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Awundja BMA, Tchuente BRT, Hagbe VP, Nnanga LS, Kamdem L, Ekedjoum DYE, Roger OMH, Maguerrite B, Patricia D, Ndanji JA, Mbah LJN, Lumngwena EN, Bongue B, Ngondi JL. Biological profile and risk factors of mortality in COVID-19 patients at Adlucem hospital in Banka-Bafang, Cameroon: a cross-sectional study. BMC Infect Dis 2025; 25:420. [PMID: 40141010 PMCID: PMC11948750 DOI: 10.1186/s12879-025-10845-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2024] [Accepted: 03/21/2025] [Indexed: 03/28/2025] Open
Abstract
BACKGROUND Despite availability of preventive vaccine and global control of the SARS-CoV-19 transmission, continuous emergence of new strains coupled with the increase spread of Mpox poses significant public health threats. Identification of simple factors for stratification and prognostics of hospitalized patients is crucial for management of these patients in limited resource settings. The aim of this study was to assess the biological profile of severe hospitalized COVID-19 patients in Cameroon and identify risk factors for mortality. METHODS A prospective, cross-sectional, analytical study was conducted of a cohort of COVID-19 patients admitted and managed at the Adlucem hospital in Banka-Bafang, Haut-Nkam Department, West Cameroon Region, from 2021 to 2022. The clinical characteristics and biological parameters of patients with COVID-19 were evaluated. RESULTS Of the 259 cases of COVID-19 included in the study, 68 cases (26.3%) died. The majority of patients who died were over 70 years of age. Key factors predictive of mortality in these patients were leukocytosis (OR = 2.035; 95%CI: 1.161-3.567; p = 0.013), thrombocytosis (OR = 4.286; 95%CI: 1.152-15.950; p = 0.030), hypokalemia (OR = 2.400; 95%CI: 1.143-5.042; p = 0.021), hyponatremia (OR = 2.292; 95%CI: 1.185-4.431; p = 0.014) and hypochloremia (OR = 2.644; 95%CI: 1.188-5.882; p = 0.017). CONCLUSION Age, electrolyte imbalance and thrombocytosis were predictive of death in COVID-19 patients in this cohort. Thus, a biological work-up should be considered for risk stratification to ensure efficient management of COVID-19 patients on a case-by-case basis in resource limited settings like Cameroon. CLINICAL TRIAL NUMBER Not applicable.
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Affiliation(s)
| | - Boris Ronald Tonou Tchuente
- Department of Biochemistry, Faculty of Sciences, University of Yaounde 1, Yaounde, P.O. Box 812, Cameroon
- Centre for Food, Food Security and Nutrition Research, Institute of Medical Research and Medicinal Plant Studies, Yaounde, Cameroon
| | - Vervaine Pauline Hagbe
- Department of Biochemistry, Faculty of Sciences, University of Yaounde 1, Yaounde, P.O. Box 812, Cameroon
| | - Leila Sandra Nnanga
- Department of Biochemistry, Faculty of Sciences, University of Yaounde 1, Yaounde, P.O. Box 812, Cameroon
- Centre for Research on Medicinal Plants and Traditional Medicine, Institute of Medical Research and Medicinal Plant Studies, Yaoundé, Cameroon
| | - Linda Kamdem
- INSERM, U1059, DVH Team, SAINBIOSE, Jean Monnet University Saint-Etienne, University Hospital of Saint-Etienne, Saint-Etienne, France
| | | | | | | | | | | | - Leonel Javeres Ntepe Mbah
- Laboratory of Human Metabolism and Non-Communicable Disease, Institute of Medical Research and Medicinal Plant Studies, Yaounde, Cameroon
| | - Evelyn Ngwa Lumngwena
- School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
- Centre for the study of Emerging and re-Emerging pathogens (CREMER), Institute for Medical Research and Medicinal Plant Studies, Yaoundé, Cameroun
| | - Bienvenu Bongue
- INSERM, U1059, DVH Team, SAINBIOSE, Jean Monnet University Saint-Etienne, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Judith Laure Ngondi
- Department of Biochemistry, Faculty of Sciences, University of Yaounde 1, Yaounde, P.O. Box 812, Cameroon.
- Centre of Nutrition and Functional Foods, PO Box 8024, Yaoundé, Cameroon.
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Kaya H, Argun Baris S, Gultepe B, Basyigit I, Boyaci H. The predictive value of the LDH-albumin ratio on poor clinical course and mortality in COVID-19 patients: A single-center study. Medicine (Baltimore) 2025; 104:e41660. [PMID: 40020123 PMCID: PMC11875623 DOI: 10.1097/md.0000000000041660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 02/06/2025] [Indexed: 03/05/2025] Open
Abstract
There are studies evaluating the association of serum lactate dehydrogenase (LDH) and albumin levels with mortality in COVID-19 patients. The aim of our study was to evaluate the predictive effect of the LDH/albumin ratio (LAR) on mortality and poor clinical course in COVID-19 patients. A total of 2093 patients for whom LDH and albumin tests were available were included in the study. Demographic data, length of hospitalization, and signs of poor clinical course were recorded and compared with the LAR value at the time of hospitalization. The study included 1010 female (48.3%) and 1083 male (51.7%) patients. Notably, 1408 (67.3%) of the patients had at least 1 comorbidity. Oxygen was required in 860 patients (41.1%) and intensive care unit was required in 215 patients (10.3%). The mortality rate was 8.1% (n: 170). The median LAR value was 8.05. A positive correlation was observed between LAR and length of hospitalization. The LAR value was significantly higher in patients who died compared with those who survived, in patients who required intensive care compared with those who did not, and in patients who required oxygen compared to those who did not. The cutoff value for LAR in predicting mortality was calculated as 10.48. The sensitivity and specificity were determined as 73.5% and 73.7%. In conclusion, serum LAR at the time of admission is predictive of poor clinical course and mortality in COVID-19 patients. Patients with LAR values higher than the cutoff value should be closely monitored for poor clinical course.
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Affiliation(s)
- Huseyin Kaya
- Department of Chest Diseases, Kocaeli City Hospital, Izmit, Kocaeli, Turkey
| | - Serap Argun Baris
- Department of Chest Diseases, University of Kocaeli, Izmit, Kocaeli, Turkey
| | | | - Ilknur Basyigit
- Department of Chest Diseases, University of Kocaeli, Izmit, Kocaeli, Turkey
| | - Hasim Boyaci
- Department of Chest Diseases, University of Kocaeli, Izmit, Kocaeli, Turkey
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Wang D, Shen Y, Wu J, Li Y, Ma K, Jiang G, Li X, Qin H, Chen K, Wu Z, Guan M. Utility of plasma nucleocapsid protein in predicting severity and prognosis in severe COVID-19 patients with comorbidities. Clin Chim Acta 2025; 565:119951. [PMID: 39216815 DOI: 10.1016/j.cca.2024.119951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 08/27/2024] [Accepted: 08/28/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVES The COVID-19 pandemic poses ongoing challenges to global public health systems, emphasizing the critical necessity for efficient diagnostic and prognostic markers. This study evaluates the MAGLUMI® SARS-CoV-2 Ag N protein chemiluminescent immunoassay (MAG-CLIA) for its analytical performance and its role in predicting disease severity and prognosis among severe COVID-19 patients with comorbidities. METHODS Analytical validation of plasma MAG-CLIA SARS-CoV-2 Ag N protein encompassed precision, interference, LoQ and linearity. Plasma N protein concentrations and other biomarkers were measured within 48 h of admission, tracked until discharge or death. The Mann-Whitney U test explored the association between plasma N protein and COVID-19 severity or prognosis. Longitudinal monitoring of plasma N protein dynamics was conducted in representative patients. RESULTS MAG-CLIA demonstrated precise quantification of plasma N protein with a CV below 10 % and minimal interference. The LoQ was 0.88 ng/L, with a broad linear range. Plasma N protein showed high diagnostic accuracy for COVID-19, achieving 95.42 % specificity and 78.32 % sensitivity at 2.388 ng/L. Plasma N protein emerged as a valuable prognostic indicator, correlating with mechanical ventilation need and patient survival. Plasma N protein concentrations ≥ 424.3 ng/L (AUC 0.8102, sensitivity 78.38 %, specificity 85.48 %) were associated with poor prognosis in severe COVID-19 patients with comorbidities. CONCLUSIONS MAG-CLIA's SARS-CoV-2 N protein detection in plasma demonstrates both analytical reliability and clinical relevance in our inaugural evaluation. As a promising prognostic biomarker for severe COVID-19 patients, it offers crucial insights into disease severity and progression, emphasizing the significance of early monitoring and intervention, especially for patients with comorbidities.
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Affiliation(s)
- Di Wang
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Yutao Shen
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Jianbo Wu
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Yaju Li
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Ke Ma
- Department of Critical Care Medicine, Huashan Hospital, Fudan University, Shanghai 201907, China
| | - Guangjie Jiang
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Xiangyu Li
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Huanhuan Qin
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Kun Chen
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Zhiyuan Wu
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China.
| | - Ming Guan
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China.
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Abdollahi A, Nateghi S, Panahi Z, Inanloo SH, Salarvand S, Pourfaraji SM. The association between mortality due to COVID-19 and coagulative parameters: a systematic review and meta-analysis study. BMC Infect Dis 2024; 24:1373. [PMID: 39623325 PMCID: PMC11610108 DOI: 10.1186/s12879-024-10229-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 11/14/2024] [Indexed: 12/06/2024] Open
Abstract
AIMS AND OBJECTIVES This systematic review and meta-analysis study evaluated the association between mortality due to COVID-19 and coagulative factors. METHODS A systematic search was conducted on electronic databases including PubMed, Scopus, and the Web of Science from the beginning of the pandemic until October 2024 to identify relevant studies on COVID-19 patients and their laboratory findings related to coagulation markers and mortality outcome. Eligibility criteria were defined based on the PICO framework, and data extraction was performed by two authors independently using a standardized sheet. Statistical analysis was accomplished using the random effects model, and heterogeneity among studies was assessed using the I2 test. R and RStudio were used for statistical analysis and visualization. RESULTS Our systematic literature search yielded 6969 studies, with 48 studies meeting the inclusion criteria for our meta-analysis. The mean platelet count was significantly lower in deceased COVID-19 patients compared to survivors (20.58), while activated partial thromboplastin time (aPTT) and fibrinogen levels did not show significant differences. The pooled mean difference of D-Dimer, International Normalized Ratio (INR), and prothrombin time (PT) were significantly lower in survived patients (-2.45, -0.10, and -0.84, respectively). These findings suggest that platelet count, D-Dimer, INR, and PT may serve as potential indicators of mortality in COVID-19 patients. CONCLUSION The results of our systematic review and meta-analysis revealed a significant reduction in the pooled platelet count among deceased individuals when compared to survivors. However, no significant distinctions were observed in the pooled mean activated aPTT and fibrinogen levels between the deceased and survivor groups. On the other hand, there were noticeable variations in the pooled estimated mean of INR, PT, and D-Dimer levels, with significantly higher values in the deceased group compared to those who survived.
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Affiliation(s)
- Alireza Abdollahi
- Department of Pathology, School of Medicine, IKHC, Teheran University of Medical Sciences, Tehran, Iran
| | - Saeed Nateghi
- Department of Cardiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Panahi
- School of Medicine, Department of Obstetrics and Gynecology, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Hassan Inanloo
- Department of Urology, Sina Hospital Tehran University of Medical Sciences, Tehran, Iran
| | - Samaneh Salarvand
- Department of Pathology, School of Medicine, IKHC, Teheran University of Medical Sciences, Tehran, Iran.
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Alvandi M, Shaghaghi Z, Fatehi Z, Naghshtabrizi B, Mohammadi T, Nikzad S. Exploring the impact of recent COVID-19 infection on perfusion and functional parameters derived from gated myocardial perfusion imaging in patients undergoing evaluation for coronary artery disease. Ann Nucl Med 2024; 38:789-794. [PMID: 38806866 DOI: 10.1007/s12149-024-01946-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 05/19/2024] [Indexed: 05/30/2024]
Abstract
OBJECTIVE This study seeks to evaluate how recent COVID-19 infection affects myocardial perfusion and functional parameters derived from gated myocardial perfusion imaging in patients undergoing evaluation for coronary artery disease. The goal is to enhance our understanding of COVID-19's influence on the cardiovascular system. METHOD Conducted at Farshchian Heart Hospital from 2022 to 2023, this case-control study enrolled patients suspected of coronary artery disease, stratified into two groups: those with confirmed COVID-19 infection within the past 6 months (study group) and those without prior COVID-19 infection (control group). Employing a 2-day protocol, stress testing and gated SPECT MPI were performed. Statistical analysis included descriptive statistics, Chi-square test, Student's t test, and Mann-Whitney U test. RESULT Among the 86 patients included, 43 were in each group. Significantly higher summed stress core and summed difference score values were observed in the study group compared to the control group (p < 0.05). In addition, the study group exhibited significantly altered global left ventricular ejection fraction, end-diastolic volume, and end-systolic volume (p < 0.05). Non-perfusion findings, including transient ischemic dilation and transient right ventricular visualization, were more prevalent in the study group. CONCLUSION Recent COVID-19 infection is associated with impaired myocardial perfusion and altered functional parameters as detected by MPI. These findings underscore the intricate interplay between COVID-19 and cardiovascular health, emphasizing the importance of comprehensive evaluation and management strategies to address cardiac complications in affected individuals. Further research is warranted to elucidate the underlying mechanisms and optimize patient care in the context of COVID-19-associated cardiovascular manifestations.
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Affiliation(s)
- Maryam Alvandi
- Cardiovascular Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Department of Nuclear Medicine and Molecular Imaging, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Zahra Shaghaghi
- Cancer Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Zhino Fatehi
- Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Behshad Naghshtabrizi
- Clinical Research Development Unit of Farshchian Heart Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Tayeb Mohammadi
- Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Safoora Nikzad
- Department of Medical Physics, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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Sun X, Zhang H, Zhang M, Fei M, Xiong L, Li C. High myoglobin level as an independent risk factor for death in elderly patients with critical COVID-19 infection: a retrospective case-control study. BMC Infect Dis 2024; 24:842. [PMID: 39164612 PMCID: PMC11334602 DOI: 10.1186/s12879-024-09621-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 07/16/2024] [Indexed: 08/22/2024] Open
Abstract
AIM This study aimed to discover risk factors for death in patients with critical COVID-19 infection in order to identify patients with a higher risk of death at an early stage. METHODS We retrospectively analyzed the clinical data of patients with critical COVID-19 infection from April 2022 to June 2022. Data were collected from the electronic medical records. Propensity matching scores were used to reduce the effect of confounding factors, such as patient baseline variables. Independent risk factors affecting patient prognosis were assessed using univariate logistic regression and multivariate logistic regression analysis. Restricted cubic spline curves were used to assess the relationship between independent and dependent variables. RESULTS The data of 132 patients with critical COVID-19 infection were included in the study. Of the 132 patients, 79 survived and 53 died. Among laboratory indicators, patients who died had higher proportions of abnormalities in procalcitonin, aspartate aminotransferase (AST), creatinine, cardiac troponin I, and myoglobin. Univariate and multivariate logistic regression analyses suggested that abnormal AST (OR = 4.98, P = 0.02), creatinine (OR = 7.93, P = 0.021), and myoglobin (OR = 103.08, P = 0.002) were independent risk factors for death. After correction for AST and creatinine, a linear relationship between myoglobin and risk of death in patients was found using restricted cubic splines. CONCLUSION High myoglobin level is an independent risk factor for death and is therefore a prognostic marker in elderly patients with severe COVID-19 infection.
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Affiliation(s)
- Xiaoxiao Sun
- Department of Critical Care Medicine, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, No. 1279, Sanmen Road, Hongkou District, Shanghai, 200434, China
- Department of Anesthesiology and Perioperative Medicine, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, 200434, China
| | - Hui Zhang
- Department of Anesthesiology and Perioperative Medicine, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, 200434, China
| | - Meixian Zhang
- Department of Anesthesiology and Perioperative Medicine, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, 200434, China
| | - Miaomiao Fei
- Department of Anesthesiology and Perioperative Medicine, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, 200434, China
| | - Lize Xiong
- Department of Anesthesiology and Perioperative Medicine, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, 200434, China.
| | - Cheng Li
- Department of Anesthesiology and Perioperative Medicine, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, 200434, China.
