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Background. The risk factors associated with COVID-19 disease severity are still being investigated. Individual susceptibility to viral infections has been known to be associated with the ABO blood group. Material and methods. This is an observational study with a prospective design. Patients were followed during treatment, and clinical outcomes were recorded, being severe or mild-moderate cases. A total of 207 confirmed COVID-19 patients who underwent treatment from November 2020 to January 2021 were included in this study. Chi-square analysis was used to determine the association between blood group A and other blood groups with the occurrence of severe cases. Multiple logistic regression analysis was used to obtain the adjusted odds ratio (OR) and determine the effect of confounding variables. Results. We found a significant association between blood group A and disease severity, though not for any other blood group. By using multiple logistic regression analysis, blood group A was independently associated with disease severity with an adjusted OR (95% confidence interval (CI)) of 2.36 (1.07-5.23) (p = 0.034). Conclusions. COVID-19 patients with blood group A have a higher risk of becoming severe cases compared to non-A blood groups.
ABSTRACT
BACKGROUND: Coronavirus disease 2019 (COVID-19) can cause coagulation parameters abnormalities such as an increase of D-dimer levels especially in severe cases. AIM: The purpose of this study is to determine the differences of D-dimer levels in severe cases of COVID-19 who survived and non-survived and determine the optimal cutoff value of D-dimer levels to predict in hospital mortality. METHODS: Data were obtained from confirmed COVID-19 patients who were treated from June 2020 to September 2020. The Mann–Whitney U test was used to determine differences of D-dimer levels in surviving and non-surviving patients. The optimal cutoff value and area under the curve (AUC) of the D-dimer level in predicting mortality were obtained by the receiver operating characteristic curve method. RESULTS: A total of 80 patients were recruited in this study. Levels of D-dimer were significantly higher in non-surviving patients (median 3.346 µg/ml;minimum–maximum: 0.939–50.000 µg/ml) compared to surviving patients (median 1.201 µg/ml;minimum–maximum: 0.302–29.425 µg/ml), p = 0.012. D-dimer levels higher than 1.500 µg/ ml are the optimal cutoff value for predicting mortality in severe cases of COVID-19 with a sensitivity of 80.0%;specificity of 64.3%;and AUC of 0.754 (95% CI 0.586–0.921;p = 0.010). CONCLUSIONS: D-dimer levels can be used as a predictor of mortality in severe cases of COVID-19.
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BACKGROUND: Identification of coronavirus disease 2019 (COVID-19) patients who have the potential to become critical cases at an early stage and providing aggressive therapy can reduce the mortality rate. AIM: This study aims to determine the diagnostic value and differences of eosinophil counts in patients with COVID19 who require treatment in intensive care unit (ICU) and non-ICU. METHOD: The prospective study was conducted on 382 patients with confirmed COVID-19 who were hospitalized from May to September 2020. Samples were obtained through consecutive sampling techniques. Mann–Whitney analysis was used to determine the difference of eosinophil counts in COVID-19 patients who require treatment in ICU and non-ICU. Receiver operating curve analysis was used to determine the diagnostic value of eosinophil count to predict the need of COVID-19 patients for treatment in ICU. RESULTS: There is a significant difference in the absolute and percentage eosinophil count in COVID-19 patients who need treatment in ICU and non-ICU. The area under the curve of absolute and percentage eosinophil count to predict the need of COVID-19 patients for treatment in ICU is 0.659 and 0.738, respectively. The best cutoff value, sensitivity and specificity of absolute and percentage eosinophil count is <0.025 × 103 µL and <0.25%;77.7% and 78.3%;and 50.0% and 57.1%, respectively. CONCLUSIONS: The eosinophil count can be used as a biomarker to predict the need of COVID-19 patients for treatment in ICU. © 2021 Ngakan Ketut Wira Suastika, Ketut Suega.
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Introduction: Identifying cases that can develop to be severe at an early stage and providing appropriate therapy to patients can reduce the mortality rate in coronavirus disease 2019 (Covid-19). This study aims to determine the diagnostic value of the platelet to lymphocyte ratio (PLR) to predict case severity in Covid-19. Method: This is a prospective study. Participants of the study are patients who had been confirmed with Covid-19 based on real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) who received treatment in the hospital from April to October 2020. The sample in this study was obtained by consecutive sampling technique. A total of 507 participants were included in this study. The receiver operating characteristic curve (ROC) method is used to obtain the area under the curve (AUC), cut off value, sensitivity, and specificity of the PLR to predict case severity. Results: PLR is significantly higher in severe cases compared to mild-moderate cases (p < 0.001). The cut off value of PLR to predict severe cases of Covid-19 is more than 150 with a sensitivity of 80.5%, a specificity of 66.3%, and an area under the curve (AUC) of 0.807 (p < 0.001, 95% confidence interval (CI) 0.759 - 0.855). In binary logistic regression analysis, PLR was independently associated with case severity with the adjusted odds ratio (OR) of 7.73 (p < 0.001, 95% CI 3.75 - 15.93). Conclusions: PLR can be used as a simple and accurate biomarker to predict the case severity in Covid-19. © 2021 UPM Press. All rights reserved.
ABSTRACT
Coagulopathy and disseminated intravascular coagulation (DIC) is one of the complications of the corona virus disease 2019 (Covid-19) that can lead to death. Several studies have shown that anticoagulants provide good clinical outcomes in Covid-19 patients, especially in severe cases. This case emphasizes the administration of low molecular weight heparin (LMWH) to prevent venous thromboembolism (VTE) in severe case of Covid-19.