ABSTRACT
Background: COVID-19 is highly heterogeneous;it ranges from asymptomatic to severe pneumonia that could progress to critical illness with hypoxemic respiratory failure requiring oxygenation, ventilator support or even death. This aim of the present study is to examine the effect of adding colchicine to standard of care in treatment of severely hypoxemic hospitalized COVID-19 patients on patients' 28 days discharge. Patients and Methods: This was a retrospective, single-centre cohort study to evaluate the effect of colchicine in the treatment of COVID-19 patients on 28 days discharge and mortality. Out of 201 patients, 153 patients, suspected and confirmed COVID-19, was included from Shebin Elkom Fever Hospital, Monofya Governorate, Egypt, from November 2020, to January 2021. Results: Among 201 patients enrolled, 153 (87.5%) patients were included in this study, and divided into two cohorts;78 patients (51%) in the non-colchicine group and 75 (49%) patients in the colchicine group. Among the 76 patients who were discharged within 28 days, 56 patients (74.67%) were in the colchicine group and 20 patients (25.64%) were in the non-colchicine group. Regarding 28-day mortality was, 77 patients died in the two groups during the 28 days from hospital admission;19 patients (23.68%) died in the colchicine group and 58 (76.32%) in the non-colchicine group (OR 0.01, 95% CI: 0.001-0.10, p-value 0.000). Conclusion: Colchicine exerts an anti-inflammatory effect that has a great impact on decreasing oxygen demand and ICU admission compared to the non-colchicine arm. © 2022, Ain Shams University Faculty of Medicine. All rights reserved.
ABSTRACT
Background: Pancreatic involvement in patients with Coronavirus 2019 (COVID-19) has been reported in the literature. The pancreatic injury in COVID-19 patients might be a result of the direct cytopathic effect of viral replication or indirectly related to the immune response to the viral infection. Methods:Westudied 183 patients diagnosed with symptomatic SARS-CoV-2 and admitted to COVID-19 facilities in Qatar. We included only the patients with documented positive SARS-COV-2 PCR and measured lipase levels. The cohort was categorized into two groups based on the serum lipase level. The cutoff was the elevation of the serum lipase more than three times the upper limit of normal. Patients with lipase levels below the cutoff were included in the first group, and those with lipase levels above the cutoff were included in the second group. The primary outcome was mortality. The secondary outcomes were disease severity on presentation and markers of disease progression. Markers of disease progression (Table 1) included the development of acute respiratory distress syndrome (ARDS), shock, multi-organ failure, the requirement for ICU admission, mechanical ventilation, continuous renal replacement therapy (CRRT), and extracorporeal membrane oxygenation (ECMO). Results: Our study population had a mean age of 49 and a mean BMI of 28. There was a male predominance in the study sample (more than 91%), reflecting the country's demographics. There was no statistically significant difference between the two groups in the mean age, BMI, gender distribution, or patients' reported symptoms. There was an increased prevalence of diabetes mellitus (DM) and hypertension (HTN) in our study population (45.4% and 44.8%). Apart from the increased prevalence of chronic liver disease in the second group, there was no statistically significant difference in the prevalence of comorbidities (e.g., DM, HTN) between the two groups (Table 1). The second group showed a statistically significant increase in mean creatinine, troponin, procalcitonin, ferritin, and amylase compared to the first group. On the other hand, the mean hemoglobin, sodium and albumin were lower (Table 2). Interestingly, more patients in the second group received tocilizumab and oseltamivir (Table 1). The mortality rate in our study population was 15.3%, with a higher mortality rate in the second group (Table 1). Almost 50% of the patients developed ARDS. Multiple markers of disease progression, including the development of ARDS, shock, and multi-organ failure;requirement for ICU, mechanical ventilation, and CRRT were increased in the second group compared to the first group. Also, the mean length of stay was higher in the second group (Table 1). Conclusion: Based on our study, hospitalized patients with COVID-19 who had higher lipase levels had a higher mortality rate and higher risk for disease progression. (Table Presented)