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Agafina A, Aguiar VC, Rossovskaya M, Fartoukh MS, Hajjar LA, Thiéry G, Timsit JF, Gordeev I, Protsenko D, Carbone J, Pellegrini R, Stadnik CMB, Avdeev S, Ferrer M, Heinz CC, Häder T, Langohr P, Bobenhausen I, Schüttrumpf J, Staus A, Ruehle M, Weissmüller S, Wartenburg-Demand A, Torres A. Efficacy and safety of trimodulin in patients with severe COVID-19: results from a randomised, placebo-controlled, double-blind, multicentre, phase II trial (ESsCOVID). Eur J Med Res 2024; 29:418. [PMID: 39138518 PMCID: PMC11321023 DOI: 10.1186/s40001-024-02008-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 08/01/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Trimodulin (human polyvalent immunoglobulin [Ig] M ~ 23%, IgA ~ 21%, IgG ~ 56% preparation) has previously been associated with a lower mortality rate in a subpopulation of patients with severe community-acquired pneumonia on invasive mechanical ventilation (IMV) and with clear signs of inflammation. The hypothesis for the ESsCOVID trial was that trimodulin may prevent inflammation-driven progression of severe coronavirus disease 2019 (COVID-19) to critical disease or even death. METHODS Adults with severe COVID-19 were randomised to receive intravenous infusions of trimodulin or placebo for 5 consecutive days in addition to standard of care. The primary efficacy endpoint was a composite of clinical deterioration (Days 6-29) and 28-day all-cause mortality (Days 1-29). RESULTS One-hundred-and-sixty-six patients received trimodulin (n = 84) or placebo (n = 82). Thirty-three patients died, nine during the treatment phase. Overall, 84.9% and 76.5% of patients completed treatment and follow-up, respectively. The primary efficacy endpoint was reported in 33.3% of patients on trimodulin and 34.1% of patients on placebo (P = 0.912). No differences were observed in the proportion of patients recovered on Day 29, days of invasive mechanical ventilation, or intensive care unit-free days. Rates of treatment-emergent adverse events were comparable. A post hoc analysis was conducted in patients with early systemic inflammation by excluding those with high CRP (> 150 mg/L) and/or D-dimer (≥ 3 mg/L) and/or low platelet counts (< 130 × 109/L) at baseline. Forty-seven patients in the trimodulin group and 49 in the placebo group met these criteria. A difference of 15.5 percentage points in clinical deterioration and mortality was observed in favour of trimodulin (95% confidence interval: -4.46, 34.78; P = 0.096). CONCLUSION Although there was no difference in the primary outcome in the overall population, observations in a subgroup of patients with early systemic inflammation suggest that trimodulin may have potential in this setting that warrants further investigation. ESSCOVID WAS REGISTERED PROSPECTIVELY AT CLINICALTRIALS.GOV ON OCTOBER 6, 2020.: NCT04576728.
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Affiliation(s)
| | | | | | - Muriel Sarah Fartoukh
- Assistance Publique-Hôpitaux de Paris, Service de Médecine Intensive Réanimation, Hôpital Tenon, and DMU APPROCHES, Sorbonne Université, Paris, France
| | - Ludhmila Abrahao Hajjar
- Instituto Do Coração InCor, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | | | - Jean-François Timsit
- Medical and Infectious Diseases ICU (M12) APHP, Hôpital Bichat-Claude Bernard, Paris, France
| | | | | | - Javier Carbone
- Hospital General Universitario Gregorio Marañon, Madrid, Spain
| | | | | | - Sergey Avdeev
- First Moscow State Medical University, Moscow, Russia
| | - Miquel Ferrer
- Hospital Clinic of Barcelona, IDIBAPS, CibeRes (CB06/06/0028) University of Barcelona, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | - Antoni Torres
- Respiratory and Intensive Care Unit, Hospital Clinic of Barcelona, IDIBAPS, CibeRes (CB06/06/0028), University of Barcelona, Barcelona, Spain.
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Sun X, Tang J, Lu J, Zhang H, Li C. Development and validation of a prediction model for mortality in critically ill COVID-19 patients. Front Cell Infect Microbiol 2024; 14:1309529. [PMID: 38979512 PMCID: PMC11228157 DOI: 10.3389/fcimb.2024.1309529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 06/07/2024] [Indexed: 07/10/2024] Open
Abstract
Background Early prediction of prognosis may help early treatment measures to reduce mortality in critically ill coronavirus disease (COVID-19) patients. The study aimed to develop a mortality prediction model for critically ill COVID-19 patients. Methods This retrospective study analyzed the clinical data of critically ill COVID-19 patients in an intensive care unit between April and June 2022. Propensity matching scores were used to reduce the effect of confounding factors. A predictive model was built using logistic regression analysis and visualized using a nomogram. Calibration and receiver operating characteristic (ROC) curves were used to estimate the accuracy and predictive value of the model. Decision curve analysis (DCA) was used to examine the value of the model for clinical interventions. Results In total, 137 critically ill COVID-19 patients were enrolled; 84 survived, and 53 died. Univariate and multivariate logistic regression analyses revealed that aspartate aminotransferase (AST), creatinine, and myoglobin levels were independent prognostic factors. We constructed logistic regression prediction models using the seven least absolute shrinkage and selection operator regression-selected variables (hematocrit, red blood cell distribution width-standard deviation, procalcitonin, AST, creatinine, potassium, and myoglobin; Model 1) and three independent factor variables (Model 2). The calibration curves suggested that the actual predictions of the two models were similar to the ideal predictions. The ROC curve indicated that both models had good predictive power, and Model 1 had better predictive power than Model 2. The DCA results suggested that the model intervention was beneficial to patients and patients benefited more from Model 1 than from Model 2. Conclusion The predictive model constructed using characteristic variables screened using LASSO regression can accurately predict the prognosis of critically ill COVID-19 patients. This model can assist clinicians in implementing early interventions. External validation by prospective large-sample studies is required.
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Affiliation(s)
- Xiaoxiao Sun
- Department of Critical Care Medicine, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jinxuan Tang
- Department of Anesthesiology and Perioprative Medicine, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jun Lu
- Department of Anesthesiology and Perioprative Medicine, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Hui Zhang
- Department of Anesthesiology and Perioprative Medicine, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Cheng Li
- Department of Anesthesiology and Perioprative Medicine, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
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Meghna N, Archana A, Bhushan D, Kumar A, Sarfraz A, Naik BN, Pati BK. Prevalence of SARS-CoV-2 virus in saliva, stool, and urine samples of COVID-19 patients in Bihar, India. Access Microbiol 2024; 6:000693.v4. [PMID: 39045236 PMCID: PMC11261694 DOI: 10.1099/acmi.0.000693.v4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 04/21/2024] [Indexed: 07/25/2024] Open
Abstract
Introduction. The coronavirus illness caused by SARS-CoV-2 can cause multiple organ involvement, with varying degrees of severity. Besides inhalation as a route for transmission, feco-oral has also been proposed. Its transmission to sewage systems is a growing public health issue. Objective. To detect SARS-CoV-2 RNA in non-respiratory samples (saliva, urine, and stool) collected from COVID-19 cases, in Bihar. Methods. This cross-sectional observational study was conducted from January 2021 to March 2022 on human non-respiratory samples. A total of 345 samples including saliva (116), stool (97), and urine (132) were collected from 143 COVID-19 cases. Samples were analysed for SARS-CoV-2 by multiplex RT-PCR targeted against E, ORF 1ab, and RdRp genes. Results. In this study, out of 143 cases, a total of 107 (74.8 %) were positive for SARS-CoV-2 RNA in at least one of the non-respiratory samples. Conclusion. There is a high prevalence of SARS-CoV-2 virus in non-respiratory samples.
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Affiliation(s)
- Nupur Meghna
- Department of Microbiology, All India Institute of Medical Sciences, Patna, India
| | - Archana Archana
- Department of Microbiology, All India Institute of Medical Sciences, Patna, India
| | - Divendu Bhushan
- Department of General Medicine, All India Institute of Medical Sciences, Patna, India
| | - Abhyuday Kumar
- Department of Anaesthesiology, All India Institute of Medical Sciences, Patna, India
| | - Asim Sarfraz
- Department of Microbiology, All India Institute of Medical Sciences, Patna, India
| | - Bijaya Nanda Naik
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Patna, India
| | - Binod Kumar Pati
- Department of Microbiology, All India Institute of Medical Sciences, Patna, India
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Geraili Z, HajianTilaki K, Bayani M, Hosseini SR, Khafri S, Ebrahimpour S, Javanian M, Babazadeh A, Shokri M. Joint modeling of longitudinal and competing risks for assessing blood oxygen saturation and its association with survival outcomes in COVID-19 patients. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:91. [PMID: 38726068 PMCID: PMC11081430 DOI: 10.4103/jehp.jehp_246_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 04/30/2023] [Indexed: 05/12/2024]
Abstract
BACKGROUND The objective of the present study is to evaluate the association between longitudinal and survival outcomes in the presence of competing risk events. To illustrate the application of joint modeling in clinical research, we assessed the blood oxygen saturation (SPO2) and its association with survival outcomes in coronavirus disease (COVID-19). MATERIALS AND METHODS In this prospective cohort study, we followed 300 COVID-19 patients, who were diagnosed with severe COVID-19 in the Rohani Hospital in Babol, the north of Iran from October 22, 2020 to March 5, 2021, where death was the event of interest, surviving was the competing risk event and SPO2 was the longitudinal outcome. Joint modeling analyses were compared to separate analyses for these data. RESULT The estimation of the association parameter in the joint modeling verified the association between longitudinal outcome SPO2 with survival outcome of death (Hazard Ratio (HR) = 0.33, P = 0.001) and the competing risk outcome of surviving (HR = 4.18, P < 0.001). Based on the joint modeling, longitudinal outcome (SPO2) decreased in hypertension patients (β = -0.28, P = 0.581) and increased in those with a high level of SPO2 on admission (β = 0.75, P = 0.03). Also, in the survival submodel in the joint model, the risk of death survival outcome increased in patients with diabetes comorbidity (HR = 4.38, P = 0.026). CONCLUSION The association between longitudinal measurements of SPO2 and survival outcomes of COVID-19 confirms that SPO2 is an important indicator in this disease. Thus, the application of this joint model can provide useful clinical evidence in the different areas of medical sciences.
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Affiliation(s)
- Zahra Geraili
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Karimollah HajianTilaki
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
| | - Masomeh Bayani
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Seyed R. Hosseini
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Soraya Khafri
- Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
| | - Soheil Ebrahimpour
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mostafa Javanian
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Arefeh Babazadeh
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mehran Shokri
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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11
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Chi L, Wang S, Wang X, Yang C, Luo J. Predictive value of C-reactive protein for disease severity and survival in COVID-19 patients: a systematic review and meta-analysis. Clin Exp Med 2023; 23:2001-2008. [PMID: 36418669 PMCID: PMC9684914 DOI: 10.1007/s10238-022-00948-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 11/09/2022] [Indexed: 11/25/2022]
Abstract
Coronavirus disease 2019 (COVID-19) is an infectious disease that can develop multiple complications and even be life-threatening. The aim of this study is to summarize current evidence of C-reactive protein's (CRP) predictive value for disease severity and survival of COVID-19 patients, focusing on curing patients and reducing the risk of death. We systematically searched related studies from four large databases: Web of Science, PubMed, China National Knowledge Infrastructure (CNKI), and Wanfang Database, all published between December 2019 and June 2021. Then, we implemented meta-analysis using random-effects models through STATA 15.1 and Review Manager 5.3. We also implemented sensitivity analysis and used funnel plots to check publication bias. From the systematic search of the four databases, we were able to identify 18 studies containing a total of 3052 patients. Meta-analysis results showed that 1) CRP levels were lower in non-severe patients than in severe patients (Standardized Mean Difference (SMD) = - 0.87 mg/L, 95% Confidence Interval (CI) = [ - 1.27, - 0.47], p < 0.001); 2) CRP levels were lower in non-intensive care unit (ICU) patients than in ICU patients (SMD = - 1.39 mg/L, 95% CI = [- 1.68, - 1.11], p < 0.001), and 3) CRP levels were lower in survivors than in non-survivors (SMD =- 1.32 mg/L, 95% CI = [- 1.95, - 0.69], p < 0.001). Sensitivity analysis showed these results were stable. Funnel plots indicated no publication bias. The CRP level may timely reflect disease severity and predict survival of COVID-19 patients and may be worthy of further popularization and application in clinic practice.
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Affiliation(s)
- Lihong Chi
- Department of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, 341004, China
| | - Shuai Wang
- Department of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, 341004, China
| | - Xiaoyu Wang
- Department of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, 341004, China
| | - Chengwu Yang
- Department of Population and Quantitative Health Sciences, TH Chan School of Medicine, UMass Chan Medical School, 368 Plantation Street, Worcester, MA, 01605, USA.
- Department of Obstetrics & Gynecology, TH Chan School of Medicine, UMass Chan Medical School, 368 Plantation Street, Worcester, MA, 01605, USA.
| | - Jianghong Luo
- Department of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, 341004, China.
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12
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Kubiliute I, Vitkauskaite M, Urboniene J, Svetikas L, Zablockiene B, Jancoriene L. Clinical characteristics and predictors for in-hospital mortality in adult COVID-19 patients: A retrospective single center cohort study in Vilnius, Lithuania. PLoS One 2023; 18:e0290656. [PMID: 37624796 PMCID: PMC10456157 DOI: 10.1371/journal.pone.0290656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND The COVID-19 infection had spread worldwide causing many deaths. Mortality rates and patients' characteristics varied within and between countries, making it important to understand the peculiarities of different populations. The aim of this study was to identify the main predictors associated with in-hospital mortality due to COVID-19 in Vilnius, Lithuania. MATERIALS AND METHODS This was a retrospective observational cohort study conducted at Vilnius University Hospital Santaros Clinics, Lithuania. The study included SARS-CoV-2 positive patients aged over 18 years and hospitalized between March 2020 and May 2021. Depersonalized data were retrieved from electronic medical records. The predictive values of laboratory parameters were evaluated using ROC analysis. Multivariable binary logistic regression was performed to reveal predictors of in-hospital mortality due to COVID-19. RESULTS Among 2794 patients, 54.4% were male, the age median was 59 years (IQR 48-70), 47.4% had at least one comorbidity. The most common comorbidities were arterial hypertension (36.9%) and diabetes mellitus (13.7%). Overall, 12.7% of patients died. Multivariable regression revealed that age (OR 1.04, 95%CI 1.02-1.06), congestive heart failure (OR 3.06, 95%CI 1.96-4.77), obesity (OR 3.90, 95%CI 2.12-7.16), COPD (OR 2.92, 95%CI 1.12-7.60), previous stroke (OR 5.80, 95%CI 2.07-16.21), urea >7.01 mmol/l (OR 2.32, 95%CI 1.47-3.67), AST/ALT >1.49 (OR 1.54, 95%CI 1.08-2.21), LDH >452.5 U/l (OR 2.60, 95%CI 1.74-3.88), CRP >92.68 mg/l (OR 1.58, 95%CI 1.06-2.35), IL-6 >69.55 ng/l (OR 1.62, 95%CI 1.10-2.40), and troponin I >18.95 ng/l (OR 2.04, 95%CI 1.38-3.02), were associated with increased risk for in-hospital mortality in COVID-19 patients. CONCLUSIONS Age, congestive heart failure, obesity, COPD, prior stroke, and increased concentration of urea, LDH, CRP, IL-6, troponin I, ALT to AST ratio were identified to be the predictors for in-hospital mortality of COVID-19 patients.
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Affiliation(s)
- Ieva Kubiliute
- Clinic of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | | | - Jurgita Urboniene
- Center of Infectious Diseases, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania
| | - Linas Svetikas
- Clinic of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Birute Zablockiene
- Clinic of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Ligita Jancoriene
- Clinic of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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13
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Al Omair OA, Essa A, Elzorkany K, Shehab-Eldeen S, Alarfaj HM, Alarfaj SM, Alabdulqader F, Aldoughan A, Agha M, Ali SI, Darwish E. Factors Affecting Hospitalization Length and in-Hospital Death Due to COVID-19 Infection in Saudi Arabia: A Single-Center Retrospective Analysis. Int J Gen Med 2023; 16:3267-3280. [PMID: 37546239 PMCID: PMC10404051 DOI: 10.2147/ijgm.s418243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 07/12/2023] [Indexed: 08/08/2023] Open
Abstract
Background The emerging COVID-19 coronavirus disease has widely spread, causing a serious worldwide pandemic. Disease severity and mortality risk can be predicted using an analysis of COVID-19 clinical characteristics. Finding out what influences patients' hospitalization length and in-hospital mortality is crucial for decision-making and planning for emergencies. The goal of this study is to identify the factors that influence hospital stay length and in-hospital death due to COVID-19 infection. Methods This cross-sectional study was conducted from August to October 2020 and included 630 patients with a confirmed diagnosis of COVID-19 infection. Using odds ratios (OR) and 95% confidence intervals (CI), a multivariable logistic regression model was used to assess the variables that are linked to longer hospital stays and in-hospital deaths. Results Most patients were male (64.3%), and most were older than 40 years (81.4%). The mean length of hospital stay (LoHS) was 10.4±11.6 days. The overall death rate among these COVID-19 cases was 14.3%. Non-survivors were older, had more comorbidities, had prolonged LoHS with increased ICU admission rates and mechanical ventilation usage, and had a more severe condition than survivors. ICU admission, low serum albumin, and elevated LDH levels were associated with longer LoHS, while ICU admission, DM, and respiratory diseases as comorbidities, total leukocytic count, and serum albumin were predictors of mortality. Conclusion Longer LoHS due to COVID-19 infection was linked to ICU admission, low serum albumin, and elevated LDH levels, while the independent predictors of in-hospital death were ICU admission, DM, and respiratory diseases as comorbidities, total leukocytic count, and serum albumin.
