Papers by Aliae Mohamed Hussein
Annals of Intensive Care, Nov 13, 2023
Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ... more Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021).
Advances in Respiratory Medicine
Introduction: Noninvasive positive-pressure ventilation (NPPV) is applied to facilitate weaning p... more Introduction: Noninvasive positive-pressure ventilation (NPPV) is applied to facilitate weaning process and decrease complications associated with prolonged intubation. Interest has emerged in using Intelligent Volume Assured Pressure Support (iVAPS) to facilitate earlier removal of an endotracheal tube. Material and methods: This study was conducted to compare the effective-ness of iVAPS versus standard Spontaneous/timed (S/T) mode in facilitating weaning process of mechanically ventilated chronic obstructive pulmonary disease (COPD) in acute exacerbation. In a prospective randomized study, 80 invasively ventilated COPD patients in acute exacerbations were extubated then immediate application of NPPV using either S/T mode (Group I) or iVAPS mode (Group II) was done. Clinical parameters (heart rate, respiratory rate, and arterial blood gas param-eters at selected time intervals of treatment were recorded for both groups and analyzed. Results: No significant differences were found be...
Gastroenterology, 2020
Background: Coronavirus disease 2019 (COVID-19) emerged in Dec 2019 and has spread globally. Diab... more Background: Coronavirus disease 2019 (COVID-19) emerged in Dec 2019 and has spread globally. Diabetics are at increased risk of infections caused by a variety of pathogens including virus. The present research was aimed to describe clinical characteristics and outcomes of COVID-19 patients with diabetes. Methods: A retrospective multicenter study of COVID-19 patients with diabetes was conducted in four hospitals in Wuhan, Shanghai and Anhui Province. RT-PCR or next generation sequencing was executed to confirm the existence of SARS-CoV-2 from respiratory specimens. Results: 54 diabetics (10.36%) were recruited from 521 COVID-19 patients, with a median age of 63 (IQR, 52-70) years. Among them, 51 were previously diagnosed with diabetes and 3 were newly diagnosed based on HbA1c over 6.5%. For COVID-19, 47 of the 54 patients had an exposure history. Fever (47/54, 87.04%), dry cough (36/54, 66.67%) and expectoration (21/53, 39.62%) were among the top three symptoms. Lung infiltration was bilateral (46/52, 88.46%) and multilobe (47/52, 90.38%), and groundglass opacity (36/37, 97.30%) was the most common pattern in radiological images. Besides, COVID-19 patients with diabetes were prone to be classified as severe or critical type (46.30%, 25/54) and complicated with acute lung injury, acute respiratory distress syndrome and acute kidney injury. The proportion of ICU admission and death This article is protected by copyright. All rights reserved. among the COVID-19 diabetics were 14.81% (8/54) and 12.96% (7/54), respectively. Conclusions: With older age, diabetics diagnosed as COVID-19 were prone to developing into severe type, and exhibited a high rate of ICU admission and mortality. Highlights: For COVID-19 with diabetes, we provided a primary and comprehensive description of the clinical features and outcomes. With older age, COVID-19 patients with diabetes were susceptible to developing severe or critical type of COVID-19 and complicated with ALI/ARDS and AKI. Thus, special attention should be paid to diabetics infected with SARS-CoV-2, who exhibited higher incidence of ICU admission and death.
Anaesthesia, 2021
SummaryPeri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this stu... more SummaryPeri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS‐CoV‐2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre‐operative SARS‐CoV‐2 infection were compared with those without previous SARS‐CoV‐2 infection. The primary outcome measure was 30‐day postoperative mortality. Logistic regression models were used to calculate adjusted 30‐day mortality rates stratified by time from diagnosis of SARS‐CoV‐2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre‐operative SARS‐CoV‐2 diagnosis. Adjusted 30‐day mortality in patients without SARS‐CoV‐2 infection was 1.5% (95%CI 1.4–1.5). In patients with a pre‐operative SARS‐CoV‐2 diagnosis, mortality was increased in patients having surgery wi...
Anaesthesia, 2021
SummarySARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critica... more SummarySARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri‐operative or prior SARS‐CoV‐2 were at further increased risk of venous thromboembolism. We conducted a planned sub‐study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS‐CoV‐2 diagnosis was defined as peri‐operative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre‐operative anti‐coagulation for baseline comorbidities was no...
