The value of artificial intelligence for the treatment of mechanically ventilated intensive care unit patients: An early health technology assessment

Journal of Critical Care, Journal Year: 2024, Volume and Issue: 82, P. 154802 - 154802

Published: April 6, 2024

The health and economic consequences of artificial intelligence (AI) systems for mechanically ventilated intensive care unit patients often remain unstudied. Early technology assessments (HTA) can examine the potential impact AI by using available data simulations. Therefore, we developed a generic health-economic model suitable early HTA patients.

Language: Английский

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The Hidden Pandemic of COVID-19-Induced Organizing Pneumonia

Pharmaceuticals, Journal Year: 2022, Volume and Issue: 15(12), P. 1574 - 1574

Published: Dec. 16, 2022

Since the beginning of COVID-19 pandemic, clinical, radiological, and histopathological studies have provided evidence that organizing pneumonia is a possible consequence SARS-CoV2 infection. This post-COVID-19 (PCOP) causes persisting dyspnea, impaired pulmonary function, produces radiological abnormalities for at least 5 weeks after onset symptoms. While most patients with PCOP recover within year acute COVID-19, 5-25% cases need specialized treatment. However, despite substantial resources allocated worldwide to finding solution this problem, there are no approved treatments PCOP. Oral corticosteroids produce therapeutic response in majority such patients, but their application limited by anticipated high-relapse frequency risk severe adverse effects. Herein, we conduct systematic comparison epidemiology, pathogenesis, clinical presentation pneumonias caused as well other viral infections. We also use efficacy postinfection OPs (PIOPs) predict treatment Finally, discuss potential candidate anti-inflammatory antifibrotic therapy based on analysis latest trials data.

Language: Английский

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Cellular and molecular features of COVID-19 associated ARDS: therapeutic relevance

Journal of Inflammation, Journal Year: 2023, Volume and Issue: 20(1)

Published: March 20, 2023

Abstract The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection can be asymptomatic or cause a disease (COVID-19) characterized by different levels of severity. main COVID-19 and death is represented (or on chronic) failure distress syndrome (ARDS), often requiring hospital admission ventilator support. molecular pathogenesis COVID-19-related ARDS (by now termed c-ARDS) still poorly understood. In this review we will discuss the genetic susceptibility to COVID-19, local systemic biomarkers correlated with c-ARDS therapeutic options that target cell signalling pathways c-ARDS.

Language: Английский

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Mechanical ventilation as a major driver of COVID-19 hospitalization costs: a costing study in a German setting

Health Economics Review, Journal Year: 2024, Volume and Issue: 14(1)

Published: Jan. 16, 2024

While COVID-19 hospitalization costs are essential for policymakers to make informed health care resource decisions, little is known about these in western Europe. The aim of the current study analyze a German setting, track development over time and daily costs.

Language: Английский

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Health-economic evaluation of the outpatient, inpatient, and public health sector in Germany: Insights from the first three COVID-19 waves

PLoS ONE, Journal Year: 2025, Volume and Issue: 20(2), P. e0314164 - e0314164

Published: Feb. 7, 2025

Aim The aim of this study is to quantify the effectiveness and cost-effectiveness outpatient inpatient sectors (specifically intensive care units, ICUs) local health departments in managing first three waves COVID-19 pandemic Germany. Methods analysis based on a modelling approach using secondary data. each sector was measured by determining reduction case fatality rate (CFR) patients May 7, 2021. A counterfactual scenario assuming absence used their effectiveness. Direct medical costs for were calculated from statutory insurance perspective, utilizing reimbursement rates both sectors. Incremental ratios (ICERs) determined, representing per death avoided. Results ICUs achieved greatest CFR during (1.9%). followed with 1.4%, contributed 0.3% decrease CFR. In terms spending, had highest expenditures among sectors, resulting an ICER €59,055 On other hand, costlier but less effective than sector. remained consistent across various input assumptions. Conclusion During Germany, (ICUs) made largest contribution preventing deaths while also incurring costs.

Language: Английский

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Cost-effectiveness Analysis of Nirmatrelvir/Ritonavir for COVID-19 Among Individuals at High Risk: A Modeling Study

Open Forum Infectious Diseases, Journal Year: 2025, Volume and Issue: 12(4)

Published: March 26, 2025

Abstract Background To prevent severe disease, nirmatrelvir/ritonavir (nirmatrelvir/r) is administered to individuals infected with SARS-CoV-2 who are at high risk, and it currently priced approximately $1375 in the Netherlands. We aim evaluate health outcomes cost-effectiveness of nirmatrelvir/r among patients risk disease. Methods used a decision-analytic model parameterized clinical care utilization data from were between September 2021 November 2023. assumed baseline event rates 1% for hospitalization 0.05% intensive unit admission. Nirmatrelvir/r-related factors varied. Costs collected third-party payer’s perspective, threshold was <$88 000 per quality-adjusted life-year gained. Sensitivity analyses performed account uncertainties. Results This study included 949 SARS-CoV-2. The sample had median age 65 years (IQR, 53–75), 416 (44%) participants female. Comorbidities obesity (25%), hematologic malignancy (21%), solid organ/stem cell transplantation (17%), immunosuppressive medication use (47%). With an low effectiveness, could reduce hospitalizations deaths (relative reduction, 21% 44%, respectively). relative reductions 89% 90% calculated deaths. Higher hospital admission positively influenced thresholds. Nirmatrelvir/r cost-effectively <$512 effectiveness <$1071 effectiveness. Conclusions current hospitalization, has potential, not only COVID-19 but do so drug price reduction 22% 63%. These findings relevant policy makers physicians emphasize importance reevaluating pricing. Clinical Trials Registration NCT05195060 (ClinicalTrials.gov).

