ABSTRACT
Objective: Since the identification and spread of the novel coronavirus disease 2019 (COVID-19) in December 2019, respiratory presentations have been introduced as the main symptoms of this new type of viral disease;however, the extra-pulmonary features are raising awareness for researchers due to the vast diversity of vital organs affected by the virus. Among the wide range of clinical manifestations, limited data are available regarding rhabdomyolysis (RML) in COVID-19. Case Presentation: In this report, we present a 58-year-old woman with COVID-19 presenting with RML, with extremely elevated creatinine phosphokinase (CPK) and lactate dehydrogenase (LDH) levels (3283 and 1280 U/L, respectively) as the second sign of disease. Since the onset of the COVID-19 pandemic, several COVID-19 induced RML cases have been reported, and timely diagnosis and proper management are of paramount importance. Conclusion: Due to the findings that rhabdomyolysis can be a critical and missed cause of myalgia in COVID-19 patients, the importance of checking the serum level of CPK in patients with myalgia and fatigue in the era of COVID-19 upon their arrival will be highlighted. © 2023 The Author(s).
ABSTRACT
During the coronavirus disease-2019 (COVID-19) pandemic, which was caused by the novel coronavirus, there is an ongoing controversy about the use of corticosteroids. This study aims to investigate the association between Dexamethasone treatment and clinical outcomes in patients with severe COVID-19. In this single-center retrospective cohort study, patients with COVID-19 were enrolled from February 16, 2020, to November 1, 2020. After performing propensity score matching with age, sex, and disease severity. The independent effect of Dexamethasone treatment on in-hospital mortality was evaluated by multivariate proportional hazards regression models. Of 1413 patients with COVID-19 diagnosis, 1172 patients entered the final analysis. 473(40.4%) patients received dexamethasone treatment with a median duration of 6.0[4.0-9.0] days. After matching and adjustment with possible confounders in the multivariate model, administration of dexamethasone significantly increased the survival in severe patients (hazard ratio: 0.25, 95 confidence intervals: 0.16-0.38, P<0.001), but there was no difference in non-severe patients (P:0.888). The administering of dexamethasone was associated with an increased in-hospital survival rate (HR: 0.25 [0.16-0.38]) in severe COVID-19 patients. The survival rate was more significant in severe patients with diabetes mellitus or hypertension after receiving dexamethasone treatment (HR:0.19). On the other hand, patients without severe disease did not benefit from dexamethasone administration.
ABSTRACT
Introduction: LipoxinA4 (LXA4) is an anti-inflammatory biomarker that participates in the active process of inflammation resolution which is suggested to be beneficial in infectious and inflammatory diseases like the coronavirus disease 2019 (COVID-19). Objectives: This study aimed to determine early changes of LXA4 levels in the hospitalized patients with confirmed COVID-19 following the clinical management as well as its correlation with common used inflammatory markers, including Erythrocyte Sedimentation Rate (ESR), C-reactive protein (CRP), and ferritin. Methods: Thirty-one adult hospitalized patients with the non-severe COVID-19 were included. LXA4, ESR, and CRP serum levels were collected on the first day of hospitalization, and LXA4 levels were measured 48-72 h later as well. Moreover, the maximum serum ferritin level during the five days of following patients was collected. Results: The mean age of patients was 61.9 ± 17 years, and the male to female ratio was 18:13. LXA4 levels were significantly increased at 48-72 h compared to the baseline concentrations (9.9 ± 0.7 vs. 21.7 ± 15.1 ng/L;P < 0.05). The mean baseline concentrations of CRP and ESR and the mean maximum concentration of ferritin were 74.7 ± 57.3 mg/L, 55.7 ± 34.4 mm/h, and 568.7 ± 530 ng/mL, respectively. Besides, CRP and ESR levels at the time of admission and maximum ferritin levels during the hospitalization were positively correlated to an increase of LXA4 levels (R = 0.499, 0.535, 0.398;P = 0.007, 0.005, 0.043, respectively). Conclusion: LXA4 may be a valuable marker to assess the treatment response compared to ESR, CRP, and ferritin in hospitalized patients with COVID-19. Furthermore, LXA4 could be considered a potential treatment option in inflammatory conditions. Further studies are necessary to clarify LXA4 role in COVID-19 pathogenesis, as well as the balance between such pro-resolving mediators and inflammatory parameters.