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Affiliation(s)
- Omar A Al Omair
- Internal Medicine Department, College of Medicine, King Faisal University, Al-Ahsa, Kingdom of Saudi Arabia
| | - Abdallah Essa
- Tropical Medicine Department, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt
- Gastroenterology and Infectious Diseases Unit, College of Medicine, King Faisal University, Al-Ahsa, Kingdom of Saudi Arabia
| | - Khaled Elzorkany
- Internal Medicine Department, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt
- Nephrology Unit, College of Medicine, King Faisal University, Al-Ahsa, Kingdom of Saudi Arabia
| | - Somaia Shehab-Eldeen
- Tropical Medicine Department, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt
- Gastroenterology and Infectious Diseases Unit, College of Medicine, King Faisal University, Al-Ahsa, Kingdom of Saudi Arabia
| | - Hamzah M Alarfaj
- King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Sumaia M Alarfaj
- Medical Student at the College of Medicine, King Faisal University, Al-Ahsa, Kingdom of Saudi Arabia
| | - Fatimah Alabdulqader
- Medical Student at the College of Medicine, King Faisal University, Al-Ahsa, Kingdom of Saudi Arabia
| | - Alghaydaa Aldoughan
- Medical Student at the College of Medicine, King Faisal University, Al-Ahsa, Kingdom of Saudi Arabia
| | - Mohammed Agha
- Chest Department, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt
| | - Sayed I Ali
- Family Medicine Department, College of Medicine, King Faisal University, Al-Ahsa, Kingdom of Saudi Arabia
| | - Ehab Darwish
- Gastroenterology and Infectious Diseases Unit, College of Medicine, King Faisal University, Al-Ahsa, Kingdom of Saudi Arabia
- Tropical Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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14
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AlQahtani SY, Alabdulqader AA, Al Mashhour WA, Aldawood ZM, Al Masari OA, Alotaibi T, AlGhamdi ZM, Alzahrani IM, Albaloushi NN. Clinical Characteristics and Outcomes of Vaccinated VS Non-Vaccinated Critically Ill COVID-19 Patients: Retrospective Observation Study. Infect Drug Resist 2023; 16:3329-3338. [PMID: 37274364 PMCID: PMC10237627 DOI: 10.2147/idr.s411299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/18/2023] [Indexed: 06/06/2023] Open
Abstract
Objective We aim to identify the clinical characteristics and outcome of vaccine breakthrough infection in critically ill COVID-19 patients and to compare the clinical course of disease between vaccinated and non-vaccinated patients. Methods A retrospective review of all adult patients aged ≥18 years admitted to the ICU in King Fahd Hospital of the University in Saudi Arabia with positive COVID-19 RT-PCR test between the period of January 1st to August 31st, 2021, were included. The recruited patients were grouped in to "vaccinated and non-vaccinated group" based on their immunization status. The demographic data, co-morbidities, modality of oxygen support, ICU length of stay (ICU LOS) and mortality were collected and analyzed. Results A total of 167 patients were included. Seventy-two patients (43%) were vaccinated. Cardiovascular diseases were higher among the vaccinated group (33.3% vs 12.6%, p value <0.001). Requirements of Non-invasive ventilation was significantly lower in vaccinated group compared to non-vaccinated group (73.6% vs 91.6%, p value <0.011). The rates of intubation were similar between both groups. The total intubation days was longer in non-vaccinated patients compared to vaccinated patients and the median duration of intubation was 8 days vs 2 days, respectively (p value 0.027). In subgroup analysis, the P/F ratio was significantly higher in patients who received two doses of vaccine compared to single dose (p value <0.002). Conclusion In critically ill COVID-19 patients, the vaccinated group has significantly less need for Non-invasive ventilation, fewer intubation days and less hypoxia compared to non-vaccinated patients. We recommend more policies and public education nationwide and worldwide to encourage vaccination and raise awareness of the general population.
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Affiliation(s)
- Shaya Yaanallah AlQahtani
- Department of Internal Medicine and Critical Care Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | | | | | - Osama Ali Al Masari
- Department of Internal Medicine and Critical Care Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Thabit Alotaibi
- Department of Internal Medicine and Critical Care Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Zeead M AlGhamdi
- Thoracic Surgery Division, Department of Surgery, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ibrahim M Alzahrani
- Department of Internal medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
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15
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Al Qahtani SY. Impact of hyperchloremia on inflammatory markers, serum creatinine, hemoglobin, and outcome in critically ill patients with COVID-19 infection. J Med Life 2023; 16:699-706. [PMID: 37520482 PMCID: PMC10375338 DOI: 10.25122/jml-2023-0013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/05/2023] [Indexed: 08/01/2023] Open
Abstract
Hyperchloremia has negative consequences, such as increased proinflammatory mediators, renal dysfunction, and mortality in patients with septic shock. However, data on the effects of hyperchloremia on COVID-19 infections are scarce. The study aimed to investigate the effects of hyperchloremia on inflammatory markers, serum creatinine, hemoglobin levels, and outcomes in critically ill COVID-19 patients. A retrospective review of all adult patients admitted to the ICU at King Fahd University Hospital with a moderate to severe COVID-19 infection from January 2020 to August 2021 was performed. Serum chloride levels, ferritin, lactate dehydrogenase (LDH), C-reactive protein (CRP), creatinine, and hemoglobin levels were collected on the first and third days of ICU admission. Demographic data, oxygen support modality, ICU length of stay (ICU LOS), renal replacement therapy (RRT), and deaths were collected. Of 420 patients, 255 were included; 97 (38%) had hyperchloremia, while 158 (62%) did not. Hyperchloremic patients had a higher percentage of increases in ferritin (54.6%), CRP (6.2%), and LDH (15.5%) between the first and third days of admission, compared to non-hyperchloremic patients (43.7%, 6.3%, and 5.7%, respectively). The decrease in hemoglobin levels was similar in both groups (p=0.103). There was a significant association between hyperchloremia and an increase in serum creatinine (p<0.0001). Sixty-six (68%) patients required endotracheal intubation in the hyperchloremic group (p=0.003). The mortality rate was significant in the hyperchloremic cohort (p=<0.0001). Hyperchloremia was significantly associated with increased risks of kidney injury, endotracheal intubation, and death. However, hyperchloremia was not associated with increased ferritin, CRP, or hemoglobin decreases in critically ill COVID-19 patients.
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Affiliation(s)
- Shaya Yaanallah Al Qahtani
- Department of Internal Medicine and Critical Care, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
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16
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Exploration of Sex and Age-Based Associations in Clinical Characteristics, Predictors of Severity, and Duration of Stay among COVID-19 Patients at the University Hospital of Saudi Arabia. Healthcare (Basel) 2023; 11:healthcare11050751. [PMID: 36900756 PMCID: PMC10000835 DOI: 10.3390/healthcare11050751] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/25/2023] [Accepted: 02/26/2023] [Indexed: 03/08/2023] Open
Abstract
COVID-19 infection has a spectrum of variable clinical severity between populations because of their characteristic demographic features, co-morbidities, and immune system reactions. This pandemic tested the healthcare system's preparedness, which depends on predictors of severity and factors related to the duration of hospital stays. Therefore, we carried out a single-center, retrospective cohort study in a tertiary academic hospital to investigate these clinical features and predictors of severe disease and study the different factors that affect hospital stay. We utilized medical records from March 2020 to July 2021, which included 443 confirmed (positive RT-PCR) cases. The data were explained using descriptive statistics and analyzed via multivariate models. Among the patients, 65.4% were female and 34.5% were male, with a mean age of 45.7 years (SD ± 17.2). We presented seven age groups with ranges of 10 years and noticed that patients aged 30-39 years old comprised 23.02% of the records, while patients aged 70 and above comprised 10%. Nearly 47% were diagnosed as having mild, 25% as moderate, 18% as asymptomatic, and 11% as having a severe case of COVID-19 disease. Diabetes was the most common co-morbidity factor in 27.6% of patients, followed by hypertension (26.4%). Our population's predictors of severity included pneumonia, identified on a chest X-ray, and co-morbid conditions such as cardiovascular disease, stroke, ICU stay, and mechanical ventilation. The median length of hospital stay was six days. It was significantly longer in patients with a severe disease and who were administered systemic intravenous steroids. An empirical assessment of various clinical parameters could assist in effectively measuring the disease progression and follow-up with patients.
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17
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Inflammation as Prognostic Hallmark of Clinical Outcome in Patients with SARS-CoV-2 Infection. Life (Basel) 2023; 13:life13020322. [PMID: 36836679 PMCID: PMC9966655 DOI: 10.3390/life13020322] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/30/2022] [Accepted: 01/19/2023] [Indexed: 01/26/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is often characterized by a life-threatening interstitial pneumonia requiring hospitalization. The aim of this retrospective cohort study is to identify hallmarks of in-hospital mortality in patients affected by Coronavirus Disease 19 (COVID-19). A total of 150 patients admitted for COVID-19 from March to June 2021 to "F. Perinei" Murgia Hospital in Altamura, Italy, were divided into survivors (n = 100) and non-survivors groups (n = 50). Blood counts, inflammation-related biomarkers and lymphocyte subsets were analyzed into two groups in the first 24 h after admission and compared by Student's t-test. A multivariable logistic analysis was performed to identify independent risk factors associated with in-hospital mortality. Total lymphocyte count and CD3+ and CD4+ CD8+ T lymphocyte subsets were significantly lower in non-survivors. Serum levels of interleukin-6 (IL-6), lactate dehydrogenase (LDH), C-reactive protein (CRP) and procalcitonin (PCT) were significantly higher in non-survivors. Age > 65 years and presence of comorbidities were identified as independent risk factors associated with in-hospital mortality, while IL-6 and LDH showed a borderline significance. According to our results, markers of inflammation and lymphocytopenia predict in-hospital mortality in COVID-19.
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18
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Montrucchio G, Sales G, Balzani E, Lombardo D, Giaccone A, Cantù G, D'Antonio G, Rumbolo F, Corcione S, Simonetti U, Bonetto C, Zanierato M, Fanelli V, Filippini C, Mengozzi G, Brazzi L. Effectiveness of mid-regional pro-adrenomedullin, compared to other biomarkers (including lymphocyte subpopulations and immunoglobulins), as a prognostic biomarker in COVID-19 critically ill patients: New evidence from a 15-month observational prospective study. Front Med (Lausanne) 2023; 10:1122367. [PMID: 37035317 PMCID: PMC10080079 DOI: 10.3389/fmed.2023.1122367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 02/20/2023] [Indexed: 04/11/2023] Open
Abstract
Background Mid-regional pro-adrenomedullin (MR-proADM), an endothelium-related peptide, is a predictor of death and multi-organ failure in respiratory infections and sepsis and seems to be effective in identifying COVID-19 severe forms. The study aims to evaluate the effectiveness of MR-proADM in comparison to routine inflammatory biomarkers, lymphocyte subpopulations, and immunoglobulin (Ig) at an intensive care unit (ICU) admission and over time in predicting mortality in patients with severe COVID-19. Methods All adult patients with COVID-19 pneumonia admitted between March 2020 and June 2021 in the ICUs of a university hospital in Italy were enrolled. MR-proADM, lymphocyte subpopulations, Ig, and routine laboratory tests were measured within 48 h and on days 3 and 7. The log-rank test was used to compare survival curves with MR-proADM cutoff value of >1.5 nmol/L. Predictive ability was compared using the area under the curve (AUC) and 95% confidence interval (CI) of different receiver-operating characteristic curves. Results A total of 209 patients, with high clinical severity [SOFA 7, IQR 4-9; SAPS II 52, IQR 41-59; median viral pneumonia mortality score (MuLBSTA)-11, IQR 9-13] were enrolled. ICU and overall mortality were 55.5 and 60.8%, respectively. Procalcitonin, lactate dehydrogenase, D-dimer, the N-terminal prohormone of brain natriuretic peptide, myoglobin, troponin, neutrophil count, lymphocyte count, and natural killer lymphocyte count were significantly different between survivors and non-survivors, while lymphocyte subpopulations and Ig were not different in the two groups. MR-proADM was significantly higher in non-survivors (1.17 ± 0.73 vs. 2.31 ± 2.63, p < 0.0001). A value of >1.5 nmol/L was an independent risk factor for mortality at day 28 [odds ratio of 1.9 (95% CI: 1.220-3.060)] after adjusting for age, lactate at admission, SOFA, MuLBSTA, superinfections, cardiovascular disease, and respiratory disease. On days 3 and 7 of the ICU stay, the MR-proADM trend evaluated within 48 h of admission maintained a correlation with mortality (p < 0.0001). Compared to all other biomarkers considered, the MR-proADM value within 48 h had the best accuracy in predicting mortality at day 28 [AUC = 0.695 (95% CI: 0.624-0.759)]. Conclusion MR-proADM seems to be the best biomarker for the stratification of mortality risk in critically ill patients with COVID-19. The Ig levels and lymphocyte subpopulations (except for natural killers) seem not to be correlated with mortality. Larger, multicentric studies are needed to confirm these findings.
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Affiliation(s)
- Giorgia Montrucchio
- Department of Surgical Sciences, University of Turin, Turin, Italy
- Department of Anesthesia, Critical Care and Emergency, “Città della Salute e della Scienza” Hospital, Turin, Italy
- *Correspondence: Giorgia Montrucchio
| | - Gabriele Sales
- Department of Surgical Sciences, University of Turin, Turin, Italy
- Department of Anesthesia, Critical Care and Emergency, “Città della Salute e della Scienza” Hospital, Turin, Italy
| | - Eleonora Balzani
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Davide Lombardo
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Alice Giaccone
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Giulia Cantù
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Giulia D'Antonio
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Francesca Rumbolo
- Clinical Biochemistry Laboratory, Department of Laboratory Medicine, “Città della Salute e della Scienza” Hospital, Turin, Italy
| | - Silvia Corcione
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Umberto Simonetti
- Department of Anesthesia, Critical Care and Emergency, “Città della Salute e della Scienza” Hospital, Turin, Italy
| | - Chiara Bonetto
- Department of Anesthesia, Critical Care and Emergency, “Città della Salute e della Scienza” Hospital, Turin, Italy
| | - Marinella Zanierato
- Department of Anesthesia, Critical Care and Emergency, “Città della Salute e della Scienza” Hospital, Turin, Italy
| | - Vito Fanelli
- Department of Surgical Sciences, University of Turin, Turin, Italy
- Department of Anesthesia, Critical Care and Emergency, “Città della Salute e della Scienza” Hospital, Turin, Italy
| | | | - Giulio Mengozzi
- Clinical Biochemistry Laboratory, Department of Laboratory Medicine, “Città della Salute e della Scienza” Hospital, Turin, Italy
| | - Luca Brazzi
- Department of Surgical Sciences, University of Turin, Turin, Italy
- Department of Anesthesia, Critical Care and Emergency, “Città della Salute e della Scienza” Hospital, Turin, Italy
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Salter B, DeBenedictis B, Spatafora L, Kapralik J, Luo C, Qiu S, Dawson L, Junek M, Pitre T, Jones A, Beauchamp M, Kruisselbrink R, Duong M, Costa AP, Tsang JL, Ho T. Hospitalised COVID-19 outcomes are predicted by hypoxaemia and pneumonia phenotype irrespective of the timing of their emergence. BMJ Open 2022; 12:e062453. [PMID: 36581424 PMCID: PMC9805826 DOI: 10.1136/bmjopen-2022-062453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
UNLABELLED Despite the known clinical importance of hypoxemia and pneumonia, there is a paucity of evidence for these variables with respect to risk of mortality and short-term outcomes among those hospitalised with COVID-19. OBJECTIVE Describe the prevalence and clinical course of patients hospitalised with COVID-19 based on oxygenation and pneumonia status at presentation and determine the incidence of emergent hypoxaemia or radiographic pneumonia during admission. METHODS A retrospective study was conducted using a Canadian regional registry. Patients were stratified according to hypoxaemia/pneumonia phenotype and prevalence. Clinical parameters were compared between phenotypes using χ2 and one-way Analysis of variance (ANOVA). Cox analysis estimated adjusted Hazard Ratios (HR) for associations between disease outcomes and phenotypes. RESULTS At emergency department (ED) admission, the prevalence of pneumonia and hypoxaemia was 43% and 50%, respectively, and when stratified to phenotypes: 28.2% hypoxaemia+/pneumonia+, 22.2% hypoxaemia+/pneumonia-, 14.5% hypoxaemia-/pneumonia+ and 35.1% hypoxaemia-/pneumonia-. Mortality was 31.1% in the hypoxaemia+/pneumonia- group and 26.3% in the hypoxaemia+/pneumonia+ group. Hypoxaemia with pneumonia and without pneumonia predicted higher probability of death. Hypoxaemia either <24 hours or ≥24 hours after hospitalisation predicted higher mortality and need for home oxygen compared with those without hypoxaemia. Patients with early hypoxaemia had higher probability of Intensive care unit (ICU) admission compared with those with late hypoxaemia. CONCLUSION Mortality in COVID-19 infection is predicted by hypoxaemia with or without pneumonia and was greatest in patients who initially presented with hypoxaemia. The emergence of hypoxaemia was predicted by radiographic pneumonia. Patients with early and emergent hypoxaemia had similar mortality but were less likely to be admitted to ICU. There may be delayed identification of hypoxaemia, which prevents timely escalation of care.
