ABSTRACT
Background Elevated serum level of interleukin-6 (IL-6) in patients with coronavirus disease 2019 (COVID-19) may be a result of a cytokine storm and can be an indicator of severe and critical forms of the disease.Therefore, it is crucial to detect and control IL-6 level early in severe acute respiratory syndrome coronavirus-2-infected patients;in addition to that, IL-6 may be a target for drug development. Aim In this study, we aimed to evaluate IL-6 serum levels in severe acute respiratory syndrome coronavirus-2-infected patients with positive PCR result early after diagnosis to detect disease severity and mortality. Study design and methods This prospective study was done on 60 COVID-19-infected patients. Serum IL-6 levels were tested after diagnosis. Tocilizumab was given to 11 patients with severe COVID-19. Results High serum levels of IL-6 had been detected in 95% of patients and in all patients of the critical group. Its levels in the mild group were 1.87 times less than that in the moderate group, whereas 2.85 times less than that in the critical group. IL-6 median levels were 24, 44.85, and 68.4 ng/l for the mild, moderate, and critical groups, respectively. The IL-6 concentration was predictive of severity (with IL-6 cutoff value >56 ng/l) and was predictive of mortality (with a cutoff value >67 ng/l) for COVID-19-infected patients. Tocilizumab cure rate was 30% in critical cases. Conclusion Serum IL-6 is of paramount importance in detecting severity and mortality of COVID-19 disease, whereas therapeutic value of tocilizumab needs confirmation by detailed studies.Copyright © 2023 The Egyptian Journal of Chest Diseases and Tuberculosis.
ABSTRACT
The current coronavirus disease known as (COVID-19) which has been declared by the World Health Organization (WHO) in December 2019 as a global health emergency and then after as a pandemic, represents a big challenge to all healthcare systems worldwide specially for managing the infection among patients who are hospitalized, acutely ill or elderly. The death rate caused by COVID-19 is not predictable but is increased by many factors including age, dyslipidemia, diabetes mellitus, obesity, and cardiovascular disorders. Since a lot of patients with these conditions are under lipid-lowering therapy, we carried out this case report study to understand the effectiveness, safety, and potential interactions between Ezetimibe, and patients with acute COVID-19 infection. In this study, the lipid profile, kidney functions, and glycated hemoglobin has been measured baseline and then after 25 days for patient with hyperlipidemia and suffers from acute COVID-19 infection. Serum cholesterol level, HDL, LDL and HDL risk factor were decreased in COVID case by 17%, 10%, 21%, and 7%, respectively. Interestingly, we observed a considerable increase in triglycerides concentration by 13.5%. These findings reveal that Sars-CoV-2 might be a factor interacting with hyperlipidemia-reducing therapy, and lower ezetimibe efficacy. However, larger cohort studies are required to confirm these findings.
ABSTRACT
BACKGROUND AND AIMS: A third novel coronavirus leading to severe respiratory infection (coronavirus disease 2019, COVID-19) was first identified in Wuhan, China in December 2019;1 as of January 2021, more than 90 million person infected and more than 2,000,000 died worldwide. 2 Hemodialysis (HD) patients are at risk of COVID-19 infection but reported infection rates are variable. 1We report results of prospectively collected data on HD patients who contracted COVID-19 infection in Kuwait. METHOD: Demographics, comorbidities, and mortality data for HD patients who got infected with COVID-19 in Kuwait from 1/March/2020 to 31/July/2020 were collected and analyzed. RESULTS: Kuwait population during that same period was 4,600,000 (63% Males and 37%Females). 3 Total number of HD patients was 2000 (representing only 0.04% of the total population with 52% Males and 48% Females). Total number of COVID-19 cases confirmed by PCR from nasopharyngeal swab was 66,957. Total number of infected HD patients was 141 (representing 7% of the total HD population and 0.2% of the total number of people infected with COVID-19 in Kuwait). All COVID-19 positive cases were treated for free in ministry of health hospitals Mean age for HD patients with COVID-19 was 57 (54 for males and 62 for males). DM was present in 70%, HTN in 95%, CV disease in 61%, respiratory illness in 20.5%, and ICU admission was required for 31 patients (22%), with 80% requiring intubation and assisted ventilation. Conventional HD was switched to CRRT in 61 patients (43%). Steroids were used for 23%, convalescent plasma in 1 patient, lopinavir/ritonavir in 7 patients, tocilizumab in 3 patients. Total number of mortality due to covid-19 infection in Kuwait was 447 (0.7% of the total cases). 4 Total mortality in HD population during that period for any reason was 100 (5% of the total HD population), however, total mortality due to COVID-19 infection was 30% of the total mortality in the HD population (and 7% of the total COVID-19 related mortality in the country). Patients who died were older with mean age of 63 vs 56 for survivors and had respiratory illness more frequently (27% vs 18%) and 60% were males. Of those who were switched to CRRT, 21 of 61 (34%) died. Of the 31 HD patients admitted to ICU, 19 (61%) died. CONCLUSION: Despite the fact the HD population represents only a small fraction of the total population, they represent a sizable proportion of the total COVID-19 positive cases and a significant percentage of the total COVID-19 related mortality. This study highlights the increased susceptibility of HD population to COVID-19 infection, which is associated with high rate of mortality, although lower than mortality rates reported in Europe and the united states. 5,6.