allibone Suzanne
- Amaro dos Santos Catorze Teodoro
- Anderson Tom
- Andric Zdravko
- Angus Derek
- Angus Derek C
- Anjum Aisha
- Ankert Juliane
- Annane Djillali
- Annane Djillali
- Anstey Matthew
- Antcliffe David
- Aparicio Christelle
- Appelt Peter
- Arabi Yaseen
- Arabi Yaseen
- Arbane Gill
- Archer Simon
- Aref Noah
- Arias Ana-Marie
- Arishi Hatim
- Arnold Donald
- Asghar Adeeba
- Ashelford Angela
- Attwood Ben
- Austin Karen
- Aysel Florescu Simin
- Azaiz Amine
- Babel Jakša
- Babio-Galan Maite
- Badie Julio
- Bagshaw Sean
- Baillie Kenneth
- Baker Evelyn
- Bakthavatsalam Dhanalakshmi
- Bamford Peter
- Banach Dorota
- Bannard-Smith Jonathan
- Barbazza Leanne
- Barber Russell
- Barge Deborah
- Barnes Nicky
- Baršić Bruno
- Bashyal Archana
- Basile Kim
- Bass Frances
- Bates Michelle
- Bauchmuller Kris
- Bean Sarah
- Beane Abigail
- Beane Abigail
- Beasley Richard
- Begin Phillipe
- Bellemare David
- Benettaib Fatna
- Benzekri Dalila
- Berdaguer Fernando Daniel
- Bergin Colin
- Berry Lindsay
- Berry Lindsay
- Berry Scott
- Berry Scott
- Bhimani Zahra
- Bhimani Zahra
- Bihari Shailesh
- Bihari Shilesh
- Binnie Alexandra
- Bion Julian
- Biradar Vishwanath
- Birch Janine
- Birch Jenny
- Birchall Katie
- Birkinshaw Isobel
- Black Ethel
- Bloos Frank
- Board Jasmin
- Bone Allsion
- Bonner Stephen
- Bonten Marc
- Bonten Marc
- Borgatta Barbara
- Borrill Zoe
- Bosch Ziekenhuis Jeroen
- Boschert Catherine
- Bossard Isabelle
- Boumahni Dounia
- Bourgoin Charlotte
- Bourne Michelle
- Bourne Richard
- Bouwman Wietske
- Bowler Helen
- Boyd Craig
- Bracke Stephanie
- Bradbury Charlotte
- Bradbury Charlotte
- Bradley-Potts Joanne
- Brailsford Jane
- Brain Matthew
- Brant Emily
- Breen Patrick
- Brett Stephen
- Brewer Chris
- Brickell Kathy
- Brightling Chris
- Brillinger Nicole
- Brimfield Lutece
- Brinkerhoff Gail
- Brochard Laurent
- Brohi Farooq
- Browne Troy
- Brunkhorst Frank
- Brunkhorst Frank
- Budd Joanna
- Buehner Ulrike
- Buhr Heidi
- Bullman Laetitia
- Burns Karen
- Burt Karen
- Buscher Hergen
- Butler Amelia
- Butler M
- Buxton Meredith
- Buxton Meredith
- Buzgau Adrian
- Byrne Deborah
- Byrne Kathleen
- Bélteczki János
- Cabreros Leilani
- Calfee Carolyn
- Callender Owen
- Campbell Andy
- Campbell Hilary
- Campbell Lewis
- Camsooksai Julie
- Caplin Cecile
- Carbonneau Elaine
- Carmona Flores Rosario
- Carr-Knott Lisa
- Carrier François Martin
- Carrier Marc
- Cartner Brittney
- Casey Ruth
- Casey Siobhan
- Castro Ferreira Ricardo Manuel
- Cate Heidi
- Cathcart Susanne
- Cavayas Alexandros
- Cawley Kathryn
- Cazzola Federica
- Centofanti John
- Chablani Manish
- Chamara Warnapura Loku
- Chan Carmen
- Chan Charles
- Chan Peter
- Charlewood Richard
- Charron Cyril
- Chartier Delphine
- Chasse Michael
- Chassé Michaël
- Chen Yan
- Cheng Allen
- Cheng Allen C
- Cherian Shiney
- Cheung Winston
- Chhablani Manish