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Affiliation(s)
- Brittany Salter
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | | | - Laura Spatafora
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Jessica Kapralik
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Candice Luo
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Steven Qiu
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Laura Dawson
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Mats Junek
- Department of Rheumatology, McMaster University, Hamilton, Ontario, Canada
| | - Tyler Pitre
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Aaron Jones
- Department of Health Research Methods, Evidence, and Impact, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Marla Beauchamp
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | | | - MyLinh Duong
- Respirology, McMaster University, Hamilton, Ontario, Canada
| | | | - Jennifer Ly Tsang
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Medicine, Niagara Health System - Saint Catharines Site, Saint Catharines, Ontario, Canada
| | - Terence Ho
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Respirology, McMaster University, Hamilton, Ontario, Canada
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Eldaboosy S, Almoosa Z, Saad M, Al Abdullah M, Farouk A, Awad A, Mahdy W, Abdelsalam E, Nour SO, Makled S, Shaarawy A, Kanany H, Qarah S, Kabil A. Comparison Between Physiological Scores SIPF, CURB-65, and APACHE II as Predictors of Prognosis and Mortality in Hospitalized Patients with COVID-19 Pneumonia: A Multicenter Study, Saudi Arabia. Infect Drug Resist 2022; 15:7619-7630. [PMID: 36582451 PMCID: PMC9793736 DOI: 10.2147/idr.s395095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
Background A coronavirus pandemic (COVID-19) is associated with catastrophic effects on the world with high morbidity and mortality. We aimed to evaluate the accuracy of physiological shock index (SIPF) (shock index and hypoxemia), CURB -65, acute physiology, and chronic health assessment II (APACHE II) as predictors of prognosis and in-hospital mortality in patients with COVID-19 pneumonia. Methods In Saudi Arabia, a multicenter retrospective study was conducted on hospitalized adult patients confirmed to have COVID-19 pneumonia. Information needed to calculate SIPF, CURB-65, and APACHE II scores were obtained from medical records within 24 hours of admission. Results The study included 1131 COVID-19 patients who met the inclusion criteria. They were divided into two groups: (A) the ICU group (n=340; 30.1%) and (B) the ward group (n=791; 69.9%). The most common concomitant diseases of patients at initial ICU admission were hypertension (71.5%) and diabetes (62.4%), and most of them were men (63.8%). The overall mortality was 18.7%, and the mortality rate was higher in the ICU group than in the ward group (39.4% vs 9.6%; p < 0.001). The SIPF score showed a significantly higher ability to predict both ICU admission and mortality in patients with COVID-19 pneumonia compared with APACHE II and CURB -65; (AUC 0.89 vs 0.87; p < 0.001) and (AUC 0.89 vs 0.84; p < 0.001) for ICU admission and (AUC 0.90 vs 0.65; p < 0.001) and (AUC 0.90 vs 0.80; p < 0.001) for mortality, respectively. Conclusion The ability of the SIPF score to predict ICU admission and mortality in COVID-19 pneumonia is higher than that of APACHE II and CURB-65. The overall mortality was 18.7%, and the mortality rate was higher in the ICU group than in the ward group (39.4% vs 9.6%; p < 0.001).
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Affiliation(s)
- Safwat Eldaboosy
- Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Cairo, Egypt,Department of Pulmonary Diseases, Almoosa Specialist Hospital, Al Ahsa, Saudi Arabia
| | - Zainab Almoosa
- Department of Infectious Diseases, Almoosa Specialist Hospital, Al Ahsa, Saudi Arabia
| | - Mustafa Saad
- Department of Infectious Diseases, Almoosa Specialist Hospital, Al Ahsa, Saudi Arabia
| | - Mohammad Al Abdullah
- Department of Infectious Diseases, Almoosa Specialist Hospital, Al Ahsa, Saudi Arabia
| | - Abdallah Farouk
- Department of Critical Care, Almoosa Specialist Hospital, Al Ahsa, Saudi Arabia,Department of Critical Care, Alexandria Faculty of Medicine, Alexandria, Egypt
| | - Amgad Awad
- Department of Nephrology and internal Medicine, Almoosa Specialist Hospital, Al Ahsa, Saudi Arabia,Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Waheed Mahdy
- Department of Critical Care, Almoosa Specialist Hospital, Al Ahsa, Saudi Arabia,Department of Chest Diseases, Banha Faculty of Medicine, Banha, Egypt
| | - Eman Abdelsalam
- Department of Internal Medicine, Al-Azhar Faculty of Medicine for Girls, Cairo, Egypt,Department of Internal Medicine, King Khalid Hospital, Hail, Saudi Arabia
| | - Sameh O Nour
- Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Sameh Makled
- Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed Shaarawy
- Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Hatem Kanany
- Department of Anesthesia and Critical Care, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Samer Qarah
- Department of Critical Care, Almoosa Specialist Hospital, Al Ahsa, Saudi Arabia
| | - Ahmed Kabil
- Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Cairo, Egypt,Correspondence: Ahmed Kabil, Department of Chest diseases, Al-Azhar University, Cairo, Egypt, Tel +201006396601, Email
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21
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Association of Clinical and Laboratory Findings in COVID-19 Patients with Thromboembolic Complications. Jundishapur J Microbiol 2022. [DOI: 10.5812/jjm-130805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background: COVID-19 is associated with dangerous thromboembolic complications, such as stroke, heart attack, pulmonary embolism, and arterial and venous thromboembolism (VTE). Early diagnosis and even prediction of thromboembolic complications using biomarkers could facilitate the treatment and decrease the mortality rate. Objectives: This study evaluated and compared the clinical and laboratory findings of COVID-19 patients with thrombotic events with other COVID-19 patients. Methods: A total of 114 confirmed COVID-19 patients referred to Taleghani Hospital, Tehran, Iran, between February and September 2020 were included in this cross-sectional study. Those with a history of thromboembolic disease were excluded. The laboratory data, including the levels of lactate dehydrogenase (LDH), D-dimer, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and counts of lymphocyte and neutrophil, along with clinical findings (such as oxygen saturation and lung involvement percentage), were retrospectively collected from the patients’ clinical files. The incidence of thrombotic events was evaluated in patients. Results: The prevalence of thrombosis in the right and left main pulmonary arteries, right and left sub-segmental pulmonary arteries, and right and left deep veins was 2.7%, 3.5%, 7%, 7.9%, 4.4%, and 1.8% of all patients, respectively. The results showed that thromboembolic complications were significantly associated with mortality (P < 0.001). Besides, it was found that LDH (P < 0.001) and neutrophil (P = 0.002) levels in thromboembolic COVID-19 patients were respectively higher and lower than those without thromboembolic manifestations. Conclusions: High LDH and neutropenia might serve as biomarkers for thromboembolism in COVID-19 patients.
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22
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Torres-Ramirez CA, Timaran-Montenegro D, Mateo-Camacho YS, Morales-Jaramillo LM, Tapia-Rangel EA, Fuentes-Badillo KD, Morales-Dominguez V, Punzo-Alcaraz R, Feria-Arroyo GA, Parra-Guerrero LM, Saenz-Castillo PF, Hernandez-Rojas AM, Falla-Trujillo MG, Obando-Bravo DE, Contla-Trejo GS, Jacome-Portilla KI, Chavez-Sastre J, Govea-Palma J, Carrillo-Alvarez S, Bonifacio D, Orozco-Vazquez JDS. CT-based pathological lung opacities volume as a predictor of critical illness and inflammatory response severity in patients with COVID-19. Heliyon 2022; 8:e11908. [PMID: 36447748 PMCID: PMC9694356 DOI: 10.1016/j.heliyon.2022.e11908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/18/2021] [Accepted: 11/18/2022] [Indexed: 11/27/2022] Open
Abstract
Objective The aim of the study was to assess the impact of CT-based lung pathological opacities volume on critical illness and inflammatory response severity of patients with COVID-19. Methods A retrospective, single center, single arm study was performed over a 30-day period. In total, 138 patients (85.2%) met inclusion criteria. All patients were evaluated with non-contrast enhanced chest CT scan at hospital admission. CT-based lung segmentation was performed to calculate pathological lung opacities volume (LOV). At baseline, complete blood count (CBC) and inflammation response biomarkers were obtained. The primary endpoint of the study was the occurrence of critical illness, as defined as, the need of mechanical ventilation and/or ICU admission. Mann-Whitney U test was performed for univariate analysis. Logistic regression analysis was performed to determine independent predictors of critical illness. Spearman analysis was performed to assess the correlation between inflammatory response biomarkers serum concentrations and LOV. Results Median LOV was 28.64% (interquartile range [IQR], 6.33-47.22%). Correlation analysis demonstrated that LOV was correlated with higher levels of D-dimer (r = 0.51, p < 0.01), procalcitonin (r = 0.47, p < 0.01) and IL6 (r = 0.48, p < 0.01). Critical illness occurred in 51 patients (37%). Univariate analysis demonstrated that inflammatory response biomarkers and LOV were associated with critical illness (p < 0.05). However, multivariate analysis demonstrated that only D-dimer and LOV were independent predictors of critical illness. Furthermore, a ROC analysis demonstrated that a LOV equal or greater than 60% had a sensitivity of 82.1% and specificity of 70.2% to determine critical illness with an odds ratio of 19.4 (95% CI, 4.2-88.9). Conclusion Critical illness may occur in up to 37% of the patients with COVID-19. Among patients with critical illness, higher levels of inflammatory response biomarkers with larger LOVs were observed. Furthermore, multivariate analysis demonstrated that pathological lung opacities volume was an independent predictor of critical illness. In fact, patients with a pathological lung opacities volume equal or greater than 60% had 19.4-fold increased risk of critical illness.
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Affiliation(s)
| | - David Timaran-Montenegro
- Department of Diagnostic and Interventional Imaging, McGovern School of Medicine, University of Texas Health Science Center, 6431 Fannin ST, MSB 2.130B, Houston, TX, 77030, USA
| | - Yohana Sarahi Mateo-Camacho
- Department of Radiology, Centro Médico Nacional 20 de Noviembre, Universidad Nacional Autonoma de Mexico (UNAM), México
| | | | - Edgar Alonso Tapia-Rangel
- Department of Radiology, Centro Médico Nacional 20 de Noviembre, Universidad Nacional Autonoma de Mexico (UNAM), México
| | - Karla Daniela Fuentes-Badillo
- Department of Radiology, Centro Médico Nacional 20 de Noviembre, Universidad Nacional Autonoma de Mexico (UNAM), México
| | - Valeria Morales-Dominguez
- Department of Radiology, Centro Médico Nacional 20 de Noviembre, Universidad Nacional Autonoma de Mexico (UNAM), México
| | - Rafael Punzo-Alcaraz
- Department of Radiology, Centro Médico Nacional 20 de Noviembre, Universidad Nacional Autonoma de Mexico (UNAM), México
| | - Gustavo Adolfo Feria-Arroyo
- Department of Radiology, Centro Médico Nacional 20 de Noviembre, Universidad Nacional Autonoma de Mexico (UNAM), México
| | - Lina Marcela Parra-Guerrero
- Department of Radiology, Centro Médico Nacional 20 de Noviembre, Universidad Nacional Autonoma de Mexico (UNAM), México
| | - Pedro Fernando Saenz-Castillo
- Department of Radiology, Centro Médico Nacional 20 de Noviembre, Universidad Nacional Autonoma de Mexico (UNAM), México
| | - Ana Milena Hernandez-Rojas
- Department of Radiology, Centro Médico Nacional 20 de Noviembre, Universidad Nacional Autonoma de Mexico (UNAM), México
| | - Manuel Gerardo Falla-Trujillo
- Department of Radiology, Centro Médico Nacional 20 de Noviembre, Universidad Nacional Autonoma de Mexico (UNAM), México
| | - Daniel Ernesto Obando-Bravo
- Department of Radiology, Centro Médico Nacional 20 de Noviembre, Universidad Nacional Autonoma de Mexico (UNAM), México
| | - Giovanni Saul Contla-Trejo
- Department of Radiology, Centro Médico Nacional 20 de Noviembre, Universidad Nacional Autonoma de Mexico (UNAM), México
| | | | - Joshua Chavez-Sastre
- Department of Radiology, Centro Médico Nacional 20 de Noviembre, Universidad Nacional Autonoma de Mexico (UNAM), México
| | - Jovanni Govea-Palma
- Department of Radiology, Centro Médico Nacional 20 de Noviembre, Universidad Nacional Autonoma de Mexico (UNAM), México
| | - Santiago Carrillo-Alvarez
- Department of Radiology, Centro Médico Nacional 20 de Noviembre, Universidad Nacional Autonoma de Mexico (UNAM), México
| | - Dulce Bonifacio
- Department of Radiology, Centro Médico Nacional 20 de Noviembre, Universidad Nacional Autonoma de Mexico (UNAM), México
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Todor SB, Bîrluțiu V, Topîrcean D, Mihăilă RG. Role of biological markers and CT severity score in predicting mortality in patients with COVID‑19: An observational retrospective study. Exp Ther Med 2022; 24:698. [PMID: 36277141 PMCID: PMC9535394 DOI: 10.3892/etm.2022.11634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 09/05/2022] [Indexed: 11/05/2022] Open
Abstract
COVID-19 pandemic is a continuing ongoing emergency of public concern. Early identification of markers associated with disease severity and mortality can lead to a prompter therapeutic approach. The present study conducted a multivariate analysis of different markers associated with mortality in order to establish their predictive role. Confirmed cases of 697 patients were examined. Demographic data, clinical symptoms and comorbidities were evaluated. Laboratory and imaging severity scores were reviewed. A total of 133 (19.1%) out of 697 patients succumbed during hospitalization. Obesity was the most common comorbidity, followed by hypertension, diabetes, coronary heart disease and chronic kidney disease. Compared with the survivor patients, non-survivors had a higher prevalence of diabetes, chronic kidney disease and coronary heart disease, as well as higher values of laboratory markers such as neutrophil-lymphocyte ratio (NLR), D-dimer, procalcitonin, IL-6 and C Reactive protein (CRP) and respectively high values of imaging severity scores. Multivariate regression analysis showed that high values of the proposed markers and chest computerized tomography (CT) severity imaging score were predictive for in hospital death: NLR [hazard ratio (HR): 3.127 confidence interval (CI) 95: 2.137-4.576]; D-dimer [HR: 6.223 (CI 95:3.809-10.167)]; procalcitonin [HR: 4.414 (CI 95:2.804-6.948)]; IL-6 [HR: 3.344 (CI 95:1.423-7.855)]; CRP [HR:2.997 (CI 95:1.940-4.630)]; and CT severity score [HR: 3.068 (CI 95:1.777-5.299)]. Laboratory markers and imaging severity scores could be used to stratify mortality risk in COVID-19 patients.
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Affiliation(s)
- Samuel-Bogdan Todor
- Pneumology Department, Pneumophtisiology Hospital Sibiu, Sibiu 550196, Romania
| | - Victoria Bîrluțiu
- Faculty of Medicine, Lucian Blaga University of Sibiu, Sibiu 550169, Romania
| | - Diana Topîrcean
- Hematology Department, Emergency County Clinical Hospital Sibiu, Sibiu 550245, Romania
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Al Aamri Z, Zadjali F, Al-Riyami N, Al Lawati F, Al Dowaiki S, Al Kindi M. Biochemical, Hematological, and Immunological Biomarkers as Predictors for Intensive Care Unit Admission in Patients with COVID-19. Oman Med J 2022; 37:e437. [PMID: 36458252 PMCID: PMC9627951 DOI: 10.5001/omj.2022.99] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 05/24/2022] [Indexed: 01/02/2025] Open
Abstract
OBJECTIVES To identify the biochemical, hematological, and immune biomarkers in COVID-19 patients on admission that are predictive of eventual admission to the intensive care unit (ICU). METHODS This retrospective cohort study was conducted on all confirmed COVID-19 cases hospitalized at Royal Hospital, Oman from 24 February to 30 July 2020. The demographic, clinical, and laboratory data were collected from the hospital information system. Patients were divided into two groups: non-ICU admitted group and ICU admitted group. RESULTS Out of 445 patients, 276 (62.0%) were male and 169 (38.0%) were female; 259 (58.2%) patients were admitted to COVID-19 general wards whereas 186 (41.8%) were admitted to ICU. Admission to ICU was more likely when patient had the following comorbidities: diabetes (OR = 1.8; 95% CI: 1.3-2.7), liver diseases (OR = 2.1; 95% CI: 1.1-4.3), and respiratory diseases (OR = 2.0; 95% CI: 1.1-3.7). Between ICU and non-ICU patients, there were significant differences in on-admission laboratory blood/serum parameters: total white blood cells (WBCs) count, lymphocytes count, C-reactive protein (CRP), ferritin, corrected calcium, interleukin 6 (IL-6), D-dimer, alanine transaminase (ALT), lactate dehydrogenase (LDH), albumin, and troponin. CONCLUSIONS The current study identified the presence of the comorbidities (i.e., diabetes, liver diseases, and respiratory diseases) and on-admission laboratory blood and serum test results (i.e., WBC, lymphocytes, CRP, ferritin, corrected calcium, IL-6, D-dimer, ALT, LDH, albumin, and troponin) that are associated with ICU admission.
