Background Coronavirus disease 2019 (COVID-19) is a global pandemic that had affected more than eight million people worldwide by June 2020. Given the importance of the presence of diabetes mellitus (DM) for host immunity, we retrospectively evaluated the clinical characteristics and outcomes of moderate-to-severe COVID-19 in patients with diabetes. Methods We conducted a multi-center observational study of 1,082 adult inpatients (aged ≥18 years) who were admitted to one of five university hospitals in Daegu because of the severity of their COVID-19-related disease. The demographic, laboratory, and radiologic findings, and the mortality, prevalence of severe disease, and duration of quarantine were compared between patients with and without DM. In addition, 1:1 propensity score (PS)-matching was conducted with the DM group. Results Compared with the non-DM group ( n =847), patients with DM ( n =235) were older, exhibited higher mortality, and required more intensive care. Even after PS-matching, patients with DM exhibited more severe disease, and DM remained a prognostic factor for higher mortality (hazard ratio, 2.40; 95% confidence interval, 1.38 to 4.15). Subgroup analysis revealed that the presence of DM was associated with higher mortality, especially in older people (≥70 years old). Prior use of a dipeptidyl peptidase-4 inhibitor or a renin-angiotensin system inhibitor did not affect mortality or the clinical severity of the disease. Conclusion DM is a significant risk factor for COVID-19 severity and mortality. Our findings imply that COVID-19 patients with DM, especially if elderly, require special attention and prompt intensive care.

A higher PVC burden (>26%/day) and the presence of retrograde P-waves were independently associated with PVC-mediated LV dysfunction.

BackgroundRespiratory syncytial virus (RSV) infection constitutes a substantial disease burden in the general population. However, the risk of death for RSV infection has been rarely evaluated with confounders or comorbidities adjusted. We aimed to evaluate whether RSV infection is associated with higher mortality than seasonal influenza after adjusting for confounders and comorbidities and the effect of oseltamivir on the mortality in patients with influenza infection.MethodsA retrospective cohort study was conducted on adult (≥18 years) patients admitted to the emergency department and ward of a university teaching hospital for suspected viral infection during 2013–2015 (N = 3743). RSV infection was diagnosed by multiplex PCR (N = 87). Adults hospitalized for seasonal influenza during the study period were enrolled as a comparison group (n = 312). The main outcome was 20-day all-cause mortality.We used Cox proportional hazard regression analyses to calculate the relative risk of death.ResultsAdult patients were less likely to be diagnosed with RSV than with influenza (2.3 vs 8.3%, respectively), were older and more likely to be diagnosed with pneumonia, chronic obstructive pulmonary disease, hypoxemia, and bacterial co-infection. In patients with RSV infection, the 20-day all-cause mortality was higher than that for influenza, (18.4 vs 6.7%, respectively). RSV infection showed significantly higher risk of death compared to the seasonal influenza group, with hazard ratio, 2.32 (95% CI, 1.17–4.58). Oseltamivir had no significant effect on mortality in patients with influenza.ConclusionsRSV infection was significantly associated with a higher risk of death than seasonal influenza, adjusted for potential confounders and comorbidities.

Background and ObjectivesThe electrophysiological properties associated with favorable outcome of radiofrequency catheter ablation (RFCA) for idiopathic ventricular arrhythmia (VA) originating from the papillary muscle (PM) remain unclear. The purpose of this study was to investigate the relationships of electrophysiological characteristics and predictors with the outcome of RFCA in patients with VAs originating from PM in the left ventricle (LV).Subjects and MethodsTwelve (4.2%) of 284 consecutive patients with idiopathic VAs originating from LV PM were assessed. The electrophysiological data were compared between the patients in the successful group and patients in the recurrence group after RFCA.ResultsIn 12 patients with PM VAs, non-sustained ventricular tachycardias (VTs, n=6), sustained VTs (n=4) and premature ventricular complexes (n=2) were identified as the presenting arrhythmias. Seven of eight patients showing high-amplitude discrete potentials at the ablation site had a successful outcome (85.7%), while the remaining four patients who showed low-amplitude fractionated potentials at the ablation site experienced VA recurrence. The mean duration from onset to peak downstroke (Δt) on the unipolar electrogram was significantly longer in the successful group than in the recurrence group (58±8 ms vs. 37±9 ms, p=0.04). A slow downstroke >50 ms of the initial Q wave on the unipolar electrogram at ablation sites was also significantly associated with successful outcome (85.7% vs. 25.0%, p=0.03).ConclusionIn PM VAs, the high-amplitude discrete potentials before QRS and slow downstroke of the initial Q wave on the unipolar electrogram at ablation sites were related to favorable outcome after RFCA.

Highlights Among 694 inpatients with COVID-19, 137 patients were classified as severe. No severe case was observed among patients aged ≤ 19 years. Asymptomatic patients accounted for 14.4% of cases. The first outbreak was primarily associated with younger age groups. The number of severe patients and the mortality rate were high in the second outbreak.