Browsing by Author "Palaiodimos, Leonidas"

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    African Americans Possessed High Prevalence of Comorbidities and Frequent Abdominal Symptoms, and Comprised A Disproportionate Share of Covid-19 Mortality among 9,873 Us- Hospitalized Patients Early in the Pandemic
    (Fortune Journals, 2024) Ashktorab, Hassan; Pizuorno, Antonio; Chirumamilla, Lakshmi Gayathri; Adeleye, Folake; Dalivand, Maryam Mehdipour; Sherif, Zaki A.; Oskrochi, Gholamreza; Challa, Suryanarayana Reddy; Jones-Wonni, Boubini; Rankine, Sheldon; Ekwunazu, Chiamaka; Banson, Abigail; Kim, Rachel; Gilliard, Chandler; Ekpe, Elizabeth; Shayegh, Nader; Nyaunu, Constance; Martins, Chidi; Slack, Ashley; Okwesili, Princess; Abebe, Malachi; Batta, Yashvardhan; Ly, Do; Valarie, Ogwo; Smith, Tori; Watson, Kyra; Kolawole, Oluwapelumi; Tahmazian, Sarine; Atoba, Sofiat; Khushbakht, Myra; Riley, Gregory; Gavin, Warren; Kara, Areeba; Hache-Marliere, Manuel; Palaiodimos, Leonidas; Mani, Vishnu R.; Kalabin, Aleksandr; Gayam, Vijay Reddy; Garlapati, Pavani Reddy; Miller, Joseph; Jackson, Fatimah; Carethers, John M.; Rustgi, Vinod; Brim, Hassan; Medicine, School of Medicine
    Background and aim: Identifying clinical characteristics and outcomes of different ethnicities in the US may inform treatment for hospitalized COVID-19 patients. Aim of this study is to identify predictors of mortality among US races/ethnicities. Design setting and participants: We retrospectively analyzed de-identified data from 9,873 COVID-19 patients who were hospitalized at 15 US hospital centers in 11 states (March 2020-November 2020). Main Outcomes and Measures: The primary outcome was to identify predictors of mortality in hospitalized COVID-19 patients. Results: Among the 9,873 patients, there were 64.1% African Americans (AA), 19.8% Caucasians, 10.4% Hispanics, and 5.7% Asians, with 50.7% female. Males showed higher in-hospital mortality (20.9% vs. 15.3%, p=0.001). Non- survivors were significantly older (67 vs. 61 years) than survivors. Patients in New York had the highest in-hospital mortality (OR=3.54 (3.03 - 4.14)). AA patients possessed higher prevalence of comorbidities, had longer hospital stay, higher ICU admission rates, increased requirement for mechanical ventilation and higher in-hospital mortality compared to other races/ethnicities. Gastrointestinal symptoms (GI), particularly diarrhea, were more common among minority patients. Among GI symptoms and laboratory findings, abdominal pain (5.3%, p=0.03), elevated AST (n=2653, 50.2%, p=<0.001, OR=2.18), bilirubin (n=577, 12.9%, p=0.01) and low albumin levels (n=361, 19.1%, p=0.03) were associated with mortality. Multivariate analysis (adjusted for age, sex, race, geographic location) indicates that patients with asthma, COPD, cardiac disease, hypertension, diabetes mellitus, immunocompromised status, shortness of breath and cough possess higher odds of in-hospital mortality. Among laboratory parameters, patients with lymphocytopenia (OR2=2.50), lymphocytosis (OR2=1.41), and elevations of serum CRP (OR2=4.19), CPK (OR2=1.43), LDH (OR2=2.10), troponin (OR2=2.91), ferritin (OR2=1.88), AST (OR2=2.18), D-dimer (OR2=2.75) are more prone to death. Patients on glucocorticoids (OR2=1.49) and mechanical ventilation (OR2=9.78) have higher in-hospital mortality. Conclusion: These findings suggest that older age, male sex, AA race, and hospitalization in New York were associated with higher in-hospital mortality rates from COVID-19 in early pandemic stages. Other predictors of mortality included the presence of comorbidities, shortness of breath, cough elevated serum inflammatory markers, altered lymphocyte count, elevated AST, and low serum albumin. AA patients comprised a disproportionate share of COVID-19 death in the US during 2020 relative to other races/ethnicities.