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Affiliation(s)
- Zakariya Al Aamri
- Clinical Biochemistry Residency Training Program, Oman Medical Specialty Board, Muscat, Oman
| | - Fahad Zadjali
- Biochemistry Department, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | - Nafila Al-Riyami
- Biochemistry Department, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
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25
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Admission Predictors of Mortality in Hospitalized COVID-19 Patients-A Serbian Cohort Study. J Clin Med 2022; 11:jcm11206109. [PMID: 36294430 PMCID: PMC9605560 DOI: 10.3390/jcm11206109] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/03/2022] [Accepted: 10/06/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Early prediction of COVID-19 patients’ mortality risk may be beneficial in adequate triage and risk assessment. Therefore, we aimed to single out the independent morality predictors of hospitalized COVID-19 patients among parameters available on hospital admission. Methods: An observational, retrospective−prospective cohort study was conducted on 703 consecutive COVID-19 patients hospitalized in the University Clinical Center Kragujevac between September and December 2021. Patients were followed during the hospitalization, and in-hospital mortality was observed as a primary end-point. Within 24 h of admission, patients were sampled for blood gas and laboratory analysis, including complete blood cell count, inflammation biomarkers and other biochemistry, coagulation parameters, and cardiac biomarkers. Socio-demographic and medical history data were obtained using patients’ medical records. Results: The overall prevalence of mortality was 28.4% (n = 199). After performing multiple regression analysis on 20 parameters, according to the initial univariate analysis, only four independent variables gave statistically significant contributions to the model: SaO2 < 88.5 % (aOR 3.075), IL-6 > 74.6 pg/mL (aOR 2.389), LDH > 804.5 U/L (aOR 2.069) and age > 69.5 years (aOR 1.786). The C-index of the predicted probability calculated using this multivariate logistic model was 0.740 (p < 0.001). Conclusions: Parameters available on hospital admission can be beneficial in predicting COVID-19 mortality.
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Tang H, Liu Y, Ruan Y, Ge L, Zhang Q. Reconstructed Genome-Scale Metabolic Model Characterizes Adaptive Metabolic Flux Changes in Peripheral Blood Mononuclear Cells in Severe COVID-19 Patients. Int J Mol Sci 2022; 23:12400. [PMID: 36293257 PMCID: PMC9604493 DOI: 10.3390/ijms232012400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/10/2022] [Accepted: 10/13/2022] [Indexed: 11/16/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) poses a mortal threat to human health. The elucidation of the relationship between peripheral immune cells and the development of inflammation is essential for revealing the pathogenic mechanism of COVID-19 and developing related antiviral drugs. The immune cell metabolism-targeting therapies exhibit a desirable anti-inflammatory effect in some treatment cases. In this study, based on differentially expressed gene (DEG) analysis, a genome-scale metabolic model (GSMM) was reconstructed by integrating transcriptome data to characterize the adaptive metabolic changes in peripheral blood mononuclear cells (PBMCs) in severe COVID-19 patients. Differential flux analysis revealed that metabolic changes such as enhanced aerobic glycolysis, impaired oxidative phosphorylation, fluctuating biogenesis of lipids, vitamins (folate and retinol), and nucleotides played important roles in the inflammation adaptation of PBMCs. Moreover, the main metabolic enzymes such as the solute carrier (SLC) family 2 member 3 (SLC2A3) and fatty acid synthase (FASN), responsible for the reactions with large differential fluxes, were identified as potential therapeutic targets. Our results revealed the inflammation regulation potentials of partial metabolic reactions with differential fluxes and their metabolites. This study provides a reference for developing potential PBMC metabolism-targeting therapy strategies against COVID-19.
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Affiliation(s)
| | | | | | | | - Qingye Zhang
- Hubei Key Laboratory of Agricultural Bioinformatics, College of Informatics, Huazhong Agricultural University, Wuhan 430070, China
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Ding J, Yang L, Zhang Y, Zhang S, Meng Z. Impact of Heat Inactivation of Blood Samples on Therapeutic Drug Monitoring of 5 Second-Generation Antipsychotics and Their Metabolites. Ther Drug Monit 2022; 44:701-706. [PMID: 35482473 DOI: 10.1097/ftd.0000000000000989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 03/03/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND The severe acute respiratory syndrome coronavirus 2 outbreak has been classified as a pandemic. Because many coronaviruses are heat sensitive, heat inactivation of patient samples at 56°C before testing reduces the risk of transmission. The aim of this study is to assess the impact of heat inactivation of patient blood samples on plasma concentrations of 5 second-generation antipsychotics and their metabolites. METHODS Blood samples were collected during routine clinical therapeutic drug monitoring examination between April 3, 2021, and April 19, 2021. Samples were divided into 2 groups: group A, noninactivated raw sample, and group B, inactivated samples. Inactivation was performed by a 30-minute incubation at 56°C. The levels of the 5 drugs and their metabolites before and after sample heat inactivation were measured using liquid chromatography-tandem mass spectrometry and compared. Furthermore, correlation and Bland-Altman analyses were conducted. RESULTS No statistically significant difference was observed between the levels of the 5 drugs and their metabolites (ie, risperidone, 9-OH-risperidone, aripiprazole, dehydroaripiprazole, olanzapine, quetiapine, norquetiapine, clozapine, and norclozapine) in the noninactivated group A and the inactivated group B ( P > 0.05). Each drug's concentration values in inactivated and noninactivated treatments correlated (Spearman rs > 0.98; P < 0.001). The results of the noninactivated treatment methods and samples alone showed good consistency via Bland-Altman analysis. CONCLUSIONS Blood sample heat inactivation had no significant effect on the therapeutic drug monitoring of 5 second-generation antipsychotics and their metabolites. This inactivated treatment method should be recommended to effectively protect laboratory staff from virus contamination.
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Affiliation(s)
- Jing Ding
- Pharmacy Laboratory, Xi'an Mental Health Center, Xi'an, P.R. China; and
- Xi'an Key Laboratory of Pharmacy (Mental Health), Xi'an, P.R. China
| | - Liu Yang
- Pharmacy Laboratory, Xi'an Mental Health Center, Xi'an, P.R. China; and
- Xi'an Key Laboratory of Pharmacy (Mental Health), Xi'an, P.R. China
| | - Yan Zhang
- Pharmacy Laboratory, Xi'an Mental Health Center, Xi'an, P.R. China; and
- Xi'an Key Laboratory of Pharmacy (Mental Health), Xi'an, P.R. China
| | - Suo Zhang
- Pharmacy Laboratory, Xi'an Mental Health Center, Xi'an, P.R. China; and
- Xi'an Key Laboratory of Pharmacy (Mental Health), Xi'an, P.R. China
| | - Zhuocheng Meng
- Pharmacy Laboratory, Xi'an Mental Health Center, Xi'an, P.R. China; and
- Xi'an Key Laboratory of Pharmacy (Mental Health), Xi'an, P.R. China
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Goel A, Raizada A, Agrawal A, Bansal K, Uniyal S, Prasad P, Yadav A, Tyagi A, Rautela RS. Correlates of In-Hospital COVID-19 Deaths: A Competing Risks Survival Time Analysis of Retrospective Mortality Data. Disaster Med Public Health Prep 2022; 16:1889-1896. [PMID: 33762056 PMCID: PMC8129688 DOI: 10.1017/dmp.2021.85] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Several aspects of the coronavirus disease 2019 (COVID-19) pandemic remain ambiguous, including its transmission, severity, geographic, and racial differences in mortality. These variations merit elaboration of local patterns to inform wider national policies. METHODS In a retrospective analysis, data of patients treated at a dedicated COVID hospital with moderate and severe illness during 8 wk of the pandemic were reviewed with attention to mortality in a competing risks framework. RESULTS A total of 1147 patients were hospitalized, and 312 (27.2%) died in hospital. Those who died were older (56.5 vs 47.6 y; P < 0.0001). Of these, 885 (77.2%) had tested positive on reverse transcriptase polymerase chain reaction (RT-PCR), with 219 (24.2%) deaths (incidence rate, 1.9 per 100 person-days). Median time from onset of symptoms to death was 11 days. A competing risks analysis for in-hospital death revealed an adjusted cause-specific hazard ratio of 1.4 for each decade increase in age. CONCLUSIONS This retrospective analysis provides broad patterns of disease presentation and mortality. Even COVID test-negative patients will receive treatment at dedicated facilities, and 33% presenting cases may die within the first 72 h, most with comorbid illness. This should be considered while planning distribution of services for effective health-care delivery.
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Affiliation(s)
- Ashish Goel
- Department of Medicine, UCMS and GTB Hospital, Delhi
- Corresponding author: Ashish Goel,
| | | | - Ananya Agrawal
- Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | | | | | - Pratima Prasad
- Department of Pedodontics and Preventive Dentistry, UCMS and GTB Hospital, Delhi, India
| | - Anil Yadav
- Department of Medicine, UCMS and GTB Hospital, Delhi
| | - Asha Tyagi
- Department of Anesthesia, UCMS and GTB Hospital, Delhi, India
| | - RS Rautela
- Department of Anesthesia, UCMS and GTB Hospital, Delhi, India
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ŞAHİN ÖZDEMİREL T, AKKURT ES, ERTAN Ö, YENİBERTİZ D, AKINCI ÖZYÜREK B. COVID-19 pnömonili hastalarda yaşa bağımlı bir prognostik faktör olarak CRP/albümin oranı. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1133756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Amaç: Çalışmamızın amacı, Covid-19 pnömonisinde C-reaktif protein/albüminin yaşa bağlı bir belirteç olup olmadığını belirlemekti.
Gereç ve Yöntem: Covid-19 pnömonisi olan 296 (166 erkek/ 130 kadın) hasta üzerinde retrospektif bir araştırma yaptık. Katılımcılar
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Affiliation(s)
| | | | - Özlem ERTAN
- ANKARA ATATURK SANATORYUM EĞİTİM VE ARAŞTIRMA HASTANESİ
| | - Derya YENİBERTİZ
- SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA DR. ABDURRAHMAN YURTASLAN ONKOLOJİ SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ
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Zhang JN, Gao Y, Wang XT, Li NN, Du X, Tang YJ, Lai QQ, Chen PF, Yue CS, Wu JH, Kang K, Zhao MY. Lymphocyte–C-reactive protein ratio can differentiate disease severity of COVID-19 patients and serve as an assistant screening tool for hospital and ICU admission. Front Immunol 2022; 13:957407. [PMID: 36248811 PMCID: PMC9554799 DOI: 10.3389/fimmu.2022.957407] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
In this study, we aimed to explore whether lymphocyte–C-reactive protein ratio (LCR) can differentiate disease severity of coronavirus disease 2019 (COVID-19) patients and its value as an assistant screening tool for admission to hospital and intensive care unit (ICU). A total of 184 adult COVID-19 patients from the COVID-19 Treatment Center in Heilongjiang Province at the First Affiliated Hospital of Harbin Medical University between January 2020 and March 2021 were included in this study. Patients were divided into asymptomatic infection group, mild group, moderate group, severe group, and critical group according to the Diagnosis and Treatment of New Coronavirus Pneumonia (ninth edition). Demographic and clinical data including gender, age, comorbidities, severity of COVID-19, white blood cell count (WBC), neutrophil proportion (NEUT%), lymphocyte count (LYMPH), lymphocyte percentage (LYM%), red blood cell distribution width (RDW), platelet (PLT), C-reactive protein (CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum creatinine (SCr), albumin (ALB), total bilirubin (TB), direct bilirubin (DBIL), indirect bilirubin (IBIL), and D-dimer were obtained and collated from medical records at admission, from which sequential organ failure assessment (SOFA) score and LCR were calculated, and all the above indicators were compared among the groups. Multiple clinical parameters, including LYMPH, CRP, and LCR, showed significant differences among the groups. The related factors to classify COVID-19 patients into moderate, severe, and critical groups included age, number of comorbidities, WBC, LCR, and AST. Among these factors, the number of comorbidities showed the greatest effect, and only WBC and LCR were protective factors. The area under the receiver operating characteristic (ROC) curve of LCR to classify COVID-19 patients into moderate, severe, and critical groups was 0.176. The cutoff value of LCR and the sensitivity and specificity of the ROC curve were 1,780.7050 and 84.6% and 66.2%, respectively. The related factors to classify COVID-19 patients into severe and critical groups included the number of comorbidities, PLT, LCR, and SOFA score. Among these factors, SOFA score showed the greatest effect, and LCR was the only protective factor. The area under the ROC curve of LCR to classify COVID-19 patients into severe and critical groups was 0.106. The cutoff value of LCR and the sensitivity and specificity of the ROC curve were 571.2200 and 81.3% and 90.0%, respectively. In summary, LCR can differentiate disease severity of COVID-19 patients and serve as a simple and objective assistant screening tool for hospital and ICU admission.
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Affiliation(s)
- Jian-Nan Zhang
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yang Gao
- Department of Critical Care Medicine, The Sixth Affiliated Hospital of Harbin Medical University, Harbin, China
- Institute of Critical Care Medicine, The Sino Russian Medical Research Center of Harbin Medical University, Harbin, China
| | - Xin-Tong Wang
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Na-Na Li
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xue Du
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yu-Jia Tang
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Qi-Qi Lai
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Peng-Fei Chen
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Chuang-Shi Yue
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Ji-Han Wu
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Kai Kang
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, China
- Institute of Critical Care Medicine, The Sino Russian Medical Research Center of Harbin Medical University, Harbin, China
- *Correspondence: Kai Kang, ; Ming-Yan Zhao,
| | - Ming-Yan Zhao
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, China
- *Correspondence: Kai Kang, ; Ming-Yan Zhao,
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Kumar A, Karn E, Trivedi K, Kumar P, Chauhan G, Kumari A, Pant P, Munisamy M, Prakash J, Sarkar PG, Prasad K, Prasad A. Procalcitonin as a predictive marker in COVID-19: A systematic review and meta-analysis. PLoS One 2022; 17:e0272840. [PMID: 36084093 PMCID: PMC9462680 DOI: 10.1371/journal.pone.0272840] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 07/27/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 has emerged as a global pandemic causing millions of critical cases and deaths. Early identification of at-risk patients is crucial for planning triage and treatment strategies. METHODS AND FINDINGS We performed this systematic review and meta-analysis to determine the pooled prognostic significance of procalcitonin in predicting mortality and severity in patients with COVID-19 using a robust methodology and clear clinical implications. DESIGN We used Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Cochrane Handbook for Systematic Reviews of Interventions guidelines. We included thirty-two prospective and retrospective cohort studies involving 13,154 patients. RESULTS The diagnostic odds ratio of procalcitonin for predicting mortality were estimated to be 11 (95% CI: 7 to 17) with sensitivity, specificity, and summary area under the curveof 0.83 (95% CI: 0.70 to 0.91), 0.69 (95% CI: 0.58 to 0.79), and 0.83 (95% CI: 0.79 to 0.86) respectively. While for identifying severe cases of COVID-19, the odds ratio was 8.0 (95% CI 5.0 to 12.0) with sensitivity, specificity, and summary area under the curve of 0.73 (95% CI 0.67 to 0.78), 0.74 (0.66 to 0.81), and 0.78 (95% CI 0.74 to 0.82) respectively. CONCLUSION Procalcitonin has good discriminatory power for predicting mortality and disease severity in COVID-19 patients. Therefore, procalcitonin measurement may help identify potentially severe cases and thus decrease mortality by offering early aggressive treatment.
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Affiliation(s)
- Amit Kumar
- Department of Laboratory Medicine, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Era Karn
- Department of Biotechnology, Patna University, Bihar, India
| | - Kiran Trivedi
- Department of Obstetrics and Gynecology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Pramod Kumar
- Department of Biochemistry, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Ganesh Chauhan
- Department of Genetics and Genomics, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Aradhana Kumari
- Department of Biochemistry, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Pragya Pant
- Department of Nephrology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Murali Munisamy
- Department of Translational Medicine, All India Institute of Medical Sciences, Bhopal, India
| | - Jay Prakash
- Department of Critical Care, Trauma Centre, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Prattay Guha Sarkar
- Department of Cardiology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Kameshwar Prasad
- Department of Neurology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Anupa Prasad
- Department of Biochemistry, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
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Ashamo AY, Bekele A, Petrose A, Gebreyes T, Etissa EK, Bekele A, Haisch D, Schluger NW, Yusuf H, Haile T, Deyessa N, Kebede D. Assessment of hypertension and other factors associated with the severity of disease in COVID-19 pneumonia, Addis Ababa, Ethiopia: A case-control study. PLoS One 2022; 17:e0273012. [PMID: 35969590 PMCID: PMC9377616 DOI: 10.1371/journal.pone.0273012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 07/29/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Various reports suggested that pre-existing medical illnesses, including hypertension and other demographic, clinical, and laboratory factors, could pose an increased risk of disease severity and mortality among COVID-19 patients. This study aimed to assess the relation of hypertension and other factors to the severity of COVID-19 pneumonia in patients discharged from Eka Kotebe Hospital in June-September, 2020. METHODS This is a single-center case-control study of 265 adult patients discharged alive or dead, 75 with a course of severe COVID-19 for the cases arm and 190 with the non-severe disease for the control arm. Three age and sex-matched controls were selected randomly for each patient on the case arm. Chi-square, multivariable binary logistic regression, and odds ratio (OR) with a 95% confidence interval was used to assess the association between the various factors and the severity of the disease. A p-value of <0.05 is considered statistically significant. RESULTS Of the 265 study participants, 80% were male. The median age was 43 IQR(36-60) years. Both arms had similar demographic characteristics. Hypertension was strongly associated with the severity of COVID-19 pneumonia based on effect outcome adjustment (AOR = 2.93, 95% CI 1.489, 5.783, p-value = 0.002), similarly, having diabetes mellitus (AOR = 3.17, 95% CI 1.374, 7.313, p-value<0.007), chronic cardiac disease (AOR = 4.803, 95% CI 1.238-18.636, p<0.023), and an increase in a pulse rate (AOR = 1.041, 95% CI 1.017, 1.066, p-value = 0.001) were found to have a significant association with the severity of COVID-19 pneumonia. CONCLUSIONS Hypertension was associated with the severity of COVID-19 pneumonia, and so were diabetes mellitus, chronic cardiac disease, and an increase in pulse rate.
