Diagnosis of COVID-19 in Patients with Acute Pulmonary Embolism.

Acute pulmonary embolism (PE) and coronavirus disease -2019 (COVID-19) are life-threatening diseases associated with significant morbidity and mortality. Yet little is known about their co-existence.This study explored clinical and laboratory differences between PE patients who tested positive with real-time reverse-transcription polymerase chain reaction (PCR+) and those who tested negative (PCR-) for SARS-CoV-2. Also, to determine whether ferritin D-dimer ratio (FDR) and platelet D-dimer ratio (PDR) can be used to predict COVID-19 in patients with PE. Files of 556 patients who underwent a computed tomography pulmonary angography (CTPA) examination were retrospectively investigated. Out of them, 197 were tested positive and 188 negative for SARS-CoV-2. One hundred thirteen patients (57.36%) in the PCR+ group and 113 (60.11%) in the PCR- group had a diagnosis of PE. Complaints, respiratory rate, and oxygen saturation level in the blood (SpO2) were recorded at the first admission. Monocyte and eosinophil levels remained low, whereas FDR and PDR were higher in the PCR+ group. No difference was detected in ferritin, D-dimer levels, comorbidities, SpO2, and death rates between the two groups. Cough, fever, joint pain, and higher respiratory rate were more common in the PCR+ group. A decrease in white blood cell, monocyte, and eosinophil levels, whereas an increase in FDR and PDR levels may predict COVID-19 in patients with PE. PE patients complaining of cough, fever, and fatigue should undergo PCR testing as common symptoms. COVID-19 does not seem to increase the risk of mortality in patients with PE.

Eosinophil Levels, Neutrophil-Lymphocyte Ratio, and Platelet-Lymphocyte Ratio in the Cytokine Storm Period of Patients with COVID-19.

Background: In the early stages of the COVID-19 pandemic, elevated inflammatory cytokine levels, particularly interleukin-6 (IL-6), were detected in patients with cytokine storm (CS). Aims: This study aimed to investigate levels, diagnostic usefulness, and optimal cutoff values of monocyte, eosinophil, neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) in CS of patients with COVID-19 and also to identify risk factors for mortality. Methods: Seventy-six patients with COVID-19 who developed CS and randomly chosen 150 COVID-19 patients who had no CS during their stay in the hospital were included in the study. Results: Lymphocytes and eosinophil levels remained lower in the CS group. Patients with low lymphocyte levels had a higher risk for mortality (OR: 1.92). Neutrophil, D-dimer, ferritin, IL-6, NLR, and PLR were higher in the CS group. High levels of neutrophil, ferritin, D-dimer, and NLR and a history of coronary artery disease (CAD) and diabetes mellitus (DM) were identified as independent risk factors for mortality. Conclusion: In the light of the obtained results, COVID-19 patients with a decrease in lymphocyte levels and an increase in NLR and D-dimer levels and a history of CAD and DM have a higher risk of cytokine storm and mortality.

Clinical and Laboratory Differences between Delta and UK Variants of SARS-CoV-2: B.1.617.2 and B.1.1.7.

At the end of 2019, the world met with the coronavirus disease 2019 (COVID-19), which will affect all humanity. Later in the course, the genetic variants of SARS-CoV-2 have emerged, bringing new questions and concerns. This study investigated differences between patients infected with the B.1.1.7 (UK variant) and the B.1.617.2 (Delta variant) regarding patient complaints, intensive care unit (ICU) admission and stay time, intubation, severe disease, mortality rates, and laboratory parameters. Hospitalized 205 patients infected with B.1.1.7 and 207 patients infected with B.1.617.2 were included in the study. Laboratory parameters, admission complaints, and the percent saturation of oxygen in the blood (SpO2) were recorded on the same day as the diagnosis and clinical findings during their follow-up. Cough and fever were more common complaints in the B.1.1.7 infected group, whereas tiredness, joint pain, and gastrointestinal complaints were more frequent in patients infected with B.1.617.2. The B.1.617.2 infected group had higher severe disease, acute coronary syndrome (ACS), mortality rates, neutrophil, troponin, and ferritin levels. In conclusion, patients infected with B.1.617.2 had a higher risk of intubation, ACS, and mortality rates. Cough and fever were more common in B.1.1.7 infected group, whereas tiredness was more frequent in B.1.617.2 infected group. Vaccination with at least one dose of Pfizer-BioNTech or CoronaVac is independently associated with a decreased mortality risk caused by two variants (Odds Ratio 0.4).

Recruitment: A Problem of Entangled Temporal Parts.

Recruitment is a pervasive activity of life that is at the center of novelty generation and persistence. Without recruitment, novelties cannot spread and biological systems cannot maintain identity through time. Here we explore the problem of identity and change unfolding in space and time. We illustrate recruitment operating at different timescales with metabolic networks, protein domain makeup, the functionome, and the rise of viral 'variants of concern' during the coronavirus disease 2019 (COVID-19) pandemic. We define persistence within a framework of fluxes of matter-energy and information and signal processing in response to internal and external challenges. A 'triangle of persistence' describing reuse, innovation and stasis defines a useful polytope in a phase space of trade-offs between economy, flexibility and robustness. We illustrate how the concept of temporal parts embraced by the perdurantist school provides a processual 4-dimensional 'worm' view of biology that is historical and atemporal. This view is made explicit with chronologies and evolving networks inferred with phylogenomic methodologies. Exploring the origin and evolution of the ribosome reveals recruitment of helical segments and/or large fragments of interacting rRNA molecules in a unification process of accretion that is counteracted by diversification. A biphasic (bow-tie) theory of module generation models this frustrated dynamics. Finally, we further elaborate on a theory of entanglement that takes advantage of the dimensionality reduction offered by holographic principles to propose that short and long-distance interactions are responsible for the increasingly granular and tangled structure of biological systems.