ABSTRACT
Background: COVID-19 is associated with dangerous thromboembolic complications, such as stroke, heart attack, pulmonary em-bolism, and arterial and venous thromboembolism (VTE). Early diagnosis and even prediction of thromboembolic complications using biomarkers could facilitate the treatment and decrease the mortality rate. Objective(s): This study evaluated and compared the clinical and laboratory findings of COVID-19 patients with thrombotic events with other COVID-19 patients. Method(s): A total of 114 confirmed COVID-19 patients referred to Taleghani Hospital, Tehran, Iran, between February and September 2020 were included in this cross-sectional study. Those with a history of thromboembolic disease were excluded. The laboratory data, including the levels of lactate dehydrogenase (LDH), D-dimer, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and counts of lymphocyte and neutrophil, along with clinical findings (such as oxygen saturation and lung involvement percent-age), were retrospectively collected from the patients' clinical files. The incidence of thrombotic events was evaluated in patients. Result(s): The prevalence of thrombosis in the right and left main pulmonary arteries, right and left sub-segmental pulmonary ar-teries, and right and left deep veins was 2.7%, 3.5%, 7%, 7.9%, 4.4%, and 1.8% of all patients, respectively. The results showed that throm-boembolic complications were significantly associated with mortality (P < 0.001). Besides, it was found that LDH (P < 0.001) and neutrophil (P = 0.002) levels in thromboembolic COVID-19 patients were respectively higher and lower than those without throm-boembolic manifestations. Conclusion(s): High LDH and neutropenia might serve as biomarkers for thromboembolism in COVID-19 patients. Copyright © 2022, Author(s).
ABSTRACT
Background: Patients with a prolonged corrected QT (QTc) interval are at risk of arrhythmias, including Torsade de pointes (TdP). This interval could be affected by demographic characteristics, ischemia, and most importantly drugs. Furthermore, hospitalized patients tend to experience arrhythmias, accompanied by electrolyte abnormalities and the inflammatory status of diseases. Methods: The present retrospective study recruited 135 patients with COVID-19. We observed the QTc interval on the third post-administration day and laboratory findings for possible risk factors for QTc-interval prolongation. Results: Ischemic heart disease was markedly more common among patients with prolonged and severely prolonged QTc intervals. Laboratory findings showed a significantly higher neutrophil-to-lymphocyte ratio (NLR) in patients with prolonged or severely prolonged QTc intervals compared with those with normal QTc intervals and QTc intervals exceeding 500 milliseconds (P<0.001) on admission and the third day. Ribavirin caused the most elevation in the QTc interval after 3 days of hospitalization compared with other drugs. Forty percent of the patients who took ribavirin experienced a QTc interval exceeding 500 milliseconds, which was significant compared with other therapeutic regimens. Conclusions: In addition to the well-known predisposing factors for the prolongation of QTc interval, we suggest focusing on the history of ischemic heart disease and inflammatory status (eg, by NLR) in patients with COVID-19 before making decisions to commence drugs that greatly affect QTc intervals. Further studies are required to shed light on the cardiac side effects of medications applied for COVID-19, particularly ribavirin.
ABSTRACT
Introduction: World Health Organization (WHO) declared a novel HCoVs (COVID-19) to be a public health emergency of international concern on 30 January, 2020. Typical clinical symptoms of patients include fever, dry cough, breathing difficulties (dyspnea). CT is the most sensitive radiological technique for the diagnosis of COVID-19, showing spectrum of lung features. The purpose of this study was to investigate clinical and laboratory outcomes and chest CT futures of patients to recognize prognostic factors for COVID-19. Methods: Clinical and laboratory findings and chest CT futures were evaluated from 226 admitted patients with the initial diagnosis of COVID-19 who were recovered or died due to the disease and its complications. The association between vital status and categorical variables was evaluated. The single and multiple logistic models were used for assessing the impact of study variables on the hazard of occurring death. Results: The prediction power of some variables were significant. The highest AUCs were observed for GGO pattern, age, lymphocyte count, Creatinine, CRP, LDH, and Systolic Blood Pressure. This study was reached an accurate for predicting vital status among COVID-19 patients. Conclusion: In this study, we evaluated and presented CT feature parameters as well as clinical and laboratory markers as a model that predicts vital status among COVID-19 patients.
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Background and Objectives: Several studies have focused on the alterations of hematological parameters for a better un-derstanding of the COVID-19 pathogenesis and also their potential for predicting disease prognosis and severity. Although some evidence has indicated the prognostic values of thrombocytopenia, neutrophilia, and lymphopenia, there are conflicting results concerning the leukocyte and monocyte count. Materials and Methods: In this retrospective Double Centre study, we reviewed the results of WBC and monocyte counts of 1320 COVID-19 patients (243 of whom (18.4%) had severe disease) both on admission and within a 7-day follow-up. Results: We found that both the number of monocytes and the percentage of monocytosis were higher in the severe group;however, it was not statistically significant. On the other hand, we found that not only the mean number of WBCs was significantly higher in the severe cases also leukocytosis was a common finding in this group;indicating that an increased number of WBC may probably predict a poor prognosis. Also, the monocyte count was not affected by age;however, univariate analysis showed that the percentage of leukocytosis was significantly greater in the older group (>50) with an odds ratio of 1.71 (P: 0.003). Conclusion: Alteration of monocytes either on admission or within hospitalization would not provide valuable data about the prediction of COVID-19 prognosis. Although the rapidly evolving nature of COVID-19 is the major limitation of the present study, further investigations in the field of laboratory biomarkers will pave the way to manage patients with severe disease better.
ABSTRACT
Background and Objectives: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was first de-scribed during a pneumonia outbreak in Wuhan, has attracted tremendous attention in a short period of time as the death toll and the number of confirmed cases is growing unceasingly. Although molecular testing is the gold standard method of SARS-CoV-2 detection, the existence of the false-negative results presents a major limitation to this method. Materials and Methods: This retrospective Double-Centre study was conducted on 1320 COVID-19 patients recruited at Taleghani and Shohadae Tajrish Hospitals in Tehran, Iran. We analyzed the leukocyte, lymphocyte and neutrophil counts of hospitalized cases both on admission and at discharge. We also evaluated the alteration of these parameters within a sev-en-day follow-up. Results: Of the whole, 1077 (81.6%) neither were admitted to intensive care unit (ICU) nor experienced death, and were defined as the mild-moderate group. Of 243 severe cases, while 59 (24.3%) were admitted to ICU and cured with the intensive care services, 184 (75.7%) patients died of the disease, either with or without ICU admission. Calculation of neu-trophil-to-lymphocyte ratio (NLR) revealed that the mild-moderate cases had a lower ratio at discharge. On the other hand, the ratio was significantly higher in the death group as compared to the ICU group;highlighting the fact that patients with a higher degree of neutrophilia and a greater level of lymphopenia have a poor prognosis. Conclusion: We suggest that NLR greater than 6.5 may reflect the progression of the disease towards an unfavorable clinical outcome, with this notion that the ratios higher than 9 may strongly result in death.