European Review for Medical and Pharmacological Sciences, Apr 1, 2022
Egyptian journal of Immunology
The identification of novel antibodies that could neutralize SARS-CoV-2 is one of the novel appro... more The identification of novel antibodies that could neutralize SARS-CoV-2 is one of the novel approaches to use in combating COVID-19. This study aimed to explore the level of neutralizing antibodies (NAbs) in asymptomatic close contacts of COVID-19 patients and asymptomatic healthcare workers. In vitro qualitative detection of serum antibodies of participants from both populations was done using an anti-SARS-CoV-2 immunoassay. The study included 107 participants, of which 59.8% were healthcare workers and 40.2% were family contacts of confirmed COVID-19 cases. Their median age was 22 years. The percentage of positivity and median titer for NAbs were significantly higher among family contacts than mong healthcare workers (P = 0.013 and <0.001, respectively). We also measured C-reactive protein (CRP) levels and the median value of CRP was significantly higher in the family members who had been in contact with COVID-19 patients than in healthcare workers (P < 0.001). In the family...
Annals of Clinical and Translational Neurology
BACKGROUND The association between autonomic dysfunction and long-COVID syndrome is established. ... more BACKGROUND The association between autonomic dysfunction and long-COVID syndrome is established. However, the prevalence and patterns of symptoms of dysautonomia in long-COVID syndrome in a large population are lacking. OBJECTIVE To evaluate the prevalence and patterns of symptoms of dysautonomia in patients with long-COVID syndrome. METHODS We administered the Composite Autonomic Symptom Score 31 (COMPASS-31) questionnaire to a sample of post-COVID-19 patients who were referred to post-COVID clinic in Assiut University Hospitals, Egypt for symptoms concerning for long-COVID syndrome. Participants were asked to complete the COMPASS-31 questionnaire referring to the period of more than 4 weeks after acute COVID-19. RESULTS We included 320 patients (35.92 ± 11.92 years, 73% females). The median COMPASS-31 score was 26.29 (0-76.73). The most affected domains of dysautonomia were gastrointestinal, secretomotor, and orthostatic intolerance with 91.6%, 76.4%, and 73.6%, respectively. There was a positive correlation between COMPASS-31 score and long-COVID duration (p < 0.001) and a positive correlation between orthostatic intolerance domain score and post-COVID duration (p < 0.001). There was a positive correlation between orthostatic intolerance domain score and age of participants (p = 0.004). Two hundred forty-seven patients (76.7%) had a high score of COMPASS-31 >16.4. Patients with COMPASS-31 >16.4 had a longer duration of long-COVID syndrome than those with score <16.4 (46.2 vs. 26.8 weeks, p < 0.001). CONCLUSIONS Symptoms of dysautonomia are common in long-COVID syndrome. The most common COMPASS-31 affected domains of dysautonomia are gastrointestinal, secretomotor, and orthostatic intolerance. There is a positive correlation between orthostatic intolerance domain score and patients' age.
Egyptian Journal of Health Care, 2021
BackgroundBeing a newly emerging disease little is known about its long-lasting post COVID-19 con... more BackgroundBeing a newly emerging disease little is known about its long-lasting post COVID-19 consequences. Aim of this work is to assess the frequency, patterns and determinants of persistent post COVID-19 symptoms and to evaluate the value of a proposed Novel COVID-19 symptoms score. Patients with confirmed COVID-19 in the registry were included in a cross sectional study. The patient demographics, comorbid disorders, the mean duration since the onset of the symptoms, history of hospital or ICU admittance, and treatment taken during acute state, as well as symptoms score before and after convalescence were recorded.ResultsThe most frequent constitutional and neurological symptoms were myalgia (60.0%), arthralgia (57.2%), restriction of daily activities (57.0%), sleeping troubles (50.9%), followed by anorexia (42.6%), chest pain (32.6%), gastritis (32.3%), cough (29.3%) and dyspnea (29.1%). The mean total score of acute stage symptoms was 31.0 ± 16.3 while post COVID 19 symptoms sc...