- Chudeau Nicolas
- Cirstea Emanuel
- Clarey Emma
- Claridge Helen
- Clark Michele
- Clark Sarah
- Claxton Andrew
- Clermont Giles
- Cloutier Ève
- Coburn Susan
- Codreanu Daniel
- Coghlan Phoebe
- Cole Jade
- Coles Holly
- Coles Jennifer
- Colin Gwenhael
- Collier Dawn
- Collins Daniel
- Collins Emma
- Collins Joanne
- Connor Jason
- Cooke Jill
- Cooper Jamie
- Cooper Melanie
- Cornell Sarah
- Cort Jon
- Courtin Laura
- Cowdrey Keri-Anne
- Cowley Nicholas
- Cowton Amanda
- Coyne Mark
- Craner Michelle
- Craven Thomas
- Creagh-Brown Ben
- Crisp Nikki
- Croft Maria
- Cusack Rebecca
- Cutler Sean
- Cviljevic Sabina
- Cárcel Fernández Sheila
- Daly James
- Daly Zoe
- Daneman Nick
- Dark Paul
- Darreau Cédric
- Dasgin Joanne
- Davey Miriam
- Davidson Neil
- Davies Gwyneth
- Davies Louisa
- Davies Michelle
- Dawda Ashlish
- Day Christopher
- De Beaux Fiona
- De Bus Liesbet
- de Courcy-Golder Kim
- de Jager P
- de Jong Menno
- De Jong Menno
- de Jonge E
- de la Fuente Martos Carmen
- de Lima Pereira Tiago Nuno Alfaro
- de Man Angelique
- De Waele Jan
- Dearden Joy
- Dechert William
- Deelchand Vashish
- Dela Rosa Arnold
- Dell Amanda
- Demetriou Carrie
- Depante Maria Theresa
- Depuydt Pieter
- Dequin PierreFrançois
- Derde Lennie
- Derde Lennie
- Detry Michelle
- Detry Michelle
- Deye Nicolas
- Digby Stephen
- Distler Michael
- Doble Patricia
- Donnelly Adrian
- Donnison Phil
- Doran Peter
- Dragija Lidija
- Driscoll Alana
- Drummond Andrew
- Duan Erick
- Duffy Eamon
- Duke Graeme
- Duncan Tracey
- Duplaix Mathilde
- Dushianthan Ahilanandan
- Dyas Sarah
- D’Aragon Frédérick
- D’Souza Ramsy
- Effelaar Evelien
- Elhassan Munzir
- Elin Hall Rebecca
- Ellis Christine
- Elmahi Einas
- Elsefi Tarek
- English Shane
- Estcourt Lise
- Estcourt Lise
- Estensen Kristen
- Everitt Robert
- Evers Mirjam
- Farahi Neda
- Fartoukh Muriel
- Faulkner Beverley
- Faulkner Maria
- Fazekas Ágnes
- Felton Tim
- Ferguson Niall
- Ferguson Susan
- Fergusson Dean
- Fernández de Pinedo Artaraz Ziortza
- Ferrier Janet
- Fierens Jan
- Finn André
- Finn Stephanie
- Fischer Roy
- Fitzgerald Mark
- Fitzgerald Mark
- Fletcher Simon
- Flint Neil
- Forbes Andrew
- Forbes Loretta
- Forton Daniel
- Fortune Louise
- Fottrell-Gould Deirdre
- Fowler Rob
- Fowler Robert
- Fox Claire
- Francia Federica
- Francoeur Charles
- Frey Anna
- Friedrich Hinrichs Carl
- Frohlich Stephen
- Fysh Ed
- Gallagher Linda Jude
- Ganguly Saibal
- Ganpat Radhika
- Garcia Rebecca
- Gardiner-Hill Caroline
- Garrard Hywel
- Garrard William
- Gates Simon
- Gattas David
- Gellamucho Minerva
- Gendall Emma
- Genetu Roman Mary
- Geng Wenli
- Geri Guillaume
- Ghamraoui Ali
- Ghosh Alison
- Gibson Charly
- Girard Timothy
- Girijadevi Dinu
- Gledhill Lisa
- Godement Mathieu
- Golden David
- Goligher Ewan
- Gomm Linda
- Goodson Jennifer
- Goodwin Jayne
- Goossens Herman
- Goossens Herman
