C3a and C5b-9 levels differentially predict COVID-19 severity and mortality

Introduction: SARS-COV-2 infection may result in pneumonia leading to ARDS and ICU treatment. Activation of the complement system was verified in COVID-19 patients as a driving factor of thromboinflammation contributing to disease progression. Aim(s): To investigate C3a and C5b-9 levels as markers of COVID-19 severity and outcome. Method(s): 79 patients with a positive polymerase chain reaction (PCR) test for SARS-COV-2 were recruited;38 severe and 42 critical. Serum samples were collected on admission and analysed for C3a and C5b-9 levels by ELISA methodology. Patients were grouped into severe vs critical, non-intubated vs intubated and survivors vs nonsurvivors for comparisons. Statistical analysis by Mann-Whitney for non-parametric analysis and receiving operating curve (ROC) analysis was performed in GraphPad Prism. Result(s): A statistically significant increase for C3a and C5b-9 levels was observed between: a) severe vs critical (p<0.001 and p<0.0001), b) non-intubated vs intubated (p<0.001 and p<0.05) survivors vs non-survivors (p<0.001 and p<0.01). ROC analysis for ICU admission revealed a higher AUC for C5b-9 (0.771, p<0.001) compared to C3a (AUC= 0.686, p<0.01). A higher AUC was observed for C3a when analysis was performed for intubation need (AUC=0.746, p<0.001) or mortality (AUC=0.758, p<0.0001) compared to C5b-9 (intubation need AUC=0.663, p<0.05 and mortality AUC=0.637, p NS). Combining C3a and C5b9 revealed a powerful prediction tool for ICU admission (AUC=0.773, p<0.0001), intubation (AUC=0.756, p<0.0001) and mortality (AUC=0.753, p<0.001). Conclusion(s): C3a and C5b-9 may serve as prognostic tools either separately or in combination for the progression and outcome of COVID-19.

Incidence and Outcomes of Covid-19 in Patients with Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension: Data from the Hellenic Pulmonary Hypertension Registry (Hope)

Few reports on coronavirus disease 2019 (COVID-19) infection in patients with group 1 or group 4 pulmonary hypertension (PH) have been published, with a discrepancy in the incidence of the disease in this rare and heterogeneous population and also differences in the reported outcomes, such as hospitalization and mortality rates. The aim was to describe the case incidence of COVID-19 among Greek PH expert centers. A total of nine PH expert centers participated in this report, cumulatively caring for 499 PH patients [372 patients with pulmonary arterial hypertension (PAH) and 127 patients with chronic thromboembolic pulmonary hypertension (CTEPH)] according to recent data retrieved from the prospective HOPE Registry and personal communication with the expert centers, to record RTPCR- confirmed COVID-19 cases. Eighteen cases of COVID-19 (12 PAH and six CTEPH) were reported from the end of February 2020 to 14 August 2021, contributing to an estimated incidence of 36.1 (95% confidence interval 21.5-56.4) COVID-19 cases in 1,000 patients with group 1 and 4 PH. The median age of affected patients was 54.5 years (range 25-86 years), and 77.8% were women. All patients reported a symptomatic course of COVID-19 [median duration 6 days (range 2-30 days)]. No case of incident venous thromboembolism was described. All patients resumed PAH-targeted therapies during the course of the infection. Eight (44.4%) patients were hospitalized, and four (22.2%) died. Three of them were >=70 years of age, and the other had significant comorbidities. The remaining four were discharged after a median of 11 days (range 8-30 days). Recovered patients do not report deterioration of their functional status after COVID-19 infection, nor persistent symptoms. There is increased severity of COVID-19 among PAH and CTEPH patients, mainly owing to the increased age and comorbidities of the patients. Strong medical advice should be offered to all PH group 1 and 4 patients to be vaccinated and continue to adhere to preventive infection measures.

Influence of full lockdown on patients' attendance in the emergency surgical specialties department of a tertiary hospital in athens, Greece;preliminary results amid covid-19 outbreak

Aims A full lockdown was forced in Greece due to the COVID-19 pandemic for 53 days and specifically from 03/13/2020 to05/04/2020. The objective of this study was to assess the impact of lockdown on the number of patients visiting theEmergency Surgical Specialties Department (ESSD) of a tertiary Greek hospital. It is common sense that the vast majority of patients examined in the ESSD have no symptoms related to SARS-CoV-2. In the Emergency Department (ED) of ourhospital, there are 6 different surgical specialties domains;Vascular Surgery, Thoracic Surgery, Urology, Opthalmology, General Surgery, and Otorhinolaryngology. Methods In this retrospective study, data exported from the Sismanogleio General Hospital's Emergency Department werestudied during 4 different periods;a) the full lockdown period of 53 days, from 03/13/2020 to 05/04/2020, b) the period of53 days right before the lockdown, from 01/20/2020 to 03/12/2020, c) the period of 53 days right after the lockdown, from05/05/2020 to 06/26/2020 and d) the time period of the previous year that is analogous with the lockdown duration, from03/13/2019 to 05/04/2019. Results The number of patients visiting the ESSD of our hospital was significantly altered during the lockdown period([ Tab. 1 ]). The reduction of this number is remarkable compared to the rest time periods of the study. To be exact, thisdecrease is 54.74 %, 51.53 %, and 61.93 % compared to the pre-traffic ban duration, the post-ban span, and the previousyear's similar time period. Conclusions Data provided by our ED is congruent with many other reports all over the world showing a dramaticlessening of people attending the ESSD amid the outbreak of COVID-19. People's angst about contracting the disease wasundoubtedly the most obvious reason for that.

The reduction of patients visiting the emergency surgical department of a tertiary general hospital of athens in the period of covid-19 lockdown forced in greece

Aims A full lockdown was forced in Greece due to the COVID-19 pandemic for 53 days and specifically from 03/13/2020 to05/04/2020. The objective of this study was to assess the impact of lockdown on the number of patients visiting theEmergency Surgical Department (ESD) of a tertiary Greek hospital. It is common sense that the vast majority of patientsexamined in the ESDs have no symptoms related to SARS-CoV-2. Methods In this retrospective study, data exported from the Sismanogleio General Hospital's Emergency Department (ED)were studied during 4 different periods;a) the full lockdown period of 53 days, from 03/13/2020 to 05/04/2020, b) theperiod of 53 days right before the lockdown, from 01/20/2020 to 03/12/2020, c) the period of 53 days right after thelockdown, from 05/05/2020 to 06/26/2020 and d) the time period of the previous year that is analogous with the lockdownduration, from 03/13/2019 to 05/04/2019. Results The number of patients visiting the ESD of our hospital was significantly altered during the lockdown period([ Tab.1 ]). The reduction of this number is remarkable compared to the rest time periods of the study. To be exact, this decreaseis 55.32 %, 52.58 %, and 55.79 % compared to the pre-traffic ban duration, the post-ban span, and the previous year'ssimilar time period. Conclusions Data provided by our ED is congruent with many other reports all over the world showing a dramaticlessening of people attending the ESD amid the outbreak of COVID-19. People's angst about contracting the disease wasundoubtedly the most obvious reason for that.