Journal of Clinical & Experimental Cardiology, 2018
Objective: We aimed to explore the utility of atherogenic index of plasma (AIP) on plaque burden ... more Objective: We aimed to explore the utility of atherogenic index of plasma (AIP) on plaque burden detected by coronary computed tomography angiography (CCTA) in patients with chest pain and intermediate probability of coronary artery disease (CAD). Methods: AIP was calculated as the logarithmically transformed ratio of the serum triglycerides to HDLcholesterol in 167 patients with chest pain (age 46.5 ± 11.8 yrs; 104 were men) and correlated with segment stenosis score (SSS), SIS and total plaque score (TPS), studied with CCTA, and compared with other lipid ratios. Results: Obstructive CAD lesions were detected in 45.5% of patients with intermediate pretest probability of CAD. CCTA documented CAD was detected in 61.7% subjects with AIP value >0.24, while CAD was detected in 26.5% patients with AIP value <0.24. AIP was 0.49 ± 0.12 in patients with CAD versus 0.14 ± 0.03; p<0.001 in those without CAD. The total coronary artery calcium score (CACS) was significantly higher in patients with AIP >0.24 than in patients with AIP <0.24 (p<0.001). AIP was correlated with SSS, SIS, TPS, and CACS (p<0.001). Moreover, it seems to be the strongest ratio than other lipid ratios. AIP was the strongest predictor of plaque burden. ROC analysis demonstrated that AIP >0.29 was the optimal cutoff value in predicting CAD, with AUC=0.78, p<0.001, and it was the strongest discriminator index compared with other lipid indices. Conclusion: AIP was significantly correlated with plaque burden and extent of CAD in patients with intermediate pretest probability of CAD who presented with chest pain and it could help in risk stratification.
PLOS ONE, 2021
Background Interleukin-18 (IL-18) and interferon-γ (IFN-γ) are cytokines of crucial role in infla... more Background Interleukin-18 (IL-18) and interferon-γ (IFN-γ) are cytokines of crucial role in inflammation and immune reactions. There is a growing evidence supporting important roles for IL-18 and IFN γ in tuberculosis (TB) infection and anti-tuberculosis immunity. Objective To evaluate the role of polymorphisms in IL-18-607 and -137 and INF-γ +874 in susceptibility to TB infection among Egyptian patients. Methods A case control study was conducted to investigate the polymorphism at IL-18-607, -137 and INF-γ+874 by sequence specific primer-polymerase chain reaction (SSP- PCR) in 105 patients with pulmonary and extra pulmonary tuberculosis and 106 controls. Results A significant protective effect against TB was found in homozygous CC genotype at IL-18 -137G/C, in addition to a 7-fold risk with GG and GC genotypes in the recessive model. Apart from a decreased risk with the AC genotype, no association was detected between the susceptibility to TB and different genotypes or alleles at t...
The Egyptian Journal of Bronchology, Nov 18, 2022
Introduction: Bronchiectasis was considered as an uncommon radiological feature of corona virus d... more Introduction: Bronchiectasis was considered as an uncommon radiological feature of corona virus disease 2019 (COVID-19) infection. The clinical course and outcome of COVID-19 bronchiectasis overlap is still a point for research. The aim of this study was to evaluate the prevalence, course, and outcome of bronchiectasis as an atypical presentation of COVID-19 infection. Methods: A cross-sectional study has been conducted from July 2021 to February 2022 and included 425 COVID-19 swab-positive patients who were examined by high resolution computed tomography of the chest during acute phase (4 weeks) of the infection. Results: Fourteen (3.3%) patients newly developed bronchiectasis-de novo. Patients with de novo bronchiectasis had significantly higher cough score, frequency of colored sputum and mMRC score, respiratory distress (p < 0.001) and respiratory failure (p = 0.02) than patients with no bronchiectasis. They also had the higher frequency of ICU's admission (p = 0.02), need to non-invasive (p = 0.01), and invasive mechanical ventilation (p = < 0.001), duration of mechanical ventilation, ICU's stay and overall hospital stay (p < 0.001). As for the outcome, death rate was also statistically significantly higher among those with De novo bronchiectasis than those without bronchiectasis (p = 0.04). Conclusion: Bronchiectasis is an uncommon presentation among COVID-19 patients. However, bronchiectasis increases disease burden in COVID-19 patients. It may have a negative impact on the outcome. Trial registration: Clini calTr ials. gov. NCT04 910113. Registered June 2, 2021.
Critical Care
Following publication of the original article [1], an error was identified in the article title: ... more Following publication of the original article [1], an error was identified in the article title: COVID-19 was incorrectly captured as COIVD-19. The article title has been updated above and in the original article.
