ABSTRACT
Objectives@#This study determined the baseline hormonal levels of the hypothalamic-pituitary-adrenal axis and their associated factors in noncritically ill hospitalized patients with coronavirus disease 2019 (COVID-19).@*Methodology@#This cross-sectional observational study was carried out in 91 noncritical RT-PCR-confirmed COVID-19 patients (18-65 years) recruited consecutively from the COVID unit, of two tertiary care hospitals over a period of six months. After screening for exclusion criteria relevant history and physical examinations were done, and blood was drawn between 07:00 am to 09:00 am in a fasting state to measure serum cortisol and plasma adrenocorticotropic hormone (ACTH) by chemiluminescent microparticle immunoassay.@*Result@#Of 91 patients, 54, 26, and 11 had mild, moderate, and severe disease respectively. Median values of serum cortisol (p=0.057) and plasma ACTH (p=0.910) were statistically similar among the severity groups. Considering cortisol cut-off of 276 nmol/L (<10 μg/dL), the highest percent of adrenal insufficiency was present in severe (27.3%), followed by mild (25.9%) and least in moderate (3.8%) COVID-19 cases. Using the cortisol/ACTH ratio >15, only 6.6% had enough reserve.@*Conclusions@#The adrenocortical response was compromised in a significant percentage of noncritically ill hospitalized patients with COVID-19, which is unrelated to infection severity, with greater percentages present in severely infected cases.
Subject(s)
Hydrocortisone , Adrenocorticotropic Hormone , SARS-CoV-2 , COVID-19ABSTRACT
The study was carried out to evaluate the role of serum eosinophil cationic protein [ECP] as a biological marker for the diagnosis and to assess the severity of bronchial asthma. This observational cross-sectional study was conducted among 70 bronchial asthma patients and 45 disease controls [tuberculosis-15, chronic obstructive pulmonary disease-15, interstitial lung disease-15] enrolled from patients attending the outpatient department of the National Institute of Disease of the Chest and Hospital [NIDCH], Dhaka, Bangladesh during July 2010 to June 2011. Global Initiative of Asthma Management and Prevention [GINA] criteria were followed for selection of both atopic and non-atopic patients with intermittent or persistent [mild, moderate and severe] asthma. Serum level of eosinophil cationic protein [ECP], IgE, forced expiratory volume in 1 second [FEV[1]% predicted] and circulatory eosinophil [CE] count were estimated. Mean serum ECP level [28.8 +/- 42.9 vs. 6.82 +/- 3.5 ng/mL; P < 0.001], IgE level [383.59 +/- 225.3 vs. 135 +/- 131.8 IU/mL; P < 0.001] and percent circulatory eosinophil count [9.95 +/- 3.7 vs. 5.95 +/- 1.4; P < 0.024] were all found significantly raised among asthma patients than disease controls but%FEV[1] was equivocal. All grades of persistent asthma patients had significantly [P < 0.025 and P < 0.002] higher mean ECP level than intermittent cases but serum IgE level and CE count did not differ significantly. FEV[1]% predicted correlated well among moderate and severe persistent asthma but was equivocal for intermittent and mild persistent cases. This study has reinforced that serum eosinophil cationic protein is a dependable biological marker with more discriminatory power over other indicators for bronchial asthma and to assess its severity