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Affiliation(s)
- Andargew Yohannes Ashamo
- Department of Internal Medicine, Division of Pulmonary and Critical Care, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abebaw Bekele
- Department of Internal Medicine, Eka Kotebe General Hospital, Addis Ababa, Ethiopia
| | - Adane Petrose
- Department of Internal Medicine, Division of Pulmonary and Critical Care, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tsegaye Gebreyes
- Department of Internal Medicine, Eka Kotebe General Hospital, Addis Ababa, Ethiopia
| | | | - Amsalu Bekele
- Department of Internal Medicine, Division of Pulmonary and Critical Care, Addis Ababa University, Addis Ababa, Ethiopia
| | - Deborah Haisch
- Department of Internal Medicine, Weill Cornell Medical College, New York City, New York, United States of America
| | - Neil W. Schluger
- Department of Internal Medicine, Westchester Medical Center, New York Medical College, New York City, New York, United States of America
| | - Hanan Yusuf
- Department of Internal Medicine, Division of Pulmonary and Critical Care, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tewodros Haile
- Department of Internal Medicine, Division of Pulmonary and Critical Care, Addis Ababa University, Addis Ababa, Ethiopia
| | - Negussie Deyessa
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Dawit Kebede
- Department of Internal Medicine, Division of Pulmonary and Critical Care, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Internal Medicine, Eka Kotebe General Hospital, Addis Ababa, Ethiopia
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Yang S, Zhao H, Cui R, Ma L, Ge X, Fu Q, Yu D, Niu X. Comparison of clinical outcomes and risk factors for COVID-19 infection in cancer patients without anticancer treatment and noncancer patients. Front Public Health 2022; 10:925519. [PMID: 36033814 PMCID: PMC9411742 DOI: 10.3389/fpubh.2022.925519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 07/18/2022] [Indexed: 01/24/2023] Open
Abstract
Background Previous studies have shown that cancer patients have higher rates of coronavirus disease 2019 (COVID-19) infection and mortality than noncancer patients. However, the differences between cancer patients undergoing regular follow-up without anticancer treatment and noncancer patients with COVID-19 have remained insufficiently investigated. Methods A retrospective case-control study of 52 patients with COVID-19 infection was performed with a 1:3 matched proportion of cancer patients undergoing regular follow-up without anticancer treatment and noncancer patients. The demographic characteristics, clinical data, laboratory tests, treatment, and complications of patients were collected from medical records. Chi-square tests and univariate and multivariate regressions were performed to assess the differences between these two cohorts of COVID-19 patients with and without cancer and risk factors for severe events in COVID-19 patients. Results Increased C-reactive protein (CRP) (>4 mg/L) (p = 0.015) and lactate dehydrogenase (LDH) (>243 IU/L) (p = 0.038) were identified as risk factors for severe events in all enrolled COVID-19 patients based on multivariate analysis, but cancer as a chronic disease (p = 1.000) was not identified as an independent risk factor for severe events in COVID-19 patients. Compared with noncancer patients, cancer patients had a significantly longer median hospitalization time (29 days vs. 19 days, p = 0.048) and a higher incidence of hypoalbuminemia complications (84.6 vs. 46.2%, p = 0.016). Conclusions Increased CRP and LDH were risk factors for severe events in all enrolled COVID-19 patients, and an increased incidence of hypoalbuminemia complications and longer hospitalization were noted in COVID-19 cancer patients undergoing regular follow-up without anticancer treatment compared with noncancer patients.
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Affiliation(s)
- Sen Yang
- Department of General Practice, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Huaxin Zhao
- Department of Oncology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ran Cui
- Department of Rheumatology and Immunology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Le Ma
- Department of General Practice, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xuhua Ge
- Department of General Practice, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
| | | | - Dehua Yu
- Yangpu Hospital, Tongji University, Shanghai, China,Dehua Yu
| | - Xiaomin Niu
- Department of Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China,*Correspondence: Xiaomin Niu
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Aldred A, Ribeiro JAS, Bezerra PMS, Antunes ACM, C. Goulart A, Desuó IC, Gomes G. Application of thermography to estimate respiratory rate in the emergency room: The journal Temperature toolbox. Temperature (Austin) 2022; 10:159-165. [PMID: 37332302 PMCID: PMC10274541 DOI: 10.1080/23328940.2022.2099215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 06/28/2022] [Accepted: 07/01/2022] [Indexed: 10/17/2022] Open
Abstract
Among the vital signs collected during hospital triage, respiratory rate is an important parameter associated with physiological, pathophysiological, and emotional changes. In recent years, the importance of its verification in emergency centers due to the severe acute respiratory syndrome 2 (SARS2) pandemic has become very clear, although it is still one of the least evaluated and collected vital signs. In this context, infrared imaging has been shown to be a reliable estimator of respiratory rate, with the advantage of not requiring physical contact with patients. The objective of this study was to evaluate the potential of analyzing a sequence of thermal images as an estimator of respiratory rate in the clinical routine of an emergency room. We used an infrared thermal camera (T540, Flir Systems) to obtain the respiratory rate data of 136 patients, based on nostrils' temperature fluctuation, during the peak of the COVID-19 pandemic in Brazil and compared it with the chest incursion count method, commonly employed in the emergency screening procedures. We found a good agreement between both methods, with Bland-Altman limits of agreement ranging from -4 to 4 min-1, no proportional bias (R2 = 0.021, p = 0.095), and a strong correlation between them (r = 0.95, p < 0.001). Our results suggest that infrared thermography has potential to be a good estimator of respiratory rate in the routine of an emergency room.
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Affiliation(s)
- Alexandre Aldred
- Department of Science and R&D, Predikta Soluções em Pesquisa, São Paulo, Brasil
| | - João A. S. Ribeiro
- Department of Science and R&D, Predikta Soluções em Pesquisa, São Paulo, Brasil
- Department of Science, Termodiagnose Institute, São Paulo, Brasil
| | - Pedro M. S. Bezerra
- Department of Science and R&D, Predikta Soluções em Pesquisa, São Paulo, Brasil
- Faculty of Electrical Engineering (FEEC), Campinas State University (UNICAMP), São Paulo, Brasil
| | - Ana C. M. Antunes
- Department of General Surgery, Hospital Universitário, Universidade de São Paulo, São Paulo, Brasil
| | - Alessandra C. Goulart
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, Brasil
- Department of Internal Medicine, Hospital Universitário, Universidade de São Paulo, São Paulo, Brasil
| | - Ivan C. Desuó
- Department of Science and R&D, Predikta Soluções em Pesquisa, São Paulo, Brasil
| | - Guilherme Gomes
- Department of Science and R&D, Predikta Soluções em Pesquisa, São Paulo, Brasil
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Sipahioglu H, Esmaoglu A, Kiris A, Dursun ZB, Kuzuguden S, Cavus MA, Artan C. Does serum butyrylcholinesterase level determine the severity and mortality of COVID-19 pneumonia?: Prospective study. Front Med (Lausanne) 2022; 9:940533. [PMID: 35957846 PMCID: PMC9357934 DOI: 10.3389/fmed.2022.940533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/08/2022] [Indexed: 01/08/2023] Open
Abstract
BackgroundThe WHO emphasized the importance of knowing the risk factors for the severity of the disease in the COVID-19 pandemic. Our aim in this study was to determine the relationship between serum Butyrylcholinesterase (BChE) level, which is rapidly affected by inflammation, and the severity of COVID-19 pneumonia and mortality.MethodsPatients diagnosed with COVID-19 pneumonia between March and May 2021 were included in the study. The patients were divided into two groups as severe and mild to moderate pneumonia according to the WHO's guidelines. Serum BChE levels were studied by ELISA method from the blood samples taken from the patients on the day of hospitalization. The severity of the disease and other factors affecting hospital mortality were also evaluated.Results147 patients with COVID-19 pneumonia were included in this study. Of these patients, 58% had severe pneumonia and 42% had mild to moderate pneumonia. The BChE level was median 13 (IQR: 11.2–21.5)ng/ml in patients with severe COVID-19 pneumonia and median 20 (IQR: 10–35.7)ng/ml in patients with mild to moderate pneumonia (p: 0.001). Hospital with mortality rate was higher in patients with low BChE levels. However, statistically, BChE hasn't associated mortality in COVID-19 pneumonia [OR 1.002 (0.957–1.049) p: 0.490]. CRP, procalcitonin, lactate, and D-dimer levels were associated mortality in COVID-19 pneumonia.ConclusionBeing not statistically significant, the mortality rate was higher in patients with low BChE levels. BChE level is an important marker in determining the severity of COVID-19 pneumonia. Early prediction of the severity of COVID-19 pneumonia will enable early planning of the treatment process.
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Affiliation(s)
- Hilal Sipahioglu
- Kayseri Education and Research Hospital, Kayseri, Turkey
- *Correspondence: Hilal Sipahioglu
| | - Aliye Esmaoglu
- Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Ayse Kiris
- Kayseri Education and Research Hospital, Kayseri, Turkey
| | | | | | | | - Cem Artan
- Kayseri Education and Research Hospital, Kayseri, Turkey
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Singh P, Ali SA. Multifunctional Role of S100 Protein Family in the Immune System: An Update. Cells 2022; 11:cells11152274. [PMID: 35892571 PMCID: PMC9332480 DOI: 10.3390/cells11152274] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/12/2022] [Accepted: 07/21/2022] [Indexed: 12/04/2022] Open
Abstract
S100 is a broad subfamily of low-molecular weight calcium-binding proteins (9–14 kDa) with structural similarity and functional discrepancy. It is required for inflammation and cellular homeostasis, and can work extracellularly, intracellularly, or both. S100 members participate in a variety of activities in a healthy cell, including calcium storage and transport (calcium homeostasis). S100 isoforms that have previously been shown to play important roles in the immune system as alarmins (DAMPs), antimicrobial peptides, pro-inflammation stimulators, chemo-attractants, and metal scavengers during an innate immune response. Currently, during the pandemic, it was found that several members of the S100 family are implicated in the pathophysiology of COVID-19. Further, S100 family protein members were proposed to be used as a prognostic marker for COVID-19 infection identification using a nasal swab. In the present review, we compiled the vast majority of recent studies that focused on the multifunctionality of S100 proteins in the complex immune system and its associated activities. Furthermore, we shed light on the numerous molecular approaches and signaling cascades regulated by S100 proteins during immune response. In addition, we discussed the involvement of S100 protein members in abnormal defense systems during the pathogenesis of COVID-19.
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Affiliation(s)
- Parul Singh
- Cell Biology and Proteomics Lab, Animal Biotechnology Center, ICAR-NDRI, Karnal 132001, India;
| | - Syed Azmal Ali
- Cell Biology and Proteomics Lab, Animal Biotechnology Center, ICAR-NDRI, Karnal 132001, India;
- Division of Proteomics of Stem Cells and Cancer, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Correspondence: ; Tel.: +91-8708591790
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ÇELİK ÇO, ÇIFTCI O, ÖZER N, MÜDERRİSOĞLU H. COVID-19'da hastane içi mortaliteyi tahmin etmede enflamatuvar temelli parametrelerin ve MELD-XI skorunun 4C mortalite skoru ile karşılaştırılması. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1050872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Purpose: In this study, we compared the roles of inflammatory parameters such as neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), C-reactive protein/lymphocyte ratio (CLR), monocyte/lymphocyte ratio (MLR), neutrophil/platelet ratio (NPR), neutrophil/monocyte ratio (NMR), CRP/albumin ratio (CAR), BUN/albumin ratio (BAR), MELD-XI score and 4C mortality score in predicting in-hospital mortality risk in COVID-19.
Materials and Methods: A total of 117 patients over 18 years old with a PCR-confirmed diagnosis of COVID-19 between June 2020 and February 2021 were retrospectively included. The roles of parameters for independently predicting in-hospital mortality were determined and compared with each other using appropriate statistical methods.
Results: Age, chronic kidney disease, diabetes mellitus, acute kidney injury, and length of hospital stay, urea, creatinine, LDH, AST, ferritin, D-dimer, CRP, albumin, Hb, CLR, BAR, CAR, MELD-XI score, and 4C mortality score were significantly correlated to in-hospital mortality. However, only the 4C mortality score and AST independently predicted in-hospital mortality in COVID-19 [OR 2.08 (%95 CI 1.06-2.36), for 4C mortality score, and OR 1.05 (%95 CI 1.00-1.10), for AST].
Conclusion: Unlike other mortality-related inflammatory parameters, the 4C mortality score and AST were independent and strong predictors of mortality in hospitalized COVID-19 patients.
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Affiliation(s)
| | - Orçun ÇIFTCI
- Başkent University Ankara Training and Research Hospital
| | - Nurtaç ÖZER
- Başkent University Konya Practise and Research Hospital
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Farouk N, Ashry WMO, El-Hagrasy HA, Mohamed EF, Eltrawy HH, El-Nasser AM, Shipl W, Attar SE, Kh Sakr L, Abdel Wahab MA, Abdelsalam EM, Sharaf FA, Ahmad IH. Admission Levels of Serum P-Selectin and IL-6 Can Predict Development of Deep Venous Thrombosis in Hospitalized Covid-19 Patients. Int J Gen Med 2022; 15:5599-5607. [PMID: 35712059 PMCID: PMC9197170 DOI: 10.2147/ijgm.s357097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 05/20/2022] [Indexed: 11/23/2022] Open
Abstract
Background and Aim Deep venous thrombosis (DVT) of the lower extremities is common in Covid-19 patients. Interleukin (IL)-6 and P-selectin were found to be elevated in Covid-19 patients. The current study aimed to evaluate P-selectin and IL6 in Covid-19 patients with DVT and to explore its relation to clinical and laboratory parameters in those patients. Patients and methods The present retrospective study included 150 hospitalized COVID-19 patients diagnosed on the basis of a positive result of reverse-transcriptase polymerase chain reaction (RT-PCR) test. Laboratory assessments were included for IL-6 and P selectin assessments via enzyme-linked immunosorbent assay. The primary outcome of the present study was the development of DVT detected by Doppler ultrasound (DU) evaluation of the lower extremities during the admission. Results The present study included 150 hospitalized Covid-19 patients. DVT was developed in 59 patients (39.3%). DVP patients had significantly higher levels of P selectin [76.0 (63.0-87.0) versus 63.0 (54.3-75.0), p < 0.001] and IL-6 [37.0 (27.0-49.0) versus 18.5 (13.5-31.5), p < 0.001]. ROC curve analysis revealed good performance of P selectin [AUC (95% CI): 0.72 (0.64-0.81)] and IL-6 [AUC (95% CI): 0.79 (0.71-0.86)] in identification of DVT. Logistic regression analysis identified the presence of severe disease [OR (95% CI): 9.016 (3.61-22.49), p < 0.001], elevated P selectin [OR (95% CI): 1.032 (1.005-1.059), p = 0.018] and elevated IL-6 [OR (95% CI): 1.062 (1.033-1.091), p < 0.001] as significant predictors of DVT development in multivariate analysis. Conclusion The present study identified a probable role of elevated P-selectin and IL-6 levels in the DVT development in hospitalized Covid-19 patients.
