Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

Background: The number of Mendelian randomization analyses including large numbers of genetic variants is rapidly increasing. This is due to the proliferation of genome-wide association studies, and the desire to obtain more precise estimates of causal effects. However, some genetic variants may not be valid instrumental variables, in particular due to them having more than one proximal phenotypic correlate (pleiotropy).

Methods: We view Mendelian randomization with multiple instruments as a meta-analysis, and show that bias caused by pleiotropy can be regarded as analogous to small study bias. Causal estimates using each instrument can be displayed visually by a funnel plot to assess potential asymmetry. Egger regression, a tool to detect small study bias in meta-analysis, can be adapted to test for bias from pleiotropy, and the slope coefficient from Egger regression provides an estimate of the causal effect. Under the assumption that the association of each genetic variant with the exposure is independent of the pleiotropic effect of the variant (not via the exposure), Egger’s test gives a valid test of the null causal hypothesis and a consistent causal effect estimate even when all the genetic variants are invalid instrumental variables.

Results: We illustrate the use of this approach by re-analysing two published Mendelian randomization studies of the causal effect of height on lung function, and the causal effect of blood pressure on coronary artery disease risk. The conservative nature of this approach is illustrated with these examples.

Conclusions: An adaption of Egger regression (which we call MR-Egger) can detect some violations of the standard instrumental variable assumptions, and provide an effect estimate which is not subject to these violations. The approach provides a sensitivity analysis for the robustness of the findings from a Mendelian randomization investigation.

/pdf/mendelian-randomization-with-invalid-instruments-effect-1pqi6rglyj.pdf

Mendelian randomization with invalid instruments: effect estimation and bias detection through Egger regression

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1. About These Statistics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .e7

2. American Heart Association's 2020 Impact Goals. . . . . . . . . . . . . . . . .e10

3. Cardiovascular Diseases . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . .e21

4. Subclinical Atherosclerosis . . . . . . . . . . . . . . . . . . . . .e45

5. Coronary Heart Disease, Acute Coronary Syndrome, and Angina Pectoris . . . . . . . . .e54

6. Stroke (Cerebrovascular Disease) . . . . . . . . . . . . . . . . . . . . . . . . . . . .e68

7. High Blood Pressure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .e88

8. Congenital Cardiovascular Defects . . . . . . . . . . . . . . . . . . . . . . . . . . . .e97

9. Cardiomyopathy and Heart Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . .e102

10. Disorders …

Heart Disease and Stroke Statistics—2012 Update A Report From the American Heart Association

Author(s): Go, Alan S; Mozaffarian, Dariush; Roger, Veronique L; Benjamin, Emelia J; Berry, Jarett D; Borden, William B; Bravata, Dawn M; Dai, Shifan; Ford, Earl S; Fox, Caroline S; Franco, Sheila; Fullerton, Heather J; Gillespie, Cathleen; Hailpern, Susan M; Heit, John A; Howard, Virginia J; Huffman, Mark D; Kissela, Brett M; Kittner, Steven J; Lackland, Daniel T; Lichtman, Judith H; Lisabeth, Lynda D; Magid, David; Marcus, Gregory M; Marelli, Ariane; Matchar, David B; McGuire, Darren K; Mohler, Emile R; Moy, Claudia S; Mussolino, Michael E; Nichol, Graham; Paynter, Nina P; Schreiner, Pamela J; Sorlie, Paul D; Stein, Joel; Turan, Tanya N; Virani, Salim S; Wong, Nathan D; Woo, Daniel; Turner, Melanie B; American Heart Association Statistics Committee and Stroke Statistics Subcommittee

Heart Disease and Stroke Statistics—2013 Update A Report From the American Heart Association

Secret History: Return of the Black Death Channel 4, 7-8pm In 1348 the Black Death swept through London, killing people within days of the appearance of their first symptoms. Exactly how many died, and why, has long been a mystery. This Secret History documentary follows experts as they pick through the evidence and reveal why the plague killed on such a scale. And they ask, what might be coming next?

Medscape

A review of age related macular degeneration

The SERPING1 gene and age-related macular degeneration – Authors' reply

Acta OphthalmologicaEarly View LETTER TO THE EDITOR Impact of the ongoing worldwide shortage of verteporfin (Visudyne®) on the visual function of patients with chronic central serous chorioretinopathy Chrysanthi Tsika, Chrysanthi Tsika orcid.org/0000-0001-9695-7162 Southampton Eye Unit, University of Southampton, University Hospital of Southampton, Southampton, Hampshire, UKSearch for more papers by this authorMoin D. Mohamed, Moin D. Mohamed Department of Ophthalmology, Guy's & St Thomas' NHS Foundation Trust, London, UKSearch for more papers by this authorAndrew J. Lotery, Corresponding Author Andrew J. Lotery [email protected] orcid.org/0000-0001-5541-4305 Southampton Eye Unit, University of Southampton, University Hospital of Southampton, Southampton, Hampshire, UK Faculty of Medicine, University of Southampton, Southampton, Hampshire, UK Correspondence Andrew J. Lotery University Hospital of Southampton, Tremona Rd, SO16 6YD Southampton, UK. Email: [email protected]Search for more papers by this author Chrysanthi Tsika, Chrysanthi Tsika orcid.org/0000-0001-9695-7162 Southampton Eye Unit, University of Southampton, University Hospital of Southampton, Southampton, Hampshire, UKSearch for more papers by this authorMoin D. Mohamed, Moin D. Mohamed Department of Ophthalmology, Guy's & St Thomas' NHS Foundation Trust, London, UKSearch for more papers by this authorAndrew J. Lotery, Corresponding Author Andrew J. Lotery [email protected] orcid.org/0000-0001-5541-4305 Southampton Eye Unit, University of Southampton, University Hospital of Southampton, Southampton, Hampshire, UK Faculty of Medicine, University of Southampton, Southampton, Hampshire, UK Correspondence Andrew J. Lotery University Hospital of Southampton, Tremona Rd, SO16 6YD Southampton, UK. Email: [email protected]Search for more papers by this author First published: 19 May 2023 https://doi.org/10.1111/aos.15714Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. REFERENCES Lotery, A., Sivaprasad, S., O'Connell, A., Harris, R.A., Culliford, L., Ellis, L. et al. (2020) Eplerenone for chronic central serous chorioretinopathy in patients with active, previously untreated disease for more than 4 months (VICI): a randomised, double-blind, placebo-controlled trial. Lancet, 395, 294– 303. Sirks, M.J., van Dijk, E.H.C., Rosenberg, N., Hollak, C.E.M., Aslanis, S., Cheung, C.M.G. et al. (2022) Clinical impact of the worldwide shortage of verteporfin (Visudyne®) on ophthalmic care. Acta Ophthalmologica, 100(7), e1522– e1532. van Dijk, E.H.C., Fauser, S., Breukink, M.B., Blanco-Garavito, R., Groenewoud, J.M.M., Keunen, J.E.E. et al. (2018) Half-dose photodynamic therapy versus high-density subthreshold micropulse laser treatment in patients with chronic central serous chorioretinopathy: the PLACE trial. Ophthalmology, 125, 1547– 1555. Early ViewOnline Version of Record before inclusion in an issue ReferencesRelatedInformation 

Impact of the ongoing worldwide shortage of verteporfin (Visudyne®) on the visual function of patients with chronic central serous chorioretinopathy.

Association of HLA polymorphisms in Age–related macular degeneration

/pdf/baseline-retinal-testing-is-no-longer-recommended-for-3vy7d1k9xs.pdf

Baseline retinal testing is no longer recommended for hydroxychloroquine users in the United Kingdom.

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