Evidence is conflicting about the diabetes characteristics associated with worse outcome among hospitalized COVID-19 patients. We aimed to assess the role of stress hyperglycemia ratio (SHR) as a prognostic marker among them. In our retrospective cohort study, patients were stratified according to SHR, admission glucose, and glycated hemoglobin tertiles. The primary outcome was a composite endpoint of invasive mechanical ventilation, intensive care unit admission, and in-hospital mortality. The study included 395 patients with a mean age of 59 years, and 50.1% were males. Patients in the third tertile of SHR developed more primary events, and the difference was significant compared to the first tertile (p = 0.038) and close to significance compared to the second tertile (p = 0.054). There was no significant difference in the outcomes across admission glucose and glycated hemoglobin tertiles. A higher SHR tertile was an independent risk factor for the primary outcome (OR, 1.364; 95% CI: 1.014–1.836; p = 0.040) after adjustment for other covariables. In hospitalized COVID-19 diabetic patients, SHR third tertile was significantly associated with worse outcome and death. SHR can be a better prognostic marker compared to admission glucose and glycated hemoglobin. A higher SHR was an independent risk factor for worse outcome and in-hospital mortality.

Background: The intensive care unit (ICU) is a center of multidrug-resistant (MDR) pathogens. This is due to overuse of antibiotics in the treatment of critically ill patients. Tigecycline is a broad-spectrum antibiotic that belongs to the glycylcycline group. Tigecycline has been indicated in treatment of complicated intra-abdominal infections (cIAIs) and complicated skin and soft-tissue infections (cSSTIs). Objective: This study was done to discover the best dose regimen of tigecycline in treatment of cSSTIs and cIAIs, especially in patients who are critically ill and obese, for clinical outcomes and safety. Setting: The study was conducted in an adult ICU that consists of 25 beds in a general hospital and was conducted within 2 years. A total of 954 patients were screened in this study. Methods: This was a retrospective cohort study that compared the clinical outcomes of patients: mortality, ICU stay, and safety of using two different dose regimens of tigecycline between patients with different body weight who were treated for infections caused by MDR pathogens in the ICU. The study was conducted within 2 years. All results were collected from patients’ files and were analyzed with SPSS version 20. Main outcome: The study was implemented to figure out the best dose regimen of tigecycline to achieve a reduction in mortality, ICU stay, treatment duration, and secondary septic-shock incidence with minimum side effects in treatment of cSSTIs and cIAIs in patients with different body weight. Results: There was a significant improvement in mortality, ICU stay, recurrent infection by the same organism, duration of tigecycline treatment, number of patients who had first negative culture after starting treatment, secondary bacteremia, and secondary septic shock with patients who used high-dose regimens of tigecycline in different subgroups of body weight, with no significant difference in side effects. Conclusion: The use of high-dose tigecycline resulted in a significant enhancement in all clinical outcomes, especially mortality and ICU stay when used in treatment of overweight and obese patients with cSSTIs and cIAIs.

Background and Objectives: An elevated procalcitonin level has classically been linked to bacterial infections. Data on the association between elevated procalcitonin and the outcome of coronavirus disease 2019 (COVID-19) are conflicting. Some linked it to associated bacterial co-infections, while others correlated the elevation with disease severity without coexisting bacterial infections. We aimed to investigate the association between high procalcitonin and the severity of COVID-19. Materials and Methods: Hospitalized patients with confirmed COVID-19 pneumonia were divided into two groups: the normal-procalcitonin group and the high-procalcitonin group (>0.05 ng/mL). Patients with concomitant bacterial infections on admission were excluded. The primary outcomes were the need for intensive care unit (ICU) admission, progression to invasive mechanical ventilation (IMV), and in-hospital 28-day mortality. Results: We included 260 patients in the normal procalcitonin group and 397 patients in the high procalcitonin group. The mean age was 55 years and 49% were females. A higher number of patients in the elevated procalcitonin group required ICU admission (32.7% vs. 16.2%, p < 0.001) and IMV (27.2% vs. 13.5%, p < 0.001). In-hospital mortality was significantly higher in the elevated procalcitonin group (18.9% vs. 8.5%, p < 0.001). After adjusting for other covariates, procalcitonin > 0.05 ng/mL was an independent predictor of progression to IMV (OR, 1.71; 95% CI, 1.08–2.71; p = 0.022), ICU admission (OR, 1.73; 95% CI, 1.13–2.66; p = 0.011), and in-hospital mortality (OR, 1.99; 95% CI, 1.14–3.47; p = 0.015). An elevated procalcitonin level was the strongest predictor of in-hospital mortality. Conclusions: Measurement of procalcitonin can have a prognostic role among COVID-19 patients. The admission procalcitonin level can identify patients at risk of ICU admission, progression to IMV, and in-hospital mortality.