The Egyptian Journal of Bronchology, Jan 28, 2022
Until now, there are more than two hundred million confirmed cases of COVID-19 including more tha... more Until now, there are more than two hundred million confirmed cases of COVID-19 including more than seven million deaths. Clinical trials of all three vaccines authorized for use in the UK (Pfizer-BioNTech, Oxford-AstraZeneca, and Moderna) have reported high vaccine efficacy. This rapid systematic review was initiated because no systematic review had been conducted to determine the safety and efficacy of AstraZeneca ChAdOx1 nCoV-19 vaccine. Evidence acquisition: A systematic search in the following platforms: PubMed, Google Scholar, Scopus, WOS, and MEDLINE databases for all articles in the English language regarding safety and efficacy of SARS-CoV-2 vaccine ChAdOx1 nCoV-19 was performed. Papers published up to end of June were included. Evidence synthesis: Out of 477 retrieved articles, fifteen are included. All the selected articles are concerned with evaluation of AstraZeneca ChAdOx1 nCoV-19 vaccine. Three of them discussed the effectiveness of ChAdOx1 nCoV-19 vaccine, while thirteen (one is common with the group of the effectiveness) measured the adverse effects associated with the vaccine. Because thrombosis was recorded as a serious adverse effect developed after ChAdOx1 nCoV-19 vaccination, it was emphasized in a special group to be analyzed separately. In conclusion: the main message of selected papers was that the value of ChAdOx1 nCoV-19 vaccination to provide critical protection should be considered higher compared to the significant worldwide burden of the emerging COVID-19 infection. No causal relations were found to link cases-having thrombotic adverse reactions to the vaccine.
Annals of Thoracic Medicine, 2021
RATIONAL: Recently, a new “Post-COVID-19 Functional Status (PCFS) scale” is recommended in the cu... more RATIONAL: Recently, a new “Post-COVID-19 Functional Status (PCFS) scale” is recommended in the current COVID-19 pandemic. It is proposed that it could be used to display direct retrieval and the functional sequelae of COVID-19. AIM OF THE STUDY: The aim of the study was to assess the PCFS and to evaluate if age, gender, smoking, hospitalization, and comorbidities have any effect on functional limitations in recovered COVID-19 patients. METHODS: A total of 444 registered confirmed COVID-19 patients were included. They were interviewed in our follow-up clinics and filled an Arabic translated PCFS scale as well as their demographic and clinical data. RESULTS: Eighty percent of COVID-19 recovered cases have diverse degrees of functional restrictions ranging from negligible (63.1%), slight (14.4%), moderate (2%), to severe (0.5%) based on PCFS. Furthermore, there was a substantial variance between the score of PCFS with age (P = 0.003), gender (P = 0.014), the duration since the onset of the symptoms of COVID-19 (P < 0.001), need for oxygen supplementation (P < 0.001), need for intensive care unit (ICU) admittance (P = 0.003), previous periodic influenza vaccination (P < 0.001), smoking status (P < 0.001), and finally, the presence of any comorbid disorder (P < 0.001). CONCLUSIONS: Most of the COVID-19 recovered cases have diverse degrees of functional restrictions ranging from negligible to severe based on PCFS. These restrictions were affected by age, gender, periodic influenza vaccination, smoking, duration since symptoms onset, need for oxygen or ICU admittance, and finally the presence of coexisting comorbidity.
The Egyptian Journal of Chest Diseases and Tuberculosis, 2021
Background Determining the clinical features and outcomes of patients diagnosed with coronavirus ... more Background Determining the clinical features and outcomes of patients diagnosed with coronavirus disease 2019 (COVID-19) is fundamental to improve the understanding and adequate management of the novel illness. This study aims to identify the determinants of survival and the outcome within 30 days in hospitalized patients with COVID-19 infection in Upper Egypt. Patients and methods A total of 1064 cases were consecutively admitted to isolation hospitals in Upper Egypt. All cases had confirmed COVID-19 infection. The electronic records of the patients were retrospectively revised and the demographic data, clinical manifestations, quick sequential organ failure assessment (qSOFA) score on admission, and 30-day outcome (ICU admission, death, recovery, or still in hospital) were analyzed. Overall cumulative survival rates in all patients and those more than or less than 50 years were calculated. Results Overall, 49.2% of the study population were males, whereas 50.8% were females, with ...
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Papers by Aliae Mohamed Hussein