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    Correction: Symptomatic, clinical and biomarker associations for mortality in hospitalized COVID-19 patients enriched for African Americans
    (BMC, 2022-08-29) Ashktorab, Hassan; Pizuorno, Antonio; Adeleye, Folake; Laiyemo, Adeyinka; Dalivand, Maryam Mehdipour; Aduli, Farshad; Sherif, Zaki A.; Oskrochi, Gholamreza; Angesom, Kibreab; Oppong-Twene, Philip; Challa, Suryanarayana Reddy; Okorie, Nnaemeka; Moon, Esther S.; Romos, Edward; Jones-Wonni, Boubini; Kone, Abdoul Madjid; Rankine, Sheldon; Thrift, Camelita; Scholes, Derek; Ekwunazu, Chiamaka; Banson, Abigail; Mitchell, Brianna; Maskalo, Guttu; Ross, Jillian; Curtis, Julencia; Kim, Rachel; Gilliard, Chandler; Ahuja, Geeta; Mathew, Joseph; Gavin, Warren; Kara, Areeba; Hache-Marliere, Manuel; Palaiodimos, Leonidas; Mani, Vishnu R.; Kalabin, Aleksandr; Gayam, Vijay Reddy; Garlapati, Pavani Reddy; Miller, Joseph; Chirumamilla, Lakshmi Gayathri; Jackson, Fatimah; Carethers, John M.; Kamangar, Farin; Brim, Hassan; Medicine, School of Medicine
    Correction to: BMC Infectious Diseases (2022) 22:552 https://doi.org/10.1186/s12879-022-07520-1
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    Symptomatic, clinical and biomarker associations for mortality in hospitalized COVID-19 patients enriched for African Americans
    (BMC, 2022-06-17) Ashktorab, Hassan; Pizuorno, Antonio; Adeleye, Folake; Laiyemo, Adeyinka; Dalivand, Maryam Mehdipour; Aduli, Farshad; Sherif, Zaki A.; Oskrochi, Gholamreza; Angesom, Kibreab; Oppong-Twene, Philip; Challa, Suryanarayana Reddy; Okorie, Nnaemeka; Moon, Esther S.; Romos, Edward; Jones-Wonni, Boubini; Kone, Abdoul Madjid; Rankine, Sheldon; Thrift, Camelita; Scholes, Derek; Ekwunazu, Chiamaka; Banson, Abigail; Mitchell, Brianna; Maskalo, Guttu; Ross, Jillian; Curtis, Julencia; Kim, Rachel; Gilliard, Chandler; Ahuja, Geetha; Mathew, Joseph; Gavin, Warren; Kara, Areeba; Hache-Marliere, Manuel; Palaiodimos, Leonidas; Mani, Vishnu R.; Kalabin, Aleksandr; Gayam, Vijay Reddy; Garlapati, Pavani Reddy; Miller, Joseph; Chirumamilla, Lakshmi Gayathri; Jackson, Fatimah; Carethers, John M.; Kamangar, Farin; Brim, Hassan; Medicine, School of Medicine
    Background and aims: Initial reports on US COVID-19 showed different outcomes in different races. In this study we use a diverse large cohort of hospitalized COVID-19 patients to determine predictors of mortality. Methods: We analyzed data from hospitalized COVID-19 patients (n = 5852) between March 2020- August 2020 from 8 hospitals across the US. Demographics, comorbidities, symptoms and laboratory data were collected. Results: The cohort contained 3,662 (61.7%) African Americans (AA), 286 (5%) American Latinx (LAT), 1,407 (23.9%), European Americans (EA), and 93 (1.5%) American Asians (AS). Survivors and non-survivors mean ages in years were 58 and 68 for AA, 58 and 77 for EA, 44 and 61 for LAT, and 51 and 63 for AS. Mortality rates for AA, LAT, EA and AS were 14.8, 7.3, 16.3 and 2.2%. Mortality increased among patients with the following characteristics: age, male gender, New York region, cardiac disease, COPD, diabetes mellitus, hypertension, history of cancer, immunosuppression, elevated lymphocytes, CRP, ferritin, D-Dimer, creatinine, troponin, and procalcitonin. Use of mechanical ventilation (p = 0.001), shortness of breath (SOB) (p < 0.01), fatigue (p = 0.04), diarrhea (p = 0.02), and increased AST (p < 0.01), significantly correlated with death in multivariate analysis. Male sex and EA and AA race/ethnicity had higher frequency of death. Diarrhea was among the most common GI symptom amongst AAs (6.8%). When adjusting for comorbidities, significant variables among the demographics of study population were age (over 45 years old), male sex, EA, and patients hospitalized in New York. When adjusting for disease severity, significant variables were age over 65 years old, male sex, EA as well as having SOB, elevated CRP and D-dimer. Glucocorticoid usage was associated with an increased risk of COVID-19 death in our cohort. Conclusion: Among this large cohort of hospitalized COVID-19 patients enriched for African Americans, our study findings may reflect the extent of systemic organ involvement by SARS-CoV-2 and subsequent progression to multi-system organ failure. High mortality in AA in comparison with LAT is likely related to high frequency of comorbidities and older age among AA. Glucocorticoids should be used carefully considering the poor outcomes associated with it. Special focus in treating patients with elevated liver enzymes and other inflammatory biomarkers such as CRP, troponin, ferritin, procalcitonin, and D-dimer are required to prevent poor outcomes.