ABSTRACT
Smell dysfunction is one of the most frequent symptoms in COVID-19 patients. In the early stages of the disease it allows to identify positive subjects. The odorous substances recognize two different systems in the olfactory epithelium: the olfactory and the trigeminal systems that coexist and interact in the processing of sensory information. In COVID-19 patients there is an inflammatory reaction of the nasal mucosa. Infected supporting cells of the nasal mucosa release molecules that activate the local antiviral innate immune response. In fact, macrophages spread inflammatory mediators, in particular TNF-η , IL-6 and IL-1. In this study we compared IL-6 levels with the degree of olfactory disorders and with the type of unperceived odour.Materials and methodsFrom 15 March to 30 November 2020 have been selected 82 patients (45 men age 62.3 ±14.2 and 37 women age 57.1± 12.8) with only smell dysfunctions were divided into mild and moderate patients. The evaluation of the smell disorder was carried out with a 14 questionnaire relating to the perception of domestic odorous: 6 questions for olfactory sensitivity (own perfume usually sprayed, oregano, olive oil, nutella, coffee aroma, orange juice) and 8 for olfactory-trigeminal sensitivity (alcohol, fish odor, vinegar, mint (gum), toothpaste, shampoo, cheese, ammonia).The IL-6 (v.n. 0 - 7 pg/ml) was measured with chemiluminescence assay using Cobas e801 (Roche Instrumentation). Statistical analyses were performed with Wilcoxon Rank test, and Mann-Whitney test (p <0.05). ResultsThe trigeminal and olfactory sensitivity are more compromised in moderate than mild patients (p <0.05). The statistically significant differences there were in IL6 levels in moderate versus mild patients when there was an impairment of trigeminal sensitivity (p <0.05). Conclusion In this study suggested that the smell disorders in Covid-19 patients couldn't be a deficit of the olfactory central nervous pathways but could be rather than mainly associated with the inflammatory process of the nasal mucosa and that deficit of the type of domestic unperceived odour ('olfactory' or 'trigeminal' sensitivity) could indicate the degree of severity of the disease.
ABSTRACT
Purpose of the study: During the emergency period Covid-19 the glycosilate hemoglobin has been required for patients admitted to specialist wards suitable for metabolic control in diabetics and non-diabetics. Material and methods: The test HbA1c has been performed on Variant II Biorad, calibrated with standard Biorad for glycate hemoglobin, using EDTA whole blood samples after running two-tier Biorad controls. Results: The patients have been studied in the wave of coronavirus infection corresponding to the two months of loackdown. Thirty patients that have been hospitalized in covid area have been tested in our laboratory . In 12 females and 6 males with average age 50 years old the HbA1c has been resulted in the limits (up to 42 mmoli/moles) and in 10 patients ( 6 females and 4 males average age 48 years old ) higher values ( between 51 and 79 mmoli/molioli ) have been found. The patients have been so followed for the care of the case. Discussion and conclusion: Thus it has been possible to discern among patients with comorbidity and patients with lower degree of exposure to risks because in return to metabolic improvement and it has been possible to collaborate for the health of the sicks.
ABSTRACT
Background and aim: Coronavirus disease 2019 (COVID-19) is a systemic illness, that recognizes the throat and nose as a gateway, due to Coronavirus 2 (SARS-CoV-2). In the lower respiratory tract, it is responsible of interstitial pneumonia developing into a severe acute respiratory distress syndrome. Human Epididymis Protein 4 (HE4) is present in many normal human tissues but also in the affected tissue of the SARSCoV-2 (oral cavity tissue, nasopharynx, respiratory tract). Many studies have shown the presence of HE4 in the lining fluid of the airway surface, secreted by the submucous glands. Its function is not fully clarified but HE4 seems to play an important role in the immune defense. Instead, in the bloodstream of COVID-19 patients, Interleukin 6 (IL-6) is the main inflammatory cytokine with a key role in the inflammatory storm (cytokine release syndrome, CRS) that accompanies the clinical onset of COVID-19 and thus represents a valid biomarker of the acute phase. Aim of this study was to evaluate the correlation between HE4 and IL-6 concentrations in patients with laboratory-confirmed COVID-19. Methods: 190 patients with laboratory-confirmed COVID-19 (115 males-median age 65y, and 75 female-median age 67y) were recruited (between March and May 2020). Patients did not require intensive care admission and they had no diagnosis of ovaric tumor, lung tumor and renal and/or lung fibrosis. HE4 (pmol/L) and IL-6 (pg/mL) were measured using chemiluminescence method by Architect i1000SR (Abbott) and Cobas e8100 (Roche) respectively in three consecutive days. Statistical analysis was obtained using MedCalc software and a p-value threshold of 5% was adopted. Results: Linear regression line: Y=11,87(x) + 78,16;intercept 11,87 (95% CI=7,22 to 16,21;P<0,05);slope=78,16 (95% CI=34,41 to 96,22;P<0,05). Pearson correlation coefficient: R=0.58 (95% CI=0,25 to 0,66;P<0,05) shows a statistically significant correlation. Conclusions: Based on our results, HE4 could play an important role in the inflammatory response in COVID-19 patients and it could be used as a potential biomarker with IL-6 in the management of patient COVID-19. Further studies are needed to confirm the usefulness of the HE4 assay and to better explain its possible role in the immune response.