ABSTRACT
COVID-19 continues to strain healthcare systems around the globe. Research has shown a relationship between COVID-19 and an inflammatory response, including neuropathological outcomes. Additionally, studies have shown positive effects of engagement with music on inflammatory responses;music may have potential, as a method, to reduce inflammation triggered by COVID-19. This review compiles exhaustive research from multiple disciplines to account for this possibility. The authors utilized a meta-narrative approach to complete this review. The search was conducted using PubMed, Embase, OneSearch, Primo, Google Scholar, Clinicaltrials.gov, and the bibliographies of relevant articles. In total, 84 articles were included for full-text review, discussion, and analysis. Articles pertaining to music and acoustics encompassed a date range from 1964–2020. Articles referencing COVID-19 spanned the years 2019–2021. This work focused on associations between engagement with music, stress response, blood-brain barrier integrity, inflammation, COVID-19, and neuropathology in preclinical and clinical models. Detailed analysis revealed that engagement with music has the potential to reduce the harmful effects of COVID-19, particularly in the inflammation and blood clotting pathways associated with a range of pathophysiological and neuropathological issues. Further work is warranted to standardize and validate existing methods associating positive effects of engagement with music on the negative effects of COVID-19. © The Author(s) 2023.
ABSTRACT
BACKGROUND: Blood coagulation alterations are frequent in patients with Coronavirus disease 2019 (COVID-19), particularly in those with severe forms. We investigated the association between standard parameters of coagulation and in-hospital mortality in COVID-19. METHODS: Demographic, clinical and laboratory data at hospital admission, including prothrombin time (PT), international normalized rate (INR), activated thromboplastin time (aPTT), and D-dimer were retrospectively collected in a consecutive series of 309 COVID-19 hospitalized patients. The associations between parameters of coagulation and in-hospital mortality were investigated with receiver operating characteristics (ROC), multiple regression and Kaplan- Meyer analyses. RESULTS: In the overall population, 220 (71.2%) patients were discharged alive, whereas the remaining 89 (28.8%) died. Non-survivors had significantly higher INR (median: 1.20;IQR: 1.03-1.32 vs. 1.06;IQR: 1.02-1.11, P<0.001), PT (median: 12.0 sec;IQR: 11.1-14.0 vs. 11.4 sec;IQR: 11.0-11.9, P<0.001), aPTT (median: 25.1 sec;IQR: 22.7-29.6 vs. 23.4 sec;IQR: 21.4-25.1, P<0.001) and D-dimer (median: 1.36 μg/mL;IQR: 0.87-4.11 vs. 0.77 μg/mL;IQR: 0.43-1.58, P<0.001). In multivariate Cox regression analysis, both the INR (HR=1.8459;95% CI: 1.0713-3.1806, P=0.027) and PT (HR=1.071;95% CI: 1.0132-1.1303, P=0.015), but not the aPTT and D-dimer, remained independently associated with survival. CONCLUSIONS: Both the PTand INRare independently associated with in-hospital mortality in COVID-19. The clinical utility of these parameters for risk stratification warrants further investigations.