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Affiliation(s)
- Nehal Farouk
- Vascular Surgery Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Walaa Mohamed Omar Ashry
- Microbiology and Immunology Department, Damietta Faculty of Medicine (Girls), Al-Azhar University, Damietta, Egypt
| | - Hanan A El-Hagrasy
- Clinical Pathology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Eman F Mohamed
- Internal Medicine Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Heba H Eltrawy
- Chest Diseases Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Asmaa M El-Nasser
- Medical Microbiology and Immunology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Walaa Shipl
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Shahinaz El Attar
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Lobna Kh Sakr
- Radio-Diagnosis Department, faculty of medicine for girls, Al-Azhar University, Cairo, Egypt
| | - Maisa A Abdel Wahab
- Vascular Surgery Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Eman M Abdelsalam
- Internal Medicine Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Fawzia A Sharaf
- Clinical Pathology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Inass Hassan Ahmad
- Endocrinology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
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Che L, Wang Z, Du N, Li L, Zhao Y, Zhang K, Liu Q. Evaluation of Serum Ferritin, Procalcitonin, and C-Reactive Protein for the Prediction of Severity and Mortality in Hemorrhagic Fever With Renal Syndrome. Front Microbiol 2022; 13:865233. [PMID: 35677912 PMCID: PMC9169039 DOI: 10.3389/fmicb.2022.865233] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 03/08/2022] [Indexed: 01/08/2023] Open
Abstract
This study aimed to analyze the clinical significance of serum ferritin, procalcitonin (PCT), and C-reactive protein (CRP) in patients with hemorrhagic fever with renal syndrome (HFRS). The demographical, clinical, and laboratory data of 373 patients with HFRS in northeastern China were retrospectively analyzed. The levels of serum ferritin and PCT in severe patients (n = 108) were significantly higher than those in mild patients (n = 265, p < 0.001) and associated with HFRS severity. The area under the receiver operating characteristic curve (AUC) values of serum ferritin and PCT for predicting the severity of HFRS were 0.732 (95% CI 0.678-0.786, p < 0.001) and 0.824 (95% CI 0.773-0.875, p < 0.001), respectively, showing sensitivity and specificity of 0.75 and 0.88 for serum ferritin, and 0.76 and 0.60 for PCT. The CRP level in HFRS with bacterial co-infection (n = 115) was higher than that without bacterial co-infection (n = 258, p < 0.001). The AUC value of CRP for predicting bacterial co-infection was 0.588 (95% CI 0.525-0.652, p < 0.001), showing sensitivity and specificity of 0.43 and 0.76, respectively. The serum ferritin level in non-survivors (n = 14) was significantly higher than in survivors (n = 359, p < 0.001). The AUC value of serum ferritin for predicting mortality was 0.853 (95% CI 0.774-0.933, p < 0.001), showing sensitivity and specificity of 0.933 and 0.739. Serum ferritin and PCT have a robust association with HFRS severity and mortality, which may be promising predictors, and CRP is an effective biomarker to assess bacterial co-infection in HFRS.
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Affiliation(s)
- Lihe Che
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China.,Key Laboratory of Organ Regeneration and Transplantation of the Ministry of Education, Center for Pathogen Biology and Infectious Diseases, The First Hospital of Jilin University, Changchun, China.,Department of Infectious Diseases, The First Hospital of Jilin University, Changchun, China
| | - Zedong Wang
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China.,Key Laboratory of Organ Regeneration and Transplantation of the Ministry of Education, Center for Pathogen Biology and Infectious Diseases, The First Hospital of Jilin University, Changchun, China
| | - Na Du
- Department of Infectious Diseases, The First Hospital of Jilin University, Changchun, China
| | - Liang Li
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
| | - Yinghua Zhao
- Key Laboratory of Organ Regeneration and Transplantation of the Ministry of Education, Center for Pathogen Biology and Infectious Diseases, The First Hospital of Jilin University, Changchun, China
| | - Kaiyu Zhang
- Department of Infectious Diseases, The First Hospital of Jilin University, Changchun, China
| | - Quan Liu
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China.,Key Laboratory of Organ Regeneration and Transplantation of the Ministry of Education, Center for Pathogen Biology and Infectious Diseases, The First Hospital of Jilin University, Changchun, China.,School of Life Sciences and Engineering, Foshan University, Foshan, China
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40
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Goncu Ayhan S, Turgut E, Ozden Tokalioglu E, Oluklu D, Sakcak B, Uyan Hendem D, Tanacan A, Moraloglu Tekin O, Sahin D. Post-COVID-19 fetal cardiac evaluation in moderate infection group of pregnant women. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:630-635. [PMID: 35524502 PMCID: PMC9348261 DOI: 10.1002/jcu.23220] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/31/2022] [Accepted: 03/31/2022] [Indexed: 06/14/2023]
Abstract
PURPOSE To determine the long-term fetal cardiac effects of the SARS-CoV-2 infection in pregnant women recovered from moderate COVID-19 with fetal echocardiography (ECHO). METHODS Forty-five pregnant women that recovered from moderate COVID-19 (CRG) 4 weeks after the infection confirmation, were compared with 45 gestational and maternal age-matched control groups (CG) in terms of demographic features fetal cardiac morphological (sphericity index, cardiothoracic ratio), and functional (myocardial performance index, mitral E/A, tricuspid E/A, mitral and tricuspid annular plane systolic excursion) parameters. RESULTS There was no difference in demographic features between the groups. Fetal cardiac morphologic parameters were found to be similar between the two groups. When the fetal cardiac functional assessment of the two groups was compared, only mitral E/A ratio results were found to be statistically significantly lower in the CRG than in the control group (p = 0.030). CONCLUSION The fetal heart does not seem to be negatively affected by COVID-19 after recovery from moderate infection. These results about the fetal effect of SARS-CoV-2 may improve our limited knowledge of the utility of fetal ECHO in pregnant women who recovered from COVID-19.
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Affiliation(s)
- Sule Goncu Ayhan
- Department of Obstetrics and GynecologyMinistry of Health Ankara City HospitalAnkaraTurkey
| | - Ezgi Turgut
- Department of Obstetrics and GynecologyMinistry of Health Ankara City HospitalAnkaraTurkey
| | - Eda Ozden Tokalioglu
- Department of Obstetrics and GynecologyMinistry of Health Ankara City HospitalAnkaraTurkey
| | - Deniz Oluklu
- Department of Obstetrics and GynecologyMinistry of Health Ankara City HospitalAnkaraTurkey
| | - Bedri Sakcak
- Department of Obstetrics and GynecologyMinistry of Health Ankara City HospitalAnkaraTurkey
| | - Derya Uyan Hendem
- Department of Obstetrics and GynecologyMinistry of Health Ankara City HospitalAnkaraTurkey
| | - Atakan Tanacan
- Department of Obstetrics and GynecologyMinistry of Health Ankara City HospitalAnkaraTurkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and GynecologyMinistry of Health Ankara City HospitalAnkaraTurkey
- Department of Obstetrics and GynecologyUniversity of Health SciencesIstanbulTurkey
| | - Dilek Sahin
- Department of Obstetrics and GynecologyMinistry of Health Ankara City HospitalAnkaraTurkey
- Department of Obstetrics and GynecologyUniversity of Health SciencesIstanbulTurkey
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Welty FK, Rajai N, Amangurbanova M. Comprehensive Review of Cardiovascular Complications of Coronavirus Disease 2019 and Beneficial Treatments. Cardiol Rev 2022; 30:145-157. [PMID: 35384908 PMCID: PMC8983616 DOI: 10.1097/crd.0000000000000422] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 and was first reported in December 2019 in Wuhan, China. Since then, it caused a global pandemic with 212,324,054 confirmed cases and 4,440,840 deaths worldwide as of August 22, 2021. The disease spectrum of COVID-19 ranges from asymptomatic subclinical infection to clinical manifestations predominantly affecting the respiratory system. However, it is now evident that COVID-19 is a multiorgan disease with a broad spectrum of manifestations leading to multiple organ injuries including the cardiovascular system. We review studies that have shown that the relationship between cardiovascular diseases and COVID-19 is indeed bidirectional, implicating that preexisting cardiovascular comorbidities increase the morbidity and mortality of COVID-19, and newly emerging cardiac injuries occur in the settings of acute COVID-19 in patients with no preexisting cardiovascular disease. We present the most up-to-date literature summary to explore the incidence of new-onset cardiac complications of coronavirus and their role in predicting the severity of COVID-19. We review the association of elevated troponin with the severity of COVID-19 disease, which includes mild compared to severe disease, in nonintensive care unit compared to intensive care unit patients and in those discharged from the hospital compared to those who die. The role of serum troponin levels in predicting prognosis are compared in survivors and non-survivors. The association between COVID-19 disease and myocarditis, heart failure and coagulopathy are reviewed. Finally, an update on beneficial treatments is discussed.
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Affiliation(s)
- Francine K. Welty
- From the Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Nazanin Rajai
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maral Amangurbanova
- From the Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
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Paganelli AI, Velmovitsky PE, Miranda P, Branco A, Alencar P, Cowan D, Endler M, Morita PP. A conceptual IoT-based early-warning architecture for remote monitoring of COVID-19 patients in wards and at home. INTERNET OF THINGS (AMSTERDAM, NETHERLANDS) 2022; 18:100399. [PMID: 38620637 PMCID: PMC8023791 DOI: 10.1016/j.iot.2021.100399] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/27/2021] [Accepted: 03/29/2021] [Indexed: 05/31/2023]
Abstract
Due to the COVID-19 pandemic, health services around the globe are struggling. An effective system for monitoring patients can improve healthcare delivery by avoiding in-person contacts, enabling early-detection of severe cases, and remotely assessing patients' status. Internet of Things (IoT) technologies have been used for monitoring patients' health with wireless wearable sensors in different scenarios and medical conditions, such as noncommunicable and infectious diseases. Combining IoT-related technologies with early-warning scores (EWS) commonly utilized in infirmaries has the potential to enhance health services delivery significantly. Specifically, the NEWS-2 has been showing remarkable results in detecting the health deterioration of COVID-19 patients. Although the literature presents several approaches for remote monitoring, none of these studies proposes a customized, complete, and integrated architecture that uses an effective early-detection mechanism for COVID-19 and that is flexible enough to be used in hospital wards and at home. Therefore, this article's objective is to present a comprehensive IoT-based conceptual architecture that addresses the key requirements of scalability, interoperability, network dynamics, context discovery, reliability, and privacy in the context of remote health monitoring of COVID-19 patients in hospitals and at home. Since remote monitoring of patients at home (essential during a pandemic) can engender trust issues regarding secure and ethical data collection, a consent management module was incorporated into our architecture to provide transparency and ensure data privacy. Further, the article details mechanisms for supporting a configurable and adaptable scoring system embedded in wearable devices to increase usefulness and flexibility for health care professions working with EWS.
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Affiliation(s)
- Antonio Iyda Paganelli
- Informatics Departament, Pontifical Catholic University, Rua Marquês de São Vicente 225-Gávea, Rio de Janeiro 22541-041, Brazil
| | - Pedro Elkind Velmovitsky
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - Pedro Miranda
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - Adriano Branco
- Informatics Departament, Pontifical Catholic University, Rua Marquês de São Vicente 225-Gávea, Rio de Janeiro 22541-041, Brazil
| | - Paulo Alencar
- David R. Cheriton School of Computer Science, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - Donald Cowan
- David R. Cheriton School of Computer Science, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - Markus Endler
- Informatics Departament, Pontifical Catholic University, Rua Marquês de São Vicente 225-Gávea, Rio de Janeiro 22541-041, Brazil
| | - Plinio Pelegrini Morita
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
- Research Institute for Aging, University of Waterloo, 250 Laurelwood Drive, Waterloo, ON N2J 0E2, Canada
- Department of Systems Design Engineering, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
- eHealth Innovation, Techna Institute, University Health Network, R. Fraser Elliott Building, 4th Floor, 190 Elizabeth St, Toronto, ON M5G 2C4, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Health Sciences Building 155 College Street, 6th floor, Toronto, ON M5T 3M7, Canada
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Ahmad R, Haque M. Surviving the Storm: Cytokine Biosignature in SARS-CoV-2 Severity Prediction. Vaccines (Basel) 2022; 10:vaccines10040614. [PMID: 35455363 PMCID: PMC9026643 DOI: 10.3390/vaccines10040614] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/08/2022] [Accepted: 04/12/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary The world has been stricken mentally, physically, and economically by the COVID-19 virus. However, while SARS-CoV-2 viral infection results in mild flu-like symptoms in most patients, a number of those infected develop severe illness. These patients require hospitalization and intensive care. The severe disease can spiral downwards with eventual severe damage to the lungs and failure of multiple organs, leading to the individual’s demise. It is necessary to identify those who are developing a severe form of illness to provide early management. Therefore, it is crucial to learn about the mechanisms and chemical mediators that lead to critical conditions in SARS-CoV-2 infection. This paper reviews studies regarding the individual chemical mediators, pathways, and means that contribute to worsening health conditions in SARS-CoV-2 infection. Abstract A significant part of the world population has been affected by the devastating SARS-CoV-2 infection. It has deleterious effects on mental and physical health and global economic conditions. Evidence suggests that the pathogenesis of SARS-CoV-2 infection may result in immunopathology such as neutrophilia, lymphopenia, decreased response of type I interferon, monocyte, and macrophage dysregulation. Even though most individuals infected with the SARS-CoV-2 virus suffer mild symptoms similar to flu, severe illness develops in some cases, including dysfunction of multiple organs. Excessive production of different inflammatory cytokines leads to a cytokine storm in COVID-19 infection. The large quantities of inflammatory cytokines trigger several inflammation pathways through tissue cell and immune cell receptors. Such mechanisms eventually lead to complications such as acute respiratory distress syndrome, intravascular coagulation, capillary leak syndrome, failure of multiple organs, and, in severe cases, death. Thus, to devise an effective management plan for SARS-CoV-2 infection, it is necessary to comprehend the start and pathways of signaling for the SARS-CoV-2 infection-induced cytokine storm. This article discusses the current findings of SARS-CoV-2 related to immunopathology, the different paths of signaling and other cytokines that result in a cytokine storm, and biomarkers that can act as early signs of warning for severe illness. A detailed understanding of the cytokine storm may aid in the development of effective means for controlling the disease’s immunopathology. In addition, noting the biomarkers and pathophysiology of severe SARS-CoV-2 infection as early warning signs can help prevent severe complications.
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Affiliation(s)
- Rahnuma Ahmad
- Department of Physiology, Medical College for Women and Hospital, Plot No 4 Road 8/9, Sector-1, Dhaka 1230, Bangladesh;
| | - Mainul Haque
- Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kem Perdana Sungai Besi, Kuala Lumpur 57000, Malaysia
- Correspondence: or
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Nieto-Codesido I, Calvo-Alvarez U, Diego C, Hammouri Z, Mallah N, Ginzo-Villamayor MJ, Salgado FJ, Carreira JM, Rábade C, Barbeito G, Gonzalez-Perez MÁ, Gonzalez-Barcala FJ. Risk Factors of Mortality in Hospitalized Patients With COVID-19 Applying a Machine Learning Algorithm. OPEN RESPIRATORY ARCHIVES 2022; 4:100162. [PMID: 37497317 PMCID: PMC8818319 DOI: 10.1016/j.opresp.2022.100162] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 01/27/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Risk stratification of patients with COVID-19 can be fundamental to support clinical decision-making and optimize resources. The objective of our study is to identify among the routinely tested clinical and analytical parameters those that would allow us to determine patients with the highest risk of dying from COVID-19. Material and methods We carried out a retrospective cohort multicentric study by consecutively, including hospitalized patients with COVID-19 admitted in any of the 11 hospitals in the healthcare network of HM Hospitals-Spain. We collected the clinical, demographic, analytical, and radiological data from the patient's medical records.To assess each of the biomarkers' predictive impact and measure the statistical significance of the variables involved in the analysis, we applied a random forest with a permutation method. We used the similarity measure induced by a previously classification model and adjusted the k-groups clustering algorithm based on the energy distance to stratify patients into a high and low-risk group. Finally, we adjusted two optimal classification trees to have a schematic representation of the cut-off points. Results We included 1246 patients (average age of 65.36 years, 62% males). During the study one hundred sixty-eight patients (13%) died. High values of age, D-Dimer, White Blood Cell, Na, CRP, and creatinine represent the factors that identify high-risk patients who would die. Conclusions Age seems to be the primary predictor of mortality in patients with SARS-CoV-2 infection, while the impact of acute phase reactants and blood cellularity is also highly relevant.