- Gopal Shameer
- Gopinath Amitha
- Gordon Anthony
- Gordon Anthony C
- Gordon Elizabeth
- Gosbell Iain
- Gould Richard
- Grecu Irina
- Green Cameron
- Green Cameron
- Gregory Jane
- Gresha Rebecca
- Grimmer Lisa
- Grimwade Kate
- Guilder E
- Guitton Christophe
- Hacking Danielle
- Hadebe Bernard
- Hagel Stefan
- Haidar Ghady
- Hall Andrew
- Hall Kathryn
- Hamilton David Oliver
- Hamilton-Davies Colin
- Hamlyn Vincent
- Hammond Naomi
- Haniffa Rashan
- Haniffa Rashan
- Hanson Jane
- Harford Rachel
- Harland Cain
- Harrington Kate
- Harris Nichola
- Harrison Susie
- Hart Ciaran
- Harvala-Simmonds Heli
- Harvey Daniel
- Harward Meg
- Hawcutt Daniel
- Hawkins Nancy
- Hay Sophie Kennedy
- Hayes Kati
- Hayes Leanne
- Hays Carole
- Health Monash
- Heinonen Jonna
- Heming Nicholas
- Henderson Seton
- Henderson Steven
- Henning Jeremy
- Henry Joanne
- Heritier Stephane
- Hickey Naomi
- Higgins Alisa M
- Higgins Lisa
- Hill Helen
- Hills Thomas
- Hills Tom
- Hird Clare
- Hodgson Carol
- Hoff Uwe
- Hoiting Oscar
- Holland Nicky
- Hollos Laszlo
- Homes Jennifer
- Hope David
- Hopkins Phil
- Hormis Anil
- Horton Michelle
- Horton Sarah
- Horvat Christopher
- Horvat Christopher
- Howcroft Clare
- Howle Ryan
- Huang David
- Huckle Abby
- Hughes Emma
- Hugill Keith
- Hullegie Sebastiaan
- Hullegie Sebastiaan J
- Hulley Amanda
- Hulme Jonathan
- Hunt Beverley
- Hunter Stephanie
- Hutter Joanne
- Hutton Paula
- Innes Richard
- Ireland Jane
- Isgro Graziella
- Ivatt Helen
- Jackson Matthew
- Jackson Shane
- Jackson Susan
- Jacques Nicola
- Jacquier Sophie
- Jagannathan Vijay
- Janin Pierre
- Jarczak Dominik
- Jeblaoui Asma
- Jeffrey Helen
- Jenkins Sarah
- Jha Rajeev
- Jhanji Shaman
- Johns Maggie
- Johnson David
- Johnson Rebekah
- Johnston Paul
- Jones Andrea
- Jones Jo
- Joseph Sibet
- José Nuno
- Juhaz Vera
- Kalchthaler Kyle
- Kalogirou Michael
- Kamel Toufik
- Karachi Tim
- Karlikowski Michal
- Karlsson Sari
- Kasipandian Vidya
- Kayani Abdul
- Kazemi Alex
- Keen Alexandra
- Keenan Samantha
- Keet Owen
- Kell Kay
- Kelly Martin
- Kelsall Olivia
- Kernan Maeve
- Kersiake Ian
- Khalid Imrana
- Khare Divya
- Kiiski Heikki
- Kimpton Sarah
- King Andrew
- Kinney Fiona
- Kirkby Amy
- Klinikum Neukölln Vivantes
- Kluge Stefan
- Knott Cameron
- Kol Mark
- Kolanos Steffi
- Koppen Cassandra
- Kosa Alma Gabriela
- Kotarski Viktor
- Kovács Sándor
- Kreß Gabriele
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- Writing Committee for the REMAP-CAP Investigators
- Xavier Kugan
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- Zhao Xiao Bei
- Zinzoni Vanessa
- Zitter Letizia
- Đimoti Renata
- Publication venue
- JAMA: Journal of the American Medical Association
- Publication date
- 06/10/2020
- Field of study
Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707
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