Language: Английский

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BigLSTM: Recurrent neural network for the treatment of anomalous temporal signals. Application in the prediction of endotracheal obstruction in COVID-19 patients in the intensive care unit

Computers in Biology and Medicine, Journal Year: 2025, Volume and Issue: 192, P. 110146 - 110146

Published: April 23, 2025

Language: Английский

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Higher urea-to-albumin ratio is associated with mortality risk in critically ill COVID-19 patients

Clinical Nutrition ESPEN, Journal Year: 2023, Volume and Issue: 56, P. 9 - 12

Published: April 26, 2023

This study aimed to evaluate the ability of urea-to-albumin ratio (UAR) predict mortality in critically ill coronavirus disease 2019 (COVID-19) patients.This retrospective included adult patients admitted with COVID-19 at two intensive care units (ICUs) University Hospital. Serum urea and albumin concentrations ICU admission were used calculate UAR. All followed up during hospitalization, rate was recorded.Two hundred eleven evaluated. The mean age 57.8 ± 15.5 years, 54% male. Approximately 84.4% considered be nutritional risk by NRS 2002, median UAR 18.3 (10.5-34.8). length stay 10 (6-16) days, 38.4% required dialysis, 64.9% died. Age, male sex, need hemodialysis, lactate level, inflammatory parameters associated higher mortality. Patients non-survivors had a (23.7 [13.6-41.8] vs. 10.9 [8.5-16.8]; p < 0.001). cutoff point best performance ROC curve for predicting ≥12.17 (AUC: 0.7201; CI 95%: 0.656-0.784). Additionally, 2.00-fold group (HR: 2.00 CI: 1.274-3.149; = 0.003) remained significant after adjusted analyzes (models 1 2).Our data suggest that increased patients.

Language: Английский

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Short-term predictor for COVID-19 severity from a longitudinal multi-omics study for practical application in intensive care units

Talanta, Journal Year: 2023, Volume and Issue: 268, P. 125295 - 125295

Published: Oct. 9, 2023

The COVID-19 pandemic challenged the management of technical and human resources in intensive care units (ICU) across world. Several long-term predictors for disease progression have been discovered. However, to support short-term planning medication that can be translated future pandemics are still missing. A workflow was established identify a predictor acute phase patients clinical decision-making. Thirty-two with SARS-CoV-2 infection were recruited on admission ICU data collected. During their hospitalization, plasma samples acquired from each patient multiple occasions, excepting one which only time point possible, proteome (Inflammation, Immune Response Organ Damage panels Olink® Target 96), metabolome lipidome (flow injection analysis liquid chromatography-mass spectrometry) analyzed sample. Patient visits grouped according changes severity based respiratory organ function, evaluated using combination statistical machine learning. resulting this multi-omics approach compared assessment progression. Furthermore, potential markers baseline levels 50 healthy subjects no known or other viral infections. total 124 parameters, 271 proteins 782 unique metabolites lipids assessed. dimensionality dataset reduced, selecting 47 1177 parameters available following down-selection, build learning model. Subsequently, two (C–C motif chemokine 7 (CCL7) carbonic anhydrase 14 (CA14)) lipid (hexosylceramide 18:2; O2/20:0) linked studied Thus, delivering prognosis an upcoming worsening patient's condition up five days advance reasonable accuracy (79 % three prior event, 84 four event) found. Interestingly, predictor's performance complementary clinicians' capabilities foresee patient. This study presents omics-based biomarkers decision-making resource ICU. successfully applied develop aggravation symptoms. methods adapted small cohort studies.

Language: Английский

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Anticoagulação Crônica em Pacientes com Fibrilação Atrial e COVID-19: Uma Revisão Sistemática e Metanálise

Arquivos Brasileiros de Cardiologia, Journal Year: 2024, Volume and Issue: 121(3)

Published: Jan. 1, 2024

Resumo Fundamento: A doença por coronavírus 2019 (COVID-19) está associada à hipercoagulabilidade. Permanece incerto se a anticoagulação contínua para fibrilação atrial (FA) em pacientes que posteriormente contraem COVID-19 melhora os desfechos clínicos. Objetivos: Comparar oral crônica com ausência de prévia FA contraíram uma infecção relação aos mortalidade todas as causas, COVID-19, admissão unidade terapia intensiva (UTI) e hospitalização. Métodos: Buscamos sistematicamente no PubMed, Embase Cochrane Library estudos elegíveis desde o início até dezembro 2022. Incluímos compararam sem FA. Foram agrupadas razões risco (RR) intervalos confiança (IC) 95% meio um modelo efeitos aleatórios. O nível significância foi estabelecido p < 0,05. As avaliações da qualidade do viés foram realizadas acordo recomendações Cochrane. Resultados: identificados 10 abrangendo 1.177.858 FA, dos quais 893.772 (75,9%) estavam Em reduziu significativamente causas (RR 0,75; IC 0,57 0,99; = 0,048; I2 89%) relacionada 0,76; 0,72 0,79; 0,001; 0%) quando comparada prévia. contrapartida, não houve diferença entre grupos hospitalização 1,08; 0,82 1,41; 0,587; 95%) ou internação UTI 0,86; 0,68 1,09; 0,216; 69%). Conclusões: Nesta metanálise, taxas mais baixas comparação anterior.

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