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Affiliation(s)
| | - Uxio Calvo-Alvarez
- Department of Respiratory Medicine, University Hospital of Ferrol, Spain
| | - Carmen Diego
- Department of Respiratory Medicine, University Hospital of Ferrol, Spain
| | | | - Narmeen Mallah
- Department of Psychiatry, Radiology, Public Health, Nursery and Medicine, Universidad de Santiago de Compostela, Spain
| | - María José Ginzo-Villamayor
- Departamento de Estadística, Análisis Matemático y Optimización, Facultad de Matemáticas, Universidad de Santiago de Compostela, Spain
| | - Francisco Javier Salgado
- Department of Biochemistry and Molecular Biology, Faculty of Biology-Biological Research Centre (CIBUS), Universidade de Santiago de Compostela, Spain
- Translational Research In Airway Diseases Group (TRIAD)-Health Research Institute of Santiago de Compostela (FIDIS), Spain
| | - José Martín Carreira
- Department of Psychiatry, Radiology, Public Health, Nursery and Medicine, Universidad de Santiago de Compostela, Spain
| | - Carlos Rábade
- Department of Respiratory Medicine, University Hospital of Santiago de Compostela, Spain
| | - Gema Barbeito
- Microbiology Department, University Hospital of Santiago de Compostela, Spain
| | | | - Francisco Javier Gonzalez-Barcala
- Department of Psychiatry, Radiology, Public Health, Nursery and Medicine, Universidad de Santiago de Compostela, Spain
- Translational Research In Airway Diseases Group (TRIAD)-Health Research Institute of Santiago de Compostela (FIDIS), Spain
- Department of Respiratory Medicine, University Hospital of Santiago de Compostela, Spain
- Spanish Biomedical Research Networking Centre-CIBERES, Madrid, Spain
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A look back at the first wave of COVID-19 in China: A systematic review and meta-analysis of mortality and health care resource use among severe or critical patients. PLoS One 2022; 17:e0265117. [PMID: 35275943 PMCID: PMC8916647 DOI: 10.1371/journal.pone.0265117] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 02/23/2022] [Indexed: 01/08/2023] Open
Abstract
Background To investigate the mortality and health care resource use among patients with severe or critical coronavirus disease of 2019 (COVID-19) in the first wave of pandemic in China. Methods We performed a systematic review and meta-analysis to investigate the mortality, discharge rate, length of hospital stay, and use of invasive ventilation in severe or critical COVID-19 cases in China. We searched electronic databases for studies from China with no restrictions on language or interventions patients received. We screened records, extracted data and assessed the quality of included studies in duplicate. We performed the meta-analysis using random-effect models through a Bayesian framework. Subgroup analyses were conducted to examine studies by disease severity, study location and patient enrolment start date. We also performed sensitivity analysis using various priors, and assessed between-study heterogeneity and publication bias for the primary outcomes. Results Out of 6,205 titles and abstracts screened, 500 were reviewed in full text. A total of 42 studies were included in the review, of which 95% were observational studies (n = 40). The pooled 28-day and 14-day mortalities among severe or critical patients were 20.48% (7,136 patients, 95% credible interval (CrI), 13.11 to 30.70) and 10.83% (95% CrI, 6.78 to 16.75), respectively. The mortality declined over time and was higher in patients with critical disease than severe cases (1,235 patients, 45.73%, 95% CrI, 22.79 to 73.52 vs. 3,969 patients, 14.90%, 95% CrI, 4.70 to 39.57) and patients in Hubei compared to those outside Hubei (6,719 patients, 26.62%, 95% CrI, 13.11 to 30.70 vs. 244 patients, 5.88%, 95% CrI 2.03 to 14.11). The length of hospital stay was estimated at 18.48 days (6,847 patients, 95% CrI, 17.59 to 21.21), the 28-day discharge rate was 50.48% (3,645 patients, 95% CrI, 26.47 to 79.53), and the use of invasive ventilation rate was 13.46% (4,108 patients, 95% CrI, 7.61 to 22.31). Conclusions Our systematic review and meta-analysis found high mortality among severe and critical COVID-19 cases. Severe or critical COVID-19 cases consumed a large amount of hospital resources during the outbreak.
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Milenkovic M, Hadzibegovic A, Kovac M, Jovanovic B, Stanisavljevic J, Djikic M, Sijan D, Ladjevic N, Palibrk I, Djukanovic M, Velickovic J, Ratkovic S, Brajkovic M, Popadic V, Klasnja S, Toskovic B, Zdravkovic D, Crnokrak B, Markovic O, Bjekic-Macut J, Aleksic A, Petricevic S, Memon L, Milojevic A, Zdravkovic M. D-dimer, CRP, PCT, and IL-6 Levels at Admission to ICU Can Predict In-Hospital Mortality in Patients with COVID-19 Pneumonia. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:8997709. [PMID: 35237386 PMCID: PMC8884120 DOI: 10.1155/2022/8997709] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 01/31/2022] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Health care workers have had a challenging task since the COVID-19 outbreak. Prompt and effective predictors of clinical outcomes are crucial to recognize potentially critically ill patients and improve the management of COVID-19 patients. The aim of this study was to identify potential predictors of clinical outcomes in critically ill COVID-19 patients. METHODS The study was designed as a retrospective cohort study, which included 318 patients treated from June 2020 to January 2021 in the Intensive Care Unit (ICU) of the Clinical Hospital Center "Bezanijska Kosa" in Belgrade, Serbia. The verified diagnosis of COVID-19 disease, patients over 18 years of age, and the hospitalization in ICU were the criteria for inclusion in the study. The optimal cutoff value of D-dimer, CRP, IL-6, and PCT for predicting hospital mortality was determined using the ROC curve, while the Kaplan-Meier method and log-rank test were used to assess survival. RESULTS The study included 318 patients: 219 (68.9%) were male and 99 (31.1%) female. The median age of patients was 69 (60-77) years. During the treatment, 195 (61.3%) patients died, thereof 130 male (66.7%) and 65 female (33.3%). 123 (38.7%) patients were discharged from hospital treatment. The cutoff value of IL-6 for in-hospital death prediction was 74.98 pg/mL (Sn 69.7%, Sp 62.7%); cutoff value of CRP was 81 mg/L (Sn 60.7%, Sp 60%); cutoff value of procalcitonin was 0.56 ng/mL (Sn 81.1%, Sp 76%); and cutoff value of D-dimer was 760 ng/mL FEU (Sn 63.4%, Sp 57.1%). IL-6 ≥ 74.98 pg/mL, CRP ≥ 81 mg/L, PCT ≥ 0.56 ng/mL, and D-dimer ≥ 760 ng/mL were statistically significant predictors of in-hospital mortality. CONCLUSION IL-6 ≥ 74.98 pg/mL, CRP values ≥ 81 mg/L, procalcitonin ≥ 0.56 ng/mL, and D-dimer ≥ 760 ng/mL could effectively predict in-hospital mortality in COVID-19 patients.
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Affiliation(s)
- Marija Milenkovic
- University Clinical Centre of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Mirjana Kovac
- Blood Transfusion Institute of Serbia, Belgrade, Serbia
| | - Bojan Jovanovic
- University Clinical Centre of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Jovana Stanisavljevic
- University Clinical Centre of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marina Djikic
- University Clinical Centre of Serbia, Belgrade, Serbia
| | - Djuro Sijan
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Nebojsa Ladjevic
- University Clinical Centre of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ivan Palibrk
- University Clinical Centre of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marija Djukanovic
- University Clinical Centre of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Jelena Velickovic
- University Clinical Centre of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Sanja Ratkovic
- University Clinical Centre of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milica Brajkovic
- University Clinical Hospital Center Bezanijska Kosa, Belgrade, Serbia
| | - Viseslav Popadic
- University Clinical Hospital Center Bezanijska Kosa, Belgrade, Serbia
| | - Slobodan Klasnja
- University Clinical Hospital Center Bezanijska Kosa, Belgrade, Serbia
| | - Borislav Toskovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- University Clinical Hospital Center Bezanijska Kosa, Belgrade, Serbia
| | - Darko Zdravkovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- University Clinical Hospital Center Bezanijska Kosa, Belgrade, Serbia
| | - Bogdan Crnokrak
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- University Clinical Hospital Center Bezanijska Kosa, Belgrade, Serbia
| | - Olivera Markovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- University Clinical Hospital Center Bezanijska Kosa, Belgrade, Serbia
| | - Jelica Bjekic-Macut
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- University Clinical Hospital Center Bezanijska Kosa, Belgrade, Serbia
| | | | - Simona Petricevic
- University Clinical Hospital Center Bezanijska Kosa, Belgrade, Serbia
| | - Lidija Memon
- University Clinical Hospital Center Bezanijska Kosa, Belgrade, Serbia
| | - Ana Milojevic
- University Clinical Hospital Center Bezanijska Kosa, Belgrade, Serbia
| | - Marija Zdravkovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- University Clinical Hospital Center Bezanijska Kosa, Belgrade, Serbia
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Levenfus I, Ullmann E, Petrowski K, Rose J, Huber LC, Stüssi-Helbling M, Schuurmans MM. The AIFELL Score as a Predictor of Coronavirus Disease 2019 (COVID-19) Severity and Progression in Hospitalized Patients. Diagnostics (Basel) 2022; 12:diagnostics12030604. [PMID: 35328157 PMCID: PMC8947178 DOI: 10.3390/diagnostics12030604] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/16/2022] [Accepted: 02/23/2022] [Indexed: 11/16/2022] Open
Abstract
Since the beginning of the COVID-19 pandemic, SARS-CoV-2 has caused a global burden for health care systems due to high morbidity and mortality rates, leading to caseloads that episodically surpass hospital resources. Due to different disease manifestations, the triage of patients at high risk for a poor outcome continues to be a major challenge for clinicians. The AIFELL score was developed as a simple decision instrument for emergency rooms to distinguish COVID-19 patients in severe disease stages from less severe COVID-19 and non-COVID-19 cases. In the present study, we aimed to evaluate the AIFELL score as a prediction tool for clinical deterioration and disease severity in hospitalized COVID-19 patients. During the second wave of the COVID-19 pandemic in Switzerland, we analyzed consecutively hospitalized patients at the Triemli Hospital Zurich from the end of November 2020 until mid-February 2021. Statistical analyses were performed for group comparisons and to evaluate significance. AIFELL scores of patients developing severe COVID-19 stages IIb and III during hospitalization were significantly higher upon admission compared to those patients not surpassing stages I and IIa. Group comparisons indicated significantly different AIFELL scores between each stage. In conclusion, the AIFELL score at admission was useful to predict the disease severity and progression in hospitalized COVID-19 patients.
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Affiliation(s)
- Ian Levenfus
- Department of Pulmonology, University Hospital Zurich, 8091 Zurich, Switzerland;
- Faculty of Medicine, University of Zurich, 8032 Zurich, Switzerland
- Correspondence: or
| | - Enrico Ullmann
- Department of Medicine, Technical University Dresden, 01307 Dresden, Germany;
- Department of Pediatric Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig Medical Center, 04103 Leipzig, Germany
- Department of Medical Biology, South Ural State University, 454080 Chelyabinsk, Russia
| | - Katja Petrowski
- Medical Psychology and Sociology, Johannes Gutenberg University Mainz, 55131 Mainz, Germany;
| | - Jutta Rose
- Clinic for Internal Medicine, Department of Internal Medicine, City Hospital Zurich Triemli, 8063 Zurich, Switzerland; (J.R.); (L.C.H.); (M.S.-H.)
| | - Lars C. Huber
- Clinic for Internal Medicine, Department of Internal Medicine, City Hospital Zurich Triemli, 8063 Zurich, Switzerland; (J.R.); (L.C.H.); (M.S.-H.)
| | - Melina Stüssi-Helbling
- Clinic for Internal Medicine, Department of Internal Medicine, City Hospital Zurich Triemli, 8063 Zurich, Switzerland; (J.R.); (L.C.H.); (M.S.-H.)
| | - Macé M. Schuurmans
- Department of Pulmonology, University Hospital Zurich, 8091 Zurich, Switzerland;
- Faculty of Medicine, University of Zurich, 8032 Zurich, Switzerland
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Fabião J, Sassi B, Pedrollo E, Gerchman F, Kramer C, Leitão C, Pinto L. Why do men have worse COVID-19-related outcomes? A systematic review and meta-analysis with sex adjusted for age. Braz J Med Biol Res 2022; 55:e11711. [PMID: 35195196 PMCID: PMC8856598 DOI: 10.1590/1414-431x2021e11711] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 11/19/2021] [Indexed: 01/09/2023] Open
Abstract
We aimed to study the mechanism behind worse coronavirus disease-19 (COVID-19) outcomes in men and whether the differences between sexes regarding mortality as well as disease severity are influenced by sex hormones. To do so, we used age as a covariate in the meta-regression and subgroup analyses. This was a systematic search and meta-analysis of observational cohorts reporting COVID-19 outcomes. The PubMed (Medline) and Cochrane Library databases were searched. The primary outcome was COVID-19-associated mortality and the secondary outcome was COVID-19 severity. The study was registered at PROSPERO: 42020182924. For mortality, men had a relative risk of 1.36 (95%CI: 1.17 to 1.59; I2 63%, P for heterogeneity <0.01) compared to women. Age was not a significant covariate in meta-analysis heterogeneity (P=0.393) or subgroup analysis. For disease severity, being male was associated with a relative risk of 1.29 (95%CI: 1.19 to 1.40; I2 48%, P for heterogeneity <0.01) compared to the relative risk of women. Again, age did not influence the outcomes of the meta-regression (P=0.914) or subgroup analysis. Men had a higher risk of COVID-19 mortality and severity regardless of age, decreasing the odds of hormonal influences in the described outcomes.
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Affiliation(s)
- J. Fabião
- Divisão de Medicina Interna, Hospital Nossa Senhora da
Conceição, Porto Alegre, RS, Brasil
| | - B. Sassi
- Divisão de Medicina Interna, Hospital Nossa Senhora da
Conceição, Porto Alegre, RS, Brasil
| | - E.F. Pedrollo
- Programa de Pós-Graduação em Ciências Médicas: Endocrinologia,
Divisão de Endocrinologia, Hospital de Clínicas de Porto Alegre, Universidade
Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - F. Gerchman
- Programa de Pós-Graduação em Ciências Médicas: Endocrinologia,
Divisão de Endocrinologia, Hospital de Clínicas de Porto Alegre, Universidade
Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - C.K. Kramer
- Mount Sinai Hospital, University of Toronto, Toronto, Ontario,
Canada
| | - C.B. Leitão
- Programa de Pós-Graduação em Ciências Médicas: Endocrinologia,
Divisão de Endocrinologia, Hospital de Clínicas de Porto Alegre, Universidade
Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - L.C. Pinto
- Divisão de Medicina Interna, Hospital Nossa Senhora da
Conceição, Porto Alegre, RS, Brasil
- Programa de Pós-Graduação em Ciências Médicas: Endocrinologia,
Divisão de Endocrinologia, Hospital de Clínicas de Porto Alegre, Universidade
Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
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Chandra A, Johri A. A Peek into Pandora’s Box: COVID-19 and Neurodegeneration. Brain Sci 2022; 12:brainsci12020190. [PMID: 35203953 PMCID: PMC8870638 DOI: 10.3390/brainsci12020190] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 01/27/2022] [Accepted: 01/28/2022] [Indexed: 02/07/2023] Open
Abstract
Ever since it was first reported in Wuhan, China, the coronavirus-induced disease of 2019 (COVID-19) has become an enigma of sorts with ever expanding reports of direct and indirect effects of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on almost all the vital organ systems. Along with inciting acute pulmonary complications, the virus attacks the cardiac, renal, hepatic, and gastrointestinal systems as well as the central nervous system (CNS). The person-to-person variability in susceptibility of individuals to disease severity still remains a puzzle, although the comorbidities and the age/gender of a person are believed to play a key role. SARS-CoV-2 needs angiotensin-converting enzyme 2 (ACE2) receptor for its infectivity, and the association between SARS-CoV-2 and ACE2 leads to a decline in ACE2 activity and its neuroprotective effects. Acute respiratory distress may also induce hypoxia, leading to increased oxidative stress and neurodegeneration. Infection of the neurons along with peripheral leukocytes’ activation results in proinflammatory cytokine release, rendering the brain more susceptible to neurodegenerative changes. Due to the advancement in molecular biology techniques and vaccine development programs, the world now has hope to relatively quickly study and combat the deadly virus. On the other side, however, the virus seems to be still evolving with new variants being discovered periodically. In keeping up with the pace of this virus, there has been an avalanche of studies. This review provides an update on the recent progress in adjudicating the CNS-related mechanisms of SARS-CoV-2 infection and its potential to incite or accelerate neurodegeneration in surviving patients. Current as well as emerging therapeutic opportunities and biomarker development are highlighted.
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50
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Nasir Kansestani A, Zare ME, Zhang J. Prognostic Accuracy of Cardiovascular Disease Biomarkers in Patients with COVID-19: A Diagnostic Test Accuracy Meta-Analysis. J Tehran Heart Cent 2022; 16:1-14. [PMID: 35082861 PMCID: PMC8728863 DOI: 10.18502/jthc.v16i1.6594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/18/2020] [Indexed: 12/02/2022] Open
Abstract
Background: Several reports have determined that cardiovascular diseases (CVDs) are common complications in patients with coronavirus disease 2019 (COVID-19) and lead them to poor outcomes. CVD biomarkers have, thus, great potential to be used as prognostic biomarkers. We aimed to determine the accuracy of CVD biomarkers for the prognosis of the COVID-19 patient’s outcome via a diagnostic test accuracy (DTA) meta-analysis. Methods: Until September 30, 2020, we searched Web of Sciences, Scopus, and MEDLINE/PubMed databases to obtain related papers. The summary points and lines were calculated using bivariate/HSROC model. As outcomes, we considered critical conditions and mortality. Results: A total of 17 659 patients from 33 studies were included. Five biomarkers, namely increased levels of lactate dehydrogenase (LDH), cardiac troponin I (cTnI), creatine kinase (CK), D-dimer, and thrombocytopenia, met the inclusion criteria. Our results indicated that LDH and cTnI had good accuracy for the prognosis of critical condition (AUCHSROC=0.83 and 0.80, respectively), while LDH, cTnI, and D-dimer had acceptable accuracy (AUCHSROC=0.74, 0.71, and 0.72, respectively) for the prognosis of mortality. LDH and D-dimer had high sensitivity, whereas cTnI had high specificity. The other biomarkers did not have acceptable accuracy. Significant publication bias was found for D-dimer (P=0.053). Conclusion: Among CVD biomarkers, LDH and cTnI had good accuracy for the prognosis of critical outcomes and acceptable accuracy for the prognosis of mortality, without publication bias. Given their different sensitivities and specificities, we recommend the use of these 2 biomarkers concomitantly.
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Affiliation(s)
- Atefeh Nasir Kansestani
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Erfan Zare
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Jun Zhang
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
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